Access to healthcare among transgender and non-binary youth in Sweden and Spain: A qualitative analysis and comparison.

BACKGROUND: Transgender and non-binary (TGNB) people tend to report worse health than cis people, however, despite an increased need for care, they face several barriers when trying to access healthcare. These barriers might be exacerbated when young age intersects with a trans identity, and so there is a need for studies highlighting the experiences of TGNB youth. AIMS: To explore and compare how TGNB youth (15-26 years old) in Sweden and Spain experienced their access to healthcare, in order to shed light on the strengths and limitations of different kinds of healthcare systems and improve healthcare provision and policy development. METHODS: This study was based on a qualitative analysis of semi-structured interviews with TGNB youth living in Sweden (n = 16) and Spain (n = 18). Of these, 22 identified as male or transmasculine, six as non-binary, and six as women or transfeminine; 25 had undergone some type of gender-affirming care, and the rest were on the waiting list or undergoing preparatory visits and had not started hormonal treatment. The interviews were analyzed using reflexive thematic analysis. An abductive approach was applied, and the Levesque conceptual framework was used to compare the analyses of each set of materials. RESULTS: We present our findings using the structure of the accessibility framework, focusing on approachability, acceptability, availability, affordability, and appropriateness. The conceptualization of accessibility in combination with the concept of cisnormativity illustrates how specific ideals and normative expectations affect access to healthcare for TGNB people across contexts, with most barriers arising from the appropriateness of the services. DISCUSSION: Young TGNB people experience barriers to accessing healthcare both in the Spanish and the Swedish contexts. Strategies to reduce these barriers should be framed within the critique of and resistance to cisnormativity and should focus on users with intersecting marginalized identities to promote health equity.

Estrés y ansiedad en estudiantes de enfermería durante la primera ola de la pandemia de COVID-19.

OBJECTIVE: To compare anxiety and acute stress levels among nursing students who joined the labour market during the first wave of the COVID-19 pandemic   and those who did not. METHODS: A cross-sectional, multicentre descriptive study across three Spanish public universities. A total of 216 nursing students participated in our study. Data collection was carried through an online questionnaire, that included variables on conditions for entering the labour market, the Zung Anxiety Self-Assessment Scale and the Stanford Acute Stress Reaction Questionnaire. We performed univariate and multivariate analyses.  Results: Overall, 42.6% (n=92) of the students entered the labour market during the first wave of the COVID-19 pandemic. The global anxiety score was x?=36.31 (SD=5.71) and the stress score was x?=82.39 (SD=30.84). Lower anxiety levels were observed among those who joined the labour market (x?=35.67; SD=5.78) as compared to those who did not (x?=36.73; SD=5.67). Overall 92.4% of the students were acutely stressed. Acute stress was higher among those who did not work (x?=84.35; SD=32.38) and significantly in women.  Conclusions: Nursing students were able to cope with stress in situations such as the COVID-19 pandemic. A healthy worker effect could not be ruled out. Stress and anxiety among nursing students should be considered by clinical practice preceptors and at the time students first enter the labour market.

OBJETIVO: Comparar los niveles de ansiedad y estrés agudo entre los/las estudiantes de enfermería que se incorporaron al trabajo durante la primera ola de la pandemia de COVID-19 y aquellos que no lo hicieron. Métodos: Estudio descriptivo transversal multicéntrico realizado en tres universidades públicas españolas. Un total de 216 estudiantes de enfermería participaron en nuestro estudio. La recopilación de datos se realizó mediante un formulario en línea. Se recopilaron variables relacionadas con las condiciones para ingresar al mercado laboral y se incluyó la Escala de Autoevaluación de Ansiedad de Zung y el Cuestionario de Reacción Aguda al Estrés de Stanford. Se llevaron a cabo análisis univariados y multivariados. RESULTADOS: El 42,6% de los estudiantes ingresaron al mercado laboral. La puntuación global de ansiedad fue x?=36,31 (DE=5,71) y la puntuación de estrés fue x?=82,39 (DE=30,84). Los niveles más bajos de ansiedad se encontraron en aquellos que se incorporaron al mercado laboral (x?=35,67; DE=5,78), en comparación con aquellos que no lo hicieron (x?=36,73; DE=5,67). El 92,4% del total de alumnos presentaron estrés agudo. El estrés agudo fue mayor en aquellos que no trabajaron (x?=84,35; DE=32,38), y significativamente en mujeres.  Conclusiones: Los estudiantes de enfermería mostraron ser capaces de hacer frente al estrés en situaciones como la pandemia de COVID-19. No se puede descartar un efecto del trabajador sano. El estrés y ansiedad de los estudiantes de enfermería deben tenerse en cuenta por los tutores de prácticas clínicas y cuando se incorporan al mercado laboral por primera vez.

Water insecurity among seasonal agriculture workers: perspectives from Spanish professionals.

BACKGROUND: Migrant seasonal agricultural workers face conditions of material vulnerability such as inadequate housing difficulties prevent access to running water supplies. The purpose of this study is to explore the perceptions of professionals involved in the care and support of seasonal migrant agricultural workers, as it relates to water access and water consumption and their impact on these workers' health, in a context of COVID-19 pandemic. METHODS: A qualitative exploratory and descriptive study was conducted in 2021 as part of a larger research project, based on 63 personal semi-structured interviews with professionals who provided support to seasonal migrant agricultural workers in three Spanish autonomous regions. COREQ checklist was used for reporting. The interviews were recorded, transcribed, and imported into ATLAS.ti-9 for an inductive thematic analysis. RESULTS: The results have been structured into two main themes: (1) Accessing and obtaining water; and (2) Health problems related to water consumption. Seasonal migrant agricultural workers experience barriers to obtaining safe water for hygiene, cleaning, food preparation and drinking. The implementation of regulations to reduce COVID-19 transmission resulted in improved hygiene levels in the migrants' quarters, including access to safe drinking water. CONCLUSION: This study suggests that water insecurity experienced by migrant seasonal agricultural workers in Spain results from their poor living conditions and causes health problems related to a lack of hygiene and the use of unsafe water. Sustainable solutions are needed beyond the pandemic in order to provide migrant workers with adequate living conditions and ensure their water needs are fulfilled.

Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study.

OBJECTIVE: The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students. METHOD: Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students). RESULTS: Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship. CONCLUSIONS: Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave.

AIMS AND OBJECTIVE: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020). BACKGROUND: As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms. DESIGN: Sequential, mixed-method, multicentre study. METHODS: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. RESULTS: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. CONCLUSION: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. RELEVANCE TO CLINICAL PRACTICE: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

Strategies to Prevent and Cope with Adolescent Dating Violence: A Qualitative Study.

BACKGROUND: Dating violence has attracted scholarly interest from many fields because of its implications for adolescents' health. This study aimed to learn which strategies adolescents use to address and prevent dating violence. METHODS: Eight focus group discussions were analyzed, which included a total of 78 adolescents between 13 and 17 years old who had the signed consent of their parents or guardians. RESULTS: The findings showed that the majority of adolescents lacked effective mechanisms to manage violence in their dating relationships, which were characterized by immaturity, a lack of trust in their families, and unrecognized relationship violence. CONCLUSIONS: Assessing roles and relationships, as well as coping mechanisms, is a valid way to approach adolescents and explore how they perceive interaction during dating and which strategies are used most frequently to prevent violence.

Factores promotores, dificultades y estrategias para emprender y continuar la lactancia materna en España: la voz de las mujeres / Factors that promote, hinder, and support promotion, hindering and strategic factors to breastfeeding in Spain: the voice of women

OBJETIVO: Identificar factores promotores, dificultades y estrategias para el inicio y continuación de la lactancia materna (LM), en base a la experiencia de mujeres lactantes. METODOLOGÍA: Estudio cualitativo fenomenológico realizado en la Región de Murcia (España) en el 2019. Se reclutaron a veintisiete mujeres que alimentaron a sus hijos/as con LM en el periodo de 2012-2018 mediante una asociación de LM y un muestreo de bola de nieve. Se realizaron entrevistas personales abiertas y un análisis temático de las transcripciones. RESULTADOS: Se estructuraron en tres temas: 1) Facilidades para el inicio y mantenimiento de la LM, 2) Dificultades ante la LM y 3) Estrategias utilizadas por las mujeres para solventar las barreras. Mientras que la motivación para amamantar y el apoyo recibido facilitaron la LM, las barreras más comunes se relacionaron con miedos e inseguridades personales, cansancio, problemas físicos y la respuesta social frente a la LM. Los motivos de abandono fueron el déficit de producción de leche, la incorporación laboral y la actitud del bebé. Las participantes desarrollaron autocuidados, búsqueda de información y asociaciones de LM y estrategias de conciliación familiar-laboral para paliar las dificultades. CONCLUSIÓN: Es necesaria una mayor implicación por parte de las/os profesionales de la salud para apoyar a las mujeres a través de la herramienta de educación para la salud, el apoyo por pares y medidas institucionales que favorezcan la LM en el lugar de trabajo.

OBJECTIVE: To identify promoting factors, difficulties, and strategies related to the initiation and continuation of breastfeeding (BF), based on the experiences of breastfeeding women. METHODOLOGY: A phenomenological qualitative study conducted in the Region of Murcia (Spain) in 2019. Twenty-seven women who breastfed their children from 2012 to 2018 were recruited through a breastfeeding association and snowball sampling. Personal open interviews were conducted, and a thematic analysis of the transcriptions was performed. RESULTS: The findings were organized into three themes: 1) Facilitators for the initiation and maintenance of BF, 2) Difficulties faced during BF, and 3) Strategies employed by women to overcome the difficulties. While the motivation to breastfeed and provision of support facilitated BF, common challenges were noted, including personal fears and insecurities, fatigue, physical problems, and societal response to BF. Reasons for discontinuation included low milk production, the need to return to work, and the baby's attitude. Participants developed self-care practices, sought information, joined breastfeeding associations, and implemented work-family reconciliation strategies to address the challenges. CONCLUSION: Greater involvement from healthcare professionals is necessary to support women who breastfeed through health education, peer support, and institutional measures that promote BF in the workplace.

Job expectations and intolerance to uncertainty of nursing students: Results from a multicentre, mixed-methods study in Spain.

AIM: To identify the job expectations and intolerance to uncertainty in final-year nursing students from three Spanish universities and evaluate the differences between them. DESIGN: Multicentre, mixed-methods study. METHODOLOGY: We included nursing students from three universities in Spain (Lleida, A Coruña and Murcia). Questionnaires were used to collect data on sociodemographic variables, job expectations and intolerance to uncertainty. In addition, in-depth personal interviews were conducted to complement quantitative data. Descriptive statistics were calculated and comparison tests (ANOVA, chi-square) were performed to analyse the differences between universities and a content analysis was carried out for qualitative data. RESULTS: The sample included 305 final-year nursing students enrolled in the 2017-2018 and 2018-2019 courses, of which 21 participants were interviewed for the qualitative phase. Findings were reported based on four main themes: Expected employment conditions, perceptions of working conditions, job uncertainty and increased chances of getting a job by continuing education after finishing the nursing degree. Results showed that 92.13% of the students were concerned about their future employment. Analysis of the in-depth interviews highlighted the uncertainty of finding a job as a nurse and the anticipated precarious employment conditions (i.e. lack of stability stemming from daily or weekly temporary contracts) in case they managed to find work. Moreover, it was shown that these perceptions affect their health, leading to situations of anxiety, stress and negativity during their time as nursing students. Overall, 65.57% considered migrating outside their town/region to increase their job opportunities and 97.0% wanted to continue their education after finishing their degree, motivated by their vocation, professional aspirations and to increase their possibilities of finding work. CONCLUSION: Nursing students find themselves in a situation of great uncertainty before finishing their studies, anticipating a future with great stress and even frustration as a result of unemployment and job insecurity. They even consider the possibility of migrating when they finish their degree to increase their job opportunities. Therefore, it is necessary to improve the recruitment process of nurses in Spain through increased security and stability and thus contribute to reducing the stress and frustration of future nurses.

Factors contributing to the perpetuation and eradication of female genital mutilation/cutting in sub-Saharan women living in Spain.

OBJECTIVE: Female Genital Mutilation/Cutting (FGM/C) is one of the most widespread traditional practices harmful to the health of women and girls in the world. Its spread to the West highlights the need to establish preventive actions in European countries taking into account the affected population. That is why this study is aimed at finding out the elements that support the continuation of FGM/C and those that promote the change of attitudes and fight against FGM / C from the perspective of the sub-Saharan women themselves who reside in Spain. DESIGN: Qualitative exploratory research that uses the method of life stories through an open interview. PARTICIPANTS AND SETTING: The participants were 24 women living in the Region of Murcia (Spain) who come from sub-Saharan countries where FGM/C is commonly practised. FINDINGS: Arguments supporting FGM/C, the lack of knowledge and family pressure are identified as factors that perpetuate the practice, whereas the motivating factors for the change in attitudes that make most of the interviewees oppose FGM/C are the awareness of the consequences on health and close negative experiences, growing awareness of their rights, supportive legislation and breaking the taboo related to this practice to question justifications for FGM / C and share experiences. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: Being aware of the arguments of both sides, women who defend FGM/C and those who oppose it, is a valuable source of information that obstetrics, midwifery and nursing professionals can use. The study provides the core elements that any healthcare education program should incorporate to prevent female genital mutilation/circumcision.

[Agricultural work and migration in Spain: socio-labour precariousness and health (AGROMISALUD project)]. / Trabajo agrícola y migración en España: precariedad sociolaboral y salud (Proyecto AGROMISALUD).

OBJECTIVE: To assess the influence of job insecurity and social exclusion on the health of migrant men and women working in the agricultural sector in Spain. METHOD: Qualitative and quantitative data will be collected in four Spanish autonomous regions (Catalonia, La Rioja, Murcia, and Andalusia) between 2021 and 2022. First, semi-structured personal interviews with at least 40 professional key informants or experts (from NGOs, associations, health, social services, trade unions, agricultural cooperatives, politics, and cultural mediators). Second, semi-structured personal interviews combined with participatory techniques (body mapping and photovoice) will be conducted with 40 migrant men and women working in agriculture. Thirdly, a cross-sectional study with an estimated sample of 400-500 migrants working in agriculture, based on the National Health Survey and the Living Conditions Survey.

Burnout and job satisfaction among nurses in three Spanish regions.

AIMS: To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions. BACKGROUND: The nursing profession involves high work stress due to emotional involvement, workload and available resources. METHODS: Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS. RESULTS: The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so. CONCLUSION: Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.

[Sexist relationships in Generation X and Millennials]. / Relaciones sexistas en la generación X y Millennials.

OBJECTIVE: To identify sexist violence features on different technological generations (Millennials and Generation X). DESIGN: Descriptive cross-sectional study. SITE: Region of Murcia, Spain. PARTICIPANTS: A total of 1269 users of social networks belonging to the Millennials generation (19-38 years) and Generation X (39-54 years) who are in a romantic relationship. MAIN MEASUREMENTS: The instrument "Questionnaire about new technologies to transmit gender violence", analyzes the use of social networks, suffered and exercised violence on couples. The study variables have been the generational group, age, sex, alcohol and drug consumption, the level of formal education, origin and residence country and sexual orientation. RESULTS: Millennials show a statistically significant association with the items on risk patterns in networks related to phising, sexting, flaming, false offers, cyberstalking, and webcam hijacking (p<0.05), while regarding violence suffered only has been observed association in items related to flaming (OR: 0.405) (95% CI: 0.226-0.726) and sexual coercion (OR: 0.420) (95% CI: 0.200-0.882). Drugs increase risky activities, as well as violence suffered and practiced (p<0.05). The women sample reports more pressure in sexual activities (OR: 2587) (95% CI: 1702-3931) and fears from their partners (OR: 2598) (95% CI: 1749-3857). CONCLUSIONS: The study shows higher risk patterns, as well as violence suffered and practiced in the Millennial group compared to Generation X. Also, it shows an increase generated by alcohol and drugs in the violence suffered and practiced by the study subjects. On the other hand, there are differences between the behaviors and violence suffered and practiced according to the different sexes, where the violence suffered by women is related to fear and activities of a sexual nature.

Postmigratory Perceptions of Female Genital Mutilation: Qualitative Life History Research.

INTRODUCTION: Female genital mutilation/cutting (FGM/C) is a practice, in breach of human rights, which currently extends to European countries. Given that migration to a Western country can involve cultural change, the aim of the present study is to explore the experiences and perceptions of sub-Saharan women regarding FGM/C following migration to Spain. METHOD: A qualitative exploratory research design utilizing life history methodology was applied. Participants (n = 24) were recruited until data saturation was reached. RESULTS: Sub-Saharan women describe their experience of FGM/C. Once in Spain, they begin to demystify the justifications for which FGM/C is practiced and to break the taboo that surrounds the practice. DISCUSSION: Migration leads individuals to reflect on the traditional practices from their countries of origin. The nursing profession must accompany migrant women throughout their process of change and provide objective information from a position of cultural understanding, avoiding attitudes that might create a sense of revictimization while their resultant health consequences are being attended to.

Living with mutilation: A qualitative study on the consequences of female genital mutilation in women's health and the healthcare system in Spain.

INTRODUCTION: Female genital mutilation is a health and human rights issue which extends to western countries. It is estimated that there are some seventeen thousand women and girls living in Spain who have either been mutilated or are at risk of being so. Healthcare professionals face the challenge of providing adequate care in response to this emerging problem. AIM: To discover the repercussions of female genital mutilation on the health of sub-Saharan women residing in Spain, as well as the healthcare received. METHODS: A life-history qualitative research design was utilized. The study population included 14 genitally mutilated women residing in the Region of Murcia who had given birth in Spain and been attended to by the national public healthcare system. RESULTS: Women suffer physical, psychological, obstetric and sexual health issues as a result of female genital mutilation and despite having a favourable perception of the healthcare received during the pregnancy and the delivery, the provision of health education, detection and treatment of female genital mutilation by healthcare professionals was seen to be lacking. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Healthcare policy must address insufficiencies in delivering adequate care to immigrant women who have been the victim of female genital mutilation by implementing the necessary resources and training for professionals to effectively meet the specific healthcare needs of this population and prevent this cruel practice from being perpetuated.

Obligation and negative consequences in primary caregivers of dependent older relatives.

The purpose of this study was to analyse the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. A secondary analysis of data from two cross-sectional studies of primary home caregivers (N = 400; probabilistic sample) of older adult relatives in Spain was conducted. Data regarding obligation (four categories basing on beliefs of obligation and social pressure: low pressure and low beliefs, low pressure and high beliefs, high pressure and low beliefs and high pressure and high beliefs), stressors, anxiety and depression were collected by interview in 2013. The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression. When the relation of behavioural problems with anxiety and depression stratified by the previous four categories of obligation was analysed, behavioural problems were associated with anxiety and depression in the subgroups with low beliefs of obligation, whereas this association disappeared in the subgroups with high beliefs of obligation.

Determinants of depression in primary caregivers of disabled older relatives: a path analysis.

BACKGROUND: Despite the large literature analysing factors related to depression, several factors such as caregiving obligation and the interrelationships among the different variables relating to depression have been little studied. The current study aimed to analyse the effect of caregiving obligation (beliefs regarding obligation and social pressure) on depression, and the mediating effects of perceived burden on the relationship between stressors and depression, in primary caregivers of older relatives. METHODS: Cross-sectional study design. A probabilistic sample of caregivers from Spain (N = 200) was used. The data collection was conducted in 2013 through structured interviews in the caregivers' homes. The measures included sense of obligation for caregiving, perceived burden, stressors and depression. RESULTS: Depression had a direct and positive association with perceived burden, behavioural problems, and social pressure, and it was indirectly related through perceived burden to behavioural problems, independence for the activities of daily living and beliefs of obligation. CONCLUSIONS: Our results support the multidimensional concept of obligation, suggesting the existence of both an external obligation (social pressure) and an internal obligation (beliefs of obligation); (b) our findings support the hypothesis that external obligation is related to negative caregiving consequences, while internal obligation protects from these consequences; and (c) our findings support the partial mediation of stressors on depression by perceived burden. The relevance of the research to clinical practice includes the importance of understanding the perceived obligation of caregiving related to both internal and external sources of obligation.

Gender differences in primary home caregivers of older relatives in a Mediterranean environment: A cross-sectional study.

A cross-sectional study was developed in Spain to analyse gender differences in intensity of care, care recipient needs and subjective burden, as well as the moderating effects of kinship on the relationship between gender and subjective burden. A probabilistic sample of 200 primary caregivers (100 male and 100 female) of older relatives was interviewed by expert nurses. Socio-demographic data and several scales regarding objective and subjective burden were used to collect data. Descriptive statistics, Student's t-test, ANOVA and multiple linear regression were used to analyse the data. There were gender differences in subjective burden, with female caregivers having more subjective burden than male caregivers, but not in objective burden (intensity of care and care recipients' needs). Kinship moderated the relationship between gender and subjective burden, as gender differences were found in spouses (wives had more subjective burden than husbands) but not in offspring.

[Male perceptions of sequelae associated with female genital mutilation]. / Percepciones de los hombres sobre las complicaciones asociadas a la mutilación genital femenina.

OBJECTIVE: To explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed. METHODS: A qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software. RESULTS: Those participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice. CONCLUSIONS: Participants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls' health, and include family-targeted campaigns which involve men in the process of eradicating this practice.

[Algorithm for the prevention of female genital mutilation. Case study from primary care]. / Algoritmo de actuación en la prevención de la mutilación genital femenina. Estudio de casos desde atención primaria.

OBJECTIVE: Create and implement a protocol for identifying and preventing female genital mutilation in a municipality of the Region of Murcia. DESIGN: A bibliographical review and significant databases were consulted for the creation of the algorithm performance. These include Cuiden, Dialnet, Medes, Medline, and other documentary sources of interest. The instrument for data collection was completed by interviewing parents of girls at risk. DRAFTING AND IMPLEMENTATION: The multi-disciplinary team was formed; the female genital mutilation risk cases were collected, and were summoned to the nursing consulting room. Two girls had been mutilated, the rest were at risk of female genital mutilation, and in one case the risk was imminent. CONCLUSION: The algorithm designed guides practitioners in their performance, achieving an effective detection and prevention of genital mutilation of girls. This is a first approach to the development of a regional protocol.