El entorno terapéutico de los cuidados de enfermería desde una visión de la promoción de la salud mental

La promoción de la salud mental es una faceta importante de la promoción general de la salud. Teniendo en cuenta los niveles de estrés y de conflicto que soportan las personas y las comunidades, es preciso redoblar esfuerzos para promover la salud mental. Uno de los objetivos de la promoción de la salud en este ámbito es identificar las conductas inadaptadas de los pacientes y promover las actividades personales y psicológicas más eficaces para poder planificar los cuidados de enfermería en un entorno terapéutico favorable. La OMS está examinando los datos disponibles sobre la eficacia de las actividades de fomento de la salud mental y ha propuesto nuevas políticas y modelos de cambio de la asistencia: enfoque comunitario y desinstitucionalización, integración de la atención en salud mental con los servicios generales de salud, la colaboración intersectorial, enfoques multidisciplinarios, reorientar las funciones de los profesionales y evitar el estigma de las personas con problemas mentales. Así mismo también se han propuesto diez áreas de acción: Apoyo a los padres y a los primeros años de vida, promover la salud mental en las escuelas, promover la salud mental en el lugar de trabajo, apoyo en el envejecimiento mentalmente sano, en grupos de riesgo de trastornos mentales, prevenir la depresión y el suicidio, prevenir la violencia y el uso de sustancias nocivas, involucrar a la atención primaria y secundaria, reducir la situación de desventaja y evitar el estigma, trabajo intersectorial. Los profesionales de enfermería de salud mental han de proporcionar los cuidados teniendo en cuenta a los nuevos modelos de atención en salud mental y las acciones propuestas

Promoción de la salud mental: cuidarse para cuidar mejor

En este artículo se pretende enfatizar el concepto de promoción de la salud mental; un espacio reservado para las intervenciones dirigidas a reforzar, mantener, incrementar y, en global, potenciar el bienestar psicológico de las personas 'mentalmente sanas'. Para su comprensión se introduce el constructo 'salud mental positiva', cuyo significado está relacionado tanto con estados de bienestar y felicidad como con situaciones de sufrimiento y conflicto emocional. Se enfatiza la necesidad de discriminar la normalidad/anormalidad de esos estados psicológicos, teniendo en cuenta la complejidad de la estructura mental del ser humano y las dificultades que existen para determinar lo que es salud y lo que es enfermedad mental. Asimismo, se vincula la promoción de la salud mental al concepto de autocuidado, relacionando la capacidad de cuidarse uno mismo con la capacidad para cuidar a los demás. Esta relación resulta especialmente significativa para la enfermería, como profesión centrada en el cuidado. El artículo finaliza con una serie de sugerencias para la promoción de la salud mental positiva.

Promoción de la salud mental: cuidarse para cuidar mejor

En este artículo se pretende enfatizar el concepto de promoción de la salud mental; un espacio reservado para las intervenciones dirigidas a reforzar, mantener, incrementar y, en global, potenciar el bienestar psicológico de las personas 'mentalmente sanas'. Para su comprensión se introduce el constructo 'salud mental positiva', cuyo significado está relacionado tanto con estados de bienestar y felicidad como con situaciones de sufrimiento y conflicto emocional. Se enfatiza la necesidad de discriminar la normalidad/anormalidad de esos estados psicológicos, teniendo en cuenta la complejidad de la estructura mental del ser humano y las dificultades que existen para determinar lo que es salud y lo que es enfermedad mental. Asimismo, se vincula la promoción de la salud mental al concepto de autocuidado, relacionando la capacidad de cuidarse uno mismo con la capacidad para cuidar a los demás. Esta relación resulta especialmente significativa para la enfermería, como profesión centrada en el cuidado. El artículo finaliza con una serie de sugerencias para la promoción de la salud mental positiva.

Retroalimentación docencia-asistencia-docencia: estudio sobre burnout en enfermeras de salud mental como estrategia de innovación y calidad docente

El síndrome de burnout se considera una vulnerabilidad en las profesiones de ayuda. La escasez de publicaciones sobre esta formación, orientó la creación de una asignatura optativa en el Grado de Enfermería de la Universidad de Barcelona (UB) en el curso 2009-2010. Igualmente, produjo interés por explorar esta temática en enfermeras asistenciales de salud mental cuya disciplina aborda la gestión del estrés. Se presenta un estudio descriptivo, transversal y de correlación, en una cohorte de 73 enfermeras que trabajaban en servicios asistenciales de salud mental en el año 2011. Los objetivos pretenden identificar si la muestra estudiada presenta afectación del síndrome de burnout y relacionar los resultados con las estrategias que dichas enfermeras declaran utilizar para hacer frente a las emociones negativas atribuidas a su trabajo. El instrumento empleado es el Maslach Burnout Inventory (MBI), una pregunta abierta y variables sociodemográficas y de salud. Los resultados indican que presentó burnout el 2,7% de la muestra estudiada junto con un nivel medio de despersonalización. Además presentan baja realización personal quienes trabajaban en unidades de enfermos crónicos. El cansancio emocional resulto mayor en mujeres que en hombres y esta presente en personal con contrato fijo y en quienes causaron baja en los dos últimos años. En general, se observa falta de formación y apoyo formal para gestionar el estrés en la muestra estudiada. Se concluye que la formación sobre burnout en el Grado de Enfermería, podría favorecer la gestión del estrés y prevenir su cronicidad hacia la desmotivación y el absentismo laboral.

Retroalimentación docencia-asistencia-docencia: estudio sobre burnout en enfermeras de salud mental como estrategia de innovación y calidad docente

El síndrome de burnout se considera una vulnerabilidad en las profesiones de ayuda. La escasez de publicaciones sobre esta formación, orientó la creación de una asignatura optativa en el Grado de Enfermería de la Universidad de Barcelona (UB) en el curso 2009-2010. Igualmente, produjo interés por explorar esta temática en enfermeras asistenciales de salud mental cuya disciplina aborda la gestión del estrés. Se presenta un estudio descriptivo, transversal y de correlación, en una cohorte de 73 enfermeras que trabajaban en servicios asistenciales de salud mental en el año 2011. Los objetivos pretenden identificar si la muestra estudiada presenta afectación del síndrome de burnout y relacionar los resultados con las estrategias que dichas enfermeras declaran utilizar para hacer frente a las emociones negativas atribuidas a su trabajo. El instrumento empleado es el Maslach Burnout Inventory (MBI), una pregunta abierta y variables sociodemográficas y de salud. Los resultados indican que presentó burnout el 2,7% de la muestra estudiada junto con un nivel medio de despersonalización. Además presentan baja realización personal quienes trabajaban en unidades de enfermos crónicos. El cansancio emocional resulto mayor en mujeres que en hombres y esta presente en personal con contrato fijo y en quienes causaron baja en los dos últimos años. En general, se observa falta de formación y apoyo formal para gestionar el estrés en la muestra estudiada. Se concluye que la formación sobre burnout en el Grado de Enfermería, podría favorecer la gestión del estrés y prevenir su cronicidad hacia la desmotivación y el absentismo laboral.

The construction process of pedagogical knowledge among nursing professors

Didactic knowledge about contents is constructed through an idiosyncratic synthesis between knowledge about the subject area, students' general pedagogical knowledge and the teacher's biography. This study aimed to understand the construction process and the sources of Pedagogical Content Knowledge, as well as to analyze its manifestations and variations in interactive teaching by teachers whom the students considered competent. Data collection involved teachers from an undergraduate nursing program in the South of Brazil, through non-participant observation and semistructured interviews. Data analysis was submitted to the constant comparison method. The results disclose the need for initial education to cover pedagogical aspects for nurses; to assume permanent education as fundamental in view of the complexity of contents and teaching; to use mentoring/monitoring and the value learning with experienced teachers with a view to the development of quality teaching.

Is the ATIC terminology oriented to nursing phenomena?

The main goal of this observational and descriptive study is to evaluate whether the diagnosis axis of a nursing interface terminology meets the content validity criterion of being nursing-phenomena oriented. Nursing diagnosis concepts were analyzed in terms of presence in the nursing literature, type of articles published and areas of disciplinary interest. The search strategy was conducted in three databases with limits in relation to period and languages. The final analysis included 287 nursing diagnosis concepts. The results showed that most of the concepts were identified in the scientific literature, with a homogeneous distribution of types of designs. Most of these concepts (87.7%) were studied from two or more areas of disciplinary interest. Validity studies on disciplinary controlled vocabularies may contribute to demonstrate the nursing influence on patients" outcomes.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.

A nursing interface terminology: evaluation of face validity

A range of different language systems for nursing diagnosis, interventions and outcomes are currently available. Nursing terminologies are intended to support nursing practice but they have to be evaluated. This study aims to assess the results of an expert survey to establish the face validity of a nursing interface terminology. The study applied a descriptive design with a cross-sectional survey strategy using a written questionnaire administered to expert nurses working in hospitals. Sample size was estimated at 35 participants. The questionnaire included topics related to validity and reliability criteria for nursing controlled vocabularies described in the literature. Mean global score and criteria scoring at least 7 were considered main outcome measures. The analysis included descriptive statistics with a confidence level of 95%. The mean global score was 8.1. The mean score for the validity criteria was 8.4 and 7.8 for reliability and applicability criteria. Two of the criteria for reliability and applicability evaluation did not achieve minimum scores. According to the experts" responses, this terminology meets face validity, but that improvements are required in some criteria and further research is needed to completely demonstrate its metric properties.

Evaluating the impact of filming on the number of errors committed by nursing students to determine the efficacy of simulated clinical situations

Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not?

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.