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Objective: To establish the construct validity of the Spanish version of the BARRIERS scale. Method: Methodological study of validation of a measurement instrument based on data from previously published studies. The study population consisted of nurses from the Basque Health Service and the Canary Health Service. The following variables were extracted and unified: Years of professional experience, possession of a specialist nursing degree, possession of a doctorate, type of activity performed by the professional and field of work. For construct validation, a confirmatory factor analysis (CFA) was performed based on the initial model proposed for the scale and RASCH analysis. A polychoric correlation matrix, factor extraction by unweighted least squares and PROMIN oblique rotation were used. For the RASCH analysis, the Joint Maximun Likelihood estimation (JMLE) method was used; the fit of the items and persons were estimated by means of outfit - Unweighted Mean Square fit statistic (UMS) and infit -Weighted Mean Square Fit Statistic (WMS), as well as the reliability and separation of items and persons. Results: A total of 1200 nurses and midwives made up the final validation sample (n = 1200), with a mean professional experience of 21.22 ± 9.26 years. The CFA presented a good fit to the data (KMO = 0.935 [95%CI:0.921-0.945]), changing the factorial assignment in 6 items, while 5 items received factorial scores in more than one factor. The fit values for the 4-factor solution were RMSEA = 0.026 [95% CI:0.026-0.027] and GFI = 0.991 [95% CI = 0.986-0.991]. In the RASCH analysis most items presented infit-WMS and outfit-UMS values with a good fit. Conclusions: The Spanish version of the BARRIERS scale has adequate construct validity although there are changes in the assignment of items to the dimensions compared to the original model. The RASCH analysis indicates adequate fit for both persons and items., Objetivo: Establecer la validez de constructo de la versión española de la escala BARRIERS. Método: Estudio metodológico de validación de un instrumento de medida a partir de los datos de estudios previamente publicados. La población a estudio estuvo conformada por enfermeras del Servicio Vasco de Salud y del Servicio Canario de la Salud. Se extrajeron y unificaron las variables: Años de experiencia profesional, tenencia de la titulación de enfermera especialista, posesión del doctorado, tipo de actividad que desempeñaba el profesional y ámbito de trabajo. Para la validación de constructo se realizó un análisis factorial confirmatorio (AFC) en base al modelo inicial propuesto para la escala y análisis RASCH. Se usó una matriz de correlaciones de tipo policórico, extracción de factores por mínimos cuadrados no ponderados y rotación oblicua PROMIN. Para el análisis RASCH se usó el método de Joint Maximun Likelihood estimation (JMLE); el ajuste de los Ítems y las personas se estimaron mediante outfit - Unweighted Mean Square fit statistic (UMS) e infit -Weighted Mean Square Fit Statistic (WMS), así como la fiabilidad y separación de ítems y personas. Resultados: Un total de 1.200 enfermeras y matronas conformaron la muestra final de validación (n = 1200), con una media de experiencia profesional de 21,22 ± 9,26 años. El AFC presentó buena adecuación de los datos (KMO = 0,935 [IC95%:0,921-0,945]), modificando la asignación factorial en 6 ítems, mientras que 5 ítems recibieron cargas factoriales en más de un factor. Los valores de ajuste para la solución de 4 factores fueron RMSEA = 0,026 [IC95%:0,026-0,027] y GFI = 0,991 [IC95% = 0,986-0,991]. En el análisis RASCH la mayoría de ítems presentaron valores infit-WMS y outfit-UMS con un buen ajuste. Conclusiones: La versión española de la escala BARRIERS posee una adecuada validez de constructo, aunque existen cambios en la asignación de ítems a las dimensiones en comparación al modelo original. El análisis RASCH indica ade

Objetivo: Establecer la validez de constructo de la versión española de la escala The BARRIERS to Research Utilization Scale (BARRIERS). Método: Estudio metodológico de validación de un instrumento de medida a partir de los datos de estudios previamente publicados. La población a analizar estuvo conformada por enfermeras del Servicio Vasco de Salud y del Servicio Canario de la Salud. Se extrajeron y unificaron las variables: años de experiencia profesional, tenencia de la titulación de enfermera especialista, posesión del doctorado, tipo de actividad que desempeñaba el profesional y ámbito de trabajo. Para la validación de constructo se realizó un análisis factorial confirmatorio (AFC) con base en el modelo inicial propuesto para la escala y el análisis Rasch. Se usó una matriz de correlaciones de tipo policórico, la extracción de factores por mínimos cuadrados no ponderados y rotación oblicua PROMIN. Para el análisis Rasch se empleó el método de Joint Maximun Likelihood estimation (JMLE); el ajuste de los ítems y las personas se estimaron mediante outfit - Unweighted Mean Square fit statistic (UMS) e infit -Weighted Mean Square Fit Statistic (WMS), así como la fiabilidad y la separación de ítems y personas. Resultados: Un total de 1.200 enfermeras y matronas conformaron la muestra final de validación (n = 1.200), con una media de experiencia profesional de 21,22 ± 9,26 años. El AFC presentó una buena adecuación de los datos (índice de Kaiser Meyer Olkin [KMO] = 0,935 [intervalo de confianza {IC} 95%: 0,921-0,945]), modificando la asignación factorial en seis ítems, mientras que cinco recibieron cargas factoriales en más de un factor. Los valores de ajuste para la solución de cuatro factores fueron Root Mean Square Error of Approximation (RMSEA) = 0,026 (IC 95%: 0,026-0,027) y Goodness of Fit Index (GFI) = 0,991 (IC 95%: 0,986-0,991). En el análisis Rasch la mayoría de los ítems presentaron valores infit-WMS y outfit-UMS con un buen ajuste. Conclusiones: La versión, Objective: To establish the construct validity of the Spanish version of the BARRIERS scale. Method: Methodological study of validation of a measurement instrument based on data from previously published studies. The study population consisted of nurses from the Basque Health Service and the Canary Health Service. The following variables were extracted and unified: Years of professional experience, possession of a specialist nursing degree, possession of a doctorate, type of activity performed by the professional and field of work. For construct validation, a confirmatory factor analysis (CFA) was performed based on the initial model proposed for the scale and Rasch analysis. A polychoric correlation matrix, factor extraction by unweighted least squares and PROMIN oblique rotation were used. For the Rasch analysis, the Joint Maximun Likelihood estimation (JMLE) method was used; the fit of the items and persons were estimated by means of outfit - Unweighted Mean Square fit statistic (UMS) and infit -Weighted Mean Square Fit Statistic (WMS), as well as the reliability and separation of items and persons. Results: A total of 1200 nurses and midwives made up the final validation sample (n = 1200), with a mean professional experience of 21.22 ± 9.26 years. The CFA presented a good fit to the data (KMO = 0.935 [95% CI:0.921-0.945]), changing the factorial assignment in 6 items, while 5 items received factorial scores in more than one factor. The fit values for the 4-factor solution were RMSEA = 0.026 [95% CI:0.026-0.027] and GFI = 0.991 [95% CI = 0.986-0.991]. In the Rasch analysis most items presented infit-WMS and outfit-UMS values with a good fit. Conclusions: The Spanish version of the BARRIERS scale has adequate construct validity although there are changes in the assignment of items to the dimensions compared to the original model. The Rasch analysis indicates adequate fit for both persons and items.

Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms “Education, Nursing” and “Educational Technology”, and the free term “Escape room”, combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area.

Midwifery empowerment is an important topic. The most widely used instrument to measure the perceived empowerment of midwives is the Perceptions of Empowerment in Midwifery Scale (PEMS), which has not been validated in Spain. The aim of this study was to translate and adapt the PEMS to the Spanish context. This research was carried out in two phases; Phase 1: Methodological study; translation, backtranslation and cross-cultural adaptation of the PEMS and pilot study on the target population (10 midwives) for evaluation of face validity. Phase 2: Cross-sectional observational study to obtain a sample for construct validation by Exploratory Factor Analysis and measurement of PEMS-e reliability. Additionally, an inferential analysis was carried out to study the possible association between several collected variables and PEMS-e subscale-scores. A total of 410 midwives from 18 Spanish regions participated in the study through an online questionnaire. An initial Spanish version of the PEMS scale was produced, demonstrating adequate face validity. A final model was produced for the PEMS-e, which included 17 items classified into two subscales (“Organizational support” and “Own skills and teamwork”) with fit indexes RMSEA = 0.062 (95%CI: 0.048–0.065) and AGFI = 0.985 (95%CI: 0.983–0.989) and Cronbach’s alpha 0.922 for the total scale. Results showed that one in four midwives had considered abandoning the profession in the last 6 months (p ≤ 0.001). This research suggests that Spanish midwives perceive their empowerment level as low. The PEMS-e is a valid tool with solid psychometric properties that can be used in future research to identify factors that contribute to increased empowerment among Spanish midwives and inform strategies to improve job satisfaction and retention in the profession.

Obstetric violence refers to dehumanized or derogative treatment of women in their pregnancy, childbirth or postpartum periods and may be manifested in different ways. Currently, there is no tool validated in Spain to measure women’s perception of obstetric violence. The objective of this study was to carry out the cultural adaptation and validation of an existing 14-item obstetric violence scale in the Spanish context and to evaluate its psychometric properties. The research was conducted in two phases: first, a methodological study designed to evaluate content validity, through assessments by eight experts (calculating the Aiken V coefficient) and face validity in a sample of 20 women; second, a cross-sectional study to evaluate construct validity (through confirmatory factor analysis and Rasch analysis), divergent validity against a scale of birth satisfaction, known-groups validity and, finally, reliability. In Phase 1, Aiken V values higher than 0.71 were obtained for all items. Phase 2 was conducted on a sample of 256 women and the fit values for the unidimensional model were RMSEA: 0.070 (95% CI: 0.059–0.105) and GFI: 0.982 (95% CI: 0.823–0.990). The Rasch analysis indicated poor performance of item 2, which was removed. The Omega and Cronbach’s Alpha coefficients were 0.863 and 0.860, respectively. A final 13-item version of the Obstetric Violence Scale was produced, with a total score ranging from 0 (no obstetric violence perception) to 52 (maximum obstetric violence perception). The Obstetric Violence Scale is a reliable and useful tool to measure women’s perception of obstetric violence. This study was not registered.

Aim: The aim of this study was to determine the prevalence of feelings of being a second victim among midwives and obstetricians in Spain and to explore possible differences between the two professions. Design: Cross-sectional descriptive-analytical observational study. Methods: An online survey collecting several variables was administered throughout the Spanish territory. Spanish version of the Second Victim Experience and Support Tool (SVEST) was used. The data collection period was from May to December 2020. Results: A total sample of 719 obstetricians and midwives were studied. There were significant differences between the two groups with respect to seven dimensions of SVEST: greater feelings of being a second victim among obstetricians in the dimensions physical distress/p ≤ .001, non-work-related support/p ≤ .001 and absenteeism/p ≤ .001 and greater feelings of being a second victim among midwives in the dimensions psychological distress/p ≤ .001, supervisor support/p = .011, professional self-efficacy/p ≤ .001 and intention to change jobs/p ≤ .001.

The fear of childbirth is a topical concern, yet the issue has barely been studied in Spain, and only one fear of childbirth measurement instrument has been validated in the country. The aim of this study was to translate, adapt and validate the Fear of Childbirth Questionnaire (CFQ) for use in Spain, as well as to describe and evaluate the psychometric properties of the Spanish version of this instrument. In a first phase, a methodological study was carried out (translation–backtranslation and cross-cultural adaptation), and pilot study was carried out in the target population. In addition, content validation of the instrument was obtained (CFQ-e) from 10 experts. In the second phase, a cross-sectional study was carried out at several centres in Gran Canaria Island to obtain a validation sample. The evaluation of the psychometric properties of the CFQ-e, including construct validity through exploratory factor analysis and confirmatory factor analysis, the calculation of reliability via factor consistency using the ORION coefficients as well as alpha and omega coefficients were carried out. The CFQ-e showed evidence of content validity, adequate construct validity and reliability. The CFQ-e is composed of 37 items distributed in four subscales or dimensions: “fear of medical interventions”; “fear of harm and dying”; “fear of pain” and “fears relating to sexual aspects and embarrassment”. The CFQ-e constitutes a valid and reliable tool to measure the fear of childbirth in the Spanish pregnant population.

Objectives: This study aimed to assess the validity and psychometric properties of the Spanish version of the Second Victim Experience and Support Tool (SVEST-E) questionnaire. Methods: This was a cross-sectional study aimed at midwives and obstetricians in Spain. An online survey was conducted consisting of 2 parts: the first part collected different variables, and the second part collected the SVEST-E. The temporal stability of the instrument was evaluated using the test-retest method. For the construct validity and reliability, an exploratory factor analysis and a confirmatory factor analysis were performed using FACTOR program v.10 with a polychoric correlation matrix. Results: A total of 689 professionals participated in the study (323 obstetrician physicians/366 midwives). The mean (SD) score on the SVEST-E for the total sample was 3.09 (0.50). The parallel analysis of the exploratory factor analysis suggested a 5-factor solution, with a total explained variability of 61.8%. The goodness-of-fit indices of the model were the following: root mean square error of approximation = 0.038 (95% confidence interval [CI], 0.031–0.042) and comparative fit index = 0.989 (95% CI, 0.988–0.992). The factor model obtained was confirmed by confirmatory factor analysis, obtaining the values of root mean square error of approximation = 0.038 (95% CI, 0.026–0.053) and comparative fit index = 0.989 (95% CI, 0.969–1.000). The intraclass correlation coefficient was 0.97 (95% CI, 0.94–0.99). Conclusions: The SVEST-E instrument maintains the same items as the original questionnaire but introduces changes in the organization of its dimensions. The Spanish version maintains adequate construct validity, reliability, and temporal stability, so it is a valid tool to evaluate the second victim experience in Spanish health professionals.

Objective: To determine the degree of satisfaction of women after childbirth at the Hospital Universitario Materno-Infantil of Gran Canaria (HUMIC) and to establish possible relationships between the degree of satisfaction and the variables studied. Method: A cross-sectional, descriptive, observational study with an analytical component. The study population comprised women who gave birth at the HUMIC in November 2018, recruited through consecutive non-probabilistic sampling. The Spanish version of the Childbirth Experience Questionnaire (CEQ-E) was used (questionnaire with 4 domains: own capacity’, professional support, perceived safety and participation/analytical model 2). In a first phase a descriptive analysis was made, and in a second phase an inferential analysis to explore the association between different variables. Results: The total sample comprised 257 women (n = 257). The total score using the CEQ was 3.24 (SD .37 points). No statistically significant differences were found in the final CEQ score between the women who had a spontaneous delivery versus induction-stimulation (p = .563) or between primiparous versus multiparous women (p = .060). The women whose labour lasted 12 h or less (p = .024), without perineal trauma (p = .021) and those who had not undergone episiotomy (p = .002) achieved a better final CEQ score. Instrumental delivery (forceps) versus normal delivery is associated with lower scores with respect to the final CEQ-E score (p ≤ .001). Conclusions: Women’s overall satisfaction after delivery in HUMIC was high. Instrumental delivery seems to be associated with lower perceived satisfaction. Aspects such as fear and fatigue in labour could affect satisfaction negatively. These aspects can be improved by establishing strategies to increase comfort and minimise pregnant women's fear of labour., Objetivo: Conocer el grado de satisfacción de las mujeres tras el parto en el Hospital Universitario Materno-Infantil de Gran Canaria (HUMIC) y establecer posibles relaciones entre el grado de satisfacción y las variables estudiadas. Método: Estudio observacional descriptivo de corte transversal con componente analítico. La población a estudio fueron las mujeres cuyo parto tuvo lugar en el mes de noviembre del 2018 en el HUMIC reclutadas mediante muestreo no probabilístico de tipo consecutivo. Se utilizó el cuestionario Childbirth Experience Questionnaire en su versión española (CEQ-E) (cuestionario con 4 dominios: capacidad propia, apoyo profesional, seguridad percibida y participación/modelo de análisis 2). En una primera fase se realizó un análisis descriptivo y en una segunda, un análisis inferencial para explorar la asociación entre diferentes variables. Resultados: La muestra total fue de 257 mujeres (n = 257). La puntuación total con el CEQ-E fue de 3,24 (DE 0,37 puntos). No se encontraron diferencias estadísticamente significativas en la puntuación final del CEQ-E entre las mujeres con parto espontáneo frente a inducciones-estimulaciones (p = 0,563) ni entre mujeres primíparas frente a multíparas (p = 0,060). Las mujeres cuyo parto había sido menor o igual a 12 h (p = 0,024), sin traumatismo perineal (p = 0,021) y aquellas a las que no se les ha realizado episiotomía (p = 0,002) obtuvieron mejor puntuación final en el CEQ-E. El parto instrumental (fórceps) frente al parto eutócico se asocia a puntuaciones menores respecto a la puntuación final en el CEQ-E (p ≤ 0,001). Conclusiones: La satisfacción global de la gestante tras el parto en el HUMIC es alta. El parto instrumental parece asociarse a menor satisfacción percibida. Aspectos como el miedo y el cansancio en el parto pueden influir negativamente en la satisfacción. Estos aspectos son susceptibles de mejora mediante el establecimiento de estrategias que ayuden a mayor bienestar y minimicen el miedo de la