Investigación en enfermería y ciencias sociales: implicaciones para la medición y el diseño de cuestionarios / Nursing and social science research: implications for measurement and questionnaire design

Las ciencias sociales pueden contribuir a la interdisciplinariedad de la investigación enfermera, ofreciendo a las cien-cias de la salud la posibilidad de estudiar a los sujetos en relación con el entramado social y aportando una mayor complejidad al abordaje empírico de la investigación. El presente artículo profundiza en algunas de las implicaciones asociadas a la investigación enfermera desde las ciencias sociales. Nos centramos en los aspectos referidos a la medición y al diseño del cuestionario. Para ello, además de aportar una discusión teórica sobre esta cuestión, nos servimos de la sistematización del proceso desarrollado en el proyecto de investigación Lenguaje y Culturas de salud (CSO2014-61928-EXP). Esta revisión nos lleva a plantear que la interdisciplinariedad, antes que limitar, supone incorporar una mirada a la realidad com-pleja de la salud y, por lo tanto, comporta la necesidad de la apertura a nuevos abordajes teóricos y metodológicos.(AU)

Social sciences can contribute to the interdisciplinary nature of nursing research, offering to health sciences the possibility of studying subjects in relation to the social framework and bringing greater complexity to the empirical research. The present article deepens into some of the implications related with nursing research from social sciences. We focus on the aspects referred to the meas-urement and design of questionnaire. To do so, in addition to providing a theoretical discussion of this subject, we use the systematization of the process developed in the research project Language and Cultures of Health (CSO2014-61928-EXP). This review leads us to propose that interdisciplinarity, rather than limiting, means incorporating a view at the complex reality of health and, therefore, entails the need to be open to new theoretical and methodological approaches.(AU)

¿Qué dicen las madres gitanas de la lactancia materna? / What gypsy mothers say about breastfeeding?

Objetivo: Conocer y profundizar en la valoración, la experiencia y la vivencia de las mujeres de etnia gitana con la lactancia materna. Método: Estudio cualitativo con un enfoque fenomenológico interpretativo, a través de la realización de un grupo focal en el que participaron 6 madres de etnia gitana usuarias del Centro de Salud de Fuente de San Luis de la ciudad de Valencia. Resultados: Las barreras descritas por estas madres en cuanto a la lactancia refieren: una falta de apoyo familiar, una asociación del amamantamiento al sacrificio y a la dependencia del bebé al pecho. De los relatos de estas madres se percibe un desinterés por la lactancia, y una falta de confianza en su propia biología que, unido a una escasa participación en las actividades de educación maternal, han supuesto las barreras que mayormente han limitado y dificultado en gran parte la lactancia en este grupo de madres. Conclusiones: Sería deseable poner en marcha acciones de mejora que prestaran mayor atención en promover, proteger y apoyar la lactancia en este colectivo.(AU)

Objective: To know and deepen in the evaluation, and experience of gypsy women with breastfeeding. Method: Qualitative study with an interpretative phenomenological approach, through a focus group with the participation of six mothers of gypsy ethnicity, users of the Fuente de San Luis Health Center in the city of Valencia. Results: The barriers described by these mothers regarding breastfeeding refer to a lack of family support, an association of breastfeeding to sacrifice and to the dependence of the baby to the breast. From the accounts of these mothers it is perceived, a disinterest in breastfeeding and a lack of confidence in their own bilogy, which together with a low participation in maternal education activities, have meant the barriers that have mostly limited and largely hindered breastfeeding in this group of mothers. Conclusions: It would be desirable to implement improvement actions that would pay more attention to promote, protect and support breastfeeding in this group.(AU)

What gypsy mothers say about breastfeeding.

OBJECTIVE: To know and deepen in the evaluation, and experience of gypsy women with breastfeeding. METHOD: Qualitative study with an interpretative phenomenological approach, through a focus group with the participation of six mothers of gypsy ethnicity, users of the Fuente de San Luis Health Center in the city of Valencia. RESULTS: The barriers described by these mothers regarding breastfeeding refer to a lack of family support, an association of breastfeeding to sacrifice and to the dependence of the baby to the breast. From the accounts of these mothers it is perceived, a disinterest in breastfeeding and a lack of confidence in their own bilogy, which together with a low participation in maternal education activities, have meant the barriers that have mostly limited and largely hindered breastfeeding in this group of mothers. CONCLUSIONS: It would be desirable to implement improvement actions that would pay more attention to promote, protect and support breastfeeding in this group.

Estrategias ante el uso de Internet por población usuaria en Atención Primaria: una clasificación sociológica / A proposal of sociological classification of Internet use in Primary Health care

Objetivo: Analizar y clasificar las estrategias comunicativas que desarrollan los/las profesionales de atención primaria de salud de la Comunitat Valenciana ante el uso de Internet como fuente de información de salud por parte de la población usuaria, a través de las categorías analíticas de poder y control que, según Basil Bernstein, caracterizan los procesos de comunicación de los encuentros terapéuticos. Método: Estudio cualitativo mediante entrevistas en profundidad a profesionales de atención primaria de salud de la Comunitat Valenciana (n=18). Para el análisis de los discursos se ha aplicado el lenguaje de descripción de la teoría de Bernstein con el objetivo de clasificar las estrategias desarrolladas por los/las profesionales y proponer una tipología. Resultados: Se aporta una tipología sociológica de estrategias utilizadas por los/las profesionales ante el uso de Internet por parte de la población usuaria, que las clasifica según la modulación de clasificación y enmarcamiento en estrategias de rechazo, estrategias de validación, estrategias de filtro y estrategias de apertura. Conclusiones: Las distintas estrategias que desarrollan los/las profesionales ante el uso de Internet como fuente de información tienen implicaciones distintas para las relaciones de poder y control propias del encuentro terapéutico. Las/los profesionales deben tomar consciencia de dichas implicaciones para incrementar una mayor participación de la población usuaria en los encuentros terapéuticos. (AU)

Objective: To analyze and classify the communication strategies developed by primary health care professionals in the Valencian Community (Spain), in view of the use of the Internet as a source of health information by the user population through the analytical categories of power and control which, according to Basil Bernstein, characterize the communication processes of therapeutic meetings. Method: Qualitative study through in-depth interviews with primary health care professionals of the Valencian Community (n=18). The language of description of Bernstein's theory was applied to the analysis of the speeches in order to classify the strategies developed by the professionals and to propose a typology. Results: A sociological typology of strategies used by professionals in the face of Internet use by the user population is provided, which classifies them according to the classification and framing modulation in rejection strategies, validation strategies, filtering strategies and opening strategies. Conclusions: The different strategies developed by professionals when faced with the use of the Internet as a source of information have different implications for the power and control relationships inherent to the therapeutic encounter. Professionals should be aware of these implications in order to increase the participation of the user population in therapeutic meetings. (AU)

[A proposal of sociological classification of Internet use in primary health care]. / Estrategias ante el uso de Internet por población usuaria en Atención Primaria: una clasificación sociológica.

OBJECTIVE: To analyze and classify the communication strategies developed by primary health care professionals in the Valencian Community (Spain), in view of the use of the Internet as a source of health information by the user population through the analytical categories of power and control which, according to Basil Bernstein, characterize the communication processes of therapeutic meetings. METHOD: Qualitative study through in-depth interviews with primary health care professionals of the Valencian Community (n=18). The language of description of Bernstein's theory was applied to the analysis of the speeches in order to classify the strategies developed by the professionals and to propose a typology. RESULTS: A sociological typology of strategies used by professionals in the face of Internet use by the user population is provided, which classifies them according to the classification and framing modulation in rejection strategies, validation strategies, filtering strategies and opening strategies. CONCLUSIONS: The different strategies developed by professionals when faced with the use of the Internet as a source of information have different implications for the power and control relationships inherent to the therapeutic encounter. Professionals should be aware of these implications in order to increase the participation of the user population in therapeutic meetings.

Culturas de salud y encuentro clínico: percepción de los profesionales sobre las dimensiones que median en el encuentro terapéutico / Cultures of health and clinical encounter: perception of the professionals on the dimensions that mediate in the therapeutic encounter

Introducción: El encuentro clínico ha sido entendido como un encuentro entre culturas de salud mediado por dimensiones: el paciente como sujeto de conocimiento, el uso de otras fuentes de información, los procesos de negociación y la implicación de los aspectos culturales. El proyecto Explora 'Lenguaje y cultura de la salud' contemplaba la realización de una encuesta sobre las cuatro dimensiones atribuidas al encuentro clínico. Sujetos y métodos: La población de estudio estuvo conformada por profesionales del ámbito de la salud en activo, que desarrollan su actividad profesional en centros de titularidad pública o privada. La muestra la componen 200 profesionales registrados en Revista de Neurología que aceptaron participar en el estudio, y cuya información fue posteriormente analizada por el equipo investigador mediante el programa SPSS v. 23. Resultados y conclusiones: Los resultados obtenidos apuntan a la existencia de una posición mayoritaria escéptica con las disposiciones culturales de los pacientes, que se ve matizada por una afirmación positiva ante la necesidad de horizontalidad en el encuentro clínico

Introduction: The clinical encounter has been understood as an encounter between health cultures mediated by dimensions: the patient as a subject of knowledge, the use of other sources of information, the negotiation processes and the implication of cultural aspects. The Explora 'Language and culture of health' project contemplated carrying out a survey on the four dimensions attributed to the clinical encounter. Subjects and methods: The study population consisted of professionals in the field of active health, who develop their professional activity in public or private ownership centers. The sample is composed of 200 professionals registered in Revista de Neurología who accepted to participate in the study, and whose information was later analyzed by the research team through the SPSS v. 23 software. Results and conclusions: The results obtained point to the existence of a majority position skeptical with the cultural dispositions of the patients, which is qualified by a positive affirmation in view of the need for horizontality in the clinical encounter

Cruising y e-citas: un nuevo contexto para los encuentros sexuales entre hombres jóvenes que tienen sexo con hombres / Cruising e e-compromissos: um novo contexto de encontros sexuais entre os jovens homens que fazem sexo com homens / Cruising and e-dates: a new context for sexual encounters among young men who have sex with men

Resumen El objetivo de este artículo es el de explorar el papel que juega, en la actualidad, la irrupción de la mediación tecnológica de la información y la comunicación en la configuración de nuevos contextos para la relación sexual. En concreto, hemos explorado una práctica determinada, el cruising, entre hombres jóvenes que tienen sexo con hombres contactado a través de las e-citas. Se ha apostado por la metodología cualitativa con la intención de recopilar los discursos sobre sexualidad, riesgos y salud que se generan y construyen entre el grupo de iguales. Según extraemos de nuestro estudio, el nuevo marco que confiere esta tecnología estaría caracterizado por (a) una mayor accesibilidad a dichas prácticas, (b) una mayor difusión de estas, (c) una mayor inmediatez de acceso a las propuestas, (d) la anticipación de lo que será ofrecido en la cita, (e) acceso anónimo que permite propuestas más atrevidas y (f) una apertura mayor a la diversidad de usuarios. Todos estos elementos confluyen en un cuadro que nos lleva a considerar una organización social renovada de la práctica sexual.

Resumo O objetivo deste artigo é explorar o papel que a irrupção da mediação tecnológica da informação e da comunicação desempenha na definição de novos contextos para a relação sexual. Em particular, explora-se uma determinada prática, o cruising entre os homens jovens que fazem sexo com homens contatados via e- encontros. Nossa aposta foi pela metodologia qualitativa, com a intenção de recolher os discursos sobre a sexualidade, a saúde e os riscos que são gerados e construídos entre o grupo de pares. De acordo com o nosso estudo, o novo quadro que oferece essa tecnologia seria marcado por: (a) uma maior acessibilidade a essas práticas; (b) uma maior divulgação das mesmas, bem como (c) um maior imediatismo de acesso para as propostas; (d) a antecipação do que vai ser oferecido no encontro; (e) acesso anônimo que permite propostas mais ousadas; e (f) uma maior abertura para a diversidade de usuários. Todos esses elementos convergem em um contexto que leva-nos a considerar uma nova organização social da prática sexual.

Abstract This article addresses the rapidly growing use of information and communication technologies in mediating new settings for sexual relations. The specific focus is on cruising among young men who have sex with men via e-dating. The study used a qualitative methodology with peer group discussions on sexuality, health, and risk. The new framework provided by technology is marked by (a) increased access to these practices, (b) greater dissemination of them, (c) greater immediacy of encounters, (d) anticipation of what will be offered during dates, (e) anonymous access, allowing bolder proposals, and (f) openness to a wider range of users. These elements converge in a framework that indicates a new social organization of sexual practice.

Cruising and e-dates: a new context for sexual encounters among young men who have sex with men.

This article addresses the rapidly growing use of information and communication technologies in mediating new settings for sexual relations. The specific focus is on cruising among young men who have sex with men via e-dating. The study used a qualitative methodology with peer group discussions on sexuality, health, and risk. The new framework provided by technology is marked by (a) increased access to these practices, (b) greater dissemination of them, (c) greater immediacy of encounters, (d) anticipation of what will be offered during dates, (e) anonymous access, allowing bolder proposals, and (f) openness to a wider range of users. These elements converge in a framework that indicates a new social organization of sexual practice.

Perceptions and experiences of parenthood and maternal health care among Latin American women living in Spain: a qualitative study.

OBJECTIVE: to explore the experiences and perceptions of parenthood and maternal health care among Latin American women living in Spain. DESIGN: an exploratory qualitative research using focus groups and thematic analysis of the discussion. SETTING AND PARTICIPANTS: three focus groups with 26 women from Bolivia and Ecuador and three focus groups with 24 midwives were performed in three towns in the Valencian Community receiving a large influx of immigrants. FINDINGS: the women interpreted motherhood as the role through which they achieve fulfilment and assumed that they were the ones who could best take care of their children. They perceived that men usually make decisions about sex and pregnancy and recognised a poor or inadequate use of contraceptive methods in planning their pregnancies. Women reported that it was not necessary to go as soon and as frequently for health examinations during pregnancy as the midwives suggested. The main barriers identified to health-care services were linked to insecure or illegal employment status, inflexible appointment timetables for prenatal checkups and sometimes to ignorance about how public services worked. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: empowering immigrant women is essential to having a long-term positive effect on their reproductive health. Antenatal care providers should be trained to build maternity care that is culturally sensitive and responds better to the health needs of different pregnant women and their newborns.