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Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.

BackgroundThe COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain.MethodThe sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of mental health (GHQ12) and well-being (Positive and Negative Affect Schedule) indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators.ResultsMental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and unemployed individuals. Positive affect was higher among women, people with a high level of studies, those not co-living with dependent seniors, the self-employed, the employed, and those working outside home. Negative affect was negatively associated with age and number of children and was higher among women, people with basic studies, singles, individuals co-living with dependent seniors, homemakers, and students.ConclusionThe most vulnerable populations were found to be women, younger people, people with basic or medium studies, students and individuals with no remunerated activities, single populations, and those co-living with dependent seniors as well as those with a reduced number of children.

To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79–0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01–1.07; p = 0.022; OR = 1.30; 95%CI 1.08–1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied. Castile and León Health Authority (SACyL) - GRS 1287/B/16 2.500 JCR (2019) Q3, 78/155 Psychiatry 1.176 SJR (2019) Q1, 30/185 Obstetrics and Gynecology, 112/545 Psychiatry and Mental Health No data IDR 2019 UEM

Background Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. Methods A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. Results Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05–0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. Discussion The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding. Los beneficios de la lactancia materna en la salud de los niños, las madres y la sociedad son ampliamente conocidos. Sin embargo, las tasas de lactancia materna varían según la población estudiada. Las mujeres de origen chino que han inmigrado a países desarrollados muestran tasas muy bajas de lactancia materna. Los objetivos de la investigación son comparar las tasas de lactancia materna exclusiva tras el parto, al alta del hospital, entre mujeres de origen chino y de origen español, y evaluar la influencia de variables biológicas, socioeconómicas, relacionadas con el trabajo y culturales sobre las tasas de lactancia materna. Estudio descriptivo transversal con comparación entre grupos. Se incluyó a 73 puérperas (33 de origen chino y 40 españolas). La asociación entre lactancia materna y país de origen se evaluó utilizando regresión logística. Resultados: Las mujeres españolas mostraron una mayor prevalencia de lactancia materna exclusiva (80%) en comparación con las mujeres de origen chino (36,4%), ajustando por nivel socioeconómico, nivel educativo de los padres, edad de la madre, parto por cesárea y peso al nacer). Sin embargo, al construir otros modelos de regresión logística en los que se incluyó variables relacionadas con el trabajo de la madre, o la actitud respecto a la lactancia materna, las diferencias pasaban a ser no significativas. Discusión: Las variables clásicas biológicas y socioeconómicas no explican la diferencia en las tasas de lactancia materna entre mujeres de origen chino y españolas. Sin embargo, parece que esas diferencias están relacionadas con las condiciones laborales de las mujeres chinas (trabajan más mujeres, por cuenta propia, incorporándose antes al mundo laboral tras el parto...) y con aspectos culturales (actitud menos positiva hacia la lactancia materna). Sin financiación 2.239 JCR (2019) Q2, 33/82 Obstetrics & Gynecology 1.275 SJR (2019) Q1, 19/185 Obstetrics and Gynecology No data IDR 2019 UEM

IntroductionPregnant women who eat a balanced diet usually practice physical activity (PA) regularly; there are many studies on PA during pregnancy and the results for the mother and baby. However, the guideline for PA during pregnancy is very general and is not quantified. The primary objective of this study is to examine the nutritional habits and levels of PA of women during pregnancy and the postpartum period. Second, it will determine the effects of these aspects on the mother and newborn baby. Its third objective is to identify the factors which influence the practice of PA during this phase.Methods and analysisSe trata de un estudio prospectivo de cohortes que dura 2 años, f rom de septiembre de 2018 para setiembre del 2020 La muestra será reclutado en tres Atención Primaria centros en el área de salud de Toledo (España). Las participantes serán mujeres embarazadas de 18 a 40 años. Ancianos que deben asistir a todos los controles durante el embarazo y el período posparto. La PA se cuantificará utilizando la acelerometría, mientras que los hábitos nutricionales y el ejercicio físico se evaluarán mediante cuestionarios validados. Se registrarán los síntomas del embarazo y el período posparto, junto con los parámetros bioquímicos y los datos antropométricos. Los resultados primarios se determinarán en las mujeres embarazadas: aumento de peso, incidencia de diabetes mellitus gestacional, preeclampsia e hipertensión inducida por el embarazo. Los resultados secundarios incluyen la duración del embarazo y el peso al nacer, la puntuación de Apgar (1 min / 5 min), el tipo de reanimación (I / II / III / IV) y el pH de la sangre del cordón umbilical en los recién nacidos.DiscussionAlthough the beneficial effects of PA during pregnancy are known, there is a need to perform studies that quantify the amount of PA undertaken by women during pregnancy and the postpartum period. The objective of such studies is to establish science-based individualised guidelines for PA for women during this stage of their lives.

Background Nursing is an art and science based on knowledge of professional caring. As such, the examination of how students perceive care may improve the way this concept is taught and learnt in nursing. Objectives To examine and describe the perception of caring among Spanish nursing students. Methods A cross-sectional design.From an initial population of 500 students, 321 volunteers participated in this study by completing the Caring Dimensions Inventory (CDI-25) during April 2014. Parametric tests were used to perform descriptive analyses of the dimensions of caring and the predominant factor; additionally, inferential (bivariate) analyses were performed of the dimensions of caring and of the predominant factor according to each of the independent variables. A logistic multinomial regression of the predominant psychosocial factor was calculated using the professional-technical factor as a reference, with adjustments for each of the covariates. Results The two dimensions most identified by students in relation to caring were: Providing privacy for a patient (D23) and Listening to a patient (D13) whereas the least identified were: Putting the needs of a patient before your own (D19) and Sharing your personal problems with a patient (D16). Overall, students identified caring mostly with the Psychosocial Factor (F1) (psychosocial aspects of care). Students in their first year identified caring more with the professional-technical factor, whereas those in their third and fourth year did so with the psychosocial factor. Conclusions The perception of caring among nursing students is a dynamic phenomenon that is modified throughout the nurse education process. The academic year, previous work experience in healthcare and the type of access to the university influence students' perceptions of caring. Sin financiación 2.490 JCR (2019) Q1, 7/121 Nursing, 9/41 Education, Scientific Disciplines 1.178 SJR (2019) Q1, 7/150 Nursing (miscellaneous), 129/1401 Education No data IDR 2019 UEM

Resumen: Introducción: La Organización Mundial de la Salud recomienda la educación interprofesional cuando estudiantes de 2 o más profesiones sanitarias aprenden juntos, para favorecer el desarrollo de las competencias interprofesionales que les van a permitir trabajar en equipo proporcionando la mejor asistencia sanitaria. En la Universidad Europea de Madrid existe un programa de educación interprofesional que trabaja las competencias de clarificación de roles, comunicación y autoridad, con estudiantes de diferentes titulaciones. Una de sus actividades es la de atención domiciliaria, en la que participan estudiantes de último curso de Medicina y de Enfermería. El objetivo de este estudio es analizar la percepción de los estudiantes que han participado en la actividad de atención domiciliaria durante el curso 2016-2017 en relación con las 3 competencias interprofesionales. Material y métodos: Estudio cualitativo descriptivo, de corte fenomenológico. Análisis de los fragmentos de texto de las reflexiones de los estudiantes acerca de la actividad de atención domiciliaria mediante el método de comparaciones constantes (codificación abierta y codificación axial). Resultados: Los estudiantes refieren que la actividad les ha ayudado a conocer mejor el rol y las tareas de los médicos y los enfermeros, de una forma diferente a las prácticas clínicas. En cuanto a la comunicación, la basan en el respeto y la confianza. Por último, en cuando a la autoridad, se decantan mayoritariamente por modelos democráticos y horizontales de toma de decisiones. Discusión: Los estudiantes perciben que la actividad resulta útil para el desarrollo de las 3 competencias interprofesionales, lo cual coincide con la literatura científica. Abstract: Introduction: The World Health Organization recommends implementing interprofessional education programs, where students from 2 or more health professions learn together, to improve interprofessional competency development that will help them to improve collaboration and the quality of care and services. At the Universidad Europea from Madrid there is a program on interprofessional education that develops the following competences: role, communication and authority, with students from several degrees. Home care is one of those activities, undertaken by students from the last years of medicine and nursing. The purpose of this research is to analyze the perception of the students about the interprofessional competences after taken the home care activity during the 2016-17 academic year. Material and methods: Phenomenological qualitative design. Student's written comments were analyzed using the constant comparative method (open and axial coding). Results: They got to know better the roles played by each other (doctors and nurses) thanks to the fact of working together. In relation to the way they communicate, they mentioned that adequate communication is based in respect and trust to each other. In relation to the different authority models, most of them tended to use and feel better in more horizontal and democratic ways of decision making. Discussion: Students reported that the activity is useful for improving their interprofessional competencies. It is coincident with other studies. Palabras clave: Educación interprofesional, Atención domiciliaria, Trabajo en equipo, Práctica colaborativa, Atención primaria, Competencias, Keywords: Interprofessional education, Home care, Team work, Collaborative practice, Primary health care, Competencies

In 2015, the Universidad Europea de Madrid started the first interprofessional education program in Spain. Nursing students undergo different interprofessional education activities in all 4 academic years, covering various aspects of the following 3 competencies: interprofessional communication, role clarification (definition, interaction and defense), and authority models and decision making. In second year, they integrate these activities with students from psychology, pharmacy and medicine. We assessed the self-perception of second year nursing students with an adapted and validated IPEC questionnaire, in four different transversal moments of the academic year 2015-16. Differences in mean values were analyzed with the Kruskal-Wallis test and post-hoc Mann-Whitney tests with Bonferroni corrections in case of statistical significance. Results showed that this IPE program improves the self-perception second year students have about their competence in interprofessional communication, especially in the dimensions of oral expression, active listening, communication tools and interprofessional conflict resolution. Sin financiación 1.772 JCR (2018) Q3, 46/82 Health Policy & Services, 61/98 Health Care Sciences & Services 0.864 SJR (2018) Q2, 712/2844 Medicine (miscellaneous) No data IDR 2018 UEM

This study aimed to explore the reflective dialogues and processes that take place between preceptors and their nursing students and to examine how preceptors make use of their expert knowledge in order to enhance students' experiential learning during clinical placements. Two 30-h courses on reflective teaching were conducted. The study sample included 15 preceptors and 27 undergraduate nursing students. Data were collected during the course and during clinical placements at two X hospitals. Data collection included non-participatory observation and informal conversations with preceptors, in-depth interviews and focus groups. Preceptors used a series of strategies to promote experiential learning; these included creating links with practice, the use of examples, allowing students to adopt professional roles and enhancing autonomy. The value of preceptors is their wealth of professional experience, which is key during the learning process of nursing students. Preceptors must learn to master the art of questioning and stimulating reflective dialogues, in order to stimulate students' critical thinking and encourage them to resolve common problems that arise during practice. Students demand a more active role in their own learning processes. Sin financiación 1.665 JCR (2018) Q1, 29/118 Nursing 0.810 SJR (2018) Q1, 17/152 Nursing (miscellaneous), 218/1400 Education; Q2, 782/2844 Medicine (miscellaneous) No data IDR 2018 UEM

Background Maternal breastfeeding is a practice that is associated with multiple health benefits for mothers and children. One of the lowest rates of breastfeeding has been observed among Chinese women who immigrate to high income countries. At present, there is a lack of comparative information between this group and that of Spanish-born women. Considering the relationship between the attitude of women towards breastfeeding and the initiation of breastfeeding, the aim of the study was to determine whether the attitude towards breastfeeding among Chinese postpartum women who have immigrated to Spain differs from that of Spanish-born postpartum women. Methods Cross-sectional study, with between-group comparison, of 73 postpartum Spanish-born and Chinese immigrant women admitted to the maternity units of “12 de Octubre” Hospital (Spain) between April and November 2016. Attitudes toward breastfeeding were analyzed using the Spanish or Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). A wide set of socioeconomic, biological, working and attitudinal conditions were considered as covariates. The association between IIFAS and country of origin was assessed by three multiple linear regression models (B, SE, and 95% confidence interval were calculated). Results All Chinese women were first generation immigrants. Chinese-born women were four years younger than Spanish-born mothers, had a lower educational level, more frequently had a paid job (mainly self-employed), and planned to return to work almost two months earlier than Spanish-born mothers did. Most Chinese women did not breastfeed exclusively. Chinese immigrant women obtained scores of approximately 9 points less in the Iowa Infant Feeding Attitude Scale (IIFAS) when compared to Spanish-born women [95% CI -15.59, -2.48], after adjusting for the different socioeconomic, educational and work-related factors. Conclusions Chinese-born women resident in Spain present a lower score on the IIFAS, when compared to Spanish-born women, which implies a more negative attitude towards breastfeeding. The between-groups difference is consistent, even when adjusting for known confounders and other factors which could affect the attitude of the mothers. It is therefore striking that, despite being in Spain, Chinese-born women maintain these preferences/attitudes regarding breastfeeding, compared with Spanish-born women, who obtain overall high scores.

Modern Western societies are characterized by a considerable cultural and ethnic diversity whereby different groups and minorities live side by side. However, not all people are viewed in the same light by the autochthonous population. This is particularly true in the case of Muslim immigrants, who are often prone to negative stereotyping and prejudice. This has become increasingly apparent since the 2001 terrorist attacks in New York and the subsequent attacks in various Western countries. This study seeks to analyze the relation between female nurses and those labeled by nurses as “Muslim fathers”, as part of a research project on the care of immigrant children in Madrid (Spain). The findings promote reflection on the effects of nurses’ stereotypes and prejudices regarding the gender roles of “Muslim fathers” and the relations between these groups. These prejudices can lead to situations of cultural imposition and/or discrimination. Self-reflection regarding stereotypes and prejudices is necessary in order to provide culturally competent care. The anthropobiological approach by Marie Françoise Collière may be useful for extending this type of care universally, not only to immigrant groups, as everyone, including nurses, patients and family members, belong to part of a specific sociocultural context Sin financiación 1.159 JCR (2017) Q3, 62/118 Nursing UEM