The post-surgical transition in adolescents who have idiopathic scoliosis. A qualitative study.

OBJECTIVE: To know the process experienced by adolescents suffering from idiopathic scoliosis when undergoing surgery to correct the physical deformity. METHOD: Qualitative study with a symbolic interactionism approach. 22 semi-structured interviews were conducted with adolescents who underwent posterior spinal fusion in a third-level hospital in Madrid between May 2019 and January 2021. Taylor and Bogdan's analysis in progress was carried out. RESULTS: Patients with adolescent idiopathic scoliosis present with a complex simultaneous health/illness and developmental transition. The main inhibitory conditions of the transition are the meanings about: their identity, social, beliefs about surgery, ignorance about the pathology, the surgical process, and their recovery. As facilitating conditions, we find: a positive attitude towards physical, aesthetic, and social change, socioeconomic level, and family support. CONCLUSIONS: The informants of this study refer that aesthetic affectation and physical limitations are the main elements that cause them discomfort. Surgical intervention is presented as the solution to this situation. Recovery is a critical point in the transition process mainly due to pain. They accept the discomfort suffered during the recovery because they hope to obtain an improvement in the image and physical limitations. The changes and differences they experience during the transition make them think that they will be able to lead a «normal life¼ to which they constantly refer in their speeches.

[Differences on postpartum family planning among nursing professionals.] / Diferencias en la planificación familiar posparto entre los profesionales de enfermería.

OBJECTIVE: In Spain, a total of 95,149 voluntary terminations of pregnancy (VTP) took place only in the year 2019, 90% of them requested by the woman, 53% of whom had at least one child. This situation highlights the relevance of postpartum family planning (PFP) and the work of the professionals in charge of its promotion. The aim of this study was to establish whether midwives and the rest of the nursing professionals regard PFP as an activity to perform within their professional role and how they implement it, as well as to identify their knowledge on it. METHODS: Study performed through an ad-hoc questionnaire between March 2017 and June 2019 in three groups of Nursing professionals dedicated to woman care (n=153) made up of: 1) Nurses specialized in Obstetrics and Gynecology Nursing (Midwifery) of the Delivery suite Department; 2) midwives in Primary Care; 3) Nurses in Postpartum Unit from 3 different hospitals and 37 associated health centers. Analysis by labor group and the comparison of the different professional activities were performed through Pearson chi-squared test or a likelihood ratio, depending on sample size in qualitative variables, and in quantitative variables, by Kruskal-Wallis' test. RESULTS: Not all professionals regard PFP as an activity within their professional role, and there is no consensus regarding its implementation (P<0.001). Concerning their level of knowledge, there are differences among professionals regarding the timeframe when the woman should receive the information on PFP (P=0.002), only 13% of them know that PFP should be started from day 21 of postpartum, and although 95% of them know about the incompatibility of breastfeeding with some contraceptive methods, this knowledge is higher among midwives than among general nurses (P=0.012). CONCLUSIONS: Although midwives are the most aware and knowledgeable professionals on PFP, the responsibility of informing women on postpartum contraception does not always fall on them, and this situation could have an effect on the woman's health and reduce the incidence of unwanted pregnancies.

OBJETIVO: En España, solo en 2019 se produjeron un total de 95.149 interrupciones voluntarias de embarazo (IVE), el 90% a petición de la mujer, de las cuales un 53% tenían al menos un hijo. Situación que resalta la importancia de la planificación familiar posparto (PFP) y la labor de los profesionales que se encargan de su promoción. El objetivo del presente estudio fue determinar si las matronas y el resto de los profesionales de Enfermería consideran la PFP como una actividad de su rol profesional y cómo la desarrollan, así como identificar sus conocimientos sobre ella. METODOS: Estudio realizado mediante un cuestionario ad hoc entre marzo de 2017 y junio de 2019 en tres grupos de profesionales de Enfermería dedicados al cuidado de la mujer (n=153) compuestos por: 1) enfermeras especialistas en Enfermería Obstétrico-Ginecológica (matronas) del Servicio de Paritorio; 2) matronas de Atención Primaria; 3) enfermeras de la Unidad de Puerperio, procedentes de 3 hospitales y sus 37 Centros de Salud asociados. Los análisis por grupo laboral y las comparaciones entre las distintas actividades profesionales se realizaron en las variables cualitativas mediante test chi-cuadrado de Pearson o razón de verosimilitudes, según tamaño de la muestra, y en las variables cuantitativas mediante test de Kruskal-Wallis. RESULTADOS: No todos los profesionales consideran la PFP una actividad de su rol profesional ni existe consenso en su desarrollo (P<0,001). En relación al nivel de conocimiento, existen diferencias entre los profesionales en cuanto al periodo en el que se debe informar a la mujer sobre PFP (P=0,002), solo un 12,7% conocen que la PFP se debe iniciar a partir del día 21 posparto, y aunque un 95,4% son conocedores de la incompatibilidad de la lactancia materna con algunos métodos anticonceptivos, este conocimiento es mayor entre las matronas que entre las enfermeras generalistas (P=0,012). CONCLUSIONES: Aunque las matronas son las profesionales más conscientes y conocedoras de la PFP, la responsabilidad de informar a la mujer sobre anticoncepción posparto no siempre recae sobre ellas, situación que podría repercutir sobre la salud de la mujer y la posibilidad de reducir la incidencia de embarazos no deseados.

The construction of contemporary nursing identity from narrative accounts of practice and professional life.

OBJECTIVE: To explore the contemporary narrative of nursing identity in Spain. METHOD: This qualitative study was conducted between 2018 and 2020. Eleven registered nurses were interviewed. The conversations were recorded in audio, were semistructured, and held in a mental health clinic affiliated with a Catholic institution. Narrative analysis of the data was carried out. FINDINGS: Two themes were identified: How do I construct my professional life?, with the subthemes 'Training and initiation in care practice', 'Ways of living the professional care experience', 'The sculpting of care' and 'Self-image and future projection'; and What do I know about my practice?, with the subthemes 'Nursing experience: shift, days, years', 'Strategy in the field of nursing care', 'Some foundations of caregiving practice', 'The specificity of the gesture of care' and 'Voice and recognition of nursing within the institution'. CONCLUSION: Contemporary nursing identity is built in reflections on the epistemology of care, confronting the weight of tradition and breaking into new modes of self-image where the profession is legitimized and projected from historical consciousness. This claim can be used to support reflective practice in academic and healthcare settings as well as to promote a paradigm shift.

Painful experience in adolescents undergoing surgical correction of scoliosis. / Experiencia dolorosa en adolescentes tratados mediante corrección quirúrgica de escoliosis.

OBJECTIVE: The aim of our study is to learn about the post-surgical pain experience in adolescents undergoing surgical correction of Adolescent Idiopathic Scoliosis (AIS). METHODS: Qualitative study with an interpretative phenomenological approach. Through semi-structured interviews, 7 informants, women aged between 12 and 21, were interviewed between the third and fifth day after being surgically treated for AIS correction. The speeches were recorded and transcribed verbatim. Content Analysis method was used to analyse the discourse. RESULTS: The categories established were: influential factors, values and ideas, coping mechanisms and improvement areas. Painful experience is a determining factor during recovery, influenced by the individuals themselves, as well as by the support received, and the environment. Their main values and ideas about the process are based on pre-surgical information, which they consider insufficient. In order to cope, they use of distraction, relaxation and drug consumption. According to the informants, increasing the information they are given about the process, facilitating visits and incorporating complementary techniques would improve pain control. CONCLUSIONS: Pain is the main focus of the process and is influenced by several factors. The patients' coping mechanisms help in its management. They also put forward different improvement areas.

La relación enfermera - padres - neonato desde la perspectiva enfermera / The Relationship Nurse-Parents-Newborn from the Nurse Perspective

RESUMEN Introducción: El nacimiento de un niño supone sentimientos de alegría e ilusión. Esta situación se quiebra cuando requiere su ingreso en una Unidad de Neonatología, lo que provoca en los padres tristeza, miedo o culpabilidad. Sienten necesidad de apoyo y, al convertirse en sujetos activos del cuidado de su hijo, disminuye su grado de ansiedad y mejora su satisfacción. La familia constituye el núcleo de desarrollo del recién nacido; y por ello tiene relevancia el papel de la enfermera en la promoción del vínculo familiar. Objetivo: Explorar la relación enfermera - padres - neonato desde la perspectiva enfermera en la Unidad de Neonatología. Métodos: Estudio cualitativo cuyo marco teórico es el Interaccionismo Simbólico. La población objeto de estudio estuvo constituida por profesionales de enfermería de la Unidad de Neonatología del Hospital Universitario La Paz. Los datos se recogieron mediante entrevistas en profundidad y se analizaron bajo Teoría Fundamentada como marco metodológico. Resultados: Se realizaron seis entrevistas y se alcanzó saturación de los datos. Se generaron 20 categorías y 12 subcategorías. Las participantes identificaron elementos que afectan a las interacciones entre la enfermera, los padres y el recién nacido, así como necesidad de individualizar los cuidados durante una evolución no lineal del neonato. Conclusiones: La figura de la enfermera resulta fundamental en el cuidado del recién nacido y de sus padres, de modo que la relación enfermera - padres - neonato resulta compleja, dinámica y única(AU)

ABSTRACT Introduction: A child birth is expected to bring feeling joy and illusion. This situation gets destroyed when the newborn requires admittance into a neonatal care unit, which causes the parents to feel sadness, fear and culpability. They feel the need for support and, by becoming active subjects in their child's care, their anxiety level decreases and their satisfaction improves. The family constitutes the nucleus of development for the newborn. Hence, the importance of nurse role in fostering family ties. Objective: To explore relationship nurse-parents-neonate from the perspective of the neonatal care unit nurse. Methods: Qualitative study whose theoretical framework is symbolic interactionism. The study population was made up by nursing professionals of the neonatal care unit of La Paz University Hospital. Data were collected through in-depth interviews and analyzed using grounded theory as methodological framework. Results: Six interviews were carried out and data saturation was achieved. Twenty categories and 12 subcategories were generated. The participants identified elements affecting the interactions between nurse, parents and newborn, as well as the need for individualizing care during the newborn non-linear evolution. Conclusions: The figure of the nurse is fundamental in the care of the newborn and the parents, which determines that the relationship nurse-parents-neonate is complex, dynamic and unique(AU)

Sobre uma alimentação correta: exploração do constructo ortorexia desde os núcleos essenciais do discurso experimental / On a correct diet: exploration of the orthorexia construct from the essential nuclei of experimental discourse

Objetivos: Explorar a experiência vivida por algumas mulheres preocupadas em seguir uma alimentação natural e orgânica. Método: Foi realizada a análise qualitativa do discurso a modo de bricolagem (análise de conteúdo temático e análise interpretativa fenomenológica, utilizando diferentes técnicas ad hoc). Resultados: A experiência subjetiva das mulheres consiste em um campo fenomenológico que define sua historicidade: passado, representado pelo tema "Por que escolheu comer assim"; presente, "Um otimismo recriado"; e futuro imaginado, "Ausência de doença como objeto de consciência ideal". Dito campo fenomenológico evolui, na experiência e no discurso, como uma dilatação intermitente do tema "A expansão da consciência no apetite correto". Conclusões: O constructo ortorexia e os discursos do apetite correto devem ser explorados em maior profundidade pela comunidade científica, a fim de investigar as ressonâncias do fenômeno em diferentes contextos: estigmatização social das pessoas preocupadas com uma alimentação saudável e, de modo associado, patologização da condição.