Kaleidoscope of emotions in hospital childbirth: A phenomenological study.

The childbirth process represents a moment of transition in the life of each woman, and is a source of complex and dynamic emotions. The aim of this study was to describe the emotions women experience during hospital childbirth and to determine the conditioning factors. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with 42 women. The negative emotions the women highlighted were fear, anguish, suffering, concern and nervousness, and they were related to factors such as: the evolution of childbirth, the appearance of complications, pain, the doubt about the ability to give birth and poor communication. The positive emotions highlighted were joy, satisfaction, security, confidence and tranquillity, and they were related to the first skin-to-skin contact, effective communication, partner support and participation in decisions. The findings may contribute to the development of policies aimed at achieving the women and newborns' maximum health and life potential.

The voice of memory in hospital birth: A phenomenological study.

OBJECTIVE: To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception. DESIGN: This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software. PARTICIPANTS: 43 women participated in the first interview, and 33 of those participated in the second interview. SETTING: Donostia University Hospital, Gipuzkoa, Spain, 2016-2017. FINDINGS: Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Hospital Childbirth: Perspectives of Women and Professionals for a Positive Experience-A Qualitative Study.

The perception and interpretation of childbirth are changing as values change. This requires women and professionals to adapt to new circumstances. The objective of this study was to analyze the perspectives of women and professionals on hospital birth and to identify improvement areas in order to achieve a positive perinatal experience. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with women, two and eight months after childbirth, participant observation, and professional focus groups. The analysis of the transcribed texts involved a thematic inductive approach. Four improvement areas emerged from the analysis: (a) strengthening communication and the therapeutic relationship; (b) unifying criteria between hospitals and primary care centers to provide coordinated and coherent information; (c) involvement of the partner in the whole process of pregnancy-childbirth-puerperium; (d) improvement of the spaces used in prenatal care and births. The need for a continuity of care from the beginning of pregnancy to the postpartum period is emphasized, which requires an improvement in information, participation, and the promotion of shared decision-making. To this end, coordinated interdisciplinary work, involvement of the partner and the improvement of the spaces used in prenatal care and births are essential.

A qualitative study of hospital birth perceptions: The helix of priority needs.

OBJECTIVE: To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women. DESIGN: This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach. PARTICIPANTS: The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth. SETTING: Donostia University Hospital, San Sebastián, Spain, in 2016-2017. FINDINGS: Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.

Significado de la experiencia del cuidado en el parto hospitalario: voces de las profesionales / The meaning of care experience with hospital births: voices of the professionals

Objetivo: Abordar el significado de la experiencia del cuidado en el parto hospitalario desde la perspectiva de las profesionales. Metodología: Metodología cualitativa fenomenológica interpretativa mediante grupos focales formados por profesionales del Servicio de Partos del Hospital Universitario Donostia. El análisis de los textos incluyó una comparación cíclica para obtener los temas principales que definen el fenómeno. Resultados: Tras la práctica reflexiva realizada por las profesionales, se han detectado cambios en las demandas que las mujeres realizan durante el parto hospitalario, observando que han pasado de tener un talante totalmente pasivo a presentar diferentes comportamientos, que van desde la indiferencia hasta la actitud activa partícipe. Respecto a la necesidad de control, seguridad y responsabilidad, el aumento de las demandas es una de las características más frecuentemente señaladas. La información constante, antes, durante y después del parto, es la reclamación más evidente identificada. La interacción constante entre estos elementos y la influencia de los cambios socioculturales continuos resultan fundamentales para entender el significado de la experiencia de cuidado en el parto hospitalario y poder realizar propuestas de mejora. Conclusiones: La adaptación continua al contexto sociocultural precisa contemplar una gestión innovadora en la que se respete la voluntad de las mujeres, y que los profesionales no perciban por ello temor a obtener resultados adversos. Las profesionales observan la necesidad de establecer protocolos interdisciplinarios de información y continuidad de los cuidados

Aim: To address the meaning of care experience with hospital births from the perspective of professionals. Methodology: A qualitative design using a phenomenology approach with focus groups made up of professionals from the Birthing Unit at Donostia University Hospital. The analysis of the texts included a constant cyclic comparison in order to obtain the main issues that define the phenomenon. Results: After reflective practice carried out by professionals, changes in the demands women make during hospital births have been detected. It has been observed that their disposition changed from being completely passive, to presenting different behaviours ranging from indifference to an attitude of active participation. With regards to the need for control, safety and responsibility, the increase in demands is one of the most frequently indicated characteristics. Constant information before, during and after the birth is the most noticeable demand identified. Constant interaction between these elements and the influence of continuous sociocultural changes are fundamental in order to understand the meaning of care experience with hospital births and to be able to make proposals for improvement. Conclusions: Continuous adaptation to the sociocultural context requires the consideration of innovative management where the wishes of women are respected, and where professionals therefore aren't afraid to obtain adverse results. The professionals see the need to establish interdisciplinary information protocols and continuity of care

The Use of the Nursing Process in Spain as Compared to the United States and Canada.

PURPOSE: To analyze the development of the nursing method process in Spain, and compare it with the development in the United States and Canada. METHODS: This is a narrative review. FINDINGS: The teaching of the nursing process in nursing schools started in Spain as from 1977 and that it started being used in professional practice in the 1990's. The development, the difficulties, the nursing models used and its application form are discussed. CONCLUSIONS: The development of the nursing process in the United States and Canada started to happen in Spain about 15-20 years later and, today, is a reality. IMPLICATIONS: Cross-sectional studies are needed to determine the changes in the development of the nursing process in Spain.

Implementation of the nursing process in a health area: models and assessment structures used.

OBJECTIVE: To analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). METHOD: A retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: The Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. CONCLUSION: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures.

Implementation of the nursing process in a health area: models and assessment structures used / Implementação do processo de enfermagem em uma área da saúde: modelos e estruturas de avaliação utilizados / Implantación del proceso de enfermería en un área de salud: modelos y estructuras de valoración utilizados

OBJECTIVE: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). METHOD: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. CONCLUSION: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures. .

OBJETIVO: analisar quais modelos de enfermagem e estruturas de avaliação de enfermagem têm sido utilizados na implementação do processo de enfermagem, nos centros públicos e privados da área de saúde de Gipuzkoa (País Basco). MÉTODO: foi realizado um estudo retrospectivo, baseado na análise dos registros de enfermagem que utilizaram os 158 centros estudados. RESULTADOS: o modelo de Henderson, a estrutura bifocal de Carpenito, a estrutura de avaliação de Gordon e a estrutura Resident Asessment Instrument Home 2.0 foram os modelos e estruturas de avaliação de enfermagem utilizados na implementação do processo de enfermagem. Em alguns centros, o modelo ou estrutura de avaliação escolhido mudou ao longo do tempo. CONCLUSÃO: foi concluído que o modelo de Henderson foi o mais utilizado na implementação do processo de enfermagem. Além disso, foi observada a tendência de complementar ou substituir o modelo de Henderson com estruturas de avaliação de enfermagem. .

OBJETIVO: analizar qué modelos de enfermería y estructuras de valoración de enfermería se han utilizado a la hora de implantar el proceso de enfermería en los centros públicos y privados del área de salud de Gipuzkoa (País Vasco). MÉTODO: se realizó un estudio retrospectivo, basado en el análisis de los registros de enfermería que han utilizado los 158 centros estudiados. RESULTADOS: el modelo de Henderson, la estructura bifocal de Carpenito, la estructura de valoración de Gordon y la estructura Resident Assessment Instrument Nursing Home 2.0 han sido los modelos y estructuras de valoración de enfermería utilizados a la hora de implantar el proceso de enfermería. En algunos centros el modelo o estructura de valoración elegido ha ido variando con el paso del tiempo. CONCLUSIÓN: se concluye que el modelo de Henderson ha sido el más utilizado a la hora de implantar el proceso de enfermería. Asimismo, se observa la tendencia de complementar o sustituir el modelo de Henderson con estructuras de valoración de enfermería. .

Retrospective study of the implementation of the nursing process in a health area.

OBJECTIVES: To analyze when the nursing process began to be used in the public and private healthcare centers of Gipuzkoa (Basque Country), and when both NANDA-I nursing diagnoses and the NIC-NOC terminologies were incorporated into this process. METHOD: A retrospective study was conducted, based on the analysis of nursing records that were used in the 158 studied centers. RESULTS: The specific data provided showed that in Gipuzkoa, the nursing process began to be used in the 1990s. As for NANDA-I nursing diagnoses, they have been used since 1996, and the NIC-NOC terminologies has been used since 2004. CONCLUSION: It was concluded that public centers are the ones which, generally speaking, first began with the nursing methodology, and that in comparison to the United States and Canada, the nursing process started to be used about 20 years later, NANDA-I nursing diagnoses around 15 years later, and the NIC-NOC terminologies, around six years later.

Retrospective study of the implementation of the nursing process in a health area / Estudo retrospectivo da implementacao do processo de enfermagem em uma area de saude / Estudio retrospectivo de la implantacion del proceso de enfermeria en un area de salud

OBJECTIVES: to analyze when the nursing process began to be used in the public and private healthcare centers of Gipuzkoa (Basque Country), and when both NANDA-I nursing diagnoses and the NIC-NOC terminologies were incorporated into this process. METHOD: a retrospective study was conducted, based on the analysis of nursing records that were used in the 158 studied centers. RESULTS: the specific data provided showed that in Gipuzkoa, the nursing process began to be used in the 1990s. As for NANDA-I nursing diagnoses, they have been used since 1996, and the NIC-NOC terminologies has been used since 2004. CONCLUSION: it was concluded that public centers are the ones which, generally speaking, first began with the nursing methodology, and that in comparison to the United States and Canada, the nursing process started to be used about 20 years later, NANDA-I nursing diagnoses around 15 years later, and the NIC-NOC terminologies, around six years later. .

OBJETIVOS: analisar os períodos de início da aplicação do processo de enfermagem em centros de saúde públicos e privados de Gipuskoa, País Basco, e da incorporação tanto do diagnóstico de enfermagem da NANDA-I quanto das terminologias Classificação de Intervenções em Enfermagem e Classificação de Resultados em Enfermagem a essa atividade. MATERIAIS E MÉTODOS: estudo retrospectivo, realizado por meio da análise de registros de enfermagem utilizados nos 158 centros de saúde que compuseram os locais de estudo. RESULTADOS: os dados coletados mostraram que, em Gipuskoa, o processo de enfermagem começou a ser utilizado na década de 1990. O diagnóstico de enfermagem da NANDA-I tem sido usado desde 1996, e as terminologias Classificação de Intervenções em Enfermagem e Classificação de Resultados em Enfermagem têm sido usadas desde 2004. CONCLUSÃO: conclui-se que os centros de saúde públicos são os que, de forma geral, iniciaram primeiramente a metodologia do processo de enfermagem, e que, em comparação com os Estados Unidos da América e o Canadá, a implementação do processo de enfermagem foi iniciada cerca de 20 anos depois, o uso de diagnósticos de enfermagem da NANDA-I cerca de 15 anos depois, e o uso das terminologias Classificação de Intervenção em Enfermagem e Classificação de Resultados em Enfermagem em torno de 6 anos após. .

OBJETIVOS: analizar cuándo se comienza a utilizar el proceso de enfermería en los centros públicos y privados del área de salud de Gipuzkoa (País Vasco) y cuándo se incorporan a dicho proceso tanto los diagnósticos de enfermería de NANDA-I, como las terminologías NIC-NOC. MÉTODO: se realizó un estudio retrospectivo, basado en el análisis de los registros de enfermería que han utilizado los 158 centros estudiados. RESULTADOS: se aportan fechas concretas que muestran que en Gipuzkoa se empieza a utilizar el proceso de enfermería en la década de 1990. En cuanto a los diagnósticos enfermeros de NANDA-I, se utilizan a partir de 1996, y las terminologías NIC-NOC, a partir de 2004. CONCLUSIÓN: se concluye que son los centros públicos los que, de forma generalizada, comenzaron primero con la metodología enfermera, y que en comparación con los Estados Unidos de América y Canadá, en Gipuzkoa el proceso de enfermería se comienza a utilizar alrededor de 20 años más tarde, los diagnósticos de enfermería de NANDA-I, en torno a 15 años más tarde, y las terminologías NIC-NOC, alrededor de 6 años más tarde. .

Use of the nursing process at public and private centers in a health area.

AIM: to analyze whether the nursing process method is used at public and private centers in the health area Gipuzkoa (Basque Country) and, if yes, to analyze in the framework of which model and how it is used. METHOD: cross-sectional study, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the nursing process is applied at 98% of the centers. It is applied at all public and 18 out of 21 private centers. Virginia Henderson's model is the most used to apply it, and most centers use nursing diagnoses, the NIC-NOC terminology and standardized care plans. CONCLUSION: the use of the nursing process is widespread in Gipuzkoa, with greater use at public than at private centers.

Use of the nursing process at public and private centers in a health area / Uso do processo de enfermagem nos serviços públicos e privados de um distrito de saúde / Uso del proceso de enfermería en los centros públicos y privados de un área de salud

AIM: to analyze whether the nursing process method is used at public and private centers in the health area Gipuzkoa (Basque Country) and, if yes, to analyze in the framework of which model and how it is used. METHOD: cross-sectional study, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the nursing process is applied at 98% of the centers. It is applied at all public and 18 out of 21 private centers. Virginia Henderson's model is the most used to apply it, and most centers use nursing diagnoses, the NIC-NOC terminology and standardized care plans. CONCLUSION: the use of the nursing process is widespread in Gipuzkoa, with greater use at public than at private centers.

OBJETIVO: analisar se a metodologia do processo de enfermagem é utilizada nos serviços públicos e privados do distrito de saúde de Gipuzkoa (País Basco) e, caso seja, analisar sob qual modelo de enfermagem e de que maneira é utilizada. MÉTODO: estudo transversal, baseado na análise dos registros de enfermagem usados pelos 158 serviços estudados. RESULTADOS: o processo de enfermagem aplica-se em 98% dos serviços estudados. É aplicado em todos os serviços públicos e em 18 dos 21 serviços privados. O modelo de Virginia Henderson é o mais utilizado para aplicá-lo, e o uso dos diagnósticos de enfermagem, da terminologia NOC-NIC e dos protocolos de cuidados padronizados é majoritário. CONCLUSÃO: conclui-se que o uso do processo de enfermagem está disseminado em Gipuzkoa, e que seu uso é maior nos serviços públicos do que nos privados.

OBJETIVO: analizar si la metodología del proceso de enfermería se utiliza en los centros públicos y privados del área de salud de Gipuzkoa (País Vasco) y, en caso de utilizarse, analizar bajo qué modelo enfermero y de qué manera se utiliza. MÉTODO: estudio transversal, basado en el análisis de los registros de enfermería que utilizan los 158 centros estudiados. RESULTADOS: el proceso de enfermería se aplica en el 98% de los centros estudiados. Se aplica en todos los centros públicos y en 18 de los 21 centros privados. El modelo de Virginia Henderson es el más utilizado para aplicarlo, y el uso de los diagnósticos enfermeros, de la terminología NOC-NIC y de los planes de cuidados estandarizados es mayoritario. CONCLUSIÓN: se concluye que el uso del proceso de enfermería está extendido en Gipuzkoa, y su uso es mayor en los centros públicos que en los privados.