Calidad de vida relacionada con la salud en personas con úlcera venosa / Health-related quality of life of people with venous ulcer / Qualidade de vida relacionada à saúde em pessoas com úlcera venosa

Introducción: la úlcera venosa es la heridade origen vascular que más se presentaen la población adulta; afecta la calidad de vida,por loque se requiereun abordajeinterdisciplinarioparala atenciónde las personas que la padecen. Objetivo:describir las variables clínicas y sociales que interfieren en la calidad de vida relacionada con la salud de un grupo deadultosconúlcera venosa.Métodos:estudio observacional de tipo cohorte; incluyó 80 personas evaluadas en tres clínicas de Medellín(Colombia), en quienes seaplicó elinstrumento de evaluaciónCharing Cross Venous Ulcer Questionnaire. Se describieron las variablessociodemográficas y la evolución de la calidad de vidahasta la cicatrización y se construyó un modelo de regresión logística para explicar las variables asociadas a tener lapeorcalidad de vida. Resultados:el 28,8%de los participantes obtuvieron 64 o más puntos, es decir, grado de afección alto durantela primera mediciónde la calidad de vida;en el 68,8%el puntaje fue63o menos, lo que significó afecciónmoderadaysolo el 2,4%tuvo baja afección.Laspeores puntuaciones se registraron enmujeres,participantes de mayor edad y quienes tenían mayor compromiso de la herida; la afección involucró las dimensiones Estado emocional, Estética, Función social y Actividades domésticas,aunque hubo evolución favorablede la calidad de vidamientrasiba cicatrizandola úlcera. Conclusiones:lacalidad de vida relacionada con la saludestá altamente afectada en las personasque tienen úlcera venosa, siendo más frecuente en quienes tienen dolor constante,heridas más grandes, de mayor tiempo de antigüedad y aquellos con mala percepción desusalud; por tanto,se requiere oportunamentela intervención profesional e interdisciplinaria en salud para el logro de la cicatrizacióny del bienestary para mejorar la calidad de vida.

ntroduction: Venous ulcers are the most common vascular injury in the adult population. They affect the quality of life, so people who suffer from venous ulcers require an interdisciplinary approach to their care. Objective: To describe clinical and social variables that affect the health-related quality of life of a group of adults with venous ulcers. Methods: Observational cohort study carried out with 80 people examined in three medical centers in Medellín (Colombia) and who were given the Charing Cross Venous Ulcer Questionnaire to answer. Sociodemographic variables and the quality-of-life evolution until scarring were described. A logistic regression model was built to explain the variables associated with having the poorest quality of life. Results:There were28.8% of the participants who scored 64 or more points on the first quality of life measurement, which indicates a highly affected quality of life; 68.8% scored 63 or less, indicating a moderately affected quality of life, while only 2.4% indicated a slightly affected quality of life. The worst scores were seen among women, older participants, and those with greater ulcer severity. The dimensions of emotional status, cosmesis, social interaction, and domestic activities were affected, although there was a favorable evolution of the quality of life while the ulcer was healing. Conclusions: Health-related quality of life is highly affected in people with venous ulcers and is more common in those with constant pain, larger and older sores, and those with poor health perceptions. Therefore, timely professional and interdisciplinary healthcare interventions are required to achieve wound healing and wellness and improve quality of life

Introdução:a úlcera venosa é a ferida de origem vascular que ocorre mais frequentemente na população adulta e afeta a qualidade de vida, por isso é necessária uma abordagem interdisciplinar para o cuidado das pessoas que a sofrem. Objetivo:descrever as variáveis clínicas e sociais que interferem na qualidade de vida relacionada à saúde de um grupo de adultos com úlcera venosa.Métodos:estudo de coorte observacional; incluíram-se 80 pessoas avaliadas em três clínicas em Medellín (Colômbia), nas quais foi aplicado o instrumento de avaliação Charing Cross Venous Ulcer Questionnaire. Descreveram-se as variáveis sociodemográficas e a evolução da qualidade de vida até a cicatrizaçãoe construiu-se um modelo de regressão logística para explicar as variáveis associadas à pior qualidade de vida.Resultados: 28,8% dos participantes obtiveram 64 ou mais pontos, ou seja, alto grau de condição na primeira mensuração da qualidade de vida; em 68,8% a pontuação foi de 63 ou menos, o que significa condição moderada e apenas 2,4% em condição baixa. As piores pontuações foram registradas em mulheres, participantes mais velhos e naqueles com maior complicação da ferida; a afecção,envolvia as dimensões Estado Emocional, Estética, Função Social e Atividades Domésticas, embora houvesse evolução favorável da qualidade de vida enquanto a úlcera cicatrizava. Conclusões:a qualidade de vida relacionada à saúde é altamente afetada em pessoas com úlcera venosa, sendo mais frequente naquelas com dor constante, feridasmaiores, mais antigas e com má percepção de saúde; portanto, é necessária intervenção oportuna profissional e interdisciplinar em saúde para alcançar a cicatrização e o bem-estar e melhorar a qualidade de vida

Volver a la presencialidad sin ser el mismo: los docentes después de la pandemia / Returning to presentiality without being the same: teachers after the pandemic

Objetivo: Comprender los significados que los docentes le dan a su práctica profesional en el regreso al trabajo presencial después del confinamiento por Covid-19. Metodología: Investigación cualitativa con enfoque etnográfico exploratorio durante febrero y agosto de 2022. La información se recolectó por entrevistas semiestructuradas y se realizó diario de campo. Resultados: Volver a la normalidad luego de pandemia es un reto pedagógico para los docentes; el regreso a las aulas les ha generado sentimientos contradictorios: por un lado, felicidad al recuperar lo que se tenía y hacían anterior a la pandemia, pero angustia y disconfort por perder lo logrado en la virtualidad. Conclusión: La presencialidad genera ventajas y desventajas para los docentes y los reta a procesos de adaptación y resistencia. Es indispensable conservar los logros de la virtualidad y, para ello, las instituciones de educación deben ofrecer las mejores condiciones laborales que favorezcan el bienestar docente y la buena formación de los futuros profesionales.(AU)

Objective: Understand the meanings that teachers give to their professional practice in the return to face-to-face work after the confinement by Covid-19. Methods: Qualitative research with an exploratory ethnographic approach during February and August 2022. The information was collected through semi-structured interviews and a field diary was carried out. Results: Returning to normality after the pandemic is a pedagogical challenge for teachers; the return to the classroom has generated contradictory feelings: on the one hand, happiness at recovering what they had and did before the pandemic, but anguish and discomfort at losing what they had achieved online. Conclusion: To be in person generates advantages and disadvantages for teachers and challenges them to processes of adaptation and resistance. It is essential to preserve the achievements of virtuality and, for this, educational institutions must offer the best working conditions that favor teacher well-being and the good training of future professionals.(AU)

Social Determination of the Health of Families from Two Neighborhoods in Medellín, Colombia.

OBJECTIVES: To understand the health process, from the approach of the social determination of health in two neighborhoods in Medellín - Colombia, to contribute to the care of people, families, and collectives in their multidimensional reality. METHODS: Qualitative research from the ethnographic perspective, approaching the general dimension with documentary analysis of social policies and community documents, the particular dimension through focal groups and interviews to community leaders, and the singular dimension with the family visit. RESULTS: Families and collectives live within a sociocultural setting of resistance, overshadowed by moments of flight and displacement derived from violence, with scant participation in city plans and programs and with structural problems of economic and political exclusion. They constructed the territory as space and shelter in the weave that protects and violates them, with processes from uprooting to rooting. The families have maintained protective processes, like family participation in decision making, knowledge on health care, among others, and destructive processes, like informal labor and job instability, without spaces for recreation and with limitations in transportation, in access to health programs and in obtaining food. CONCLUSIONS: The health of the families has been determined by historical exclusion to work to obtain resources for a minimum vital subsistence, which is why they suffer social vulnerability due to few opportunities for development; they have lived a transformation process of the territory with resistance, solidarity, and construction of social networks.

Social Determination of the Health of Families from Two Neighborhoods in Medellín, Colombia / Determinación social de la salud de las familias de dos barrios de Medellín, Colombia / Determinação social da saúde das famílias em dois bairros de Medellín, Colômbia

Objective. To understand the health process, from the approach of the social determination of health in two neighborhoods in Medellín - Colombia, to contribute to the care of people, families, and collectives in their multidimensional reality. Methods. Qualitative research from the ethnographic perspective, approaching the general dimension with documentary analysis of social policies and community documents, the particular dimension through focal groups and interviews to community leaders, and the singular dimension with the family visit. Results. Families and collectives live within a sociocultural setting of resistance, overshadowed by moments of flight and displacement derived from violence, with scant participation in city plans and programs and with structural problems of economic and political exclusion. They constructed the territory as space and shelter in the weave that protects and violates them, with processes from uprooting to rooting. The families have maintained protective processes, like family participation in decision making, knowledge on health care, among others, and destructive processes, like informal labor and job instability, without spaces for recreation and with limitations in transportation, in access to health programs and in obtaining food. Conclusion. The health of the families has been determined by historical exclusion to work to obtain resources for a minimum vital subsistence, which is why they suffer social vulnerability due to few opportunities for development; they have lived a transformation process of the territory with resistance, solidarity, and construction of social networks.

Objective. To understand the health process, from the approach of the social determination of health in two neighborhoods in Medellín - Colombia, to contribute to the care of people, families, and collectives in their multidimensional reality. Methods. Qualitative research from the ethnographic perspective, approaching the general dimension with documentary analysis of social policies and community documents, the particular dimension through focal groups and interviews to community leaders, and the singular dimension with the family visit. Results. Families and collectives live within a sociocultural setting of resistance, overshadowed by moments of flight and displacement derived from violence, with scant participation in city plans and programs and with structural problems of economic and political exclusion. They constructed the territory as space and shelter in the weave that protects and violates them, with processes from uprooting to rooting. The families have maintained protective processes, like family participation in decision making, knowledge on health care, among others, and destructive processes, like informal labor and job instability, without spaces for recreation and with limitations in transportation, in access to health programs and in obtaining food. Conclusion. The health of the families has been determined by historical exclusion to work to obtain resources for a minimum vital subsistence, which is why they suffer social vulnerability due to few opportunities for development; they have lived a transformation process of the territory with resistance, solidarity, and construction of social networks.

Objetivo. Compreender o processo de saúde, a partir da abordagem da determinação social da saúde em dois bairros de Medellín, para contribuir com o cuidado de indivíduos, famílias e grupos em sua realidade multidimensional. Métodos. Pesquisa qualitativa na perspectiva etnográfica; abordou a dimensão geral com análise documental de políticas sociais e documentos comunitários, a dimensão particular por meio de grupos focais e entrevistas com lideranças comunitárias e a dimensão singular com a visita familiar. Resultados. Famílias e grupos vivem em um espaço sociocultural de resistência, matizado por momentos de fuga e deslocamento derivados da violência, com pouca participação nos planos e programas da cidade e com problemas estruturais de exclusão econômica e política. Construíram o território como espaço e refúgio na urdidura que os protege e os viola, com processos de desenraizamento ao enraizamento. As famílias têm mantido processos protetivos como a participação da família na tomada de decisões, o conhecimento dos cuidados de saúde, entre outros, e processos destrutivos como o trabalho informal e a precarização do emprego, sem espaços de lazer e com limitações no transporte, no acesso aos programas de saúde e na obtenção de alimentos. Conclusão. A saúde das famílias tem sido determinada pela exclusão histórica do trabalho para obtenção de recursos para um mínimo vital de subsistência, pelo qual sofrem vulnerabilidade social devido às escassas oportunidades de desenvolvimento; vivenciaram um processo de transformação do território com resistência, solidariedade e construção de redes sociais.

Estado de la investigación en enfermería de América Latina: una revisión de la literatura / State-of-the-Art of nursing research in Latin America: a literature review / Estado da pesquisa em enfermagem na América Latina: revisão da literatura

Introducción: la enfermería requiere analizar la producción de conocimiento para identificar la situación actual de la investigación en América Latina y los desafíos que surgen en el ejercicio profesional. Método: revisión integrativa que contempló la producción científica entre los años 2014 y 2018, según Whittemore, y Whittemore y Knafl, quienes proponen: identificación del problema, búsqueda de literatura, evaluación, análisis, reducción y presentación de resultados. Resultados: emergieron el cuidado de enfermería ­humanizado, seguro y culturalmente congruente­, APS y promoción de la salud, cuidado durante el ciclo vital, formación, educación y liderazgo en los servicios de salud y salud en el trabajo. Discusión: el cuidado de enfermería durante todas las etapas del ciclo vital humano requiere la comprensión e investigación de las dimensiones Filosófica, disciplinar, heurística, hermenéutica y política que sustenta la práctica científica. Conclusiones: se develan las necesidades por un cuidado humanizado y seguro, que comprenda la diversidad cultural, el fomento de la APS y promoción de la salud, el cuidado durante el ciclo vital, y la búsqueda de un ejercicio digno y seguro, con liderazgo y fortaleza política

Introduction: Nursing needs to analyze the knowledge production in order to identify the state-of-the-art of research in Latin America. Methods: It is a comprehensive review covering the scientific production between 2012 and 2018, after Whittemore, and Whittemore & Knafl who state: identification of problem, literature search, evaluation, analysis, reduction and result presentation. Results: this review found the following topics: nursing care ­humanized, save and culturally congruent­, APS and health promotion, care during the lifetime, formation, education and leadership in healthcare and health at work. Discussion: Nursing care throughout all the stages of the human lifetime needs to understand and research the philosophical, heuristic, disciplinary, hermeneutic and political dimensions that support the scientific practice. Conclusions: it was found that there is a need to count on a humanized and save care, embracing the cultural diversity, the APS format and health promotion, care in the lifetime, and the quest for an appropriate and save practice, with leadership and political strength.

Introdução: a enfermagem requer analisar a produção de conhecimento para identicar a situação atual da pesquisa na América Latina e os desaos que surgem na pratica profissional. Método: revisão integrativa que contemplou a produção científica entre 2014 e 2018, segundo Whittemore, e Whittemore e Knafl, que propõem: identificação do problema, procura de literatura, avaliação, análise, redução e apresentação de resultados. Resultados: surgiram o cuido de enfermagem ­humanizado, seguro e culturalmente consistente­, APS e promoção da saúde, cuidado durante o ciclo vital, formação, educação e liderança em serviços de saúde e saúde ocupacional. Discussão: o cuidado de enfermagem em todas as etapas do ciclo vital humano requer a compreensão e pesquisa das dimensões AlosóAca, disciplinar, heurística, hermenêutica e política que sustentam a prática cientíAca. Conclusões: desvelaramse as necessidades de um cuidado humanizado e seguro, que compreenda a diversidade cultural, fomento da APS e promoção da saúde, o cuidado durante o ciclo vital e a busca de um exercício digno e seguro, com liderança e força política.

Factors Associated to the Cicatrization Success of Lower-Limb Ulcer of Venous Etiology.

OBJECTIVES: The study sought to establish the relationship among the sociodemographic and clinical factors with cicatrization success in patients with lower-extremity ulcers of venous etiology (UVE). METHODS: Multi-center, prospective cohort study with participation of 80 patients with UVE assessed in three clinics from the city of Medellín (Colombia). Sociodemographic conditions were characterized and the clinical characteristics of the wounds evaluated with the Resvech 2.0 scale. RESULTS: The work showed that 48.7% of the patients (52.5% of the women and 38.1% of the men) had cicatrization success of the lesion during a maximum time of 90 days. The Cox proportional risk model showed that cicatrization time was higher in patients belonging to low socioeconomic level (HR = 2.0), with lesions of greater compromise (HR = 2.7), and who were treated by nurses with experience <5 years (HR = 2.1). CONCLUSIONS: The factors associated with cicatrization success of ulcers of venous etiology are: belonging to socioeconomic levels above two (on a scale from 1 to 6), with a slight lesion, and the nursing staff treating the patient having five or more years of experience in the treatment of wounds. Promotion should take place for nurses to be trained on these themes and on improving their expertise, given that this is a factor that can be modified and which indicates the success of the cicatrization of these lesions.