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Background: Decision-making tools represent a paradigm shift in the relationship between the clinician and the user/patient. Some of their advantages include patient commitment, the promotion of preferences and values, and increased treatment adherence. This study protocol aims to assess the effectiveness of a decision-making tool in contraception (SHARECONTRACEPT) concerning: a) Improvement in counselling on hormonal contraception at the medical consultation, measured in terms of decreasing decisional conflict and improving knowledge of available contraceptive options; b) Improvement in adherence to treatment measured in terms of: persistence in the chosen treatment, compliance with dose or procedure of use, and ability to deal with incidents related to the use of the contraceptive method; and decreasing unwanted pregnancies and voluntary interruption of pregnancy. The SHARECONTRACEPT tool, developed by previous phases of this project, is available at: http://decisionscompartides.gencat.cat/en/decidir-sobre/anticoncepcio_hormonal/ METHODS/DESIGN: A longitudinal, prospective-type, randomized, controlled community clinical trial, carried out in the clinical contraceptive counselling units of 6 autonomous regions in Spain, with an experimental group and a control group. Description of the intervention: The health professionals participating will be randomly assigned to one of the two groups. Clinicians assigned to the experimental group will perform contraceptive counselling assisted by SHARECONTRACEPT, and those of the control group will follow the conventional contraceptive counselling provided in their clinical unit. It is planned to study 1708 users (control group n = 854 and intervention group n = 854), recruited from women who attend the consultations of the health professionals. The selected users will be followed up for one year. The data will be collected through ad-hoc questionnaires, and validated instruments for measuring decisional conflict and adherence to treatment.Discussion: The results of this study protocol will offer evidence of the effectiveness of a shared decision-making tool, SHARECONTRACEPT, which may prove a useful tool for users and professionals to promote adherence to contraceptive methods.Trial Registration: Clinical Register number ISRCTN5827994 . Date: 15/04/2019 (Retrospectively registered). [ABSTRACT FROM AUTHOR]

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018-2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years.

This aim of this paper is to determine the relationship between the consumption of tobacco, cannabis, and alcohol (including drunkenness and binge drinking consumption patterns) in the previous 30 days by Spanish adolescents and the information that is available to adolescents on drug consumption. This cross-sectional study employed data from the Survey on Drug Use in Secondary Education in Spain (ESTUDES 2016), which was conducted on students aged 14 to 18 ( n = 35,369). Contingency tables, mean comparison tests, and logistic regression analyses were conducted and prevalence ratios (PR) were obtained. The results show that the probability that an adolescent will smoke tobacco is associated with whether their mother and/or father smoke (PR: 1.30), whether some of their friends smoke (PR: 14.23), whether the majority of their friends smoke (PR: 94.05) and how well informed they perceive themselves to be (PR: 1.30). Cannabis use is mainly associated with whether most of their friends also use cannabis (PR: 93.05) and whether they are sufficiently informed regarding this consumption (PR: 1.59). Alcohol consumption is associated with whether their mothers drink regularly (PR: 1.21), whether most of their friends drink (PR: 37.29), and whether they are well informed (PR: 1.28). Getting drunk and binge drinking are associated with whether their friends have these behaviors (PR: 44.81 and 7.36, respectively) and whether they are sufficiently informed (PR: 1.23 for both behaviors). In conclusion, the consumption of these substances is more frequent among Spanish adolescents who believe that they are better informed and whose friends have similar patterns of consumption.

Background: Cultural competence (CC) is becoming an essential component of healthcare professionals. There is a gap in the research evaluating CC in order to develop competency-based approach programs. Spain has become a multicultural society and it is necessary to evaluate and promote CC attitudes to reduce the disparity of care for vulnerable and minority groups., Objectives: To adapt and validate the Cultural Competence Assessment (CCA) of Schim et al. (2003), to get evidence-based data of CC in Spanish healthcare professionals., Method: A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. An on-line cross-sectional survey questionnaire was used. Statistical and metrical analysis was based in a sample of 568 healthcare professionals who worked daily with patients in a health care institution in South Catalonia in 2018., Results: The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis results confirm an acceptable consistency for each subscale: active behaviour (0.86), seeking information (0.86), awareness (0,94), and sensitivity (0.69). ANOVA showed no differences between healthcare professionals, age and gender. The scores showed a normal distribution and it was proposed a standardization of scores., Conclusions: The translation and transcultural-validation process of the CCA resulted in a Spanish-language for the 25 items, like the original. The psychometric analysis proved that the Spanish version is a reliable and valid instrument. This scale is going to be useful to analyze healthcare professional's attitudes to create effectiveness training programs focused on specific needs. The four-factor model and the standardization of the scores will be useful to achieve future objectives about research in cultural competence in healthcare professionals., (Copyright © 2018 Elsevier Ltd. All rights reserved.)