Alfaro-Díaz, C. (Cristina)
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- Effectiveness of web-based personalised feedback interventions for reducing alcohol consumption among university students: A systematic review and meta-analysis(2024) Esandi, N. (Nuria); Carver, H. (Hannah); Pueyo-Garrigues, M. (María); Alfaro-Díaz, C. (Cristina); Parr, A. (Amy); Canga-Armayor, N. (Navidad); Lavilla-Gracia, M. (María)Meta-analysis was conducted to examine standalone web-based personalised feedback interventions (PFI) delivered in non-structured settings for reducing university students' alcohol consumption. Subgroup analyses by gender-focus, type-of-content and accessibility were conducted. Characteristics of the sample, the intervention and study quality were examined as moderators.ApproachTen databases were searched from 2000 to 2023. Eligible articles involved only randomised controlled trials. Random-effects meta-analysis was conducted to calculate the effect size on weekly alcohol consumption comparing web-PFIs and non-active controls. Meta-regressions were applied to explore effect moderators.Key FindingsThirty-one studies were included in the narrative synthesis, 25 of which were meta-analysed. Results found significant effect size differences on weekly alcohol consumption in favour of the intervention group in the short- (SMD = 0.11, 95% confidence interval [CI] 0.06, 0.15) and long-term period (SMD = 0.09, 95% CI 0.02, 0.15). Subgroup analyses identified that interventions which were gender-specific, multicomponent and had unlimited access had higher and significant effect sizes, although they were very similar with respect to comparative groups. Moderator analyses showed that times feedback was accessed significantly contributed to the effectiveness of the intervention. Effects diminished over time, although they remained significant.ImplicationsThe meta-analysis evidences the effectiveness of web-PFI for addressing university students' alcohol use, decreasing by 1.65 and 1.54 drinks consumed per week in the short- and long-term, respectively.ConclusionsThe results offer empirical evidence that supports the significant, although small, effect of web-PFI delivered remotely in universities. Future research should focus on increasing their impact by introducing booster sessions and content components based on students' preferences.
- Personal and contextual factors to the successful implementation of a family nursing approach in oncology care(Sage, 2022) Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Canga-Armayor, A.D. (Ana Dolores); Pardavila-Belio, M.I. (Miren Idoia); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad)The aim of this study was to explore nurses’ attitudes and beliefs about the importance of families in nursing care, as well as the barriers and facilitators within the clinical context that influence the implementation offamily nursing in an in-patient oncology service. A cross-sectional study design, incorporating quantitative and qualitative measurements, was used with a sample of nurses in Spain from an oncology service (N = 39). In general, oncology nurses reported positive attitudes and beliefs about the importance of family in nursing care. However, they did not effectively involve the family in their daily clinical practice. This was due to the nurses’ lack of clinical skills and competence to work with families as well as contextual factors such as the lack of time and workload that acted as barriers to the implementation of family-oriented care. This study identified areas of improvement that are needed to promote the effective and sustainable implementation of family nursing knowledge in clinical practice settings.
- Training nursing students in motivational interviewing for alcohol misuse: a mixed method study(2023) Fotopoulou, M. (M.); Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Canga-Armayor, A.D. (Ana Dolores); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad); Lavilla-Gracia, M. (María)Background: Motivational interviewing led by nurses has been demonstrated to be effective in reducing alcohol consumption among university students. However, most of these professionals feel that they lack the competence necessary for motivational interviewing due to a lack of formal training in the nursing curriculum. Objectives: To design, implement and evaluate a motivational interviewing training course for alcohol misuse in an undergraduate nursing curriculum and to explore students' experiences with this course. Design: A mixed-methods study involving a descriptive comparative quantitative design and qualitative focus group interviews with nursing students. Settings: An elective nursing course in a Spanish university. Participants: A total of 21 fourth-year nursing students. Methods: The course was developed as a twelve-week, two-hour course. It comprised three modules covering the concepts, tools and skills associated with motivational interviewing for alcohol misuse. Quantitative and qualitative data were collected after the completion of the course to evaluate the training received by students; these data were categorized using Kirkpatrick's model. The quantitative results included students' satisfaction, knowledge, skills and attitudes, which were measured using an ad hoc questionnaire, a multiple-choice exam, and two rater-based assessments (the Peer Proficiency Assessment instrument and an evidence-based checklist). Qualitative focus groups were used to explore students' experiences of the entire programme. Results: Students' satisfaction with the course was rated 9 out of 10, highlighting the usefulness and adequacy of the course content. The quantitative and qualitative results both indicated that all students acquired the knowledge necessary to perform motivational interviewing and significantly improved their motivational interviewing microskills. Only half of the students reached the level of proficiency in two of the three ratios calculated. The three main themes identified pertained to the learning atmosphere, module methodologies, and students' self-perceptions of competence. Finally, the students reported having transferred their learning to clinical practice. Conclusion: A course on motivational interviewing for alcohol misuse positively influences nursing students both personally and in terms of their future professional work by improving their knowledge, skills, attitudes and self-perceived competence.
- Peer-led interventions to reduce alcohol consumption in college students: A scoping review(2022) Pueyo-Garrigues, M. (María); Canga-Armayor, A.D. (Ana Dolores); Pardavila-Belio, M.I. (Miren Idoia); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad); Pueyo-Garrigues, S. (Sara); Lavilla-Gracia, M. (María)Risky alcohol consumption among college students is a significant public health issue. In the college setting, students can collaborate in the implementation of peer-led interventions. To date, evidence of peer-led programmes in reducing harmful alcohol consumption in this population is inconclusive. The aim of the current scoping review is to provide a broad overview by systematically examining and mapping the literature on peer-led interventions for preventing risky alcohol consumption by college students. The specific aims were to (1) identify the underlying focus of the interventions and assess their (2) effectiveness and (3) feasibility. A comprehensive search was conducted in PubMed, PsycINFO, CINAHL, Cochrane Library, Web of Science, DART-Europe, RCAAP, Trove and ProQuest. The inclusion criteria were peer-led interventions that exclusively addressed alcohol consumption, college students as the target population and interventional studies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses of interventions). The methodological quality of the articles was evaluated. From 6654 potential studies, 13 were included. Nine interventions were described within these studies: Voice of Reason programme, Brief Advice sessions, Peer Theatre, Alcohol Education programme, Perceptions of Alcohol Norms intervention, Motivational Intervention, Alcohol Skills Training programme, Lifestyle Management Class and the Brief Alcohol Screening and Intervention for College Students. Only the last showed significant reductions in three of the four outcome measures: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol-related consequences. It did not significantly decrease the number of heavy-drinking episodes. Peer interventions may be effective in preventing alcohol use among college students, although the evidence is weak and scarce. Further research is needed to strengthen the findings about peer-led interventions.
- Cross-cultural adaptation and psychometric testing of the spanish version of Iceland health care practitioner illness beliefs questionnaire(2020) Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Gutiérrez-Alemán, M.T. (María Teresa); Canga-Armayor, A.D. (Ana Dolores); Pardavila-Belio, M.I. (Miren Idoia); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad)The beliefs of nursing professionals who care for families experiencing illness are fundamental to the quality of the nurse-family relationship and the level of the nurse's involvement in the therapeutic process of Family Systems Nursing. It is essential to have valid and reliable instruments for assessing nurses' illness beliefs, especially in the Spanish context where no instruments have been identified to date. The Iceland Health Care Practitioner Illness Beliefs Questionnaire (ICE-HCP-IBQ) is a reliable and valid measure of professionals' beliefs about their understanding of the meaning of the illness experience of families. The purpose of this study was to adapt and psychometrically test the Spanish version of the ICE-HCP-IBQ (N= 249 nurses). The exploratory factor analysis showed one-factor solution with good internal consistency (Cronbach's alpha = .91) and test-retest reliability (r= .72,p< .01). This questionnaire is a promising tool for mapping nurse's illness beliefs and monitoring the effectiveness of family nursing educational interventions in the Spanish context.
- Psychometric evaluation of the spanish families importance in nursing care: nurses' attitudes scale through classical test theory and rasch analysis(Sage, 2023) Esandi, N. (Nuria); Rodríguez-Blazquez, C. (Carmen); Pueyo-Garrigues, M. (María); Canga-Armayor, A.D. (Ana Dolores); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad); Forjaz, M.J. (Maria João)Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.
- NURSES’ knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional study(Elsevier, 2022) Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Canga-Armayor, A.D. (Ana Dolores); Pardavila-Belio, M.I. (Miren Idoia); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad)Aim: To explore nurses’ knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors. Background: Clinical nurses are expected to perform effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development. Design: A cross-sectional study. Methods: A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report ques- tionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson’s and Spearman’s correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used Results: The mean scores of the knowledge (70.10 ± 15.11), skills (92.14 ± 15.18) and personal attributes scales (32.32 ± 5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence’s domains were significant (p < 0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales. Conclusion: Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses’ health education competence. Identifying nurses’ educational needs on the main domains of the competence and its intrinsic/ extrinsic influential factors may assist in both planning and organizing tailored training strategies and in pro- moting appropriate environments to support a high-quality health education practice Tweetable abstract: Nurses’ knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key
- Validación lingüística del Demand-Control-Support Questionnaire para profesionales de enfermería en España(Gobierno de Navarra, 2020) Esandi, N. (Nuria); Carrión-Torre, M. (María); Gutiérrez-Alemán, M.T. (María Teresa); Canga-Armayor, A.D. (Ana Dolores); Alfaro-Díaz, C. (Cristina)Fundamento. Los profesionales de enfermería son uno de los grupos más afectados por el estrés laboral, lo que puede afectar la calidad de vida del profesional y comprometer la calidad de los cuidados de enfermería. A nivel internacional, el Demand-Control-Support Questionnaire (DCSQ) ha demostrado ser una herramienta breve, válida y fiable para evaluar el estrés laboral. El objetivo de este estudio fue obtener una versión adaptada al español del DCSQ para profesionales de enfermería. Método. La validación lingüística se realizó en dos fases: 1) traducción-retrotraducción y adaptación lingüística del instrumento y 2) validación de contenido del instrumento mediante un panel de siete expertos y evaluación de la aplicabilidad y comprensión de la versión adaptada en una muestra de veintiún profesionales de enfermería. Resultados. Fase 1) En el proceso de traducción, un ítem precisó cambios semánticos, mientras que cinco ítems precisaron cambios sintácticos. Las retrotraducciones fueron similares. Las dudas más relevantes se encontraron en el ítem 5, identificado como un ítem problemático a lo largo de todo el proceso. Fase 2) El análisis de la validez de contenido mostró excelentes resultados (índice de validez de contenido ≥ 0,90 y valores de kappa ≥ 0,65); además, el estudio piloto confirmó la adecuada comprensibilidad y aplicabilidad del cuestionario. Conclusiones. El empleo de una metodología sistemática y rigurosa ha permitido obtener una versión adaptada al español del DCSQ, conceptual y lingüísticamente equivalente al instrumento original, y adecuada para valorar de manera multidimensional el estrés psicosocial de profesionales de enfermería en el ámbito laboral.
- Instruments for assessing family functioning in adults patients with cancer: a systematic review of measurement properties(Elsevier, 2024) Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Dieperink, K.B. (Karin B.); Moller-Clausen, A. (Anne); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad)Objectives: To identify instruments for assessing family functioning in adults patients with cancer and summarize their psychometric properties. Methods: Psychometric systematic literature review was conducted to June 2023 using four databases: PubMed, CINAHL, Psych INFO, and Web of Science. The psychometric properties of the instruments and the methodological quality of the studies were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to rate the best available evidence. Results: Forty-four studies reporting 13 instruments were included. The instruments measured varied attributes of family functioning and the dimensions were heterogeneous. The Cancer Communication Assessment Tool for Patients and Families (CCAT-PF) was rated the highest in terms of both methodological rigor and instrument quality. However, the Family Adaptability and Cohesion Evaluation Scale (FACES) and the Ice-Expressive Family Functioning Questionnaire (ICE-EFFQ) offer a more comprehensive measure of family functioning, since they assess multiple dimensions of family functioning and demonstrate high-quality measurement properties. Conclusions: Instruments to assess family functioning were heterogeneous and exhibited limited reliability and validity. The FACES and the ICE-EFFQ seem to be the most suitable measures for adult cancer patients and their families. Future research should aim to refine the content of existing instruments and rigorously assess their psychometric properties. Implications for Nursing Practice: Given the profound impact of cancer on family functioning, the initial step in crafting effective interventions is providing valid and reliable instruments to measure the impact of these interventions. This paper could assist nursing professionals in making informed decisions regarding the most suitable instrument for assessing family functioning in adults patients living with life-threatening illness as is the case with cancer.
- Effectiveness of educational programs for clinical competence in family nursing: A systematic review(Sage, 2021) Esandi, N. (Nuria); Pueyo-Garrigues, M. (María); Gutiérrez-Alemán, M.T. (María Teresa); Canga-Armayor, A.D. (Ana Dolores); Pardavila-Belio, M.I. (Miren Idoia); Alfaro-Díaz, C. (Cristina); Canga-Armayor, N. (Navidad)Evidence shows that applying family nursing theory to practice benefits the patient, the family, and nursing professionals, yet the implementation of family nursing in clinical practice settings is inconsistent and limited. One of the contributing factors may be related to insufficient or inadequate educational programs focused on family nursing. This article presents a systematic review of the research that has examined the effectiveness of family nursing educational programs aimed at promoting clinical competence in family nursing. Six databases were systematically searched and 14 studies met the inclusion criteria, generating three themes: general study characteristics, educational program components, and outcome measures. These educational programs reported effectiveness in developing family nursing knowledge, skills, and attitudes, but did not evaluate the nurses' actual acquisition and implementation of family nursing clinical competencies. This review offers relevant implications for research and for family nursing education, especially when designing and evaluating future educational programs. Future research must more closely address the process and outcomes of best educational practices in family nursing education and how these are applied and evaluated in actual practice settings.