ABSTRACT
La vulnerabilidad es un concepto ampliamente utilizado en la literatura de las ciencias sociales, e incorporado al ámbito sanitario con el desarrollo de la bioética y el modelo de determinantes sociales de la salud. Ha sido descrito por expertos como un concepto complejo y de gran utilidad para abordar poblaciones susceptibles de enfermar. Esto obliga a enfermería a identificar estos grupos y responder a sus necesidades de cuidado. Objetivo. Revisar la literatura para analizar las intersecciones en la relación conceptual entre vulnerabilidad y cuidado, desde una perspectiva de enfermería. Metodología. Se realizó una revisión integradora de la literatura basada en la sistematización propuesta por Whittemore y Knafl. Se consideró la literatura de los últimos cinco años disponible en las bases de datos Wos®, Scopus® y PubMed®. En la estrategia de búsqueda se utilizaron las palabras claves "vulnerability" and "care". Resultados. Se seleccionaron 18 artículos, coincidente con países que han desarrollado modelos sanitarios con enfoque social, como Canadá y Brasil. En el análisis se identificaron y describieron cinco temas en que se interceptan vulnerabilidad y cuidado; paradigma ontológico, epidemiológico, social y bioético, y la asociación entre vulnerabilidad y necesidades de cuidado. Conclusiones. La literatura da cuenta de la estrecha relación entre vulnerabilidad y cuidado, dado que la naturaleza de los cuidados profesionales de enfermería es la respuesta organizada socialmente a la vulnerabilidad humana.
Vulnerability is a concept widely used in the social sciences literature, and incorporated into the health field with the development of bioethics, and the model of social determinants of health. It has been described by experts as a complex concept, and very useful for addressing populations susceptible to illness. This ethically obliges nursing to identify these groups and respond to their care needs. Goal. To review the literature to analyze the intersections in the conceptual relationship between vulnerability and care, from a nursing perspective. Methodology. An integrative review of the literature was carried out based on the systematization proposed by Whittemore and Knafl. Literature from the last five years available in the Wos®, Scopus® and PubMed® databases was considered. The keywords "vulnerability" and "care" were used in the search strategy. Results. 18 articles were selected, coinciding with countries with health models with a social focus, such as Canada and Brazil. In the analysis, five themes were identified and described in which vulnerability and care intersect; ontological, epidemiological, social and bioethical paradigm, and the association between vulnerability and care needs. conclusions. The literature reports the close relationship between vulnerability and care, given that the nature of professional nursing care is the socially organized response to human vulnerability.
A vulnerabilidade é um conceito amplamente utilizado na literatura das ciências sociais, incorporado ao âmbito sanitário com o desenvolvimento da bioética e o modelo de determinantes sociais da saúde. Foi descrito por especialistas como um conceito complexo e de grande utilidade para abordar populações suscetíveis a adoecer. Isto obriga eticamente a enfermagem a identificar estes grupos e responder a suas necessidades de cuidado. Objetivo. Revisar a literatura para analizar as intersecções na relação conceitual entre vulnerabilidade e cuidado, a partir de uma perspectiva da enfermagem. Metodologia. Realizou-se uma revisão integradora da literatura baseada na sistematização proposta por Whittemore e Knafl. Considerou-se a literatura dos últimos cinco anos disponíveis nas bases de dados Wos®, Scopus® e PubMed®. Na estratégia de busca utilizou-se as palavras chaves "vulnerability" and "care". Resultados. Foram selecionados 18 artigos, coincidentes com países que desenvolveram modelos sanitários com enfoque social, como o Canadá e o Brasil. Na análise identificaram-se e descreveram-se cinco temas em que se interceptam vulnerabilidade e cuidado: paradigma ontológico, epidemiológico, social e bioético, e a associação entre vulnerabilidade e necessidades de cuidado. Conclusões. A literatura dá conta da estreita relação entre vulnerabilidade e cuidado, dado que a natureza dos cuidados profissionais de enfermagem é a resposta organizada socialmente à vulnerabilidade humana.
ABSTRACT
El nervio mediano desciende por el brazo y, en el codo, comienza a atravesar estructuras que pueden generar compresión, como el ligamento de Struthers, el lacertus fibrosus, el pronador redondo, el flexor superficial de los dedos. Finalmente, en la muñeca, se encuentra otro sitio de compresión producido por el ligamento transverso del carpo. Todas estas estructuras pueden provocar signos y síntomas de atrapamiento nervioso y favorecer el deterioro funcional del nervio. Nuestro objetivo es dar a conocer una actualización sobre estos sitios de atrapamiento del nervio mediano, y cómo realizar un diagnóstico preciso e indicar un trata-miento adecuado. Nivel de Evidencia: IV
The median nerve is a nervous structure that begins to cross structures at the level of the elbow that might cause compression. The Struthers ligament, lacertus fibrosus, pronator teres, and flexor digitorum superficialis are among them. Finally, the transverse carpal ligament creates another compression site in the wrist. All these structures can develop pathological signs and symptoms of nerve entrapment, which favors nerve functional degradation. Our objective is to provide an update on these median nerve entrap-ment sites, as well as information on how to establish an accurate diagnosis and provide adequate treatment. Level of Evidence: IV
Subject(s)
Wrist Joint , Carpal Tunnel Syndrome , Decompression, Surgical , Median Neuropathy , Elbow , Median NerveABSTRACT
In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 ± 33 SD; online mean = 336 ± 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12; 95% CI= 0,82 - 1,55; p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63; 95% CI = 8,64 - 18,46; p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.
Subject(s)
Humans , Psychiatry , Students, Medical , Education, Medical, Undergraduate , Self-Management , COVID-19 , SARS-CoV-2ABSTRACT
Background: Scientific research is fundamental to the education of medical students. However, their involvement in research is limited. Aim: To describe the perceptions of medical students about facilitators and constraints to perform undergraduate research. Material and Methods: Medical students attending the Chilean Congress of Medical Students in the Metropolitan Region in 2018, were surveyed. The responses obtained were subjected to a qualitative content analysis and were grouped according to perceptions of facilitators and constraints. Results: The main facilitators reported were linkage with research teachers, personal motivation towards research, and research-oriented curriculum. The main constraints were lack of time for research, lack of access to formal information channels to engage in research, and sub-optimal conditions for research. Conclusions: The main factor promoting research at the undergraduate level was the link with the teacher, mainly through informal channels. The lack of official information provided through formal instances and lack of time hampers the access to research.
ABSTRACT
Resumen: El ageísmo en la vejez se ha relacionado con el imaginario social, responsable de mantener prejuicios y estereotipos hacia personas mayores. Prevaleciendo como fenómeno común en países occidentalizados como Chile, replicando una imagen de vejez llena de carencias y deterioro corporal. Este artículo reflexiona sobre el fenómeno de ageísmo que promueve conductas que excluyen a las personas mayores de la vida en sociedad y del cuidado formal. Para ello, se contextualizará sobre los imaginarios que predominan en la sociedad chilena sobre la vejez, y que afectan transversalmente a la familia, las instituciones y las profesiones; en segundo lugar se describirán algunas teorías explicativas sobre el ageísmo para mayor comprensión del fenómeno y su impacto generacional, y finalmente, sobre el abandono inicial de las personas mayores durante la pandemia por Covid-19 resultado del ageísmo de Estado. Visibilizar este tema favorece el debate social informado y la promoción de nuevas políticas públicas en favor de inclusión de personas mayores.
Abstract: Ageism in old age has been related to the social imaginary, responsible for maintaining prejudices and stereotypes towards older people. Prevailing as a common phenomenon in westernized countries like Chile, replicating an image of old age full of deficiencies and bodily deterioration. This article reflects on the phenomenon of ageism that promotes behaviors that exclude older people from life in society and from formal care. For this, it will be contextualized on the imaginaries that predominate in Chilean society about old age, and that transversally affect the family, institutions and professions; secondly, some explanatory theories about ageism will be described to better understand the phenomenon and its generational impact, and finally, about the initial abandonment of the elderly during the Covid-19 pandemic as a result of State ageism. Making this issue visible favors informed social debate and the promotion of new public policies in favor of the inclusion of older people.
Resumo: O preconceito de idade na velhice tem sido relacionado ao imaginário social, responsável por manter preconceitos e estereótipos em relação aos idosos. Prevalece como fenômeno comum em países ocidentalizados como o Chile, reproduzindo uma imagem da velhice repleta de deficiências e deterioração corporal. Este artigo reflete sobre o fenômeno do preconceito de idade que promove comportamentos que excluem os idosos da vida em sociedade e dos cuidados formais. Para isso, será contextualizado nos imaginários que predominam na sociedade chilena sobre a velhice e que afetam transversalmente a família, as instituições e as profissões; em segundo lugar, algumas teorias explicativas sobre o preconceito de idade serão descritas para melhor compreender o fenômeno e seu impacto geracional e, por fim, sobre o abandono inicial de idosos durante a pandemia de Covid-19 como resultado do preconceito de idade do Estado. A visibilidade dessa questão favorece o debate social informado e a promoção de novas políticas públicas em prol da inclusão dos idosos.
Subject(s)
Humans , Aged , Ageism , COVID-19 , Prejudice , Empathy , Social TheoryABSTRACT
Recently, the Chilean Senate approved the main ideas of a constitutional reform and a Neuro-rights bill. This bill aims to protect people from the potential abusive use of "neuro-technologies". Unfortunately, a literal interpretation of this law can produce severe negative effects both in the development of neuroscience research and medical practice in Chile, interfering with current treatments in countless patients suffering from neuropsychiatric diseases. This fear stems from the observation of the negative effects that recent Chilean legislations have produced, which share with the Neuro-Rights Law the attempt to protect vulnerable populations from potential abuse from certain medical interventions. In fact, Law 20,584 promulgated in 2012, instead of protecting the most vulnerable patients "incapacitated to consent", produced enormous, and even possibly irreversible, damage to research in Chile in pathologies that require urgent attention, such as many neuropsychiatric diseases. This article details the effects that Law 20.584 had on research in Chile, how it relates to the Neuro-Rights Law, and the potential negative effects that the latter could have on research and medical practice, if it is not formulated correcting its errors.
Subject(s)
Humans , Patient Rights , Vulnerable Populations , ChileABSTRACT
RESUMEN Objetivo: El propósito de este estudio fue interpretar las opiniones de familias que participaron en el programa de promoción de la salud bucal "Sembrando Sonrisas" en la Región de Atacama. Material y Método: Estudio descriptivo-interpretativo que utilizó metodología cualitativa y análisis de contenido. Se analizaron 294 opiniones expresadas por 194 familias, en el cuaderno viajero del programa piloto realizado el año 2017 en doce jardines públicos repartidos en cuatro comunas diferentes de la región. El análisis de contenido se realizó con apoyo del programa Atlas.ti®. Resultados: En la primera fase se construyeron 25 categorías y en una segunda fase emergieron 8 categorías teóricas, destacando: actitudes de los padres sobre la salud bucal en sus hijos(as), conocimiento sobre salud bucal, relación lúdica con la higiene bucal, relación entre imagen física y salud bucal, entre otras. Conclusiones: La estrategia educativa contribuye a disminuir brechas de conocimiento en salud bucal de padres y madres de sectores vulnerables, y aporta a mayor justicia social en cuanto mayor acceso al cuidado bucal, pero se requiere de acompañamiento continuo de personal capacitado.
ABSTRACT Objective: The purpose of this article is to evaluate the opinions of families that participated in the oral health promotion program "Sembrando sonrisas" (Sowing smiles) in the Atacama Region in northern Chile. Materials and Methods: Descriptive-interpretative study using qualitative methodology and content analysis. We analyzed 294 opinions expressed by 194 families in the class project book called "cuaderno viajero" of the pilot program, carried out in 2017 in twelve public kindergardens of four different cities. The content analysis was carried out with the support of the Atlas.ti® software. Results: 25 categories were established in the first phase and 8 theoretical categories emerged in a second phase, of which the following stand out: parental attitudes that favor oral health in their children, knowledge about oral health, playful relationship with oral hygiene, relationship between physical image and oral health, among others. Conclusions: The educational strategy contributes to reducing gaps in knowledge of oral health among parents from vulnerable sectors, and contributes to greater social justice in terms of greater access to oral care, but requires continuous monitoring by trained personnel.
RESUMO Objetivo: O objetivo deste artigo foi interpretar a opinião das famílias que participaram do programa de promoção da saúde bucal "Semeando sorrisos" na Região de Atacama. Material e Método: Estudo descritivo-interpretativo que utilizou metodologia qualitativa e análise de conteúdo. Foram analisadas 294 opiniões expressas por 194 famílias, no caderno itinerante do programa piloto realizado em 2017 em doze creches públicas de quatro cidades diferentes na região. A análise de conteúdo foi realizada com o apoio do programa Atlas.ti®. Resultados: Na primeira fase foram construídas 25 categorias e na segunda fase emergiram 8 categorias teóricas, destacando: atitudes dos pais sobre a saúde bucal de seus filhos(as), conhecimentos sobre saúde bucal, relação lúdica com a higiene bucal, relação entre imagem física e saúde bucal, entre outras. Conclusões: A estratégia educativa contribui para a redução das lacunas de conhecimento em saúde bucal de pais e mães de setores vulneráveis e contribui para maior justiça social em termos de maior acesso à higiene bucal, mas é preciso acompanhamento contínuo de pessoal capacitado.
ABSTRACT
Background: The participation of medical students in research generates professional, scientific, and personal benefits for the student. Aim: To evaluate the interest and opportunities for medical students in Chile to participate in scientific research and their perceptions about factors influencing research. Material and Methods: All students attending the 2018 Chilean Congress for Medical Students were invited to answer a 44 questions survey about interest and opportunities to participate in research. Results: The survey was answered by 489 of the 538 students attending the congress. Eighty five percent referred interest in conducting scientific research, but only 47% had the opportunity to actively participate in a research project. The main research area providing opportunities was epidemiology and the main form to access a research project was through direct contact with a medical professor or researcher. Seventy seven percent of respondents had courses of scientific investigation in their medical curriculum and 92% had a scientific society for medical students in their university. Conclusions: Respondents showed a great deal of interest in participating in scientific research. However, there is a gap between this interest and the available opportunities. Medical professors should promote and facilitate the participation of their students in research.
Subject(s)
Humans , Students, Medical , Education, Medical, Undergraduate , Universities , Chile , CurriculumABSTRACT
Resumen Este estudio tiene como propósito describir aspectos éticos relacionados con la atención de enfermería en personas con discapacidad, población considerada socialmente vulnerable y reconocida en condiciones de desigualdad. Corresponde a una primera fase de estudio primario realizado en la región de Atacama, Chile, que utilizó metodología cualitativa y análisis de contenido. Se realizan entrevistas a profesionales de enfermería respetando los criterios éticos de Ezekiel Emanuel. Los principales hallazgos dan cuenta de las categorías ontológicas: razonamiento moral, sistema de valores, modelo de relación enfermera-paciente, consecuencias de la acción ética de enfermería, estrategias para superar conflictos morales y barreras en el cuidado. Se concluye que cuidar personas con discapacidad es fuente de dilema y angustia moral para los profesionales de enfermería, especialmente cuando se trata de sujetos con discapacidad sensitiva o cognitiva. El modelo médico paternalista predomina en el contexto clínico, lo que limita el derecho a la autonomía de las personas con discapacidad. A los valores morales tradicionales promovidos por los profesionales de enfermería se suman valores instrumentales como la eficiencia. No se mencionan valores cívicos considerados fundamentales ante el desafío de la diversidad humana y la vida en democracia.
Abstract The purpose of the study is to describe ethical aspects related to nursing care for persons with disabilities; a population considered socially vulnerable and in conditions of inequality. It corresponds to the first phase of a primary study conducted in Atacama, Chile using a qualitative methodology and content analysis. Nursing graduates are interviewed respecting Ezekiel Emanuel's ethical criteria. The main findings account for ontological categories such as moral reasoning, value system, nurse-patient relationship model, consequences of the ethical nursing action, strategies to overcome moral conflicts, and barriers in care. It is concluded that caring for people with disabilities is a source of dilemma and moral anguish for nurses, especially when it comes to individuals with sensitive or cognitive disabilities. The paternalistic medical model predominates in the clinical context, limiting the right to autonomy of persons with disabilities. Instrumental values such as efficiency are added to traditional moral values promoted by nurses. Civic values considered fundamental to the challenge of human diversity and life in democracy are not mentioned.
Resumo Este estudo tem como objetivo descrever aspectos éticos relacionados com a atenção de enfermagem em pessoas com deficiência, população considerada socialmente vulnerável e reconhecida em condições de desigualdade. Corresponde a uma primeira fase de estudo realizado na região de Atacama, Chile, que utilizou metodologia qualitativa e análise de conteúdo. Foram realizadas entrevistas com profissionais de enfermagem, respeitando os critérios éticos de Ezekiel Emanuel. Os principais achados evidenciam as categorias ontológicas: raciocínio moral, sistema de valores, modelo de relação enfermeiro-paciente, consequências da ação ética de enfermagem, estratégias para superar conflitos morais e barreiras no cuidado. Conclui-se que cuidar de pessoas com deficiência é fonte de dilema e angústia moral para os profissionais de enfermagem, especialmente quando se trata de pessoas com deficiência sensitiva ou cognitiva. O modelo médico paternalista predomina no contexto clínico, o que limita o direito à autonomia das pessoas com deficiência. Aos valores morais tradicionais promovidos pelos profissionais de enfermagem, somam-se valores instrumentais como a eficiência. Não são mencionados valores cívicos considerados fundamentais ante o desafio da diversidade humana e a vida na democracia.