The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study.

AIMS AND OBJECTIVES: To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation. BACKGROUND: Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process. DESIGN: Observational descriptive study. METHODS: A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used. RESULTS: The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories 'Ethical considerations', 'Practical considerations' and 'Treasuring life'. On the other hand, there was a significant positive correlation between age and work experience and 'Spiritual beliefs' category. CONCLUSIONS: The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application. RELEVANCE TO CLINICAL PRACTICE: It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Experiences and opinions towards baby-led weaning by healthcare professionals. A qualitative study.

BACKGROUND: Baby-led weaning (BLW) is an alternative method to spoon-feeding to introduce solid foods. This study aimed to describe and understand the experiences and opinions of pediatricians and pediatric nurse specialists of the implementation of the BLW approach. METHODS: An interpretive descriptive qualitative research was carried out. A focus group with 7 participants and 13 face-to-face interviews were conducted between February and May 2022 (17 females and 3 males). All were audio-recorded, transcribed, and analyzed with the supported by Atlas.Ti qualitative data analysis software. RESULTS: From the data, two themes developed: (1) BLW as an ideal method of introducing solid food, with the subthemes: "a natural method of introducing complementary feeding" and "BLW is a safe method"; (2) Perceived barriers to the uptake of the BLW method, with the subthemes: "a lack of BLW training prevents the best practice" and "the influence of family and social context on parents." CONCLUSIONS: Healthcare professionals perceive BLW to be a safe and natural weaning approach. The lack of training of healthcare professionals and the influence of family social context on parents may limit the implementation of BLW. IMPACT: Baby-led weaning is perceived by healthcare professionals as a safe complementary feeding method that promotes chewing, improves growth, and the development of fine motor skills. However, lack of training of healthcare professionals and the family social context of the parents hinders the uptake of baby-led weaning. The views of the family and parents' social context about baby-led weaning may restrict their willingness to use the method. Family education delivered by healthcare professionals may avoid risks and allay parental anxieties about safety.

Attitudes of nursing students towards the legalization of euthanasia, end-of-life planning and the spiritual dimension: A quantitative study.

BACKGROUND: The Law on Euthanasia was approved in Spain and implemented in the health system. Nursing students must position themselves with respect to euthanasia in their work in the near future. OBJECTIVES: To know the attitudes of nursing students towards the legalization of euthanasia, its relationship with end-of-life planning, and the spiritual dimension. DESIGN: A cross-sectional descriptive quantitative study. SETTINGS AND PARTICIPANTS: Study carried out with students of the Nursing Degree at the Universities of Huelva and Almería in Spain from April to July 2021. METHODS: Attitudes towards the final phase of life, Anxiety towards death, and Attitudes towards Euthanasia questionnaires were administered. Descriptive, inferential and logistic regression statistics were calculated to determine the relationship between attitudes towards euthanasia and sociodemographic variables, end-of-life planning, and the spiritual dimension. RESULTS: 285 Nursing students with an average age of 23.58 years (SD = 8.19) participated. The scores on the attitude towards euthanasia were higher than the mean. While 70.5 % of the students were aware about advanced planning, only 2.5 % of them had made advanced plans. In religious practice and the spiritual dimension, the average score was high as they considered these elements to be of great support at the end of life. In terms of anxiety about death, the average score was significantly higher in women. Age, spiritual accompaniment and help, and the frequency with which spiritual beliefs are practiced are predictive factors for the attitude towards euthanasia. CONCLUSIONS: Students have a positive vision of euthanasia while admitting anxiety about death. They emphasize advance planning and greater religious practice as supports for euthanasia. The need for curricular training related to moral deliberation and values that support euthanasia is clear.

Effect of Gestational Pesticide Exposure on the Child's Respiratory System: A Narrative Review.

BACKGROUND: In recent years, concern has arisen worldwide about the potential adverse effects that could result from early-life exposure to pesticides. Asthma, bronchitis, and persistent cough in children have been linked to gestational exposure to pesticides. The respiratory effects of gestational exposure to pesticides are controversial. The aim of this study was to determine the relationship between pesticide exposure in pregnant women and its effect on the respiratory system of their children. METHODS: A narrative review was carried out by means of a search in the main databases. RESULTS: Findings of studies confirmed the effects of pesticides on the child's health. These substances cross the placenta and become transmitters of exposure to the individual at the most sensitive stage of her development. CONCLUSIONS: Chronic exposure to pesticides in fetuses is associated with chronic respiratory symptoms and disease.

Attention Given to Victims of Gender Violence from the Perspective of Nurses: A Qualitative Study.

Women victims of gender violence consider the health system an appropriate place to seek help. Aims and Objectives: to describe and understand how nurses perceive gender-based violence in health care for women victims of gender-based violence. Qualitative descriptive study. The recommendations of the COREQ guide for qualitative research reporting were followed. Sixteen nurses who were working in different health services, both primary and specialized care, were selected to take part in the study. Three focus groups and a semi-structured interview were conducted. The ATLAS.ti 9 computer programme was used. The nurses highlighted that when caring for women who are victims of gender violence, they encounter two types of violence: invisible or latent, and visible or patent. Part of the nurses' role is based on the skill of knowing how to act and being trained to do so. In addition, there are certain controversies around the concept and origin of violence. On the one hand, they refer to gender violence as a universal phenomenon with strong cultural and educational roots, and, on the other hand, it is difficult to characterize. The findings report how nurses play a fundamental role in caring for victims of gender-based violence, but they encounter certain difficulties regarding this concept. It is therefore essential to continuously train and educate nurses on gender-based violence. Gender violence should be a competency in nursing curricula. Health systems must offer training and awareness programmes that teach nurses to detect and make decisions regarding female victims of gender violence. It is also necessary to set up spaces in the different services so that the nurses can attend to the victims.

Unbearable Suffering: A Concept Analysis.

To understand and analyze the concept of "unbearable suffering" using a concept analysis method and to propose a new nursing diagnosis, the Walker and Avant method of concept analysis was used. Following the concept analysis method in 8 steps, a literature search was carried out in the MEDLINE, Dialnet, WOS, and PsycINFO databases between 2016 and 2020. Articles of theoretical or empirical nature, written in English, with the abstract available were included. As a result, 11 articles (4 theoretical and 7 empirical) were included. In addition, 2 cases were developed. The proposed new diagnosis, "unbearable suffering," refers to the situation of an individual who, because of a variety of factors, regardless of the cause, feels that he/she is unable to bear the suffering he/she is experiencing. The diagnosis is proposed for inclusion in "Domain 9: Coping/Stress Tolerance" and "Class 2: Coping Responses" of the North American Nursing Diagnosis Association taxonomy. Recognition of a nursing diagnosis for unbearable suffering could be key in identifying this type of suffering and facilitating interventions to reduce or mitigate it. Nurses play a fundamental role in situations of high levels of end-of-life suffering.

Emotional Intelligence and Perceived Health Related to Expressed Compassion Fatigue: A Study in Health Sector at Regional Level.

Background: The work of health professionals often involves physical as well as psychological strain. They constantly deal with traumatic situations of pain and suffering, which destabilize the sense of well-being. Compassion fatigue is a feeling that appears in these cases and is related to other variables such as burnout or emotional drain. Aims: The principal aim of this project was to deepen the analysis of compassion fatigue and how it could be explained through the relationship with other constructs such as emotional intelligence and perceived health. Methods: This work followed the STROBE checklist for cross-sectional studies. In this study 1,521 nurses (M age = 47.32; SD = 8.44) participated. The responses reported by the nurses were analyzed by classifying them as high or low compassion fatigue and the differences of both groups were analyzed for the variables of emotional intelligence, perceived health and quality of professional life. Results: It was obtained significant differences for all factors except for emotional intelligence factor. A linear regression analysis showed both emotional intelligence and perceived health helped to explain (12%) compassion fatigue. Conclusion: This study provides light on comprehending the conception of compassion fatigue. It highlights the importance of intervention programs that improve the quality of professional life.

Emotions, Feelings, and Experiences of Social Workers While Attending to Vulnerable Groups: A Qualitative Approach.

Social workers in the community setting are in constant contact with the suffering experienced by the most vulnerable individual. Social interventions are complex and affect social workers' emotional well-being. The aim of this study was to identify the emotions, feelings, and experiences social workers have while attending to individuals in situations of vulnerability and hardship. A qualitative methodology based on hermeneutic phenomenology was used. Six interviews and two focus group sessions were conducted with social workers from the community social services and health services of the Andalusian Public Health System in the province of Almería (Spain). Atlas.ti 8.0 software was used for discourse analysis. The professionals highlighted the vulnerability of certain groups, such as the elderly and minors, people with serious mental problems, and people with scarce or no economic resources. Daily contact with situations of suffering generates a variety of feelings and emotions (anger, sadness, fear, concern). Therefore, more attention should be paid to working with the emotions of social workers who are exposed to tense and threatening situations. Peer support, talking, and discussions of experiences are pointed out as relevant by all social workers. Receiving training and support (in formal settings) in order to learn how to deal with vulnerable groups could be positive for their work and their professional and personal quality of life.

Compassion and empathy in community social workers: A qualitative study in Spain.

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term 'compassion' generates controversy among social workers, while the term 'empathy' seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers' experiences with empathy and compassion in the community setting. Between January and June 2019, nine in-depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress.

Perceived health, caregiver overload and perceived social support in family caregivers of patients with Alzheimer's: Gender differences.

Perceived health in caregivers is related to caregiver burden, psychological well-being and social support. Women perceive poorer health and are more likely than men to experience caregiver overload. The objectives of this study were to analyse perceived health, perceived social support and caregiver overload in family caregivers of patients with Alzheimer's disease, as well as to study the effect of the perceived social support as a mediating variable between perceived health and caregiver overload was also analysed, taking into account the caregivers' gender. A cross-sectional descriptive design was used. The sample consisted of 255 family caregivers of individuals with Alzheimer's disease in the Almería Health District (Spain). This study was conducted from January to December 2015. The caregivers' mean age was 55.35 years (SD = 12.35), with 85.5% (n = 218) being women and 14.5% (n = 37) being men. The following questionnaires were administered: Goldberg's General Health Questionnaire-28; the Caregiver Strain Index, measuring caregiver overload; and the Duke-UNC-11 functional social support questionnaire. Poor perceived health, high caregiver overload and high perceived social support were found. Differences in perceived health and perceived social support were significantly higher in women than in men. In women, perceived social support was a mediating variable between perceived health and family caregiver overload. This mediation was not observed in men. This study suggests that perceived social support influences the emotional well-being and the caregiver overload of family caregivers of patients with Alzheimer's. However, its effect differs according to gender. It would, therefore, be necessary to have an in-depth understanding of the variables determining these differences in family caregivers.

Mindfulness therapies on health professionals.

Health professionals are exposed to situations of emotional vulnerability by being in continuous contact with patients and their suffering, which can cause conditions such as compassion fatigue. To address this issue, therapies such as mindfulness are being used to reduce stress and promote self-compassion. The objective of this research was to carry out a systematic review and meta-analysis to analyse the types of mindfulness interventions that are being used for healthcare professionals and their effectiveness in reducing stress and improving self-compassion and mindfulness. Following the PRISMA guideline, a systematic review of original studies was carried out in the following databases: Medline, Scopus, Cinhal, PsycINFO, Lilacs, and Science Direct, without a limited time frame. Controlled experimental mindfulness interventions on health professionals were selected, in which the following outcome variables were measured: stress, self-compassion, and mindfulness. A meta-analysis was performed with a random effects model. In cases of very high heterogeneity, the data were analysed by subgroup. Mindfulness-Based Stress Reduction Therapy (MBSR) was the most often used in the studies. There is diversity in the implementation of MBSR, and a common finding is a reduction of stress and increased mindfulness in health professionals. However, studies that analyse self-compassion are scarce. The effect of these therapies varies depending on how long the individual has been practising meditation. In conclusion, more studies are needed to describe the clinical usefulness of these programmes, to jointly analyse these three variables (stress, self-compassion, and mindfulness), and to measure compassion fatigue as an outcome variable.

Predictor Factors of Perceived Health in Family Caregivers of People Diagnosed with Mild or Moderate Alzheimer's Disease.

Caring for a person diagnosed with Alzheimer's disease has a negative impact on family caregivers' psychological health. This study examined the factors related to 'perceived health' and 'presence of new-onset mental health problems' in family caregivers of people diagnosed with mild and moderate Alzheimer's disease. A cross-sectional observational study carried out in Almeria's Healthcare District (Spain). A total of 255 family caregivers (42.4% cared for people with mild Alzheimer's disease and 57.6% cared for people with moderate Alzheimer's disease) participated in the study from January to December 2015. Mainly, caregivers were women (81.5% in the mild Alzheimer's disease group and 88.4% in the moderate Alzheimer's disease group), and their average age was 56.54 years (standard deviation (SD) = 13.13) and 54.47 years (SD = 11.71), respectively. Around 47% of the caregivers had been caring for the person with Alzheimer's between two and five years. The Goldberg General Health Questionnaire was used to measure perceived health and the presence of new-onset mental health problems. An exploratory descriptive analysis and a multivariate logistic regression analysis were conducted. For caregivers of people with mild Alzheimer's disease, 'perceived health' was related to 'perceived social support' (r = -0.21; p = 0.028), 'person's level of dependency' (r = -0.24, p = 0.05), 'severity of the person's neuropsychiatric symptoms' (r = 0.22; p = 0.05), and 'caregiver's emotional distress in response to the person's neuropsychiatric symptoms' (r = 0.22; p = 0.05). For caregivers of people with moderate Alzheimer's disease, 'perceived health' was related to 'perceived social support' (r = -0.31; p ˂ 0.01), 'presence of neuropsychiatric symptoms' (r = 0.27, p = 0.01), 'severity of the person's neuropsychiatric symptoms' (r = 0.32, p = 0.01) and 'caregiver's emotional distress in response to the person's neuropsychiatric symptoms' (r = 0.029; p = 0.01). The presence of new-onset mental health problems was detected in 46.3% (n = 50) of caregivers of people with mild Alzheimer's and 61.9% (n = 91) of caregivers of people with moderate Alzheimer's. When people are diagnosed with mild Alzheimer's disease, intervention programs for caregivers should aim to regulate emotions and promote positive coping strategies. When people are diagnosed with moderate Alzheimer's disease, intervention programs for caregivers must allow them to adapt to caregiving demands that arise with the progression of Alzheimer's disease.

Communicating Health Information at the End of Life: The Caregivers' Perspectives.

Health information and communication are key elements that allow patients and family members to make decisions about end-of-life care and guarantee a death with dignity. Objective: To understand caregivers' experiences regarding health information and communication during the illness and death of family members. Methods: This qualitative study was conducted in Andalusia based on the paradigm of hermeneutic phenomenology. Participants were caregivers who had accompanied a family member at the end of life for over 2 months and less than 2 years. Five nominal groups and five discussion groups were established, and 41 in-depth interviews with 123 participants were conducted. Atlas.ti 7.0 software was used to analyze the discourses. A comprehensive reading was carried out along with a second reading. The most relevant units of meaning were identified, and the categories were extracted. The categories were then grouped in dimensions and, finally, the contents of each dimension were interpreted and described given the appropriate clarifications. Results: Four dimensions of the dying process emerged: differences in caregivers' perceptions of information and communication, a conspiracy of silence, consequences of the absence or presence of information, and the need for a culture change. Conclusions: Poor management of health information and communication at the end of life increased the suffering and discomfort of patients and their families. The culture of denying and avoiding death is still present today. A change in education about death would better enable health professionals to care for patients at the end of life.

The Experiences of Family Caregivers at the End of Life: Suffering, Compassion Satisfaction and Support of Health Care Professionals: Experiences of Caregivers at the End of Life.

A death with dignity is influenced by the quality of care offered to patients. The objective of this study was to identify, through the firsthand experiences and insights of family caregivers, the key elements related to the care offered to patients with a terminal illness at the end of life. This multicenter qualitative study was based on the paradigm of hermeneutic phenomenology. Participants were relatives of patients with terminal illness who had been identified as primary caregivers. Five discussion groups and 41 in-depth interviews were organized with a total of 81 participants. The content of the interviews was analyzed based on the methods developed by Giorgi (J Phenom Psychol 1997;28(2):235-260). The results indicate the existence of 3 dimensions: the caregiver's suffering, compassion satisfaction with the care provided, and the support of health care professionals. Understanding the experiences of family members providing end-of-life care allows improved care and provides dignity in death. Health and social systems must provide comprehensive assistance covering the different aspects of needed care. Health professionals occupy a privileged position in the care of these patients and their families.

Estudio cualitativo sobre las vivencias del cuidador de Alzheimer: adaptación e impacto / Qualitative study on the experiences of the Alzheimer caregiver: adaptation and impact / Estudo qualitativo sobre as experiências do cuidador de Alzheimer: adaptação e impacto

OBJETIVO: Profundizar a través de las vivencias de los cuidadores familiares, cuáles eras las percepciones que tenían los cuidadores con respecto al proceso de adaptación de la enfermedad de Alzheimer y el impacto que tenía en sus vidas. METODOLOGÍA: se formaron dos grupos focales de cuidadores de pacientes con demencia tipo Alzheimer, representativos de la población de estudio. RESULTADOS: Del análisis de los discursos emergieron cinco dimensiones o unidades de significado con catorce subdimensiones. Estas cinco dimensiones son: conocimientos sobre la enfermedad, sufrimiento del cuidador, emociones, capacidad de afrontamiento y las consecuencias en la vida del cuidador. CONCLUSIÓN: Podemos determinar que la adaptación al rol de cuidador de una persona con Alzheimer queda condicionada por las creencias erróneas o pensamientos disfuncionales que surgen en el cuidador, las emociones derivadas de la responsabilidad moral de asumir el rol de cuidador desde la perspectiva de género y, por último, las consecuencias que produce el cuidado en este periodo las repercusiones en su vida personal, familiar y laboral

OBJECTIVE: To deepen, through the experiences of family caregivers, what were the perceptions that caregivers had regarding the process of adaptation of Alzheimer's disease and the impact it had on their lives. METHODOLOGY: Two focus groups of caregivers of patients with Alzheimer-type dementia were formed, representative of the study population. RESULTS: From the analysis of the discourses five dimensions or units of meaning emerged with fourteen subdimensions. These five dimensions are: knowledge about the illness, the caregiver's suffering, emotions, coping skills and the consequences in the life of the caregiver. CONCLUSIONS: We can determine that the adaptation to the role of caregiver of a person with Alzheimer's is conditioned by the mistaken beliefs or dysfunctional thoughts that arise in the caregiver, the emotions derived from the moral responsibility to assume the role of caregiver from the perspective of gender and, finally, the consequences of care during this period, the repercussions on their personal, family and work life

OBJETIVO: Aprofundar, através das vivências dos familiares cuidadores, quais as percepções que os cuidadores possuíam em relação ao processo de adaptação dadoença de Alzheimer e o impacto que isso teve em suas vidas. METODOLOGIA: Foram constituídos dois grupos focais de cuidadores de pacientes comdemência tipo Alzheimer, representativos da população estudada. RESULTADOS: A partir da análise dos discursos, emergiram cinco dimensões ouunidades de significado com quatorze subdimensões. Essas cinco dimensões são: conhecimento sobre a doença, o sofrimento do cuidador, emoções, habilidades deenfrentamento e as consequências na vida do cuidador. CONCLUSÃO: Podemos determinar que a adaptação ao papel de cuidador de uma pessoa com Alzheimer é condicionada pelas crenças equivocadas ou pensamentos disfuncionais que surgem no cuidador, as emoções derivadas da responsabilidade moral de assumir o papel de cuidador a partir da perspectiva de gênero e, por fim, as consequências do cuidado nesse período, as repercussões na sua vida pessoal, familiar e laboral

Atención recibida al final de la vida en los servicios de urgencias desde la perspectiva de los cuidadores: estudio cualitativo / Care received at the end of life in emergency services from the perspective of caregivers: A qualitative study

Objetivo: Conocer las vivencias de los pacientes que se encontraban al final de la vida y fueron atendidos por los servicios de urgencias, mediante los discursos de sus cuidadores familiares que acompañaban al familiar en este tránsito asistencial. Método: Estudio de enfoque cualitativo, basado en el paradigma de la fenomenología hermenéutica. En total participaron 81 cuidadores familiares. Las técnicas que se utilizaron fueron la entrevista en profundidad y el grupo de discusión, con un total de 5 grupos de discusión y 41 entrevistas. El período de recopilación de los datos se realizó entre enero del 2013 y junio del 2014. Resultados: En la red de los discursos obtenida respecto a la «Atención Urgente», todos los códigos se aglutinan respecto a una única línea argumentativa: las deficiencias en la atención urgente. Entre ellos, hemos encontrado distintas dimensiones que se establecen en función de los diferentes tiempos de la atención, o los distintos aspectos determinantes de estas deficiencias: desorganización de la atención recibida, poca experiencia de los profesionales en las urgencias, aplicación de protocolos generales, en los servicios de urgencias, inadecuada atención en el trato recibido, demoras en la atención en urgencias. Conclusiones: En general, destacamos la insatisfacción de los familiares con respecto a la atención en los servicios de urgencias. Las necesidades que precisan este tipo de situaciones no están cubiertas desde estos servicios y son de baja calidad. Por tanto, es necesario reorientar los protocolos de atención de estos pacientes

Objective: To discover the experiences of end-of-life patients attended by the emergency services, through the discourse of the family caregivers who accompanied the family member in this care transit. Method: A qualitative approach study, based on the paradigm of hermeneutical phenomenology. In total, 81 family caregivers participated. The techniques used were the in-depth interview and the discussion group, with a total of 5 discussion groups and 41 interviews. The period of data collection was carried out between January 2013 and June 2014. Results: In the network of discourses obtained with respect to "Urgent Care", all the codes were grouped in relation to a single argumentative line: deficiencies in urgent care. Among them, we found different dimensions that are established depending on the different times of care, or the different determinant aspects of these deficiencies: disorganization of the care received, lack of experience of the professionals in emergencies, application of general protocols in the emergency services, inadequate care in the treatment received, delays in emergency care. Conclusions: In general, we highlight the dissatisfaction of the family members with respect to the care received from the emergency services. The needs of these types of situation are not covered from these services and are of low quality. Therefore, it is necessary to reorient the care protocols for these patients

Competence and Compassion: Key Elements of Professional Care at the End of Life From Caregiver's Perspective.

In the act of caring for and helping people in the end-of-life process, the professional who provides care and assistance must know how to maintain a relationship of closeness, empathy, and compassion for the pain and suffering of the person who is going to die. The objective was to understand, elaborate on, and characterize the key elements of end-of-life care of patients from a caregiver's perspective through a qualitative phenomenological multicenter study. Participants were caregivers who had lost a family member at least 2 months but less than 2 years in the past. The techniques used were 5 discussion groups and 41 in-depth interviews, which included a total of 81 participants. To analyze the information, a protocol developed by Giorgi was followed. Two dimensions or units of meaning, with subdimensions, emerged: (1) Technical competence, with the subdimensions "Control of symptoms" and "Continuity of care," and (2) Compassion, with the subdimensions "Effective/affective communication," "Attitudes of kindness and closeness toward the patient and the family," and "Generosity and personalized flexibility of care." Assistance at the end of life requires the proper preparation of professionals who care for these patients, in addition to a compassionate attitude on the part of professionals and the people accompanying the dying person, that fosters a more humanized and dignified treatment in the dying process.

Care received at the end of life in emergency services from the perspective of caregivers: A qualitative study. / Atención recibida al final de la vida en los servicios de urgencias desde la perspectiva de los cuidadores: estudio cualitativo.

OBJECTIVE: To discover the experiences of end-of-life patients attended by the emergency services, through the discourse of the family caregivers who accompanied the family member in this care transit. METHOD: A qualitative approach study, based on the paradigm of hermeneutical phenomenology. In total, 81 family caregivers participated. The techniques used were the in-depth interview and the discussion group, with a total of 5 discussion groups and 41 interviews. The period of data collection was carried out between January 2013 and June 2014. RESULTS: In the network of discourses obtained with respect to "Urgent Care", all the codes were grouped in relation to a single argumentative line: deficiencies in urgent care. Among them, we found different dimensions that are established depending on the different times of care, or the different determinant aspects of these deficiencies: disorganization of the care received, lack of experience of the professionals in emergencies, application of general protocols in the emergency services, inadequate care in the treatment received, delays in emergency care. CONCLUSIONS: In general, we highlight the dissatisfaction of the family members with respect to the care received from the emergency services. The needs of these types of situation are not covered from these services and are of low quality. Therefore, it is necessary to reorient the care protocols for these patients.