Representaciones sociales del desastre natural para las madres damnificadas de una comunidad urbano-marginal de Lima, Perú / Social Representations of Natural Disasters for Affected Women from an Urban-Marginal Community in Lima, Peru

Introducción: Los desastres naturales generan un impacto negativo en la salud y vida de la población; sin embargo, existen escasos estudios cualitativos que aborden su repercusión en la vida, la salud mental y el imaginario de los afectados. Objetivo: Caracterizar las representaciones sociales del desastre natural que tienen las madres damnificadas del fenómeno del Niño Costero de una comunidad urbano-marginal de Lima, Perú. Métodos: Investigación cualitativa, exploratoria, basada en la metodología de las representaciones sociales. Se realizó en diciembre del 2019, en Lima, Perú. El muestreo fue no probabilístico intencional, debido al acceso al lugar y la disponibilidad hasta llegar al punto de saturación; se entrevistó en profundidad a 11 madres y luego se realizó análisis del discurso. Resultados: Emergieron tres categorías: vivir la vulnerabilidad socioambiental, reconfortarse con un ser divino y enfrentar la crisis ecológica. Conclusiones: Las mujeres damnificadas reconocen la vulnerabilidad socioambiental por su condición socioeconómica precaria y vivir en la ribera del río. Asimismo, no encuentran las estrategias para superar su situación y se refugian en la ayuda y protección de un ser divino; frente al desastre natural tienen conciencia de la crisis ecológica en la que viven y la necesidad de una respuesta integral y colectiva(AU)

Introduction: Natural disasters generate a negative impact on the health and life of the population; however, there are few qualitative studies addressing their impact on the life, mental health and imaginary of those affected. Objective: To characterize the social representations of the natural disaster held by mothers affected by "El Niño Costero" phenomenon in an urban-marginal community of Lima, Peru. Methods: A qualitative and exploratory research, based on the methodology of social representations, was conducted in December 2019, in Lima, Peru. The sampling was intentional nonprobabilistic, due to the access to the place and the availability until reaching the saturation point; in-depth interviews were conducted with 11 mothers and then discourse analysis was performed. Results: Three categories emerged: living the socioenvironmental vulnerability, being comforted by a divine being, and facing the ecological crisis. Conclusions: The affected women recognize their socioenvironmental vulnerability due to their precarious socioeconomic condition and the fact that they live on the riverbank. Likewise, they do not find any strategies for overcoming their situation and take refuge in the help and protection from a divine being instead. In the face of the natural disaster, they are aware of the ecological crisis in which they live and the need for an integral and collective response(AU)

Dressings and dignity in community nursing.

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of 'leaky' bodies.

Help Me Cope and Make It Easier: A Perspective from Community Nursing.

SE Health is one of Canada's largest social enterprises, providing home and community care to Canadians since 1908. The organization's 8,000 staff make 18,000 contacts with people in their homes, per day, to deliver healthcare services. Registered nurses and registered practical nurses provide assessments and treatments and support patients and their families to remain healthy, stay safe at home, self-manage and be independent.

Visibilidad de actores sociales sobre los cuidados de enfermería comunitaria a la persona, familia y comunidad / Visibility of Social Actors regarding Community Nursing Cares for the Patients, their Families and the Community

Introducción: Cuidar significa movilizar las capacidades del ser humano en estado de salud o enfermedad, teniendo presente sus costumbres; exige del cuidador desarrollar capacidades de percepción, comprensión, ingenio, inventiva y creatividad. Las vivencias acumuladas por la autora, le permitieron identificar de manera empírica que no todos los cuidados brindados por la enfermera comunitaria son registrados y por tanto visibilizados. Objetivo: Identificar la visibilidad de los actores sociales sobre los cuidados que brinda el especialista de enfermería comunitaria a la persona, familia y comunidad. Métodos: Investigación de corte cualitativo-descriptivo, en el consultorio del médico y enfermera de la familia No. 23, del Policlínico Plaza de la Revolución, La Habana, durante 2019. Universo de 1080 personas, por muestreo no paramétrico (criterio de saturación o redundancia) se seleccionaron 43 personas. Se emplearon análisis documental y la entrevista grupal semiestructurada a actores sociales de la comunidad. Las indagaciones obtenidas se procesaron a través del análisis de contenido de los datos. Resultados: A través de lo expresado, los actores sociales reconocen las acciones que realiza este profesional en relación al cuidado de su salud y la de sus familiares. Entre los criterios emitidos sobre los cuidados percibidos adquirieron relevancia: "toma de la tensión arterial y "visita a la casa". Conclusión: Se evidenciaron cuidados que les permitía poner en práctica todo lo aprendido y utilizar el conocimiento y las técnicas propias de la profesión para el cuidado a la salud, lo que le otorga un actuar profesional responsable y comprometedor con un enfoque humanista(AU)

Introduction: Caring means mobilizing the capacities of the human being in a state of health or illness, considering his/her customs. It demands that the caregiver develop skills of perception, understanding, cleverness, inventiveness and creativity. The experiences gathered by the author allowed her to identify, empirically, that not all the care provided by the community nurse is recorded and, therefore, made visible. Objective: To identify the visibility of social actors concerning the care provided by the community nurse specialist to the person, family or the community. Methods: Qualitative-descriptive research carried out, during 2019, in the family doctor and nurse's office number 23 of Plaza de la Revolución Polyclinic, Havana. The universe was 1080 people. By nonparametric sampling (saturation criterion or redundancy), 43 people were selected. Documentary analysis and a semistructured group interview with social actors from the community were used. The inquiries obtained were processed through content analysis applied to the data. Results: Based on what the participants expressed, the social actors recognize the actions carried out by the community nurse regarding healthcare of patients and their family members. Among the criteria expressed about perceived care, the following were relevant: blood pressure measurement and home visit. Conclusion: Cares were evidenced that allowed them to put into practice everything that they learned and use the knowledge and techniques of the profession as part of healthcare, which guarantees that they perform through responsible and committed professional acts with a humanistic approach(AU)

La humanización del cuidado enfermero del anciano en estado de necesidad en la comunidad / Humanization of Nursing Care for the Community Elderly in Needs

Introducción: La enfermería tiene como esencia el cuidado humanizado desde una perspectiva holística, orientada hacia la búsqueda de soluciones específicas para cubrir las necesidades de los ancianos en estado de necesidad en la comunidad. Objetivo: Sistematizar el alcance y la naturaleza de la literatura científica existente sobre la humanización del cuidado enfermero del anciano en estado de necesidad en la comunidad. Métodos: Revisión integrativa realizada en 2019 para desarrollar un análisis crítico reflexivo, en documentos, artículos originales y de revisión disponibles en SciELO, Redalyc, Medigraphic y Medline, publicados en español, portugués e inglés entre 2005 y 2019. La pregunta guía se elaboró a través del acrónimo CPC. La estrategia de búsqueda se realizó mediante las palabras clave "cuidado enfermero en la comunidad"; "cuidados humanizado en ancianos"; "humanización de la atención", identificadas en DeCS o MeSH enlazados por los operadores booleanos AND y OR. Se utilizó el diagrama de flujo (PRISMA). El análisis, síntesis y sistematización de contenido permitió interpretar los referentes teóricos y la organización del conocimiento de las 13 bibliografías seleccionadas. Conclusiones: Mediante la sistematización de las bibliografías científicas se abordó el alcance y la naturaleza del cuidado humanizado del anciano en estado de necesidad en la comunidad, con una visión integradora desde una perspectiva holística en la atención comunitaria, a través de la relación del profesional de enfermería en las instituciones de salud(AU)

Introduction: Nursing's essence is humanized care from a holistic perspective, oriented towards searching for specific solutions to meet the needs of community elderlies. Objective: To systematize the scope and nature of the existing scientific literature about humanization of nursing care for the community elderlies in needs. Methods: Integrative review carried out in 2019 to develop a reflective-critical analysis in documents, as well as in original and review articles, available in SciELO, Redalyc, Medigraphic and Medline, published in Spanish, Portuguese and English between 2005 and 2019. The guiding question was elaborated through the CPC acronym. The search strategy was carried out using the keywords cuidado enfermero en la comunidad [community nursing care], cuidados humanizado en ancianos [humanized care for elderlies], and humanización de la atención [humanization of care], identified in DeCS or MeSH and linked using the Boolean operators AND and OR. A flow chart (PRISMA diagram) was used. The analysis, synthesis and systematization of content allowed to interpret the theoretical references and the organization of knowledge from the thirteen selected bibliographies. Conclusions: Through the systematization of the scientific bibliographies, the scope and nature of humanized care for community elderlies in needs was addressed, with an integrative vision, from a holistic perspective oriented towards community care, and through the relationship of the nursing professional in health institutions(AU)

The Perception of Plastic Surgery by Community-Based, Private Practice Nurses: A French National Descriptive Study.

Plastic surgery is a dynamic field but remains poorly understood by general practitioners, medical students, health professionals, and the public. The main health care professionals in the community who are involved in the follow-up of plastic surgery patients are nurses; they help to facilitate wound healing and rehabilitation in the postoperative period. In this study, the authors assessed the medical knowledge and perceptions of plastic surgery by nurses working in the community setting and explored their understanding of classical scenarios commonly encountered in reconstructive surgery. An online survey was designed to assess the demographics of nurses working in the community in France and their knowledge of plastic surgery. This was disseminated to all practicing nurses working outside of hospitals by means of an online social network from the period of April 2019 to June 2019. The survey was completed by 318 nurses. Specific training in plastic surgical nursing will be required to optimize the management of these patients following discharge from hospital. This gap in knowledge may affect patient recovery negatively.

Two Nursing Outreach Interventions to Engage Vulnerable Populations in Care.

People experiencing substance use disorders, homelessness, mental health conditions, or poverty often have difficultly engaging in healthcare services particularly prevention services. This brief report describes two nursing interventions implemented by nursing students that aim to empower vulnerable populations and draw them into care using empathetic and patient-centered approaches. The first intervention uses street outreach with naloxone training in an area of Baltimore experiencing a high rate of overdose deaths. The second uses home or street outreach to link people living with HIV to HIV care.

Oral conditions in the community patient: part 1.

Oral health is essential to prevent pain, ensure adequate nutrition and promote optimum general and psychosocial wellbeing. The detrimental effects of poor oral health can often be overlooked, resulting in low prioritisation of oral care when compared to other care roles. A multidisciplinary approach to maintaining good oral health of dependent community patients must be established, with stakeholders including dentists, nurses, carers, and family members. This article aims to explore fundamental oral health considerations for community nurses to maintain oral health.

Clinical effectiveness of flucloxacillin delivery using an elastomeric device for outpatient parenteral antimicrobial therapy.

There has been a surging interest in using elastomeric infusion devices to deliver outpatient parenteral antimicrobial therapy (OPAT), which is more cost-effective than standard antibiotic administration, which requires multiple daily home visits. This has been particularly important since the outbreak of the coronavirus pandemic, because reducing patient contact can also help to minimise transmission of COVID-19 to outpatients who are at a high risk of COVID-19-triggered complications. In this retrospective study, the clinical effectiveness of intravenous (IV) infusion of flucloxacillin using an elastomeric device was explored in a convenience sample of patients. Patients with three primary infective diagnoses-bloodstream infection, non-vertebral osteomyelitis and vertebral osteomyelitis-were included in the analyses. In non-vertebral osteomyelitis patients, Accufuser antibiotic infusion shortened the course of OPAT care relative to standard antibiotic administration (p<.05). In contrast, in vertebral osteomyelitis patients, it prolonged the course of OPAT care relative to standard administration (p<.05). In patients with bloodstream infections, no significant difference was found between the treatment modes (p=.93). Thus, the clinical effectiveness of Accufuser antibiotic infusion varies among patients with different infective diagnoses, and there seems to be a complex relationship between the method of antibiotic delivery and the patient's condition.

Life is for living: the contribution of the arts and gardens.

Quality of life and life enrichment are important throughout the lifespan and no less during ill-health or later life. The role of the arts and gardens and their potential benefits are not prominent within healthcare practice. This paper outlines the evidence reported in two literature reviews, one addressing the arts and the other focusing on gardens and gardening so that district nurses can understand what art-based and gardening opportunities they may offer their clients and their carers.

Encouraging exercise in older adults: advice for nurses.

Physical activity is well documented to contribute to better mental and physical wellbeing in older adults. Physical exercise also plays a part in falls prevention, thus reducing fear of injury when exercising. Motivational interviewing to encourage exercise among older adults should be assertive yet kind, with the provision of an appropriately trained staff member, convenient fitness facilities to access and consideration of cost. Facilitators and barriers affect an older person's motivation to engage in physical exercise. Barriers include cost, physical barriers, fear of injury, low motivation, dislike of exercise, locality of the service and more. In this article, the available evidence is examined to discuss the subjects of motivational interviewing, facilitators and barriers to exercise and ways to overcome the latter.

Promoção da saúde e atenção primária no cuidado às pessoas com doença crônica não transmissível / Health promotion and primary care for people with chronic non-transmissible diseases / Promoción de salud y atención primaria en el cuidado a las personas con enfermedades crónicas no transmisibles

RESUMO Objetivo Compreender as práticas de promoção da saúde desenvolvidas pelos enfermeiros da Atenção Primária à Saúde, no cuidado às pessoas com doença crônica não transmissível. Método Estudo qualitativo, desenvolvido por meio do discurso do sujeito coletivo, realizado com vinte e três enfermeiros da Estratégia Saúde da Família, de um município do Sul do Brasil. Resultados As práticas de promoção da saúde desenvolvidas pelos enfermeiros referemse a dois campos principais, dos cinco campos de ação propostos pela Carta de Ottawa: reorientação do sistema de saúde e desenvolvimento de habilidades pessoais. Emergiu como um dos discursos e ideia central os limites para o desenvolvimento dos campos da Carta de Ottawa. Conclusões Percebeuse que apesar dos esforços empreendidos pelos enfermeiros, para o desenvolvimento das práticas de promoção da saúde, estas se apresentam em determinados momentos de forma ampliada, pensando em uma nova lógica da promoção da saúde, e em outras situações se mostra de maneira mais restritiva, voltando a uma prática mais tradicional.(AU)

ABSTRACT Objective Understand the health promotion practices developed by primary health care nurses in a southern county of Brazil, in the care of people with chronic non-communicable diseases. Method Qualitactive research, developed by multiple speeches, in twenty three health centers of a southern county of Brazil. Results According to speeches, the health promotion practices developed by nurses refer to two main fields, of the five action fields proposed by the Ottawa Letter: reorientation of the health system and developing personal abilities. It appeared as a speech, related to the central idea about the limits to developing fields of the Ottawa letter. Conclusions Besides the efforts spent to develop health promotion practices, these appear in some moments in an amplified way, thinking in a new logic to Health promotion and in other situations it shows itself in a more restrictive way, returning to a more traditional practice.(AU)

RESUMEN Objetivo Entender las prácticas de promoción de la salud desarrolladas por enfermeras en la atención primaria de salud, en una ciudad al sur de Brasil, en el cuidado de personas con enfermedades crónicas no transmisibles. Método Se trata de un estudio cualitativo desarrollado a 143 pacientes a través del discurso del sujeto colectivo, realizado con la estrategia de veintitrés enfermeros de la salud de la familia, en veintitrés centros de salud de una ciudad del sur de Brasil, de junio a agosto de 2016. Resultados De acuerdo con los discursos que se han presentado, las prácticas de promoción de la salud desarrolladas por los enfermeros se refieren a dos campos principales de los cinco campos de acción propuestos por la Carta de Ottawa: orientación del sistema de salud y desarrollo de habilidades personales. Surgió como uno de los discursos la idea relacionada con los límites para el desarrollo de los campos de la Carta de Ottawa. Conclusiones Se observó que, a pesar de los esfuerzos realizados por los enfermeros para el desarrollo de las prácticas de promoción de la salud en el cuidado a las personas con enfermedades crónicas no transmisibles, estos se presentan en determinados momentos por lo expandido, pensando en una nueva lógica de promoción de la salud. En otras situaciones se muestran de una manera más restrictiva, con la que se vuelve a una práctica más tradicional.(AU)

Compassionate care in the community: reflections of a student nurse.

Reflecting on practice and analysing situations when compassionate care has been delivered can be a valuable way of helping student nurses develop their understanding of humanising care. This exemplar showcases a scenario when a second-year student nurse studying for a BSc (Honours) in adult nursing explored an experience while working in the community. She critically reflected on an incident highlighting a simple yet powerful example of how she helped an older couple manage an aspect of their care. This exercise helped the student to explore and understand what compassionate care means and highlighted how the value of reflection can be used to gain new insights to enhance the care of older people in her future practice in the community.

Systematic and integrative reviews: synthesising evidence for community nursing practice.

Ease of access to vast amounts of information presents significant opportunities and challenges for nurses in the community as they seek to base their practice on the best available evidence. Growing expectations around evidence-based practice have developed alongside developments in evidence synthesis, which adopts robust approaches to identifying, appraising and synthesising key evidence for clinical decision-making. The context in which evidence-based practice occurs is key, and this article discusses the skills and knowledge needed for community nurses to discern how evidence and information should influence their decisions to review and change approaches to clinical practice. Importantly, if nurses understand the status of evidence underpinning areas of practice, they can ensure that the preferences and needs of patients and families are met.

Interfaces of vulnerability dimensions in violence against children.

OBJECTIVE: present and discuss the potential use of the concept of vulnerability for the development of practices to address violence against children. METHOD: this is a theoretical study that presents the characteristics of the phenomenon of violence against children, to which the concept of vulnerability is applied. RESULTS: proposal of a framework for the analysis of violence against children in the perspective of vulnerability, creating individual and collective dimensions. Violence against children, when analyzed in the perspective of this concept, broadens the understanding of this phenomenon, as it exposes aspects and conditions from outside the family that are co-responsible for the occurrence of this phenomenon. CONCLUSION: developing studies to identify the vulnerability of children to violence is essential for the development of practices to address this issue.

Homeless Hope: a voluntary, nurse-led organisation working to educate and support people sleeping rough.

This article describes the development of a nurse-led voluntary organisation that provides basic foot care to the homeless at street level in three Welsh cities. There is a large percentage of street sleepers who choose not to access professional health and care services for various reasons, and many of these individuals have foot health problems, such as sore, painful, swollen feet from continuous walking, calluses, dried skin, blisters that are often de-roofed and trench foot. Through support and education, however, several of these people have been able to take ownership of their identified problems, by building trusting relationships with Homeless Hope nurses. Through collaborative communication with professional services, Homeless Hope nurses provide an informal link between non-engaging rough sleepers and the services in place to help support them.

Population health management and its relevance to community nurses.

Local services can provide better and more joined-up care for patients when different organisations work collaboratively in an integrated system. Population health management (PHM) provides the shared data about local people's current and future health and wellbeing needs. Joint care planning and support addresses both the psychological and physical needs of an individual recognising the huge overlap between mental and physical wellbeing. Joint posts and joint organisational development are likely to become more commonplace and community nurses will have a vital contribution to planning and delivery of integrated care to improve health and care outcomes for their local populations.