Sedación profunda basada en propofol y administrada por electrofisiólogos en la ablación de la fibrilación auricular / Deep sedation with propofol administered by electrophysiologists in atrial fibrillation ablation

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Perfil sociosanitario e información a donantes y receptores renales de vivo en tres hospitales andaluces / Socio-sanitary profile and information for living kidney donors and recipients in three Andalusian hospitals

ANTECEDENTES: La información suministrada por profesionales sanitarios a posibles donantes y receptores es fundamental para una decisión autónoma y objetiva de donar un riñón en vida. OBJETIVOS: Conocer las características de la información que reciben los donantes y receptores renales de vivo, averiguando su perfil sociosanitario, sus características sociodemográficas, económico-laborales, de salud y la actividad cuidadora de dichos donantes y receptores. MÉTODOS: Estudio observacional, descriptivo, transversal, de la población de donantes y receptores renales de vivo, de los Hospitales Universitarios Puerta del Mar (Cádiz), Virgen del Rocío (Sevilla) y Complejo Hospitalario Universitario de Granada, entre el 8 de abril de 2014 y el 8 de junio de 2015. RESULTADOS Y CONCLUSIONES: Según los 40 donantes y 40 receptores renales de vivo encuestados, los facultativos de nefrología son principalmente quienes dan a conocer e informan sobre la donación renal en vida. Casi la mitad de receptores demandan más información, por lo que se deberían actualizar los procesos de evaluación y de información antes de la donación. En general, el donante renal vivo es mujer, de 50 años, con estudios de Primaria/ESO, vive en pareja, está emparentado con el receptor del riñón, realiza un trabajo remunerado, tiene sobrepeso, percibe su salud como muy buena o buena, y no fuma ni consume alcohol. Sin embargo, el receptor renal tipo es hombre, con 44 años, tiene estudios de bachillerato/FP, no trabaja, percibe su salud como buena o regular, y son personas independientes para las actividades de la vida diaria

BACKGROUND: Information provided by health professionals to potential donors and recipients is essential for an autonomous and objective decision to make a living kidney donation. OBJECTIVES: To determine the characteristics of the information received by living kidney donors and recipients, to find out their socio-sanitary profile, their socio-demographics, financial and labour characteristics, health and the caregiving activity of these donors and recipients. METHODS: Observational, descriptive and cross-sectional study of the population of living kidney donors and recipients from the University Hospitals Puerta del Mar (Cádiz), Virgen del Rocío (Seville), and the University Hospital Complex of Granada, between 08/04/2014 and 08/06/2015. RESULTS AND CONCLUSIONS: According to the 40 living kidney donors and their 40 recipients surveyed, it is mainly nephrologists who make people aware and provide information about living kidney donation. Almost half of recipients require more information so the evaluation processes and pre-donation information should be updated. In general, the living kidney donor is female, aged 50, with primary/secondary education, lives with a partner and is related to the kidney recipient. Also, the living kidney donor is in paid employment, is overweight, perceives her health as very good or good, and does not smoke or drink alcohol. However, the typical living kidney recipient is male, aged 44 and has completed secondary school studies and vocational training. Furthermore, he does not work, perceives his health as good or regular, and he is an independent person for activities of daily living

Socio-sanitary profile and information for living kidney donors and recipients in three Andalusian hospitals. / Perfil sociosanitario e información a donantes y receptores renales de vivo en tres hospitales andaluces.

BACKGROUND: Information provided by health professionals to potential donors and recipients is essential for an autonomous and objective decision to make a living kidney donation. OBJECTIVES: To determine the characteristics of the information received by living kidney donors and recipients, to find out their socio-sanitary profile, their socio-demographics, financial and labour characteristics, health and the caregiving activity of these donors and recipients. METHODS: Observational, descriptive and cross-sectional study of the population of living kidney donors and recipients from the University Hospitals Puerta del Mar (Cádiz), Virgen del Rocío (Seville), and the University Hospital Complex of Granada, between 08/04/2014 and 08/06/2015. RESULTS AND CONCLUSIONS: According to the 40 living kidney donors and their 40 recipients surveyed, it is mainly nephrologists who make people aware and provide information about living kidney donation. Almost half of recipients require more information so the evaluation processes and pre-donation information should be updated. In general, the living kidney donor is female, aged 50, with primary/secondary education, lives with a partner and is related to the kidney recipient. Also, the living kidney donor is in paid employment, is overweight, perceives her health as very good or good, and does not smoke or drink alcohol. However, the typical living kidney recipient is male, aged 44 and has completed secondary school studies and vocational training. Furthermore, he does not work, perceives his health as good or regular, and he is an independent person for activities of daily living.

Indicios de profesionalización de la enfermería en España en el siglo XVII, según los estatutos de hospitales de Sevilla / Indications of Professionalization in Nursing in Spain in the Seventeenth Century According to Hospital Statutes in Seville / Indícios de profissionalização da enfermagem na Espanha no século XVII, segundo os estatutos de hospitais de Sevilha

RESUMEN Objetivo: conocer los rasgos de profesionalización de enfermeras/os que ejercían en hospitales de Sevilla (España), en el siglo XVII. Método: investigación cualitativa de tipo histórico, abordada desde la microhistoria, mediante el análisis de contenido de los estatutos que regían en el siglo XVII en los hospitales sevillanos de las Cinco Llagas, del Espíritu Santo, de la Santa Caridad y de los Venerables Sacerdotes. También se aportaron dos pinturas de esa época. Resultados y discusión: en las enfermeras que ejercieron en hospitales sevillanos en el siglo XVII se identificaron seis rasgos de profesionalización, pues se constató que la actividad enfermera era regulada por las autoridades hospitalarias; algunos hospitales exigían a los enfermeros requisitos académicos y formativos para ejercer; se impartía formación a enfermeras; la actividad cuidadora tenía un alto reconocimiento social; había enfermeros que además de cuidar asumían tareas de gestión del contexto hospitalario y supervisaban oficios paramédicos, y también había enfermeras remuneradas a cambio de su trabajo. El único rasgo de profesionalización no constatado fue la regulación de los contenidos curriculares formativos de los enfermeros. La ausencia de este importante rasgo impedía culminar definitivamente el proceso de profesionalización de las enfermeras.

ABSTRACT Objective: Become acquainted with the characteristics of professionalization among nurses working at hospitals in Seville (Spain) during the 17th century. Method: This is a qualitative study of a historical nature approached through microhistory, with content analysis of seventeenth century statutes governing the Sevillian hospitals of Cinco Llagas, Espiritu Santo, Santa Caridad and Venerables Sacerdotes. Two paintings from that era are included as well. Results and Discussion: Nursing activity was found to be regulated by hospital authorities, and six features of professionalization were identified among the nurses who worked at Sevillian hospitals in the 17th century. Some hospitals had academic and training requirements for nurses in order to practice. Nurses were given training, and being a caregiver was held in high regard by society. There were nurses who, in addition to providing care, assumed hospital management duties and supervised paramedical tasks. Some nurses were paid in exchange for their work. The only feature of professionalization that was not verified was the regulation of curricular content in education, a shortcoming that prevented the process of nursing professionalization from culminating definitively.

RESUMO Objetivo: conhecer as características de profissionalização de enfermeiras/os que trabalhavam em hospitais de Sevilla (Espanha), no século XVII. Método: pesquisa qualitativa de tipo histórico, abordada a partir da micro-história, mediante a análise de conteúdo dos estatutos do século XVII nos hospitais sevilhanos das Cinco Llagas, do Espíritu Santo, da Santa Caridad e dos Venerables Sacerdotes. Também foram fornecidas duas pinturas dessa época. Resultados e discussão: identificaram-se seis características de profissionalização nas enfermeiras que trabalharam em hospitais sevilhanos no século XVII, pois se constatou que a atividade de enfermagem era regulada pelas autoridades hospitalares; alguns hospitais exigiam dos enfermeiros requisitos acadêmicos e formativos para exercer a atividade; dava-se formação a enfermeiras; a atividade cuidadora tinha um alto reconhecimento social; havia enfermeiros que, além de cuidar, assumiam tarefas de gerenciamento do contexto hospitalar e supervisionavam trabalhos paramédicos; também havia enfermeiras remuneradas em troca de seu trabalho. A única característica de profissionalização que não consta foi a regulação dos conteúdos curriculares formativos; a ausência destes impedia culminar definitivamente o processo de profissionalização das enfermeiras.

La comunicación de crisis en errores sanitarios: reflexiones sobre las estrategias institucionales / The crisis communication in medical errors: reflections about institutional strategies

El objetivo es reflexionar sobre las estrategias de comunicación empleadas en crisis por errores sanitarios ocurridos en un hospital español y otro brasileño. Se analizaron noticias aparecidas en 2009 y 2011, en medios digitales de España y Brasil, que trataban del fallecimiento de dos niños e informaban que en ambos casos, personal de enfermería por equivocación infundió leche en vena. Desde ambos hospitales calificaron públicamente los errores, señalaron al personal involucrado y precisaron las causas del error. También informaron de acciones positivas que los hospitales desarrollaron tras los hechos. La principal estrategia de comunicación de crisis empleada fue transferir la responsabilidad de los errores a terceros, que junto a la actitud de silencio no son estrategias acertadas. Los hospitales debieron comunicar con transparencia, aceptando la provisionalidad de la información y sin culpabilizar. También debieron permanecer accesibles a los medios y comunicar las medidas establecidas para evitar nuevos errores

The aim is to reflect on the communication strategies employed in crisis caused by medical errors, occurred in a Spanish hospital and another Brazilian hospital. It was analyzed news published in 2009 and 2011, in digital media from Spain and Brazil, that dealt with the death of two children and reported that in both cases, the nursing staff injected milk into vein by mistake. Both hospitals described publically the errors, they indicated explicitly to the personnel involved and specified the causes of the error. Also, both hospitals informed of positive actions developed after the facts. It concludes that in both cases, the main crisis communication strategy employed was to shift the blame of the error to other persons. The hospitals should have communicated with openness and accepting the provisional character of the information. Also, they should not blame anyone and consider the receiver´s emotions. Equally, the hospitals should have remained accessible to the media and communicate the actions implemented to avoid similar errors in the future. In both cases, hospitals employed successful strategies that they did not use enough: communicate quickly, assume errors and apologize, compensate victims emotionally and highlight good qualities of the hospitals

[The reaction of practicantes in medicine and surgery to the creation of a nursing qualification in 1915]. / La reacción de los practicantes en Medicina y Cirugía frente a la creación del titulo de Enfermera en 1915.

This paper deals with the arguments justifying the Government's passage of the Sovereign Ordinance of 7 May 1915, which officially established a course and qualification in Nursing in Spain; and examines how and why Medical and Surgical practicantes (medical assistants) reacted to this decision. The ordinance legalized nurses' care practices, thereby providing official recognition for a healthcare profession other than that of practicante. The Government based its approval on three arguments: the physicians' recommendations; deficiencies in the basic and professional training of practicantes"; and the fact that the nursing profession emerged as a new path providing Spanish women with an opportunity to acquire training and join the labour force. The new legislation was met with outrage by practicantes, who opposed it in the belief that it equated nurses' scope of practice to their own and thus jeopardized their future employment prospects. Additionally, they contended that nurses would be legally qualified to perform the same medical practices as they did, despite receiving their degrees in a shorter period of time with a less prolonged internship, at a lower economic cost and through less effort. Professional associations of practicantes immediately launched a campaign against the Sovereign Ordinance, meeting with the Minister of Public Instruction to request its repeal, organizing a massive telegram campaign directed at the minister, and requesting the nullity of the ordinance before the Supreme Court, which would reject the appeal by the practicantes two years later. Professional associations also used their press organs to publish the arguments of prominent practicantes, who vehemently voiced their opposition in extremist, uncompromising, radical, and ironic terms, arising from a strong gender ideology in tune with the patriarchal mentality of the era and the dominant position that male hegemony conferred to practicantes.

Sexist stereotypes and biases associated with the female nursing model in advertising communication / Estereótipos e sinais sexistas associados ao modelo da mulher enfermeira na comunicação publicitária / Estereotipos y sesgos sexistas asociados al modelo de mujer enfermera en la comunicación publicitaria

In the media, gender stereotypes and biases appear that transmit a sexist representation of women. The aim of this study was to know the sexist stereotypes and biases that are projected on female nurses in advertising campaigns and to identify the characteristics of the female nurse model shown in advertising. A qualitative study was performed on four campaigns featuring female nurses in white dresses and caps, using descriptive and inferential content analysis. Conclusions show that female nurses appearing in advertising transmit both sexist stereotypes (female profession, gentleness, lack of control, strong affectivity, frivolousness, passivity, submissiveness, commitment to basic care, merely sexual and aesthetic value) and sexist biases (androcentrism and double standards). In particular, advertising propagates the model of the seductive nurse, depicted as a young, attractive, sensual and defiant woman that is used merely as a decorative presence.

Os meios de comunicação apresentam estereótipos e sinais "machistas" que transmitem uma representação sexual da mulher. O objetivo deste estudo foi conhecer os estereótipos e sinais sexistas projetados sobre as mulheres enfermeiras em ações publicitárias e identificar as características da mulher enfermeira descrita pela publicidade. Realizou-se um estudo qualitativo, mediante análise de conteúdo, de caráter descritivo e inferencial, a partir da análise de quatro peças publicitárias em que apareciam mulheres enfermeiras com vestido e quepe branco. Conclui-se que quando a mulher enfermeira aparece na publicidade são transmitidos estereótipos sexuais sobre ela - profissão feminina, ternura, falta de controle, afetividade marcada, frivolidade, passividade, submissão, dedicação a cuidados básicos, simples valor estético e sexual; e sinais - o androcentrismo e a norma dupla. Na publicidade transmite-se, sobretudo, a imagem da enfermeira sedutora caracterizada pela imagem de uma mulher jovem, atrativa, sensual e desafiante, com presença simplesmente decorativa.

En los medios de comunicación aparecen estereotipos y sesgos de género que transmiten una representación sexista de la mujer. El objetivo del estudio fue conocer los estereotipos y sesgos sexistas que se proyectan sobre las mujeres enfermeras en acciones publicitarias, e identificar las características del modelo de mujer enfermera que transmite la publicidad. Se realizó un estudio cualitativo mediante análisis de contenido descriptivo e inferencial, de cuatro acciones publicitarias donde aparecían mujeres enfermeras con vestido y cofia blanca. Se concluye que cuando la mujer enfermera aparece en la publicidad se transmiten estereotipos sexistas sobre ella -profesión femenina, ternura, falta de control, afectividad marcada, frivolidad, pasividad, sumisión, dedicación a cuidados elementales, simple valor estético y sexual, y sesgos sexistas - el androcentrismo y la doble moral. En la publicidad se transmite, sobre todo, el modelo de enfermera seductora, caracterizado como mujer joven, atractiva, sensual y desafiante, con presencia simplemente decorativa.

La reacción de los practicantes en Medicina y Cirugía frente a la creación del título de Enfermera en 1915 / The reaction of Practicantes in Medicine and Surgery to the creation of a Nursing qualification in 1915

El objetivo de este trabajo es conocer los argumentos que justificaron que el Gobierno promulgase la Real Orden de 7 de mayo de 1915, que creaba oficialmente los estudios y el título de Enfermera en España, y por qué y cómo reaccionaron los practicantes en Medicina y Cirugía a esa Real Orden. Dicha norma legalizó el ejercicio asistencial de las enfermeras y se reconoció así a una profesión sanitaria alternativa a la de Practicante, lo cual fue justificado por el Gobierno con tres argumentos: que lo aconsejaron los médicos, la escasa formación básica y profesional de parte de los practicantes y que la profesión enfermera surgía como una nueva vía para que la mujer española tuviese más oportunidades de formarse e incorporarse al mercado laboral. Los practicantes acogieron dicha Real Orden con indignación y se opusieron a ella porque pensaban que atribuía a las enfermeras las mismas competencias que a ellos, y como consecuencia peligraba su futuro laboral. Además, éstos sostenían que las enfermeras para equipararse en funciones a ellos, podían formarse en un menor periodo de tiempo, con menos prácticas, inferior coste económico y menor esfuerzo que los practicantes. Los colegios profesionales de practicantes iniciaron acciones contra la Real Orden: entrevistas con el ministro de Instrucción Pública para solicitarle la derogación de la Real Orden, envío masivo de telegramas de protesta al ministro y recurso ante el Tribunal Supremo para que se declarase la nulidad de la Real Orden, el cual casi dos años después rechazó las pretensiones de los practicantes. También, desde la prensa de los colegios profesionales, significados practicantes realizaron una oposición ardorosa, extremista, intransigente, radical, irónica y guiada por una marcada ideología de género, fruto de la mentalidad patriarcal de entonces y de la superioridad que la hegemonía masculina le otorgaba al colectivo de los practicantes (AU)

This paper deals with the arguments justifying the Government's passage of the Sovereign Ordinance of 7 May 1915, which officially established a course and qualification in Nursing in Spain; and examines how and why Medical and Surgical practicantes (medical assistants) reacted to this decision. The ordinance legalized nurses' care practices, thereby providing official recognition for a healthcare profession other than that of practicante. The Government based its approval on three arguments: the physicians' recommendations; deficiencies in the basic and professional training of practicantes’; and the fact that the nursing profession emerged as a new path providing Spanish women with an opportunity to acquire training and join the labour force. The new legislation was met with outrage by practicantes, who opposed it in the belief that it equated nurses' scope of practice to their own and thus jeopardized their future employment prospects. Additionally, they contended that nurses would be legally qualified to perform the same medical practices as they did, despite receiving their degrees in a shorter period of time with a less prolonged internship, at a lower economic cost and through less effort. Professional associations of practicantes immediately launched a campaign against the Sovereign Ordinance, meeting with the Minister of Public Instruction to request its repeal, organizing a massive telegram campaign directed at the minister, and requesting the nullity of the ordinance before the Supreme Court, which would reject the appeal by the practicantes two years later. Professional associations also used their press organs to publish the arguments of prominent practicantes, who vehemently voiced their opposition in extremist, uncompromising, radical, and ironic terms, arising from a strong gender ideology in tune with the patriarchal mentality of the era and the dominant position that male hegemony conferred to practicantes (AU)

Características de la formación continuada en comunicación científica impartida a profesionales de la salud / Characteristics of continued training in scientific communication provided to health professionals

Introducción. La trascendencia de los nuevos conocimientos sobre salud y la enfermedad obligan a médicos, enfermeros y otros profesionales sanitarios a saber comunicarlos adecuadamente a la comunidad científica y a la opinión pública. Objetivo. Conocer las características del Programa de Formación en Comunicación Científica impartido a profesionales de la salud entre 2001 y 2011. Materiales y métodos. Se realizó un estudio observacional, transversal, descriptivo y retrospectivo en el que se cuantificaron y analizaron los contenidos lectivos teóricos y prácticos de todas las ediciones que se han desarrollado de dicho programa, desde 2001 a 2011. Resultados y conclusiones. En ese periodo se han realizado 19 ediciones del programa de formación, en las que se han impartido 247,25 horas lectivas teóricas y prácticas de formación en comunicación científica, y se ha instruido a 890 profesionales de la salud, mayoritariamente enfermeras. El contenido lectivo del programa se estructuró en cinco áreas: introducción a la comunicación científica, escritura científica, comunicación oral, elaboración de presentaciones audiovisuales y comunicación en formato póster. Casi la mitad de la carga lectiva del programa se empleó en formar para publicar artículos científicos, y el resto, en instruir para comunicar la ciencia en reuniones científicas. Además, desde 2008 se incluyó formación para afrontar el reto de desarrollar la alfabetización mediática de los profesionales sanitarios. Por la demanda de formación y la importancia de comunicar la ciencia, debería ofertarse formación en comunicación científica en grado y posgrado, y dedicar más contenidos a la alfabetización mediática (AU)

Introduction. The importance of new knowledge in health and disease requires doctors, nurses and other health professionals to know how to properly communicate this knowledge to the scientific community and the public. Aim. To understand the characteristics of the Training Programme in Scientific Communication taught to health professionals between 2001 and 2011. Materials and methods. To this end, we performed an observational, cross-sectional, descriptive and retrospective study that quantified and analysed the contents of theoretical and practical lessons of all rounds taught in this programme from 2001 to 2011. Results and conclusions. According to the results, 19 rounds of the training programme were carried out, which imparted 247.25 hours of theoretical and practical lessons on scientific communication to 890 health professionals, mostly nurses. The program's lessons were structured into five areas: introduction to scientific communication, scientific writing, oral communication, preparation of audio-visual presentations, and poster format communication. Almost half the workload of the programme was used to provide training on publishing scientific articles; the rest provided instruction on how to communicate knowledge in scientific meetings. Since 2008, training has also been included to address the challenge of developing media literacy in health professionals. Due to the demand for training and the importance of communicating science, training should be offered in scientific communication at undergraduate and graduate level, and more content should be devoted to media literacy (AU)

Imagen social de las enfermeras y estrategias de comunicación pública para conseguir una imagen positiva / Social image of nursing and public communication satrategies to obtain a positive image

La identidad o esencia de las enfermeras no coincide con su imagen social pues continua plagada de estereotipos, y el público sigue percibiendo una imagen dependiente y poco profesional de las enfermeras. Esa discordancia entre identidad e imagen, en parte se debe a que las propias enfermeras no se han preocupado suficientemente, de modo individual y colectivo, por comunicar eficazmente su verdadera identidad a la sociedad. Y para transmitir la identidad de las enfermeras estas deben comunicar a la sociedad su función y quehacer, para lo cual conviene que las instituciones enfermeras cuenten con gabinetes de comunicación eficientes y bien estructurados, y que las enfermeras integren en su práctica profesional el uso de recursos de la comunicación pública, tales como aplicar las nuevas tecnologías en su práctica diaria, difundir científica y masivamente su producción intelectual, divulgarla e informar a los medios de actividades enfermeras susceptibles de convertirse en producto informativo (AU)

The identity or essence of nursing does not match their social image as this profession continues to be full of stereotypes and the general public still retains the idea of dependence and lack of professionalism of nurses. This lack of concordance between image and identity is partly due to the fact that nurses themselves have not cared enough, both individually and as a group, to communicate effectively their true identity to society. In order to transmit the identity of nursing, these professionals must explain their tasks and functions to society. In this sense, nursing institutions should have at their disposal efficient and well organized communication departments. Also, nurses should include in their daily practice the use of public communication resources such as the application of ITCs to their tasks, the mass divulgation of their intellectual production in scientific publications, the broadcasting of nursing activities which could become informative products (AU)

Valoración del riesgo psicosocial en las enfermeras de nefrología de los hospitales de Sevilla / Evaluation of the psychosocial risk in nephrology nurses in hospitals in seville

El objetivo general de este trabajo fue realizar una evaluación psicosocial del personal de enfermería de las unidades de nefrología de los hospitales “Virgen del Rocío” y “Virgen Macarena” de Sevilla, siendo los objetivos específicos del estudio describir la situación de este grupo en cuanto a clima laboral, tipo de conflictos del grupo, gestión de los conflictos, relación con el mando inmediato y bases de poder, acoso laboral y comparación entre las unidades de ambas instituciones. El estudio se realizó evaluando 66 encuestas contestadas por el personal de enfermería de los servicios de nefrología, de ambos hospitales. Las conclusiones obtenidas fueron las siguientes: 1. El clima laboral es una mezcla entre clima de apoyo y reglas.2. El tipo de conflicto que predomina en la organización es de tareas sobre el afectivo.3. El estilo de gestión para solucionar los conflictos es el deintegración.4. Las bases de poder están divididas entre formales e informales y el mando no es autoritario.5. El acoso laboral es casi inexistente, siendo éste sobre la función laboral del trabajador, lo que provoca muy baja incidencia somática en el individuo.6. Las diferencias halladas entre las dos unidades no son significativas

The general aim of this work was to conduct a psychosocial assessment of nursing staff in the nephrology units of the hospitals Virgen del Rocío and Virgen Macarena in Seville, the specific aims of the study being to describe the situation of this group as regards the working environment, type of group conflicts, conflict management, relations with immediate superiors and power bases, harassment and comparison between the units in the two hospitals. The study was carried out by assessing 66 surveys to which nephrology service nursing staff in both hospitals had responded. The conclusions obtained were as follows: 1. The working environment is a mixture of support and rules.2. The predominating type of conflict in the organization relates to tasks rather than emotional. 3. The management style to resolve conflicts is integration.4. The power bases are divided between formal and informal and command is not authoritarian.5. Harassment is almost non-existent, and is directed at the employee’s work, which causes a very low somatic incidence on the individual.6. The differences found between the two units are not significant