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Aims: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions., Design: A complementary multi-method study combining survey methods and qualitative interviews will be adopted., Methods: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a 'framework analysis' will be performed., Discussion: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building., Impact: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts., Stakeholder Engagement: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Objective: to evaluate the level of cultural competence of an undergraduate nursing students' population from four European higher education institutions., Method: a total of 168 nursing students from four different countries were included in our study. The study methodology involved a cross-sectional assessment of cultural competence among undergraduate nursing students from four European universities. Data collection included sociodemographic variables, as well as the following validated tools: the Intercultural Sensitivity Scale, the Cultural Competence Assessment Tool (student version) and the Cultural Awareness Scale., Results: our results indicated that students demonstrated a high level of intercultural sensitivity but a moderate level of cultural competence and cultural awareness. Variations existed among students from different countries, suggesting potential differences in educational approaches. Despite expectations that higher-level students would exhibit greater cultural competence, no significant differences were found by year of study, indicating a lack of effective integration of cultural competence into nursing curricula., Conclusion: nurse educators should consider the students' cultural competence before designing related study programmes. Training programmes related to cultural competence should include elements which have been associated with enhanced cultural competence, including language skills, cultural encounter, and opportunities for internationalisation.

Objective: To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management., Design: Systematic review based on the PRISMA recommendations., Data Sources: Pubmed, Scopus, Cuiden, Web of Science and Google Scholar databases were reviewed., Study Selection: Sixteen articles published between 2014 and 2021 were included, with access to full text, languages: English, French and Spanish and pediatric population: 0-18 years., Data Extraction: Two thousand three hundred and thirteen children were participated. The variables analyzed were: level of care, type of intervention, correct performance of the inhalation technique, follow-up of the technique, delivery of written recommendations, professional-educator category, variables related to respiratory pathology, school absenteeism, quality of life and economic costs., Results: The health care level was primary, hospital and community care, where specialist doctors, nurses and pharmacists stood out as educators. The most prevalent educational interventions are on-site demonstration and delivery of recommendations or multimedia interventions. Several articles report that asthma education is not carried out correctly, others state that their technique improves after the intervention, but most of them highlight the importance of periodic review of the technique., Conclusions: The authors report improvement in the inhalation technique in all of them, as well as greater self-management of the disease and adherence to treatment. It is necessary to intensify the education of patients in the correct handling of the devices, and the follow-up and subsequent review to optimize the control of the disease., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors., Aim: To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses., Methods: Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an " ad hoc " questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models., Results: The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week., Conclusion: Student nurses could benefit from the implementation of both physical and mental health promotion initiatives., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ramón-Arbués, Sagarra-Romero, Echániz-Serrano, Granada-López, Cobos-Rincón, Juárez-Vela, Navas-Echazarreta and Antón-Solanas.)

Introduction: Currently, access to the Internet through smartphones has led to their functions going beyond purely communicative ones, allowing the management of massive, instantaneous, and easily accessible information. This research analyzed the differences in smartphone use and the prevalence of nomophobia, mainly according to gender and university degree of Health Sciences students at the University of Zaragoza during the COVID-19 confinement in Spain., Methods: A descriptive cross-sectional study was carried out on a sample of 318 first and second-grade students, who completed an online questionnaire sent to their institutional email, which included sociodemographic questions, other questions about smartphone use, and the Nomophobia Questionnaire (NMP-Q) scale., Results: Compared to men ( n  = 58), women ( n  = 260) were more likely to use their smartphones more intensively daily, as were occupational therapy students compared to the other degree programs studied. The prevalence of nomophobia was moderate, being around the risk of suffering from it. No significant differences in scores for nomophobia among students were found according to gender, university degree, or population nucleus for the nomophobia scores of the students., Discussion: The present study extends the existing literature on nomophobia by providing results of interest in terms of gender and the exceptional healthcare context of COVID-19. The results suggest that despite intense daily smartphone use young people did not reach severe nomophobia figures. This fact underlines the need for appropriate and healthy technology education. Understanding the characteristics of the populations that use the smartphone the most may help to analyze nomophobia rates and the massive use of the device., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Navas-Echazarreta, Juárez-Vela, Subirón-Valera, Rodríguez-Roca, Antón-Solanas, Fernández-Rodrigo, de Viñaspre-Hernandez, Sabater, Echániz-Serrano, Saus-Ortega, Santolalla-Arnedo and Satústegui-Dordá.)

Background: Men with prostate cancer who undergo radical prostatectomy experience a decrease in quality of life, often related to sexual disfunction and urinary incontinence. Knowing and measuring the impact of radical prostatectomy on the individual's social, emotional, and family quality of life could help to plan and develop an appropriate, patient-centred therapeutic approach., Aim: In this study, we aimed to evaluate changes in quality of life of patients with prostate cancer before and after radical prostatectomy., Methods: A longitudinal, observational study of 114 participants was conducted using the method of test-retest. Quality of life before and after radical prostatectomy was measured through the following self-administered questionnaires: (1) The EORTC QLQ-C30 in its Spanish version was used to assess the generic quality of life the participants; (2) the EORTC QLQ-PR25 in its Spanish version was used to assess the specific, health-related quality of life of prostate cancer patients., Results: A total of 114 men took part in this study. The results from the QLQ-C30 questionnaire indicated an improvement in the dimensions of emotional role and cognitive function, as well as in the symptoms of fatigue, pain, nausea and vomiting, insomnia, and loss of appetite, after surgery. Patients scored lower in the dimensions of role functioning, social function, and economic impact after radical prostatectomy. According to the results from the QLQ-PR25 questionnaire, 61.40% of the participants experienced sexual impotence and 26.31% suffered urinary incontinence after surgery. There were significant differences in some postsurgical outcomes between patients who had neurovascular bundles preserved and those who had not., Conclusions: In-depth knowledge of, and measurement of changes in, quality of life after radical prostatectomy should allow for comprehensive, multidisciplinary, patient-centred care planning. Psychosocial assessment, both before and after surgery, is crucial in patients with prostate cancer. This study was prospectively registered with the CEIC-A on 2012-06-27, with registration number C.P.-C.I. PI12/0088.

Objective: to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students., Method: a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity., Results: the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms., Conclusion: Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Background: Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals., Objective: The objective of the study was to examine the health literacy of nursing students and its associated factors., Methods: A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire., Results: 6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone ( p  < 0.05)., Conclusion: A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ramón-Arbués, Granada-López, Antón-Solanas, Cobos-Rincón, Rodríguez-Calvo, Gea-Caballero, Juárez-Vela, Tejada-Garrido and Echániz-Serrano.)

Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy., Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain., Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables., Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain.

Objective: This systematic review aimed to summarise and update existing knowledge about ageism among nursing students through the following research question: what is the perception and attitudes of ageism among student nurses?, Design: A systematic review of longitudinal and cross-sectional studies of ageism in nursing students was carried out., Data Sources: The literature search was conducted in the scientific databases Pubmed and Scopus in February 2021., Review Methods: After the screening process, 22 studies meeting the selection criteria were selected; 8 more were identified after manually searching the selected paper' reference lists. A total of 30 studies were included in the review. The JBI Critical Appraisal Checklists for Analytical Cross-Sectional studies and for Cohort Studies were used to appraise the articles' quality., Results: There was large variability in the manifestation of ageism among student nurses, as well as in the instruments used for assessment. Most of the articles analysed attitudes towards old age, the majority of which were positive. Being a female student, being on the final year of study and having regular contact or cohabitation with an older adult were three of the main determinants in the expression of positive attitudes towards the elderly., Conclusions: Our findings suggest that student nurses generally have positive attitudes towards old age, although ageist beliefs and discriminatory behaviours were identified and should be studied in greater depth. Training programs for future care professionals have a responsibility to educate from a non-stereotypical perspective based on current societal needs., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Professional self-concept in nurses is understood as the way nurses think and feel about themselves in their nursing role and is both a predictor of quality of care and a protective factor against burnout. The aim of this study was to translate, culturally adapt and validate the Spanish version of the Nurses Self-Concept Instrument in a sample of 483 Spanish registered nurses. In addition, we analyzed gender differences in its dimensions in the same sample. Internal reliability was evaluated using Cronbach's Alpha, while construct validity was assessed using both exploratory and confirmatory factor analysis. The differences between groups were analyzed using the Mann-Whitney U test. Factor distribution was different from the original model. A gender gap was observed in the Nurse Thinking and Perception of Capabilities dimensions with higher values in the women group, while in the Leadership dimension, higher values were observed in the men group. While the Spanish version of the Nurses Self-Concept Instrument is a valid and reliable tool to measure this construct, the differences in its dimensions lead to a deeper understanding of the cultural differences in the construction of professional self-concept.

Background: The circumstances arising from the COVID-19 pandemic have accelerated the use of digital teaching and learning in health professions education. Digital gamification-based teaching and learning activities are innovative and versatile tools for the acquisition of professional competencies in higher education, which can be used on a range of topics and can be supplemental to other teaching methods., Objectives: This study aimed to investigate nursing students' gameful experience whilst playing a digital escape room. In addition, we aimed to analyze the students' motivation, learning experience and outcome of the activity, and the students' perception of the degree of achievement of the intended learning outcomes., Design: Cross-sectional descriptive study., Participants: A total of 136 undergraduate first year student nurses enrolled in a "Fundamentals of Nursing" course., Method: The digital escape room game took place online during the academic year 2020-2021. The measures included the GAMEX scale in its Spanish version and a self-reported questionnaire to evaluate the outcome of the scape room game and the degree of achievement of the intended learning outcomes., Results: More than 80 % of the participants were moderately to very motivated to play the game. Three GAMEX dimensions achieved a mean score of 3 or above 3, namely Enjoyment, Creative Thinking and Absence of Negative effects. The mean score for each of the outcome variables was over 3. However, the degree of achievement of the learning outcomes after exiting the digital escape room was uneven., Conclusion: Gamification-based teaching and learning activities, such as digital escape rooms, can be effective in fostering specific skills, including teamwork, communication and critical thinking. However, they should be designed carefully, and used as a complement, rather than a substitute, of other educational activities., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Quality of life (QOL) is a complex and multifaceted concept that has been used to study different aspects of people's lives, including physical and psychological wellbeing, financial independence, social relationships, personal beliefs and living situation. In this study, we aimed to assess the QOL of a group of Spanish university students and identify associated factors., Method: We completed a cross-sectional study of the QOL of 868 university students using the WHOQOL-BREF questionnaire. In addition, data regarding sociodemographic information and self-esteem (Rosenberg Self-Esteem Scale), physical activity (International Physical Activity Questionnaire-Short version), diet (Spanish Index of Healthy Eating), alcohol consumption (CAGE questionnaire) and sleep quality (Pittsburgh Sleep Quality Index) were collected., Results: A total of 66.2% of participants assessed their QOL positively, while 58.8% favorably evaluated their overall health. Students reported the highest scores for the physical health domain of QOL, whereas they gave the lowest scores for the psychological health domain. Age was inversely associated with QOL. Higher self-esteem and satisfaction with academic performance, as well as sleep and diet quality, were directly associated with higher QOL. The physical health domain of QOL was scored more highly by participants who had a healthy body weight or those who reported moderate levels of physical activity. Higher scores in the social relationships domain of QOL were directly linked to alcohol intake, smoking and low body weight in addition to being inversely associated with screen time. The psychological domain of QOL was lower for those who were overweight or lived alone., Conclusion: Many sociodemographic, academic and behavioral variables are associated with university students' QOL. The present findings underscore the need to direct further initiatives toward identifying and overcoming barriers to increased QOL for university students.

Objective: To analyze the perception of culture and experience of working in European health services of a purposive sample of qualified migrant and ethnic minority nurses currently living in Belgium, Portugal, Spain and Turkey., Method: A qualitative phenomenological method was chosen. Individual interviews took place with 8 qualified migrant and ethnic minority nurses currently living in four European countries. Thematic analysis was conducted using Braun and Clark's stages after qualitative data had been verbatim transcribed, translated into English, and analyzed., Results: Four themes and 4 subthemes emerged from thematic analysis of the transcripts., Conclusion: Migrant and ethnic minority nurses working in the European Union experience and witness discrimination and prejudice from patients and colleagues due to cultural differences. European health services should closely monitor and address discrimination and prejudice towards migrant and ethnic minority staff and patients, and take initiatives to reduce and, eventually, eradicate them.

While it has long been recognized that diet is a leading behavioral risk factor for human health, recent scientific findings have also suggested that diet and sleep quality may be connected. The purpose of the present study is to evaluate the association between diet and sleep quality among a group of Spanish university students. To do so, a cross-sectional study of 868 students was carried out. Sleep quality was assessed using the Spanish version of the Pittsburgh Sleep Quality Index (PSQI), while diet was assessed using the Spanish Healthy Eating Index (SHEI). The study revealed a noteworthy rate of bad sleepers (51.6%) and students whose diet needed modifications (82.2%). Unhealthy eaters were more likely to have poor sleep quality (aOR = 4.20; CI 95%: 2.07-8.52). The unbalanced intake of vegetables (aOR = 1.63; CI 95%: 1.14-2.34), fruits (aOR = 4.08; CI 95%: 2.90-5.74), dairy products (aOR = 1.96; CI 95%: 1.41-2.72), lean meats (aOR = 1.82; CI 95%: 1.19-2.78), legumes (aOR = 1.43; CI 95%: 1.00-2.02), sweets (aOR = 1.60; CI 95%: 1.13-2.25) and sugary soft drinks (aOR = 1.46; CI 95%: 1.07-1.99) was associated with lower sleep quality., Competing Interests: The authors declare no conflict of interest.

Promoting the adoption of healthy habits represents a great challenge for health and education professionals. In this sense, childhood and adolescence are propitious times for the acquisition and consolidation of behaviors and skills, being that numerous and different determinants act in the genesis of behavior. The purpose of this study was to test the Psychometric properties and cultural adaptation of "LifeConScale" -Life Conditions Scale for Adolescents-. A cross-sectional and multicenter study was carried out in a representative sample of adolescents enrolled in 1st and 2nd year of Compulsory Secondary Education in 18 educational centers in Aragon, during the 2018-2019 school year. Sociodemographic characteristics, life skills, daily habits, and academic performance were analyzed using an adapted questionnaire from different scales and previous studies. For the adaptation of the questionnaire, the expert panel technique was used and for its validation, exploratory factor analysis was carried out and Cronbach's Alpha was applied, assessing the global internal consistency and of each one of the factors. The instrument showed a Kaiser-Meyer-Olkin sample size adequacy of 0.8122. A 6-dimensional model was chosen that explained 75.25% of the variance. The goodness of fit obtained a value of 0.802 in the Nomed Fix Index. The Comparative Fit Index was 0.891. The result of the analysis of variances and covariances carried out according to the Standardized Root Mean Square Residual yielded a value of 0.093 The analysis showed excellent application conditions in the study population and construct validity. This instrument will be useful for the evaluation of educational programs that work to promote health in educational centers, such as Health Promoting Schools., Competing Interests: The authors have declared that no competing interests exist.

Objective: To determine the degree of psychological distress and fear of COVID-19 experienced by undergraduate student nurses who were about to begin their clinical placements., Method: A cross-sectional study was carried out with 100 second- and third-year undergraduate student nurses of the University of Zaragoza (Spain). Measures included the Fear of COVID-19 Scale and the Depression Anxiety Stress Scales., Results: Regularly, student nurses did not think of themselves as vulnerable to COVID-19. However, a significant association was observed between the student nurses' level of psychological distress and cohabiting with relatives or people who were considered vulnerable to the infection (p = 0.035). The Depression Anxiety Stress Scale results revealed a low level of psychological distress in general; the Fear of COVID-19 Scale indicated moderate fear (2.94)., Conclusion: Student nurses who lived with their relatives experienced higher levels of stress due to the perceived risk of transmission, but were less fearful of loss of work and income. Anxiety in our sample was associated principally with not knowing their upcoming placement location.

Background: European nurses are expected to provide appropriate care for patients from diverse cultural backgrounds. However, there is limited knowledge and understanding of this process. The aim of this study was to analyse the perceptions of culture and experiences of caring for patients from diverse cultural backgrounds of a purposive sample of qualified nurses from four European countries, namely Belgium, Portugal, Spain and Turkey., Methods: A qualitative phenomenological approach was selected in order to understand complex phenomena through the participants' lived experiences, meanings and perspectives. Individual interviews and focus groups took place with 28 staff nurses and 11 nurse managers from four European countries. The sociodemographic and cultural characteristics of the sample were described and analysed using descriptive statistics. Qualitative data were transcribed verbatim, translated into English and analysed following Braun and Clark's phases for thematic analysis., Results: Five themes and twelve subthemes emerged from thematic analysis of the transcripts. The themes included: (1) relevance of culture for nursing; (2) culture in the healthcare service; (3) qualities of the healthcare professionals; (4) challenges to culturally competent care; (5) becoming a culturally competent nurse., Conclusions: There are challenges to the delivery of culturally congruent care, namely language and communication difficulties, prejudices and stereotyping in the health service, a tendency for ethnocentrism, a lack of education and training in cultural competence and a lack of support from the health service to facilitate new ways of acting.

SARS-CoV-2 can cause neurologic symptoms, as well as respiratory ones. Older adults are at risk of developing acute delirium in older persons (ADOP). The combination of experiencing respiratory isolation due to COVID-19, as well as other associated risk factors for older adults, may have had an impact on ADOP and ADOP management in the acute hospital setting. This study aimed to analyze the characteristics of ADOP in patients admitted to a COVID-19 unit. An observational prospective study on a sample of 108 patients was carried out between November 2020 and May 2021. The following data were collected: sociodemographic characteristics, risk factors for ADOP, management of ADOP, and impact on ADOP on both functional and cognitive deterioration. A 29.6% proportion of older adults admitted to an acute COVID-19 unit presented hyperactive ADOP, mainly during the night. Management of ADOP in our sample involved mainly pharmacological treatment and had a serious impact on hospital stay and both functional and cognitive deterioration. Preventive strategies and being accompanied by a relative or a carer may be useful to manage ADOP during hospital admission due to COVID-19.

Background: There is insufficient evidence about the impact of health promoting schools on the student's health and academic performance. The aim of this study was to compare the life skills, lifestyle habits and academic performance of 7 th and 8 th grade students registered in health promoting and non-health promoting schools in the Autonomous Community of Aragon., Methods: An observational, descriptive, comparative study of the life skills, lifestyle habits and academic performance of 7 th and 8 th grade students registered in 43 randomly selected health promoting and non-health promoting schools was carried out. We used an adapted tool, which was validated through the expert panel technique, to evaluate the students' life skills (self-efficacy, social skills and affect balance), lifestyle habits (diet, sleep, physical exercise, use of screen and substance abuse) and academic performance., Results: The socioeconomic level of the mothers and fathers of the students who attended non-health promoting schools was significantly higher than that of the parents of the adolescents who attended health promoting schools ( p < 0.001). The students who attended non-health promoting schools had better self-efficacy, led a healthier life generally and achieved better academic results ( p = 0.03)., Conclusions: As opposed to previous studies, which found a positive association between health promoting schools and life skills, lifestyle habits and academic performance, our findings suggest that the impact of these health programs on the students' health and academic performance is limited. We recommend that the degree of implementation of health promotion programs in health promoting schools is systematically evaluated, and the health promoting school accreditation process and requirements reviewed, in order to ensure that the health of school children and adolescents is safeguarded and promoted in the short, medium and long term., Competing Interests: The authors declare that they have no competing interests., (© 2022 Sánchez-Hernando et al.)

Introduction: European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds., Materials and Methods: A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal., Results: 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice., Conclusion: The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities., Competing Interests: The authors have declared that no competing interests exist.

Introduction: While European health policies do frequently take into consideration the ideas and experiences of their users, the voices of minority and marginalized communities are not often heard. European healthcare services must address this issue as the number of healthcare users with an MM background increases., Aim: To explore the perspectives of key stakeholders and healthcare users with an MM background on transcultural care in four European countries., Design: Qualitative phenomenological study., Methods: Semi-structured, individual interviews were conducted with stakeholders and MM users. Interviews were translated and transcribed verbatim and were carried out from February to May 2021. Descriptive statistics was used to describe the characteristics of the sample; qualitative data were analyzed thematically following Braun and Clarke's phases, resulting in 6 themes and 18 subthemes., Results: For stakeholders and MM users with long-established residence in their respective countries, cultural differences involve different family and community norms, religious beliefs, lifestyles, and habits. These components are perceived as in tension with healthcare norms and values, and they mediate in two key and related aspects of the relationship between MM users and healthcare providers: accessibility and communication., Conclusions: Communication and access to healthcare are key to MM health service users, and they are the most frequent sources of misunderstanding and conflict between them and healthcare professionals., Impact: It is important to extend the investigation of cultural issues in healthcare to stakeholders and MM users. There is no doubt that healthcare professionals should be trained in cultural competence; however, cultural competence training is not the only area for improvement. There should be a change in paradigm in healthcare services across Europe: from individual to organizational integration of culture and diversity.

Given that there is only a limited body of evidence available concerning the dietary habits of Spanish university students, the present study assesses the quality of this group's diet, their adherence to the National Food-Based Dietary Guidelines, and the predictive factors of their diet quality. To do so, a cross-sectional study was performed on a sample of 1055 students. The quality of the participants' diets was then analysed by using the Spanish Healthy Eating Index, and then their level of compliance was assessed in light of the dietary recommendations put forth by the Spanish Society for Community Nutrition. According to these standards, only 17.4% of the participants had a healthy diet. The level of compliance with the recommendations was poor, highlighting especially the low levels of "fruit" and "vegetables" that they consumed as well as high levels of "cold meats and cuts" and "sweets". The factors that predicted a worse diet are being male, living alone, low levels of physical activity, smoking, high alcohol intake, leading a sedentary lifestyle, psychological distress, and insomnia ( p < 0.005). Furthermore, participants with low or high body weights showed signs of a higher quality diet ( p < 0.001). The present findings suggest that a significant proportion of university students ought to change their dietary habits; these also attest to the importance of developing strategies that are directly targeted at university students in order to promote a healthy diet.

Background: Sexual satisfaction is a complex and multidimensional concept. It encompasses physical, emotional, relational and cultural dimensions, and constitutes an essential component of sexual health, as well as an indicator of quality of life and wellbeing. The Sexual Satisfaction Scale for Women (SSS-W) was designed in the United States, and it is a valid and reliable tool to measure women's sexual satisfaction., Aim: The aim of this study was to culturally adapt and translate the SSS-W into Spanish and analyze its psychometric properties., Methods: First, the original instrument was culturally adapted and translated from English to Spanish. Then, we tested the psychometric properties of the instrument in its Spanish version in a sample of 316 women who attended a family planning clinic in Logroño, Spain. Internal consistency reliability of the whole scale and each subscale separately was measured using Cronbach's alpha. Factorial validity of the SSS-W in its Spanish version was analyzed using exploratory factor analysis through the Kaiser-Meyer-Olkin measure of sample adequacy and Bartlett's Sphericity test., Results: The Cronbach's alpha coefficients of the total scale and each subscale were satisfactory (>0.7). Exploratory factor analysis confirmed the five hypothetical dimensions of the scale in its Spanish version. The five dimensions (contentment, communication, compatibility, relational concern, and personal concern) explained 60% of the total variance of the scale; factor analysis using varimax rotation revealed strong loads in each of the five components., Conclusions: The SSS-W in its Spanish version is a valid and reliable tool to assess sexual satisfaction in Spanish women of reproductive age and, therefore, can be used both in clinical practice and for the investigation of sexual health.

A healthy lifestyle is important to the present and future development and health of school age people. This study aims to analyze the relationship between daily lifestyle habits and academic performance in a sample of adolescents from the autonomous community of Aragon (Spain). We performed a cross-sectional study to analyze the lifestyle habits and academic performance of a total of 1745 7th and 8th grade middle school students during the academic year 2018-2019; the participants were selected from a random sample of 43 middle schools from the region of Aragon. The following data were collected through an anonymized, previously validated questionnaire: diet, sleep, physical activity, use of screens, use of toxic substances, and academic performance. We found a statistically significant association between all the lifestyle habits analyzed and academic performance ( p < 0.001) in our sample. Based on our findings, we suggest that health promotion and education in healthy lifestyles should be integrated in middle school curricula to improve academic performance and, more importantly, to promote both present and future health outcomes of adolescents.

Background: The integration of innovative strategies to teaching and learning in higher education, such as escape room games, can enhance the acquisition of key professional competencies including communication, teamwork and critical thinking., Objectives: This study aimed to evaluate undergraduate student nurses' gameful experience while playing an escape room game as part of a nursing course., Design: Cross-sectional descriptive study., Participants: A total of 126 third year student nurses enrolled in the "Community Health Nursing II" course., Method: The escape room game took place in a classroom at the Faculty of Health Ciences. The measures included the GAMEX scale in its Spanish version and a self-reported questionnaire to evaluate the student's outcome of scape room game immediately after the end of the activity., Results: The vast majority (99.21%) considered the escape room game to be an appropriate and an innovative teaching and learning strategy. The mean score for each of the GAMEX dimensions was over 3, with the exception of Absence of negative effects. Our results suggest that the students enjoyed playing the game (mean = 4.40; SD = 0.71), that escape room games should be integrated in nursing courses (mean = 4.54; SD = 0.74) and that playing the game increased their motivation for learning (mean = 3.06; SD = 1.09). Gender differences were observed in the GAMEX Dominance dimension (p < 0.005)., Conclusion: Gamification in general, and escape rooms in particular, have proven to be a valid tool for the acquisition of professional competencies in higher education., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

(1) Background: To examine the prevalence, and associated factors of, problematic Internet use in a sample of Spanish university students. (2) Methods: Cross-sectional descriptive study of a convenience sample of 698 university students. Self-esteem, alcohol consumption, perceived social support, depression, anxiety, stress and problematic Internet use were evaluated using the Rosenberg, CAGE, DUKE-UNC-11, DASS-21 and Young's Internet Addiction Test, respectively. (3) Results: Problematic internet use was reported by 21% of respondents. Risk of problematic Internet use was independently associated with the preferred use of the smartphone, time of exposure to the Internet, less perceived social support, problematic alcohol consumption and symptoms of stress and anxiety. We found significant association between problematic internet use and time of exposure to the Internet, residential status, alcohol consumption, self-esteem, perceived social support and psychological distress, after bivariate analysis. (4) Conclusions: A considerable prevalence of problematic Internet use was found; in our sample problematic Internet use was associated with stress, alcohol consumption, anxiety and perceived social support. Strategies aimed at the early identification of problematic Internet use may lead to an improvement in the psychosocial health of the university student population.

Background: Sitting time has negative effects on health, increasing the risk of obesity, osteoporosis, diabetes, and cancer. Thus, primary health care education interventions aimed to reduce sitting time and sedentary behavior could have beneficial effects on people's health and wellbeing. The purpose of this study was to assess the effectiveness of an intervention based on reducing sitting time to decrease cardiometabolic risk on a sample of women diagnosed with fibromyalgia and moderate obesity., Methods: Randomized controlled trial to evaluate the effectiveness of an intervention to decrease cardiometabolic risk in 84 participants. Sedentary behavior was monitored using an accelerometer before and at 3-month follow-up., Results: Compared with the control group, body mass index decreased, and the number of steps taken increased, in the intervention group 3 months after the intervention. No significant differences were found in the rest of the variables measured., Conclusion: The intervention group decreased sitting time after the intervention. Group activities and support from primary care may be useful to improve treatment adherence. RCT registration: NCT01729936.

Background: Heart failure is a chronic, progressive syndrome of signs and symptoms, which has been associated to a range of comorbidities including insomnia. Acute decompensation of heart failure frequently leads to hospital admission. During hospital admission, long-term pharmacological treatments such as hypnotics can be modified or stopped., Aim: To synthesize the scientific evidence available about the effect of withdrawing hypnotic drugs during hospital admission in patients with decompensated heart failure and insomnia., Method: A systematic review of the literature following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was carried out in the following scientific databases: PubMed, Scopus, Dialnet and Cochrane., Inclusion Criteria: studies including a population of adults with heart failure and sleep disorders in treatment with hypnotics and admitted to hospital, studies written in English or Spanish and published until June 2020., Exclusion Criteria: studies involving children, patients admitted to intensive care and patients diagnosed with sleep apnea., Results: We identified a total of 265 documents; only nine papers met the selection criteria. The most frequently used drugs for the treatment of insomnia in patients with heart failure were benzodiazepines and benzodiazepine agonists; their secondary effects can alter perceived quality of life and increase the risk of adverse effects. Withdrawal of these drugs during hospital admission could increase the risk of delirium. Future research in this area should evaluate the management of hypnotics during hospital admission in patients with decompensated heart failure. In addition, safe and efficient non-pharmacological alternatives for the treatment of insomnia in this population should be tested and implemented.

Background: Learning and socio-emotional development is promoted through the creation and nurturing of an optimal school climate. This study aims to analyze the relationship between life skills and academic performance in a large sample of adolescents from the autonomous community of Aragón (Spain)., Methods: A cross-sectional study was conducted on the life skills and academic performance of a sample of 7th and 8th grade middle school students during the academic year 2018-2019. A sample of 43 middle schools were randomly selected; the final sample comprised 1745 students. The following data were collected through an anonymized, previously validated questionnaire: sociodemographic variables, social skills, self-efficacy, affective balance, and academic performance., Results: We found a statistically significant association between life skills and academic performance ( p < 0.001) in our sample. We also observed significant gender differences in life skills, with boys obtaining higher scores in cognitive skills and affective balance, and with girls achieving higher scores in social skills., Conclusion: We argue that life skills should be integrated into educational policies in order to improve the academic performance and health outcomes of students.

Background and Purpose: Professional commitment is frequently used as a humanistic care indicator. Thus, it is important to design and validate a tool which is able to measure professional commitment of nurses in Spain. In this study we aimed to analyze the psychometric properties of the Nijmegen Professionalism Scale for Spanish (NPS-S) nursing in order to verify its validity and reliability., Methods: We undertook the pilot testing and psychometric validation of the NPS-S. A total sample of 249 nursing professionals from a variety of areas of expertise took part in this study. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was used for reporting this research., Results: The NPS-S achieved a high degree of content validity, construct validity, internal consistency, temporal stability, and usability; this version is, thus, equivalent to the Nijmegen Professionalis Scale in its original version., Implications for Practice: Based on the results obtained from the validation of this tool, it is possible to affirm that the NPS-S is an effective instrument for measuring professional commitment in this population. The NPS-S will evaluate and thus contribute to the promotion of professional commitment in Spanish nursing. Additionally, it will serve to establish correlations between professional commitment and other variables including quality of care and patient satisfaction. Future studies should analyze the evaluation capacity of this tool., (© Copyright 2021 Springer Publishing Company, LLC.)

The aim of this study was to analyze the correlation between the participants' self-reported quality of life and their sense of coherence in a sample ( n = 85) of patients on treatment with oral antivitamin K anticoagulants. A cross-sectional design was used. The measurement instruments included a questionnaire on sociodemographic variables, the Spanish version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), an oral-anticoagulant-treatment-specific quality-of-life questionnaire, and the sense-of-coherence (SOC) scale. We analyzed the correlations between the participants' characteristics and the results from the quality-of-life and SOC scales. Age, level of education, employment status, living arrangement, and treatment length were the determinants of the quality of life in people treated with oral anticoagulants. We found a significant association between the four domains of the WHOQOL-BREF questionnaire and general treatment satisfaction ( p < 0.01); no significant correlations were found between the SOC subscales and the oral-anticoagulant-treatment-specific quality of life in our sample. Women had a worse level of self-management than men. Nursing interventions should be tailored to the needs of the populations on treatment with oral anticoagulants in order to facilitate a higher level of self-management., Competing Interests: The authors declare no conflict of interest.

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers' perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers' perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark's phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed.

Visible nursing work is usually associated with formal work and physician-delegated tasks which are protocolised and usually well documented. Nevertheless, nurses carry out many actions and display specific attitudes and behaviours which, despite contributing to the well-being, recovery of patients and satisfaction with the attention received, are not as visible. Previous studies have been conducted in order to define 'invisible nursing interventions', but no quantitative instruments focused on measuring invisible nursing interventions have been found in the literature., Purpose: To test the psychometric properties of the Perception of Invisible Nursing Care-Hospitalisation (PINC-H) questionnaire., Methods: Cross-sectional survey design. A self-administered questionnaire was completed by 381 participants recruited consecutively after discharge from a Spanish hospital. Data were collected from 2012 to 2020., Results: Three factors were identified from exploratory factor analysis, namely 'Caring for the person', 'Caring for the environment and the family' and 'Caring presence'. Criterion Validity Coefficient was highly significant (p < 0.001) with values ranging between 0.63 and 0.71. Cronbach's alpha was 0.96. Test-retest reliability was estimated in a subsample of 187 participants; in all the items, correlation coefficients were highly significant (p < 0.001) and within range (0.532-0.811) with a mean value of 0.680. Also, correlations between each dimension and the complete questionnaire indicated good temporal stability between measurements., Conclusions: The instrument had satisfactory validity and reliability. PINC-H can contribute to highlight nursing interventions and behaviours which are often unseen and, thus, less valued. We argue that PINC-H will also be useful to evaluate the quality of invisible nursing care to oncology inpatients., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Nursing work environments are defined as the characteristics of the workplace that promote or hinder the provision of professional care by nurses. Positive work environments lead to better health outcomes. Our study aims to identify the strengths and weaknesses of primary health care settings in Spain., Methods: Cross-sectional study carried out from 2018 to 2019. We used the Practice Environment Scale of the Nursing Work Index and the TOP10 Questionnaire of Assessment of Environments in Primary Health Care for data collection. The associations between sociodemographic and professional variables were analyzed., Results: In total, 702 primary care nurses participated in the study. Responses were obtained from 14 out of the 17 Spanish Autonomous Communities. Nursing foundation for quality of care, management and leadership of head nurse and nurse-physician relationship were identified as strengths, whereas nurse participation in center affairs and adequate human resources to ensure quality of care were identified as weaknesses of the nursing work environment in primary health care. Older nurses and those educated to doctoral level were the most critical in the nursing work environments. Variables Age, Level of Education and Managerial Role showed a significant relation with global score in the questionnaire., Conclusion: Interventions by nurse managers in primary health care should focus on improving identified weaknesses to improve quality of care and health outcomes.

Background: Within the European higher education context, students and lecturers are encouraged to engage in teaching and learning activities abroad. This frequently involves using a second language and being exposed to students and lecturers from culturally different backgrounds., Objective: To design a model for teaching and learning cultural competence in a multicultural environment (CCMEn)., Design: Theory development from empirical experience, research, and scholarly works., Method: This model was developed based on our experience of teaching and learning cultural competence in a multicultural environment in a nursing education context; it rests on three pillars, namely, Coyle's Content and Language Integrated Learning educational approach, the concept of social and emotional learning, as defined by the Collaborative for Academic, Social and Emotional Learning, and the existing literature surrounding teaching and learning cultural competence in higher education., Results: The CCMEn model is intended to guide the process of teaching and learning cultural competence in a multicultural environment through the use of a second language and has been adapted from existing educational approaches and theory., Conclusion: Teaching and learning in multilingual and multicultural contexts in Europe is becoming more common. Students who learn alongside students and teachers from different cultural backgrounds need to be supported from an academic, linguistic and socioemotional perspective. We believe that the CCMEn model can serve as a guide to enhancing student learning in this context.

Background : Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. Materials and methods : We carried out a cross-sectional study to analyze the quality of sleep in a sample of 203 patients with a diagnosis of heart failure admitted to an Internal Medicine Service. The Pittsburg Sleep Quality Index (PSQI) was used to evaluate sleep quality in our sample over a one-month period. Results : 75% of the sample presented sleep disorders. The most common problems included the interruption of sleep (73.5% nocturia and 30% breathing difficulties); 35% had poor sleep efficiency; 33% showed a decrease in daytime performance; 84% had used hypnotics at some point to induce sleep and 35% used them regularly. Conclusions : This is the first study to report on the perceived sleep quality of patients with heart failure in Spain. Self-perception of sleep quality differed from that estimated by the PSQI. The prevalence of the use of sleep-inducing medication was very high. The diurnal dysfunction generated by sleep disorders in a heart failure environment can contribute to the development of self-care and cognitive deterioration problems.

Background : Heart failure (HF) is a progressive and debilitating condition that represents an ever-growing problem for health systems worldwide. HF patients feel that they are a burden on their families, they feel socially isolated and have a low perception of their health. Accordingly, the objectives of this study were to: (1) to explore the profile of care dependency in a representative sample of Spanish HF patients through the Care Dependency Scale (CDS), and (2) to identify correlates of care dependency in this population. Material and Methods : We performed a cross-sectional study of 187 patients admitted for HF decompensation to the Hospital Clínico of Zaragoza (Spain). Results : Only 15% of our sample was highly or completely dependent on care from others. More specifically, our results indicate that HF patients felt a greater level of dependency on care from others when it comes to moving, getting dressed and undressed, maintaining good personal hygiene, participating in daily and recreational activities and being continent. Conclusions : We find association between the CDS categories that present a low score for care dependency in HF patients and the patients' physical deterioration.

Aim: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students., Method: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students., Results: We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress; lacking a stable partner was significantly associated with depressive symptoms; and frequent consumption of alcohol was significantly associated with symptoms of anxiety., Conclusion: We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Interventions aimed at promoting mental health among college students should be implemented.

Falls in the elderly are one of the main geriatric syndromes and a clear indicator of fragility in the older adult population. This has serious consequences, leading to an increase in disability, institutionalization and death. The purpose of this cross-sectional study was to analyze the prevalence of risk of falling and associated factors in a population of 213 non-institutionalised, able older adults with a history of falling in the previous year. We used the following assessment tools: Questionnaire of the WHO for the study of falls in the elderly, Geriatric Depression Scale and Tinetti's Gait and Balance Assessment Tool. Age, using ambulatory assistive devices, polymedication, hospital admission following a fall and depression were significantly associated with risk of falling. In order to prevent fall reoccurrence, community-based fall prevention programs should be implemented.

Objective: to determine the prevalence of cardiovascular risk factors in a cohort of workers and to quantify its association with compliance with the Mediterranean diet follow-up., Method: a cross-sectional descriptive study was carried out on a cohort of 23,729 workers. Clinical data from annual medical examinations and the Mediterranean Diet Adherence Screener were used to assess adherence to the Mediterranean diet., Results: 51.3% of the participants showed good adherence to the Mediterranean diet. The multivariate analysis showed an inverse and significant association between the follow-up of the Mediterranean diet and the prevalence of abdominal obesity (Odds Ratio = 0.64, 95% CI 0.56; 0.73), dyslipidemia (Odds Ratio = 0.55, 95% CI 0.42; 0.73), and metabolic syndrome (Odds Ratio = 0.76, 95% CI 0.67; 0.86)., Conclusions: our results suggest that the Mediterranean diet is potentially effective in promoting cardiovascular health. Implementing the interventions promoting the Mediterranean diet in the working population seems justified.

Background and Purpose: The aim of this investigation was to perform the cross-cultural and linguistic translation and adaptation of the Nijmegen Professionalism Scale for Spanish nursing. Originally designed by Tromp et al. (2010) for its use by general practitioners, the new Spanish version of this tool assesses professional commitment, allowing for the comparison, prevention, association, and longitudinal monitoring of commitment among nursing professionals., Methods: The linguistic translation from English to Spanish was performed using the translation-back-translation method; the process of cross-cultural adaptation to the Spanish nursing context was carried out following the recommendations given by a panel of experts comprised of 24 practicing nurses with different professional backgrounds. The data for the feasibility study were collected between December 2015 and January 2016., Results: The original English version of the instrument contains 106 items and was originally developed for assessing professional behavior of general practitioner trainees; the new version, with a significant reduction in the initial number of items, comprises 49 items and is now ready for pilot testing and validation in our context., Implications for Practice: The Nijmegen Professionalism Scale in its Spanish version will act not only as a tool for measuring professional commitment among Spanish nurses but also as a motivational resource and means for reflection which will, in turn, increase the quality of the care provided by these professionals., (© Copyright 2019 Springer Publishing Company, LLC.)

Objective: To determine the number of drugs taken per day, which represents a risk factor for falls among noninstitutionalized older adults with a history of falls in the last year., Method: This was a descriptive study that used random sampling and the following measurement instruments: the WHO questionnaire for the study of falls in older adults, gait scale and geriatric depression scale and gait and balance. Univariate and bivariate analysis, nonparametric chi-squared test, and binary logistic regression were performed using the SPSS statistical program version 21.0., Results: 214 individuals participated in the study. Those who took ≥ 4 drugs presented higher risk of falling, p=0.010 OR=4.034. The same was not true for individuals who took ≤ 3 drugs, p=0.006 OR=0.335., Conclusion: The use of four or more drugs per day was considered a risk factor for falls among older adults.

The purpose of this paper was to estimate the prevalence of depression and associated factors in people aged 65 or older with a history of falling in the last 12months. A cross-sectional descriptive study was performed involving a random sample of 213 participants from two social centers for older adults in the city of Zaragoza (Spain). The mean age of the participants was 77.3years (SD±7.0). Our findings reveal a prevalence of depression of 28.2% in the study sample, with older adults who were at a high risk of falling being more susceptible to developing depression. In conclusion, one in three elderly people who were at risk of suffering a fall in the 12months prior to data collection had symptoms of depression. This is in agreement with the results from previous studies, which confirm that there is a high prevalence of depression in elderly patients with a previous history of falls., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This work aims to develop a practical guide to writing a research project.

This work aims to develop a practical guide to writing a research project.

This study aims to develop a practical guide to applying the nur- sing model recognized Virginia Henderson NANDA taxonomy and nursing process.