Primary health care: Nurses' meanings in a Colombian municipality

Introduction: Primary health care is a strategy that involves the different health professionals and other agents in the system who can influence the social determinants that affect human wellbeing. Objective: To know the meanings about primary health care of nursing professionals practicing in this field in a municipality of Colombia. Materials and Methods: Qualitative, exploratory, descriptive study. The research was conducted in a State Social Company (ESE for its acronym in Spanish) that provides primary health care services. Data was collected through semi-structured interviews. The sample consisted of 13 professionals. IRaMuTeQ software was used to help data interpretation. Results: 'Nurse' was the most frequent word. The content analyzed was categorized into four classes: 'Meanings about primary health care', 'nursing activities in primary health care', 'barriers encountered in primary health care', 'primary health care organization and work team'. Conclusions: Primary health care meaning is understood as the entry point of users into the health system and the one responsible for coordinating their passage through other points of the healthcare network according to users' health needs. In addition, primary health care is understood as the level of care at which essential health actions focused on the early detection of health risks and complications are carried out, so that health interventions can be planned, implemented, and evaluated on that basis.

Establishment of role function of position among oncology genetic nurses / 中国实用护理杂志

Objective:Based on the needs of advanced nursing practice development, to establish an indicator system of role function of position of oncology genetic nurses suitable for our national condition, and to provide a basis for position establishing of nocology genetic nurses.Methods:Initial indexes were generated through the literature review and semi-structured interviews. From September to December 2022, two rounds of expert consultations and analytic hierarchy process were conducted to establish the evaluation index for role function of position of oncology genetic nurses.Results:A total of 43 experts were included in the study, the response rates of 2 rounds were 93.62%(44/47) and 97.73%(43/44), and the authority coefficients of the experts were 0.821 and 0.853. The Kendall′s coefficients of concordance for the 2 rounds of consultations were 0.100-0.150 (all P<0.01) and 0.101-0.237 (all P<0.01). Finally, the role function system of position for oncology genetic nurses was formed, which consisted of 5 first-level indexes, 17 second-level indexes and 86 third-level indexes. Conclusions:The system of role function of position for oncology genetic nurses is reasonable, scientific and reliable, professional and specific, which can provide a theoretical reference for the development of advanced nursing practice on hereditary oncology in China.

Application of teach-back-based role transition shock model in knee arthroplasty nursing internship teaching / 中华医学教育探索杂志

Objective:To explore the application of a role transition shock model based on the teach-back technique in knee arthroplasty nursing teaching.Methods:We assigned 50 nursing student interns practicing in the knee arthroplasty team of Orthopedics Department of Nanjing First Hospital between August 2020 and August 2022 into control group ( n=25, traditional teaching) and observation group ( n=25, teach-back-based role transition shock model teaching) according to the order of admission. At the end of internship, the examination scores, the impact of transition shock on comprehensive abilities, and teaching satisfaction of the students were assessed and analyzed using the t test and Fisher's exact test with the use of SPSS 22.0. Results:Compared with the control group, the observation group scored significantly lower in the physical, psychological, knowledge and skills, and sociocultural and developmental dimensions of the transition shock assessment scale ( P<0.05). The observation group showed significantly higher scores of nurse-patient communication, nursing practice, disease observation, health education, humanistic care, team cooperation, clinical thinking, and emergency response than the control group ( P<0.05). The examination results of the observation group were significantly better than those of the control group ( t=12.31, 11.52, P<0.001). The teaching satisfaction rate of the observation group was significantly higher than that of the control group [100.00% (25/25) vs. 68.00% (17/25), χ2=9.52, P=0.002]. Conclusions:The teach-back-based role transition shock model can help alleviate the transition impact faced by nursing student interns when entering clinical practice, and also improve their comprehensive abilities as well as satisfaction with teaching.

Research on improving nurses'ethical literacy in the application of human-assisted reproductive technology / 中国医学伦理学

The role and function of nurses in the application of assisted reproductive technology were sorted out.Addressing potential ethical dilemmas,this paper analyzed the restrictive factors in dealing with difficulties in nursing practice and proposed the construction of a nursing ethics literacy system.It is suggested to improve ethical rules and education systems,strengthen case education,enhance risk prevention capabilities,and cultivate a healthy ethical culture,so as to effectively enhance nurses'ethical literacy.

The Influence of Organizational Support on Doctors'Career Satisfaction in Public Hospitals:An Analysis of Mediating Effects Based on Role Stress / 中国医院管理

Objective To explore the influence of organizational support on the career satisfaction of doctors in public hospitals and the mediating effect of role stress.Methods Using the survey data of 523 public hospital doctors from 9 medical institutions in 4 places in 2022,OLS linear regression model was used to analyze the influence of organizational support on career satisfaction,and Bootstrap test was used to explore the mediating effect of role stress.Results Organizational support had a positive effect on the career satisfaction of doctors in public hospitals,and for every unit increase in organizational support score,career satisfaction score will increase by 0.528 points.And role stress had a negative effect on the career satisfaction of doctors in public hospitals.Conclusion Organizational managers should take measures to promote the positive impact of organizational support on doctors'career satisfaction in public hospitals,reduce doctors'role stress,and continuously improve their career satisfaction.

O eu em nós: marcas e aproximações de uma diretora no processo psicoterápico / The self in us: marks and approaches of a director in the psychotherapeutic process / El yo dentro de nosotros: marcas y enfoques de una directora en el proceso psicoterapêutico

RESUMO O objetivo deste trabalho foi aprofundar as marcas e aproximações de uma diretora no processo psicoterápico. Trata-se de um estudo de caso psicodramático utilizando o registro documental de sessões de psicoterapia bipessoal de três pacientes atendidas anteriormente pela primeira autora e os relatos da própria autora sobre suas percepções nos atendimentos. Foram apresentadas reflexões que demonstram resultados positivos sobre as aproximações na relação psicoterapêutica mediante o humor, a poesia e a música como formas de conexão entre psicodramatista e cliente.

ABSTRACT The objective of this work was to deepen the approaches and distances of a director in the psychotherapeutic process. This is a psychodramatic case study that used the documentary record of bipersonal psychotherapy sessions of three patients previously attended by the first author and the author's own reports about her perceptions in the sessions. Reflections were presented that demonstrate positive results regarding the approaches in the therapeutic relationship, using humor, poetry, and music as means of connection between the psychodramatist and the client.

RESUMEN El objetivo de este trabajo fue profundizar los acercamientos y distancias de una directora en el proceso psicoterapéutico. Se trata de un estudio de caso psicodramático utilizando el registro documental de sesiones de psicoterapia bipersonal de tres pacientes atendidos previamente por la primera autora y los relatos de la propia autora sobre sus percepciones en las sesiones. Se presentaron reflexiones que demuestran resultados positivos en relación a las aproximaciones en la relación terapéutica, utilizando el humor, la poesía y la música como formas de conexión entre el psicodramatista y el cliente.

Image of nurses in Chile through children's drawings: An iconographic study / A imagem de enfermeiras(os) no Chile por meio de desenhos infantis: um estudo iconográfico / Imagen de enfermeras(os) en Chile a través del dibujo infantil: un estudio iconográfico

Abstract Objective To reveal the image of nursing professionals in Chile through the analysis of children's drawings. Method This is an exploratory qualitative study, involving the collection of information through nine drawings made by children aged between 7 and 10 years, using free technique, and then were analyzed with the Iconographic Method proposed by Erwin Panofsky. Results Most drawings depict clinical activities of nurses, focusing predominantly on the technical dimension of the profession. Although nursing is commonly associated with a mostly female occupation, permeated by gender stereotypes, some participants were able to identify the presence and importance of the male role in this professional field. No iconographic elements were identified that would reinforce stigmas associated with nursing professionals, such as the view that they are supporters, aides, or mere medical assistants. Conclusions and implications for practice Children's drawings serve as a reflection of the collective imagination of society. By studying them in relation to nursing, we can identify the advances of the profession and glimpse its near future. This research contributes to understanding the current image of the profession in society, and allows an analysis that goes further, helping to establish future directions and the evolution of this collective perception.

Resumo Objetivo Revelar a imagem do profissional de enfermagem no Chile por meio da análise iconográfica de desenhos infantis. Método Estudo qualitativo exploratório, envolvendo a coleta de informações por meio de nove desenhos elaborados por crianças com idades entre 7 e 10 anos, utilizando técnica livre e posteriormente examinados com base no Método Iconográfico proposto por Erwin Panofsky. Resultados A maioria retrata as atividades clínicas do enfermeiro, enfocando predominantemente em sua dimensão técnica. Embora a enfermagem seja comumente associada a uma ocupação majoritariamente feminina, permeada por estereótipos de gênero, alguns participantes conseguiram identificar a presença e a importância do papel masculino nesse campo profissional. Não foram identificados elementos iconográficos que reforçassem estigmas associados aos profissionais de enfermagem, como a visão de serem simples assistentes, ajudantes ou meros auxiliares dos médicos. Conclusões e implicações para a prática Os desenhos infantis são reflexo do imaginário coletivo da sociedade. Ao estudá-los em relação à enfermagem, podemos identificar avanços na profissão e vislumbrar seu futuro próximo. Esta pesquisa contribui para compreender a imagem atual da profissão na sociedade e possibilita uma análise que ajuda a estabelecer direções futuras e a evolução dessa percepção coletiva.

Resumen Objetivo Revelar la imagen de los profesionales de enfermería en Chile a través del análisis de dibujos infantiles. Método Estudio cualitativo exploratorio, que involucra la recolección de información a través de nueve dibujos en técnica libre realizados por niños entre siete y diez años, posteriormente analizados mediante el Método Iconográfico propuesto por Erwin Panofsky. Resultados La mayoría representa las actividades clínicas de las enfermeras, centrándose predominantemente en la dimensión técnica. Aunque la enfermería se asocia comúnmente a una ocupación mayoritariamente femenina, impregnada de estereotipos de género, algunos participantes identificaron la presencia y la importancia del papel masculino en la profesión. No se identificaron elementos iconográficos que reforzaran estigmas asociados a los profesionales de enfermería, como la visión de que son simples asistentes, ayudantes o meros auxiliares médicos. Conclusiones e implicaciones para la práctica Los dibujos son reflejo del imaginario colectivo de la sociedad. Al estudiarlos en relación con la enfermería, podemos identificar avances en la profesión y vislumbrar su futuro próximo. Esta investigación contribuye a comprender la imagen actual de la profesión en la sociedad y permite un análisis que ayuda a establecer las orientaciones futuras y la evolución de esta percepción colectiva.

Atuação de psicólogos(as) escolares nas falas de professoras do ensino fundamental do sudoeste da Bahia: uma análise discursiva / Role of Educational Psychologists from primary school teachers' point of view in Southwest Bahia State, Brazil: a discursive analysis / Le rôle des psychologues de l'éducation du point de vue des enseignants du primaire dans le sud-ouest d'État de Bahia, au Brésil: une analyse discursive / El rol del psicólogo educativo según las maestras de la primaria en el sudoeste de Bahía, Brasil: una mirada discursiva

No contexto educacional brasileiro, a promulgação da Lei n. 13.935, de 11 de dezembro de 2019, formalizou a contratação de psicólogos escolares. Esta pesquisa investigou as expectativas de professoras do Ensino Fundamental do sudoeste da Bahia sobre a contratação de profissionais de psicologia escolar para atuar na rede de ensino. Para entender a promulgação da Lei, realizou-se um resgate histórico do campo da psicologia escolar no Brasil. Filiadas à perspectiva psicanalítica e da análise do discurso de Pêcheux, foram realizadas e analisadas cinco entrevistas semiestruturadas, que indicaram duas formações discursivas (FD) antagônicas. Além disso, as FD - nomeadas "detecção e encaminhamento" (FD1) e "professoras trabalhadoras" (FD2) - estão filiadas a uma formação ideológica denominada "médica-higienista-normativa". Os resultados demonstram que as respostas das participantes veiculam a FD1, que reproduz o modelo médico classificatório, mas não impede que na FD2 haja formas de resistência, por meio das denúncias de más condições de trabalho das professoras

In the Brazilian educational context, issuance of Law no. 13935, on December 11, 2019, authorized the hiring of psychologists by public schools. This research investigated primary teachers' expectations regarding psychologist intervention in public schools from Southwest Bahia State. To understand the law's enactment we conducted a historical overview on the role of Educational Psychology in the country. Based on psychoanalysis and Pêcheux's discourse analysis, we conducted and analyzed five semi-structured interviews and identified two opposite discursive formations (DFs). These DFs-named "detection and referral" (DF1) and "working teachers" (DF2)-are affiliated to a "medical-hygienist-normative" ideology. Results show that the participants' statements emphasize the classificatory medical paradigm (DF1), which does not exclude possible resistance in DF2 by denouncing poor working conditions

Dans le contexte éducatif brésilien, la publication de la loi 13935, le 11 décembre 2019, a autorisé l'embouche de psychologues par les écoles publiques. Cette recherche a étudié les attentes des enseignants du primaire concernant l'intervention d'un psychologue dans le réseau d'éducation publique. Pour comprendre cette promulgation, nous avons effectué un survol historique du rôle de la psychologie de l'éducation dans le pays. Basé sur la psychanalyse et de l'analyse du discours de Pêcheux, nous avons mené et analysé cinq entretiens semi-structurés et identifié deux formations discursives (FD) opposées. Ces formations discursives - appelées « détection et orientation ¼ (FD1) et « enseignants en activité ¼ (FD2) - sont affiliées à une idéologie "médicale-hygiéniste-normative ¼. Les résultats montrent que leur réponses mettent l'accent sur le paradigme médical classificatoire (FD1), ce qui n'exclut pas une résistance dans FD2 en dénonçant les mauvaises conditions de travail

En el contexto educativo brasileño, se promulgó la Ley N.º 13.935, de 11 de diciembre de 2019, por la cual autoriza la contratación de psicólogos educativos. Esta investigación buscó identificar las expectativas de las maestras del sudoeste de estado de Bahía (Brasil) sobre la contratación de los profesionales de psicología educativa para trabajar en la red de enseñanza. Para comprender esta promulgación, se realizó un rescate histórico del campo de la psicología escolar en Brasil. A partir de la perspectiva psicoanalítica y de análisis del discurso de Pêcheux, se analizaron cinco entrevistas semiestructuradas que señalaron dos formaciones discursivas (FD) antagónicas. Además, las FD denominadas "detección y derivación de casos" (FD1) y "maestras trabajadoras" (FD2) se vinculan a una formación ideológica denominada "médico-higienista-normativa". Los resultados muestran que las respuestas de las participantes expresan FD1, que reproduce el modelo de clasificación médica; pero no evita formas de resistencia en FD2 mediante denuncias de malas condiciones laborales para los docentes

Role adoption, anxiety, depression and loneliness in family caregivers of patients with chronic diseases / Adopción del rol, ansiedad, depresión y soledad en cuidadores familiares de pacientes con enfermedades crónicas / Adoção do papel, ansiedade, depressão e solidão em cuidadores familiares de pacientes com doenças crônicas

Objective: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. Methods: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. Results: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. Conclusion: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness.

Objetivo: describir y explorar la relación de la soledad, la ansiedad y la depresión con la adopción del rol de cuidador entre personas que se ocupan de cuidar pacientes con enfermedades crónicas en Colombia. Métodos: se trató de un estudio exploratorio y transversal con la participación de 960 cuidadores principales de personas con enfermedades crónicas. Aplicamos la Escala de Adopción del Rol de Cuidador, la Escala de Soledad de la Universidad de California de Los Ángeles y la Escala de Ansiedad y Depresión. Se realizaron análisis de componentes principales y de correspondencia múltiple para el clustering . Resultados: el 40,8% de los cuidadores que participaron en el estudio informó padecer depresión, el 59% informó ansiedad, el 54,6% indicó soledad de moderada a grave y el 88,6% presentó adopción satisfactoria del rol de cuidador. Los cuidadores que presentaron los niveles básico o insuficiente en términos de adopción del rol tendieron a obtener puntuaciones de ansiedad, depresión y soledad más elevadas. Conclusión: adoptar el rol de cuidador es un mediador de los niveles de ansiedad, depresión y soledad entre los cuidadores. Las estrategias dirigidas a apoyar a los cuidadores deberían incluir preparación para dicho rol a fin de mitigar los efectos negativos de la ansiedad, la depresión y la soledad.

Objetivo: descrever e explorar a relação entre a solidão, a ansiedade e a depressão com a adoção do papel de cuidador entre os indivíduos que cuidam de pessoas com doenças crônicas na Colômbia. Método: trata-se de um estudo exploratório e transversal que envolveu 960 cuidadores primários de indivíduos com doenças crônicas. Foi aplicada a Escala de Adoção do Papel de Cuidador, a Escala de Solidão da Universidade da Califórnia em Los Angeles e a Escala de Ansiedade e Depressão. Foram realizadas análises de componentes principais e de correspondência múltipla para o agrupamento. Resultados: entre os cuidadores participantes, 40,8% relataram ter depressão, 59% relataram ansiedade, 54,6% relataram solidão moderada a grave e 88,6% relataram uma adoção satisfatória do papel de cuidador. Os cuidadores que apresentaram níveis básicos ou insuficientes de adoção do papel tenderam a ter pontuações mais elevadas de ansiedade, depressão e solidão. Conclusão: a adoção do papel de cuidador é um mediador nos níveis de ansiedade, depressão e solidão entre os cuidadores. As estratégias destinadas a apoiar os cuidadores devem incluir o treinamento para o papel de cuidador, a fim de atenuar os impactos negativos da ansiedade, da depressão e da solidão.

Relationship between self-perceived noise intensity and sleep quality in noise-exposed workers—A mediating role of negative emotions / 环境与职业医学

Background Studies on the relationships of environmental noise exposure with negative emotions and sleep quality have long been reported. Self-perceived noise intensity is not only related to environmental noise exposure, but also reflects an individual's susceptibility to noise; however, few studies on self-perceived noise intensity, negative emotions, and sleep quality have been reported, and it is not clear whether negative emotions play a mediating role in the relationship between self-perceived noise intensity and sleep quality. Objective To analyze the mediating role of negative emotions (anxiety, depression, and stress) in the relationship between self-perceived noise intensity and sleep quality in noise-exposed workers, and to provide a scientific basis for addressing psychological problems and sleep quality induced by noise exposure. Methods Stratified cluster sampling was used to select noise-exposed workers from a large equipment manufacturing plant in Chengdu from May to June 2023, and demographic characteristics were investigated using a self-designed general information questionnaire; self-perceived noise intensity was reported by the study subjects as the noise intensity of their workplaces; sleep quality was synthesized from three indicators: night sleep duration, self-perceived sleep quality, and sleep-related symptoms; the Anxiety-Depression-Stress Scale (DASS-21 scale) was used to evaluate anxiety, depression, and stress of a worker. Structural equation modeling was used to analyze the pathways of negative emotions (anxiety, depression, and stress) between self-perceived noise intensity and sleep quality. Results The positive rates of negative emotions were 33.1% (anxiety symptoms, 215/649), 26.0% (depression symptoms, 169/649), and 14.0% (stress symptoms, 91/649), respectively in a total of 649 noise-exposed workers. Self-perceived noise intensity was positively correlated with sleep quality score (r=0.218, P<0.001) and negative emotions (anxiety, depression, and stress) (r=0.167, 0.145, 0.167, P<0.001); sleep quality score was positively correlated with negative emotions (anxiety, depression, and stress) (r=0.512, 0.447, 0.513, P<0.001). The results of path analysis showed that the negative emotions (anxiety, depression, and stress) partially mediated between self-perceived noise intensity and sleep quality (β=0.123，P<0.001). Self-perceived noise intensity was positively correlated with negative emotions and sleep quality, and there was a path of self-perceived noise intensity → negative emotion → sleep quality (P<0.001), and the mediating effect accounted for 42.71%. Conclusion The positive rates of anxiety, depression, and stress are high among the noise-receiving workers in this manufacturing industry, and negative emotions characterized by anxiety, depression, and stress partially mediate the relationship between self-perceived noise intensity and sleep quality.

Qualities of role models of internal medicine residents in a Tertiary National University Hospital in the Philippines

Background@#Teachers in medicine do not only teach scientific facts about health and disease to their learners but they are also looked up to as role models. Little is known about the qualities of consultant-faculty members who are regarded as role models by Filipino internal medicine residents.@*Objective@#This study aimed to determine the reasons why consultant-faculty members are considered role models by Filipino internal medicine residents.@*Methods@#A cross-sectional survey was conducted among internal medicine residents at a tertiary national university hospital in the Philippines. Participants were asked to give the reasons for citing consultant-faculty members who they consider as role models.@*Results@#There were 81 residents who participated (93% response rate) who gave a total of 332 qualities as reasons for citing them as role models. The most commonly cited quality category was those of personal qualities (35.84% of all responses). This was followed by academic, clinical, teaching, leadership and research qualities. Physical qualities were the least cited (0.30% of all responses). Across the four batches of residents, personal qualities were consistently cited the most number of times, while physical qualities were consistently cited the least.@*Conclusion@#Filipino internal medicine residents identified personal qualities as the most frequent reason for considering their consultant-faculty as role models.

Should an emergency physician be a “surgeon” in a rural area? A case of blunt cardiac rupture successfully treated by an emergency physician / Journal of Rural Medicine

Objective: Blunt cardiac rupture is a life-threatening injury that requires surgical repair by cardiovascular or trauma surgeons. We report a case of blunt cardiac rupture in a rural area in which emergency physicians performed emergency department thoracotomy and surgical repair to save the patient’s life.Patient and Methods: This case involved an 18-year-old female who was injured in a traffic accident and underwent emergency thoracotomy and surgical repair.Results: The patient’s left thorax was deformed, and sonographic assessment revealed pericardial effusion. She experienced cardiopulmonary arrest 13 min after hospital arrival. An emergency physician performed an emergency department thoracotomy. The clots were removed from the surface of the left ventricle, followed by wound compression to control bleeding from the ruptured left ventricular wall. After the recovery of spontaneous circulation, the emergency physician sutured the ruptured heart. The patient survived with good neurological function.Conclusion: In rural areas, blunt cardiac rupture may require emergency department thoracotomy and cardiac repair by emergency physicians. The establishment of educational systems that include continuous education on trauma surgical procedures and consensus guidelines is needed to assist rural emergency physicians in performing surgical procedures.

Analysis of role adaptation and associated factors among college freshmen / 中国学校卫生

Objective@#To explore the influencing factors of role adaptation of college freshmen, so as to provide empirical support for developing adaptive education in college.@*Methods@#A cluster sampling method was used to select 3 126 freshmen from six universities of Hefei City and Wuhu City in Anhui Province in October 2022, who were investigated with Positive Psychological Capital Questionnaire (PPQ), Freshmen s Role Adaptability Scale, Connor Davidson Resilience Scale (CD-RISC) and Life Satisfaction Scale. Independent sample t-test and oneway ANOVA were used to compare the scores (caverage score of items) of various variables of college freshmen with different demographic characteristics. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation.@*Results@#There were statistically significant differences in scores of psychological capital, resilience, life satisfaction and role adaptation among college freshmen of different origin (large and mediumsized cities: ３.６３± ０.５４，３.７３±０.６４，３.４７±０.８０，３.１４±０.６５；county level city or county seat:３.５７±０.５２，３.６１±０.６３，３.３５±０.７５，３.０９±０.６３；villages and towns:３.５０±０.５０，３.５４±０.５８，３.２３±０.７５，３.０６±０.６０), whether in class committee (yes:３.６３±０.５２，３.６９±０.６０，３.４０± ０.７６ ，３.１８±０.５９； no:３.４３±０.５０，３.４８±０.６４，３.２５±０.７７，２.９３±０.６５), father s education level (junior high school or below:３.５２± ０.５１ ，３.５７±０.６１，３.２７±０.７５，３.０７±０.６１； senior high school or technical secondary school:３.６２±０.５３，３.６８±０.６３，３.４４±０.７８，３.１２±０.６３；junior college or above:３.６８±０.５６，３.７８±０.６４，３.５７±０.８０，３.１９±０.６８)，mother s education level(junior high school or below:３.５３±０.５１，３.５８±０.６１，３.２８±０.７５，３.０６±０.６０；senior high school or technical secondary school:３.６３±０.５５，３.７０±０.６３，３.４８±０.７８，３.１５±０.６６；junior college or above:３.７２±０.５４，３.８６±０.６５，３.６２±０.８３，３.２７±０.７０) ( F / t =11.89,21.89,23.02,3.83；10.08，9.20， 5.20 ，10.63；19.34，20.76，29.52，6.44；22.51，26.79，30.94，13.92， P <0.05). The differences of scores in resilience and role adaptation of different genders (boys:3.66±0.64, 3.12±0.65; girls:3.56±0.59, 3.05±0.58) and in life satisfaction whether being an only child (yes:3.40±0.79; no:3.33±0.76) among college freshmen were statistically significant ( t =4.51, 2.75, 2.35, P <0.05). Pearson correlation analysis showed that psychological capital, resilience and life satisfaction of college freshmen were positively correlated with role adaptation ( r =0.49, 0.49, 0.36), while psychological capital, resilience and role adaptation were positively correlated ( r =0.60, 0.59) and Psychological capital was positively correlated with resistance ( r =0.81)( P <0.01). The results of multiple linear regression analysis showed that gender, whether in class committee, psychological capital, resilience and life satisfaction were positively associated with role adaptation among college freshmen ( R 2=0.28, β =0.04, 0.10, 0.23, 0.26, 0.07， P <0.05).@*Conclusions@#Role adaptation of college freshmen is related with psychological capital, resilience and life satisfaction. Schools should strengthen mental health education to promote smooth role transition for college freshmen.

Practical Research on the Teaching of "Medical Interpersonal Communication" Integrate into the Red Doctor’s Spirit for Students Majoring in Public Health Management / 中国医学伦理学

The red doctor’s spirit is an important spiritual guidance for the cultivation of medical talents during the development of medical and health services in China. The teaching reform, which is oriented towards position competence, requires that students majoring in public health management should not only master solid medical knowledge and professional skills, but also possess an ability to handle medical public relations, such as shaping an excellent image of the organization, improving the medical interpersonal communication, and managing public relations crisis. Under the guidance of inheriting the red gene and innovating the medical education, the driving force of learning should be "serving the people to improve their health" led by "political firmness" , the learning goal "striving for perfection" inspired by "excellent technology" , and the working criterion "respecting patients, involving full participation and shouldering public responsibility" embodied in "making selfless dedication and helping the wounded and dying" . The article based on the characteristic culture of red medicine in the Air Force Medical University, applied the teaching method of role-playing case simulations to explore the teaching practice road of "theory-experience-practice-reflection" .

Homens cuidadores informais de idosos dependentes no Brasil / Hombres cuidadores informales de ancianos dependientes en Brasil / Men as informal caregivers of dependent older adults in Brazil

O objetivo deste estudo foi compreender as motivações e as implicações do cuidado de familiares idosos dependentes realizado por homens. Com base em pesquisa qualitativa realizada entre julho e dezembro de 2018 em seis cidades nas cinco regiões brasileiras, foram entrevistados 11 homens que desempenham a tarefa de cuidadores informais. Eles assumiram essa tarefa em razão de as mulheres estarem exaustas e adoecidas, assim como por reciprocidade afetiva e marital. Os filhos manifestaram desconforto na administração de cuidados pessoais aos pais, enquanto os cônjuges apresentaram dificuldades com atividades domésticas. Os cuidadores solitários estavam cansados, com dores, privação do sono, sintomas depressivos e solidão. O suporte prestado por familiares e cuidadores formais mostrou-se valioso para amenizar o sofrimento dos cuidadores que relutavam em pedir ajuda. Há necessidade de os profissionais de saúde estarem atentos aos prestadores de cuidados informais aos familiares.(AU)

El objetivo de este estudio fue comprender las motivaciones y las implicaciones del cuidado de familiares ancianos dependientes realizado por hombres. A partir de una investigación cualitativa realizada entre julio y diciembre de 2018 en seis ciudades en las cinco regiones brasileñas, se entrevistaron 11 hombres que desempeñan la tarea de cuidadores informales. Los hombres asumieron esta tarea porque las mujeres estaban exhaustas y enfermas y por reciprocidad afectiva y marital. Los hijos manifestaron incomodidad en la administración de cuidados personales a los padres, mientras que los cónyuges presentaron dificultades con actividades domésticas. Los cuidadores solitarios estaban cansados, con dolores, privación de sueño, síntomas depresivos y soledad. El soporte prestado por familiares y cuidadores formales se mostró valioso para disminuir el sufrimiento de los cuidadores que titubeaban en pedir ayuda. Existe la necesidad de que los profesionales de salud estén atentos a los prestadores de cuidados informales a los familiares.(AU)

The objective of study was to understand the motivations and implications of care given by men for dependent elderly family members. Qualitative research happened between July and December 2018 in six cities in the five Brazilian regions, interviewing 11 men who perform tasks as informal caregivers. The men assumed this task because the women's exhaustion and sickness, added to affective and marital reciprocity. Their sons expressed discomfort in taking personal care of their parents, while the spouses had difficulties with domestic activities. Lonely caregivers were tired, in pain, sleep deprived, experiencing depressive symptoms and loneliness. Support provided by family members and formal caregivers proved to be valuable in alleviating the suffering of caregivers who were reluctant to ask for help. Health professionals are called to pay attention to informal care providers for family members.(AU)

Competencia profesional de enfermeros en unidades de urgencias y emergencias: estudio de método mixto / Nurses' professional competencies in urgency and emergency units: A mixed-methods study / Competências profissionais dos enfermeiros de unidades de urgência e emergência: estudo de método misto

Objetivo: describir las competencias profesionales de los enfermeros que trabajan en urgencias y emergencias y comprender la percepción que tienen sobre las competencias esenciales para el desempeño y la actualización profesional. Método: estudio secuencial explicativo de métodos mixtos, realizado con enfermeros de urgencias y emergencias. Para obtener datos cuantitativos, se utilizó un cuestionario con 78 ítems, respondido por 39 enfermeros, que fueron analizados mediante estadística descriptiva y pruebas no paramétricas. Los datos cualitativos se obtuvieron a través de entrevistas semiestructuradas con 17 enfermeros, que fueron interpretados mediante el análisis temático de contenido inductivo. Los datos se combinaron por conexión. Resultados: se obtuvo un alto nivel de competencia en la autoevaluación de los enfermeros de urgencias y emergencias en el factor 2 - relaciones en el trabajo y un nivel más bajo en el factor 6 - excelencia profesional (p=0,036). Los datos cualitativos coincidieron positivamente con el factor relaciones en el trabajo, identificando la asociación entre conocimiento y experiencia práctica con las competencias, además de un escenario que carece de educación continua. Conclusión: a pesar de los altos niveles de competencia identificados en los enfermeros de urgencias y emergencias, el fortalecimiento de las estrategias educativas favorece el desarrollo y reconocimiento profesional.

Objective: to describe the professional competencies of nurses working in urgency and emergency services and to understand their perception of the essential competencies for professional performance and updating. Method: a sequential, mixed-methods and explanatory study, conducted with emergency nurses. To obtain the quantitative data, a questionnaire with 78 items was used, answered by 39 nurses and analyzed using descriptive statistics and non-parametric tests. In turn, the qualitative data were obtained through semi-structured interviews with 17 nurses, whose interpretation was based on inductive content thematic analysis. The data were combined by connection. Results: a high level of competence was obtained in the self-assessment of urgency and emergency nurses in Factor 2 - Relations at work and a lower level in Factor 6 - Professional excellence (p=0.036). The qualitative data corroborated positively with the "Relations at work" factor, identifying the association of knowledge and practical experience, with competencies beyond a scenario devoid of permanent education. Conclusion: despite the high levels of competence identified in emergency nurses, the strengthening of educational strategies favors professional development and recognition.

Objetivo: descrever as competências profissionais dos enfermeiros que atuam em urgência e emergência e compreender sua percepção a respeito das competências essenciais para a atuação e a atualização profissional. Método: estudo sequencial explanatório de métodos mistos, realizado com enfermeiros de urgência e emergência. Para a obtenção dos dados quantitativos, utilizou-se um questionário com 78 itens, respondidos por 39 enfermeiros, que foram analisados mediante estatística descritiva e testes não paramétricos. Já os dados qualitativos, foram obtidos por entrevista semiestruturada realizada com 17 enfermeiros, cuja interpretação deu-se pela análise temática de conteúdo indutiva. Os dados foram combinados por conexão. Resultados: obteve-se alto nível de competência na autoavaliação dos enfermeiros de urgência e emergência no fator 2 - relações no trabalho e menor nível no fator 6 - excelência profissional (p=0,036). Os dados qualitativos corroboraram de forma positiva com o fator relações no trabalho, identificando a associação do conhecimento e experiência prática com competências, além de um cenário desprovido de educação permanente. Conclusão: apesar de altos níveis de competência identificados nos enfermeiros de urgência e emergência, o fortalecimento de estratégias educacionais favorece o desenvolvimento e o reconhecimento profissional.

Gênero e violência nos relacionamentos afetivo-sexuais entre adolescentes / Gender and violence in affective-sexual relationships among adolescents

O objetivo deste estudo foi compreender as relações entre gênero e violência nos relacionamentos afetivo-sexuais de adolescentes. Para tanto, foram realizados grupos focais com 29 adolescentes, estudantes do 9o ano do ensino fundamental e EJA de três escolas públicas de uma cidade no interior do Rio Grande do Sul. Os participantes tinham entre 13 e 17 anos de idade. Os dados coletados foram submetidos à Análise Temática Reflexiva, o que possibilitou a elaboração de dois temas. No primeiro, a violência apresentou-se como ferramenta para a construção das masculinidades. A violência física ocupa um lugar central no imaginário desses jovens, sendo uma via de descarga para agressividade, bem como uma prática sujeita a sanções legais. No segundo tema, a violência evidenciou-se como um dispositivo de coerção e amedrontamento das meninas adolescentes. Foi possível observar que as situações de violência são onipresentes nas vivências das adolescentes, sendo mais intensas no contexto dos relacionamentos e após o término. Conclui-se que a violência é um importante marcador das desigualdades de gênero nos relacionamentos entre adolescentes, colocando as meninas adolescentes em situação de desvantagem em relação aos meninos.

The aim of this study was to understand the relationship between gender and violence in adolescents' affective-sexual relationships. Focal groups were carried out with 29 adolescents, students of the 9th year of elementary school and EJA from three public schools in a city in the interior of Rio Grande do Sul. The participants were between 13 and 17 years old. The collected data were submitted to Reflexive Thematic Analysis, which allowed the elaboration of two themes. In the first theme, violence was a tool for the construction of masculinities. Physical violence particularly occupies a central place in the imagination of these adolescents, being a way of discharge for aggression, as well as a practice subject to legal sanctions. In the second theme, violence was a tool of coercion and intimidation of adolescent girls. It was possible to observe that situations of violence are omnipresent in the experiences of adolescents, being more intense in the context of relationships and after the breakup. We conclude that violence is an important marker of gender inequalities in relationships between adolescents, placing adolescent girls at a disadvantage compared to boys.

Enfermería de Práctica Avanzada en el Sistema de Salud: evolución, aceptación y reconocimiento / Advanced Practice Nursing in the Health System: evolution, acceptance and recognition

Introducción: se estima escasez de 5.9 millones de profesionistas de la salud a nivel mundial. La Enfermería de Práctica Avanzada (EPA), cuenta con conocimientos, competencias y habilidades clínicas específicas para actuar en situaciones de déficit de personal médico, tratando desde enfermedades agudas hasta crónico degenerativas, preservando tanto la salud mental como física. Objetivo: Determinar el desempeño de la Enfermería de Práctica Avanzada en el Sector Salud. Metodología: revisión sistemática sobre la EPA, que incluyó revisiones y artículos originales del periodo 2013-2022 en español e inglés, acerca de su desempeño: evolución, aceptación y reconocimiento. Para la identificación, cribado e inclusión de los artículos se utilizó el modelo PRISMA 2020. Resultados: de un total de 838 artículos identificados, se incluyeron 20 artículos y 7 de otras fuentes como citas y otros sitios web, obteniendo un total de 27 artículos de revisión, que abordan la evolución, la aceptación y reconocimiento. Se realizó análisis cualitativo. Conclusiones: el desempeño de EPA surge por las demandas poblacionales de atención primaria a la salud, diversos países ya cuentan con EPA, asistiendo a sus habitantes desde sus especialidades. La EPA es diversa y extensa, su profesionalización debe ser continua y permanente. En México falta camino para tomar la EPA como parte del equipo multidisciplinario

Abstract Introduction: About 5.9 millions healthcare professionals lack across the world. The Advanced Practice Nursing (APN), has specific knowledge, competences, and clinical abilities to act in medical absence, taking care from acute illness until chronic diseases, preserving both mental and physical health. Objective: To determine the Advanced Practice Nursing (APN) performance in the Health Sector. Methods: A systematic review about APN, including reviews and original articles from the period 2013-2022 in Spanish and English, about performance: evolution, acceptance and recognition. For the identification, screening, and inclusion of the articles the PRISMA 2020 model was used. Results: Of 838 total identified articles, 20 articles were included from the search and 7 from other sources such as citations and other websites, obtaining 27 total articles to be reviewed, which regard the evolution, acceptance and recognition. A qualitative analysis was performed. Conclusions: The APN performance arose because of demands for primary health care; several countries already have APN, providing care to inhabitants through their different specialties. APN is diverse and extensive, its professionalization must be continuous and permanent. In Mexico there is still some way to go to APN to take part in the multidisciplinary team.

Rol del coordinador de enfermería en las subdirecciones de gestión del cuidado / The role of nursing coordinators within care management sub-directorates / Papel do coordenador de enfermagem nas subdiretorias de gestão assistente

Objetivo: El objetivo de esta reflexión fue explorar de acuerdo con la evidencia científica disponible, las funciones y atributos del rol de las enfermeras coordinadoras en atención cerrada. Desarrollo: En Chile la gestión del cuidado de enfermería para atención cerrada de establecimientos hospitalarios de mediana y alta complejidad se encuentra regulada por la norma general administrativa N° 19, con resolución exenta 1127 de 2007. A más de 15 años de su implementación se ha cuantificado una desigualdad en cuanto a estructura y alta heterogeneidad de las funciones enmendadas a través de la norma que las regula. A nivel internacional y nacional no existe consenso en relación con la estructura de enfermería y con ello el rol de coordinadoras de enfermería dentro de las subdirecciones de gestión del cuidado. Esta investigación demuestra divergencia en las estructuras de Enfermería y las definiciones con respecto a las coordinaciones de Enfermería, aspecto fundamental para la gobernanza de Enfermería. El estilo de liderazgo, motivación, comunicación efectiva, acompañamiento y el conocimiento de sistemas complejos, pueden determinar características de las enfermeras coordinadoras. Conclusiones: La definición y funciones del desarrollo del rol de la coordinación de enfermería es divergente. En la actualidad las estructuras son disímiles entre los establecimientos hospitalarios. Se sugiere establecer una estructura orgánica general desde el nivel central para la universalidad de las subdirecciones de enfermería, considerando las diferencias de acuerdo con carteras de servicios, complejidad y especialidad de los hospitales chilenos.

Objective: This reflection aimed to explore, based on the existing scientific evidence, the functions and attributes of the nurse coordinator's role in hospital care. Development: In Chile, nursing management for hospital care in medium- and high-complexity establishments is regulated by general administrative standard No. 19 through the exempt resolution 1127, 2007. More than 15 years after its implementation, some inequalities have been detected in its structure, as well as high heterogeneity in the functions that have been amended through the norm that regulates them. There is no consensus regarding the structure of nursing roles, whether at the international or national level; this includes the role of nursing coordinators within care management sub-directorates. This reflection reveals the divergence that exists among the structures of Nursing and the definitions related to nursing coordination, a fundamental aspect of governance in Nursing. Leadership style, motivation, effective communication, support, and knowledge of complex systems can determine the characteristics of nursing coordinators. Conclusions: The definition and functions of the nursing coordination role are divergent. Currently, the structures are dissimilar among hospital facilities. It is suggested that a general organizational structure is developed from a central level and universalized to all nursing sub-directorates, considering differences according to the service portfolios, complexity, and specialty of hospitals in Chile.

Objetivo: O objetivo desta reflexão foi explorar, de acordo com a evidência científica disponível, as funções e atributos da atuação dos enfermeiros coordenadores no cuidado fechado. Desenvolvimento: No Chile, a gestão da assistência de enfermagem para atendimento fechado em estabelecimentos hospitalares de média e alta complexidade é regulamentada pela norma administrativa geral nº 19, com isenção da resolução 1.127 de 2007. Mais de 15 anos após sua implementação, quantificou-se uma desigualdade em termos de estrutura e elevada heterogeneidade das funções alteradas pela norma que as regulamenta. A nível internacional e nacional não existe consenso em relação à estrutura de enfermagem e, portanto, ao papel dos coordenadores de enfermagem nas subdireções de gestão do cuidado. Esta reflexão demostra divergências nas estruturas e definições de enfermagem em relação à coordenação de enfermagem, um aspecto fundamental para a governança em enfermagem. O estilo de liderança, a motivação, a comunicação eficaz, o suporte e o conhecimento de sistemas complexos podem determinar características dos enfermeiros coordenadores. Conclusões: A definição e funções do desenvolvimento do papel da coordenação de enfermagem são divergentes. Atualmente, as estruturas são díspares entre os estabelecimentos hospitalares. Sugere-se estabelecer uma estrutura orgânica geral a partir do nível central para a universalidade das subdireções de enfermagem, considerando as diferenças segundo carteiras de serviços, complexidade e especialidade dos hospitais chilenos.

Variables académicas y de calidad de vida en estudiantes universitarios mexicanos / Academic and quality of life variables in mexican university students

Resumen. Objetivo. Analizar el efecto de las expectativas y metas de progreso académicas en las dimensiones de la calidad de vida de estudiantes universitarios mexicanos. Método. El tipo de investigación es cuantitativa con un diseño transversal, abierto, observacional con alcances descriptivos y predictivos. Las técnicas estadísticas utilizadas fueron estadística descriptiva, coeficiente de correlación y análisis de senderos con el método GLS. El muestreo fue no probabilístico por conveniencia, con un total de 465 participantes. Resultados. Se demostró que, para el modelo explicativo resultante, la variable metas de progreso académicas es un predictor directo de la dimensión función física. Asimismo, las expectativas académicas de resultado son un predictor de las dimensiones rol emocional y la función física. Respecto a los componentes de la salud física y mental, este último presentó la puntuación más baja.

Abstract. Objective. To analyze the effect of expectations and goals of academic progress on the dimensions of the quality of life of Mexican university students. Method. The research was quantitative with a cross-sectional, open, observational design with descriptive and predictive scopes. The statistical techniques used were descriptive statistics, correlation coefficient and path analysis with the GLS method. Sampling was non-probabilistic for convenience, with a total of 465 participants. Results. For the resulting explanatory model the variable academic progress goals is a direct predictor of the physical function dimension. And academic expectations of outcome are a predictor of the emotional role and physical function dimensions.