Continuing Bonds in grieving men: A comparative description of Costa Rica and Spain.

Continuing Bonds among grieving men from Costa Rica and Spain were compared, with the primary hypothesis that there would be significant differences between the two groups. A descriptive, comparative, and cross-sectional research study was conducted. Non-probability and convenience sampling was employed, involving 227 grieving men who completed an online questionnaire comprising sociodemographic data, mediators of mourning, and the Continuing Bonds Scale. The results did not reveal significant differences in Continuing Bonds expressions. However, upon controlling for the interaction between degree of kinship with the deceased person, notable differences emerged in Continuing Bonds and internalized and externalized Continuing Bonds (p < 0.05). The influence of sociocultural factors in each country on Continuing Bonds expressions is considered. The findings could support the development of strategies centered on grieving men, Continuing Bonds, and their specific needs.

Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements.

Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.

Community Care Needs of Highly Complex Chronic Patients: An Epidemiological Study in a Healthcare Area.

One of the priorities in family and community care is the epidemiological surveillance of the care needs and dysfunctionality present in populations of highly complex chronic patients (HCCPs) using standardised nursing languages. The aim of this study is to establish the prevalence of care needs and dysfunctionality among HCCPs in a specific health area by municipalities and geographical areas (metropolitan, north, and south) while verifying correlations with sociodemographic, financial, and health characteristics. This is an epidemiological, observational, descriptive, cross-sectional study carried out with a sample of 51,374 HCCPs, whose data were grouped into 31 municipalities. Data were collected on the following variables: sociodemographic, financial, health, functional status (health patterns), and care needs (nursing diagnoses). The mean age of the HCCPs was 73.41 (1.45) years, of which 56.18 (2.86)% were women. The municipalities in the northern area have a significantly higher proportion of older patients, HCCPs, lower incomes, and higher unemployment rates. The southern area had higher proportions of non-Spanish nationals and professionals in the hotel and catering industry, and the metropolitan area had a higher proportion of employed individuals and higher levels of education. Northern municipalities had a higher prevalence of illnesses and anxiolytic and anti-psychotic treatments. Dysfunctionality frequencies did not differ significantly by area. However, a higher prevalence of 13 nursing diagnoses was observed in the north. A high number of correlations were observed between population characteristics, dysfunctionality, and prevalent diagnoses. Finally, the frequencies of dysfunctionality in the population and the most common care needs were mapped by municipality. This research sought to ascertain whether there was an unequal distribution of these two aspects among HCCPs in order to gain a deeper epidemiological understanding of them from a family and community perspective using standardised nursing languages. This study was not registered.

Nursing Interventions in Primary Care for the Management of Maladaptive Grief: A Scoping Review.

Grief is a natural and self-limited adaptation process to a new reality that emerges after a significant loss (whether real or perceived), with a broad variety of manifestations that exert an impact on a grieving person's health. The study aim was to synthesize the evidence available about the interventions carried out by Primary Health Care nurses, by means of an individual approach to reduce maladaptive grief or maladaptive grief risk. A scoping review was conducted (November and December 2023) through searches in Medline, Cinahl, Web of Science, ProQuest and Scopus using MeSH terms combined with Booleans. Primary research of any design in adult people undergoing grief situations and receiving professional assistance by nurses in the primary, home and community care contexts published after 2009 in English, Spanish or Portuguese languages were included. Excluded publications were those conducted in in-hospital clinical settings and which did not correspond to research designs or the gray literature. The screening process was carried out by two reviewers using the appropriate JBI critical appraisal tools for each design and discrepancies were resolved by a third reviewer. A total of n = 10 studies were included (n = 4 qualitative, n = 2 RCTs, n = 1 quasi-experimental, n = 2 cross-sectional observational, and n = 2 mixed methods). The qualitative studies identified topics and subtopics of professionals' and families' experiences of grief. The observational studies analyzed symptoms and factors associated with the grieving process. Interventions consisted of cognitive-behavioral therapies delivered by psychological specialists who assessed the severity of grief in a range of cultural contexts using different instruments. The evidence retrieved from the studies that address the reduction in maladaptive grief or maladaptive grief risk is not conclusive. There is a need to increase both the number and the methodological quality of studies assessing the effectiveness of Nursing care in Primary Health Care for individuals experiencing maladaptive grief or maladaptive grief risk. Further research should focus on experimental studies, developing specific interventions conducted by nurses to address individual's grief and prevent maladaptive grief.

Continuing bonds in men grieving a loved one. / Continuidad de vínculos en hombres que experiencian duelo por un ser querido.

OBJECTIVE: to examine internalized and externalized continuing bonds in men grieving a loved one. METHOD: a correlational, descriptive and cross-sectional study. Convenience sample comprised by 170 mourning men. The variables were mediators of mourning, continuing bonds and sociodemographic data. The instrument used was an online questionnaire comprised by mediators of mourning, a continuing bonds scale and sociodemographic data. Descriptive statistics, analysis of variance and Spearman's coefficient were used. The significance level adopted was p<0.05. RESULTS: the participants' mean age was 36.61 years old (SD=13.40), and 80.00% had Higher Education. The mean values corresponding to internalized and externalized continuing bonds were 24.85 (SD=7.93) and 7.68 (SD=2.33), respectively. Significant differences were established referring to internalized and externalized continuing bonds in terms of kinship with the deceased person (p<0.001), and none with the cause of death or with the time elapsed since the event. No significant correlations were defined between internalized/externalized continuing bonds and mediators of mourning. CONCLUSION: grieving men express internalized and externalized continuing bonds frequently and occasionally, respectively, with differences according to who the deceased person was. The Nursing discipline might devise specific strategies that strengthen coping with grief in this population group. (1) It was usual to continue the bond with the deceased loved one. (2) The expression of internalized continuing bonds was frequent after the death. (3) When facing the loss, there was occasional expression of externalized continuing bonds. (4) There were differences in internalized and externalized continuing bonds according to kinship. (5) There were no associations between continuing bonds and mediators of mourning.

Beyond scientific and technical training: Assessing the relevance of empathy and assertiveness in future physiotherapists: A cross-sectional study.

Background and Aims: Empathy and assertiveness are two essential social skills for a health professional such as a physiotherapist and are necessary for developing moral thinking. Previous studies show that the development of empathy and other social skills improves as students progress in their studies. However, other authors show deterioration of empathy as students progress in their studies and acquire clinical experience. Training in soft skills, such as assertiveness, among health science students will have an impact on the quality of patient care. Effective communication, conflict resolution and the ability to work as part of a team are competencies that have been put to one side as a result of the recent COVID-19 pandemic and it is important to resume training students in soft skills. The objective of this study is to investigate to determine the empathic and assertive state of physiotherapy university students. Methods: A descriptive cross-sectional study of physiotherapy university students was conducted in the 2022/2023 academic year. The Interpersonal Reactivity Index (IRI) scales for empathy and the Rathus test for assertiveness (RAS) were used as study tools. Finally, 127 students participated in the study, 52.91% of the total population of physiotherapy students. The questionnaire was available for 4 weeks in November and December 2022. Results: The empathetic and assertive development of the students was found to be acceptable. Significant differences were also observed according to the gender variable in the students, with female students presenting better results (p = 0.01). Students who are working or have clinical experience in other professions score lower on the empathy personal distress subscale (p < 0.001). Conclusion: Future research should be considered to help improve clinical and professional expertise in physiotherapy students about empathic and assertive development. The findings provide new evidence on the levels of empathy and assertiveness in physiotherapy students.

Psychosocial Care Needs, Personality Styles, and Coping Strategies of Mourners in a Rural Municipality in Spain: An Observational Study.

Grieving is a natural, self-limiting process of adaptation to a new reality following a significant loss, either real or perceived, with a wide range of manifestations that have an impact on the health of the grieving individual. This study aims to analyse the relationships between interpersonal styles, coping strategies, and psychosocial care needs in a sample of mourners in a rural municipality. Initial hypothesis: there are associations between types of grief and psychosocial needs, as well as between types of grief and interpersonal styles or coping strategies. An observational, descriptive, analytical, cross-sectional study was carried out with a sample of 123 people. Female participants represented 64.2% of all participants. The mean age was 42.7 (±13.2) years, and 86.2% of participants reported continuing to suffer from the loss, with a 10.5% prevalence of maladaptive grieving. Regarding the associations identified between coping strategies and the interpersonal characteristics of the mourners, we found that those with the best coping scores described themselves as self-confident, boastful, jovial, forceful, gentle-hearted, self-assured, outgoing, and/or neighbourly. By contrast, mourners who obtained poorer coping scores self-identified as shy, unsparkling, timid, unsociable, unbold, and/or bashful. This provides a clinical profile linked to maladaptive grieving in which emotional, self-perception, and social problems are prevalent.

Knowledge of Diabetic Retinopathy among Primary Care Nurses Performing Fundus Photography and Agreement with Ophthalmologists on Screening.

Diabetic retinopathy (DR) is one of the complications of diabetes mellitus (DM), with macular oedema being one of the leading causes of avoidable blindness among individuals with DM worldwide. Fundus screening is the only method for early detection and treatment. High-quality training programmes for professionals performing primary care screening are essential to produce high-quality images that facilitate accurate lesion identification. This is a two-phase observational, descriptive, and cross-sectional study. The first phase analysed DR knowledge in a sample of nurses. The second phase explored agreement on DR screening between referral ophthalmologists in image assessment (gold standard) and a small group of nurses involved in the previous phase. In phase 1, the agreement rate for screening results was 90%. In phase 2, the overall raw agreement on the screening of fundus photography results between nurses and ophthalmologists was 75% (Cohen's kappa = 0.477; p < 0.001). Agreement on screening with ophthalmologists was moderate, suggesting that implementing a specific training programme for nurse-led imaging screening would help develop this competence among nurses, ensuring a good level of agreement and patient safety and adding value for users, and also for the sustainability of the healthcare system. This study was not registered.

Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia.

(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia were recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: five language dimensions explained 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen's κ: 0.9; p < 0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen's κ: 0.6; p < 0.001), and concordances of up to 96% (Cohen's κ: 0.9; p < 0.001) using NOC indicators. The internal consistency (Cronbach's alpha) was 0.98. Reliability tests revealed test-retest concordances of 76-100% (p < 0.001). (4) Conclusions: the CEECCA is an easy-to-use, valid, and reliable instrument to assess the ability to communicate among individuals with aphasia.

Nursing Diagnoses, Planned Outcomes and Associated Interventions with Highly Complex Chronic Patients in Primary Care Settings: An Observational Study.

The information logged by nurses on electronic health records (EHRs) using standardised nursing languages can help us identify the characteristics of highly complex chronic patients (HCCP) by focusing on care in terms of patients' health needs. The aim of this study was to describe the profile of HCCPs using EHRs from primary care (PC) facilities, presenting patients' characteristics, functional status based on health patterns, NANDA-I nursing diagnoses, health goals based on Nursing Outcomes Classification (NOC), and care interventions using Nursing Interventions Classification (NIC). With an observational, descriptive, cross-sectional, epidemiological study design, this study was carried out with a sample of 51,374 individuals. The variables were grouped into sociodemographic variables, clinical variables, resources, functional status (health patterns), nursing diagnoses, outcomes, and interventions. A total of 57.4% of the participants were women, with a mean age of 73.3 (12.2), and 51% were frail or dependent. Prevalent conditions included high blood pressure (87.2%), hyperlipidaemia (80%), osteoarthritis (67.8%), and diabetes (56.1%). The participants were frequent users of healthcare services, with 12.1% admitted to hospital in the past year. Some 49.2% had one to four health patterns assessed, with more information on biological and functional aspects than on psychosocial aspects. The mean number of nursing diagnoses was 7.3 (5.2), NOC outcomes 5.1 (4.1), and NIC interventions 8.1 (6.9). Moderately and highly significant differences were observed between dysfunction in physical activity/exercise health pattern and age group, and between dysfunction in other health patterns and classification as a frail or dependent elderly person. Regarding the presence of certain nursing diagnoses, significant differences were observed by age group, classification of elderly person status, and presence of diseases. A total of 20 NIC interventions showed moderately or relatively strong associations for older age groups, higher levels of dependency, and chronic health conditions.

Use of the Nursing Interventions Classification and Nurses' Workloads: A Scoping Review.

BACKGROUND: The Nursing Interventions Classification allows the systematic organisation of care treatments performed by nurses, and an estimation of the time taken to carry out the intervention is included in its characteristics. The aim of this study is to explore the evidence related to the use of the Nursing Interventions Classification in identifying and measure nurses' workloads. METHODS: A scoping review was conducted through a search of the databases Ovid Medline, PubMed, Web of Science, CINAHL, Scopus, LILACS and Cuiden. The DeCS/MeSH descriptors were: "Standardized Nursing terminology" and "Workload". The search was limited to articles in Spanish, English and Portuguese. No limits were established regarding year of publication or type of study. RESULTS: Few reports were identified (n = 8) and these had methodological designs that contributed low levels of evidence. Research was focused on identifying specific interventions, types of activities, the prevalence of interventions and the time required to perform them. CONCLUSIONS: The evidence found on determination of nurses' workloads using the Nursing Interventions Classification was inconclusive. It is essential to increase the number of reports, as well as the settings and clinical context in which the Nursing Interventions Classification is used, with greater quality and methodological rigour.

Use of the Nursing Outcomes Classification (NOC) to measure perceived knowledge about the control of SARS-CoV-2 infection: The impact of a training program in primary healthcare professionals.

PURPOSE: To analyze the impact of an online training intervention on primary healthcare professionals in Tenerife (Canary Islands, Spain), evaluating the perceived knowledge about prevention and control of SARS-CoV-2 infection using the NOC outcome "Knowledge: Infection management" [1842]. METHODS: Quasi-experimental design with prepost analysis of 12 indicators. The participants were the 705 primary healthcare professionals, both healthcare professionals and nonhealthcare professionals, who completed the online training program prepared and implemented by nurses in the teaching and research fields between May and July 2020. The change in the perceived level of knowledge before and after, as well as other associations between this knowledge and the other variables included in the study, were confirmed. FINDINGS: The results of the study describe significant differences in the change between pre- and posttraining for all indicators included in the comparison. CONCLUSIONS: This research shows the effectiveness of an online training program, appropriate for the need for social distancing required by the pandemic, in improving the knowledge of primary healthcare professionals about prevention and control of COVID-19. It also describes a new context for the use of the Nursing Outcomes Classification (NOC) through a training program organized and led by nurses. IMPLICATIONS FOR NURSING PRACTICE: Our results suggest that the NOC classification is useful for assessing perceived knowledge about prevention and control of SARS-CoV-2 infection in the community among primary healthcare professionals. This study also provides evidence of the effectiveness of a nurse-led, nurse-designed online training intervention. To this end, the outcome criterion "Knowledge: Infection management" [1842] was used and its 12 original indicators were operationally defined. Overall, this study proposes a useful new framework for the NOC taxonomy, which, in addition to being intended for the assessment of outcomes among patients, families, and communities, is versatile enough to assess knowledge outcomes among professionals as well.

Happiness and Mental Disorders.

The research object is the approach the meaning of happiness for people with severe mental illness (SMI) under follow-up in a mental health unit in Tenerife. The research aims to improve the care they receive. This qualitative, phenomenological study uses convenience and intentional sampling. Questions were administered to a focus group consisting of 4 women and 1 man, aged 35-69, and 16 individual interviews were conducted with 8 women and 8 men, aged 20-62. The interviews were audio-recorded, with prior consent, transcribed verbatim, coded, and analyzed using QSR N-Vivo Release 1.4.1 (851), Spain. Happiness has three dimensions: personal, interpersonal-relational, and temporal. The personal dimension includes personality, positive emotions, health, motivations for establishing personal goals, and engaging in activities. The interpersonal-relational dimension includes family support; social support and relationships; social and occupational functioning; overcoming deaths, breakups, or job losses; and the absence of stigma on mental illness. The temporal dimension establishes that happiness can be comprised of either a set of happy moments or a continuous state of happiness that varies throughout life. Based on the results of this research, it could be proposed that future research should focus on the effectiveness of nursing interventions, addressing the life goals of people with mental disorders, and the pursuit of their happiness.

Development and Content Validation of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia Based on the NANDA-I and NOC.

This study presents the development and content validation of an instrument assessing the ability to communicate among individuals with aphasia. The study consists of three stages: (i) Selection and definition of the component dimensions and areas, construction of items assessing these dimensions, administration instructions, and qualitative criteria for assigning diagnoses; (ii) Face validity and content validity; (iii) Pilot test. The tentative questionnaire was designed using two defining characteristics of the NANDA-I ("Impaired verbal communication" and "Readiness for enhanced communication") and the NOC outcome indicators "Communication", "Communication: Expressive", "Communication: Receptive", and "Information Processing". The areas and items reached initial content validity index (CVI) and representativeness index (RI) values of 0.87 and above. Those that did not reach the expected values were modified after expert review. The resulting questionnaire was pilot-tested for feasibility and administration times. An instrument containing five dimensions, fourteen areas, and 43 items was obtained and administered in 15 (12-31) minutes. A panel of experts evaluated the final questionnaire (CEECCA), awarding its areas and items CVI and RI values of 0.90 and above. In the absence of further psychometric studies, the questionnaire appears to be useful for assessing ability to communicate in individuals with aphasia.

Expresiones de continuidad de vínculos en personas que experimentan el duelo por la muerte de un ser querido / Expressions of Continuity of Ties in People Experiencing Mourning for the Death of a Loved Being

Introducción: La continuidad de vínculos es una perspectiva del duelo reciente que ha sido estudiada para evidenciar de qué forma se expresa en las personas dolientes y su función ante la pérdida de un ser querido. Objetivo: Identificar expresiones de continuidad de vínculos en personas que experimentan duelo por la muerte de un ser querido. Métodos: Se realizó una revisión integrativa en cinco etapas, que incluyó estudios publicados en revistas de acceso abierto y texto completo, en inglés, español o portugués, de 1997 a 2021. Excluyó información contenida en libros, tesis, editoriales u opiniones, y estudios desvinculados a la muerte de una persona. La pregunta de investigación utilizó el acrónimo PICo. Se ejecutó una estrategia de búsqueda en las bases de datos PubMed, SciELO, Science Direct, Scopus, y Web of Sciences durante el 2022. Se identificaron 303 documentos. La muestra final fue de 28 artículos, que se evaluaron con las herramientas de evaluación crítica propuestas por JBI, se redujeron y se analizaron por el método comparativo constante. Conclusiones: Las expresiones de continuidad de vínculos son lazos referentes a la persona fallecida, que podrían manifestarse por pensamientos y sentimientos, percepciones alteradas, imitación, negociación del estatus, experiencias paranormales o ritos sobre la muerte. Tienen distintos roles y funciones en las personas dolientes. Para la Enfermería de Salud Mental, su estudio supone una visión más amplia en el cuidado de las personas en duelo que favorece el abordaje centrado en la persona al validar la propia historia y sus significados(AU)

Introduction: The continuity of ties is a perspective of any recent grief that has been studied to show how it is expressed in grieving people and its function in the face of the loss of a loved one. Objective: To identify expressions of continuity of ties in people who experience grief over the death of a loved one. Methods: An integrative review was carried out in five stages, which included full-text studies published in open access journals, in English, Spanish or Portuguese, from 1997 to 2021. It excluded information contained in books, theses, editorials or opinions, and studies unrelated to the death of a person. The research question used the PICo acronym. A search strategy was performed in the PubMed, SciELO, Science Direct, Scopus, and Web of Sciences databases during 2022. An amount of 303 documents were identified. The final sample was 28 articles, which were evaluated with the critical appraisal tools proposed by Joanna Briggs Institute, reduced and analyzed using the constant comparative method. Conclusions: Expressions of continuity of ties are links referring to the deceased person, which could be manifested by thoughts and feelings, altered perceptions, imitation, status negotiation, paranormal experiences or rites about death. They have different roles and functions in grieving people. For mental health nursing, its study represents a broader vision in the care of people in mourning that favors a person-centered approach by validating their own history and its meaning(AU)

Reflexión sobre la Relevancia de la Investigación Cualitativa y/o Fenomenológica en la Diabetes / Reflexão sobre a Relevância da Pesquisa Qualitativa e/ou Fenomenológica em Diabetes / Reflection about Relevance of Qualitative and / or Phenomenological Research in Diabetes

Objeto del presente ensayo reflexivo: Mostrar y reflexionarsobre la utilidad que tiene la investigación cualitativa y/ofenomenológica en la atención del paciente que presenta diabetes.Desarrollo: la atención integral de una forma biopsicosocial,cultural y espiritual tanto al paciente como a la familia del mismopor parte del profesional sanitario, juega un papel importantea la hora de tener calidad de vida en el nuevo estilo de vida.Conclusiones y reflexiones finales: La investigación cualitativaen enfermería, ayuda a interpretar el sufrimiento del paciente,su relación con su entorno social y cultural y sus sentimientose inquietudes dentro de la diabetes.(AU)

The main objective of this reflective essay is to show theusefulness of qualitative and / or phenomenological researchin the care of patients with diabetes. Comprehensive carein a biopsychosocial, cultural and spiritual way for both thepatient and the family of the same by the health professional,plays an important role when it comes to having quality oflife in the new lifestyle. Qualitative research in nursing helpsto interpret the suffering of the patient, her relationshipwith her social and cultural environment and her feelingsand concerns within diabetes.(AU)

Objetivo: mostrar e refletir sobre a utilidade da pesquisaqualitativa e/ou fenomenológica no cuidado ao paciente comdiabetes.Desenvolvimento: o cuidado integral de forma biopsicossocial,cultural e espiritual tanto para o paciente quanto para suafamília pelo profissional de saúde, desempenha um papelimportante quando se trata de ter qualidade de vida nonovo estilo de vida.Conclusões e reflexões finais: A pesquisa qualitativa emenfermagem ajuda a interpretar o sofrimento do paciente,sua relação com seu meio social e cultural, seus sentimentose preocupações frente ao diabetes.(AU)

Continuidad de vínculos con el ser querido fallecido y los cuidados de Enfermería de Salud Mental según el Modelo Tidal / Continuing bonds with the deceased loved one and Mental Health Nursing care from the perspective of the Tidal Model

El objetivo principal es analizar de qué manera el Modelo Tidal favorece la reconstrucción de significados en el duelo como continuidad de vínculos. El duelo es un proceso complejo que tiene componentes naturales y construidos, en ocasiones, las personas dolientes validan la continuidad de vínculos con la persona fallecida por medio de la organización de las autonarrativas. El manejo de este fenómeno es interdisciplinario donde destaca la Enfermería de Salud Mental orientada por el Modelo Tidal el cual se apoya en la historia personal para la reconstrucción de los significados tras la muerte de un ser querido favoreciendo la adaptación a través del cuidado. Conclusión principal: El abordaje de la continuidad de vínculos desde el Modelo Tidal favorece la adaptación al duelo centrado en la persona y su historia al afianzar la reconstrucción de significados que mejoren la calidad de vida por medio del cuidado enfocado en las necesidades actuales. (AU)

The objective is to analyze how the Tidal Model favors the reconstruction of meanings in grief as a continuing bond. Results: Grief is a complex process that has natural and constructed components. Sometimes, bereaved people validate the continuing bonds with the deceased person through the organization of self-narratives. The management of this phenomenon is interdisciplinary, where Mental Health Nursing stands out, guided by the Tidal Model, which is based on personal history for the reconstruction of meanings after the death of a loved one, favoring their adaptation through care. Conclusions: The approach to the continuing bonds from the Tidal Model favors adaptation to grief centered on the person and their history by strengthening the reconstruction of meanings that improve quality of life through care focused on the needs of the current experience. (AU)

Continuidad de vínculos en hombres que experiencian duelo por un ser querido / Continuing bonds in men grieving a loved one / Manutenção de vínculos em homens em luto por um ente querido

Objetivo: examinar la continuidad de vínculos interna y externa en hombres que experiencian duelo por un ser querido. Método: estudio correlacional, descriptivo y transversal. Muestra a conveniencia de 170 hombres dolientes. Las variables fueron mediadores del duelo, continuidad de vínculos y datos sociodemográficos. Se utilizó un cuestionario en línea compuesto por mediadores de duelo, escala de continuidad de vínculos y datos sociodemográficos. Se empleó estadística descriptiva, análisis de varianza y coeficiente de Spearman. El nivel de significancia correspondió a p<0,05. Resultados: la media de edad de los participantes fue de 36,61 años (DE=13,40), y el 80,00% tenía educación superior. Los valores medios de continuidad de vínculos interna y externa fueron 24,85 (DE=7,93) y 7,68 (DE=2,33), respectivamente. Se establecieron diferencias significativas referentes a la continuidad de vínculos interna y externa entre parentesco de la persona fallecida (p<0,001), y ninguna con la causa de muerte o con el tiempo transcurrido desde el fallecimiento. No se precisaron correlaciones significativas entre continuidad de vínculos interna/externa y mediadores del duelo. Conclusión: los hombres dolientes expresan la continuidad de vínculos interna de manera frecuente y la externa en ocasiones, con diferencias respecto a quién era la persona fallecida. La Enfermería podría diseñar estrategias específicas que fortalezcan el afrontamiento del duelo en este grupo.

Objective: to examine internalized and externalized continuing bonds in men grieving a loved one. Method: a correlational, descriptive and cross-sectional study. Convenience sample comprised by 170 mourning men. The variables were mediators of mourning, continuing bonds and sociodemographic data. The instrument used was an online questionnaire comprised by mediators of mourning, a continuing bonds scale and sociodemographic data. Descriptive statistics, analysis of variance and Spearman's coefficient were used. The significance level adopted was p<0.05. Results: the participants' mean age was 36.61 years old (SD=13.40), and 80.00% had Higher Education. The mean values corresponding to internalized and externalized continuing bonds were 24.85 (SD=7.93) and 7.68 (SD=2.33), respectively. Significant differences were established referring to internalized and externalized continuing bonds in terms of kinship with the deceased person (p<0.001), and none with the cause of death or with the time elapsed since the event. No significant correlations were defined between internalized/externalized continuing bonds and mediators of mourning. Conclusion: grieving men express internalized and externalized continuing bonds frequently and occasionally, respectively, with differences according to who the deceased person was. The Nursing discipline might devise specific strategies that strengthen coping with grief in this population group.

Objetivo: examinar a manutenção de vínculos interna e externa em homens vivenciando o luto por um ser querido. Método: estudo correlacional, descritivo e de corte transversal. Amostra de conveniência de 170 homens em luto. As variáveis foram: mediadores do luto, manutenção de vínculos e dados sociodemográficos. Utilizou-se um questionário online composto por mediadores de luto, escala de manutenção de vínculos e dados sociodemográficos. Empregou-se estatística descritiva, análise de variância e coeficiente de Spearman. Nível de significância p<0,05. Resultados: os participantes tinham uma média de idade de 36,61 anos (DP=13,40) e 80,00% tinham ensino superior. A média de manutenção interna dos vínculos foi de 24,85 (DP=7,93) e a de manutenção externa foi de 7,68 (DP=2,33). Foram estabelecidas diferenças significativas para a manutenção dos vínculos internos e externos entre os parentes do falecido (p<0,001), nenhuma com a causa da morte ou o tempo decorrido desde a morte. Não foram encontradas correlações significativas entre a manutenção dos vínculos internos e externos e os mediadores do luto. Conclusão: os homens em luto expressaram a manutenção interna dos vínculos com frequência e a manutenção externa dos vínculos ocasionalmente, com diferenças a respeito de quem era a pessoa falecida. A enfermagem poderia criar estratégias específicas para fortalecer o enfrentamento do luto nesse grupo.

Bereavement care interventions and outcome criteria planned by community nurses in the Canary Islands. / Intervenciones y criterios de resultado planificados por las enfermeras comunitarias en la atención al duelo en Canarias.

Nursing care in bereavement is complex. Primary health care is the ideal setting to support the bereaved, but we do not know much about the care plans designed by primary health care nurses in the treatment of grief. OBJECTIVE: To identify the outcomes criteria and interventions planned by nurses for mourners with and without complications in the Canary Islands. METHOD: Retrospective longitudinal study, using the electronic health records of the Canary Islands health service of people with a diagnosis of grieving, risk of complicated grieving and complicated grieving, in the period 2009-2014. RESULTS: NOC outcomes criteria were recorded in 67% of the mourners, and up to 24 different outcomes were identified. The main outcomes measures were Grief resolution; Psychosocial adjustment, Life change; Coping; Family coping; Family social climate and Caregiver emotional health. The remaining outcomes were present in less than 1% of the mourners. Although the outcomes criteria proposed by nurses in the mourners with and without complications were quite homogeneous, differences in interventions were found. In 67% of the cases, NIC interventions were reported. Ninety-nine different interventions were identified in the mourners; the most frequent were Emotional support; Grief work facilitation; Active listening; Coping enhancement and counselling. The remaining identified interventions were present in less than 5% of patients. The main interventions in the mourners with complications were Grief work facilitation; Coping enhancement; Active listening; Counselling and Family integrity promotion. CONCLUSION: Nurses state that there are more interventions and outcomes in mourners with complications. Given the few methodologically reliable studies that prove their effectiveness, continued research in this area is recommended.