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RESUMEN Objetivo: Conocer cansancio emocional en estudiantes de enfermería de cuatro Universidades. Método: Estudio de corte transversal, correlacional, realizado en Chile y España (2017-2018). Respondieron instrumento autoaplicado 1368 estudiantes (variables sociodemográficas/académicas y escala de Cansancio Emocional). Análisis con Stata 15, según variables: Pruebas de Chi2, sumas y rangos de Wilcoxon (Mann Whitney), análisis de varianza y regresión múltiple; nivel de confianza 95% y significancia 5% (p < 0,05). Aprobado por Comité de Ética, Universidad de Girona. Resultados: Variables académicas y estrés percibido destacan Bastante/Mucho para: Exámenes, Aprendizaje Basado en Problemas, Laboratorio/Simulación. Diferencias estadísticamente significativas entre cansancio emocional según sexo, personas a cargo, trabajadores, tiempo traslado > a 30 minutos. Mayor cansancio emocional al cursar asignaturas por segunda vez y en actividades académicas donde declaran un estrés percibido como Bastante/Mucho (p < 0,005). Conclusión: Todos los estudiantes presentan cansancio emocional medio (>26 y

Objective: To know emotional exhaustion in nursing students from four universities. Method: Cross-sectional, correlational study, carried out in Chile and Spain (2017-2018), with 1,368 students answering a self-applied instrument (sociodemographic/academic variables and the Emotional Exhaustion scale). Analysis with Stata 15, according to variables: Chi2 tests, Wilcoxon rank sum test (Mann Whitney U test), analysis of variance and multiple regression; confidence level 95% and significance 5% (p < 0.05). Approved by the Ethics Committee, Universidad de Girona. Results: Academic variables and perceived stress with Quite Much/Much classification: Exams, Problem-Based Learning, Laboratory/Simulation. Statistically significant differences in emotional exhaustion, according to sex, dependent people, workers, commuting time >30 minutes. Greater emotional exhaustion when taking courses for the second time and in academic activities where they declare perceived stress as Quite Much/Much (p < 0.005). Conclusion: All students present mean level of emotional exhaustion (>26 and

Context A key to advancing the eradication of gender-based violence (GBV) is knowing how to recover from it. Objective To identify the changes that are indicators of having overcome GBV and determine the role of various support networks. Search strategy We systematically searched Web of Science. Inclusion criteria Publications whose abstracts contained a minimum of two of the following words: (a) support or network or solidarity, (b) violence and (c) recovery or healing. Data extraction and synthesis Of the 273 documents retrieved, 52 were used using a narrative synthesis approach. Main results For recovery, women must reconnect with themselves, with their environment and with the world in general. Doing so requires support from both formal and informal networks. The intervention of other people is a common element in successful recovery processes. We identify three requirements for the intervention of these support networks to be effective: not blaming the victim, making women part of their own recovery process by showing them their own transformation potential and promoting reflection on the socialization they have experienced in their affective-sexual relationships. Conclusions There are multiple benefits to having formal or informal support during recovery. In informal networks, raising awareness and providing training are insufficient for promoting active support. Instead, the Second Order of Sexual Harassment must specifically be combatted. Public contribution From the authors' previous research, harassed women and survivors have underlined the necessity to identify indicators of recovery and which kind of support has an impact on it.

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p &lt, 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770, CI 95%: 1.229–6.242, p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839, 95% CI: 1.551–5.197, p = 0.001) and individuals pressured to consume alcohol (OR: 2.091, 95% CI: 1.332–3.281, p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.

Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. Aims: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. Methods: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013&ndash, 2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. Results: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. Conclusion: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

Although some study has been made into quality of life in patients with peritoneal dialysis, little is known about how this relates to social support. The aim of this paper was to study health-related quality of life, perceived social support and the experiences of people receiving peritoneal dialysis. A cross-sectional study was conducted using quantitative and qualitative methodologies, between June 2015 and March 2017. Fifty-five patients receiving peritoneal dialysis were studied. The most affected quality of life dimensions were the effects of the disease, the burden of the disease, occupational status, sleep and satisfaction. The physical component of the quality of life questionnaire was negatively associated with the number of hospital admissions over the previous year (p = 0.027) and positively associated with social support (p = 0.002). With regard to the mental component, age (p = 0.010) and social support (p = 0.041) were associated with a better quality of life. Peritoneal dialysis, while not a panacea, is experienced as being less aggressive than hemodialysis, allowing greater autonomy and improved perceived health. Greater symptomology corresponded to worse quality of life and to perceiving the disease as a burden. Patients had to adapt to the new situation despite their expectations. Social support was observed to be a key factor in perceived quality of life.

Background Active and Healthy Ageing (AHA) is the process of optimizing opportunities related to health, participation, and safety in order to improve quality of life. The approach most often used to measure AHA is Rowe and Kahn’s Satisfactory Ageing model. Nonetheless, this model has limitations. One of the strategic objectives of the WHO Global Strategy and Action Plan (2016) is to improve Healthy Ageing measurement. Our objectives were to compare two models of assessing AHA and further compare the results by country and sociodemographic variables. Methods This was a cross-sectional, observational analysis of a representative sample of the general population aged 50 years and older in Europe. The data analysed were obtained by the Study of Health, Ageing and Retirement in Europe (SHARE). The dependent variable was AHA and its dimensions, measured using the Rowe and Kahn AHA model (AHA-B) and the authors’ model based on the WHO definition (AHA-BPS). A descriptive analysis and multivariate models of binary logistical regression were developed. Results The sample consisted of 52,641 participants (mean age 65.24 years [SD = 10.18; Range = 50–104], 53.2% women). Healthy Ageing prevalence in the AHA-B model was 23.5% (95%CI = 23.1%-23.9%). In the AHA-BPS model, this prevalence was 38.9%. In both models, significant variations were observed between countries, and were distributed along a north-western to south-eastern gradient. The sociodemographic variables associated with the absence of AHA were advanced age, female sex, death of spouse, low educational level, lack of employment, and low financial status. Comparing the two models, the strength of association between absence of AHA and advanced age (85 years and older) was four times greater in the AHA-B model. Conclusions Our results showing differences between these two models provide evidence that the AHA-BPS model does not penalize older age and is more likely to characterize AHA from a health promotion perspective.

Background Intimate partner violence (IPV) is one of the most important challenges facing today's society. Health professionals, and nurses in particular, play a leading role in addressing this problem. Having an instrument to study Nursing students' perception of this type of violence may enable appropriate and necessary educational strategies for their pre-service training and help them identify and address IPV in their future careers. Objectives To adapt and validate the IPV scale of Beccaria et al. (2011) in order to study nursing students' perception of IPV. Method The original instrument (63 items) underwent back-translation. Statistical and metrical analysis in a sample of 1064 students of the four-year Nursing degree program at four public universities in Catalonia (Spain) were based on their responses to the Spanish version. 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 showed adequate internal consistency for each subscale in the instrument: Education (0.83); Identification of the Victim (0.72); Nursing Role and Values (0.78), and Identification of the Perpetrator (0.66). Conclusion The translation, cultural adaptation and validation process of the original IPV scale resulted in a Spanish-language instrument (IPV scale Spanish version) with 32 items in four subscales. We concluded that the Spanish version of the instrument is reliable and valid, and that its implementation would enable the assessment of nursing students' perception of IPV situations

Difficulty in accessing peripheral veins in emergency departments increases patients' discomfort and impedes their diagnosis. The objective of this study was to develop and test the prognostic accuracy of an easily applied scale to measure difficult venous access to peripheral veins in emergency departments, called the Adult-Difficult Venous Catheterization scale.This prospective observational study was conducted in adults from the hospital catchment area attending the emergency department. Using the Delphi technique, 5 experts reached a consensus regarding a 3-item scale scored from 0 to 5. Concurrent validity and predictive validity were analyzed using a numeric rating scale and the number of access attempts, respectively. Internal consistency and interobserver reliability for 3 independent observers were analyzed using Cronbach alpha and Cohen kappa, respectively.In 392 participants, the concurrent and predictive validity scores pointed to positive relationships with the numeric rating scale (r = 0.82; P0.001) and the number of access attempts (r = 0.5; P0.001), respectively. The odds ratio for 1 to 2 access attempts versus more than 2 access attempts in relation to the Adult-Difficult Venous Catheterization scale score was 2.76 (95% confidence interval 1.86, 4.08; P0.001). Sensitivity and specificity values for the Adult-Difficult Venous Catheterization scale were good, at 93.75% and 78.99%, respectively, as were internal consistency (Cronbach alpha 0.81) and interobserver reliability (Cohen kappa 0.75).The Adult-Difficult Venous Catheterization scale is a valid and reliable instrument for predicting difficult venous access in emergency departments.

Resumen La hiperglucemia es uno de los problemas mas frecuentes en el paciente critico, de ahi la importancia de un buen control de esta en las UCI. Objetivos Identificar la via de eleccion para el control de la glucemia en el paciente critico; distinguir los controles necesarios para garantizar unos correctos niveles de glucemia en el paciente critico; determinar el intervalo de valores de glucemia adecuado en este tipo de pacientes. Metodos Revision bibliografica exhaustiva en diferentes bases de datos, como MEDLINE con la asistencia del buscador especifico PubMed y ProQuest, CUIDEN-PLUS y el portal editorial ELSEVIER. Resultados Se obtuvieron 24 articulos: estudios descriptivos, analiticos, de cohortes y revisiones bibliograficas. La via de eleccion para el analisis de la glucemia en el paciente critico es la via arterial, pudiendose utilizar tambien la via venosa y excluyendo la via capilar. El analisis debe llevarse a cabo en el laboratorio, pero tambien es posible utilizar glucometros que ofrecen medidas instantaneas. Los controles de glucemia en el paciente critico inicialmente se realizan de manera horaria hasta su estabilizacion, y posteriormente se espacian a periodos de 2-3 h. El indice glucemico recomendado es moderado, estableciendo valores comprendidos entre 140-180 mg/dl. Conclusiones La via arterial es la de eleccion para el analisis de la glucemia en el paciente critico. Los controles deben ser horarios al inicio, hasta su estabilizacion, y posteriormente cada 2-3 h. La glucemia en el paciente critico debe datar de un indice comprendido entre 140-180 mg/dl, lo que se considera un control moderado.

Background The European Higher Education Area places students at the centre of the teacher-guided learning process and requires them to participate more in their education and to be responsible for acquiring the professional competences relevant to their career. Self-directed learning is a key means for developing the skills necessary for professional careers. Objective To measure self-directed learning readiness in health science undergraduates. Method Observational descriptive cross-sectional study of a convenience sample drawn from the total health science (medicine, nursing, physiotherapy and psychology) undergraduate population (n = 1699) at the University of Girona (Spain). The data collection instrument was a self-directed learning readiness scale with 38 items administered to the 1134 undergraduates who agreed to participate. Results Just over three quarters of the sample (n = 865; 76.27%) completed the full questionnaire. Self-directed learning readiness was indicated by an overall mean (standard deviation) score of 143.65 (11.76) points. Nursing undergraduates obtained the highest mean (SD) score – 145.08 (14.13) – in the overall scale. Associations were observed between degree course and self-directed learning readiness in the learning planning, desire for learning, self-confidence, self-management and self-evaluation subscales. Women scored better than men (p Conclusion The sampled students exhibited good self-directed learning readiness. Training students in self-directed learning skills is a necessary part of the teaching-learning process. This kind of training in universities needs to be reinforced to develop learning autonomy, promote lifelong learning and prepare competent future health professionals.

Through the construct "The sense of coherence" (SOC), the salutogenic model explains why people subjected to stressors are able to maintain good health. The SOC was defined by Antonovsky as a global orientation that expresses the extent to which a person has a highly internalized, permanent - but at the same time dynamic - feeling of confidence; this feeling of confidence is predictable and leads to a high probability that events will turn out well. The present article reviews the literature on the SOC in the nursing profession. The results show that the SOC is a protective factor against stressors in the work environment and in the work-life balance. Low SOC levels are associated with health problems such as burnout or depression, as well as certain personality traits.

Background Adapting university programmes to European Higher Education Area criteria has required substantial changes in curricula and teaching methodologies. Reflective learning (RL) has attracted growing interest and occupies an important place in the scientific literature on theoretical and methodological aspects of university instruction. However, fewer studies have focused on evaluating the RL methodology from the point of view of nursing students. Objectives To assess nursing students' perceptions of the usefulness and challenges of RL methodology. Design Mixed method design, using a cross-sectional questionnaire and focus group discussion. Methods The research was conducted via self-reported reflective learning questionnaire complemented by focus group discussion. Results Students provided a positive overall evaluation of RL, highlighting the method's capacity to help them better understand themselves, engage in self-reflection about the learning process, optimize their strengths and discover additional training needs, along with searching for continuous improvement. Nonetheless, RL does not help them as much to plan their learning or identify areas of weakness or needed improvement in knowledge, skills and attitudes. Among the difficulties or challenges, students reported low motivation and lack of familiarity with this type of learning, along with concerns about the privacy of their reflective journals and about the grading criteria. Conclusions In general, students evaluated RL positively. The results suggest areas of needed improvement related to unfamiliarity with the methodology, ethical aspects of developing a reflective journal and the need for clear evaluation criteria.

Peripheral catheterization is a technique that can be difficult in some patients. Some studies have recently described the use of ultrasound to guide the venous catheterization.To describe the success rate, time required, complications of ultrasound-guided peripheral venous catheterization. and patients and professionals satisfactionThe search was performed in databases (Medline-PubMed, Cochrane Library, CINAHL and Cuiden Plus) for studies published about ultrasound-guided peripheral venous catheterization performed on patients that provided results on the success of the technique, complications, time used, patient satisfaction and the type of professional who performed the technique.A total of 21 studies were included. Most of them get a higher success rate 80% in the catheterization ecoguide and time it is not higher than the traditional technique. The Technical complications analyzed were arterial puncture rates and lower nerve 10%. In all studies measuring and comparing patient satisfaction in the art ecoguide is greater. Various professional groups perform the technique.The use of ultrasound for peripheral pipes has a high success rate, complications are rare and the time used is similar to that of the traditional technique. The technique of inserting catheters through ultrasound may be learned by any professional group performing venipuncture. Finally, it gets underscores the high patient satisfaction with the use of this technique.

Nursing students begin to complete practicum experiences during their first year, increasing the number of applied credits as they progress toward degree completion. This contributes to integrating knowledge and skills from all of their courses and to obtaining the basic competencies of the nursing profession. It is also essential to identify the student’s sources of stress in order to provide strategies to confront them and diminish the potential consequences. Therefore, it is a priority to ascertain the perception of stress and the stressors. This study applied both quantitative and quality methods to achieve its objectives: to analyze the perception of stress and the stress-generating factors faced by third- and fourth-year nursing students during the mental health practicum, and to determine satisfaction with the new mental health practicum in a student survey and in a focus group of mentor nurses. Study results identified four major stress factors before students began the practicum: the difficulty of providing nursing care for the patient with a mental disorder, knowing how to react in an unfamiliar situation, lack of knowledge about mental health services, and the possibility of patient aggression. Only the latter remained as a stressor after the practicum was completed. Student satisfaction with the mental health practicum was highly positive. Mentor nurses were particularly satisfied with the changes in student follow-up and evaluation, emphasizing the importance of reflective practice and students’ self-management of their learning experience as set out by the European Higher Education Area.

Through the construct "The sense of coherence" (SOC), the salutogenic model explains why people subjected to stressors are able to maintain good health. The SOC was defined by Antonovsky as a global orientation that expresses the extent to which a person has a highly internalized, permanent - but at the same time dynamic - feeling of confidence; this feeling of confidence is predictable and leads to a high probability that events will turn out well. The present article reviews the literature on the SOC in the nursing profession. The results show that the SOC is a protective factor against stressors in the work environment and in the work-life balance. Low SOC levels are associated with health problems such as burnout or depression, as well as certain personality traits.

Cerebral injuries as a result of craniocerebral trauma are the most frequent cause of death in traffic collisions involving two-wheeled vehicles. In spite of the proven effectiveness of the use of the head protective devices to prevent injuries in the event of traffic collisions, some teenagers and youngsters do not use it. The main goal of this research is to identify the best predictors of helmet use among adolescents.Transversal study of a population of 874 young students of Secondary Education during the academic year 2005-06. The population object of study were students of 3rd and 4th year of the 6 public secondary schools of Gerona and only those present in class in the day of the data capture participated in the study. The participation was 74.6%. The data capture was carried out by means of a self-devised survey. An analysis of hierarchical logistical regression was also carried out.Predictable variables of helmet use in motorcycle drivers: age (OR=0.56), safety as main reason for its use (OR=0.02), possession of driving license (OR=0.17), peer influence (OR=0.23) and family influence (OR=0.17). In passengers: age (OR=0.46), peer influence (OR=0.35) and safety as main reason for its use (OR=0.38).The variables that predict the use of the helmet in the motorcycles users are: age, being in possession of the license to drive motorcycles, wearing the helmet as a safety device and social reinforcement (friends and family).

The COVID-19 pandemic has had an important impact on the academic world. Bearing in mind that university studies already have an influence on the mental health of students, and especially those studying health sciences, we proposed this study with the aim of analysing whether the pandemic has affected the mental well-being of final-year nursing students. This was a multi-centre study, with a descriptive, longitudinal and prospective design. Mental well-being was evaluated using the General Health Questionnaire. We also examined whether the subjects had experienced the pandemic and included several sociodemographic, academic and health-related variables. A total of 305 participants were included in the study, of whom 52.1% had experienced the COVID-19 pandemic. Statistically significant differences were found between the two groups studied, in terms of their age, how they had entered university, their average mark, and their mental well-being, self-esteem, emotional exhaustion and sense of coherence. In the case of their mental well-being, a direct association was found with the pandemic situation (OR=2.32, p=0.010) and the emotional exhaustion scores (OR=1.20, p