Uma metassíntese das transformações no trabalho de taxistas em tempos de uberização / A metasynthesis of labor changes for taxi drivers in times of uberization

Este estudo parte da Psicologia Social do Trabalho e se propõe a analisar como são referidas nas publicações científicas latino-americanas as modificações no trabalho de motoristas de táxi em função da entrada no mercado do serviço de transporte de passageiros por motoristas de aplicativos, buscando mais especificamente discutir as diferenças e os elementos laborais comuns a essas duas categorias profissionais. Trata-se de uma metassíntese, para a qual quatro fases foram desenvolvidas: exploração, refinamento, descrição e análise. Inicialmente, as informações obtidas em uma busca sistemática foram organizadas em três categorias descritivas principais: informações metodológicas, perspectiva teórica adotada e principais temas abordados. Esse mapeamento auxiliou a compreender como se configuram as produções bibliográficas consideradas. Um resultado significativo encontrado na etapa de análise foi que o material localizado não abordou efetivamente as transformações no trabalho de motoristas de táxi. Desse modo, tornou-se imperativo ultrapassar as informações encontradas nesse material, sendo necessária sua articulação com outras obras que, em alguma medida, abordavam aspectos da atualidade do trabalho de taxistas, visando refletir sobre como tais aspectos podem estar relacionados às transformações recentes no mundo laboral, as quais encontram no fenômeno da uberização uma caracterização fulcral sobre o trabalho na contemporaneidade. Assim, foi propiciada uma ampliação do olhar reflexivo sobre o que é trabalhar como taxista atualmente, dado que as mudanças engendradas pelas novas tecnologias e seu uso em prol da criação de novas formas de precarização laboral incidem também sobre essa categoria profissional e produzem efeitos sobre seu cotidiano de trabalho e sua subjetividade

Based on Social Psychology of Work, this study analyzes how Latin American scientific publications refer to labor changes in taxi service given the entry of app drivers into the passenger transport service market, seeking to discuss the differences and labor elements common to these two professional categories. A metasynthesis was conducted in four phases: exploration, refinement, description and analysis. Firstly, data were systematically searched and organized into three main descriptive categories: methodological information, theoretical perspective and main topics found. Analysis went beyond the information found in the selected material, as it did not effectively address the labor changes in taxi service. As such, the authors sought to articulate other works that to somewhat addressed current aspects of taxi service work and reflect on how such aspects may be related to recent labor transformations, namely the phenomenon of uberization. This provided a broader reflective perspective on what it means to work as a taxi driver today, as the changes promoted by new technologies and their use in favor of creating new forms of precarious work also reflect on this professional category, affecting their daily work and

Razões e consequências das perdas dentárias em adultos e idosos no Brasil: metassíntese qualitativa / Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis

Resumo O objetivo foi analisar e sistematizar evidências levantadas por estudos qualitativos sobre razões e consequências de perdas dentárias em adultos e idosos no Brasil. Foi executada revisão sistemática da literatura de pesquisas de métodos qualitativos, e metassíntese dos resultados. A população de estudo foi de adultos acima de 18 anos e idosos brasileiros. Foi realizada busca nas bases de dados BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO e SciELO. A síntese temática definiu oito temas analíticos sobre razões das perdas dentárias e três temas analíticos sobre as consequências. A dor dentária, o modelo de atenção, a situação financeira e o desejo de reabilitação protética foram fatores determinantes para as exodontias. Houve reconhecimento da negligência com o cuidado bucal e da naturalidade das perdas dentárias ligada à velhice. Dentes perdidos causaram impactos psicológicos e fisiológicos. É imperativo verificar se os fatores que causaram as perdas dentárias persistem, e quanto influenciam as decisões de extrair dentes na população jovem e adulta atual. Há que se mudar o modelo de atenção pela inclusão e qualificação da atenção em saúde bucal da população adulta jovem e idosa, sob pena de persistir o modelo de mutilação dentária e a cultura de edentulismo.

Abstract The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.

Synthesis of Qualitative Evidence on Malaria in Pregnancy, 2005-2022: A Systematic Review.

Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal-sexist gender roles, and predominance of local conceptions on maternal-fetal-neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease.

Social determination of alcohol consumption among Indigenous peoples in Colombia: a qualitative meta-synthesis.

BACKGROUND: Alcohol consumption is a social phenomenon that involves society, groups, and individuals from different cultures around the world. Among some Indigenous groups located in Colombia, South America, alcohol consumption has been present in their lives, where contradictory processes occur and generate public health attention. We aimed to analyze qualitative research findings on alcohol consumption among Indigenous peoples in Colombia. METHODS: This article used the qualitative meta-synthesis methodology, which included: (a) comprehensive search strategy, (b) appraisal of qualitative research reports, (c) findings classification, and (d) synthesis. Databases were searched for papers published from 2004 to 2019 in SCOPUS, LILACS, PROQUEST, and JSTOR, among other sources of information. A total of 2,159 papers were reviewed and finally, 13 studies were included in this meta-synthesis. The synthesis of findings included a constant comparative analysis and also aimed for the articulation of its findings to alternative perspectives in a predefined matrix. RESULTS: Nine Indigenous ethnic groups of Colombia were represented in the 13 articles analyzed. From the analysis emerged the symbolic approach "Alcohol: a chameleon that unpredictable society colors" as the meta-theme of this research. This reflects four social processes that influence interaction with alcohol: Dynamic Systems Mergers (Indigenous system, influence of non-Indigenous system); Diverse Authority Spheres (parenting, Indigenous authority, school, university, religious and spiritual, traditional medicine); Between Transculturation and Interculturality (cultural crises effects and dynamism); and the Paradoxes of the Normalization of Alcohol (reasons, functions, and types of alcohol consumption). Likewise, these results support the social determination of health and sociocultural epidemiology perspectives, as being an adequate way of explaining a complex phenomenon. CONCLUSION: Alcohol consumption among Indigenous peoples in Colombia is a social construction. Alcohol acts as an instrument, which is present in the changing relationships and tensions of social processes. This is reflected in harmonies, or disharmonies, in the life of Indigenous Colombians, which take place in a historical, sociocultural, economic, and political context. The results provide a reference point to guide practice and research but also reiterate the need to include the social determination of health perspective in public policies, as a path to the understanding of alcohol consumption.

Comensalidade, câncer e sobrevivência: uma metassíntese qualitativa sobre experiências alimentares de pacientes após o diagnóstico de câncer / Commensality, cancer and survival: A qualitative meta-synthesis of patients' food experiences after cancer diagnosis

Resumo Objetivo Compreender as experiências e as práticas alimentares a partir do diagnóstico de câncer. Método: Trata-se de uma pesquisa bibliográfica, do tipo metassíntese qualitativa. Utilizou-se a diretriz ENTREQ como protocolo, tendo como pergunta norteadora: "Quais são as experiências e as práticas alimentares de indivíduos após o diagnóstico de câncer?". A busca foi realizada nas bases de dados Lilacs, Pubmed, Embase e Food Science and Techonology, a partir da combinação de palavras-chave relacionadas à alimentação e nutrição, ao adoecimento por câncer e à pesquisa qualitativa, publicados entre 2015 e 2020, em português, inglês e espanhol. Método Foram encontrados 414 artigos e excluídos 396, após leitura dos títulos e resumos. Além dos 18 artigos potenciais, foram incluídos cinco artigos de outras fontes, totalizando 23. Foram identificadas três categorias empíricas: ruptura da trajetória alimentar e estratégias de adaptação; reconstrução da identidade; e vicissitudes da comensalidade. Conclusões As perdas relacionadas à alimentação impactam na existencialidade do ser, na expressão da identidade e nas relações sociais, podendo levar ao isolamento e a desritualização da alimentação. As mudanças físicas podem levar a distúrbios de imagem corporal e sofrimento psíquico. Em decorrência dos sintomas de impacto nutricional, a família é o suporte emocional para reorganização da alimentação.

Abstract Objective To understand the experiences and eating practices from the diagnosis of cancer. Method This is a bibliographic research, of the qualitative meta-synthesis type, using the ENTREQ guideline as a protocol, with the guiding question: "What are the experiences and eating practices of individuals after being diagnosed with cancer?". The search was carried out in the Lilacs, Pubmed, Embase and Food Science and Techonology databases based on the combination of keywords related to food and nutrition, illness from cancer and qualitative research, published between 2015 and 2020, in Portuguese, English and Spanish. Results 414 articles were found and 396 were excluded after reading the titles and abstracts. In addition to the 18 potential articles, 5 articles from other sources were included, totaling 23. Three empirical categories were identified: disruption of the food trajectory and adaptation strategies; reconstruction of identity; and vicissitudes of commensality. Conclusions Losses related to food impact the existentiality of being, the expression of identity and social relationships, which can lead to the isolation and de-ritualization of food. Physical changes can lead to body image disorders and psychological distress. Due to the symptoms of nutritional impact, the family is the emotional support for the reorganization of food.

Diet and fluid restriction experiences of patients on hemodialysis: a meta-synthesis study / Experiencias de pacientes en hemodiálisis con restricción de dieta y de líquidos: metasíntesis

ABSTRACT Introduction:Non-compliance with diet and fluid restriction is an important and common health behavior problem in the hemodialysis population and is associated with increased morbidity and mortality. Therefore, investigating the perceptions and experiences of patients undergoing hemodialysis regarding diet and fluid restriction is very important in terms of achieving the management of diet and fluid restriction. Methods: This is a meta-synthesis study. CINAHL, MEDLINE, PubMed, Web of Science, OVID, and Scopus electronic databases were utilized for the literature review. Studies were critically evaluated using the Joanna Briggs critical appraisal tool. Qualitative data were extracted, meta-summarized, and then meta-synthesized. The thematic analysis method was used in the analysis of the data. Results: This review consisted of 23 qualitative studies. The experiences of patients undergoing hemodialysis about diet and fluid restriction were classified into three main themes, namely, "the meaning of diet and fluid restriction for the patient", "perceived barriers", and "patient's own management strategies for diet and fluid restriction". Conclusion: The results of the synthesis in our study indicated that patients undergoing hemodialysis perceived diet and fluid restriction as a complex and challenging process involving a constant struggle. Some personal, social, and systemic barriers perceived by the patients made compliance with diet and fluid restriction even more difficult. More importantly, it was determined that most of the patients were not supported enough in the management of diet and fluid restriction and that they had developed strategies in their own right. In line with these results, we recommend that individual counseling services for diet-fluid restriction of patients undergoing hemodialysis should be increased, the obstacles perceived by the patient should be considered while planning patients' diet-fluid restriction, and that the planning should be realistic and feasible.

RESUMEN Introducción: El incumplimiento de la dieta y la restricción de líquidos es un problema de comportamiento común e importante en la población en hemodiálisis, con impacto en el estado de salud, y que se asocia con aumento de la morbimortalidad. Por lo tanto, investigar las percepciones y experiencias de los pacientes en hemodiálisis con respecto a la dieta y a la restricción de líquidos es muy importante para alcanzar el manejo de los mismos. Métodos: Este es un estudio de metasíntesis. Para la revisión de la literatura se utilizaron las bases de datos electrónicas CINAHL, MEDLINE, PubMed, Web ofScience, OVID y Scopus. Los estudios se evaluaron críticamente utilizando la herramienta de evaluación crítica de Joanna Briggs. Fueron extraídos los datos cualitativos, meta-resumidos y luego meta-sintetizados. En el análisis de los datos se utilizó el método de análisis temático. Resultados: Esta revisión consistió en 23 estudios cualitativos. Las experiencias de los pacientes sometidos a hemodiálisis en relación con la dieta y la restricción de líquidos se clasificaron en tres temas principales, a saber, "el significado de la dieta y la restricción de líquidos para el paciente", "barreras percibidas" y "estrategias de manejo propias del paciente para la dieta y la restricción de líquidos". Conclusión: Los resultados de la síntesis en nuestro estudio indicaron que los pacientes en hemodiálisis percibían la dieta y la restricción de líquidos como un proceso complejo y desafiante que implicaba una lucha constante. Algunas barreras personales, sociales y sistémicas percibidas por los pacientes dificultaron aún más el cumplimiento de las indicaciones. Más importante aún, se determinó que la mayoría de los pacientes no recibieron suficiente apoyo en el manejo de la dieta y la restricción de líquidos y que habían desarrollado estrategias por sí mismos. De acuerdo con estos resultados, recomendamos aumentar los servicios de asesoramiento individual para la restricción dietética-líquida de los pacientes en hemodiálisis, considerar los obstáculos percibidos por ellos al planificar la restricción dietética-líquida y realizar una planificación que sea realista y factible.

Experience of Sexuality in Women with Gynecological Cancer: Meta-Synthesis of Qualitative Studies.

Gynecological cancers have an impact on women's psychosexual health in which results vary from adjuvant cancer therapy, such as loss of pleasure, to anxious symptoms. This study aimed to present a meta-synthesis of qualitative primary studies on the sexual experience of women with gynecological cancer. The SPIDER tool and the PRISMA guidelines were used to recover evidence from the databases Web of Science, SCOPUS, PubMed/MedLine, CINAHL, PsycINFO and LILACS. Twenty articles were included. The thematic synthesis showed that alterations in sexual functions can be mitigated by direct involvement and dialogue with a sexual partner and the resignification of sexual intimacy.

Systematic review of qualitative studies about malaria in Colombia.

INTRODUCTION: The research about malaria in Colombia has centered mainly on the biomedical (clinical, parasitological, epidemiological and entomological) field, with little focus on qualitative research. PURPOSE: Analyzing social categories related to malaria in Colombia, based on qualitative studies published among scientific literature. METHODS: Systematic review following Cochrane and PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) recommendations. An ex-ante protocol was applied, comprehensive and reproducible for the search, screening, and extraction of information. Methodological quality was evaluated through SRQR (Standards for Reporting Qualitative Research). RESULTS: 10 studies complied with the protocol; these studies interviewed 500 infected or exposed subjects, program administrators, health professionals, and indigenous people. 40 categories were identified, which account for social-economical, cultural and ecological determiners of malaria; insights and ways to understand the disease at an individual level; malaria consequences, and medical attention, disease control and elimination actions. CONCLUSION: A wide variety of populations and subjects was considered. They show similar qualitative evidence on structural determiners, family-individual effects, and ways to understand malaria. Motivations to participate in disease interventions are less known, and they constitute the central axis for subsequent studies aimed to improve community engagement in disease control and elimination initiatives.

O retorno ao trabalho de mulheres após a experiência do câncer de mama: uma metassíntese / Womens return to work after experiencing breast cancer: a metasynthesis

Resumo Introdução: o câncer de mama (CM) é a neoplasia mais comum em mulheres no mundo e o número de casos vem aumentando na população economicamente ativa. Por isso, o retorno ao trabalho após CM tem despertado interesse da comunidade científica. Objetivo: sistematizar e sintetizar os estudos qualitativos que abordam a experiência do retorno ao trabalho após o CM. Métodos: metassíntese qualitativa com busca dos estudos primários nas bases ASSIA, BIREME, CINAHL, Embase, PsycInfo, SciELO, Scopus e Web of Science. Foram localizados 779 artigos, dos quais, nove atenderam aos critérios de seleção. Resultados: seis conceitos de segunda ordem foram gerados: os efeitos da doença na reabilitação; questões financeiras; medo de recidivas; apoio da família, amigos e profissionais de saúde; e mudanças do significado do trabalho após CM. Conclusão: o retorno ao trabalho não deve se limitar aos aspectos relacionados aos obstáculos e facilitadores da reabilitação Os "mundos da vida" evidenciados nos fatores contextuais mais abrangentes revelam que o enfrentamento do retorno ao trabalho implica no aprimoramento do suporte às trabalhadoras no ambiente de trabalho, na vida familiar, na relação com os sistemas de saúde e seguridade social e na esfera individual, a fim de prevenir aposentadorias precoces e incapacidade prolongada.

Abstract Introduction: breast cancer (BC) is the most common cancer in women worldwide and the number of cases has increased among the economically active population. Therefore, issues related to returning to work after BC has aroused the interest of the scientific community. Objective: To systematize and synthesize qualitative studies that address the experience of returning to work after BC. Methods: qualitative meta-synthesis with search for primary studies in ASSIA, BIREME, CINAHL, Embase, PsycInfo, SciELO, Scopus and Web of Science databases. The total of 779 articles were found, of which only nine met the inclusion criteria. Results: six second-order concepts were generated: the effects of the disease on rehabilitation; financial problems; fear of recurrences; support from family, friends and health professionals; and changes in the meaning of work after BC. Conclusion: the return to work should not be limited to aspects related to obstacles and facilitators of rehabilitation. The "worlds of life" shown in the broader contextual factors reveal that facing the return to work implies improving support for workers in the work environment, in family life, in the relationship with the health and social security systems and in the individual sphere, to prevent early retirements and prolonged disability.

Masculinities of prostate cancer survivors: a qualitative metasynthesis / Masculinidades de supervivientes de cáncer de próstata: una metassíntesis cualitativa / Masculinidades de sobreviventes de câncer de próstata: uma metassíntese qualitativa

ABSTRACT Objective: To identify the production of knowledge in the health literature about masculinities in the context of prostate cancer survivors and to analyze the implications of this relationship for the maintenance of health care. Method: Metasynthesis of 21 qualitative studies, performed in the LILACS, MEDLINE and CINAHL databases, with the scientific descriptors of DeCS and MeSH terms masculinity, prostate neoplasms. Results: Illness due to prostate cancer imposes numerous changes in male relationships, especially the non-dominance of the body and vulnerability to treatments and their consequences. The cultural values surrounding the disease and the hegemonic behaviors have implications for the health care of men. Conclusion: It has been shown that this relationship makes it difficult to communicate about the disease, marital relationships and family support, mainly influencing neglect of health. The knowledge produced is useful to promote the engagement of men in strengthening care.

RESUMEN Objetivo: Identificar la producción de conocimiento en la literatura de la salud sobre las masculinidades, en el contexto de los sobrevivientes del cáncer de próstata, y analizar las implicaciones de esta relación para el mantenimiento de la atención de salud. Método: Metassíntesis de 21 estudios cualitativos, realizada en las bases de datos LILACS, MEDLINE y CINAHL, con los descriptores científicos del DeCS y MeSH terms masculinidad, neoplasias de la próstata. Resultados: La enfermedad por el cáncer de próstata impone innumerables cambios en las relaciones masculinas, sobre todo el no dominio del cuerpo y la vulnerabilidad frente a los tratamientos y sus consecuencias. Los valores culturales alrededor de la enfermedad y los comportamientos hegemónicos, traen implicaciones para el cuidado de la salud de los hombres. Conclusión Se evidenció que esta relación dificulta la comunicación sobre la enfermedad, las relaciones conyugales y el apoyo familiar, influenciando principalmente la negligencia con la salud. El conocimiento producido resulta ser útil para promover el compromiso de los hombres en el fortalecimiento de los cuidados.

RESUMO Objetivo: Identificar a produção de conhecimento na literatura da saúde sobre as masculinidades, no contexto dos sobreviventes do câncer de próstata, e analisar as implicações desta relação para a manutenção dos cuidados de saúde. Método: Metassíntese de 21 estudos qualitativos, realizada nas bases de dados LILACS, MEDLINE e CINAHL, com os descritores científicos do DeCS e MeSH terms masculinidade, neoplasias da próstata. Resultados: O adoecimento pelo câncer de próstata impõe inúmeras mudanças nas relações masculinas, sobretudo o não domínio do corpo e a vulnerabilidade frente aos tratamentos e suas consequências. Os valores culturais entorno da doença e os comportamentos hegemônicos, trazem implicações para o cuidado a saúde dos homens. Conclusão: Evidenciou-se que esta relação dificulta a comunicação sobre a doença, as relações conjugais e o apoio familiar, influenciando principalmente a negligência com a saúde. O conhecimento produzido revela-se útil para promover o engajamento dos homens no fortalecimento de cuidados.

Estratégias de redução de danos no uso prejudicial de álcool e outras drogas: revisão de literatura / Harm reduction strategies regarding the misuse of alcohol and other drugs: a review of the literature

O presente estudo traz uma sistematização acerca de experiências de atenção à saúde a pessoas que fazem uso prejudicial de álcool e outras drogas que têm por base as diretrizes da redução de danos no Brasil e no mundo. Foi realizado um levantamento bibliográfico em publicações de língua portuguesa e inglesa dos últimos dez anos hospedadas nas bases de dados SciELO, Lilacs, Medline e PsycINFO. Após a seleção do corpus, recorreu-se à metassíntese a fim de integrar o material obtido. Foi possível identificar e analisar avanços e impasses na implantação de estratégias de redução de danos, bem como comparar as diferentes abordagens identificadas nos serviços e ações de cuidado oferecidas aos usuários. Nota-se que a Redução de Danos tem se consolidado como estratégia de prevenção e tratamento e, dessa forma, torna-se imprescindível ampliar as produções acadêmica e científica na área.

Abstract The present study attempts to systemize the experiences of those that have been treated in the primary health care system for alcohol and drug abuse with a view to obtaining reductions in the damages caused to Brazil and the world at large. A bibliographical study was conducted of publications in Portuguese and in English over the past ten years on the following databases SciELO, Lilacs, Medline and PsycINFO. After the selection of the corpus, meta-synthesis was carried out in order to integrate the material obtained. It was possible to identify and analyze advances and impasses in the implementation of harm reduction strategies, and to compare the different approaches identified in the services and care activities offered to users. We noticed that Harm Reduction has become consolidated as a prevention and health care strategy; therefore, it is essential that more academic and scientific research in this area is conducted.

Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care.

BACKGROUND: Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. AIM: To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. DESIGN: A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. METHODS: Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. RESULTS: Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. CONCLUSION: Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments.

Pressupostos epistemológicos da saúde mental e trabalho em teses brasileiras / Epistemological assumptions of mental health and work in brazilian theses / Presupuestos epistemológicos de la salud mental y el trabajo en las tesis brasileñas

O presente estudo realizou uma pesquisa qualitativa de tipo bibliográfica utilizando o método da metassíntese. Objetivou-se conhecer e analisar os pressupostos epistemológicos que alicerçam as teses desenvolvidas na área da saúde mental e trabalho no âmbito da pós-graduação brasileira. A investigação foi desenvolvida em cinco fases: exploração, refinamento, cruzamento, descrição e análise. A análise de 16 teses consolida a metassíntese e apresenta os seguintes resultados: a área de conhecimento da saúde mental e trabalho fundamenta-se nos pressupostos epistemológicos do campo da saúde do trabalhador. Observa-se, porém, um hibridismo de conceitos com implicações políticas e ideológicas. Assim, faz-se necessário investigar e assumir uma posição política. Caso contrário, o uso indevido de conceitos pode ser interpretado como uma incoerência epistemológica; ou seja, expressar uma postura, mas assumir outra, em sentido contrário. Os conceitos ocultam, portanto, um posicionamento político implícito no desenvolvimento da pesquisa. É, pois, o campo da saúde do trabalhador que alicerça a produção científica da área da saúde mental e trabalho; essa coerência epistemológica é condição imprescindível para o êxito nos processos investigativos e, consequentemente, nos resultados apresentados por essa área do conhecimento.

The present study carried out a qualitative research of the bibliographical type using the meta-synthesis method. The objective was to know and analyze the epistemological assumptions that underpin the theses developed in the area of Mental health and work within the Brazilian postgraduate education. It was developed in five phases: Exploration, Refinement, Crossing, Description and Analysis. The analysis of 16 theses consolidates the meta-synthesis and shows the following results: the Mental Health and Work area of knowledge is based on the epistemological presuppositions on the field of Occupational Health. It is observed, however, a hybridism of concepts with political and ideological implications. Therefore, it is necessary to investigate and take a political position. Otherwise, the misuse of concepts can be interpreted as an epistemological inconsistency, in other words, they express a posture, but assume other, in the opposite direction. They mask, therefore, an implicit political positioning in the research. It is because the field of Occupational Health underpins the scientific production Mental Health and Work area that this epistemological coherence is essential to the success in investigative processes and, consequently, the results presented by this area of knowledge.

En este estudio se llevó a cabo una investigación cualitativa de tipo bibliográfica utilizando el método de Metasíntesis. El objetivo fue conocer y analizar los presupuestos epistemológicos que sustentan las tesis desarrolladas en el ámbito de la Salud mental y trabajo, en el nivel de post graduación brasileña. La investigación se desarrolló en cinco fases: Exploración, Refinamiento, Cruzamiento, Descripción y Análisis. El análisis de 16 tesis consolida la metasíntesis y muestra los siguientes resultados: el área de conocimiento de la salud mental y el trabajo se basa en los presupuestos epistemológicos de la esfera de la salud del trabajador. Se observa, sin embargo, unos conceptos híbridos con implicaciones políticas e ideológicas. Por lo tanto, es necesario investigar y tomar una posición política. De lo contrario, el uso indebido de los conceptos puede ser interpretado como una inconsistencia epistemológica, o sea, expresan una postura, pero asumen otra en la dirección opuesta. Los conceptos ocultan, por lo tanto, un posicionamiento político implícito en el desarrollo de la investigación. Es debido a que, el campo de la salud en el trabajo, sustenta la producción científica en el área de la salud mental y trabajo, que esta coherencia epistemológica es condición esencial para el éxito en los procesos de investigación y, por consiguiente, los resultados presentados por esta área del conocimiento.

Aspectos do conceito de juventude nas ciências humanas e sociais: análises de teses, dissertações e artigos produzidos de 2007 a 2011 / Aspects of youth concept in humanities and social sciences: analyses of theses, dissertations and articles from 2007 to 2011 / Aspectos de concepto de la juventud en las ciencias humanas y sociales: análisis de tesis, disertaciones y artículos de 2007 a 2011

Nos últimos anos, o tema juventude tem adquirido destaque crescente no campo político, no cultural e no acadêmico. Utilizando método de pesquisa de tipo metassíntese, realizou-se uma reflexão teórica sobre o conceito de juventude a partir de pesquisa em teses, dissertações e artigos das Ciências Humanas e Sociais Aplicadas, publicados entre 2007 e 2011. Analisou-se o processo de produção desse conceito, suas rupturas, permanências e desafios. Descreve-se aqui a relação entre os termos e os conceitos de juventude/jovem e adolescência/adolescente. Discute-se também a condição juvenil como constituidora de grupo que apresenta ou não posturas intrínsecas, juventude como homogeneidade sócio-histórica e relação entre as categorias juventude e tempo. Os resultados indicam que o conceito de juventude é polissêmico, interdisciplinar e constrito à realidade sócio-histórica-cultural da experiência humana. Ressalta-se ainda a importância do processo identitário e da sobreposição geracional estabelecida nas sociedades.

In recent years, the theme of youth has become increasingly relevant within the political, cultural and academic fields. Using the metasynthesis method, a theoretical reflection regarding the concept of youth was performed by researching Brazilian dissertations, theses and scientific articles in humanities and applied social sciences, published between 2007 and 2011. The producing process of this concept, its disruptions, stabilities and challenges were analyzed. The relationship between the terms and concepts of youth/young and adolescence/adolescent are described here. The young condition as a group that may or may not have intrinsic attitudes, the youth as a socio-historical homogeneity, and the relationship between both categories youth and time are also discussed. The results show that the concept of youth is polysemic, interdisciplinary, and restricted to the social-historical-cultural reality of human experience. It is also emphasized the prominence of the identity process, and of the generational overlap established within the societies.

En los últimos años, el tema de la juventud se ha convertido cada vez más relevante en el ámbito político, cultural y académico. Utilizando el método metasíntesis, una reflexión teórica sobre el concepto de juventud se llevó a cabo mediante la investigación de disertaciones, tesis y artículos científicos en las humanidades y ciencias sociales aplicadas, publicados entre 2007 y 2011. Se analiza acá el proceso de producción de este concepto, sus interrupciones, su estabilidad y desafíos. Se describe la relación entre los términos y conceptos de juventud/jóvenes y de adolescencia/adolescente. También se discuten la condición de los jóvenes como un grupo que puede o no puede tener actitudes intrínsecas, la juventud como una homogeneidad socio-histórica, y la relación entre las categorías jóvenes y tiempo. Los resultados muestran que el concepto de juventud es polisémico, interdisciplinario, y restringido a la realidad socio-histórica cultural de la experiencia humana. También se hizo hincapié en la importancia del proceso de la identidad y de la superposición generacional establecida dentro de las sociedades.

Calidad de vida de los cuidadores de personas con enfermedad crónica / Quality of Life of Caregivers for the Chronically Ill / Qualidade de vida dos cuidadores de pessoas com doença crônica

RESUMEN El alto impacto epidemiológico, social, económico y cultural de las enfermedades crónicas no transmisibles afecta el significado de calidad de vida en las personas que las padecen y en sus cuidadores familiares. Objetivo: describir la forma como se construye el significado de calidad de vida de cuidadores de personas con enfermedad crónica. Método: investigación desarrollada con la propuesta de metasíntesis cualitativa de Sandelowski y Barroso. Resultados: se presentan tres momentos en la trayectoria: 1) se afecta (destrucción celular programada); 2) se trasforma (autocontrol del desarrollo y crecimiento), y 3) se resignifica (condensación); y cuatro factores condicionantes para la construcción del significado de calidad de vida para el cuidador como son el soporte social, la espiritualidad, la habilidad para cuidar y el tiempo. Conclusiones: la calidad de vida se afecta y se reconstruye en virtud del significado que el cuidador tenga de esta.

ABSTRACT The high epidemiological, social, economic and cultural impact of chronic non-communicable diseases affects what quality of life means to those who suffer from such illnesses and their family caregivers. Objective: Describe how the quality of life of those who care for the chronically ill is constructed. Method: Sandelowski and Barroso's proposal for qualitative metasynthesis was used to develop the study. Results: There are three moments in the process: 1) it is affected (programmed cell destruction), 2) transformed (self-control of development and growth) and 3) redefined (condensation). Construction of the meaning of quality of life for the caregiver is conditioned by four factors: social support, spirituality, ability to care and time. Conclusions: Quality of life is affected and reconstructed by virtue of the meaning the caregiver assigns to it.

RESUMO O alto impacto epidemiológico, social, econômico e cultural das doenças crônicas não transmissíveis afeta o significado de qualidade de vida nas pessoas que as padecem e em seus cuidadores familiares. Objetivo: descrever a forma como se constrói o significado de qualidade de vida de cuidadores de pessoas com doença crônica. Método: pesquisa desenvolvida com a proposta de metassíntese qualitativa de Sandelowski e Barroso. Resultados: apresentam-se três momentos na trajetória: I) afeta-se (destruição celular programada); II) transforma-se (autocontrole do desenvolvimento e crescimento) e III) ressignifica-se (condensação); além disso, quatro fatores condicionantes para a construção do significado de qualidade de vida para o cuidador como são o suporte social, a espiritualidade, a habilidade para cuidar e o tempo. Conclusões: a qualidade de vida é afetada e reconstruída em virtude do significado que o cuidador tenha desta.

Metasíntesis: discusión de un abordaje metodológico / Metasynthesis: a discussion of a methodological approach

El concepto de metasíntesis ha sido abordado por varios autores, coincidiendo en que es una forma de integrar hallazgos de investigación cualitativa con el fin de lograr una nueva interpretación que explica el fenómeno con un nivel mayor de evidencia científica. El presente artículo presenta las aproximaciones conceptuales y metodológicas de la propuesta de Sandelowski y Barroso, tomando como ejemplo la aplicación del método en un estudio de metasíntesis de calidad de vida en cuidadores de personas con enfermedad crónica.

The concept of metasynthesis has been addressed by several authors who agree that is a way of integrating qualitative research findings in order to achieve a new interpretation that explains any given phenomenon with a higher level of scientific evidence. This paper presents the conceptual and methodological approach of the proposal by Sandelowski and Barroso, using as an example the application of this method in a study of meta-synthesis of quality of life among caregivers for people with chronic disease.

Adult men's beliefs, values, attitudes and experiences regarding contraceptives: a systematic review of qualitative studies.

AIMS AND OBJECTIVES: To explore the men's beliefs, values, attitudes and experiences towards contraceptives. BACKGROUND: The promotion of male participation in contraceptive practices requires the knowledge and consideration of the beliefs, values, attitudes and experiences involved. The systematic review of the literature focusing on these themes can be useful for the evidence-based health care. DESIGN: A systematic review of qualitative studies. METHODS: Studies published between 1994 until 2011 (inclusive) were included. The participants included men from all cultures, ethnic backgrounds and religions who have expressed their beliefs, values, attitudes and experiences regarding male contraceptives. The databases CINAHL, PubMed, PsycINFO, SciELO, LILACS and MedCarib were explored. The appraisal of primary studies, carried out through the JBI-QARI (Qualitative Assessment and Review Instrument) resulted in the inclusion of 16 studies in this systematic review. RESULTS: The set of statements of beliefs, values, attitudes and experiences regarding contraceptives resulted in five synthesis: (1) contraceptive behaviour is influenced by religious, family and social backgrounds; (2) gendered, male-centred values predominate in contraceptive behaviours; (3) the sense of invulnerability influences contraceptive behaviours; (4) strong obstacles should be overcome to use contraceptives; (5) behaviours, decision-making and experiences regarding male contraceptives. CONCLUSIONS: The male beliefs and values regarding contraceptives are strongly influenced by religious, family and social backgrounds, and their attitudes in this scope are male centred. RELEVANCE TO CLINICAL PRACTICE: A deeper male consciousness regarding contraceptive responsibility should be promoted. It requires the knowledge of the men's personal backgrounds regarding contraceptives because they can be diverse according to family, social and cultural contexts. The consideration of the men's personal perspective is essential in the planning and implementation of reproductive health care. These aspects are essential for the concretisation of the evidence-based health care, a current challenge worldwide.

Produção social, histórica e cultural do conceito de juventudes heterogêneas potencializa ações políticas / Producción social, histórica y cultural del concepto de juventudes heterogéneas potencializa acciones políticas / The social, historical and cultural concept production of the heterogeneous youth(s) enhances political actions

Conceitos são definidos no contexto social, cultural, histórico, constituindo-se no ambiente sociopolítico. O campo social, espaço onde a ação do homem tem significado e produz sentido, é o lócus da produção de conceitos. A metassíntese realizada analisou 37 artigos científicos e 176 teses e dissertações que discutem o conceito de juventude, do período de 2007 a 2011, encontradas através do banco de teses da CAPES e da biblioteca eletr™nica SCIELO pelo Google Acadêmico. Resultados indicam que o conceito de juventudes, expresso pelas distintas forças políticas, é um exemplo do poder mobilizador do ato de conceituar, evidenciado na contemporaneidade. A perspectiva da lógica linear e fásica da vida convive com a heterogeneidade, expressando assim um campo propício para as distintas perspectivas e posturas teóricas. A psicologia social crítica é desafiada a fortalecer presença nos circuitos da produção de conceitos, promovendo reflexão significativa e elementos de transformação.

Los conceptos se definen en el contexto cultural, social, historico, convirtiéndose en el ambiente sociopolítico. El espacio del campo social en que la acción humana tiene un significado y produce sentido, es el lócus de la producción de los conceptos. A meta-síntesis realizada analizó 37 artículos científicos y 176 tesis y disertaciones que tratan sobre el concepto de juventud , del período de 2007 a ​​2011, encontradas en la base de tesis CAPES y en la biblioteca electrónica SciELO por Google Scholar. Los resultados indican que el concepto de los juventudes, expresada por diferentes fuerzas políticas, es un ejemplo del poder de movilización del acto de la conceptualización, evidenciado en la época contemporánea. La perspectiva de la lógica lineal y fásica de la vida coexiste con la heterogeneidad, expresando así un campo favorable para los diferentes puntos de vista y posiciones teóricas. La psicología social crítica tiene el reto de fortalecer la presencia en el circuitos de producción de los conceptos, promoviendo reflexión significativa y elementos de transformación.

Concepts are social, cultural and historical definitions, whose constitutive process is within the sociopolitical environment. The social field, is the locus to concepts production. The metasynthesis carried, analyzed 37 papers and 176 thesis and dissertations that discuss about youth concept, published 2007-2011 period, found through the CAPES thesis database and the electronic library SCIELO by Google Scholar. Results indicate youth concept, expressed by different political forces, is an example of the mobilizing power of the conceptualizing act, evidenced in contemporary times. The linear and phasic perspective of the life, coexists with heterogeneity, thus expressing a field conducive to the different perspectives and theoretical positions. The social and critical Psicology is challenged to strengthen presence in the circuit of concepts production, promoting meaningful reflection and transformation elements.

Produção social, histórica e cultural do conceito de juventudes heterogêneas potencializa ações políticas / Producción social, histórica y cultural del concepto de juventudes heterogéneas potencializa acciones políticas / The social, historical and cultural concept production of the heterogeneous youth(s) enhances political actions

Conceitos são definidos no contexto social, cultural, histórico, constituindo-se no ambiente sociopolítico. O campo social, espaço onde a ação do homem tem significado e produz sentido, é o lócus da produção de conceitos. A metassíntese realizada analisou 37 artigos científicos e 176 teses e dissertações que discutem o conceito de juventude, do período de 2007 a 2011, encontradas através do banco de teses da CAPES e da biblioteca eletr™nica SCIELO pelo Google Acadêmico. Resultados indicam que o conceito de juventudes, expresso pelas distintas forças políticas, é um exemplo do poder mobilizador do ato de conceituar, evidenciado na contemporaneidade. A perspectiva da lógica linear e fásica da vida convive com a heterogeneidade, expressando assim um campo propício para as distintas perspectivas e posturas teóricas. A psicologia social crítica é desafiada a fortalecer presença nos circuitos da produção de conceitos, promovendo reflexão significativa e elementos de transformação.

Los conceptos se definen en el contexto cultural, social, historico, convirtiéndose en el ambiente sociopolítico. El espacio del campo social en que la acción humana tiene un significado y produce sentido, es el lócus de la producción de los conceptos. A meta-síntesis realizada analizó 37 artículos científicos y 176 tesis y disertaciones que tratan sobre el concepto de juventud , del período de 2007 a ​​2011, encontradas en la base de tesis CAPES y en la biblioteca electrónica SciELO por Google Scholar. Los resultados indican que el concepto de los juventudes, expresada por diferentes fuerzas políticas, es un ejemplo del poder de movilización del acto de la conceptualización, evidenciado en la época contemporánea. La perspectiva de la lógica lineal y fásica de la vida coexiste con la heterogeneidad, expresando así un campo favorable para los diferentes puntos de vista y posiciones teóricas. La psicología social crítica tiene el reto de fortalecer la presencia en el circuitos de producción de los conceptos, promoviendo reflexión significativa y elementos de transformación.

Concepts are social, cultural and historical definitions, whose constitutive process is within the sociopolitical environment. The social field, is the locus to concepts production. The metasynthesis carried, analyzed 37 papers and 176 thesis and dissertations that discuss about youth concept, published 2007-2011 period, found through the CAPES thesis database and the electronic library SCIELO by Google Scholar. Results indicate youth concept, expressed by different political forces, is an example of the mobilizing power of the conceptualizing act, evidenced in contemporary times. The linear and phasic perspective of the life, coexists with heterogeneity, thus expressing a field conducive to the different perspectives and theoretical positions. The social and critical Psicology is challenged to strengthen presence in the circuit of concepts production, promoting meaningful reflection and transformation elements.

Metasíntesis de calidad de vida en cuidadores familiares de personas en situación de enfermedad crónica / Metasynthesis of quality of life in family caregivers of people with chronic disease

Las enfermedades crónicas no transmisibles afectan la calidad de vida de las personas que la padecen y de sus cuidadores familiares. La investigación en el área de la cronicidad ha demostrado que se cambian los estilos de vida, hay manifestación con la aparición del dolor y las limitaciones, se altera la socialización y hay una constante presencia de sentimientos de pérdidas y muerte. A partir de las investigaciones que abordan la experiencia de la salud humana (el componente intangible de la enfermedad crónica) se requiere construir teóricamente conocimiento sobre la calidad de vida de los cuidadores familiares. Objetivo: Realizar una integración interpretativa de la evidencia científica (investigaciones cualitativas) en el fenómeno de calidad de vida de cuidadores de personas con enfermedad crónica. Método: Metasíntesis de 24 artículos publicados de investigaciones científicas de tipo cualitativo (teoría fundamentada, estudios de caso, etnografía, fenomenología) acerca del fenómeno de calidad de vida de cuidadores de personas con enfermedad crónica, publicadas en bases de datos electrónicas y físicas de la Universidad Nacional de Colombia. El método de análisis fue el propuesto por Sandelowsky y Barroso (2007). Resultados: Se encontró un patrón que conecta las categorías y variables que sustenta la hipótesis teórica de una teoría del significado de la calidad de vida denominada "Reconstruyendo el significado de calidad de vida en el cuidado". De Esta hipótesis se sustenta en tres momentos para el significado que son: Vivir en desasosiego, Vivir para la calidad de vida del otro y Construir la propia calidad de vida. Los conceptos que presenta esta teoría se enmarcan la experiencia de la cronicidad vivida por el cuidador y que depende en unos primeros momentos de la calidad de vida del paciente pasando por una trayectoria llena de dificultades y de aprendizajes que hacen que se redimensione y se construya un significado propio de la calidad de vida producto de la labor de cuidado. Implicaciones: los resultados aportan al conocimiento de enfermería en el área, al refinar el concepto de calidad de vida en un sujeto de cuidado novedoso para enfermería que son los cuidadores familiares como insumo para la construcción de indicadores para medir la carga del cuidado en la enfermedad crónica.

Nontransmissible diseases affect the quality of life of people that are affected and their family caregivers. Research in the area of chronicity has shown that lifestyles change, there is manifestation with the onset of pain and limitations, socialization is disturbed and there is a constant presence of feelings of loss and death. From the research that addresses the human health experience (the intangible component of chronic disease) it is required theoretically to build knowledge about the quality of life of family caregivers. Objective: To integrate interpretation of scientific evidence (qualitative research) in the phenomenon of quality of life of carers of people with chronic illness. Method: Meta-synthesis of 24 scientific research papers published qualitative (grounded theory, case studies, ethnography, phenomenology) on the phenomenon of quality of life of carers of people with chronic disease, published in electronic databases and the physical National University of Colombia. The method of analysis was proposed by Sandelowsky and Barroso (2007). Results: We found a pattern that connects the categories and variables underlying the theoretical assumptions of a theory of meaning of quality of life called "Rebuilding the meaning of quality of life in care". In This hypothesis it is based on three times and the meanings are: Living in distress, Living for the quality of life of another and build one's quality of life. The concepts of this theory are part of the chronicity experience lived by the caregiver and dependent on a few first moments of the quality of life of patients undergoing a full path and learning difficulties that make them resize and build a proper meaning of the quality of life of the work product of care. Implications: The results contribute to nursing knowledge in the area, to refine the concept of quality of life in a subject new to nursing care that are family caregivers as input for the construction of indicators to measure the burden of care on chronic disease.