Repercusiones de la COVID-19 en un proceso de investigación-acción participativa con adolescentes gitanas / Repercussions of COVID-19 in a participatory action-research process with adolescent Roma women

El objetivo de este artículo es describir la repercusión que ha tenido la pandemia de COVID-19 en la implementación del proyecto RoMoMatter, con una metodología de investigación-acción participativa basada en la comunidad, en Córdoba. Participaron cinco investigadoras académicas y 30 de la comunidad. Se utilizaron como técnicas de recogida de datos la entrevista individual, los grupos focales y las notas de campo. Las entrevistas fueron grabadas en audio con el consentimiento de las participantes y se transcribieron textualmente. La información recogida fue codificada mediante el software Atlas Ti. Se destacan los esfuerzos de adaptación al nuevo escenario de la pandemia realizados por las participantes y el papel de apoyo técnico y emocional que tuvo el equipo de adaptación. Se concluye que la principal repercusión de la pandemia se evidenció en el proceso participativo de todas las personas implicadas, y en el formato y el número de actividades.(AU)

The objective of this article is to describe the impact of the COVID-19 pandemic on the implementation of the RoMoMatter project, using a community-based participatory action research methodology, in Córdoba (Spain). Five academic researchers and 30 community members participated. Individual interviews, focus groups and field notes were used as data collection techniques. The interviews were audio-recorded with the consent of the participants and transcribed verbatim. The information collected was coded using Atlas Ti software. The efforts of adaptation to the new pandemic scenario made by the participants and the technical and emotional support role played by the adaptation team are highlighted. It is concluded that the main impact of the pandemic was evidenced in the participatory process of all the people involved, and in the format and number of activities. (AU)

[Repercussions of COVID-19 in a participatory action-research process with adolescent Roma women]. / Repercusiones de la COVID-19 en un proceso de investigación-acción participativa con adolescentes gitanas.

The objective of this article is to describe the impact of the COVID-19 pandemic on the implementation of the RoMoMatter project, using a community-based participatory action research methodology, in Córdoba (Spain). Five academic researchers and 30 community members participated. Individual interviews, focus groups and field notes were used as data collection techniques. The interviews were audio-recorded with the consent of the participants and transcribed verbatim. The information collected was coded using Atlas Ti software. The efforts of adaptation to the new pandemic scenario made by the participants and the technical and emotional support role played by the adaptation team are highlighted. It is concluded that the main impact of the pandemic was evidenced in the participatory process of all the people involved, and in the format and number of activities.

Capacitación de población gitana en abogacía para la salud: un estudio de caso en Torreblanca, Sevilla / Training for Roma health advocacy: a case study of Torreblanca, Seville

Objetivo: El objetivo del presente estudio es crear capacidad de abogacía entre un grupo de vecinos/as gitanos/as que viven en contextos de riesgo de exclusión social. Método: Se ha utilizado un diseño de Investigación Acción Participativa Basada en la Comunidad, en el que el que 4 miembros de la comunidad participaron en el proceso de recogida de evidencias mediante fotovoz, análisis de estas siguiendo el método ReACT y diseminación de los resultados. Resultados: Se recogieron un total de 96 evidencias que fueron analizadas para el análisis de datos cualitativos. Estas fueron categorizadas atendiendo a (a) el tipo de condiciones insalubres y (b) la zona del barrio donde se encontraban. La posterior agrupación temática permitió identificar como causas: (a) El abandono de los servicios públicos; (b) la discriminación y (c) la falta de presencia de población gitana en los espacios comunitarios. Las consecuencias señaladas fueron (a) problemas de salud mental y física y (b) normalización de condiciones de vida indignas. El plan diseñado tuvo por objetivo abogar por la presencia gitana en los espacios comunitarios. Conclusiones: Nuestro estudio puso en evidencia la pertinencia del fotovoz para trascender la perspectiva biomédica y desarrollar acciones de abogacía basadas en el conocimiento creado por la comunidad. Futuras investigaciones deberían profundizar en el impacto de la abogacía para la salud en la reducción de las desigualdades y considerar la importancia de implicar a investigadores/as, profesionales de salud pública y la comunidad en su abordaj. (AU)

Objective: The objective of this study is to build advocacy capacity among a group of gipsy Roma neighbours living in contexts of risk of social exclusion. Methods: A Community Based Participatory Action Research design was used, in which 4 members of the community participated in the process of collecting evidence by photovoice, analysing it using the ReACT method and disseminating the results. Results: A total of 96 pieces of evidence were collected and analysed for qualitative data analysis. These were categorised according to (a) the type of unhealthy conditions and (b) the area of the neighbourhood where they were located. The subsequent thematic grouping made it possible to identify the causes: (a) the abandonment of public services; (b) discrimination; and (c) the lack of Roma presence in community spaces. The consequences identified were (a) mental and physical health problems and (b) the normalisation of undignified living conditions. The plan was designed to advocate for the presence of Roma in community spaces. Conclusions: Our study highlighted the relevance of the photovoice to transcend the biomedical perspective and develop advocacy actions based on the knowledge created by the community. Future research should look more deeply into the impact of health advocacy on reducing inequalities and consider the importance of involving researchers, public health professionals and the community in addressing it. (AU)

[Training for Roma health advocacy: a case study of Torreblanca, Seville]. / Capacitación de población gitana en abogacía para la salud: un estudio de caso en Torreblanca, Sevilla.

OBJECTIVE: The objective of this study is to build advocacy capacity among a group of gipsy Roma neighbours living in contexts of risk of social exclusion. METHODS: A Community Based Participatory Action Research design was used, in which 4 members of the community participated in the process of collecting evidence by photo-voice, analysing it using the ReACT method and disseminating the results. RESULTS: A total of 96 pieces of evidence were collected and analysed for qualitative data analysis. These were categorised according to (a) the type of unhealthy conditions and (b) the area of the neighbourhood where they were located. The subsequent thematic grouping made it possible to identify the causes: (a) the abandonment of public services; (b) discrimination; and (c) the lack of Roma presence in community spaces. The consequences identified were (a) mental and physical health problems and (b) the normalisation of undignified living conditions. The plan was designed to advocate for the presence of Roma in community spaces. CONCLUSIONS: Our study highlighted the relevance of the photo-voice to transcend the biomedical perspective and develop advocacy actions based on the knowledge created by the community. Future research should look more deeply into the impact of health advocacy on reducing inequalities and consider the importance of involving researchers, public health professionals and the community in addressing it.

Nursing Diagnosis of Grieving in Cases of Perinatal Loss: A Preliminary Clinical Validation.

PURPOSE: To develop a preliminary clinical validation the NANDA-I nursing diagnosis "Grieving" in cases of perinatal loss. METHODS: Descriptive cross-sectional study using the Fehring model. FINDINGS: The overall clinical validity index for the diagnosis was 0.15. Only four defining characteristics and five manifestations identified in the literature were validated. CONCLUSIONS: The variability of manifestations identified in the study participants is considered to be detrimental to the overall clinical validity index. IMPLICATIONS FOR NURSING PRACTICE: The clinical validity of the diagnosis could not be substantiated by the preliminary results of this study and, therefore, additional research is necessary to determine the ability of the diagnosis to adapt to perinatal loss situations in real contexts. Some manifestations have been proposed to NANDA-I for inclusion as defining characteristics in the nursing diagnosis of grieving. OBJETIVO: Validar clínicamente de forma preliminar el diagnóstico enfermero NANDA-I duelo en caso de pérdida perinatal. MÉTODOS: Estudio descriptivo transversal usando el modelo de Fehring. RESULTADOS: El índice de validez clínica global del diagnóstico fue de 0.15. Se validaron únicamente cuatro características definitorias y cinco manifestaciones identificadas en la literatura. CONCLUSIONES: Se considera que la variabilidad de las manifestaciones presentadas por los participantes actuó en detrimento del índice de validación clínica global. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: La validez clínica del diagnóstico no pudo ser corroborada por los resultados preliminares de este estudio y, por tanto, se necesita investigación adicional para terminar la capacidad de este diagnóstico para adaptarse a las situaciones de pérdidas perinatales en contexto reales. Se han propuesto a NANDA-I algunas manifestaciones para que sean incluidas como Características Definitorias del diagnóstico enfermero Duelo.

Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla / Advocacy for Roma health: in-service training of professionals from the Seville Health District

Se describe la experiencia de un taller cuyo objetivo fue capacitar a profesionales para abogar por la salud de la población gitana. La abogacía por la salud es recomendada por organismos internacionales y expertos en salud pública para superar las inequidades en salud. Participaron 16 profesionales de tres centros de salud de barrios con una alta densidad de población gitana, en riesgo de exclusión social. El taller se organizó en tres sesiones dirigidas a sensibilizar, dar a conocer el marco conceptual y metodológico de la abogacía, y diseñar un plan de abogacía. Se pone de manifiesto la utilidad de este espacio de reflexión y análisis, y la necesidad de abogar por la salud de la población gitana, junto a otros agentes gitanos/as y sectores comunitarios, identificando oportunidades y utilizando los recursos comunitarios. Futuras investigaciones deben profundizar en el desarrollo de planes de abogacía intersectoriales y difundirlos, para facilitar su implementación en otros contextos de características similares

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics

Building Meaningful Community Advocacy for Ethnic-based Health Equity: The RoAd4Health Experience.

The pervasive failure of policies aimed at overcoming health inequities suffered by European Roma reflects the oppressive and impoverished living conditions of many ethnic minorities in the Western world. The multiple social inequities that Roma experience and the cumulative effect on their health prove that the failure of health policies that impact Roma must be attributed to their ameliorative nature. These policies legitimize the mechanisms of oppression that sustain inequities, fueling fatalistic attitudes toward minorities, while these minorities internalize the stigma and attempt to survive on the margins of society. This paper presents the RoAd4Health project, a community initiative in which academic researchers partnered with Roma communities to overcome health inequities. We present the multiple methods utilized for building meaningful advocacy, such as photovoice and asset mapping led by Roma agents of change. These methods provided the capacity to develop a local narrative of disparities, build alliances to gain capacity to respond to injustices, and take actions to promote social change. The results of effectively involving all significant stakeholders (i.e., community agents of change, residents, health and social care providers, Roma community grassroots organizations, and institutional actors) are discussed along with lessons learned.

RoMoMatteR: Empowering Roma Girls' Mattering through Reproductive Justice.

Aim: To present a protocol study directed at tackling gender discrimination against Roma girls by empowering their mattering so they can envision their own futures and choose motherhood only if-and when-they are ready. Background: Motherhood among Roma girls (RGM) in Europe impoverishes their lives, puts them at risk of poor physical and mental health and precipitates school dropouts. Overwhelming evidence affirms that the conditions of poverty and the social exclusionary processes they suffer have a very important explanatory weight in their sexual and reproductive decisions. Methods: Through a Community-based Participatory Action Research design, 20-25 Roma girls will be recruited in each one of the four impoverished communities in Bulgaria, Romania and Spain. Data collection and analysis: Desk review about scientific evidences and policies will be carried out to frame the problem. Narratives of Roma women as well as baseline and end line interviews of girl participants will be collected through both qualitative and quantitative techniques. Quantitative data will be gathered through reliable scales of mattering, socio-political agency, satisfaction with life and self. A narrative analysis of the qualitative information generated in the interviews will be carried out. Expected results: (1) uncover contextual and psychosocial patterns of girl-motherhood among Roma women; (2) build critical thinking among Roma girls to actively participate in all decisions affecting them and advocate for their own gender rights within their communities; and (3) empower Roma girls and their significant adults to critically evaluate their own initiatives and provide feedback to their relevant stakeholders. Conclusions: Roma girls will improve their educational aspirations and achievements and their social status while respecting and enhancing Roma values.

[Advocacy for Roma health: in-service training of professionals from the Seville Health District]. / Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla.

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.

Pornography Influence Among Young Students: Adaptation and Validation of Pornography Consumption Inventory into Spanish.

This manuscript intends to adapt and validate Pornography Consumption Inventory (PCI) into Spanish in a sample of 211 young students who admitted to consume pornography. They completed a questionnaire that referred to sociodemographic characteristics, sexual behavior and PCI. Results showed a factorial structure of the scale with good data fit, composed of 13 items divided into three dimensions, i.e., emotional avoidance, sexual curiosity, and excitement seeking and sexual pleasure. These factors were positively interrelated and presented excellent internal consistency reliability. Some gender differences were observed, so that men presented higher scores in the three dimensions than women.

Implementing a cultural competence training as a psychopolitical empowerment process.

The cultural competence training (CCT) of health care professionals represents a useful resource to face the challenges involved in health care assistance for multicultural populations. However, the traditional perspective has shown limited results, as it does not consider professionals in their contexts and avoids continuous assessment processes. In response to these limitations, we describe a model of CCT implemented by two professors of the Faculty of Nursing at the University of Seville in Spain as a psychopolitical empowerment process, and exemplified by the experience of the emergency nurses at the Virgen Macarena Hospital. This process adds the notion of power to traditional CCT and uses dialogic learning to: (a) state a mission and develop critical thinking; (b) take stock of the actions for change and increase the capacity of nurses to respond; and (c) motivate nurses to plan the future and take action. As a result, professionals become a learning community, able to develop a new professional identity and role, and can also implement actions for the transformation of health care settings.

Nursing diagnosis of grieving: content validity in perinatal loss situations.

PURPOSE: To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. METHODS: Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. FINDINGS: The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. CONCLUSION: The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation.

Experiencias de niños hospitalizados en unidades de pediatría del Hospital Virgen Macarena / Experiences of the children hospitalized in the paediatric units of the Virgen Macarena Hospital

Objetivo: describir las características de las enfermeras percibidas por los niños y niñas, y conocer la valoración que hacen de las actividades y recursos durante su ingreso hospitalario. Método: se realizó un estudio descriptivo con utilización de técnicas cualitativas. Participaron 24 niños ingresados en la Unidad de Preescolares y Hemato-Oncología. Se les realizó una entrevista semiestructurada en una sala de juegos. El análisis de contenido de la entrevista se realizó siguiendo el método de Giorgi (1997). Resultados: Los niños percibieron a las enfermeras como personas cercanas y amigables, que informaban bien y cuya función principal era cuidarlos y devolverlos buenos a su hogar. Plantearon que los uniformes del personal de enfermería debían diseñarse con colores alegres. En cuanto a la valoración de recursos y actividades lúdicas, reclamaban entretenimiento y espacios abiertos para jugar. Los menús hospitalarios fueron motivos de crítica por la mayoría de los niños y, en cuanto a los pijamas existía diversidad de opiniones en cuanto a las preferencias. Conclusiones: Es importante recoger las opiniones de los niños para identificar sus necesidades. Además, dada la importancia que conceden al juego, debería considerarse su utilidad para trasmitir información o para recogerla (AU)

Objective: To describe children's perceptions about nursing characteristics and to know children's valuation of the activities and resources employed during their hospital stay. Method: A descriptive study by means of qualitative techniques was done. 24 children hospitalized in the Infant and Hemato-Oncological Unit participated. To collect the information, a semi structured interview was done at the playroom. The content analysis of the interviews was done following Giorgi's method (1997). Results: Children perceived nurses as close and friendly, and as people who gave properly the information. Respect nurses' missions, children considered that they were to take care of them, and to restore them back to home. Children also suggested that nursing uniforms should be more colourful. According to the valuation of the activities and resources employed during their hospital stay, children claimed for more entertainment and open spaces to play. Hospital meals were criticised by the majority of children, and there was a diversity of opinions respect to their preferences for the pyjamas design. Conclusions: It is important to collect children's opinions, in order to identify their needs. Also, because of the importance that children give to play, it should be considered useful to give or collect information(AU)

Afrontamiento del estrés ocupacional entre profesionales de enfermería hospitalaria desde la investigación acción participativa / Coping with occupational stress among nursing staff by participatory action research

Objetivo. Describir una práctica colaborativa centrada en el afrontamiento del estrés en profesionales de enfermería hospitalaria. Método. La práctica se centra en la contextualización de los problemas y en el diseño e implementación de acciones usando el enfoque psicopolítico y la metodología de investigación acción participativa (IAP). Método. Los participantes han sido profesionales de enfermería de 4 unidades de medicina interna del Hospital Universitario Virgen Macarena de Sevilla. Se ha utilizado el cuestionario ISTAS, entrevistas y grupos de discusión, mediante los cuales enfermeras e investigadores han valorado, definido, propuesto e implementado diferentes acciones para mejorar sus condiciones de trabajo. Resultados. Las situaciones problemáticas identificadas con el cuestionario se relacionan con las exigencias psicológicas, el conflicto de roles y la estima. La principal causa del estrés en los profesionales es la falta de personal, según la opinión de los supervisores. En los grupos de discusión se decide intervenir sobre tres situaciones: a) necesidad de presencia continua del celador en las unidades para la movilización de pacientes no autónomos; b) necesidad de controlar el horario de visitas y el número de familiares que acompañan a los pacientes, y c) necesidad de mejorar los registros de las actividades implantados al personal de enfermería. Conclusiones. Entre las fortalezas del uso del enfoque psicopolítico y de la IAP en el contexto hospitalario destacan la movilización de los profesionales y el desarrollo de conciencia crítica. Entre las debilidades, las barreras derivadas de la rigidez del modelo burocrático. Estas barreras suponen un desafío para el cambio y el desarrollo organizacional(AU)

Objective. To describe a collaborative practice focused on coping with the occupational stress among nursing staff in a hospital setting. Method. These practices focus on the contextualization of the problems and the design and implementation of actions using the psychopolitical model and the participatory action research (PAR) methodology. Participants were the nurses of 4 units of internal medicine at the public hospital "Virgen Macarena" in Seville. We have used the ISTAS questionnaire, interviews and discussion groups through which nurses and researchers have assessed, defined, proposed and implemented different actions in order to improve their work conditions. Conclusions. Among the strength of the psychopolitical model and PAR in a hospital context we must emphasize on the mobilization of professionals and the development of a critical consciousness. Among the weakness, those derived from bureaucratic processes. These barriers imply a challenge for change and organizational development(AU)

[Coping with occupational stress among nursing staff by participatory action research]. / Afrontamiento del estrés ocupacional entre profesionales de enfermería hospitalaria desde la investigación acción participativa.

OBJECTIVE: To describe a collaborative practice focused on coping with the occupational stress among nursing staff in a hospital setting. METHOD: These practices focus on the contextualization of the problems and the design and implementation of actions using the psychopolitical model and the participatory action research (PAR) methodology. Participants were the nurses of 4 units of internal medicine at the public hospital "Virgen Macarena" in Seville. We have used the ISTAS questionnaire, interviews and discussion groups through which nurses and researchers have assessed, defined, proposed and implemented different actions in order to improve their work conditions. RESULTS: Problematic situations detected by the questionnaires are associated to psychological demands, role conflicts and esteem. The main cause of stress in healthcare professionals is the lack of staff, according to the opinion laid by supervisors. In the discussion groups, nurses accorded to get involved in three situations: a) the need of the continuous presence of an orderly to move patients which aren't autonomous; b) the need of controlling visit hours and the number of accompanying people with each patient; and c) the need to improve the registration of the activities assigned to nursing staff. CONCLUSIONS: Among the strength of the psychopolitical model and PAR in a hospital context we must emphasize on the mobilization of professionals and the development of a critical consciousness. Among the weakness, those derived from bureaucratic processes. These barriers imply a challenge for change and organizational development.

[Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge]. / Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta.

OBJECTIVE: To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. METHOD: A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). RESULTS: Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. CONCLUSIONS: Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced.

Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta / Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge

Objetivo. Conocer las necesidades de los cuidadores principales de los pacientes portadores de un desfibrilador automático implantable (DAI) durante el ingreso en la Unidad Coronaria del Hospital Virgen Macarena y tras el alta hospitalaria. Método. Estudio cualitativo descriptivo. Se realizó mediante entrevistas semiestructuradas y abiertas. El análisis de contenido de las entrevistas se realizó siguiendo el método de Giorgi (1997). Resultados. Participaron 12 sujetos. Durante la hospitalización destacó la escasa comunicación entre los cuidadores principales y los profesionales de enfermería, su falta de participación en los cuidados y sus dificultades para asimilar la información acerca del DAI. Tras el alta, el miedo y la necesidad de sobreproteger al paciente marcaron los primeros días. El posterior seguimiento en la unidad de ritmo facilitó el proceso de adaptación y la confianza en el DAI. Conclusiones. Sería necesario incluir en la planificación de cuidados al paciente la atención a las necesidades de información y apoyo emocional de los familiares, y que los profesionales de enfermería participasen en el proceso de transmitir la información acerca del DAI y sus posibles complicaciones. Ello permitiría una información progresiva y personalizada, con el fin de preparar el alta y facilitar el ajuste a la nueva situación. Se debería modificar la duración de los horarios de visitas en función de las circunstancias de cada paciente y su familia. Sería necesario poner en marcha estrategias que favorezcan la comunicación entre los cuidadores y los profesionales de enfermería

Objective. To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. Method. A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). Results. Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. Conclusions. Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced

Evaluación de la calidad asistencial y posterior ajuste a la nueva situación tras el implante de un desfibrilador en pacientes ingresados en la Unidad Coronaria del Hospital Virgen Macarena (Sevilla) / Evaluation of the quality of care in implantable cardioverter defibrillator recipients and their adjustment to this therapy in the Coronary Unit of the Hospital Virgen Macarena (Sevilla)

Objetivos. Evaluar la calidad asistencial de enfermería percibida por las personas receptoras de un desfibrilador automático implantable (DAI) ingresadas en la Unidad Coronaria del Hospital Virgen Macarena, e identificar los principales problemas y necesidades que tienen tras el alta, al objeto de mejorar la práctica clínica de enfermería y el proceso de ajuste a la nueva situación. Método. Estudio cualitativo. A 10 sujetos se les realizaron entrevistas semiestructuradas, cuyo guión incluía las dimensiones del modelo SERVQUAL para evaluar la calidad asistencial, y abiertas, para explorar el proceso de ajuste a la nueva situación. Para el análisis de contenido de las transcripciones aplicamos el método de Giorgi (1997). Resultados. Las dimensiones de calidad asistencial mejor valoradas fueron la capacidad de respuesta de enfermería a las necesidades que presentan en el ingreso hospitalario y la empatía. En contraste, algunos aspectos de la tangibilidad relacionados con las visitas de los familiares son los que obtienen una evaluación más negativa. Tras el alta, los pacientes expresaron limitaciones derivadas de cambios físicos, psicológicos y sociales. Estos resultados corroboran los obtenidos en otros estudios que señalan las dificultades en el ajuste a la nueva situación. Conclusiones. Es preciso introducir medidas de mejora durante la hospitalización encaminadas a corregir las deficiencias observadas en la dimensión de tangibilidad y a facilitar la adaptación a la nueva situación. Sería necesario planificar el alta progresivamente durante la hospitalización para paliar el miedo y desconocimiento que genera en los pacientes el readaptar los estilos de vida a la terapia con el DAI

Objectives. To evaluate the quality of nursing care perceived by patients receiving implantable cardioverter defibrillators (ICD) hospitalized in the Coronary Unit of the Hospital Virgin Macarena (Sevilla) and to identify the main problems and needs of these patients after discharge in order to improve clinical nursing practice and patients' adjustment to ICD therapy. Method. A qualitative study was performed. In 10 patients, semi-structured interviews that included the dimensions of the SERVQUAL model were used to evaluate the quality of care, while open interviews were used to explore the process of adjusting to ICD therapy. Content analysis of the transcripts was performed following Giorgi's (1997) method. Results. The quality dimensions receiving the highest rating were nurses' responsiveness to patients' needs on admission and empathy. By contrast, some aspects of tangibility related to family visits received the lowest rating. After hospital discharge, patients reported that they experienced limitations as a consequence of physical, psychological and social changes. These findings corroborate those of other studies that highlight patients' difficulties in adjusting to ICD therapy. Conclusions. Measures aimed at correcting the deficiencies found in the dimension of tangibility and facilitating adaptation to the implantation of ICD should be introduced. During hospitalization, patients should be progressively prepared for discharge to alleviate the fear and lack of knowledge about lifestyle changes required after ICD implantation

Apoyo social, características sociodemográficas y burnout en enfermeras y auxiliares de hospital / Social support, sociodemographic characteristics and burnout syndrome in hospital nurses and nursing auxiliaries

Este estudio explora la relación entre síndrome de burnout (agotamiento emocional, despersonalización y falta de realización personal) y apoyo procedente de la red social: vínculos informales (familia y amigos) y vínculos del lugar de trabajo (supervisores y compañeros). Para la recogida de datos se utilizaron la Multidimensional Support Scale (Winefield HR, Winefield AH, Tiggemann M, 1992) y el Maslach Burnout Inventory (Maslach C, Jackson SE, 1986) en una muestra de enfermeras de un hospital general. Se obtuvieron los siguientes resultados: a) el agotamiento emocional se relacionó positivamente con el apoyo social de los compañeros, y b) la suficiencia con el apoyo de la familia y de los amigos estaba asociada a la realización personal. Para futuras investigaciones se debe considerar la importancia de valorar qué necesidades de apoyo social específicas requieren diferentes vínculos sociales y el rol que los vínculos informales tienen en la prevención del síndrome. Finalmente, se discuten algunas implicaciones que nuestros hallazgos tienen en el diseño y la implementación de programas de prevención (AU)