[Design of the evaluation of the socio-educational groups for men in primary care]. / Diseño de la evaluación de los grupos socioeducativos para hombres en atención primaria.

The Public Health System of Andalusia develops the Socio-Educational Groups Strategy (GRUSE), focused on promoting the health and emotional well-being of those who present somatic symptoms without organic cause in primary care health centers. This intervention began with groups of women and has been extended to groups of men, after verifying that the unemployment caused by the economic crisis, generated discomfort due to the loss of the "productive role". A mixed methodology research has been designed to measure the effects of GRUSE in male participants. The quantitative design has longitudinal and quasi-experimental section, in which a battery of scales are used as instruments for collecting information. The qualitative design includes semi-structured interviews and focus groups. The objective of this article is to present the design of the research, with which it is expected to collect evidence of the impact of the intervention.

Diseño de la evaluación de los grupos socioeducativos para hombres en atención primaria / Design of the evaluation of the socio-educational groups for men in primary care

El Sistema Sanitario Público de Andalucía desarrolla la Estrategia Grupos Socioeducativos (GRUSE), enfocada a la promoción de la salud y del bienestar emocional de quienes presentan síntomas somáticos sin causa orgánica en los centros de salud de atención primaria. Esta intervención comenzó con grupos de mujeres y se ha ampliado a grupos de hombres, tras comprobar que el desempleo provocado por la crisis económica generaba malestares por la pérdida del «rol productivo». Se ha diseñado una investigación con metodología mixta para medir los efectos de los GRUSE en los hombres participantes. El diseño cuantitativo tiene corte longitudinal y cuasiexperimental, y se usa una batería de escalas como instrumentos de recogida de la información. El diseño cualitativo contempla la realización de entrevistas semiestructuradas y grupos focales. El objetivo de este artículo es presentar el diseño de la investigación, con la que se espera recoger evidencias del impacto de la intervención. (AU)

The Public Health System of Andalusia develops the Socio-Educational Groups Strategy (GRUSE), focused on promoting the health and emotional well-being of those who present somatic symptoms without organic cause in primary care health centers. This intervention began with groups of women and has been extended to groups of men, after verifying that the unemployment caused by the economic crisis, generated discomfort due to the loss of the “productive role”. A mixed methodology research has been designed to measure the effects of GRUSE in male participants. The quantitative design has longitudinal and quasi-experimental section, in which a battery of scales are used as instruments for collecting information. The qualitative design includes semi-structured interviews and focus groups. The objective of this article is to present the design of the research, with which it is expected to collect evidence of the impact of the intervention. (AU)

Percepción de profesionales de la salud sobre la intervención grupal socioeducativa con mujeres que presentan síntomas somáticos sin causa orgánica / Health professionals’ perception about the socio-educational group intervention with women who present somatic symptoms without organic cause

Objetivo: Conocer la percepción y opinión de profesionales de la salud de Atención Primaria sobre el impacto de la intervención grupal socioeducativa (GRUSE) no medicalizadora con mujeres que presentan síntomas somáticos sin causa orgánica. Diseño: Estudio cualitativo fenomenológico. Emplazamiento: Centros de salud de atención primaria de la Comunidad Autónoma de Andalucía, durante los años 2017 y 2018. Participantes o contextos: Se incluyó a 24 profesionales del ámbito de la salud, seleccionados según su nivel de implicación en la estrategia GRUSE (grupos socioeducativos). Método: Se aplicó una metodología cualitativa, a través del método fenomenológico. La técnica empleada para recopilar la información es el grupo de discusión, sobre el que se realizó un análisis de contenido. El software Atlas.ti 8.0 se empleó como recurso de apoyo al análisis. Resultados: Los profesionales ponen en valor el trabajo de grupo como medio para provocar cambios y refieren la importancia de la intervención como estrategia no medicalizadora. Perciben que las participantes obtienen una serie de beneficios: mejora de su bienestar personal, aumento de su autoestima y autodeterminación y la generación de redes sociales, beneficios que repercuten igualmente en su entorno más inmediato. Conclusiones: En opinión de los profesionales, la estrategia tiene efectos positivos en las mujeres y no supone un incremento de los recursos para el sistema sanitario. Además, manifiestan la importancia de dotar a las mujeres de herramientas para el afrontamiento de problemas de la vida cotidiana, que derivan, en muchas de las ocasiones, de los mandatos de género predominantes en la sociedad patriarcal.(AU)

Objective: To know the perception and opinion of primary care health professionals on the impact of non-medicalizing group educational intervention (GRUSE) with women who present somatic symptoms without organic cause. Design: Qualitative phenomenological study. Setting: Primary care health centers in Andalusia, during 2017 and 2018. Participants and/or contexts: Twenty-four health professionals, selected according to their level of involvement in the GRUSE strategy (socio-educational groups). Method: A qualitative methodology is applied, through the phenomenological method. The technique used to collect the information is the discussion group, and a content analysis is carried out on it. The software Atlas.ti 8.0 is used as a support resource for the analysis. Results: Health professionals highlight group work as a means of achieving change, and point to the importance of intervention as a non-medicalizing strategy. They perceive that the participants obtain some benefits: the improvement of their personal well-being, the increase of their self-esteem and self-determination, and the generation of social networks, benefits that also affect their immediate surroundings. Conclusions: In the opinion of the professionals, the strategy has positive effects on women and does not mean an increase in resources for the health system. In addition, they express the importance of provide women with tools to cope with daily life problems derivates mostly from gender mandates of a patriarchal society.(AU)

Impacto de los grupos socioeducativos de atención primaria en la salud mental de las mujeres / Impact of primary care socio-educational groups in mental health of women

Objetivo: Presentar parte de los resultados de la evaluación de esta estrategia. Método: Diseño longitudinal (pre-post) y cuasiexperimental (grupo experimental y control), recogiendo información de 228 mujeres (114 en cada grupo) en cuatro momentos (un mes antes del programa, al mes de finalizarlo, a los 6 meses y al año y medio). Entre los instrumentos utilizados se encuentran la Escala de Ansiedad y Depresión y la Escala de Autoestima. Resultados: Las mujeres del grupo experimental reducen sus síntomas de depresión y ansiedad, y mejoran su autoestima, tras participar en el programa, y esta mejoría se mantiene hasta un año y medio después de finalizarlo. Por el contrario, las mujeres del grupo control no presentan diferencias pre-post en casi ninguna de las variables analizadas (salvo en los síntomas de ansiedad). Conclusión: Estos resultados apoyan los GRUSE como intervención no medicalizadora, y se considera que pueden servir como estímulo para mantener la estrategia e incluso extenderla a otros grupos de población que también experimenten malestar psicosocial. (AU)

Objective: To present part of the results of the evaluation of this strategy. Method: Longitudinal (pre-post) and quasi-experimental (experimental and control group) design, collecting information from 228 women (114 each group) in four moments (one month before the program; one month after the end of the program; six months and a year and a half). Among the instruments used are the Anxiety and Depression Scale and the Rosenberg Self-Esteem Scale. Results: Women in the experimental group reduce their symptoms of depression and anxiety and improve their self-esteem after participating in the program, and this improvement is maintained until a year and a half after the end of it. On the contrary, women in the control group do not present pre-post differences in almost none of the variables analyzed (except in anxiety symptoms). Conclusion: These results support GRUSE as a non-medical intervention, and it is considered that they can serve as a stimulus to maintain the strategy and even extend it to other population groups that also experience psychosocial discomfort. (AU)

[Health professionals' perception about the socio-educational group intervention with women who present somatic symptoms without organic cause]. / Percepción de profesionales de la salud sobre la intervención grupal socioeducativa con mujeres que presentan síntomas somáticos sin causa orgánica.

OBJECTIVE: To know the perception and opinion of primary care health professionals on the impact of non-medicalizing group educational intervention (GRUSE) with women who present somatic symptoms without organic cause. DESIGN: Qualitative phenomenological study. SETTING: Primary care health centers in Andalusia, during 2017 and 2018. PARTICIPANTS AND/OR CONTEXTS: Twenty-four health professionals, selected according to their level of involvement in the GRUSE strategy (socio-educational groups). METHOD: A qualitative methodology is applied, through the phenomenological method. The technique used to collect the information is the discussion group, and a content analysis is carried out on it. The software Atlas.ti 8.0 is used as a support resource for the analysis. RESULTS: Health professionals highlight group work as a means of achieving change, and point to the importance of intervention as a non-medicalizing strategy. They perceive that the participants obtain some benefits: the improvement of their personal well-being, the increase of their self-esteem and self-determination, and the generation of social networks, benefits that also affect their immediate surroundings. CONCLUSIONS: In the opinion of the professionals, the strategy has positive effects on women and does not mean an increase in resources for the health system. In addition, they express the importance of provide women with tools to cope with daily life problems derivates mostly from gender mandates of a patriarchal society.

Enhancing Self-Esteem and Body Image of Breast Cancer Women through Interventions: A Systematic Review.

Breast Cancer (BC) is the most common neoplasm in women worldwide, considered a global public health problem. Among BC women, some of the most common psychological symptoms in the adaptation to the disease are reduction in self-esteem and distorted body image (BI). Although there are numerous studies with the goal of promoting different psychological variables, BI and self-esteem are often separately observed despite their relationship and their importance in the process of the illness. Moreover, there have been no reviews that have synthesized the findings related to interventions aimed at enhancing both self-esteem and BI in BC women. Therefore, the objective of this review was to identify and examine the implemented interventions aimed at boosting both variables in this population. For this purpose, a systematic review was implemented following the PRISMA statement. A thorough search was performed on the following databases: Web of Science, PubMed, PsychInfo, PsychArticles, and Scopus. Among 287 records, only eight articles met the eligibility criteria. Interventions were grouped into three types according to their characteristics: Group therapies, Physical activity therapies, and Cosmetic and beauty treatments. The levels of effectiveness of the different interventions varied between them, and within each, in their impact on self-esteem and BI. More interventions focused on developing BI and self-esteem in this population are needed due to their ability to predict psychological functioning and quality of life of women with breast cancer.

[Impact of primary care socio-educational groups in mental health of women]. / Impacto de los grupos socioeducativos de atención primaria en la salud mental de las mujeres.

OBJECTIVE: To present part of the results of the evaluation of this strategy. METHOD: Longitudinal (pre-post) and quasi-experimental (experimental and control group) design, collecting information from 228 women (114 each group) in four moments (one month before the program; one month after the end of the program; six months and a year and a half). Among the instruments used are the Anxiety and Depression Scale and the Rosenberg Self-Esteem Scale. RESULTS: Women in the experimental group reduce their symptoms of depression and anxiety and improve their self-esteem after participating in the program, and this improvement is maintained until a year and a half after the end of it. On the contrary, women in the control group do not present pre-post differences in almost none of the variables analyzed (except in anxiety symptoms). CONCLUSION: These results support GRUSE as a non-medical intervention, and it is considered that they can serve as a stimulus to maintain the strategy and even extend it to other population groups that also experience psychosocial discomfort.

La desmedicalización de la vida cotidiana de las mujeres: los grupos socioeducativos en el Sistema Sanitario Público Andaluz / The demedicalisation of women's daily lives: socio-educational groups in the Andalusian Public Health System

Los grupos socioeducativos (GRUSE) constituyen una estrategia de promoción de la salud y el bienestar emocional desde un enfoque de salud positiva basada en activos. Mayoritariamente se dirigen a mujeres que acuden a los centros de salud con signos de malestar para los que no se encuentra base orgánica. La estrategia se evalúa mediante un diseño longitudinal y cuasi-experimental, con metodología mixta. Se ha recogido información de 228 mujeres con una batería de escalas y el análisis de bases de datos del sistema sanitario. Se han realizado 10 entrevistas en profundidad a mujeres y tres grupos de discusión con profesionales. El objetivo de este artículo es dar a conocer la estrategia GRUSE como intervención alternativa no medicalizadora y presentar el diseño de la investigación, con la que se espera identificar las evidencias de esta práctica implantada en los centros de salud de atención primaria de Andalucía

The socio-educational groups (GRUSE) are a health and emotional well-being promotion strategy, from an asset-based positive health approach. They principally target women who attend health centres with signs of discomfort with no organic basis finding. The strategy was evaluated through a quasi-experimental longitudinal design, with a mixed methodology. Information was collected from 228 women with a battery of scales and from an analysis of health system databases. Ten in-depth interviews with women were conducted, and 3 discussion groups with professionals. The aim of this article was to introduce the GRUSE strategy as a non-medical alternative intervention and to present the research design, seeking to identify the evidence of this practice implemented in primary health centres of Andalusia (Spain)

[The demedicalisation of women's daily lives: socio-educational groups in the Andalusian Public Health System]. / La desmedicalización de la vida cotidiana de las mujeres: los grupos socioeducativos en el Sistema Sanitario Público Andaluz.

The socio-educational groups (GRUSE) are a health and emotional well-being promotion strategy, from an asset-based positive health approach. They principally target women who attend health centres with signs of discomfort with no organic basis finding. The strategy was evaluated through a quasi-experimental longitudinal design, with a mixed methodology. Information was collected from 228 women with a battery of scales and from an analysis of health system databases. Ten in-depth interviews with women were conducted, and 3 discussion groups with professionals. The aim of this article was to introduce the GRUSE strategy as a non-medical alternative intervention and to present the research design, seeking to identify the evidence of this practice implemented in primary health centres of Andalusia (Spain).

How a deliberative approach includes women in the decisions of screening mammography: a citizens' jury feasibility study in Andalusia, Spain.

OBJECTIVES: To verify whether a citizens' jury study is feasible to the Andalusian population and to know if women, when better informed, are able to answer the research question of whether the Andalusian Public Health System must continue offering screening mammography to women aged 50-69. The reasons for the pertinent decision and recommendations to the political authorities will be stated. DESIGN: Qualitative research study with the methodology of citizens' jury. SETTING: Breast cancer screening programme in Andalusia (Spain). PARTICIPANTS: Thirteen women aged 50-69 with secondary school or higher education accepted to participate as a jury. Two epidemiologists were the expert witnesses. The main researcher was the neutral moderator. INTERVENTIONS: Jury met on Monday, 15 February 2016. The moderator indicated to the jury that it had to assess the screening programme's key benefits and main harm. On Tuesday, 16 February, the expert witnesses positioned for and against the programme. On Thursday, 18 February, the jury deliberated, reached final conclusions, submitted its vote and stated its recommendations to politicians. The deliberation session was transcribed and analysed with the support of ATLAS.ti.5.2 software. PRIMARY AND SECONDARY OUTCOME MEASURES: Feasibility in the Andalusian population, women's vote and opinion, reasons for votes and recommendations to political authorities. RESULTS: Eleven participants voted yes and two voted no. There are three reasons to vote 'yes': health, the test nature, and individual freedom. Some women invoke the lack of efficacy and the cost to justify their negative vote, at least in universal terms. On completion, they made suggestions to be submitted to the pertinent authorities for the improvement of information, psychology services and research. CONCLUSIONS: The deliberative strategy is feasible and causes a favourable positioning regarding screening mammography, although information changes the opinion of some women, who desire informed decision making and to keep or increase medicalisation in their lives.

Adaptation to spanish of an ethnocultural empathy scale / Adaptação ao espanhol de uma escola de empatia etnocultural / Adaptación al español de una escala de empatía etnocultural

The aim of this study is to adapt the Ethnocultural Empathy Scale of Wang, et al. to Spanish. A process of translation and back-translation of the items was carried out and their psychometric properties were explored in a sample of 441 nursing students from universities in Western Andalusia. Exploratory analyses were used to form sets of items that would reduce the number of indicators for each latent factor in the confirmatory analysis. After obtaining the sets of items, we tested the fit of the data to two factorial structures: a model with four interrelated first-order factors, and another with a second-order factor composed of four first-order factors. The factor structure of the original scale and an appropriate reliability and validity are confirmed. The results obtained support the utilization of the Spanish version of this scale with students of health sciences.

O objetivo deste estudo é a adaptação para espanhol da escala de empatia etnocultural de Wang, et al. Foi realizado um processo de tradução e retrotradução dos itens e as suas propriedades psicométricas foram exploradas numa amostra de 441 estudantes de Enfermagem de universidades da Andaluzia Ocidental. As análises exploratórias foram utilizadas para agrupar os itens, o que reduziu o número de indicadores de cada fator na análise confirmatória. Testou-se o ajuste dos dados a duas estruturas fatoriais: um modelo com quatro fatores de primeira ordem inter-relacionados e outro com um fator de segunda ordem composto por quatro fatores de primeira ordem. Confirma-se a estrutura fatorial da escala original e uma adequada fiabilidade e validade externa. Os resultados apoiam a utilização da versão espanhola desta escala em estudantes de ciências da saúde.

El objetivo de este estudio es adaptar al español la escala de Empatía Etnocultural de Wang, et al. Se llevó a cabo un proceso de traducción y retrotraducción de los ítems y se exploraron sus propiedades psicométricas en una muestra de 441 estudiantes de Enfermería de universidades de Andalucía Occidental. Los análisis exploratorios se emplearon para formar paquetes de ítems que permitieran reducir el número de indicadores de cada factor latente en los análisis confirmatorios. Se puso a prueba el ajuste de los datos a dos estructuras factoriales: un modelo con cuatro factores de primer orden relacionados entre sí, y otro con un factor de segundo orden compuesto por cuatro factores de primer orden. Se confirma la estructura factorial de la escala original y una adecuada fiabilidad y validez externa. Los resultados apoyan la utilización de la versión española de esta escala en estudiantes de ciencias de la salud.

Contribuciones de la Psicología de la Liberación a la Integración de la Población Inmigrante / Contributions of Liberation Psychology to the Integration of the Immigrant Population

La migración es una dimensión inherente a la conducta humana desde el comienzo de la humanidad. Sin embargo, los éxodos actuales de personas empobrecidas hacia las zonas más opulentas del planeta representan nuevos desafíos que necesitan ser explorados con nuevas perspectivas y aproximaciones. La psicología de la liberación puede ayudar a dar respuesta a estos desafíos. Por un lado, permite explicar el sufrimiento de personas desplazadas e inmigrantes en términos de experiencias opresivas de vida impuestas por grupos que pretenden perpetuar y aumentar sus privilegios. Por otro, permite conocer cómo los inmigrantes confrontan y superan condiciones de injusticia, destruyen su posición de oprimidos, fortalecen lazos con otros grupos y llevan a cabo acciones colectivas para asegurar cohesión social y cooperación en los contextos de recepción y logran equitativas relaciones multiculturales. Este artículo describe las iniciativas que ha llevado a cabo CESPYD (Coalición para el Estudio de la Salud, el Poder y la Diversidad) para abordar en profundidad estos aspectos. Primero, discutimos las dificultades que la perspectiva dominante de la psicología de la aculturación tiene para abordar los desafíos de las nuevas migraciones. Complementariamente, proponemos la psicología de la liberación como un adecuado enfoque para completarla perspectiva tradicional. A continuación, redefinimos los conceptos de integración y competenciacultural como procesos de empoderamiento psicopolítico y las organizaciones de base comunitaria y las organizaciones sanitarias como escenarios comunitarios empoderadores. Finalmente, este artículo propone algunas direcciones de investigación que pueden ser abordadas desde este enfoque (AU)

Mobility is a human dimension that has been a part of human behaviour since humanity began. However, the actual exodus of impoverished people to the more opulent zones of the planet represents new challenges that need to be explored with new perspectives and approaches. Liberation psychology can assistin answering these challenges. On one hand, it permits an explanation of displaced people and poor immigrants’human suffering in terms of the life experiences oppressively imposed on them by other human groups as a means to maintain privileges. On the other hand, it allows knowing how immigrants confrontand overcome unjust conditions, destroy their position as oppressed, strengthen bonds with other groups,and carry out actions as a means to forge cohesion and cooperation in the contexts of reception and toachieve equitable multicultural international relations. This paper describes the initiatives that we have achieved in CESPYD for the purpose of studying these aspects in depth. First we discuss the difficulties that the dominant perspective of acculturation psychology poses in tackling the challenges that new migration represents. Additionally, we suggest liberation psychology as an adequate focus to complete a traditional perspective. Furthermore, we redefine concepts of integration and cultural competency as processes of psychopolitical empowerment and the community-based organizations and health organizations as empowering community settings. Finally, this paper proposes some research directions that can broaden its focus (AU)

Emancipación y participación ciudadana de mujeres de una zona urbana con necesidades de transformación social / Emancipation and citizen participation among women from a poor neighborhood

Se describe el proceso emancipador por el que las mujeres oprimidas de una zona urbana con necesidades de transformación social de Sevilla desarrollan conciencia crítica y aserción para exigir su autodeterminación, así como habilidades para participar en la toma de decisiones y el reparto de los recursos. Siguiendo las propuestas de Kieffer (1984), el Área de Igualdad del Ayuntamiento de Sevilla, llevó a cabo un proceso de investigación-acción participativa cuyos resultados más sobresalientes fueron: a) muchas mujeres adquirieron conciencia crítica y competencia participativa, b) constituyeron asociaciones de mujeres orientadas a promover la igualdad en los procesos de cambio social, y c) realizaron cambios efectivos en el barrio, tales como un centro comunitario, la implementación de programas de fomento de empleo para mujeres y de respiro a familiares cuidadoras de personas dependientes. Además, constituyeron coaliciones con otras asociaciones de mujeres de la ciudad para realizar campañas de sensibilización contra la violencia de género (AU)