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Background: Obstetric violence is a problem that has grown worldwide, and a particularly worrying one in Spain. Such violence has repercussions for women, and for the professionals who cause them. Preventing this problem seems fundamental. Objective: This study evaluated how health sciences students perceived obstetric violence. Design: A cross-sectional study conducted between October 2019 and November 2020. Participants: A sample of Spanish health sciences students studying degrees of nursing, medicine, midwifery, and psychology. Methods: A validated questionnaire was used: Perception of Obstetric Violence in Students (PercOV-S). Socio-demographic and control variables were included. A descriptive and comparative multivariate analysis was performed with the obtained data. Results: 540 questionnaires were completed with an overall mean score of 3.83 points (SD +/- 0.63), with 2.83 points (SD +/- 0.91) on the protocolised-visible dimension and 4.15 points (SD +/- 0.67) on the non-protocolised-invisible obstetric violence dimension. Statistically significant differences were obtained for degree studied (p < 0.001), gender (p < 0.001), experience (p < 0.001), ethnic group (p < 0.001), the obstetric violence concept (p < 0.001) and academic year (p < 0.005). There were three significant multivariate models for the questionnaire's overall score and dimensions. Conclusions: Health sciences students perceived obstetric violence mainly as non-pmtocolised aspects while attending women. Degree studied and academic year might be related to perceived obstetric violence.

Background: Competence evaluations in the clinical setting represent approximately 50% of the nurse training process. Factors, such as perceived learning environment and clinical nurse participation, may influence nursing student satisfaction during clinical placements. Objective: To evaluate the relationship between the levels of nursing student satisfaction with clinical placements, the clinical learning environment, and the level of nurse tutor participation. Design: A cross-sectional study. Setting and participants: We included 61 nursing students and 45 clinical nurses from 35 primary care centres assigned to the Universitat Jaume I. Variables and data collection: We assessed the overall level of student satisfaction with clinical placements, students' perception of the learning environment, tutors' level of participation, and socio-demographic variables. Data analysis: We performed a descriptive analysis of the study sample, as well as correlation and simple linear regression analyses. Questionnaire results were analysed depending on the nature of the variables. Results: The students' perception of the learning environment was 4.39 +/- 0.48 points out of 5. The overall satisfaction level was 8.89 +/- 1.22 points out of 10. Tutor participation level in students learning was 3.91 +/- 0.58 points out of 5. Conclusions: Both student perception of the learning environment in the clinical setting and their overall level of satisfaction with clinical placements in the primary care centres were considered high. Tutors were participative, but poorly satisfied.

Background: COVID-19 challenges world governments. In Spain, measures to contain the pandemic are novel, and include the possibility of contracting Nursing and Medical students who might not be ready or willing to treat infected cases. Objectives: To study Spanish Nursing and Medical students' knowledge about COVID-19 community transmission prevention measures, treating infected patients, and their confidence and willingness to treat cases. To learn their views about the first public health policy measures adopted by the Spain government to contain the pandemic. Design: Cross-sectional study. Settings and participants: 237 Spanish Nursing and Medical students. Methods: An online questionnaire was designed on the knowledge, confidence and willingness to treat, and the suitability of the public health policy measures adopted in Spain. The data were collected through social networks. The results were compared according to their university degree. Results: Knowledge about community prevention was suitable, unlike knowledge about treating infected patients. Students had little confidence in treating cases, but their willingness and moral responsibility were high. Very few significant differences were found in their university degrees. Medical students evaluated the measures taken in Spain more favorably. Conclusions: Students' knowledge about COVID-19 community prevention measures was adequate, but not about preventive measures when treating patients with COVID-19. They felt little confidence despite being willing to treat infected patients. The sample agreed with the public health measures adopted in Spain.

Background There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain). Design Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016. Methods First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety. Results Exploratory factorial analysis explained 53.82 % of the variance, with good internal consistency (alpha = 0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (chi 2 = 366; p < 0.001; chi 2/df = 1.886; RMSEA = 0.07; IC95 %=0.059-0.081; CFI = 0.885). Intra-observer reliability was good (ICC = 0.792, p < 0.001). The mean overall score of the questionnaire was 3.92 (95 % CI = 3.88-4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p = 0.012) and the academic year (p = 0.25). Conclusions The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Background: Mobile applications related to health issues are currently expanding. Different uses of new technologies have produced positive results regarding breastfeeding support. Breastfeeding applications are increasing. Objective: We conducted a descriptive analysis of a mobile application for breastfeeding (LactApp) to study the user profile and the most frequent queries. Materials and Methods: This was a retrospective, comparative, and descriptive ecological time-series study of LactApp from 2016 to 2019. Google Analytics and the app itself were used for data collection. The data were analyzed in Excel, and for the time series, Prais-Winsten autoregressions were applied based on the Durbin-Watson method in Stata. Results: A total of 115,830 users and 71,780 infants were registered in the application. A total of 1.91% of these users obtained the medical version. The application was used for both queries and surveys and for users to interact through chat. A total of 30.17% of the responses were related with "baby's sleep" (8.94%), 8.91% were related to "preservation of milk," 6.16% were related to "breastfeeding crisis," and 6.15% were related to "physiological evolution of breastfeeding," all with an increasing trend. Conclusion: LactApp is a resource for breastfeeding that is widely downloaded and used by a substantial number of individuals. The most recurring topics were baby's sleep, milk extraction and preservation, breastfeeding crisis and physiological evolution of breastfeeding.

Background: Exclusive breastfeeding is one of the main health and infant survival elements. To start and maintain breastfeeding, health professionals must receive culturally sensitive evidence-based breastfeeding training to offer future mothers the required information and support. While studying the nursing degree, acquiring the necessary knowledge and skills to successfully perform this work is essential. Objective: Study the level of nursing students' breastfeeding knowledge at three Spanish public universities; explore which variables are related to acquire this knowledge. Design: An observational, descriptive, cross-sectional multicentre study. Methods: Participants were the students registered for the 4 nursing degree years at the three participating universities (N = 1540). They were asked about their breastfeeding knowledge with the self-administered AprendeLact Questionnaire; breastfeeding-related socio-demographic variables were included. Results: The overall mean score of the 684 returned questionnaires was 4.659 (+/- 2.377) out of 10. The year-4 students from the Castell & acute;on university obtained significantly higher mean scores and had been on practicals in maternity or neonatology units, belonged to breastfeeding associations and were artificially fed as infants. University belonged to, current academic year and placements in maternity or neonatology units were relevant factors for acquiring breastfeeding knowledge. Conclusions: Syllabi based on progressive transversal learning, and participating in real maternity-related health settings, could be facilitating strategies to acquire a suitable level of breastfeeding knowledge.

The interaction between nurses and their managers is a very important factor in nurses' error reporting behaviour, which is crucial to improving patient safety in healthcare organizations. However, little theoretical work has been undertaken to analyse this interaction. This paper uses a game-theoretic principal-agent framework with asymmetric information to study this interaction. We suppose that the principal (the nurse manager) asks the agent (the nurse) to perform a task with a certain patient. In case a mistake is made while treating the patient, the nurse has to decide whether to report it to the manager, who can observe whether the patient suffered an accident. We consider different manager's leadership styles and analyse their performance in obtaining error notification from nurses in this framework.

Background: Breastfeeding is the best source of food that a mother can offer her child during the first months of life because it provides numerous benefits for both mother and baby. Despite breastfeeding being an innate act, it requires qualified health professionals for advice and support. Objectives and participants: To design and validate a questionnaire to evaluate nursing student breastfeeding knowledge. Methods and design: Cross-sectional study. Construction and validation of the questionnaire (content validity, test-retest reliability and internal consistency). Descriptive and bivariate analyses of socio-demographic variables and the questionnaire results. Results: Optimum results were obtained in terms of internal consistency (KR-20 = 0.9) and test-retest reliability (ICC = 0.925) with a samples of 144 participants (mean age of 22.69 years). Statistical significance were observed among the questionnaire score and academic year, clinical practice, type of breastfeeding in childhood, knowing about support groups and participating in a breastfeeding workshop or course. Conclusion: A questionnaire on breastfeeding knowledge was validated. Nursing students progressively acquire breastfeeding skills as they advance in their undergraduate studies.

Background: Despite scientific recommendations for exclusive breastfeeding until 6 months of age and complementary breastfeeding to 2 years of age, breastfeeding abandonment rates increase with time, and one of the main reasons is that women go back to work. Aim: To analyze the perception of support of breastfeeding workers to continue breastfeeding at two Spanish universities, and associated factors. Methods: A multicenter retrospective cross-sectional comparative study conducted in a population of 777 female workers at the Universidad de Sevilla (US) and the Universitat Jaume I (UJI) in Spain using an online questionnaire. Results: The response rate was 38.74% (n= 301). Of all the participants, 57.8% continued breastfeeding after returning to work. The factors associated with continuing breastfeeding for longer were the university having a breastfeeding support policy and special accommodation (p< 0.001); participating in breastfeeding support groups (p< 0.001); intending to continue breastfeeding after returning to work (p< 0.001); knowing the occupational legislation in force (p= 0.009); having a female supervisor (p= 0.04). Conclusion: Breastfeeding support initiatives and having special accommodation to pump and preserve breast milk after returning to work are associated with a longer duration of female workers' breastfeeding.

Introduction: One of the factors to influence abandoning breastfeeding is mothers' use of medications. The www.e-lactancia.org website is a reliable source in Spanish and English for online free-access information about the compatibility of medications with breastfeeding. The aim of this study was to analyse the search profiles, and groups and products, searched the most on this website. Materials and methods: A retrospective and descriptive study of the e-lactancia.org website during 2014-2018. Google Analytics was used for data collection. The following variables were analysed: number of users and queries; professional profile; country; language; users' and groups' access modes/devices; most searched products. Results: We found 16,821.559 users and 63,783.866 pages. Of users, 62.7 % were "mother/father", and 31.9 % were health professionals. Visits came mostly from: Spain (25.86 %); Mexico (16.87 %); Argentina (7.99 %); Chile (7.31 %). The preferred access mode and device were organic searches (62.1 %) and mobile phones (73.4 %), respectively. Phytotherapy (14.4 %), antibacterial agents (12.3 %) and NSAIDs (12.3 %) were the most searched groups, and ibuprofen (6.25 %) was the most popular product. Conclusion: Users and consultations in e-lactation increased significantly during the study period. Mothers/fathers were the main website users, followed by health professionals. The main consulted groups were antibacterial agents, NSAIDs and systemic phytotherapy. Ibuprofen, paracetamol and amoxicillin stood out as the most consulted products. These results revealed increase Internet resources use to solve parents and health professionals' breastfeeding doubts. Future research should study how users (parents, health professionals) interact with this information.

Background: Academic motivation guides students toward the achievement of academic objectives and influences their learning. However, there is little research on this subject in nursing education, and validated instruments are not available in Latin America. Objective: To determine the validity and reliability of the Academic Goals Orientation Questionnaire in Colombian nursing students. Design: Cross-sectional psychometric study developed in the second semester of 2016. Settings and participants. Undergraduate students in nursing at the National University of Colombia (n = 323). Methods: The Academic Goals Orientation Questionnaire was administered electronically. In addition, the variables of age, sex and academic year were collected. An analysis of construct validity was carried out by exploratory and confirmatory factor analysis. The reliability of the questionnaire was studied with Cronbach's alpha. Results: The exploratory factor analysis revealed the presence of four factors that explain 53.4% of the total variance and that correspond to the dimensions of the original instrument. The overall reliability was alpha = 0.714. The confirmatory factor analysis verified a good fit of the model (chi(2) = 128, p = .024); its standardized mean square residue (SRMR) was 0.0471; the root mean square error of approximation (RMSEA) was 0.03 (IC95% = 0.011-0.044), and the comparative fit index (CFI) was 0.972. The learning or task goal obtained the highest average score (m = 4.67, 95% CI = 4.629-4.712), and the Work avoidance goal was the worst rated (m = 2.126, 95% CI = 2.055-2.198) by the students. Conclusion: The Academic Goal Orientation Questionnaire has an adequate validity and reliability in the Colombian context that allows it to be applied in nursing students. However, it is recommended to expand the study with larger samples and other countries in the same context.

Background: Academic burnout appears attributable to work and academic overload and may negatively affect learning and care quality during clinical clerkship. Objectives: To evaluate the presence of burnout syndrome in nursing students and to detect the main stressors that occur during clinical clerkship. Design: Observational, descriptive and cross-sectional study carried out between January and July 2017. Settings and participants: Second-, third- and fourth-year nursing students at Jaume I University (Universitat Jaume I) (Spain) (n = 126). Methods: The KEZKAK questionnaire and the Maslach Burnout Inventory Student Survey were used when carrying out the data collection; sociodemographic and clinical clerkship variables were also collected. Descriptive and bivariate analyses of these instruments' variables were performed. Results: No student manifested high levels of depersonalisation or low personal accomplishment. Moreover, depersonalisation was found to increase as the academic year progressed (p = 0.027). The most stressful factors were Helplessness and Uncertainty (m = 3.61, sd = 0.345) and Confusion of Medication (m = 2.50, sd = 0.754). The female subsample showed higher stress levels due to multiple factors, such as Lack of Competence (p = 0.001) and Having to Give Bad News (p = 0.01). Conclusion: This study found that its sample did not meet the criteria indicating the presence of burnout syndrome. In addition, the main stressors affecting nursing students during clinical clerkship were identified.

Objective: To evaluate the level of participation of clinical nurses from Castellon where Universitat Jaumei nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses' participation in students' clinical mentorship. Method: This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014. Results: The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: +/- 18.692; interquartile range 95%: 119.415-126.26). The variable "previous training for mentorship students" was statistically significant in the overall score and for all dimensions (P

Objective: To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students. Design: A cross-sectional analytical study using a validated questionnaire between February and June 2014. Setting and Participants: A consecutive sample of 117 nurses who worked in public health centres in the province of Castellon (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were < 50% complete were excluded. Methods: A descriptive analysis of the sample and an association analysis between variables were performed. The questionnaire and its dimensions were performed with a logistic regression and the maximum likelihood method, which used a complementary log-log link method. The concordance index was calculated using contingency tables. Results: The mean age was 42.56 years, and the overall mean questionnaire score was 122.84 (SD = 18.69; 95% CI: 119.415-126.26). Across the sample, 58.1% (n = 68) of the nurses obtained an Excellent score, followed by Adequate in 41% (n = 48). Overall, the predictive variables were age, mentoring of students in the last 5 years and previous training to mentor students. Conclusion: The main predictive variable for greater participation in the mentorship of students was previous training in mentoring. This study also reflected on other variables that could influence nurses' participation in student mentoring.

Background: Writing a bachelor thesis (BT) is the last step to obtain a nursing degree. In order to perform an effective assessment of a nursing BT, certain reliable and valid tools are required. Objectives: To develop and validate a 3-rubric system (drafting process, dissertation, and viva) to assess final year nursing students' BT. Design: A multi-disciplinary study of content validity and psychometric properties. The study was carried out between December 2014 and July 2015. Settings: Nursing Degree at Universitat Jaume I. Spain. Participants: Eleven experts (9 nursing professors and 2 education professors from 6 different universities) took part in the development and content validity stages. Fifty-two theses presented during the 2014-2015 academic year were included by consecutive sampling of cases in order to study the psychometric properties. Methods: First, a group of experts was created to validate the content of the assessment system based on three rubrics (drafting process, dissertation, and viva). Subsequently, a reliability and validity study of the rubrics was carried out on the 52 theses presented during the 2014-2015 academic year. Results: The BT drafting process rubric has 8 criteria (S-CVI = 0.93; alpha= 0.837; ICC = 0.614); the dissertation rubric has 7 criteria (S-CVI = 0.9; alpha= 0.893; ICC = 0.74), and the viva rubric has 4 criteria (S-CVI = 0.86; alpha= 8.16; ICC = 0.895). Conclusion: A nursing BT assessment system based on three rubrics (drafting process, dissertation, and viva) has been validated. This system may be transferred to other nursing degrees or degrees from other academic areas. It is necessary to continue with the validation process taking into account factors that may affect the results obtained. (C) 2015 Elsevier Ltd. All rights reserved.

Objective: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. Method: prospective longitudinal study conducted in a population of 60 second-year Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. Results: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p