Hospital-based Health Professionals Research Articles

Hospital-Based Health Professionals' Perceptions of Frailty in Older People.

There is a high prevalence of frailty amongst older patients in hospital settings. Frailty guidelines exist but implementation to date has been challenging. Understanding health professional attitudes, knowledge, and beliefs about frailty is critical in understanding barriers and enablers to guideline implementation, and the aim of this study was to understand these in rehabilitation multidisciplinary teams in hospital settings. Twenty-three semistructured interviews were conducted with health professionals working in multidisciplinary teams on geriatric and rehabilitation wards in Adelaide and Sydney, Australia. Interviews were audio recorded, transcribed, and coded by 2 researchers. A codebook was created and interviews were recoded and applied to the Framework Method of thematic analysis. Three domains were developed: diagnosing frailty, communicating about frailty, and managing frailty. Within these domains, 8 themes were identified: (1) diagnosing frailty has questionable benefits, (2) clinicians don't use frailty screening tools, (3) frailty can be diagnosed on appearance and history, (4) frailty has a stigma, (5) clinicians don't use the word "frail" with patients, (6) frailty isn't always reversible, (7) there is a lack of continuity of care after acute admission, and (8) the community setting lacks resources. Implementation of frailty guidelines will remain challenging while staff avoid using the term "frail," don't perceive benefit of using screening tools, and focus on the individual aspects of frailty rather than the syndrome holistically. Clinical champions and education about frailty identification, reversibility, management, and communication techniques may improve the implementation of frailty guidelines in hospitals.

“We don’t look too much into the communication disability”: clinicians’ views and experiences on the effect of communication disability on falls in hospital patients with stroke

Purpose Difficulty with communicating basic needs and attracting the attention of health professionals may contribute to falls for patients with communication disability after stroke. The aim of this study was to explore the views of hospital-based health professionals on: (a) the effect of communication disability on falls in patients with stroke; (b) falls prevention strategies for patients with communication disability following stroke; and (c) the roles of speech pathologists in the assessment, management, and prevention of falls in this population. Materials and Methods Online focus groups were conducted and analysed using content thematic analysis. Results In total, 11 health professionals participated in four focus groups. Clinicians viewed that: (a) the effects of falls in patients with communication disability are far-reaching; (b) communication disability complicates falls risk assessment and falls management; (c) current falls prevention strategies do not meet the needs of patients with communication disability; and (d) strong relationships have a central role in decreasing falls in this population. Conclusions Health professionals articulate concerning gaps in falls prevention strategies for patients with communication disability. Further research should investigate strategies enabling falls prevention and management to be more inclusive of patients with communication disability following stroke and consider ways in which speech pathologists could contribute to this field.

153 Challenges and facilitators experienced by professionals recording long-term outcomes after hip fracture: a Consolidated Framework for Implementation Research qualitative study

Abstract Background Older people with hip fracture can experience slow recovery. Hospitals in Ireland record inconsistent information about survival, recovery, and treatment adherence up to one year after fracture. The Irish Hip Fracture Database aims to implement outcome fields to standardise this information. This study aimed to explore local facilitators and challenges experienced by hospital-based health professionals in Ireland to long-term hip fracture outcome recording. Methods Health care professionals who had experience of collecting long-term outcomes after hip fracture in Irish acute and rehabilitation hospitals were identified through a systematic literature review and advertisement. They were sampled purposively by profession and geographical location. Semi-structured interviews and focus groups were conducted online, audio-recorded, and transcribed. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Research Ethics Committee approval was received. Results There were 21 participants: eight geriatricians, six physiotherapists, three nurses, three orthopaedic surgeons and an anaesthetist. Challenges and facilitators across five CFIR domains were identified. 1) Characteristics of Individuals: Patient-focused, persistent, and flexible professionals have driven long-term outcome recording locally. 2) Innovation characteristics: Patient contact mode and complexity of information recorded affected activity difficulty. 3) Process: Protected space, time, administrative support, role clarity and staff consistency aided sustainability. 4) Inner setting: Support of local governance groups, senior clinicians and management facilitated activity. 5) Outer setting: Professional collaborations between hospitals and international exemplars inspired activity, while perceived policy focus on acute data hindered prioritisation of long-term outcome recording. Conclusion While site-specific circumstances are evident, common challenges and facilitators have been identified to recording of long-term outcomes after hip fracture by hospital-based health professionals across Ireland. Education and implementation strategies are currently being developed based on these findings, with input from patients and international experts. Further research will evaluate implementation outcomes including feasibility of specific data fields.

Stakeholders' Perspectives on the Quality of End-of-Life Health Care Services for Chronic Obstructive Airways Disease: A Focus Group Study.

Delivery of end-of-life care for severe chronic obstructive pulmonary disease (COPD) has been hampered by an unpredictable disease trajectory and poor integration of health care and social services. To critically explore the perspectives, values, and experiences of stakeholders in COPD end-of-life healthcare services in a large district in Aotearoa New Zealand. Focus groups analysed utilising critical theory and Actor-Network Theory. Stakeholders in end-of-life COPD healthcare services were purposively sampled from a large healthcare network in Canterbury, Aotearoa New Zealand to participate in seven focus groups (bereaved carers, community-based health professionals, non-Māori, non-Pacific patients, and support people (two groups), Māori patients, supporters and health professionals, Pacific patients, support people and health professionals, and hospital-based health professionals). Participants discussed end-of-life care services for people with COPD. Transcripts were coded utilising descriptive and structural coding to develop themes related to provision of quality care. Participants were positioned as experts. We considered how the themes arising supported and disrupted the healthcare network for end-of-life COPD. Five themes related to quality of care for end-of-life COPD were identified: compassion, competence, community, commitment, and collaboration. The absence of any of these five themes required for quality care led to power imbalances within healthcare systems. Power inequities created disconnection among stakeholders which then disrupted commitment, community, and collaboration. A dysfunctional healthcare network impeded compassion between stakeholders and did not support their competence, leading to lower quality care. All five themes were identified as essential to delivery of high-quality end-of-life care in COPD. Stakeholders' perspectives of end-of-life care for COPD identified of core features of a health system network that enabled or impeded the actions of stakeholders and allocation of resources to provide quality care.

What do hospital-based health professionals need and expect from an mHealth app to support the first 1000 days of life? Results from a cross sectional study.

Several attempts have been made to introduce mHealth solutions to support maternal, newborn, and child health (MNCH). However, most of the available apps do not meet the needs of end-users, underscoring the urgency of involving them in the co-design of telehealth interventions. With this in mind, we investigated the needs and expectations of hospital-based health professionals (i.e., secondary users) providing care to pregnant women and new mothers with their babies for a hypothetical mHealth app to support the first 1000 days of life. From November 2021 to March 2022, we surveyed health professionals using a questionnaire that explored the perceived importance of specific content, functionalities, and technical features of the proposed app. We also collected sociodemographic information from secondary users. We performed descriptive analysis and then used Ward hierarchical clustering method to classify respondents according to their response patterns. We recorded the needs and expectations of 145 hospital-based health professionals from obstetrics/gynecology, nursery/neonatology, and pediatrics. We found general agreement with the proposed content of the app, particularly general information about health during pregnancy (92%) and potential risky infections during pregnancy (91%). Three clusters emerged from the analysis, with the high and medium demanding clusters rating the importance of app content and technical features as very high and high, respectively, while low demanding cluster expressing more skepticism, especially about some of the proposed functionalities of the app. Assessing the needs and expectations of end-users is an essential process for developing tailored and effective mHealth solutions. This study has shown that hospital-based health professionals generally recognize the value of the proposed app, suggesting their propensity to integrate such a telehealth solution into mainstream clinical practice.

Providing Lactation Care Following Stillbirth, Neonatal and Infant Death: Learning from Bereaved Parents

Objective: The study aimed to identify how, from the perspective of bereaved parents, hospital-based health professionals can better meet their lactation care needs. Methods: In-depth interviews were conducted with 17 mothers and 7 fathers bereaved by stillbirth, neonatal death, or older infant death. Participants were recruited from three large hospitals in Eastern Australia including two with human milk banks. Qualitative thematic data analysis identified bereaved parents' lactation experiences, needs, and how parents wanted lactation care to be provided. Results: Participants experienced lactation after infant death as hard and challenging, while at the same time they received limited lactation care. The negative impact of lactation, however, could be mediated by anticipatory guidance, assistance to make sense of lactation, support to make decisions from available lactation and breast milk management options, and support with breast care for as long as required. Bereaved parents explained lactation care was best provided by health professionals they had come to know and trust rather than by a particular professional role. Care should be provided with compassion, in a manner respectful of individual circumstances, inclusive of partners, and supplemented by quality written information. When bereaved parents felt supported to manage their lactation in a manner consistent with their unique needs, lactation for some could have a positive impact on grief. Conclusion: Bereaved parents have demonstrated that comprehensive lactation care is critical to their health and well-being. Such care should be more fully incorporated into hospital-based bereavement care policies and practices.

Establishing priorities for diabetes action goals according to key opinion leaders and health professionals

BackgroundThe ever-increasing burden of diabetes and the limited resources highlight the need for prioritization of national action goals for diabetes management. The Israeli National Diabetes Council (INDC) initiated a prioritization process aiming to set a top list of diabetes related goals, as suggested by decision makers and health professionals.MethodsA 2-step prioritization process, including a small (n = 32) circle of key opinion leaders of the INDC and a larger (n = 195) nationwide circle of diabetes health professionals consisting of physicians, nurses, and dieticians working in diabetes care centers, hospitals and family practice clinics, was established. An online questionnaire presenting 45 different action areas in diabetes prevention and care was distributed to the INDC members who ranked the 3 top diabetes priorities based on their individual interpretation of importance and applicability. The 7 highest ranking priorities were later presented to hospital-based and community diabetes health professionals. These professionals selected the 3 top priorities, based on their perceived importance.ResultsCouncil members opted mostly for action areas regarding specific populations, such as clinics for adult type-1 diabetes patients, diabetic foot, and pediatric and adolescent patients, while the health professionals’ top priorities were mostly in the general field of prevention, namely high-risk prediabetes population, prevention of obesity, and promotion of healthy life-style. In addition, priorities differed between hospital and community health professionals as well as between different professional groups.ConclusionsA national prioritization process of action areas in diabetes prevention and care is attainable. The resulting item list is affected by professional considerations. These priorities may direct efforts in the implementation of interventions to improve national-level diabetes management.

"Challenging Professional Boundaries": A Grounded Theory Study of Health Professionals' First Experiences of End-of-Life Care in Hospital.

Little is known about health professionals first experiences of End-of-Life care in hospital. This study aims to understand the psycho-social process that occurs when hospital-based health professionals engage in caring for a dying patient for the first time. We conducted a Grounded Theory study, with 19 health professionals. Challenging professional boundaries is the core category which explains the overall process. The theoretical model we conceptualized evidenced three phases: 1) building a relationship between patient/family and professionals, 2) the disrupting impact and 3) the reaction phase. Our analysis highlighted the initial strong impact of this experience, which brought professionals to perceive emotional suffering and feelings of inadequacy. The new aspect our grounded theory revealed is that all the categories are pertinent to all the professionals involved, therefore they explain important aspects of interprofessional collaboration in End-of-Life care.

UNIFIED: Understanding New Information from Emergency Departments Involved in the San Bernardino Terrorist Attack.

IntroductionEmergency departments (ED) are on the front line for treating victims of multi-casualty incidents. The primary objective of this study was to gather and detail the common experiences from those hospital-based health professionals directly involved in the response to the San Bernardino terrorism attack on December 2, 2015. Secondary objectives included gathering information on experiences participants found were best practices.MethodsWe undertook a qualitative study using Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines by performing semi-structured interviews with physicians, nurses, and incident management staff from multiple institutions responding to the San Bernardino terrorist attack. We coded transcripts using qualitative analysis techniques and we delineated and agreed upon a refined list with code definitions using a negotiated group process. Final themes were developed and analyzed.ResultsA total of 26 interviews were completed; 1172 excerpts were coded and categorized into 66 initial themes. Six final categories of communication, training, unexpected help, process bypassed, personal impact/emotions, and practical advice resulted.ConclusionOur study provides context regarding the response of healthcare personnel from multiple institutions to a singular terrorist attack in the United States. It elucidates several themes to help other institutions prepare for similar events. Understanding these common experiences provides opportunity to prepare for future incidents and develop questions to study in future events.

Suicidal ideation disclosure: Patterns, correlates and outcome

This study aimed to identify how frequently suicidal individuals disclosed their ideation, assess which sources were perceived to be most helpful and identify correlates of disclosure and source helpfulness. A cross-sectional survey was conducted with 1,616 Australian adults reporting suicidal ideation in the past 12-months. Participants were recruited from social media and reported on their disclosure of suicidal thoughts to formal and informal sources. 39% of participants did not disclose to anyone, while 47% disclosed to an informal source and 42% to a health professional. The responses of psychologists and counsellors were perceived to be the most helpful, while parents and hospital-based health professionals were perceived to be the least helpful. Severity of suicidal thoughts, younger age, and a suicide attempt in the past 12-months were associated with greater likelihood of disclosure, while participants who were younger, linguistically diverse, had greater suicidal ideation or personal stigma were less likely to perceive the response of a GP to be helpful. This study demonstrates that non-disclosure of suicidal thoughts is frequent and that the response received to a disclosure may not always be perceived to be helpful. Further research is needed to identify how best to support individuals who disclose suicide.

Differences in implementation of family focused practice in hospitals: a cross-sectional study

BackgroundChanges in Norwegian law and health policy require all health professionals to help safeguard the provision of information and follow-up for the children of parents with mental or physical illness, or substance abuse problems, to decrease their risk of psychosocial problems. There is a lack of knowledge on how the national changes have been received by hospital-based health professionals, and if they have led to an increase in family focused practice.MethodsThis cross-sectional study examined the adherence of health professionals’ (N = 280) in five hospitals to new guidelines for family focused practice, using a translated and generic version of Family Focused Mental Health Practice Questionnaire.ResultsOverall, health professionals scored high on knowledge and skills, and were confident in working with families and children, but reported moderate levels of family support and referrals. Comparison of the five hospitals showed significant differences in terms of workplace support, knowledge and skills and family support. The smallest hospital had less workplace support and less knowledge and skills but scored medium on family support. The two largest hospitals scored highest on family support, but with significant differences on parents refusing to have conversations with children.ConclusionsDifferences in implementation of family focused practice highlight the need to tailor improvement strategies to specific barriers at the different hospitals. The use of implementation theories and improvement strategies could promote full implementation, where all families and children in need were identified and had access to family support.Trial registration The study is approved by the Regional Committee on Medical and Health Research Ethics South-East Q5 37 (reg. no. 2012/1176) and by the Privacy Ombudsman.

Human Trafficking 3: Intervention And Therapy

Emergency department (ED) physicians must familiarize themselves with all mandatory reporting laws that apply to those whom they suspect of being the victims of human trafficking. Furthermore, ED physicians must be aware of when to require a forensic evaluation and when to enlist social services to help with the process of documentation, keeping in mind the medical, legal, and safety considerations of the patient. Subspecialty consultation should proceed in accordance with typical practice. Following the identification of a trafficked patient, a comprehensive interdisciplinary response should ensue: in addition to social workers, other hospital-based health professionals whose knowledge and skills may be needed include addiction service providers, child protection specialists, forensic and sexual assault nurse examiners, mental health providers, case managers, hospital legal counsel, and risk management specialists. Despite ED physician and related professional intervention, little is known regarding the outcomes of human trafficking. This review contains 1 figure, 3 tables and 13 references Key words: forensic evaluation, mandatory reporting laws, medical record documentation, neutral language, reported human trafficking, suspected human trafficking, trafficking in persons

The proposal of Paediatric Virology and its perspectives: An interview with Professor of Paediatrics Maria Theodoridou.

Professor Maria Theodoridou, Emeritus Professor of Paediatrics at the University of Athens, is one of the few paediatricians in Greece, who have experienced almost all the infectious diseases of the second half of the 20th century and their severe consequences, prior to the widespread adoption of immunisations. A milestone during her career was the establishment of a specialised National Reference Unit for the care of paediatric patients with acquired immune deficiency syndrome (AIDS) at the ‘Aghia Sophia’ Children's Hospital in Athens, Greece. According to Professor Theodoridou, training on the prevention, management and treatment of neonatal and paediatric viral infections represents a new educational challenge for both community as well as hospital-based paediatric health professionals. The debate of the potential strategically principal role of Paediatric Virology subspecialists in the primary, secondary and tertiary clinical practice is definitely necessary and needs further discussion and evaluation, she adds. She describes the difficulties that Greece, a country under a long-standing financial crisis, faces for the hospital-based management of paediatric viral infections and refers to the future advances, which are expected in the field of diagnosis and treatment of viral infections in neonates and children. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens on October 7th, 2017, Professor Theodoridou will focus on the immigration crisis and vaccination policy.

Somatic Symptom and Related Disorders

Somatic symptom and other related disorders are chronic and difficult psychiatric presentations for providers to assess, diagnose, and treat and are seen more in the medical than psychiatric setting. Because patients with these disorders are commonly referred to the consultation-liaison service, it is important for hospital-based mental health professionals to understand these illnesses. Identifying and differentiating between these diagnoses requires an understanding of several factors, including the patient's medical history, circumstances that may be driving behavior, and careful evaluation of the patient's awareness of these factors. Such factors are also essential in directing treatment, which tends to be time intensive and prolonged. This article provides an illustrative case and general guidelines for the diagnosis and treatment of illnesses under the category of somatic symptoms and related disorders. [ Psychiatr Ann . 2017;47(4):184–191.]

Level of adherence to the GOLD strategy document for management of patients admitted to hospital with an acute exacerbation of COPD.

The Global initiative for chronic Obstructive Lung Disease (GOLD) strategy document has been available since 2001. Little is known about level of adherence to the GOLD document among hospital-based health professionals assessing and managing inpatients admitted with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The primary aim of the study was to evaluate the level of adherence among health professionals to GOLD. A retrospective audit of medical histories was completed on a random sample of 240 patients admitted to hospital with a primary diagnosis of AECOPD within a calendar year. The audit evaluated adherence to GOLD recommendations on appropriateness of hospital and intensive care unit admissions as well as pharmacological and non-pharmacological management. High levels of adherence to indications for hospital admissions (97%), indications for intensive care unit admissions (100%) and prescription of bronchodilators (100%) were observed. However, antibiotics (45%) and oxygen therapy (68%) were over-prescribed. Adherence to non-pharmacological management was poor in areas such as smoking cessation (25%) and pulmonary rehabilitation referrals (16%). Patients admitted under the care of the respiratory team were more likely (odds ratio = 2.6, 95% confidence interval: 1.3-5.4) to be referred to pulmonary rehabilitation than patients admitted under the general medicine team. Health professionals in the respiratory team had better adherence to GOLD as compared to health professionals in other teams. Nonetheless, pharmacological interventions were both appropriately prescribed and also over-prescribed, whereas non-pharmacological interventions were used rarely, suggesting a need for practice review in these areas.

Supporting communication for children with cerebral palsy in hospital: Views of community and hospital staff

Objective: We aimed to investigate the views of allied health and nursing staff on supporting the communication of children with cerebral palsy (CP) and complex communication needs (CCN) in hospital.Method: We conducted 12 focus groups with 49 community- and hospital-based allied health professionals and hospital nurses.Results: Participants reported having active roles in supporting children's seating, mobility, equipment, mealtime management and psychosocial needs, but not in supporting the children's communication in hospital. Participants described several environmental barriers to supporting children's augmentative and alternative communication (AAC) in hospital, and suggested a range of strategies to ease communication difficulties at the bedside.Conclusion: Results indicate a potential new role for community- and hospital-based health professionals in supporting nurses to implement AAC strategies at the bedside. Supporting nursing staff to remove environmental barriers and use communication technologies might create a more communicatively accessible hospital ward for children with CP and CCN.

Health professional's perceptions of and potential barriers to smoking cessation care: a survey study at a dental school hospital in Japan

BackgroundSmoking is currently accepted as a well-established risk factor for many oral diseases such as oral cancer and periodontal disease. Provision of smoking cessation care to patients with oral problems is a responsibility of health care professionals, particularly dentists and dental hygienists. This study examined the smoking-related perceptions and practices of dental school hospital-based health professionals in Japan.FindingsA cross-sectional study design was used. The sample was formed from dentists, dental hygienists, physicians and nurses of a dental school hospital in Tokyo, Japan (n = 93, 72%). Participants were asked to complete an 11-item questionnaire assessing demographic variables and smoking history, provision of smoking cessation advice or care, attitudes about smoking cessation, and perceived barrier(s) to smoking cessation care. Eighteen percent of participants reported being current smokers and 15% reported being ex-smokers, with higher smoking rates reported by dentists compared with other health professionals (p = 0.0199). While recognizing the importance of asking patients about their smoking status, actual provision of smoking cessation advice or care by participants was relatively insufficient. Interventions such as 'assess willingness to make a quit attempt' and 'assist in quit attempt' were implemented for less than one-quarter of their patients who smoke. Non-smokers were more likely to acknowledge the need for increased provision in smoking cessation care by oral health professionals. 'Lack of knowledge and training' was identified as a central barrier to smoking cessation care, followed by 'few patients willing to quit'.ConclusionsA need for further promotion of smoking cessation activities by the health professionals was identified. The findings also suggest that dentists and dental hygienists, while perceiving a role in smoking care, do require training in the provision of smoking cessation care to hospital patients. In order to overcome the potential barriers, it is necessary to provide staff with appropriate training and create an atmosphere supportive of smoking cessation activities.

Impact of a nationwide outreach program on the diffusion of evidence-based practice in Taiwan

To disseminate evidence-based practice (EBP) among hospital-based health professionals, since 2007 the National Health Research Institutes (NHRI) of Taiwan has run a complex outreach program that includes information resource support and promotional campaigns. The aim is to evaluate the impact of this outreach program on the diffusion of EBP. Sixty-one regional hospitals in Taiwan. A cross-sectional, pre- and post-survey of a nationally representative sample of physicians and nurses was carried out in 2007 and 2009 to examine views related to EBP including changes in beliefs, attitudes, knowledge, skills, perceived barriers and behaviors. Physicians and nurses in the 2009 survey tended to have more knowledge and skill of EBP than their counterparts in the 2007 survey. They were less likely, however, to believe that EBP can improve patient care quality and to support the implementation of EBP. The prevalence of perceived barriers to EBP declined during the 2-year study period. In addition, physicians and nurses were more likely to access the online evidence retrieval databases according to the 2009 survey when compared with responses to the 2007 survey. The knowledge of, skill in, and behavior regarding EBP have improved among physicians and nurses of regional hospitals in Taiwan after a promotion period of 2 years and they perceive fewer barriers to EBP. These data suggest that the multifaceted nationwide promotion program of the type conducted by NHRI succeeded in diffusion and implementation of EBP among professionals.

What Information Do General Practitioners Need to Care for Patients with Lung Cancer? A Survey of General Practitioners Perceptions

General practitioners (GPs) are an integral part of the multidisciplinary team that care for patients with lung cancer. It is essential that patient information including results of tests, management plans, treatment, and follow-up arrangements are communicated between hospital-based carers and the community-based GP. The aim of this study was to explore GPs' views about the information they need from hospital-based health professionals in the management of their patients with lung cancer. This exploration is undertaken within the context of a multidisciplinary model of care, a relatively new concept in service delivery for cancer patients. Data were collected using a questionnaire that was distributed to the population of 433 GPs from one Australian regional Division of General Practice. Questions related to from whom, what, when and how GPs would like to receive information from the multidisciplinary hospital-based lung cancer team. GPs reported that they wanted information from all members of the multidisciplinary hospital-based lung cancer team, not just physicians. The key triggers for communication included: any change in the patient's condition; following initial outpatient visit; at admission and discharge; and following treatment milestones. Both medical and social information were seen as important to GPs and there was strong support to receive information electronically. This study illustrates the desire by GPs to receive information from all members of the hospital-based lung cancer team if it is relevant to the ongoing care of their patient. Technology-enabled solutions, such as an electronic multidisciplinary discharge summary, the electronic health record and the person-controlled electronic health record, offer strategies to improve both timeliness and access to information.

Validación de un cuestionario en español sobre comportamientos, actitudes y conocimientos relacionados con la exposición solar: «Cuestionario a pie de playa»

BackgroundQuestionnaires are the usual method for investigating sun-related behavior. However, such tools must be validated through evaluation of their measurement properties. The aim of the present study was to assess the validity and reliability of a Spanish questionnaire evaluating habits, attitudes, and understanding of exposure to sunlight. Patients and methodsIn a cross-sectional study, the questionnaire was administered to a sample of 422 participants found on beaches. For the test-retest analysis, 70 hospital-based health professionals were interviewed on 2 separate occasions. The construct validity, internal consistency, and reproducibility were analyzed. ResultsFactorial analysis of the principal components confirmed the construct validity with commonalities and factor saturations > 0.50, and revealed multiple dimensions with Cronbach a values > 0.70. The items on habits and understanding showed intraclass correlation and d coefficient values > 0.70, but those on attitude had lower stability values (0.50-0.80). ConclusionsThis is the first Spanish questionnaire with demonstrated validity and reliability for evaluating habits, attitudes, and understanding of exposure to sunlight. It will be a useful instrument for future epidemiologic studies and research into the prevention of skin cancer in Spain.