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.

[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.

¿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.

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.

La Investigación Cualitativa en Ciencias de la Salud: contribuciones desde la Etnografía / Pesquisa qualitativa em Ciências da Saúde: contribuições da etnografia / Qualitative research in Health Sciences:

Resumen: Este trabajo tiene como objetivo exponer una de las estrategias más utilizadas en la investigación social-sanitaria, como lo es la Etnografía. Asimismo, demostrar las ventajas de su utilización a los profesionales de las Ciencias de la Salud. Se hace referencia a las formas de Etnografía más empleadas en investigaciones sanitarias con las formas de recolección de información características de cada una. El artículo presenta ejemplos de estudios que aplicaron las diferentes formas de esta estrategia en el área de la salud

Summary: This paper aims to elucidate one of the most commonly used strategies in social-health research, ethnography, and to demonstrate the advantages of its use to professionals in health sciences. The forms of ethnography most employed in health research will be considered, along with the methods of collecting information particular to each of them. This paper presents examples of studies that have applied the various forms of this strategy in the area of health

Resumo: Este artigo pretende expor uma das estratégias mais utilizadas na pesquisa de saúde social, como a etnografia. Da mesma forma, demonstre as vantagens de seu uso para profissionais das Ciências da Saúde. Refere-se às formas de etnografia mais utilizadas na pesquisa em saúde com as formas de coletar informações características de cada uma. O artigo apresenta exemplos de estudos que aplicaram as diferentes formas desta estratégia na área da saúde.

Perceptions of abuse in nursing home care relationships in Uruguay.

PURPOSE: To describe the care relationships between caregivers and elderly people in Uruguayan nursing homes. DESIGN: A qualitative study with an ethnographic approach conducted at nine nursing homes for elderly people located in four Uruguayan departments. Twenty-three purposively and theoretically selected participants were interviewed and observed between January 2011 and January 2012. RESULTS: Study of relationships among caregivers, managers, and residents revealed a number of issues: perception and experience of elder abuse, suffering when faced with death, and existential pain. CONCLUSION: A cultural context of discrimination against the elderly and other factors converge to perpetuate elder abuse and suffering in care homes: the lack of adequate regulations covering safety and quality of care, lack of a care model and regular inspections, absence of minimum training requirements for caregivers, and lack of support in situations that have psychic and spiritual repercussions. The inclusion of nurses could promote the development of educational interventions to modify abusive conduct. Nursing home managers need knowledge, skills, and communication strategies to identify and manage inappropriate behavior. An urgent review of nursing home regulations is required to protect elderly people's rights.

Long-term care of the elderly in Uruguay.

OBJECTIVE: To explore the perception of care of the elderly in long-term centers. DESIGN: Qualitative study through participant observation and 23 in-depth interviews with administrators, caregivers, and residents between January 2011 and January 2012 in nine long-term care centers in Uruguay. From analysis, three care-perception factors emerged: (a) meaning of care, (b) experience of care, and (c) care continuity. CONCLUSION: Care of the elderly in nursing homes is perceived as a duty. There is an exchange of feelings and recognition of the caregiver is needed. However, the need for technical or specialized training is not mentioned. Recognition of the task of care provision, duty as a moral determinant, the exchange of affection and solidarity between staff and the elderly allows care continuity despite the centers' lack of resources. CLINICAL RELEVANCE: This study contributes information that may help improve the care conditions of elderly institutionalized people.