Experiences of Women With Breast Cancer and Their Partners in Achieving Coherence as a Couple During the Disease Journey.

OBJECTIVE: To describe the experiences of female patients with breast cancer and their partners in achieving coherence as a couple during the disease journey. DESIGN: Qualitative study. SETTING: Colombia, South America. PARTICIPANTS: Women diagnosed with breast cancer in the last 2 years and their intimate partners with whom they lived during the 6 months before study enrollment. In total, 16 heterosexual couples participated in individual interviews and focus groups. METHOD: Interviews and focus groups were analyzed using content analysis. RESULTS: Four themes were identified: The Diagnosis: A Moment That Destabilizes the Couple, Couple's Sexuality: Seeking the Best Conditions Between Desire and Reality, Generating Mutually Supportive Dynamics in the Face of Cancer, and The Transformation of a Negative Situation Into a Positive One and Achieving Coherence Within the Couple. The first theme represents the initial moment of uncertainty and emotional reactions due to the confirmation of the diagnosis of breast cancer. The second captures the physical and emotional effects in the couple's sexuality generated by the treatment and diagnosis as well as the strategies used to strengthen the couple's relationship. The third reflects how the couple's support is based on commitment, companionship, and the performance of daily actions. The last describes how the adaptation process allows couples experiencing the disease to achieve coherence. CONCLUSION: These findings highlight that couples experiencing breast cancer can transform the negative situation into an opportunity to strengthen their relationship by achieving coherence. Future research is needed to investigate the antecedents, attributes, and outcomes related to couples' coherence. Moreover, health professionals should perform periodic assessments on the dynamics, coping strategies, and resources at couples' disposal to help promote couples' adaptation and coherence.

Rural Women in Colombia, Facing the Postconflict: A Qualitative Synthesis.

Women have been the major victims of the Colombian armed conflict for more than 50 years. Nowadays, when the country faces an aftermath focused on reconciliation, understanding women's experiences during the conflict is key to providing them tools for social justice and effective fulfilling of their needs. This qualitative synthesis of literature includes publications in Spanish and English of electronic databases over the past 20 years regarding rural women and the Colombian armed conflict. Studies were included for review if they were published between 2000 and 2019, were qualitative peer-reviewed articles, and addressed directly or indirectly the pregnancy process as well as the women's sexual and reproductive health in rural Colombia. Seven of 169 articles initially identified were included for an inductive analysis of categories and themes. After the analysis process, three main themes emerged from the literature: (a) crumbling families, (b) being a woman: the challenges between being a peacemaker and a victim, and (c) protecting and caring of life. These three themes comprise 10 categories and 20 subcategories that provide support to the inductive qualitative synthesis. This review provides a comprehensive synthesis of the Colombian armed conflict focused on the victimization of women. It concludes with reflections about the Colombian women's role in transitioning toward peace.

Experiences of women with preeclampsia in an Obstetric Intensive Care Unit in Colombia. / Vivencias de mujeres con preeclampsia en la Unidad de Cuidados Intensivos Obstétricos en Colombia.

OBJECTIVE: To describe the meaning that pregnant women with preeclampsia attach to nursing care in an obstetric intensive care unit of a hospital in Neiva (Colombia). METHOD: Qualitative-phenomenological study, guided by the theoretical guidelines of Diekelmann, Allen and Tanner. The data was collected during the second semester of 2017 and the first semester of 2018, through in-depth interviews with eleven participants, which were subsequently analysed until reaching theoretical saturation. RESULTS: 273 significant fragments, eight common meanings and four emerging themes: establishing links that satisfy, an invisible woman, approaching a transpersonal relationship of care, and the pursuit of understanding emerged from this study. CONCLUSION: Admission to the obstetric intensive care unit due to severe pre-eclampsia represents a change of role for women who, in addition to undergoing physical changes, also manifest a variety of emotions related to the circumstances of care and the actions of nurses.

Beliefs and practices of culture care in colombian Wayúu pregnant women / Creencias y prácticas de cuidado genérico en gestantes Wayúu colombianas / Crenças e práticas de cuidado genérico em mulheres grávidas colombianas do povo Wayuu

Objective: Understand the beliefs and care practices of the expectant mothers of the Wayuu indigenous community in the rancherias Sapalou and Sutalu, La Guajira. Methodology: Qualitative study with an ethnographic focus, which was performed on eleven expectant mothers of the mentioned indigenous community. The information was obtained through participative observation and a semi-structured interview. For the analysis of the data, the analysis guide of four tenets by Leininger was used. Results: The Wayuu expectant mothers described the practices of prenatal care inherited from their culture. During pregnancy, Wayuu mothers are not allowed to eat some foods such as shrimp, crab, rabbit or turtle, to prevent complications at birth and in the child to be born. They do not have contact with people that have committed murder, manipulated corpses or have assisted to funerals, since according to their beliefs this can cause bleeding at birth. The midwife becomes a significant member of the community during the pregnancy and labor process. Conclusions: It is imperative that nursing understands the cultural traits of the indigenous communities to bring holistic and quality nursing. Also, it is indispensable to continue with studies that explore the beliefs and practices of care during labor and postpartum of this populations.

Objetivo: Conocer las creencias y prácticas de cuidado de las gestantes de la comunidad indígena wayuu en las rancherías de Sapalou y Sutalu, La Guajira. Metodología: Estudio cualitativo con enfoque etnográfico, el cual se llevó a cabo con once gestantes de dicha comunidad indígena. La información se obtuvo mediante la observación participativa y una entrevista semiestructurada. Para el análisis de los datos, se utilizó la guía de análisis de cuatro fases propuesta por Leininger. Resultados: Las gestantes wayuu describieron las prácticas de cuidado prenatal heredadas por su cultura. Durante la gestación, las wayuu se cohíben de comer algunos alimentos, como camarón, cangrejo, conejo o tortuga, para evitar complicaciones en el parto y en el hijo por nacer. No tienen contacto con personas que hayan cometido homicidio, manipulado cadáveres o asistido a funerales, pues según sus creencias esto puede generar sangrados durante el parto. La partera se convierte en un miembro significativo en la comunidad durante el proceso de gestación, trabajo de parto y parto de las gestantes. Conclusiones: Es imperativo que la enfermería conozca los rasgos culturales de las comunidades indígenas para brindar cuidados holísticos y de calidad. Así mismo, es indispensable continuar con estudios que indaguen las creencias y prácticas de cuidado durante el parto y el puerperio de este tipo de población.

Objetivo: Conhecer as crenças e práticas de cuidado das mulheres grávidas da comunidade indígena Wayuu ou uaiús em ranchos de Sapalou e Sutalu, Estado de "La Guajira", na Colômbia. Metodologia: Estudo qualitativo com uma abordagem etnográfica, o qual foi realizado com onze mulheres grávidas da referida comunidade indígena. A informação se obteve através da observação participativa e uma entrevista semiestruturada. Para a análise dos dados, utilizou-se a guia da análise de quatro fases proposta por Leininger. Resultados: As mulheres grávidas Wayuu descreveram as práticas de cuidado pré-natal herdadas por sua cultura. Durante a gestação, as wayuu são inibidas de comer alguns alimentos como: camarão, caranguejo, coelho ou tartaruga, para evitar complicações no parto e no filho que está por nascer. Não têm contato com pessoas que tenham cometido homicídio, manipulado cadáveres ou ter participado de funerais, pois segundo suas crenças isto pode gerar sangramentos durante o parto. A parteira se converte num membro significativo na comunidade durante o processo de gestação, trabalho de parto e parto das grávidas. Conclusões: é imperativo que a enfermagem conheça as características culturais das comunidades indígenas para fornecer cuidados holísticos e de qualidade. Assim mesmo, é indispensável continuar com estudos que indaguem as crenças e práticas de cuidado durante o parto e o puerpério deste tipo de população.

Percepción de los profesionales de enfermería y las gestantes sobre la asesoría en virus de inmunodeficiencia humana en una empresa social del Estado de primer nivel en Bogotá, Distrito Capital / Perception of Nursing Professionals and Pregnant Women about Counseling on HIV in a First Level ESE in Bogota, Capital District / Percepção dos profissionais de enfermagem y as gestantes sobre a assessoria em HIV em uma ESE de Primeiro Nível em Bogotá, Distrito Capital

Objetivo: describir la percepción que tienen las profesionales de enfermería y las gestantes en relación con la asesoría en la detección del virus de inmunodeficiencia humana (vih), a partir de los lineamientos descritos en la Guía Técnica del proyecto Integra: Modelo de Gestión Integral de Servicios de Salud Sexual y Reproductiva y Prevención de la Infección por vih, para orientar acciones que permitan el fortalecimiento de esta actividad, en una empresa social del Estado (ese) deBogotá. Metodología: diseño cualitativo, descriptivo, con enfoque hermenéutico; el análisis de los datos fue mediante la técnica de análisis de contenido a dieciséis entrevistas semiestructuradas, realizadas durante cuatro meses. Participaron ocho profesionales de enfermería que realizan asesoría en VIH y a ocho gestantes que asisten a la asesoría en VIH. Resultados: el tema central que emergió del análisis de las entrevistas fue "las paradojas de la asesoría en vih", dado que a partir de los testimonios de las participantes se encontró una serie de ambivalencias en relación a sus opiniones, experiencias, creencias y sentimientos. El tema fue evidenciado en las siguientes categorías, retomadas del discurso de las personas entrevistadas: los sentimientos, entre la ansiedad y la tranquilidad. Las categorías emergentes del discurso de los profesionales de enfermería se centraron en: entre la frustración y la tranquilidad. Conclusiones: para las gestantes y los profesionales de enfermería, la asesoría en vih/sida se percibió como una paradoja, con sentimientos ambivalentes entre la alegría y la tristeza, el temor y la ansiedad, la frustración y la tranquilidad, lo que se debe hacer y la realidad encontrada. Son percepciones que permitirán trabajar en la prevención de la infección del VIH por parte de las profesionales, para así lograr en las gestantes cambios de comportamiento saludables y optimizar la asesoría como estrategia útil para al contención de la epidemia en este grupo poblacional.

Objective: This study sought to describe perception of nursing professionals and expectant mothers with respect to counseling on detection of human immunodeficiency virus (HIV) based on the guidelines described in the Technical Guide of the INTEGRA project: Sexual and Reproductive Health Comprehensive Management Model and HIV Infection Prevention Services in order to orient actions allowing strengthening of this activity in a State-Owned Social Company (ESE) of Bogota. Methodology: Qualitative, descriptive design with a hermeneutical approach. Data were analyzed through the technique of content analysis (author) of sixteen semi-structured interviews undertaken during four months. Eight nursing professionals who provided HIV counseling and eight pregnant women receiving HIV counseling participated. Results: The central topic resulting from the analysis of the interviews was "the paradoxes of HIV counseling" since, based on the participants' testimonies, a series of ambivalences were found in relation with their opinions, experiences, beliefs and feelings. The topic was divided into the following categories taken from the speech of interviewed people: feelings, between anxiety and calm. The categories established from the speech of nursing professionals focused on: between frustration and calm. Conclusion: for pregnant women and nursing professionals, the HIV/AIDS was perceived as a paradox with ambivalent feelings between joy and sadness, fear and anxiety, frustration and clam, what should be done and the reality faced. These are perception that shall allow working on HIV prevention by professionals, as well as bringing about healthy behavior changes on pregnant women and optimizing counseling as a useful strategy for epidemic control in this population group.

Objetivo: descrever a percepção que os profissionais de enfermagem e as gestantes têm em relação com a assessoria na detecção de vírus de imunodeficiência humana (HIV), com base nas diretrizes descritas no Guia Técnico do projeto INTEGRA: Modelo de Gestão Integral de Serviços de Saúde Sexual e Reprodutiva e Prevenção da Infeção por HIV para nortear ações que possibilitem o fortalecimento desta atividade em uma empresa social do Estado (ESE) de Bogotá. Metodologia: desenho qualitativo, descritivo, com abordagem hermenêutica; a análise dos dados se fez mediante a técnica de análise de conteúdo (autor) de dezasseis entrevistas semiestruturadas, realizadas durante quatro meses. Participaram oito profissionais de enfermagem que fazem assessoria em HIV e oito gestantes que recebem assessoria sobre HIV. Resultados: a questão central que surgiu da análise das entrevistas foi "os paradoxos da assessoria em HIV/Aids", sendo que a partir dos testimoniais dos participantes encontrouse uma série de ambivalências a respeito das opiniões, experiências, crenças e sentimentos. A questão se evidenciou nas seguintes categorias, retomadas do discurso das pessoas entrevistadas: os sentimentos, entre a ansiedade e a tranquilidade. As categorias emergentes do discurso dos profissionais de enfermagem se focou em: entre a frustração e a tranquilidade. Conclusões: para as gestantes e os profissionais da enfermagem, a assessoria em HIV/Aids foi percebida como um paradoxo, com sentimentos ambivalentes entre a alegria e a tristeza, o temor e a ansiedade, a frustração e a tranquilidade, o que deve ser feito e a realidade encontrada. Estas são percepções que irão permitir um melhor trabalho na prevenção da infeção do HIV por parte dos profissionais a fim de conseguir mudanças de comportamento saudáveis nas gestantes e aprimorar a assessoria como estratégia útil para a contenção da epidemia neste grupo populacional.

Percepción de los profesionales de enfermería y las gestantes, sobre la asesoría en VIH en una ESE de primer nivel de Bogotá distrito capital  / Perception of nursing professionals and pregnant women, about HIV counseling in a first level ESE of Bogotá capital district

Objetivo: Describir la percepción que tienen las profesionales de enfermería y las gestantes con relación a la asesoría en VIH, a partir de los lineamientos descritos en la Guía Técnica del proyecto INTEGRA: Modelo de Gestión Integral de Servicios de Salud Sexual y Reproductiva y Prevención de la Infección por VIH, para orientar acciones que permitan el fortalecimiento de esta actividad, en el Hospital del Sur, Empresa Social del Estado de Bogotá. Metodología: Diseño cualitativo, descriptivo, con enfoque hermenéutico, realizado mediante la técnica de análisis de contenido a las entrevistas semiestructuradas de 8 profesionales de enfermería que realizan asesoría en VIH y 8 gestantes que asisten a la asesoría en VIH. Resultados: El tema central "Las paradojas de la asesoría en VIH" según el Diccionario de la lengua Española (1), se entiende por paradoja, "Una figura del pensamiento que consiste en emplear expresiones o frases que expresan contradicción al menos aparente, entre dos cosas o ideas, también se puede considerar una idea extraña o irracional que se opone al sentido común y a la opinión general". Porque en los testimonios de las gestantes y profesionales de enfermería se evidenciaron situaciones ambivalentes dando una contradicción aparente por su opinión, experiencia, creencias, y sus sentimientos. Este tema de las paradojas de la asesoría, están sustentadas por una serie de categorías; tanto para las gestantes como para los profesionales de enfermería. Las categorías emergentes en las gestantes se evidencian: Los sentimientos entre la ansiedad y la tranquilidad. . La asesoría nos hace pensar en nuestra vida y la vida de otros, pero al final…, son mínimos los cambios. Entre lo que nos dicen en la asesoría: el condón, lo que creemos…, y lo que no nos dicen. Entre el tiempo, y el papeleo…, la asesoría es importante: hay que cuidarse. La enfermera es sincera, me hablo bonito…, pero al final ¿qué queda?. Las categorías emergentes para los profesionales de enfermería se encuentra entre la frustración y la tranquilidad. . La realidad que se encuentra y el deber ser de la asesoría. Entre las necesidades identificadas…, y lo que se debe ofrecer. Lo que la enfermera desea…, con las usuarias y la institución. Conclusiones: Tanto para las gestantes como para las profesionales de enfermería, la asesoría en VIH/SIDA se percibió como una paradoja, con sentimientos ambivalentes entre la alegría y la tristeza, el temor y la ansiedad. La frustración y la tranquilidad, lo que se debe hacer y la realidad encontrada. Son percepciones que permitirán trabajar en la prevención de la infección del VIH, por parte de las profesionales para así lograr en las gestantes cambios de comportamiento saludables y optimizar la asesoría como estrategia útil.

Objective: Describe the perceptions of nurses and pregnant women in relation to HIV counseling, based on the guidelines described in the Technical Guide INTEGRA Project: Integral Management Model Services Sexual and Reproductive Health and Infection Prevention HIV, to guide actions to strengthen this activity in the Hospital del Sur, ESE Bogotá. Methodology: design qualitative, descriptive, hermeneutic approach, carried out by the technique of content analysis, semi-structured interviews with eight nurses who perform HIV counseling and eight pregnant women attending the HIV counseling. Results: The central theme "The paradoxes of HIV counseling," according to the Dictionary of the Spanish language (1), the term paradox, "A figure of thought is to use expressions or phrases that express apparent contradiction between two things or ideas, can also be considered strange or irrational idea that is opposed to common sense and the general opinion. " Because the testimony of the pregnant women and nursing professionals are ambivalent situations showed an apparent contradiction by giving your opinion, experience, beliefs, and feelings. This issue of the paradoxes of counseling is supported by a number of categories, both for pregnant women and nursing professionals. The emerging categories are evident among pregnant women: The feelings between anxiety and tranquility. . The advice makes us think of our lives and the lives of others, but in the end ... there are very few changes. Between what we say in advising: the condom, which we believe ... and what they tell us. Between the time and paperwork ... the advice is important: one must be careful. The nurse is sincere, I speak pretty ... but in the end what is left? The emerging categories of nursing professionals are between frustration and quiet. . The reality shows and "must be" adviceis. Among the identified needs ... and what to offer. What nurses want to ..., with clients and the institution. Conclusions: Both for pregnant women and for professional nursing, counseling on HIV / AIDS was perceived as a paradox, with ambivalent feelings between joy and sadness, fear and anxiety. The frustration and quiet, what to do and the reality shows. Are perceptions that will work in preventing HIV infection, by the professionals and pregnant women achieve healthy behavior change as a strategy to optimize the useful advice.