Background: Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries.Methods: A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis.Results: Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage.Conclusion: WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.

Patient satisfaction with nursing care is an indicator of patient satisfaction with the hospital stay in general. The Nursing Intensive Care Satisfaction Scale is the only scale about patient satisfaction with nursing care received in an intensive care unit that incorporates the critically ill patient's perspective into its design and validation. We validated the scale nationally, incorporating intensive care units at public and private hospitals of different levels of complexity in Spain. The objective of this study was to validate in Spanish intensive care units the Nursing Intensive Care Satisfaction Scale, a patient-centred questionnaire that evaluates recently discharged intensive care patients' satisfaction with the nursing care they received. We used a psychometric quantitative methodology and a descriptive cross-sectional design. The study was conducted in intensive care units at level II and III public and private hospitals throughout Spain. The study population was all patients discharged from intensive care units from December 2018 to December 2019 from the 19 participating hospitals. We used consecutive sampling until reaching a sample size of 677 patients. The assessment instruments were given to patients at discharge and 48 h later to measure temporal stability. The validation process included the analysis of internal consistency (Cronbach's α coefficient), temporal stability (test-retest), construct validity through a confirmatory factor analysis, and criterion validity using the Pearson correlation coefficient and three criterion items that assessed similar constructs. The reliability of the scale was 0.97, and the factors obtained values between 0.87 and 0.96. The intraclass correlation coefficient for the total scale was 0.83, indicating good temporal stability. Construct validity showed a good fit and a four-factor structure, in accordance with the theoretical model. Criterion validity presented a correlation that was between moderate and high (range: 0.46 to 0.57). The Nursing Intensive Care Satisfaction Scale has good psychometric properties, demonstrating its ability to accurately measure patient satisfaction across a range of contexts in Spain. Continuous monitoring of satisfaction will allow nurses to identify areas for improvement that can increase the quality of care.

Background: Most standardized nursing care plans for healthy neonates include multiple nursing diagnoses to reflect nurses' judgments on the infant's status; however scientific literature concerning this issue is scarce. Newborn physiological immaturity is a concept in the ATIC terminology (architecture, terminology, interface, information, nursing [infermeria], and knowledge [coneixement]) to represent the natural status of vulnerability of the healthy neonate. Purpose: To identify the essential attributes of the concept and provide its conceptual and operational definition, using the Wilsonian approach. Findings: The concept under analysis embeds a natural cluster of vulnerabilities and environmental interactions that enhance the evolving maturation process. Implications for Practice: The use of this diagnosis may simplify the process of charting the nursing care plans and reduce time needed for documentation while maintaining the integrity of the information. Implications for Research: Consistent development and use of nursing concepts is essential for knowledge building. Studies on the actual use of nursing diagnoses are needed to inform decision making.

Professionals that work in neonatal units need to identify the strengths and weaknesses of the premature infant who is in the transition process from feeding through a gastric tube to oral feeding. The main aim of this study was to validate the Oral FEeding Assessment in premaTure INfants (OFEATINg) instrument. A psychometric validity and reliability study was conducted in Neonatal Intensive Care Units of two public, metropolitan, university hospitals. The study population were premature infants at a postconceptional age of 31–35 weeks. The study included evaluation of the reliability, convergent, discriminant and construct validity, sensitivity and specificity of the OFEATINg instrument. A total of 621 feedings of 56 preterm infants were evaluated. Confirmatory factor analysis identified 3 factors and 13 indicators with a good fit to the model. Cronbach's alpha coefficient was 0.78. The instrument showed high indices of inter-rater reliability (Pearson 0.9 and intraclass correlation coefficient 0.95). The OFEATINg scale is a valid and reliable instrument for evaluating the readiness for oral feeding of preterm infants. It may enable clinicians to evaluate the physiological and behavioral abilities involved in the oral feeding process and help them make decisions related to the transition to full oral feeding.Clinical trial registration: This study was prospectively registered at the two Institutional review boards.

Aim To determine the impact of the Best Practice Spotlight Organization® initiative on nurses’ perception of their work environment and their attitudes to evidence-based practice. Design Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines. Methods The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials. Discussion The study findings will show the current state of nurses’ perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme. Impact The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system.