Lifestyles and academic stress among health sciences students at the National University of Chimborazo, Ecuador: a longitudinal study.

Background: The significant changes experienced by university students in their training are inherent to educational processes. Social isolation caused by the COVID-19 pandemic, online education and the reopening of higher-education institutions produced substantial variations in the lifestyle of university students in health sciences and generated academic stress and perceived stress. This study was conducted at the National University of Chimborazo (UNACH), a public institution located in Riobamba, central Ecuador, the diverse student's population provided an ideal setting for examining the interplay between academic and perceived stress, lifestyle factors, and learning modalities. The research focused on health sciences students across six academic programs. The university's geographical position and demographic characteristics offered a representative sample for investigating these factors within the context changing. Aim: To compare academic and perceived stress and university students' lifestyles at two different periods: (1) during the mandatory social confinement caused by the COVID-19 pandemic with an online learning modality (T1); (2) in the post-pandemic period with a return to face-to-face activities (T2). Design: An observational, analytical, quantitative, and longitudinal study. Participants: Students from six programs (Nursing, Physiotherapy, Clinical Laboratory, Medicine, Dentistry, and Clinical Psychology) from the Faculty of Health of the National University of Chimborazo-Ecuador (n = 2,237) participated voluntarily, the students had one mean age of M = 21.31 (SD = 2.36) at T1 and M = 22.94 (SD = 2.40) at T2. Non-probability convenience sampling was employed due to the accessibility of the student population and the importance of including the maximum number of relevant individuals within the study population. Methods: The following instruments were used: Nola Pender's Lifestyle Profile Questionnaire, Cognitive Systemic Inventory for the study of academic stress, and Cohen's Perceived Stress Scale. Results: In T1 and T2, students reported high levels of stress, and increased unhealthy lifestyle increased with the return to classrooms. Additionally, upon returning to face-to-face activities (T2), the mean score applied to the responses of Nola Pender's Lifestyle Profile Questionnaire decreased from M = 113.34 (SD = 23.02) to M = 107.2 (SD = 29.70; p < 0.001). There was significant difference (p < 0.001) in academic stress in T1 [M = 66.25 (SD = 15.66)] and T2 [M = 64.00 (SD = 17.91)]. Conclusions: Upon returning to university classrooms (T2), the number of students who reported an "unhealthy" lifestyle increased. Academic stress was high in T1 and T2 and was reported higher in online activities during social isolation.

Validation of Nursing Outcome Indicators in Patients with Postsurgical Delirium / Validación de indicadores de resultados enfermeros en pacientes con delirium postquirúrgico / Validação de indicadores de resultados de enfermagem em pacientes com delirium pós-cirúrgico

Objective. To validate the content of the indicators proposed from the Nursing Outcome Classification in a care plan for delirium management in older adults. Methods. Content validity study, conducted under the expert judgment technique. The procedure was developed in five moments: organization of indicators that respond to the nursing outcome classification for delirium management, support with literature of the indicators that responds to the result, selection of experts, establishment of agreements, and discussion. Quality criteria evaluated: pertinence and relevance, the Content Validity Coefficient and average scores assigned by the experts were calculated. Results. The study had the participation of 14 experts. The indicators, according to criteria of pertinence and relevance evaluated by experts showed a global average content index value of 0.93; 97.05% (66) of the indicators had Content Validity Coefficient > 0.75. Conclusion. The quantitative findings of the indicator validation process showed high relevance and pertinence index, which favors their being applied to measure care changes in patients with delirium.

Objetivo. Validar el contenido de los indicadores propuestos a partir de Nursing Outcome Classification en un plan de cuidados para el manejo de delirium en los adultos mayores. Métodos. Estudio de validación de contenido realizado bajo la técnica de juicio de expertos. El procedimiento se desarrolló en cinco momentos: organización de los indicadores que responden a la clasificación de resultados de enfermería para manejo de delirium, soporte con literatura de los indicadores que responde al resultado, selección de expertos, establecimiento de acuerdos y discusión. Criterios de calidad evaluados: pertinencia y relevancia. Se calculó el Coeficiente de Validez de Contenido, así como los promedios de los puntajes asignados por los expertos. Resultados. Se contó con la participación de 14 expertos. Los indicadores según los criterios de pertinencia y relevancia evaluados por expertos mostraron un valor global promedio de índice de contenido de 0.93. El 97.05% (66) de los indicadores presentaron Coeficiente de Validez de Contenido mayor a 0.75. Conclusión. Los hallazgos cuantitativos del proceso de validación de los indicadores mostraron alto índice de relevancia y pertinencia lo que favorece que puedan ser aplicados para medir cambios de cuidado en los pacientes con delirium.

Objetivo. Validar o conteúdo dos indicadores propostos pela Classificação dos Resultados de Enfermagem em um plano de cuidados para o manejo do delirium em idosos. Métodos. Estudo de validação de conteúdo, realizado através da técnica de julgamento de especialistas. O procedimento foi desenvolvido em 5 momentos: organização dos indicadores que respondem à classificação dos resultados de enfermagem para manejo do delirium, suporte com literatura dos indicadores que respondem ao resultado, seleção de especialistas, estabelecimento de acordos e discussão. Foram calculados os critérios de qualidade avaliados: relevância e pertinência, o Coeficiente de Validade de Conteúdo e as médias das notas atribuídas pelos especialistas. Resultados. Participaram 14 especialistas. Os indicadores segundo os critérios de relevância e pertinência avaliados por especialistas apresentaram valor médio do índice de conteúdo global de 0.93. O 97.05% (66) dos indicadores apresentaram Coeficiente de Validade de Conteúdo superior a 0.75. Conclusão. Os achados quantitativos do processo de validação dos indicadores apresentaram alto índice de relevância e pertinência, o que favorece sua aplicação para mensurar mudanças no cuidado de pacientes com delirium.

Validation of Nursing Outcome Indicators in Patients with Postsurgical Delirium.

Objective: To validate the content of the indicators proposed from the Nursing Outcome Classification in a care plan for delirium management in older adults. Methods: Content validity study, conducted under the expert judgment technique. The procedure was developed in five moments: organization of indicators that respond to the nursing outcome classification for delirium management, support with literature of the indicators that responds to the result, selection of experts, establishment of agreements, and discussion. Quality criteria evaluated: pertinence and relevance, the Content Validity Coefficient and average scores assigned by the experts were calculated. Results: The study had the participation of 14 experts. The indicators, according to criteria of pertinence and relevance evaluated by experts showed a global average content index value of 0.93; 97.05% (66) of the indicators had Content Validity Coefficient > 0.75. Conclusion: The quantitative findings of the indicator validation process showed high relevance and pertinence index, which favors their being applied to measure care changes in patients with delirium.

Association between Sexual Habits and Sexually Transmitted Infections at a Specialised Centre in Granada (Spain).

Sexually transmitted infections are an important public health issue. The purpose of this study is to analyse the association between different sexual habits and the prevalence of sexually transmitted infections in the population of Granada who consult with a specialised centre. An observational, cross-sectional study was conducted based on the medical records of 678 people from the Sexually Transmitted Diseases and Sexual Orientation Centre of Granada, who were diagnosed positively or negatively with a sexually transmitted infection, during the 2000-2014 period. Sociodemographic and clinical data, as well as data on frequency and type of sexual habits, frequency of condom use and sexually transmitted infection positive or negative diagnosis were collected. Univariate and bivariate analyses were conducted. The most popular sexual habits were vaginal intercourse, oral sex (mouth-vagina and mouth-penis) and the least popular were anus-mouth and anal sex. The use of condom is frequent in vaginal and anal sex and less frequent in oral sex. Sexually transmitted infection is associated with mouth-penis (p = 0.004) and mouth-vagina (p = 0.023) oral sex and anal sex (p = 0.031). It is observed that there is a relationship between the presence of STIs and oral sex practices, people having such practices being the ones who use condoms less frequently. There is also a relationship between anal sex and the prevalence of STIs, although in such sexual practice the use of condom does prevail.

Economic Crisis and Sexually Transmitted Infections: A Comparison Between Native and Immigrant Populations in a Specialised Centre in Granada, Spain.

This study aimed to analyse the influence of the economic crisis on the prevalence of sexually transmitted infections (STIs) in the immigrant population compared to the native population. A cross-sectional study was conducted by reviewing 441 clinical records (329 Spanish nationals and 112 non-Spanish nationals) of individuals who, between 2000 and 2014, visited an STI clinic in Granada and tested positive for an infection. Descriptive statistical analyses were performed, and infection rates, odds ratios, and 95% confidence intervals (CIs) were calculated. The mean age was 28.06 years (SD = 8.30; range = 16-70). During the period 2000-2014, the risk of being diagnosed with an STI was higher among non-Spanish nationals than among Spanish nationals (odds ratio (OR) = 5.33; 95% CI = 4.78-6.60). Differences between both populations were less marked during the crisis period (2008-2014: OR = 2.73; 95% CI = 2.32-3.73) than during the non-crisis period (2000-2007: OR = 12.02; 95% CI = 10.33-16.17). This may be due to underreporting of diagnoses in the immigrant population. Immigrants visiting the STI clinic in Granada are especially vulnerable to positive STI diagnoses compared to the native population.

Cultural Adaptation, Validation, and Analysis of the Self-Efficacy in Palliative Care Scale for Use with Spanish Nurses.

The aim of the present study is to validate the Self-Efficacy in Palliative Care Scale (SEPC) in Spanish nursing professionals and students, to describe their levels of self-efficacy, and to determine the influencing factors. A validation study and a cross-sectional descriptive study were carried out, with the data analysed using contrast tests and multiple linear regression; 552 nurses and 440 nursing students participated. The Spanish version consists of 23 items and has a high degree of reliability (α = 0.944). Confirmatory factor analysis revealed one additional factor (i.e., management of psychosocial and spiritual aspects) in comparison to the original scale. Contrast tests revealed that the mean SEPC score was higher in professionals than in students (p < 0.001) and that the professionals who had higher levels of self-efficacy were older (p < 0.001), had more previous training (p < 0.001), and had more experience in end-of-life care (p = 0.001). The linear analysis results confirm a significant association between age and previous training in end-of-life care. The Spanish version of the SEPC is a reliable tool for both nursing professionals and students. The level of self-efficacy of both groups is moderate and is influenced by age, experience, and training in end-of-life care.

[Socio-demographic characteristics, indicators of risk and health care in relation to sexual transmission infections in migrant population of Granada]. / Características sociodemográficas, indicadores de riesgo y atención sanitaria en relación a infecciones de transmisión sexual en población inmigrante de Granada.

OBJECTIVE: The objective of this paper was to describe the sociodemographic profile, the characteristics of clinical care received, the risk indicators and the prevalence of Sexually Transmitted Infections (STI) in an immigrant population attending a specialized center in Granada, as well as to analyse the association between the presence or absence of STI with the sociodemographic variables and risk indicators. METHODS: A cross-sectional observational and analytical study was conducted at the at the Center for Sexually Transmitted Diseases and Sexual Orientation in Granada, by reviewing the clinical records of 374 immigrants extracted from a sample of 1.455 records of subjects with a suspected of STI, corresponding to the period 2000-2014. Univariate analyses was conducted, bivariate analyses was conducted by using Mann-Whitney U and chi-square test, in addition to multiple logistic regression. RESULTS: The mean age of individuals was 28,28 years (Dt=7,54). 69,3% were women and 30,7% were men, mainly from the Southern Common Market (39%) and the European Union (35.6%). 36.1% were professionals or former sex professionals, 34,5% had higher education and 79,9% were single. 70% of the cases had a positive diagnosis of STI, Human Papilloma Virus was the most prevalent infection. The number of partners in the last year (OR = 1,39; IC 95% = 1,12 - 1,74; p = 0,002) was significantly associated with the presence of STI. CONCLUSIONS: The sample, mainly women, sex workers or former sex workers, young people, from South America and Europe, has a high prevalence of infections and an increased risk as the number of partners increases in the last year.

OBJETIVO: El objetivo de este estudio fue describir el perfil sociodemográfico, las características de la atención clínica recibida, los indicadores de riesgo y la prevalencia de Infecciones de Transmisión Sexual (ITS) en la población inmigrant que acude a un centro especializado en ITS de la provincia de Granada, así como analizar la asociación entre la presencia o no de ITS con variables sociodemográficas e indicadores de riesgo. METODOS: Se realizó un estudio observacional, transversal y analítico, elaborado en el Centro de Orientación y Enfermedades de Transmisión Sexual de Granada. Se revisaron las historias clínicas de 374 inmigrantes, extraídas de una muestra de 1.455 historias de sujetos con sospecha de padecer una ITS, correspondientes al periodo 2000-2014. Se realizó análisis univariante, bivariante mediante U de Mann-Whitney y test de chi cuadrado, además de regresión logística múltiple. RESULTADOS: La edad media de los sujetos fue de 28,28 años (Dt=7,54). El 69,3% eran mujeres y el 30,7% hombres, procedentes del Mercado Común del Sur (39%) y Unión Europea (35,6%), fundamentalmente. Un 36,1% eran profesionales o ex profesionales del sexo, un 34,5% tenía estudios superiores y un 79,9% eran solteros. Un 70% de los casos tuvo un diagnóstico positivo de ITS, siendo la más prevalente el Virus del Papiloma Humano. El número de parejas en el último año (OR=1,39; IC 95%=1,12-1,74; p=0,002) se asoció significativamente a la presencia de ITS. CONCLUSIONES: En la muestra, que es principalmente de mujeres, profesionales o ex profesionales del sexo, jóvenes, procedentes de Sudamérica y Europa, hay una prevalencia alta de ITS y un mayor riesgo a medida que aumenta el número de parejas en el último año.

The Design and validation of a Nursing Plan for Elderly Patients with Postoperative Delirium.

Delirium is the sudden alteration of the state of consciousness and perception, fluctuating over hours or days. It predominates in older adults and is associated with the aging process. The incidence of delirium increases between 10% and 15% in surgical interventions. The objective of this study was the design and validation of a nursing care plan for elderly patients with postoperative delirium. This study was based on the Delphi method and applied to nursing professionals at the Hospital Universitario del Caribe, Cartagena. The sample consisted of 36 nurses with knowledge of the taxonomy of nursing diagnoses. The care plan was applied in two rounds. For the analysis, measures of central tendency and dispersion were used, as well as frequency and percentages. The participants were women (90.9%) from the hospitalization service (51.5%), with training in Nursing Diagnosis (NANDA), Nursing interventions classification (NIC) and Nursing Outcome Classifications (NOC) (78.8%). The validated care plan has eight diagnostic features. Highlights include "Risk for Ineffective Cerebral Tissue Perfusion" and "Disturbed Sleep Pattern" (in 98.1%; 11 results), with the highest score in the first round being "Vital Signs" (with 100%) and "Sleep" (100%) and "Mobility" (100%) in the second round. Forty-four interventions and 18 suggested activities were identified. This care plan offers the nursing professionals reliable and pertinent tools in clinical practice for the management of patients with postoperative delirium.

Understanding the Occupational Adaptation Process and Well-Being of Older Adults in Magallanes (Chile): A Qualitative Study.

Background: Aging and longevity are important topics nowadays. Purpose: To describe how older adults perform the occupational adaptation process in the extreme region of Magallanes (Chile), and to identify the factors that might contribute to successful occupational adaptation and well-being. Method: Qualitative study, with a phenomenological interpretative approach. In-depth interviews were carried out with 16 older adults, with high or low levels of well-being, assessed with the Ryff Scale. An inductive content analysis according to Elo and Kyngäs was performed. Findings: Resilience, self-esteem and interdependence with significant others are key elements that promote well-being. Participants develop strategies to minimize the effects of environmental factors. The occupation's function in terms of socialization, use of time, and social participation is revealed as a conditioning factor of occupational adaptation. Implications: Interventions with older people to achieve a successful occupational adaptation process must take into consideration the commitment to meaningful activities.

Sexually Transmitted Infections and Associated Factors in Homosexuals and Bisexuals in Granada (Spain) During the Period 2000-2015.

Sexually transmitted infections (STIs) are a major public health issue. Previous research shows the vulnerability of the homosexual and bisexual population, as well as the influence of economic, political, and cultural determinants. The aim of this study was to describe the socio-demographic healthcare profile and the main risk factors associated with STIs in homosexuals and bisexuals seen at the STI clinic in Granada (Spain) during the years 2000-2015. Infection prevalences were compared between the economic crisis period (2008-2014) and the rest of the years analysed. A cross-sectional observational and analytical study was conducted by reviewing 261 clinical records of individuals with suspected or present infection. Univariate, bivariate, and multivariate analyses were performed. 91.2% of the individuals were men, and 8.8% were women, with the mean age being 28.61 (SD = 9.35, Range = 17-74) years old. The prevailing sexual orientation identity was homosexual. 94.2% were single. The main reason for consultation was HIV. Differences in prevalence were found between crisis and non-crisis years (OR = 3.91; 95% CI = 1.73-9.19). In conclusion, their profile was that of a young, single man suspecting possible HIV infection. STI prevalence was significantly higher in the years of economic recession in comparison to the rest of the years.

Differences in Sexually Transmitted Infections between the Precrisis Period (2000⁻2007) and the Crisis Period (2008⁻2014) in Granada, Spain.

OBJECTIVE: To analyze the difference in the prevalence of sexually transmitted infections (STIs) between two time periods (2000⁻2007 and 2008⁻2014, with the latter period characterized by the economic crisis), as well as determine differences in sociodemographic factors, clinical care, and risk indicators. METHODS: This was a retrospective, observational, and analytical study, reviewing 1437 medical records of subjects attending a specialized center in the province of Granada (Spain) for consultation associated with the presence or suspicion of an STI between 2000⁻2014. Data were collected on variables relating to the research objective. A descriptive and bivariate statistical analysis was performed by multiple logistic regression. RESULTS: In the analysis comparing the presence of STIs between the crisis and non-crisis periods, the percentage of positive diagnoses reached 56.6% compared to 43.4% negative diagnoses during the non-crisis period, while the percentages were 75.2% and 24.8%, respectively, during the crisis period. This difference was statistically significant (p < 0.001) with an odds ratio (OR) of 2.21 after adjusting for age, sex, days since last unprotected sexual intercourse, and partners in the last year. CONCLUSIONS: There are significant differences in the prevalence of STIs between the study periods, which is consistent with the reports of some authors regarding the effect of the financial crisis on these conditions; however, it is worth considering other aspects that might explain the differences.

Level of Cultural Self-Efficacy of Colombian Nursing Professionals and Related Factors.

PURPOSE: To describe the level of cultural self-efficacy of Colombian nursing professionals and determine the main influencing factors. METHOD: A descriptive, analytical cross-sectional study was conducted in 211 nursing professionals selected by systematic random sampling for a finite population, using the Colombian version of the Cultural Self-Efficacy Scale. After descriptive statistical analysis, nonparametric tests were applied to determine between-variable associations, followed by multiple linear regression analysis. RESULTS: The mean Cultural Self-Efficacy Scale score was 2.58. An association with sex and age ( p < .05) was observed in regression analysis. The mean score for knowledge of cultural concepts was 3.20 and associated with age, years of experience, educational level, and cross-cultural experiences ( p < .05). The mean score for confidence in performing cultural nursing skills was 3.29. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The cultural self-efficacy level of this sample of nursing professionals, with their consequent capacity to provide culturally competent care, is moderate and is associated with sex and age. Confidence in knowledge of cultural concepts is affected by age, educational level, years of experience, and cross-cultural experiences. This evidence supports the implementation of changes to improve the cultural knowledge and therefore cultural self-efficacy of these professionals.

Ostomy patients' perception of the health care received.

AIM: to describe ostomy patient's perception about health care received, as well as their needs and suggestions for healthcare system improvement. METHOD: qualitative phenomenological study was conducted, involving individual and semi-structured interviews on the life experiences of 21 adults who had a digestive stoma. Participants were selected following a purposive sampling approach. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stoma therapy nurses. The software Atlas.ti was used. RESULTS: perception of health care received is closely related to the information process, as well as training for caring the stoma from peristomal skin to diet. It is worthy to point out the work performed by stoma care nurses ensuring support during all stages of the process. CONCLUSION: findings contribute to address the main patients' needs (better prepared nurses, shorter waiting lists, information about sexual relation, inclusion of family members all along the process) and recommendations for improving health care to facilitate their adaptation to a new status of having a digestive stoma.

Culture-bound syndromes in migratory contexts: the case of Bolivian immigrants.

Objective: to describe the culture-bound syndromes maintained by Bolivian immigrants in the new migratory context and analyze the care processes of these health problems. Method: qualitative research with an ethnographic methodological approach. Sample: 27 Bolivian immigrants. In-depth interviews and participatory observation were the strategies used for data collection. Data were classified and categorized into logical schemes manually and using the ATLAS-ti program v.5. Results: susto, "wayras", amartelo, pasmo de sol, pasmo de luna and pasmo de sereno are some of the folk illnesses that affect the Bolivian immigrants and that they have to treat in the new migratory context. Conclusions: in the new environment, the group under study preserves culture-bound syndromes that are common in their country of origin. The care strategies used for these health problems are adapted to the resources of the new context and based on interactions with the domestic environment, biomedicine and traditional medicine. It was observed the need for the health professionals to realize that the efficacy of certain therapies occurs within the scope of cultural beliefs and not in that of the scientific evidence.

Cultural Adaptation and Validation of the Cultural Self-Efficacy Scale for Colombian Nursing Professionals.

PURPOSE: The level of cultural self-efficacy indicates the degree of confidence nursing professionals possess for their ability to provide culturally competent care. Cultural adaptation and validation of the Cultural Self-Efficacy Scale was performed for nursing professionals in Colombia. DESIGN: A scale validation study was conducted. METHOD: Cultural adaptation and validation of the Cultural Self-Efficacy Scale was performed using a sample of 190 nurses in Colombia, between September 2013 and April 2014. This sample was chosen via systematic random sampling from a finite population. RESULTS: The scale was culturally adapted. Cronbach's alpha for the revised scale was .978. Factor analysis revealed the existence of six factors grouped in three dimensions that explained 68% of the variance. CONCLUSION: The results demonstrated that the version of the Cultural Self-Efficacy Scale adapted to the Colombian context is a valid and reliable instrument for determining the level of cultural self-efficacy of nursing professionals.

Ostomy patients' perception of the health care received / Percepção de pacientes ostomizados sobre os cuidados de saúde recebidos / Percepción de las personas ostomizadas sobre la atención de salud recibida

ABSTRACT Aim: to describe ostomy patient's perception about health care received, as well as their needs and suggestions for healthcare system improvement. Method: qualitative phenomenological study was conducted, involving individual and semi-structured interviews on the life experiences of 21 adults who had a digestive stoma. Participants were selected following a purposive sampling approach. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stoma therapy nurses. The software Atlas.ti was used. Results: perception of health care received is closely related to the information process, as well as training for caring the stoma from peristomal skin to diet. It is worthy to point out the work performed by stoma care nurses ensuring support during all stages of the process. Conclusion: findings contribute to address the main patients' needs (better prepared nurses, shorter waiting lists, information about sexual relation, inclusion of family members all along the process) and recommendations for improving health care to facilitate their adaptation to a new status of having a digestive stoma.

RESUMO Objetivo: descrever a percepção dos pacientes ostomizados sobre os cuidados de saúde recebidos, bem como suas necessidades e sugestões para melhorar o sistema de saúde. Método: foi realizado um estudo fenomenológico qualitativo, envolvendo entrevistas individuais e semiestruturadas sobre as experiências de vida de 21 adultos com estoma digestivo. Os participantes foram selecionados seguindo uma abordagem de amostragem proposital. A análise se baseou na comparação constante dos dados, na incorporação progressiva dos sujeitos e na triangulação entre pesquisadores e enfermeiros estomaterapeutas. O software Atlas.ti foi utilizado. Resultados: a percepção sobre os cuidados de saúde recebidos está intimamente relacionada ao processo de informação e à formação para cuidar do estoma, abrangendo desde a pele periestomal até a dieta. O trabalho realizado pelos enfermeiros estomaterapeutas deve ser destacado, garantindo suporte durante todas as etapas do processo. Conclusão: os resultados contribuem para atender às principais necessidades dos pacientes (enfermeiras melhor preparadas, listas de espera mais curtas, informações sobre relações sexuais, inclusão de membros da família ao longo do processo) e recomendações para melhorar os cuidados de saúde para facilitar sua adaptação à nova condição de ostomizado digestivo.

RESUMEN Objetivo: Describir la percepción que los pacientes con estoma tienen sobre los cuidados de salud recibidos así como las necesidades y sugerencias para mejorar el sistema de salud. Método: Estudio cualitativo descriptivo de carácter fenomenológico, realizando entrevistas individuales semi-estructuradas sobre las experiencias de vida de 21 adultos que portaban un estoma digestivo. La selección se hizo mediante un muestreo intencional. El análisis se basó en la comparación constante de datos, la progresiva incorporación de sujetos y triangulación entre investigadores y expertos en estomaterapia. Se usó el software Atlas-ti. Resultados: la percepción de la atención recibida está íntimamente ligada al proceso de información, así como a la formación para el cuidado del estoma desde la piel periestomal hasta la dieta. Se debe resaltar el trabajo de la enfermera estomaterapeuta, garantizando el soporte durante todas las fases del proceso. Conclusiones: los resultados contribuyen a señalar las principales necesidades de los pacientes (enfermeras mejor preparadas, listas de espera más cortas, información sobre relaciones sexuales, inclusión de los familiares a lo largo del proceso) y recomendaciones para mejorar los cuidados y así facilitar su adaptación al nuevo estado de portar un estoma digestivo.

Culture-bound syndromes in migratory contexts: the case of Bolivian immigrants / Síndromes vinculadas à cultura nos processos migratórios: o caso dos imigrantes bolivianos / Síndromes culturalmente definidos en los procesos migratorios: el caso de los inmigrantes bolivianos

ABSTRACT Objective: to describe the culture-bound syndromes maintained by Bolivian immigrants in the new migratory context and analyze the care processes of these health problems. Method: qualitative research with an ethnographic methodological approach. Sample: 27 Bolivian immigrants. In-depth interviews and participatory observation were the strategies used for data collection. Data were classified and categorized into logical schemes manually and using the ATLAS-ti program v.5. Results: susto, "wayras", amartelo, pasmo de sol, pasmo de luna and pasmo de sereno are some of the folk illnesses that affect the Bolivian immigrants and that they have to treat in the new migratory context. Conclusions: in the new environment, the group under study preserves culture-bound syndromes that are common in their country of origin. The care strategies used for these health problems are adapted to the resources of the new context and based on interactions with the domestic environment, biomedicine and traditional medicine. It was observed the need for the health professionals to realize that the efficacy of certain therapies occurs within the scope of cultural beliefs and not in that of the scientific evidence.

RESUMO Objetivo: descrever as síndromes vinculadas à cultura mantidas pelos imigrantes bolivianos no novo contexto migratório e analisar os processos de cuidado para esses problemas de saúde. Método: projeto de pesquisa de natureza qualitativa e com abordagem metodológica etnográfica. Amostra: 27 imigrantes bolivianos. As estratégias para a coleta de dados foram as entrevistas em profundidade e a observação participativa. Os dados foram classificados e categorizados em esquemas lógicos manualmente e por meio do programa ATLAS-ti v.5. Resultados: o susto, os "wayras", o amartelo (tristeza), o pasmo de sol, o pasmo de lua e o pasmo de sereno são algumas das síndromes de caráter popular que acometem os imigrantes bolivianos, e que eles tratam no novo contexto migratório. Conclusões: no novo ambiente, as síndromes vinculadas à cultura, comuns em seu país de origem, são mantidas pelo grupo estudado. As formas de cuidado para esses problemas de saúde são adaptadas aos recursos do novo contexto e baseadas em interações com o ambiente doméstico, a biomedicina e a medicina tradicional. Foi constatada a necessidade de que os profissionais de saúde reconheçam que a eficácia de determinadas terapias se dá no âmbito das crenças culturais e não no âmbito da comprovação científica.

RESUMEN Objetivo: describir los síndromes de filiación cultural que mantienen los inmigrantes bolivianos en el nuevo contexto migratorio y analizar los procesos de atención de estos padecimientos. Método: diseño de investigación de carácter cualitativo con enfoque metodológico etnográfico. Muestra: 27 inmigrantes bolivianos. Las estrategias para recoger datos fueron las entrevistas en profundidad y la observación participante. Los datos se categorizaron y ordenaron en esquemas lógicos manualmente y a través del programa ATLAS-ti v.5. Resultados: el susto, los "wayras", el amartelo, el pasmo de sol, el pasmo de luna y el pasmo de sereno son algunos de los síndromes de carácter folk que los inmigrantes bolivianos padecen y tratan en el nuevo contexto migratorio. Conclusiones: en el nuevo entorno, el colectivo estudiado mantiene síndromes de filiación cultural comunes en su país de origen. Las formas de atención de éstos padecimientos se adaptan a los recursos del nuevo contexto y se basan en transacciones con el ámbito doméstico, la biomedicina y la medicina tradicional. Se constata la necesidad de que el profesional sanitario reconozca que la efectividad percibida de ciertas terapias opera dentro del ámbito de las creencias culturales y no en el de la evidencia científica.

Experiences and coping with the altered body image in digestive stoma patients.

Objective: to describe the coping of stoma patients with the news about the ostomy, as well as to analyze the meaning and the experience of their new bodily reality. Method: qualitative phenomenological study undertaken through semistructured interviews with 21 stoma patients. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stomal therapy nurses. The software Atlas.ti was used. Results: two main categories emerge: "Coping with the news about receiving a stoma" and "Meaning and experience of the new bodily reality". The informants' answer varies, showing situations that range from the natural acceptance of the process to resignation and rejection. The previous experiences of other family members, the possible reconstruction of the stoma or the type of illness act as conditioning factors. Conclusions: the coping with the news about the stoma is conditioned by the type of illness, although the normalization of the process is the trend observed in most informants. Nursing plays a fundamental role in the implementation of cognitive-behavioral interventions and other resources to promote the patients' autonomy in everything related to care for the stoma.

Factores sociodemográficos y de participación social relacionados con el bienestar psicológico en adultos mayores en la región de Magallanes, Chile / Wellbeing of Chilean older adults is associated with group participation

Background: Subjective aspects such as personal growth and the development of their potential are relevant for the perception of wellbeing of older adults. These dimensions appear to be connected with meaningful group participation. Aim: To assess the perception of psychological wellbeing of older adults in a Chilean region and determine its association with socio-demographic variables and participation in organizations. Material and Methods: Ryff’s scale of psychological wellbeing perception was applied to 101 adults (43 men) from Magallanes, aged 60 and 88 years. Sociodemographic data was also collected. Results: Mean wellbeing scores reported were 193.7 ± 20 (maximum score: 234). Those older adults who participated in organizations had higher scores than those who did not take part in them. Participation in organizations appeared to be specifically associated to positive relationships (p = 0.03) and personal growth (p < 0.01). The number of organizations in which older adults participated was positively correlated with the perception of wellbeing (p < 0.01). Greater personal wellbeing was associated with leadership roles in organizations (p = 0.01). Significant differences between level of schooling and personal growth (p = 0.01) were also observed found. There were no differences associated with sex, age and marital status. Conclusions: The perception of wellbeing of older adults is influenced by their participation in organizations. Leadership is associated with the highest levels of wellbeing.

Palliative care team visits. Qualitative study through participant observation.

OBJECTIVES: To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. METHODS: A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. RESULTS: The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. CONCLUSION: Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

OBJETIVOS: Conocer cómo se produce el encuentro clínico en la atención a los enfermos por parte de un equipo de Cuidados Paliativos, y qué elementos lo condicionan, indicando si son favorables o desfavorables en función de las expectativas y los sentimientos de los distintos participantes. MÉTODOS: Estudio de casos cualitativo, realizado mediante observación participante. Se realizaron 12 observaciones de los encuentros de los equipos de cuidados paliativos con los pacientes y familiares en diferentes entornos (domicilio, hospital y consulta). El tipo de visitas fueron de seguimiento o primera visita, programadas o a demanda. Se realizó un análisis de contenido de las observaciones. RESULTADOS: El análisis mostró una actividad normal de seguimiento de una unidad de cuidados paliativos centrada en el control de síntomas, la comunicación de información y el asesoramiento sobre pautas terapéuticas y cuidados. Se observó que los escenarios condicionan la expresión de los pacientes y el modo de relación. Como condiciones favorables del encuentro clínico destacan la afabilidad y la gratitud. Las condiciones desfavorables fueron el deterioro por la cercanía de la muerte, los objetivos poco realistas de los familiares y la escasez de recursos. CONCLUSIÓN: Las visitas domiciliarias de equipos básicos en Cuidados Paliativos tienen un importante papel, y parecen estar centradas en el control de síntomas y condicionadas por los recursos disponibles.