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Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization. Sin financiación 2.663 JCR (2021) Q3, 69/109 Health Care Sciences & Services 0.752 SJR (2021) Q2, 760/2489 Medicine (miscellaneous) No data IDR 2021 UEM

Previous studies have observed a link between gender and well-being and health in young populations. The purpose of this research was twofold: (1) to analyse the cross-sectional relationship between gender status with well-being indicators and self-perceived health in adolescents at baseline and at 2-year follow-up and (2) to evaluate the prospective associations between gender at baseline and well-being indicators/self-perceived health assessed at 2-year follow-up. Well-being was measured using the KIDSCREEN-10 questionnaire (as a measure of health-related quality of life (HR-QoL)), the Children's Hope Scale and the Positive and Negative Affect Schedule. Health status of the adolescents was assessed using self-perceived health. Multilevel mixed-effects linear/logistic regression models were carried out to assess the associations between gender status and well-being and health of a sample of 1590 Spanish adolescents. Adolescent girls were shown to have lower HR-QoL scores and higher negative affect scores, and had a higher risk of reporting poor health than boys, in both cross-sectional and longitudinal analyses. Adolescent girls seem to be more vulnerable to poorer well-being and self-reported health than boys. When looking at hedonic and eudemonic well-being separately, longitudinal differential evolution of boys and girls seems to indicate greater deterioration of hedonic well-being among girls as compared to boys. Overall, gender may have a relevant impact on mental and physical health during adolescence. Ministerio de Ciencia e Innovación (DEP 2010-21662-C04-00) 7.521 Q1 JCR 2021 1.698 Q1 SJR 2021 No data IDR 2021 UEM

Background A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. Aim To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. Research design Qualitative study with a content analysis according to Elo and Kinglas framework. Participants and research context Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. Methodology The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. Ethical considerations Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. Findings Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. Conclusion All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.

Background and objective Several interventions have resulted in effectively reducing stress and anxiety in nursing students, however the efficacy of these interventions has only been investigated in the short term. This study had to objectives 1) to determine the effect of an intervention program to manage stress and anxiety in nursing students during clinical practices with two phases, phase I composed by cognitive behavioral therapy and progressive muscle relaxation and phase II or reinforcement phase with progressive muscle relaxation and 2) to determine the effect of phase I of the intervention program to manage stress and anxiety in nursing students during clinical practices. Design An experimental, analytical, longitudinal and prospective study. Methods Data were collected between April 2018 to June 2019 with 4 measurements of KEZKAK questionnaire and State-Trait Anxiety Inventory. An intervention program composed of cognitive behavioral therapy and progressive muscle relaxation was developed. The intervention program was divided in two phases, phase I and phase II or reinforcement phase. Fifty-nine nursing students from a Spanish university participated. A control group (n = 29), an intervention group one (n = 15) that received phase I and an intervention group 2 (n = 15) that received phase I and phase II or reinforcement phase were formed. Results After completing phase I, significant differences were found in the state of stress and anxiety between nursing students who received this phase and those who did not and after 3 months they continued to show differences. After phase II or reinforcement phase, the inter-groups did not present significant differences between them. The inter-group comparison of the stress and anxiety values at the end of the intervention program minus the initial values indicated that the CG presented significant differences with both intervention groups in the total of the KEZKAK and also with the IG1 in factors 3 (p = 0.030) and 4 (p = 0.027) and with the IG2 in factors 1 (p = 0.006) and 7 (p = 0.018). On the other hand, no differences were found between both intervention groups, IG1-IG2, in levels of stress and anxiety (p > 0.05) Conclusions The intervention program contributes to provide evidence on the effectiveness of cognitive behavioral therapy and progressive muscle relaxation for stress and anxiety management in nursing students during clinical practices. This study suggests that we should continue in this line of research to improve the available evidence.

Aim/Objective To describe and analyse the use of a station within an OSCE to assess interprofessional competence performance in undergraduate nursing students. The specific objectives were: - To measure the students' level of competence performance in relation to the interprofessional competences Roles and Responsibilities, Communication and Teamwork. - To determine inter-observer concordance in the assessment of the interprofessional competences. Background Teamwork competencies are key to improving patient safety and avoiding medical errors. Today, healthcare professionals work in interdisciplinary teams. To foster a culture of safety, some of the measures that can be taken at the individual, team and organisational levels include fostering clear communication among team members, knowledge of respective roles and functions, and deepening team functioning through respect and trust in judgement and capabilities. The World Health Organization recommends starting to develop these competencies in university studies, through interprofessional education. There are numerous programmes in universities all over the world, but more research is needed on the assessment of interprofessional education activities, preferably through objective methods. Competency performance can be assessed by an external evaluator, in a simulated environment, with the Objective Structured Clinical Examination, which is widely used in nursing. Design Cross-sectional study. Methods 63 second-year nursing undergraduate students completed an interprofessional competencies station within an 8-station OSCE. Communication, Roles and Responsibility and Teamwork competences were assessed. The Interprofessional Collaborator Assessment Rubric (ICAR) was used as a model to assess the performance of students. Inter-observer concordance analysis was performed using the kappa coefficient and the concordance rate. Results 92.1% of students reached a good level in communication competence, 88.9% in roles and responsibility competence, and 55.6% in teamwork competence. The global concordance rate was 83.8%, and the kappa coefficient was 0.67. Conclusions Most students have demonstrated interprofessional competence performance at a good level. However, the inter-observer concordance obtained for some of the items was not as expected. The assessment of interprofessional competencies, as it deals mainly with relational and communicative aspects, requires greater preparation both in terms of the specification of assessment items and in agreement between examiners.

BackgroundThe COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain.MethodThe sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of mental health (GHQ12) and well-being (Positive and Negative Affect Schedule) indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators.ResultsMental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and unemployed individuals. Positive affect was higher among women, people with a high level of studies, those not co-living with dependent seniors, the self-employed, the employed, and those working outside home. Negative affect was negatively associated with age and number of children and was higher among women, people with basic studies, singles, individuals co-living with dependent seniors, homemakers, and students.ConclusionThe most vulnerable populations were found to be women, younger people, people with basic or medium studies, students and individuals with no remunerated activities, single populations, and those co-living with dependent seniors as well as those with a reduced number of children.

Background Depression during pregnancy is a prevalent problem with significant potential health effects on women and children. The most widely used screening instrument is the Edinburgh Postnatal Depression Scale (EPDS). Two validations of the EDPS in Spanish have been published. Given the differences in cut-off point, sensibility and specificity among the Spanish EPDS validations, the aim of this study is to provide further information regarding the topic through a validation of the EPDS is Spain with a different sample.Methods Cross-sectional study. 194 women being followed up for normal pregnancy in Primary Healthcare in Spain completed the EPDS and had a semi-structured interview with a clinical psychologist using the DSM-5 manual criteria for diagnosing depression. The ROC curve was calculated to determine the optimal cut-off point, sensitivity and specificity.Results The age range of the participating pregnant women was from 18 to 42 years of age. The optimal cut-off point is 11/12, with a sensitivity of 93.33% and a specificity of 91.62%. The ROC curve has an area of 0.936. Discussion The cut-off point is slightly lower than that of the Spanish version validated in Chile. Likewise, compared to the version validated in Spain, the cut-off point is slightly higher. In our research, sensitivity is notably higher, and specificity slightly lower than in the Spanish version validated in Chile. Compared with the Spanish version validated in Spain, sensibility and specificity were notably higher in our research.Conclusions Given the differences in cut-off point, sensibility and specificity, we propose to continue searching for an optimal cut-off point in the Spanish version of the EPDS. In our opinion, further research is necessary in order to use the EPDS for antenatal depression screening in Spain. A multicentric study including pregnant women from all over the country would be suitable.

To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79–0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01–1.07; p = 0.022; OR = 1.30; 95%CI 1.08–1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied. Castile and León Health Authority (SACyL) - GRS 1287/B/16 2.500 JCR (2019) Q3, 78/155 Psychiatry 1.176 SJR (2019) Q1, 30/185 Obstetrics and Gynecology, 112/545 Psychiatry and Mental Health No data IDR 2019 UEM

Objectives: Previous research has postulated immigrant status as a relevant factor influencing eating disorder (ED) risk in adolescents. The present study assesses differences by sex in ED risk between Spanish native and immigrant adolescent populations residing in Spain and analyzes longitudinal differences in ED risk between immigrant and native adolescents over 2-year follow-up. Method: The study sample was 981 adolescents aged 11-19 years at baseline. ED risk was evaluated using the Spanish version of the SCOFF Questionnaire. Logistic regression was used to value associations between country of origin and ED risk prevalence by sex, as well as changes in ED risk at 2-year follow-up. Results: Immigrant adolescent girls and boys presented greater ED risk than their Spanish counterparts. Prospective analyses showed that immigrant boys presented greater likelihood of acquiring ED risk over 2 years compared to Spanish adolescent boys. Conclusion: Immigrant adolescent populations, particularly boys, seem to be vulnerable to ED. (PsycINFO Database Record (c) 2019 APA, all rights reserved). Spanish Government (DEP 2010-21662-C04-00) Universidad Autonoma de Madrid 2.147 JCR (2019) Q1, 4/20 Ethnic Studies 1.343 SJR (2019) Q1, 40/315 Social Psychology No data IDR 2019 UEM

Background Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. Methods A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. Results Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05–0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. Discussion The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding. Los beneficios de la lactancia materna en la salud de los niños, las madres y la sociedad son ampliamente conocidos. Sin embargo, las tasas de lactancia materna varían según la población estudiada. Las mujeres de origen chino que han inmigrado a países desarrollados muestran tasas muy bajas de lactancia materna. Los objetivos de la investigación son comparar las tasas de lactancia materna exclusiva tras el parto, al alta del hospital, entre mujeres de origen chino y de origen español, y evaluar la influencia de variables biológicas, socioeconómicas, relacionadas con el trabajo y culturales sobre las tasas de lactancia materna. Estudio descriptivo transversal con comparación entre grupos. Se incluyó a 73 puérperas (33 de origen chino y 40 españolas). La asociación entre lactancia materna y país de origen se evaluó utilizando regresión logística. Resultados: Las mujeres españolas mostraron una mayor prevalencia de lactancia materna exclusiva (80%) en comparación con las mujeres de origen chino (36,4%), ajustando por nivel socioeconómico, nivel educativo de los padres, edad de la madre, parto por cesárea y peso al nacer). Sin embargo, al construir otros modelos de regresión logística en los que se incluyó variables relacionadas con el trabajo de la madre, o la actitud respecto a la lactancia materna, las diferencias pasaban a ser no significativas. Discusión: Las variables clásicas biológicas y socioeconómicas no explican la diferencia en las tasas de lactancia materna entre mujeres de origen chino y españolas. Sin embargo, parece que esas diferencias están relacionadas con las condiciones laborales de las mujeres chinas (trabajan más mujeres, por cuenta propia, incorporándose antes al mundo laboral tras el parto...) y con aspectos culturales (actitud menos positiva hacia la lactancia materna). Sin financiación 2.239 JCR (2019) Q2, 33/82 Obstetrics & Gynecology 1.275 SJR (2019) Q1, 19/185 Obstetrics and Gynecology No data IDR 2019 UEM

IntroductionPregnant women who eat a balanced diet usually practice physical activity (PA) regularly; there are many studies on PA during pregnancy and the results for the mother and baby. However, the guideline for PA during pregnancy is very general and is not quantified. The primary objective of this study is to examine the nutritional habits and levels of PA of women during pregnancy and the postpartum period. Second, it will determine the effects of these aspects on the mother and newborn baby. Its third objective is to identify the factors which influence the practice of PA during this phase.Methods and analysisSe trata de un estudio prospectivo de cohortes que dura 2 años, f rom de septiembre de 2018 para setiembre del 2020 La muestra será reclutado en tres Atención Primaria centros en el área de salud de Toledo (España). Las participantes serán mujeres embarazadas de 18 a 40 años. Ancianos que deben asistir a todos los controles durante el embarazo y el período posparto. La PA se cuantificará utilizando la acelerometría, mientras que los hábitos nutricionales y el ejercicio físico se evaluarán mediante cuestionarios validados. Se registrarán los síntomas del embarazo y el período posparto, junto con los parámetros bioquímicos y los datos antropométricos. Los resultados primarios se determinarán en las mujeres embarazadas: aumento de peso, incidencia de diabetes mellitus gestacional, preeclampsia e hipertensión inducida por el embarazo. Los resultados secundarios incluyen la duración del embarazo y el peso al nacer, la puntuación de Apgar (1 min / 5 min), el tipo de reanimación (I / II / III / IV) y el pH de la sangre del cordón umbilical en los recién nacidos.DiscussionAlthough the beneficial effects of PA during pregnancy are known, there is a need to perform studies that quantify the amount of PA undertaken by women during pregnancy and the postpartum period. The objective of such studies is to establish science-based individualised guidelines for PA for women during this stage of their lives.

Background Nursing is an art and science based on knowledge of professional caring. As such, the examination of how students perceive care may improve the way this concept is taught and learnt in nursing. Objectives To examine and describe the perception of caring among Spanish nursing students. Methods A cross-sectional design.From an initial population of 500 students, 321 volunteers participated in this study by completing the Caring Dimensions Inventory (CDI-25) during April 2014. Parametric tests were used to perform descriptive analyses of the dimensions of caring and the predominant factor; additionally, inferential (bivariate) analyses were performed of the dimensions of caring and of the predominant factor according to each of the independent variables. A logistic multinomial regression of the predominant psychosocial factor was calculated using the professional-technical factor as a reference, with adjustments for each of the covariates. Results The two dimensions most identified by students in relation to caring were: Providing privacy for a patient (D23) and Listening to a patient (D13) whereas the least identified were: Putting the needs of a patient before your own (D19) and Sharing your personal problems with a patient (D16). Overall, students identified caring mostly with the Psychosocial Factor (F1) (psychosocial aspects of care). Students in their first year identified caring more with the professional-technical factor, whereas those in their third and fourth year did so with the psychosocial factor. Conclusions The perception of caring among nursing students is a dynamic phenomenon that is modified throughout the nurse education process. The academic year, previous work experience in healthcare and the type of access to the university influence students' perceptions of caring. Sin financiación 2.490 JCR (2019) Q1, 7/121 Nursing, 9/41 Education, Scientific Disciplines 1.178 SJR (2019) Q1, 7/150 Nursing (miscellaneous), 129/1401 Education No data IDR 2019 UEM

Resumen: Introducción: La Organización Mundial de la Salud recomienda la educación interprofesional cuando estudiantes de 2 o más profesiones sanitarias aprenden juntos, para favorecer el desarrollo de las competencias interprofesionales que les van a permitir trabajar en equipo proporcionando la mejor asistencia sanitaria. En la Universidad Europea de Madrid existe un programa de educación interprofesional que trabaja las competencias de clarificación de roles, comunicación y autoridad, con estudiantes de diferentes titulaciones. Una de sus actividades es la de atención domiciliaria, en la que participan estudiantes de último curso de Medicina y de Enfermería. El objetivo de este estudio es analizar la percepción de los estudiantes que han participado en la actividad de atención domiciliaria durante el curso 2016-2017 en relación con las 3 competencias interprofesionales. Material y métodos: Estudio cualitativo descriptivo, de corte fenomenológico. Análisis de los fragmentos de texto de las reflexiones de los estudiantes acerca de la actividad de atención domiciliaria mediante el método de comparaciones constantes (codificación abierta y codificación axial). Resultados: Los estudiantes refieren que la actividad les ha ayudado a conocer mejor el rol y las tareas de los médicos y los enfermeros, de una forma diferente a las prácticas clínicas. En cuanto a la comunicación, la basan en el respeto y la confianza. Por último, en cuando a la autoridad, se decantan mayoritariamente por modelos democráticos y horizontales de toma de decisiones. Discusión: Los estudiantes perciben que la actividad resulta útil para el desarrollo de las 3 competencias interprofesionales, lo cual coincide con la literatura científica. Abstract: Introduction: The World Health Organization recommends implementing interprofessional education programs, where students from 2 or more health professions learn together, to improve interprofessional competency development that will help them to improve collaboration and the quality of care and services. At the Universidad Europea from Madrid there is a program on interprofessional education that develops the following competences: role, communication and authority, with students from several degrees. Home care is one of those activities, undertaken by students from the last years of medicine and nursing. The purpose of this research is to analyze the perception of the students about the interprofessional competences after taken the home care activity during the 2016-17 academic year. Material and methods: Phenomenological qualitative design. Student's written comments were analyzed using the constant comparative method (open and axial coding). Results: They got to know better the roles played by each other (doctors and nurses) thanks to the fact of working together. In relation to the way they communicate, they mentioned that adequate communication is based in respect and trust to each other. In relation to the different authority models, most of them tended to use and feel better in more horizontal and democratic ways of decision making. Discussion: Students reported that the activity is useful for improving their interprofessional competencies. It is coincident with other studies. Palabras clave: Educación interprofesional, Atención domiciliaria, Trabajo en equipo, Práctica colaborativa, Atención primaria, Competencias, Keywords: Interprofessional education, Home care, Team work, Collaborative practice, Primary health care, Competencies

Resumen Objetivo principal: Explorar los cuidados en los hijos de inmigrados y la relación enfermera-padres inmigrados. Metodología: Estudio de casos cualitativo con enfoque etnográfico. Observación en dos hospitales y un centro de atención primaria. Veinticuatro entrevistas semiestructuradas grabadas. Análisis cualitativo mediante comparaciones constantes. Resultados principales: Los resultados se articulan en tres grandes bloques: (1) Ser padre o madre inmigrado, (2) El sistema sanitario y los inmigrados, y (3) Los cuidados culturales. Conclusión principal: Se constataron diferencias en la percepción en relación a cuidados específicos como la higiene, el colecho, el método canguro, el cordón umbilical, la ropa, la lactancia materna y la alimentación. Factores como la barrera idiomática, los roles de género, los patrones familiares, entre otros, influyen en las diferencias encontradas. La relación inmigrante (padres) / profesionales viene determinada por la sociedad en la que ambos están inmersos (culturas de origen y culturas autóctonas) y el contexto institucional (culturas profesionales). Abstract Objective: To explore the care provided to immigrant children and the relationships between nurses and immigrant parents within the Madrid health services (Spain). Methods: Qualitative case-study design with ethnographic approach. Field observations took place in two hospitals and a primary health care center. Twenty-four interviews were recorded and qualitative analysis of the data was conducted via the constant comparison method. Results: Results are shown in three sections: (1) Being an immigrant parent; (2) The health system and immigrants; and (3) Cultural care. Conclusions: The differences between the immigrant parents and the Spanish parents were centered on practices such as child hygiene, co-sleeping, the kangaroo-mother method, caring for the umbilical cord, clothing, and breastfeeding. The language barrier, gender roles, family composition and other socioeconomic factors influence the care. When studying the relationships between nurses and immigrants, the context in which these occur is highly relevant, and includes both the societal context and that of the health services.

In 2015, the Universidad Europea de Madrid started the first interprofessional education program in Spain. Nursing students undergo different interprofessional education activities in all 4 academic years, covering various aspects of the following 3 competencies: interprofessional communication, role clarification (definition, interaction and defense), and authority models and decision making. In second year, they integrate these activities with students from psychology, pharmacy and medicine. We assessed the self-perception of second year nursing students with an adapted and validated IPEC questionnaire, in four different transversal moments of the academic year 2015-16. Differences in mean values were analyzed with the Kruskal-Wallis test and post-hoc Mann-Whitney tests with Bonferroni corrections in case of statistical significance. Results showed that this IPE program improves the self-perception second year students have about their competence in interprofessional communication, especially in the dimensions of oral expression, active listening, communication tools and interprofessional conflict resolution. Sin financiación 1.772 JCR (2018) Q3, 46/82 Health Policy & Services, 61/98 Health Care Sciences & Services 0.864 SJR (2018) Q2, 712/2844 Medicine (miscellaneous) No data IDR 2018 UEM

This study aimed to explore the reflective dialogues and processes that take place between preceptors and their nursing students and to examine how preceptors make use of their expert knowledge in order to enhance students' experiential learning during clinical placements. Two 30-h courses on reflective teaching were conducted. The study sample included 15 preceptors and 27 undergraduate nursing students. Data were collected during the course and during clinical placements at two X hospitals. Data collection included non-participatory observation and informal conversations with preceptors, in-depth interviews and focus groups. Preceptors used a series of strategies to promote experiential learning; these included creating links with practice, the use of examples, allowing students to adopt professional roles and enhancing autonomy. The value of preceptors is their wealth of professional experience, which is key during the learning process of nursing students. Preceptors must learn to master the art of questioning and stimulating reflective dialogues, in order to stimulate students' critical thinking and encourage them to resolve common problems that arise during practice. Students demand a more active role in their own learning processes. Sin financiación 1.665 JCR (2018) Q1, 29/118 Nursing 0.810 SJR (2018) Q1, 17/152 Nursing (miscellaneous), 218/1400 Education; Q2, 782/2844 Medicine (miscellaneous) No data IDR 2018 UEM

Background Maternal breastfeeding is a practice that is associated with multiple health benefits for mothers and children. One of the lowest rates of breastfeeding has been observed among Chinese women who immigrate to high income countries. At present, there is a lack of comparative information between this group and that of Spanish-born women. Considering the relationship between the attitude of women towards breastfeeding and the initiation of breastfeeding, the aim of the study was to determine whether the attitude towards breastfeeding among Chinese postpartum women who have immigrated to Spain differs from that of Spanish-born postpartum women. Methods Cross-sectional study, with between-group comparison, of 73 postpartum Spanish-born and Chinese immigrant women admitted to the maternity units of “12 de Octubre” Hospital (Spain) between April and November 2016. Attitudes toward breastfeeding were analyzed using the Spanish or Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). A wide set of socioeconomic, biological, working and attitudinal conditions were considered as covariates. The association between IIFAS and country of origin was assessed by three multiple linear regression models (B, SE, and 95% confidence interval were calculated). Results All Chinese women were first generation immigrants. Chinese-born women were four years younger than Spanish-born mothers, had a lower educational level, more frequently had a paid job (mainly self-employed), and planned to return to work almost two months earlier than Spanish-born mothers did. Most Chinese women did not breastfeed exclusively. Chinese immigrant women obtained scores of approximately 9 points less in the Iowa Infant Feeding Attitude Scale (IIFAS) when compared to Spanish-born women [95% CI -15.59, -2.48], after adjusting for the different socioeconomic, educational and work-related factors. Conclusions Chinese-born women resident in Spain present a lower score on the IIFAS, when compared to Spanish-born women, which implies a more negative attitude towards breastfeeding. The between-groups difference is consistent, even when adjusting for known confounders and other factors which could affect the attitude of the mothers. It is therefore striking that, despite being in Spain, Chinese-born women maintain these preferences/attitudes regarding breastfeeding, compared with Spanish-born women, who obtain overall high scores.

Modern Western societies are characterized by a considerable cultural and ethnic diversity whereby different groups and minorities live side by side. However, not all people are viewed in the same light by the autochthonous population. This is particularly true in the case of Muslim immigrants, who are often prone to negative stereotyping and prejudice. This has become increasingly apparent since the 2001 terrorist attacks in New York and the subsequent attacks in various Western countries. This study seeks to analyze the relation between female nurses and those labeled by nurses as “Muslim fathers”, as part of a research project on the care of immigrant children in Madrid (Spain). The findings promote reflection on the effects of nurses’ stereotypes and prejudices regarding the gender roles of “Muslim fathers” and the relations between these groups. These prejudices can lead to situations of cultural imposition and/or discrimination. Self-reflection regarding stereotypes and prejudices is necessary in order to provide culturally competent care. The anthropobiological approach by Marie Françoise Collière may be useful for extending this type of care universally, not only to immigrant groups, as everyone, including nurses, patients and family members, belong to part of a specific sociocultural context Sin financiación 1.159 JCR (2017) Q3, 62/118 Nursing UEM

Introduccion: Tras la Ley General de Sanidad se ha desarrollado la consulta de enfermeria tanto programada como a demanda. Objetivo: Determinar la proporcion entre consulta a demanda y programada en nuestro centro y conocer los motivos que llevan a los usuarios a acudir a la consulta de enfermeria a demanda. Material y metodo: Estudio observacional (descriptivo transversal). Muestra aleatoria estratificada de los pacientes que acuden a consulta de enfermeria una semana. Variables principales: edad, tipo de consulta, motivo para acudir, consulta programada, consulta a demanda, otras actividades realizadas. Resultados: Un 28% de los casos acude a consulta programada, mientras que un 72% lo hace a demanda. Motivo de consulta: Un 57,5% acude para procedimientos y protocolos; un 39,2%, para cumplimentar recetas medicas, y un 3,3%, el resto. Discusion: La mayor parte de la poblacion acude para control mediante tecnicas y tambien para tratamiento medico de recetas. Hay un esfuerzo por realizar otras actividades aparte de la que genero la consulta. Comparando con otros articulos, hay mucha variacion entre unos y otros. Es necesario dar a conocer mas a la poblacion los servicios que ofrece la enfermeria

La práctica de la enfermería tiene lugar en el marco de las instituciones sanitarias, siendo la relación interpersonal el eje principal de dicha práctica. En el caso de los inmigrados se pretende proporcionar cuidados culturalmente competentes. Sin embargo, el carácter jerárquico y normativo de los hospitales (instituciones totales) dificulta la relación entre enfermeras y pacientes, máxime cuando estos provienen de otros horizontes culturales. El objetivo de este estudio es explorar las relaciones de poder e identificar las barreras en la relación enfermera-padre/madre inmigrado debido a los condicionantes institucionales del hospital. El estudio, de corte etnográfico, recoge datos a través de los testimonios de los profesionales y de los padres y madres de los niños inmigrados y también mediante observación de los entornos de las prácticas en dos hospitales públicos de tamaño medio de la Comunidad de Madrid. Los resultados muestran que las enfermeras a través del ejercicio del poder institucional establecen con las madres y padres inmigrados relaciones asimétricas favorecidas por la barrera idiomática, los prejuicios y los estereotipos. Para proporcionar cuidados culturalmente competentes, es necesario superar las barreras institucionales y personales y establecer relaciones dialógicas, que permitan flexibilizar e individualizar los cuidados, evitando el etnocentrismo. The practice of nursing takes place in the context of healthcare institutions, being the interpersonal relationship the backbone of the practice. In the case of immigrants the goal is to provide culturally competent care. However, the hierarchical and normative hospitals (total institutions) make the relationship between nurses and patients difficult, especially when they come from other cultural backgrounds. The objective of this study is to explore the power relations and to identify barriers in the relationship between nurses- immigrant fathers/mothers due to institutional constraints of the hospital. The ethnographic study collected data through the testimonies of the professionals and the parents of immigrant children and also by observing the practice environments in two public hospitals of average size of the Community of Madrid. The results show that nurses, through the exercise of institutional power, establish with immigrant parents asymmetrical relationships favored by language barriers, prejudice and stereotypes. To provide culturally competent care, you need to overcome institutional and personal barriers and establish dialogic relationships that allow flexible and individualized care, avoiding ethnocentrism. A prática de enfermagem tem lugar no contexto das instituições de saúde, com o relacionamento interpessoal o principal foco da prática. No caso dos imigrantes a meta é a prestação de cuidados culturalmente competente. No entanto, os hospitais hierárquicos e normativos (instituições totais) faz com que a relação entre enfermeiros e pacientes, especialmente quando eles vêm de outras origens culturais. O objetivo deste estudo é explorar as relações de poder e identificar barreiras no relacionamento enfermera-padre/madre imigraram devido a restrições institucionais do hospital. Estudo etnográfico, os dados coletados através do testemunho dos profissionais e os pais de filhos de imigrantes e também observando os ambientes favoráveis à prática em dois hospitais públicos de tamanho médio da Comunidade de Madrid. Os resultados mostram que os enfermeiros, através do exercício do poder institucional, estabelecida com mães imigrantes e pais de relações assimétricas, favorecidos por barreiras linguísticas, preconceitos e estereótipos. Para prover um cuidado culturalmente competente, é preciso superar as barreiras institucionais e pessoais e estabelecer relações dialógicas que permitem atendimento flexível e individualizado, evitando o etnocentrismo.

La práctica de la enfermería tiene lugar en el marco de las instituciones sanitarias, siendo la relación interpersonal el eje principal de dicha práctica. En el caso de los inmigrados se pretende proporcionar cuidados culturalmente competentes. Sin embargo, el carácter jerárquico y normativo de los hospitales (instituciones totales) dificulta la relación entre enfermeras y pacientes, máxime cuando estos provienen de otros horizontes culturales. El objetivo de este estudio es explorar las relaciones de poder e identificar las barreras en la relación enfermera-padre/madre inmigrado debido a los condicionantes institucionales del hospital. El estudio, de corte etnográfico, recoge datos a través de los testimonios de los profesionales y de los padres y madres de los niños inmigrados y también mediante observación de los entornos de las prácticas en dos hospitales públicos de tamaño medio de la Comunidad de Madrid. Los resultados muestran que las enfermeras a través del ejercicio del poder institucional establecen con las madres y padres inmigrados relaciones asimétricas favorecidas por la barrera idiomática, los prejuicios y los estereotipos. Para proporcionar cuidados culturalmente competentes, es necesario superar las barreras institucionales y personales y establecer relaciones dialógicas, que permitan flexibilizar e individualizar los cuidados, evitando el etnocentrismo. The practice of nursing takes place in the context of healthcare institutions, being the interpersonal relationship the backbone of the practice. In the case of immigrants the goal is to provide culturally competent care. However, the hierarchical and normative hospitals (total institutions) make the relationship between nurses and patients difficult, especially when they come from other cultural backgrounds. The objective of this study is to explore the power relations and to identify barriers in the relationship between nurses- immigrant fathers/mothers due to institutional constraints of the hospital. The ethnographic study collected data through the testimonies of the professionals and the parents of immigrant children and also by observing the practice environments in two public hospitals of average size of the Community of Madrid. The results show that nurses, through the exercise of institutional power, establish with immigrant parents asymmetrical relationships favored by language barriers, prejudice and stereotypes. To provide culturally competent care, you need to overcome institutional and personal barriers and establish dialogic relationships that allow flexible and individualized care, avoiding ethnocentrism. A prática de enfermagem tem lugar no contexto das instituições de saúde, com o relacionamento interpessoal o principal foco da prática. No caso dos imigrantes a meta é a prestação de cuidados culturalmente competente. No entanto, os hospitais hierárquicos e normativos (instituições totais) faz com que a relação entre enfermeiros e pacientes, especialmente quando eles vêm de outras origens culturais. O objetivo deste estudo é explorar as relações de poder e identificar barreiras no relacionamento enfermera-padre/madre imigraram devido a restrições institucionais do hospital. Estudo etnográfico, os dados coletados através do testemunho dos profissionais e os pais de filhos de imigrantes e também observando os ambientes favoráveis à prática em dois hospitais públicos de tamanho médio da Comunidade de Madrid. Os resultados mostram que os enfermeiros, através do exercício do poder institucional, estabelecida com mães imigrantes e pais de relações assimétricas, favorecidos por barreiras linguísticas, preconceitos e estereótipos. Para prover um cuidado culturalmente competente, é preciso superar as barreiras institucionais e pessoais e estabelecer relações dialógicas que permitem atendimento flexível e individualizado, evitando o etnocentrismo.

[ES] La materia “Habilidad es para Comunicary Educar en Salud” incluye la comprensión de la enfermería como una relación humanacliente ‐ enfermero/a para identificar y responder a la necesidad de ayuda,desarrollando la comunicación como principal instrumento para la prestación de cuidados. Para alcanzar las competencias en esta asignatura, durante el curso 2009‐ 10, se desarrolló una metodología activa basada en un aprendizaje significativo. La evaluación se realizó a través de la demostración práctica de la adquisición de habilidades en comunicación verbal y no verbal, mediante técnicas de dramatización evaluadas por el profesorado y complementada por una evaluación entre iguales. Este sistema supuso un desafío tanto para estudiantes como para profesores. Con objeto de conocer: grado de acuerdo del alumnado con esta metodología de aprendizaje y evaluación, con cordancia de resultados en evaluaciones de profesorado ‐alumnado y nivel de consecución de los objetivos de aprendizaje respecto al bloque temático de Comunicación y Relación de Ayuda, se diseñó un estudio descriptivo transversal con 95 alumnos/as. Los resultados mostraron la satisfacción de los alumnos/as, la falta de concordancia en las evaluaciones de profesorado y alumnado (coincidiendo con otros estudios) y evidenciaron la eficacia de esta metodología para adquirir habilidades específicas en comunicación., [EN] Communication and Education Skills for Health "includes an understanding of nursing as a humanrelation client ‐ nurse to identify and respond to the need of help, developing communication as the main instrument for the provision of care. To achieve competence in this subject during the academic course 2009-10, we developed an active methodology based in meaning fullearning. The evaluation was made through practical demonstration of the acquisition of in verbal and non verbal communication through dramat echniques(rol‐playing) evaluated by teachers and supplemented by apeer review. This system was a challenge for both students and teachers. In order to know: the agreement of students with this method of learning and assessment, the agreement of results between teacher and students assessments and the level of achievement of learning objectives in the unit “Helping Relationship and Communication”, we designed a descriptive study with 95 students. The results showed the satisfaction of the students, the lack of consistency in the evaluation sof teachers and students (coinciding with other studies)and demonstrated the effectiveness of this methodology to acquire specific skills in communication., [FR] La matière "Compétences pour la communication et l’éducation pour la santé ”comprende une compréhension des soins infirmiers comme une relation client–in firmièr/e pour identifier et répondre aux besoins d'aider à développer la communication comme instrument principal de la prestation de soins. Pour atteindre les compétences dans cette matière au cours de l'année académique 2009‐10, nous avons développé une méthodologie active baseé sur un apprentissage significatif. L'évaluation a été réalisée par des démonstrations pratiques de l'acquisition d'aptitudes en communication verbale et non verbale grâceà des techniques théâtrales évalués par les professeurs et complétées par les pairs. Cesystème a representé un défi pour les étudiants et les enseignants.Nos objetifs ont été: connaître le degré d’acceptation de cette méthode d'apprentissage et d'évaluation para les étudiants,connaître la concordance de l'évaluation des enseignants et de celle des élèves, en plus du niveau d’atteinte des objectifs d'apprentissage de l'unité thématique “Communication et Relations d 'aide”. Nous avons réalisé une étude descriptive avec 95 étudiants. Les résultats ont montré la satisfaction des étudiants, ont révélé un décalage entre les évaluations des enseignants et celles des étudiants (confirmées par d'autres études) et ont démontré l'efficacité de cette méthode pour acquérir des compétences spécifiques en matière de communication.

In the European Higher Education Area (EEES in Spanish reference), a change in the pedagogical model has occurred: from teaching centered on the figure of the professor to learning centered on students, from an integral perspective. This learning must bring together the full set of competencies included in the program requirements necessary to obtain a degree. The specific competencies characterize a profession and distinguish one from others. The transversal competencies surpass the limits of one particular discipline to be potentially developed in all; these are subdivided in three types: instrumental, interpersonal and systemic. The authors describe and compare the acquisition of transversal competencies connected to students' portfolios and Problem-based Learning as pedagogical methods from the perspective of second year nursing students at the European University in Madrid during the 2007-8 academic year To do so, the authors carried out a transversal descriptive study; data was collected by a purpose-made questionnaire the authors developed which they based on the transversal competencies of the Tuning Nursing Project. Variables included age, sex, pedagogical method, perception on acquisition of those 24 competencies by means of a Likert Scale. U de Mann-Whitney descriptive and analytical statistics. The authors conclude that the portfolio and Problem-based Learning are useful pedagogical methods for acquiring transversal competencies; these results coincide with those of other studies. Comparing both methods, the authors share the opinion that the Problem-based Learning method could stimulate the search for information better than the portfolio method.