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Spirituality and spiritual care in professional nursing are conceptualised and recognised as fundamental components of holistic healthcare. Despite the acceptance of and interest in spiritual care, a lack of education and clinical training on the subject limits nurses’ ability to meet patients’ spiritual needs. Consequently, the aim of this study was to analyse the effectiveness of a training programme designed to teach the specific knowledge, attitudes and competencies necessary to provide spiritual care in nursing practice. This study consisted of a one-group pre-post intervention design with two measurement times (baseline/pre-intervention and post-intervention). A teaching activity about spiritual care in nursing practice was designed and implemented (focal groups, open discussion, discussion groups and clinical case studies). The educational intervention was developed by the authors based on a literature review, research and feedback from the undergraduate students. A convenience sample of 369 nursing students at the University of Alicante (Spain) who were enrolled in the teaching subject of Psychology participated in this study. The effectiveness of the teaching activity was assessed through a self-administered 15-item questionnaire. The post-intervention results indicated that the programme was effective in improving knowledge, competencies and attitudes related to spiritual care. The implications of this study for teaching practice and future research are discussed

The aim of this paper was to explore a select group of Spanish nurses’ views of spirituality and spiritual care. An exploratory design using both qualitative and quantitative methods was used in this study. The participants were nurses who were enrolled in a Master of Nursing Research. Data were collected via an open questionnaire. Furthermore, participants completed the Meaning in Life Scale (MiLS-Sp), whose results were analysed using quantitative methodology. The results that were obtained from the quantitative analyses reported a satisfactory mean score on nurses’ self-reported spirituality. Qualitative data were analysed using grounded theory procedures. Qualitative analysis showed two approaches to spirituality nurses’ views: (i) a clinical approach that influenced by the context of their clinical practice and (ii) an alternative approach where spirituality was viewed as a health resource, moving away from the biomedical model of nursing training. Nurses are sensitive to spirituality issues and acknowledge their importance to practice. Despite this, they view spirituality in a rather mechanistic way without changing their attitudes, competences and perspectives on healthcare.

Scarce evidence exists about the best treatment for multi-system inflammatory syndrome (MIS-C). We analyzed the effects of steroids, intravenous immunoglobulin (IVIG), and their combination on the probability of discharge over time, the probability of switching to second-line treatment over time, and the persistence of fever 2 days after treatment. We did a retrospective study to investigate the effect of different treatments on children with MIS-C from 1 March 2020 to 1 June 2021. We estimated the time-to-event probability using a Cox model weighted by propensity score to balance the baseline characteristics. Thirty of 132 (22.7%) patients were initially treated with steroids alone, 29/132 (21.9%) with IVIG alone, and 73/132 (55%) with IVIG plus steroids. The probability of early discharge was higher with IVIG than with IVIG plus steroids (hazard ratio [HR] 1.65, 95% CI 1.11–2.45, p  = 0.013), but with a higher probability of needing second-line therapy compared to IVIG plus steroids (HR 3.05, 95% CI 1.12–8.25, p  = 0.028). Patients on IVIG had a higher likelihood of persistent fever than patients on steroids (odds ratio [OR] 4.23, 95% CI 1.43–13.5, p  = 0.011) or on IVIG plus steroids (OR 4.4, 95% CI 2.05–9.82, p  < 0.001). No differences were found for this endpoint between steroids or steroids plus IVIG.    Conclusions : The benefits of each approach may vary depending on the outcome assessed. IVIG seemed to increase the probability of earlier discharge over time but also of needing second-line treatment over time. Steroids seemed to reduce persistent fever, and combination therapy reduced the need for escalating treatment. What is Known: • Steroids plus intravenous immunoglobulin, compared with intravenous immunoglobulin alone for multi-system inflammatory syndrome (MIS-C) might reduce the need for hemodynamic support and the duration of fever, but the certainty of the evidence is low. What is New: • Intravenous immunoglobulin, steroids, and their combination for MIS-C may have different outcomes. • In this study, intravenous immunoglobulin increased the probability of discharge over time, steroids reduced persistent fever, while combination therapy reduced the need for second-line treatments.

Spiritual care is a core component of holistic nursing; however, nursing students frequently report limited preparation and confidence in addressing patients' spiritual needs. Although simulation-based education has shown promise for developing complex professional competencies, little is known about how nursing students experience the process of learning spiritual care through high-fidelity simulation. Therefore, this study aimed to explore nursing students' perceptions and experiences regarding the development of spiritual care competencies through high-fidelity clinical simulation. The design of the study was qualitative phenomenological study. First-year undergraduate nursing students (n = 55) from a public Spanish university participated in a structured high-fidelity simulation focused on spiritual care. Data were collected through reflective narratives written after the simulation, following Lederman's debriefing model. Data were analyzed using reflexive thematic analysis based on Braun and Clarke's approach, combining inductive and deductive coding strategies and supported by ATLAS.ti software. Four themes were identified: (1) emotional positioning in relation to spirituality, reflecting initial emotional responses to a novel learning experience; (2) negotiating complexity in spiritual care practice, comprising two subthemes: (2.1) relational uncertainty and ethical tension in spiritual encounters, and (2.2) relational enablers and communicative attunement in spiritual care; (3) meaning-making and reflective transformation, representing the development of reflective capacity and a deeper understanding of spiritual care as part of holistic nursing; and (4) integration of spiritual care into professional identity, highlighting perceived transferability to future clinical practice. Participants described simulation as a psychologically safe environment that promoted emotional engagement, ethical awareness, and reflective learning. High-fidelity simulation shows potential as an educational strategy for developing spiritual care competencies in nursing education. Introducing spiritual care training early in nursing curricula may enhance students' ability to provide holistic, person-centered care that addresses patients' spiritual needs. Not applicable.

This cross-sectional study examined whether university students from the U.S. ( n  = 392) and Spain ( n  = 200) considered the viewing of sexually explicit material (SEM) to be tantamount to committing infidelity. Participants’ ages ranged from 18 to 36 (U.S. sample) and 18 to 35 (Spain sample), respectively. At both universities, the study was made available to students via a computer program that allows recruitment and completion of the questionnaires online. It was found that the majority of U.S. and Spanish participants (73 and 77%, respectively) indicated that they did not consider viewing SEM as an act of infidelity. Also, overall, U.S. participants, those who were not currently in a relationship, and those who do not view SEM, were significantly more likely to believe that viewing SEM constituted infidelity compared to Spanish participants, those currently in a relationship, and those who view SEM. Finally, it was found that among U.S. and Spanish participants, intolerance of infidelity in general, negative attitudes toward SEM, and the proclivity for jealousy significantly correlated with believing that viewing SEM was tantamount to infidelity. For U.S. participants only, religiosity and (low) self-esteem also correlated with the belief that viewing SEM was infidelity. Implications of the findings are discussed.

To adapt and validate the Spanish version of the Spirituality and Spiritual Care Rating Scale (SSCRS-Sp) for nursing students, ensuring its psychometric reliability and suitability for assessing perceptions of spirituality and spiritual care in educational contexts. Spirituality and spiritual care are key aspects of holistic nursing, yet they remain insufficiently integrated into nursing education. Valid and reliable tools are required to evaluate students’ understanding and attitudes, especially in Spanish-speaking populations. An observational, descriptive, cross-sectional study following STROBE guidelines. The study was conducted in two phases. Phase one involved adapting the SSCRS-Sp from a validated version for nursing professionals, including expert review and a pilot test with 34 students to ensure content validity and cultural relevance. Phase two included a psychometric evaluation with 435 first-year nursing students from two Spanish universities. Structural validity was tested using confirmatory factor analysis (CFA) and reliability assessed through Cronbach’s alpha, McDonald’s omega and Guttman’s lambda 6 coefficients. CFA confirmed the original four-factor model (Spirituality, Spiritual Care, Religiosity, Personalized Care). Internal consistency was acceptable (α = 0.72; ω = 0.82; λ₆ = 0.80), though the Personalized Care subscale showed lower reliability (α = 0.43). Students reported moderate perceptions of spirituality and spiritual care. The SSCRS-Sps is a valid and reliable instrument for evaluating nursing students’ perceptions of spirituality and spiritual care, supporting educational improvements and future longitudinal research. •Nursing students face challenges in spiritual care due to limited formal education.•Existing tools lack specificity in assessing students' spiritual care competencies.•The SSCRS-Sp was adapted and validated for Spanish nursing students.•This 17-item scale shows strong reliability and validity in an academic setting.•The SSCRS-Sp helps identify training needs and improve nursing education.

High-fidelity simulation is an educational technique that utilizes advanced technology and realistic clinical scenarios to replicate real-life situations, offering students a safe and immersive environment to practice and enhance their skills. A quantitative experimental study with a pretest–posttest single-group design was conducted, where 143 first-year undergraduate nursing students ( n  = 143) participated in a simulation program focusing on spiritual care. The response rate was 49.5%, calculated as the number of students who completed the questionnaire (143) divided by the total number of students approached (289). The pretest and posttest were conducted one month apart. The Spirituality and Spiritual Care Rating Scale (SSCRS-Sp) was used to assess changes in students' spiritual competencies before and after the simulation. Results indicated significant improvements in students' perceptions of spiritual care, suggesting that simulation is an effective method for enhancing spiritual competencies.

The aim of this study was to examine the validity of the Spanish version of the Distance Education Learning Environments Survey (Sp-DELES). This instrument assesses students’ perceptions of virtual learning environments using six scales: Instructor Support, Student Interaction and Collaboration, Personal Relevance, Authentic Learning, Active Learning, and Autonomy. Further, the Sp-DELES includes an additional scale that assesses students’ Satisfaction with their classes. The original DELES has been used in at least 27 independent studies with strong reliability and validity. For this study, we sampled 265 students from the University of Alicante enrolled in various hybrid and distance education courses taught by the Department of Health Psychology. We analysed the Sp-DELES for validity using principal component factor analysis with varimax rotation, and for reliability using Cronbach’s alpha. The Sp-DELES exhibited good reliability (Cronbach’s alpha for the scales ranging from 0.86 to 0.97) and the original six-factor structure was replicated and accounted for 72.9 % of the total variance. Overall the results are consistent with those of the original English-language version of the instrument. The Sp-DELES has proven to be a reliable and valid instrument for assessing psychosocial learning environments in tertiary-level hybrid and distance-education settings.

Doc number: 311 Abstract Background: The aging process involves a decline in immune functioning that renders elderly people more vulnerable to disease. In residential programs for the aged, it is vital to diminish their risk of disease, promote their independence, and augment their psychological well-being and quality of life. Methods: We performed a randomized controlled study, evaluating the ability of a relaxation technique based on Benson's relaxation response to enhance psychological well-being and modulate the immune parameters of elderly people living in a geriatric residence when compared to a waitlist control group. The study included a 2-week intervention period and a 3-month follow-up period. The main outcome variables were psychological well-being and quality of life, biomedical variables, immune changes from the pre-treatment to post-treatment and follow-up periods. Results: Our findings reveal significant differences between the experimental and control groups in CD19, CD71, CD97, CD134, and CD137 lymphocyte subpopulations at the end of treatment. Furthermore, there was a decrease in negative affect, psychological discomfort, and symptom perception in the treatment group, which increased participants' quality of life scores at the three-month follow-up. Conclusions: This study represents a first approach to the application of a passive relaxation technique in residential programs for the elderly. The method appears to be effective in enhancing psychological well-being and modulating immune activity in a group of elderly people. This relaxation technique could be considered an option for achieving health benefits with a low cost for residential programs, but further studies using this technique in larger samples of older people are needed to confirm the trends observed in the present study. Trial registration: International Standard Randomised Controlled Trial Number Register ISRCTN85410212