Entrega de malas noticias: emociones experimentadas por internos de obstetricia en un escenario clínico simulado / Breaking bad news: emotions experienced by midwifery students in a simulated clinical scenario

Objetivo: Identificar y analizar la respuesta emocional de un grupo de internos de Obstetricia durante el desarrollo de un escenario clínico simulado de entrega de malas noticias en salud. Métodos: Estudio cualitativo con enfoque fenomenológico en el que participaron 21 estudiantes de último año de la carrera de Obstetricia de la Universidad Mayor de Santiago de Chile durante el año 2019. Posteriormente a la simulación clínica con paciente estandarizado se realizaron cuestionarios y entrevistas semiestructuradas, que fueron analizados mediante Análisis Temático Cualitativo. Resultados: Emergieron una categoría central (Emociones experimentadas durante el proceso) y cuatro subcategorías (Autopercepción de emociones en el ejercicio simulado; Emociones y malestar ante la entrega de malas noticias en salud; Sentimientos encontrados y su afección en el desempeño de la actividad; y Gestión y estrategias para la entrega de malas noticias en salud). El miedo y la ansiedad fueron las emociones más referidas, vinculadas principalmente al desconocimiento sobre la posible respuesta del paciente. La tristeza y la empatía se relacionaron con experiencias propias. Las manifestaciones físicas de la emoción pueden tornarse intensas, pudiendo desorganizar y/o bloquear el desempeño. Por último, la principal estrategia de respuesta utilizada por los estudiantes fue la represión de sus propias emociones. Conclusiones: La simulación clínica de alta fidelidad con paciente estandarizado es una herramienta muy útil para el desarrollo de competencias de entrega de malas noticias en salud. Abogamos por incorporar la educación emocional en la formación de matronas y matrones. (AU)

Objective: To identify and analyze the emotional response of a group of Obstetrics interns during the development of a simulated clinical scenario of delivering bad health news. Methods: Qualitative study with a phenomenological approach in which 21 senior students of the Obstetrics career of the Universidad Mayor de Santiago de Chile participated during the year 2019. Questionnaires and semi-structured interviews were carried out after the clinical simulation with a standardized patient, the that were analyzed through Qualitative Thematic Analysis. Results: A central category emerged (Emotions experienced during the process) and four subcategories (Self-perception of emotions in the simulated exercise; Emotions and discomfort when delivering bad health news; Mixed feelings and their effect on the performance of the activity; and Management and strategies for the delivery of bad health news). Fear and anxiety were the most frequently reported emotions, mainly linked to ignorance about the patient's possible response. Sadness and empathy were related to their own experiences. Physical manifestations of emotion can become intense, disorganizing and/or blocking performance. Finally, the main response strategy used by the students was the repression of their own emotions. Conclusions: High-fidelity clinical simulation with a standardized patient is a very useful tool for developing skills in delivering bad news in health. We advocate incorporating emotional education in the training of midwives and midwives. (AU)

Childhood Socioeconomic Position and Cardiovascular Disease Among Older Women and Men: The Moderating Role of Parenthood Onset.

Objectives: Based on a life-course approach, the purpose of this study is to analyze how the age at the birth of a first child moderates the relationship between childhood socioeconomic position (SEP) and cardiovascular diseases (CVD) incidence in old age, separately for women and men. Methods: We used a rich and representative life history survey of people aged from 65 to 75 living in Santiago, Chile (n = 802), and weighted multivariate statistical models. Data collection process involved the use of face-to-face life history calendars, administered by well-trained interviewers. Results: Early motherhood increases the risk of suffering CVD among older women with a disadvantaged childhood SEP, while late motherhood decreases it. By contrast, early fatherhood decreases CVD risk among older men with an adverse childhood SEP, while late fatherhood increases it. Conclusion: Our findings about the moderating role of parenthood onset on CVD risk among older women and men with a disadvantaged childhood SEP contributes to public health reflections on unexplored cardiovascular risk factors, which lead to substantial changes in women's and men's life courses, and might optimize cardiovascular prevention strategies.

Implementation of a programme to develop research projects in a school of midwifery in Santiago, Chile.

BACKGROUND: The acquisition of research skills by midwifery students is increasingly important especially for midwifery programmes in universities. Recently, universities in Chile have included the development of research skills in the majority of professional curricula for basic and post-basic degree programmes. The lack of research training is a limitation recognised and shared with other Latin American countries which prevents scientific and technological development. OBJECTIVES: To describe the process of implementation of a programme of research projects by midwifery students in a school in Chile and the results obtained, and the perceptions of students and teachers. RESULTS: 31 work groups were formed (92 students), who developed and implemented research projects in gynecology, public health and neonatology. Research was conducted at six public hospitals serving high risk populations, a private clinic, and nine family health centres. The average scores earned for the projects was a 5.7 (scale of 1-7). The students and teachers positively rated the experience of undertaking research. CONCLUSION: The development of research projects allows students to acquire competencies and confidence in their research skills. It is an experience that can be replicated in other countries supported by the commitment of the midwifery and university faculty and the training and motivation of a group of midwifery educators.