El análisis situacional de la teoría fundamentada en salud: una revisión integrativa de la variante postmoderna de la teoría fundamentada

Introducción: La complejidad de la época actual exige tener en cuenta enfoques cuantitativos y cualitativos, datos de diferentes fuentes, métodos múltiples y un crisol de enfoques. Para dar respuesta a esta complejidad se presenta el análisis situacional como método posible. Metodología: Se presenta una revisión integrativa en relación con la variante de análisis situacional, que sigue los siguientes pasos: 1) identificación del problema (pregunta y objetivo de la investigación claramente definidos); 2) búsqueda bibliográfica (estrategia de búsqueda exhaustiva); 3) evaluación de datos; 4) análisis de datos (reducción de datos, visualización, comparación y conclusiones); y 5) presentación de los resultados así como las implicaciones para la práctica, la política públicas y las futuras investigaciones. Resultados: Emerge literatura que da cuenta del análisis situacional como una metodología utilizada en educación en salud, gestión en salud, políticas públicas y atención en salud, que incorpora elementos del análisis de discurso y teorías poshumanistas. Conclusiones: El análisis situacional es una metodología de comprensión de los fenómenos sociales, culturales, sanitarios y de educación, que está disponible y es acorde con la mirada multidimensional requerida para comprender la complejidad del entorno y fluidez de la era que estamos viviendo.

Introdução: A complexidade da realidade atual exige que se levem em conta enfoques quantitativos e qualitativos, dados de diferentes fontes, múltiplos métodos e uma porção de abordagens. Para responder a essa complexidade, a análise situacional é apresentada como um método possível. Metodologia: É apresentada uma revisão integrativa em relação à variante da análise situacional, que segue as seguintes etapas: 1) identificação do problema (questão e objetivo de pesquisa claramente definidos); 2) pesquisa bibliográfica (estratégia de pesquisa abrangente); 3) avaliação dos dados; 4) análise dos dados (redução, visualização, comparação e conclusões dos dados); e 5) apresentação dos resultados, bem como implicações para a prática, políticas públicas e pesquisas futuras. Resultados: Surge uma literatura que ampara a análise situacional como uma metodologia usada na educação em saúde, na gestão da saúde, nas políticas públicas e na assistência à saúde, incorporando elementos da análise do discurso e das teorias pós-humanistas. Conclusões: A análise situacional é uma metodologia de compreensão de fenômenos sociais, culturais, de saúde e de educação, que está disponível e alinhada com a visão multidimensional necessária para entender a complexidade do ambiente e a fluidez da era em que vivemos.

Introduction: The complexity of the current era requires considering quantitative and qualitative perspectives, data from different sources, multiple methods, and a melting pot of approaches. To respond to this complexity, situational analysis is presented as a possible method. Methodology: An integrative review is presented in relation to the variant of situational analysis, which follows the following steps: 1) problem identification (clearly defined research question and objective); 2) literature search (comprehensive search strategy); 3) data assessment; 4) data analysis (data reduction, visualization, comparison, and conclusions); and 5) presentation of results as well as implications for practice, public policy, and future research. Results: Literature emerges that accounts for situational analysis as a methodology used in health education, health management, public policy, and health care, which incorporates elements of discourse analysis and posthumanist theories. Conclusions: Situational analysis is a methodology for understanding social, cultural, health and educational phenomena, which is available and in accordance with the multidimensional view required to understand the complexity of the environment and fluidity of the era we are living in.

[Sociodemographic characterization of adolescents who accessed to services related to voluntary termination of pregnancy due to rape. Chile: 2018 - 2020]. / Caracterización sociodemográfica de adolescentes que tuvieron acceso a las prestaciones vinculadas con la interrupción voluntaria del embarazo por violación. Chile: 2018 - 2020.

Ground N°3 of Law 21,030 allows for the termination of a pregnancy due to rape, with the woman's consent, establishing a gestational age limit of 14 weeks for adolescents under 14 years of age and 12 weeks for those over 14 years of age. OBJECTIVE: To describe, between the period 2018-2020, the main sociodemographic and other variables linked to ground N°3 in minors under 14 years, adolescents aged 14 years or older and under 18 years, and women aged 18 years or older. PATIENTS AND METHOD: Cross-sectional, descriptive, and population-based design. National data was obtained from the official registry of the Ministry of Health and through the Transparency Law. Measures of central tendency (median), dispersion (interquartile range), absolute frequencies, and percentages were used. RESULTS: 31.6% of the women with rape-related pregnancies were under 18 years of age. Women under 14 lived mainly in the regions of the country, had a higher gestational age at the time of the ground factor, and 31.2% decided to continue the pregnancy. Adolescents aged 14 or older and under 18, had a higher multidimensional poverty index. Women aged 18 or older were most frequently foreigners, lived mainly in the Metropolitan Region, and decided to terminate the pregnancy. 57.4% of those who reported the rape and 11.1% who failed to establish the ground were under 18. CONCLUSIONS: Sexual violence is a public health problem. Pregnancy due to rape in adolescents is a social reality. There should be permanent evaluation and monitoring of the implementation of Law 21,030, guaranteeing timely, efficient, and nondiscriminatory access to benefits.

Main barriers to services linked to voluntary pregnancy termination on three grounds in Chile.

Introduction: After decades of absolute criminalization, on September 14, 2017, Chile decriminalized voluntary termination of pregnancy (VTP) when there is a life risk to the pregnant woman, lethal incompatibility of the embryo or fetus of genetic or chromosomal nature, and pregnancy due to rape. The implementation of the law reveals multiple barriers hindering access to the services provided by the law. Objectives: To identify and analyze, using the Tanahashi Model, the main barriers to the implementation of law 21,030 in public health institutions. This article contributes to the follow-up of this public policy, making visible the obstacles that violate women's rights of women to have dignified access to abortion and that affect the quality of health care in Chile. Material and method: Qualitative design, following the postpositivist paradigm. The sample consisted of relevant actors directly related to pregnancy termination. Snowball sampling and semi-structured interviews were used. Grounded theory was used through inductive coding, originating categories regrouped into meta-categories following Tanahashi's model. The rigor criteria of transferability, dependability, credibility, authenticity, and epistemological theoretical adequacy were used. The identity of the participants and the confidentiality of the information were protected. Results: From January 2021 to October 2022, 62 interviews were conducted with 20 members of the psychosocial support team; 18 managers; 17 members of the biomedical health team; 4 participants from of civil society, and three women users. The main obstacles correspond to availability barriers, accessibility barriers, acceptability barriers, contact barriers, and effectiveness barriers. Conclusions: Barriers to access abortion under three grounds violate the exercise of women's sexual and reproductive rights. It is urgent to carry out actions of control and follow-up of this public policy to the corresponding entities.

Conscientious objection as structural violence in the voluntary termination of pregnancy in Chile.

Introduction: After three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital or genetic lethal pathology, and in pregnancy due to rape. The law incorporates conscientious objection as a broad right at the individual and institutional levels. Objectives: The aim of the study was to explore the exercise of conscientious objection in public health institutions, describing and analyzing its consequences and proposals to prevent it from operating as structural violence. Materials and methods: This study uses a qualitative, post-positivist design. At the national level, according to the chain technique, people who were identified as key actors due to their direct participation in implementing the law were included. Grounded theory was used to analyze the information obtained through a semi-structured interview. The methodological rigor criteria of transferability or applicability, dependability, credibility, auditability, and theoretical-methodological adequacy were met. Results: Data from 17 physicians, 5 midwives, 6 psychologists, 8 social workers, 2 nursing technicians, and 1 lawyer are included. From an inductive process through open coding, conscientious objection as structural violence and strategies to minimize the impact of objection emerge as meta-categories. The first meta-category emerges from the barriers linked to the implementation of the law, the infringement of the rights of the pregnant person, and pseudo conscientious objection, affecting timely and effective access to pregnancy termination. The second meta-category emerges as a response from the participants, proposing strategies to prevent conscientious objection from operating as structural violence. Conclusion: Conscientious objection acts as structural violence by infringing the exercise of sexual and reproductive rights. The State must fulfill its role as guarantor in implementing public policies, preventing conscientious objection from becoming hegemonic and institutionalized violence.

[How do patients on dialysis experience their disease? A qualitative approach]. / ¿Como viven su enfermedad las personas en diálisis?: una mirada cualitativa a la experiencia del paciente.

BACKGROUND: End-stage chronic kidney disease is a severe public health problem due to the poor quality of life of patients on dialysis and the costs associated with renal replacement treatment. AIM: To understand the social representations of kidney disease of people on dialysis. MATERIAL AND METHODS: In a qualitative study under the post-positivist paradigm, eighteen patients in peritoneal or hemodialysis participated in an in-depth interview. The analysis was performed using content analysis. RESULTS: Eight categories were identified: Friends, Health Care Team, Spirituality and Disease, Family, Health Support System, Physical Consequences, Psychosocial Consequences, Self-Care of Continuous Health-Disease. CONCLUSIONS: Health care of people on dialysis should take into consideration the experience of kidney disease from the perspective of the patient, including his beliefs and feelings and involving the family, community, and the state.

Experiences of miscarriage: the voice of parents and health professionals.

The death of a child in the intrauterine stage has legal, psychological, spiritual, and health-related connotations that condition the woman's experience. To understand better the processes set in motion around early pregnancy loss, this ethnographic study explores the experiences of miscarriage in a group of 15 women. The following themes are analyzed: Experience of losing the child, spirituality, health care, and the need to physically recognize the child. The study shows that the need women have to honor the child who did not live may be conditioned by the perception of an uncertain loss and by the absence of a place to honor him/her. Attitudes among professionals are revealed that could be perceived as gender-related abuse. The care of women places emphasis on physical aspects, underlining the lack of comprehensive care during the grieving process.

¿Cómo viven su enfermedad las personas en diálisis?: una mirada cualitativa a la experiencia del paciente / How do patients on dialysis experience their disease? A qualitative approach

BACKGROUND: End-stage chronic kidney disease is a severe public health problem due to the poor quality of life of patients on dialysis and the costs associated with renal replacement treatment. Aim: To understand the social representations of kidney disease of people on dialysis. MATERIAL AND METHODS: In a qualitative study under the post-positivist paradigm, eighteen patients in peritoneal or hemodialysis participated in an in-depth interview. The analysis was performed using content analysis. Results: Eight categories were identified: Friends, Health Care Team, Spirituality and Disease, Family, Health Support System, Physical Consequences, Psychosocial Consequences, Self-Care of Continuous Health-Disease. CONCLUSIONS: Health care of people on dialysis should take into consideration the experience of kidney disease from the perspective of the patient, including his beliefs and feelings and involving the family, community, and the state.

Prevalencia y características de objetores de conciencia a la Ley 21. 030 en instituciones públicas / Prevalence and characteristics of conscientious objectors to Law 21. 030 in public institutions

INTRODUCCIÓN: La Ley 21.030 permite la objeción de conciencia al personal de salud al interior del pabellón y a las instituciones privadas. Ha sido considerada conflicto de intereses no monetario, al anteponer los valores personales, afectando el cumplimiento del deber profesional. OBJETIVOS: Establecer la prevalencia de funcionarios/as objetores/as en los hospitales de la red pública del país y caracterizarles según edad, género y nacionalidad. MÉTODO: Estudio cuantitativo, analítico y transversal. Se utilizaron medidas de tendencia central y dispersión. Para medir la asociación entre variables sociodemográficas, profesión y causal objetada, se utilizaron las pruebas de χ2, exacta de Fisher y de Kruskal-Wallis. RESULTADOS: En 57 hospitales, se observa una mayor frecuencia de objetores en causal 3. En 443 objetores, la mediana de edad fue de 43 años, el 64,8% mujeres y el 87,4% de nacionalidad chilena. En las zonas centro y sur del país se concentra la mayor proporción de hospitales con más del 50% de objetores. CONCLUSIONES: La dificultad para obtener información impide conocer cabalmente la magnitud de la objeción de conciencia. Resulta preocupante la alta prevalencia de objetores, específicamente en la causal violación. La objeción no puede operar como barrera que vulnere los derechos y la dignidad de las mujeres.

INTRODUCTION: Law 21.030 incorporates conscientious objection for health personnel inside the surgical ward and allows its invocation by private institutions. It has been considered a conflict of interest, not monetary, by putting personal values first, affecting the fulfillment of professional duty. OBJECTIVE: To establish the prevalence of objectors in the countrys public network hospitals and characterize them according to age, gender, and nationality. METHOD: Quantitative, analytical, and cross-sectional study. Central and dispersion trend measures were used. For measuring the association between sociodemographic variables, profession and causal objected, test χ2, Fisher exact and Kruskal-Wallis test were used. RESULTS: In 57 hospitals, a higher frequency of objectors were observed in the third causal. In 443 objectors, the median age was 43 years, 64.8% are women, and 87.4% are Chilean. The central and southern areas of the country have the highest proportion of hospitals, with more than 50% objectors. CONCLUSIONS: The difficulty for obtaining the information prevents fully knowing the magnitude of conscientious objection in Chile. The high prevalence of objectors, specifically in the causal violation is worrying. The conscientious objection cannot operate as a barrier that violates the rights and dignity of women.

Dysregulated Immune Responses in COVID-19 Patients Correlating With Disease Severity and Invasive Oxygen Requirements.

The prognosis of severe COVID-19 patients has motivated research communities to uncover mechanisms of SARS-CoV-2 pathogenesis also on a regional level. In this work, we aimed to understand the immunological dynamics of severe COVID-19 patients with different degrees of illness, and upon long-term recovery. We analyzed immune cellular subsets and SARS-CoV-2-specific antibody isotypes of 66 COVID-19 patients admitted to the Hospital Clínico Universidad de Chile, which were categorized according to the WHO ten-point clinical progression score. These included 29 moderate patients (score 4-5) and 37 severe patients under either high flow oxygen nasal cannula (18 patients, score 6), or invasive mechanical ventilation (19 patients, score 7-9), plus 28 convalescent patients and 28 healthy controls. Furthermore, six severe patients that recovered from the disease were longitudinally followed over 300 days. Our data indicate that severe COVID-19 patients display increased frequencies of plasmablasts, activated T cells and SARS-CoV-2-specific antibodies compared to moderate and convalescent patients. Remarkably, within the severe COVID-19 group, patients rapidly progressing into invasive mechanical ventilation show higher frequencies of plasmablasts, monocytes, eosinophils, Th1 cells and SARS-CoV-2-specific IgG than patients under high flow oxygen nasal cannula. These findings demonstrate that severe COVID-19 patients progressing into invasive mechanical ventilation show a distinctive type of immunity. In addition, patients that recover from severe COVID-19 begin to regain normal proportions of immune cells 100 days after hospital discharge and maintain high levels of SARS-CoV-2-specific IgG throughout the study, which is an indicative sign of immunological memory. Thus, this work can provide useful information to better understand the diverse outcomes of severe COVID-19 pathogenesis.

Modelos y Teorías de Enfermería: Sustento Para los Cuidados Paliativos / Modelos e Teorias De Enfermagem: Suporte para Cuidados Paliativos / Nursing Models and Theories: Support for Palliative Care

Resumen: El cuidado es la base de la ciencia de enfermería y puede conceptualizarse como todas las acciones que ayudan a preservar y mantener la vida. Se origina en la necesidad de supervivencia humana en circunstancias adversas, y si bien es inherente a la especie, se ha diferenciado por género. Las necesidades de cuidado familiar, alimentos, ropa y afecto se han relacionado históricamente con las mujeres; en el caso de los hombres, la atención se relaciona con actos que requieren fuerza física y el logro de alimentos a través del trabajo de caza y pesca. La enfermería moderna tomó desde sus orígenes la práctica del cuidado como la base de su disciplina, siendo abordada desde varios aspectos, en los que se incluye: atención, investigación, docencia y gestión. El cuidado es una parte específica de la cultura, los valores y las creencias de las personas, poniendo a la preocupación por los demás como el pilar de la existencia humana. Cuidar es una forma de vivir y de estar en relación con otros, de habitar en el mundo, que es esencial para cualquier adaptación. Desde la perspectiva de la Enfermería en Cuidados Paliativos, hay varios modelos de enfoques para una intervención holística, que combinan aspectos físicos, sociales, psicológicos y espirituales que brindan atención a la familia y a la sociedad en general. El objetivo de este artículo es identificar la utilización de los modelos y teorías de enfermería en los cuidados paliativos.

Resumo: O cuidado é a base da ciência da enfermagem e pode ser conceituado como todas as ações que ajudam a preservar e sustentar a vida. Origina-se na necessidade de sobrevivência humana em circunstâncias adversas e, embora seja inerente à espécie, foi diferenciada por gênero. As necessidades de cuidado familiar, alimentação, vestuário e afeto têm sido historicamente relacionadas às mulheres. No caso dos homens, a atenção se relaciona com atos que competem fisicamente na obtenção de alimentos através da caça e pesca.A enfermagem moderna cuidou de si mesma como base de sua disciplina, sendo abordada a partir de diversos aspectos, nos quais está inserida; atenção, pesquisa, ensino e gestão. O cuidado é uma parte específica da cultura, valores e crenças das pessoas, colocando a preocupação pelos outros como o pilar da existência humana. Cuidar é um modo de viver e estar em relação com os outros, de viver no mundo, o que é essencial para qualquer adaptação.Na perspectiva da Enfermagem em Cuidados Paliativos, existem vários modelos de abordagens para uma intervenção holística, que combinam aspectos físicos, sociais, psicológicos e espirituais que dão atenção à família e à sociedade em geral. O objetivo deste artigo é conhecer o uso e aplicação dos modelos e teorias específicas da disciplina de enfermagem em cuidados paliativos.

Abstract: Care is the foundation of the Nursing Science and can be conceptualized as all actions that help preserve and maintain life. It originates in the need for human survival in adverse circumstances, and while it is inherent to the species, it has been differentiated by gender. Family care, food, clothing and affection needs have been historically linked to women; in the case of men, care was related to acts requiring physical strength and achieving food through hunting and fishing work. Modern Nursing took since its origins care practice as the basis of their discipline, being approached from various aspects, in which it is included; care, research, teaching and management. Care is a specific part of the culture, values ​​and beliefs of people, placing concern for others as the pillar of human existence. Caring is a way of living and of being in relationship with others, to habit in the world, which is essential for any adaptation.From the perspective of Nursing in Palliative Care, there are various models of approaches to a holistic intervention, which combine physical, social, psychological and spiritual aspects that bring care to the family and society. The objective of this article is to identify the use and application of nursing models and theories in palliative care.

Reflexiones acerca de autoetnografía interpretativa: un camino para humanizar el cuidado de Enfermería / Reflexões sobre a autoetografia interpretativa: uma forma de humanizar o cuidado de enfermagem / Reflections on interpretive autoethnography: a way to humanize Nursing care

Resumo Apresentamos um ensaio de reflexão sobre a auto-etnografia interpretativa, uma metodología pouco explorada na língua espanhola e nasaúde. Essa metodología resgata a sensibilidade da atenção, enquadrada no eu, cultura e método. Utilizamos como método a reflexão sobre a experiência vivida pelos autores naprestação do cuidado de enfermagem, bem como a experiência no uso da auto-etnografia como método, complementada com a revisão e análise de artigos e livros de jornais. Conclui-se que o enfermeiro pode utilizar a autoetnografia interpretativa se é conhecida e reconhecida como um ser humano com múltiplas possibilidades e potencialidades, mas também com imperfeições e limitações e com a possibilidade de olhar para o outro, sabendo que o paciente é tal humano. perfeita e imperfeita como ela.

Resumen Este ensayo expone una reflexión sobre la autoetnografía interpretativa, una metodología poco explorada en la lengua española y en el área de la salud, la cual rescata la sensibilidad de la atención, enmarcada en el yo, la cultura y el método. Como método, los autores de este trabajo utilizan la reflexión acerca de la experiencia en cuanto a la provisión de cuidados de enfermería y laautoetnografía como método, complementada con la revisión y análisis de artículos de revistas y libros. Se concluye que la enfermera puede usar este método si se conoce y se reconoce a sí como un ser humano con múltiples posibilidades y potencialidades, pero también con imperfecciones y limitaciones y con la posibilidad de mirar al otro, siendo consciente de que el paciente es un ser humano tan perfecto e imperfecto como ella.

Abstract A reflection essay oninterpretive autoethnography is presented, a methodology Little explored in the Spanish language and health. This methodology rescues the sensitivity of health care, framed in the self, culture and method. We use as a method the reflection about the experience lived by the authors in the provisión of nursing care, as well as the experience in autoethnography like a method, complemented with review and analysis of journal articles and books. It is concluded that the nurse can use this method if she knows and recognizes herself as a human being with multiple possibilities and potentialities, but also with imperfections and limitations and with the possibility of looking at the other, being aware that the patientis a human being as perfect and imperfect as her.

Mayores cuidando mayores: sus percepciones desde una mirada integral / Anciãos cuidando anciãos: suas percepções de um olhar completamente / Seniors caring for seniors: their perceptions from a comprehensive point of view

Resumen: El envejecimiento es un proceso que conlleva múltiples cambios en el ser humano, generando que algunos adultos mayores se encuentren en situación de dependencia y requieran un cuidador. Este estudio cualitativo, con enfoque metodológico de estudio de caso, tiene por objetivo conocer las percepciones de adultos mayores que son cuidadores de otro adulto mayor con dependencia severa. Se realizaron entrevistas en profundidad empleando análisis de contenido y se definieron las siguientes categorías de investigación: motivaciones, dificultades, emociones del cuidador, postergación por el bien del otro, redes de apoyo familiares, emociones asociadas al diagnóstico, religión, institucionalización, expectativas de cuidado de enfermería, acceso a beneficios del estado, y muerte. Los resultados muestran que la mayoría de los cuidadores son mujeres, sin apoyo familiar, que tienen un vínculo sentimental con la persona cuidada, y que sus motivaciones para desempeñar esta labor son el cariño y la obligación. Se observó postergación por parte del cuidador dedicándose por completo a esta labor, abandonando actividades ajenas al cuidado y experimentando sobrecarga acompañada de limitaciones económicas debido a los bajos ingresos que reciben.

Resumo: O envelhecimento é um processo que envolve múltiplas mudanças no ser humano, gerando algumas pessoas idosas em uma situação de dependência, exigindo um cuidador. Este estudo qualitativo, com abordagem metodológica de estudo de caso, visa conhecer as percepções de idosos que são cuidadores de outra pessoa idosa com dependência severa. Foram realizadas entrevistas em profundidade utilizando análise de conteúdo e foram definidas as seguintes categorias de pesquisa: motivações, dificuldades, emoções do cuidador, adiamento para o bem do outro, redes de apoio familiar, emoções associadas ao diagnóstico, religião, institucionalização, expectativas de atendimento de enfermagem, acesso a benefícios estatais e morte. Os resultados mostram que a maioria dos cuidadores são mulheres, sem apoio familiar, que têm vínculo sentimental com a pessoa atendida e que suas motivações para realizar este trabalho são carinho e obrigação. O adiamento foi observado por parte do cuidador, dedicando-se completamente a essa tarefa, abandonando atividades que não sejam cuidados e experimentando sobrecarga, acompanhada de limitações econômicas devido à baixa renda que recebem.

Abstract: Aging is a process that involves multiple changes in the human being, forcing some elderly people in a situation of dependency to require a caregiver. This is a qualitative study with a methodological approach of case study, aiming to know the perceptions of older people who are caregivers of another elderly people with severe dependence. In-depth interviews were conducted using content analysis. The following categories were defined: motivations, difficulties, caregiver emotions, self postponement for the sake of the other, family support, emotions associated with the diagnosis, religion, institutionalization, nursing care expectations, access to state benefits, and death. The results show that most caregivers are women, without family support, who have a sentimental bond with the person cared for, and that their motivations to perform this task where affection and obligation. Self postponement was observed; the caregiver devots completely to this task, abandoning other activities and experiencing burden accompanied by economic limitations due to the low income they receive.

Contando historias para cuidar y transformar / Contando histórias para cuidar e transformar / Telling stories to care and transforming

Resumen: La postmodernidad ha traído consigo individualismo, globalización y fragmentación del tejido social. Enfermería en su visión holística debe mantener el cuidado integral de la persona familia y comunidad, sin perder la conexión consigo misma y con el entorno social. El objetivo de este ensayo fue reflexionar acerca de las emociones, sentimientos y pensamientos que emergen en la enfermera-investigadora, cuando se explora el cuidado y las representacionales sociales de las personas con enfermedad renal. Como metodología se usó la autoetnografía interpretativa, como una propuesta metodológica que rompe con la dinámica de enfermería tradicional. Como conclusión hemos podido observar el vínculo existente entre la experiencia de la enfermedad, de la investigación cualitativa y del cuidado desde la perspectiva del paciente y la enfermera, validando la metodología de la autoetnografía interpretativa como una forma de mejorar la comprensión de los fenómenos asociados al cuidado de enfermería.

Resumo: O pós-modernismo trouxe consigo o individualismo, a globalização e a fragmentação do tecido social. A enfermagem em sua visão holística deve manter o cuidado integral da pessoa família e comunidade, sem perder a conexão consigo mesma e com o meio social. O objetivo deste ensaio foi refletir sobre as emoções, sentimentos e pensamentos que emergem no enfermeiro-pesquisador, quando se exploram os cuidados e representações sociais de pessoas com doença renal. Como metodologia, utilizou-se a auto-etnografia interpretativa como proposta metodológica que rompe com a dinâmica tradicional da enfermagem. Em conclusão, vimos a ligação entre a experiência da doença, a pesquisa qualitativa e cuidado do ponto de vista do paciente e a enfermeira, validando a metodologia de autoethnography interpretativa como uma maneira de melhorar a compreensão dos fenómenos associados cuidados de enfermagem.

Abstract: Postmodernity has arrived bringing individualism, globalization, and fragmentation of the social fabric. Nursing, in its holistic care conception, must look after the health of the person, the family and the community without losing the connection with itself. The aim of this work was to reflect about the emotions, feelings and thoughts that arise in the nurse-researcher when exploring about the care and the social representations of patients with renal disease. The method used was the interpretative autoethnography, as a methodological proposal that sets apart from the traditional dynamic of nursing. Our conclusion was that there is a connection between the experience of the disease, the qualitative research and the care from the point of view of patients and nurses, confirming the chosen methodology as a proper way to improve the understanding of the phenomena associated with nursing care.

Explorando la sexualidad en mujeres en diálisis: una aproximación cualitativa / Exploring sexuality in women undergoing dialysis: a qualitative approach

INTRODUCCIÓN: La enfermedad renal crónica es una patología que afecta tanto a la persona como a su familia en todos los ámbitos de la vida. Una de las áreas que ha sido poco estudiada es la vivencia de la sexualidad de las personas en diálisis, la cual se relaciona directamente con la calidad de vida. MATERIAL Y MÉTODOS: Estudio de tipo cualitativo, bajo el paradigma post-positivista, con perspectiva de teoría fundada. Se usó como técnica de recolección de datos la entrevista en profundidad. Participaron 7 mujeres en terapia dialítica. OBJETIVO: El objetivo general de esta investigación fue explorar la vivencia de la sexualidad en mujeres en diálisis. RESULTADOS: Posteriormente al análisis de las entrevistas, se identificaron las categorías corporalidad, limitaciones en las prácticas sexuales, adaptaciones en las prácticas sexuales, riesgo de infecciones, autoestima, relación de pareja y miedo al futuro. CONCLUSIONES: Para las mujeres en diálisis, la vivencia de la sexualidad es un aspecto fundamental en su vida, la cual debe ser considerada en la formación del personal de salud que trabaja en el área renal. Se sugiere realizar un próximo estudio focalizado en mujeres en diálisis peritoneal y con un mayor número de participantes

INTRODUCTION: Chronic kidney disease is a condition that affects both patients and their families in every aspect of life. One of them which has not been much explored and which bears a direct relation with life quality is sexuality in patients undergoing dialysis. METHODS: A qualitative study within the post-positivist paradigm and from the perspective of a grounded theory was conducted. The in-depth interview was used as a data collection technique. Seven women on dialysis participated. OBJECTIVE: The main aim of this research was to explore sexuality in female patients undergoing dialysis. RESULTS: After examining the interviews, the following categories were identified: corporality, sexual practice limitations, sexual practice adaptations, risk of infections, self-esteem, kind of couple relationship and fear of the future. CONCLUSIONS: For women on dialysis, sexuality is a fundamental aspect of their lives, which should be considered in the training of healthcare staff working in the renal area. Further research is suggested regarding women on peritoneal dialysis and with a greater number of participants