Forest bathing practices benefit individuals' physical and mental health. A growing number of published studies provide evidence of such effects in diverse populations and contexts. However, no literature has been found that evaluates the effects of forest bathing on people with intellectual disabilities. In this paper, we present a quasi-experimental pre-post protocol for assessing the preliminary efficacy and feasibility of a forest bathing intervention in a group of adults with intellectual disability. An 11-weekly session program will be applied in the forests of the Ollo Valley, Navarre (Spain). The preliminary efficacy outcomes will be blood pressure, psycho-physiological coherence parameters and quality of life. The feasibility of the intervention will be assessed through data on barriers and facilitators of the implementation process and indicators of environmental comfort (physiological equivalent temperature and thermic perception). This study offers an opportunity for people with intellectual disabilities to benefit from a forest bathing intervention and explore its effects not only on their quality of life, but also on the improvement in their physiological and psychological state. This feasibility study is an essential step to explore crucial aspects for a future full-scale trial.

Home cooking and the type of cooking techniques can have an effect on our health. However, as far as we know, there is no questionnaire that measures in depth the frequency and type of cooking techniques used at home. Our aim was to design a new Home Cooking Frequency Questionnaire (HCFQ) and to preliminarily assess its psychometric properties. For this purpose we used a five-phase approach, as follows: Phase 1: item generation based on expert opinion, relevant literature and previous surveys; Phase 2: content validity assessed by experts for relevance and clarity (epidemiologists, dietitians, chefs); Phase 3: face validity and inter-item reliability; Phase 4: criterion validity using a 7-day food and culinary record; and Phase 5: test stability and inter-item reliability. The content validity index for scale and item level values provided evidence of the content validity for relevance and clarity. Criterion validity analysis showed intraclass correlation coefficients ranged from 0.31-0.69. Test-retest reliability coefficients ranged from 0.49-0.92, with ¿ values > 0.44. Overall Cronbach's alpha was 0.90. In conclusion, the HCFQ is a promising tool with sound content and face validity, substantial criterion validity, and adequate reliability. This 174-item HCFQ is the first questionnaire to assess how often people cook and which cooking methods they use at home.

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 questionnaire 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 promoting 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.

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 of out-of-home 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.

Aim To develop and psychometrically test the Nurse Health Education Competence Instrument for assessing nurses' knowledge, skills and personal attributes concerning competent health education practice. Design A psychometric instrument development and validation study. Methods A four-step approach was used: Step 1) operational definition based on an up-to-date concept analysis and experts' judgement; step 2) item generation and content validation by expert panel and target population; step 3) item analysis based on acceptability, internal consistency and face validity; and step 4) psychometric evaluation based on construct validity, criterion validity, internal consistency and stability, conducted from January -February 2019 with 458 hospital-care nurses. Results The operational framework and expert groups showed good content validity, resulting in the first version. From the initial 88-item pool, 58 items were retained after item analysis. Exploratory factor analysis revealed three scales concerning the cognitive (three-factor solution with 23 items), psychomotor (two-factor solution with 26 items) and affective-attitudinal (one-factor solution with nine items) competency domains, which respectively accounted for 58%, 53% and 54% of the variance. Known-group study demonstrated significant differences by years working in the service and training received in health education, providing evidence for the measure's sensitivity. The three scales correlated positively ...

Aim To translate and psychometrically validate the Demand-Control-Support Questionnaire for nurses in Spain. Background Nurses are one of the groups most affected by work-related stress. The combination of high job demands and low control is identified as the main source of stress among nurses. The Demand-Control-Support Questionnaire is a valid and reliable tool for assessing psychosocial stress in the workplace. Methods A two-phase cross-sectional descriptive descriptive study. The instrument was translated according to Sousa and Rojjanasrirat guidelines, including forward and backward translations, consensus meetings, pilot testing and expert committee. Structural validity, convergent and discriminative validity, internal consistency and test-retest reliability were assessed in a sample of 247 nurses. Results Exploratory factor analysis verified a three-factor solution with good internal consistency (Cronbach's alpha values ranged from 0.62 to 0.87) and test-retest reliability (intraclass correlation coefficients ranged from 0.65 to 0.85). Conclusions The Spanish version of the Demand-Control-Support Questionnaire seems to be a brief, valid and reliable instrument to measure psychosocial stress in the workplace in nurses. Implications for nursing management The use of the Demand-Control-Support Questionnaire can be of value to inform the design and implementation of appropriate management strategies to foster a more favourable work environment that promotes the well-being of professionals.

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.

Objectives: The concept of health education has traditionally focused on enabling people to change unhealthy behaviours and lifestyles. Although, at the theoretical level, there exist definitions of the concept, it remains complex and ambiguous. Furthermore, nurses often confuse the concept with other related terms, such as health information or health promotion. The aim here is to report a concept analysis of health education and elucidate a current definition. Design: Rodgers' evolutionary concept analysis. Data sources: A systematic search was conducted using PubMed and CINAHL for articles written in English or Spanish, published between 1986 and 2017. A guide search was performed, and grey literature was also reviewed. A pre-determined template of study inclusion-related questions assisted the process. Review methods: Rodgers' evolutionary method guided the narrative analysis. The attributes of health education, as well as its antecedents, consequences, related terms and contextual instructions were extracted and synthesized. Results: Based on the review of 31 studies on health education, the attributes are a learning process, health-oriented, multidimensional, person-centred and partnership. The antecedents are professional awareness of health education, training of health professionals, available resources, individual's willingness to act, and health as an individual's priority in life. The consequences are the increase in knowledge, skills and/or attitudes; ...

Background: Although beliefs, self-efficacy and intention to quit have been identified as proximal predictors of initiation or quitting in young adults, few studies have studied how these variables change after a smoking cessation intervention. Purpose: To evaluate the changes in the beliefs, self-efficacy and intention to avoid smoking, and determine if these are potential mediators in quitting, following a smoking cessation intervention, aimed at tobacco-dependent college students. Design: Single-blind, pragmatic randomized controlled trial with a 6-month follow-up. Method: A total of 255 smoker students were recruited from September 2013 to February 2014. Participants were randomly assigned to intervention group (n=133) or to control group (n=122). The students in the intervention group received a multi-component intervention based on the Theory of Triadic Influence. The strategies of this program consisted of a 50-minute motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. The smoking-related Self-efficacy, Belief and Intention scale was used to assess outcomes. Results: Intention to quit smoking is partial moderator explaining 36.2% of the total effects in smoking cessation incidence. At 6-month follow-up, the differences in the mean scores of self-efficacy and intention related to stopping smoking were significantly higher in the intervention than in the control group. Conclusions: A multicomponent intervention based on the Theory of Triadic Influence, tailored to college students positively increased the self-efficacy to avoid smoking, and the intention to quit, suggesting intention as potential mediator of quitting.

End-of-life care is provided in a variety of settings around the world, including residential care. The goal of this work is to delve into the needs of the family of a terminally ill patient institutionalised in a residential centre. To this end, a clinical case is presented which, together with the scientific evidence, financial aid will help us to determine what the family's needs are at this time. The analysis of the case is structured into four sub-themes: the need for contact and speech between the family and healthcare professionals, the need for medical presence, the need for nursing presence and emotional and social needs. This work shows the importance of the nursing professional developing a plan for identifying and attending to family needs. This family approach will make it possible to provide a higher quality attendance , which will lead to an improvement in the health of the family members.

Tobacco use is the leading preventable cause of disease, disability and death in the world and is considered a preventable pandemic. Health professionals have an essential role to play in helping smokers to quit. Therefore, during their university education, they should be provided with the knowledge, skills and aptitudes necessary to carry out smoking cessation interventions. With this in mind, goal researchers and professors from the Institut Català d'Oncologia (ICO), the University of Navarra, King's College London, the Escola Superior de Enfermagem de Coimbra, the Université Libre de Bruxelles, the University of Barcelona, the Erasmushogeschool Brussel and the University of Lleida have developed the INSTrUCT course. This innovative e-learning course resource educational is available open in four languages: Spanish, English, French and Portuguese. The purpose of this guide is to guide university teachers in the implementation and evaluation of this course, as well as to deepen the role of the teacher and the student in it. Finally, it is important to note that the development of this course has been made possible thanks to funding from the ERASMUS+ programme.

Tobacco consumption represents the first cause of preventable illness, disability, and death in the world, being considered an avoidable "pandemic". According to the World Health Organization (2020; [WHO]), tobacco consumption, at a global level, is responsible for over eight million deaths per year. All in all, the INSTrUCT course has the general goal to enable healthcare profession students in the assessment of the tobacco consumption status and in the main interventions to quit smoking. This guide intends to guide the professor through the implementation and assessment of the INSTrUCT course and to discuss which is the role of the professor and the student during its development.