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This paper describes the beginning of the implementation process of the health impact assessment in the Valencian Community (Spain), as an instrument to incorporate the framework of social determinants and health inequalities in the policies issued by the different departments of the Valencian government. The proposal involves: 1) political commitment, with legislative and strategic planning actions; 2) the creation of structures to allow intersectoral collaboration, with the establishment of the health impact assessment commission and the intersectoral technical committee; and 3) the design and validation of a tool for the simplified health impact assessment of non-health policies adapted to the Valencian Community. We highlight the importance of the participatory methodology used in the whole process and the potential of the health impact assessment for the development of public policies oriented to improve health and equity., (Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To explore, from a gender perspective, the experiences of mothers and fathers of children with congenital heart disease at the time of diagnosis, including the opinions of medical staff taking care of these children and their families., Methods: Qualitative research. Four individual interviews with medical staff and four focus groups with mothers and fathers living in Valencia Region (Spain) were carried out. Participants were selected by purposive sampling. The discourse analysis was triangulated between techniques and researchers and the results were verified with mothers, fathers and medical staff., Results: Mothers and fathers differed in the way they expressed their emotions and in how they accepted the diagnosis of a serious illness in their child. However, both parents expressed the need for psychological support and highly appreciated the informal support from other parents with similar experiences., Conclusions: The experience of the disease in a child is experienced differently by mothers and fathers. Health servies should pay attention to the psychological well-being of families, by including peer support groups and patient associations, which can play an important role as health assets., (Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.)

Objectives: To determine the reliability and the content and construct validity of the Mackey Childbirth Satisfaction Rating Scale to measure women's satisfaction with labor and delivery., Methods: The translation-back translation method was used to obtain an adapted version of the scale. For the validation study, a sample of 325 women who had delivered a healthy neonate through the vaginal route was selected. Data collection was performed using a self-administered questionnaire that included the modified scale, childbirth expectations, obstetric variables and sociodemographic characteristics. Reliability was assessed in a subsample of 45 women who completed the scale for the second time 15-30 days later. The factorial structure and internal consistency of the scale were analyzed. Construct validity was evaluated by analyzing the relationship between satisfaction with the experience, fulfillment of expectations and preferences regarding pain management., Results: In the test-retest study, an intraclass correlation coefficient of 0.93 was obtained for the total scale. Factor analysis identified six factors that explained 69.42% of the variance. Cronbach's alpha coefficient was 0.94 for the total scale, ranging from 0.72 to 0.96 for the subscales. Satisfaction with the experience of childbirth was higher among women whose expectations were met and among those who accessed the pain relief method chosen., Conclusions: This scale is a useful instrument to measure women's satisfaction with the experience of childbirth, adapted to our context and with good psychometric properties., (Copyright © 2011 SESPAS. Published by Elsevier España. All rights reserved.)

Objectives: To study the return to paid work between the 5th and 12th month after the birth of a child depending on socioeconomic and occupational characteristics of employed mothers. Furthermore, to analyse the differences at the time of returning to work (5th or 12th month) according to these characteristics., Methods: Longitudinal study carried out on a sample of 528 primiparous or secundiparous women who have had a child in a public hospital in the city of Valencia and who have carried out a professional activity during pregnancy. Three cross-sectional cut off points were made; the first two days after childbirth, the second five months later and the third a year after the child was born. The information collection was conducted by means of a questionnaire. Uni and multivariate statistical analysis techniques have been used., Results: Five months after childbirth the probability of returning to work was greater in women who worked with permanent contracts in the private sector (ORadjusted: 7.4) or public sector (ORadjusted: 7.8). Likewise it is higher in service workers (ORadjusted: 2.0), administrative staff (ORadjusted: 2.5) and professionals or technical workers (ORadjusted: 2.9). The probability of returning to paid work a year after childbirth is higher in the mother who works in the public sector with permanent or temporary contracts (ORadjusted: 21.0 and 5.1 respectively) and in the private sector with permanent contracts (ORadjusted: 5.1). It is also higher in service workers (ORadjusted: 2.2), in administrative staff (ORadjusted: 2.7) and professionals or technical workers (ORadjusted: 4.7)., Conclusions: Childbirth may lead to a break in the working career of the woman. The socio-demographic and professional factors which might explain this break are low professional qualifications and unstable employment in private sector companies.

The objective of this study is to assess the relationship between the decision to return to work during the first year after delivery and socio-demographic and professional factors, as well as the reasons why the decision is made. Data collection was carried out by a personal interview in the hospital, two days after childbirth. 597 primiparous or secundiparous women who had developed a professional activity during pregnancy were interviewed. Uni and multivariate statistical analysis techniques were used. Blue collar workers (ORadjusted = 0.13), administrative staff (ORadjusted = 0.16), women who give up work more than a month before the birth (ORadjusted = 0.33 and 0.28), women without a contract (ORadjusted = 0.19) and temporary workers (ORadjusted = 0.30) were less likely to make the decision of returning to work. According to these results, the continuity of the women in the labour market after maternity is determined to a great extent by the social and employment context where she works; a fact which must be taken into account when putting into practice maternal and child health promotion programmes.