María Belén Conesa Ferrer

Background/objectives: The most common foetal malposition is the occipital posterior (OP) position, which accounts for 33.3% of malpositions occurring during labour, and the rate of dystocia reaches 95%. The aim of this study was to describe observed outcomes of a mobilisation protocol in correcting posterior foetal head positions during labour. Methods: A pilot study was conducted using a cross-sectional, multicentre methodology involving 25 pregnant women with a posterior foetal position who were asked to follow a mobilisation protocol. The women’s level of satisfaction was measured using the validated questionnaire, the Childbirth Experience Questionnaire—CEQ (Spanish version). Results: Anterior rotation was observed in 68% of cases, but in the absence of a control group, these findings cannot be distinguished from spontaneous physiological rotation, and 88% of these achieved vaginal delivery with a 95% confidence interval (76–100%). Apgar scores of ≥9 at 5 min were recorded in 100% of newborns, with an average of 9.96 with a 95% confidence interval (9.88–10.04). Women’s level of satisfaction was moderate to high, with the ‘Professional support’ and ‘Participation’ subscales standing out in particular; 100% of women noted the support they received from the midwife, and 95.24% stated that they had been involved in decision-making. Regarding perineal outcomes, no third-degree tears were recorded among women who received the protocol, and 44% of participants maintained an intact perineum. Conclusions: The protocol was feasible to implement, and anterior rotation, vaginal deliveries, favourable neonatal outcomes, and moderate-to-high maternal satisfaction were observed in this small cohort. However, future research will need to demonstrate the protocol’s efficacy through randomised controlled trials comparing the protocol with standard care.

Objectives: This study aimed to identify the prevalence of gender-based violence experienced through social networks among adult women in Spain. Specific objectives included describing in-person sexual violence within the context of GBV and analyzing the relationship between GBV experienced on social networks and in-person sexual violence. Methods: This observational, cross-sectional, and correlational study surveyed 1177 adult women aged 18–59 years. Data were collected through validated instruments, including the Cyber Dating Abuse Questionnaire, Online Sexual Victimization Scale, and Dating Violence Questionnaire. Statistical analyses, including the Mann–Whitney U test, Kruskal–Wallis test, and Spearman’s Rho, were used to examine violence as a function of sociodemographic variables, social network usage, and pornography consumption. Results: Of participants, 68.2% reported experiencing GBV on social networks, 62.7% reported online sexual violence, and 66.0% reported in-person sexual violence. Gender-based violence was significantly correlated with online sexual violence (r = 0.390, p < 0.001) and in-person sexual violence (r = 0.463, p < 0.001). Women from lower socioeconomic backgrounds reported higher victimization rates for all forms of violence analyzed (p < 0.05). Increased daily social network usage and pornography consumption were associated with higher victimization rates (p < 0.05). Conclusions: Gender-based violence on social networks is pervasive among adult women in Spain and is closely linked to in-person sexual violence. Socioeconomic factors, time spent on social networks, and pornography consumption were key predictors of victimization. These findings highlight the need for targeted interventions addressing online violence to mitigate gender-based violence in broader contexts.

Health systems play a key role in the detection and management of gender-based violence. This study aimed to evaluate the effectiveness of a training program designed to enhance the knowledge, skills, and attitudes of emergency healthcare professionals in addressing gender-based violence. A quasi-experimental pre-post study was conducted with 115 emergency health professionals from the Murcian Health Service. Participants completed a 10-hour online training program utilizing active learning methodologies, including guided reflection on didactic and dramatized problem-based videos. The Knowledge, Skills, and Attitudes on Gender-Based Violence Questionnaire (CCHA-VioGen) was administered before and after the training Results. Statistically significant improvements were observed in all three dimensions. Knowledge and skills showed medium effect sizes (d=2.07 and d=1.99, respectively), while attitude improved with small effect size (d=0.61). Participants rated the course highly in terms of learning consolidation and applicability, indicating that the course content was perceived as relevant and useful. The perceived need for further training was low, suggesting a strong sense of preparedness following the intervention. The training program is highly effective in enhancing healthcare professionals´ competencies in managing cases of gender-based violence. Short, online courses that incorporate innovative resources such as dramatized problem videos represent a feasible and impactful strategy for professional development, especially in setting with limited resources.

Background: Communication skills (CSs) and evidence-based practice (EBP) are key foundations for offering personalized and quality nursing care. CS that results in open communication is fundamental for applying EBP. Objectives: The objective of the study was to assess the relationship between the acquisition of EBP competencies and learning CS after taking an EBP course in the nursing degree. Methods: Pre-test-post-test quasi-experimental study without a control group. The study population comprised fourth-year undergraduate nursing students. Before and after an EBP course, students completed a questionnaire on CS competence (HP-CSS) and EBP competence (EBP-COQ). The EBP course lasts for 15 weeks, with 150 h of work for the student. Out of these 150 h, 60 are conducted in person, while the remaining 90 h are for independent or group work, utilizing the flipped classroom methodology. Bivariate, correlational, pairwise Student’s t-test, and linear regression multivariate analyses were performed. Results: The sample was composed of 153 students. After completing the EBP course, there was a statistically significant improvement in informative communication (p = 0.046) and assertiveness (p = 0.018). However, there were no observed changes in empathy, respect, and the total score of the CS competence. The results from the multivariate analysis showed that the dimensions of attitude towards EBP and EBP knowledge had a positive relation to three of the four dimensions of the CS and overall competence. Regarding the students’ variables and characteristics, admission through special programs for athletes and older students (p < 0.001) and being female (p = 0.004) were positively statistically associated with empathy. Conclusions: EBP training positively affects the development of CS in nursing students, as shown by significant improvements in the total scores of the CS and the dimensions of informative communication and assertiveness after the intervention. This study demonstrates the initial applicability and usefulness of an EBP training program for the development of CS in nursing students.

(1) Background: Clinical simulation is an educational approach that aims to replicate real-life scenarios. Its primary goal is to help nursing students acquire the necessary knowledge and skills to perform effectively in clinical settings. This study focuses on the relationship between communication skills, evidence-based practice (EBP), and clinical simulation. We aimed to assess how communication skills and EBP competencies affect nursing students’ performance in simulated clinical scenarios. (2) Methods: We conducted an observational, cross-sectional study with 180 third-year nursing students at the University of Murcia. We used validated instruments to evaluate the students’ EBP competencies, communication skills, non-technical skills, and nursing interventions in simulated scenarios. (3) Results: The results showed that the students had varying competencies in EBP and communication skills. However, there was a positive and statistically significant correlation (p < 0.001) between these variables, non-technical skills, and the simulated clinical scenario nursing interventions. Our regression models revealed that communication skills and EBP competence significantly influenced the performance of the student nurses regarding their clinical and non-technical skills in the simulated scenarios. (4) Conclusions: Communication skills and EBP competencies predict performance in simulated scenarios for nursing students.

Background. Few studies have analyzed the negative outcomes of disruptive behaviors in the nurse-physician relationship in patient care and their impact on patient safety. These multicausal studies significantly relate to organizational, institutional, and professional attitudinal risk factors. Aim. Analyze healthcare professionals perceptions of disruptive behavior and factors associated with patient safety climate in the nurse-physician relationship at the hospital level. Methods. A multicenter cross-sectional study was conducted with a sample of 370 nurses and physicians assigned to different public hospitals in the Murcia/Spain region, applying the adapted and validated Spanish version of the Nurse-Physician Relationship Scale: Impact of Disruptive Behavior on Patient Care. The analysis used proportions or means (standard deviation (SD)), univariate and multivariate linear regression models, and the chi-square test. Results. Disruptive behavior was more prevalent in the ICU (81.6) and the emergency department (67.8). Professionals indicate that fear of reprisals is the main barrier to the reporting system. Likewise, stress and frustration are more associated with disruptive behavior and influence the safety climate. Conclusion. Professionals indicate that disruptive behaviors can have a negative impact on clinical outcomes. Age and type of service were identified as the most relevant socio-occupational factors. Stress, frustration, and communication problems are the factors that most influence the safety climate.

Introducción: En el siglo XX el parto pasó de ser atendido en casa al ámbito hospitalario. Se adoptaron de forma acrítica intervenciones inapropiadas e innecesarias que condujeron a una deshumanización del parto. Este es el modelo que existe actualmente en la mayoría de los hospitales españoles y que fue cuestionado por la OMS ya en 1996. Objetivo: Describir las diferencias que existen en los resultados obstétricos y neonatales en primíparas en dos modelos distintos de asistencia al parto (biomédico y humanizado). Método: Se llevó a cabo un estudio descriptivo, de corte transversal. Se obtuvo una muestra por conveniencia de 205 primíparas, 110 del modelo biomédico y 95 del humanizado. Se compararon los resultados obstétricos y neonatales en dos hospitales con modelos diferentes de asistencia al parto en España. Resultados: En el modelo humanizado de asistencia al parto se obtuvieron unos mejores resultados obstétricos (inicio espontáneo, parto eutócico, periné íntegro o desgarro de I grado y menos episiotomías) que en el biomédico. No hubo diferencias en los resultados neonatales. Conclusión: Los beneficios de instaurar un modelo humanizado de asistencia al parto deberían ser considerados por los responsables de políticas sanitarias y reflejados en la mujer y su criatura.

En el clarinete, la interpretación del doble picado resulta compleja especialmente a altas velocidades. El objetivo es utilizar las TIC para medir la mejora de la velocidad del doble picado en este instrumento. Se realiza una prueba piloto con 13 participantes con el Título de Enseñanzas Profesionales de Clarinete. Se grabaron 2 ejercicios en dos ocasiones. La primera grabación pretendía medir la velocidad máxima a la que los participantes interpretaban los ejercicios con doble picado. Posteriormente, se facilitaron 29 piezas durante 8 semanas. Finalmente, se realizó una última grabación para observar si existía mejoría. Las herramientas tecnológicas utilizadas fueron ZyMi (para las grabaciones y el estudio), Audacity (para realizar las grabaciones), Sibelius7 (para escribir ejercicios) y Sonic Visualiser (para asegurar la calidad de la técnica). Las velocidades iniciales fueron bastante bajas puesto que a un tempo mayor se perdía calidad en la técnica. En cambio, en la última grabación, 5 de los participantes habían doblado las velocidades y 4 las triplicaron. Además, los Participantes 3 y 5 aumentaron tres veces la velocidad en el primero de los ejercicios y la doblaron en el segundo. Por su parte, el Participante 13 aumentó desde negra igual a 13 hasta negra igual a 105 en el primer ejercicio y hasta 85 en el segundo con apenas unas semanas de estudio. Se puede concluir que el uso de las TIC ayudó a los participantes a aumentar la velocidad sin errores de ejecución. Además, mejoraron en estabilidad el tempo al utilizar ZyMi desde velocidades bajas.

La técnica del doble picado no suele utilizarse en el clarinete por la dificultad que entraña. El objetivo es demostrar que la técnica puede ser desempeñada con el clarinete utilizando las TIC. Se puso en práctica la técnica en 13 clarinetistas con el Título de Grado Profesional o cursando estudios superiores. Estos la estudiaron mediante 29 ejercicios tras realizar una primera grabación de 2 ejercicios. Tras 8 semanas de estudio se realizó la última grabación para ver si la calidad de la técnica era mayor. La implementación de las TIC consistió en el uso de Audacity (para grabar), Sibelius7 (para escribir los ejercicios), ZyMi (para grabaciones y estudio) y los espectrogramas en Sonic Visualiser de los audios pregrabados (para valorar si existe evolución de la calidad del doble picado). Una vez que fueron analizados los espectrogramas y se escucharon las grabaciones en Sonic Visualiser, se observó que en la primera grabación la calidad del doble picado fue bastante deficiente en los registros agudo y sobreagudo de muchos de los participantes. Sin embargo, en la última grabación todos ellos consiguieron realizar los dos ejercicios con gran calidad en todos los registros. Como conclusión, puede decirse que el doble picado puede ser ejecutado por cualquier clarinetista y que, para ello, es muy recomendable la utilización de las TIC. La utilización de ZyMi y Sonic Visualiser permitió ver en los espectrogramas si la ejecución era precisa en cuanto a tempo, calidad del sonido, articulación, duración e igualdad de las notas.