An Interpretable Machine Learning Approach to Predict Sensory Processing Sensitivity Trait in Nursing Students.

Sensory processing sensitivity (SPS) is a personality trait that makes certain individuals excessively sensitive to stimuli. People carrying this trait are defined as Highly Sensitive People (HSP). The SPS trait is notably prevalent among nursing students and nurse staff. Although there are HSP diagnostic tools, there is little information about early detection. Therefore, the aim of this work was to develop a prediction model to identify HSP and provide an individualized nursing assessment. A total of 672 nursing students completed all the evaluations. In addition to the HSP diagnosis, emotional intelligence, communication skills, and conflict styles were evaluated. An interpretable machine learning model was trained to predict the SPS trait. We observed a 33% prevalence of HSP, which was higher in women and people with previous health training. HSP were characterized by greater emotional repair (p = 0.033), empathy (p = 0.030), respect (p = 0.038), and global communication skills (p = 0.036). Overall, sex and emotional intelligence dimensions are important to detect this trait, although personal characteristics should be considered. The present individualized prediction model could help to predict the presence of the SPS trait in nursing students, which may be useful in conducting intervention strategies to avoid the negative consequences and reinforce the positive ones of this trait.

Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study.

BACKGROUND: Nursing home residences suffered a lockdown from the beginning of the COVID-19 pandemic. The present study prospectively evaluates the frailty, functional, and nutritional statuses of nursing home residents. METHODS: Three hundred and one residents from three nursing homes took part in the study. Frailty status was measured using the FRAIL scale. Functional status was evaluated using the Barthel Index. Additionally, Short Physical Performance Batter (SPPB), SARC-F, hand-grip strength, and gait speed were also evaluated. Nutritional status was determined using the mini nutritional assessment test (MNA) and several anthropometrical and biochemical markers. RESULTS: Mini Nutritional Assessment test scores decreased in 20% throughout the confinement (p < .001). Barthel index, SPPB and SARC-F scores also decreased, although to a lesser extent, reflecting a decrease in functional capacity. However, both anthropometric parameters, hand grip strength and gait speed, remained stable throughout confinement (p > .050 in all cases). Morning cortisol secretion significantly decreased by 40% from baseline to post-confinement. A significant reduction in daily cortisol variability was observed, which may suggest increased distress. Fifty-six residents died during the period of confinement (81.4% survival rate). Sex, FRAIL and Barthel Index scores were significant predictors of resident survival. CONCLUSION: After the first COVID-19 blockade, several alterations in residents' frailty markers were observed, which were small and potentially reversible. However, many of the residents were pre-frail after the lockdown. This fact highlights the need for preventive strategies to reduce the impact of future social and physical stressors on these vulnerable individuals.

Educational Intervention to Decrease Justification of Adolescent Dating Violence: A Comparative Quasi-Experimental Study.

Adolescent dating violence has become a public health problem because of the associated high morbidity and mortality rates. Despite social awareness about dating violence, the high justification of violence among adolescents is one of the main risk factors for both perpetration and victimisation. Therefore, the objective of the present work was to evaluate the effectiveness of an educational intervention in reducing the justification of violence in adolescent dating. A quasi-experimental, longitudinal, prospective study with a control group was conducted. The study was carried out in six different schools in the Region of Murcia (Spain), and the participants were 854 students aged 14-18 years. The educational intervention was focused on reducing the justification of adolescent dating violence and consisted of 9 weekly 1 h group sessions. The Justification of Verbal/Coercive Tactics Scale (JVCT) and the Attitudes About Aggression in Dating Situations (AADS) survey were administered at baseline and at the end of the intervention in order to determine the justification of psychological and physical violence, respectively. At baseline, the justification of physical violence was at a medium-to-high level in boys (76.8%) and girls (56.7%), whereas psychological violence was much less justified. Concretely, female psychological violence was justified by 19.5% boys and 16.7% girls, while male violence was justified by 19.0% boys and 17.8% girls. After the educational intervention, a significant decrease in physical violence justification, especially in the AADS dimension of female aggression, was observed. The effect of the intervention was especially evident in psychological violence justification: a statistically significant difference was observed in the JVCT scores of boys (-6.4 and 1.3 points in the intervention and control groups, respectively; p = 0.031), but not of girls (p = 0.594). In conclusion, the educational intervention was adequate to reduce the justification of dating violence among the participants. It may provide adolescents with the skills and resources necessary to confront and resolve conflicts in relationships in a non-violent manner.

Research, Reading, and Publication Habits of Nurses and Nursing Students Applied to Impact Journals: International Multicentre Study.

Publishing in JCR and SJR journals has become crucial for curricular development. Results from nursing investigations "compete" for publication in journals which are not specific to the field of care, affecting the academic development of these investigators. This phenomenon may lead to an ongoing adverse effect on nursing researchers and academics engaged in research in nursing care. The aim of this study was to evaluate habits regarding scientific literature consulting, the transfer of published material, and the citation of nursing investigations. A cross-sectional descriptive study by means of questionnaires was carried out, focusing on both Spanish and Portuguese nurses. The findings of the study reveal the following reasons for reading the scientific literature: that the language was understood; for learning and applying what was learnt; that the journal was of open access; for elaborating protocols and work procedures; and that the journal was indexed in scientific databases and in nursing databases. The reasons for reading, using, and publishing in journals were related to knowledge of the language and the associated usefulness of learning and applying knowledge. Creating a specific index of research publications in nursing will have a positive effect on the scientific production of caring methodologies.

Sociosanitary Legal and Economic Aspects in Nursing Homes for the Elderly in Spain.

AIM: The study aimed to identify and compare aspects of the different Spanish regulations on the minimum conditions that nursing homes must meet and to compare whether these requirements significantly affect the price of a nursing home place in each region. METHODS: We analyzed and compared the 17 regional regulations that must be met by nursing homes in terms of equipment and social and healthcare staff and combined this information with regional information concerning the price and coverage of public and subsidized places in nursing homes. RESULTS: The study revealed significant regional inequality in physical facilities and human resources. However, the number of regulatory measures referring to the mandatory availability of physical space or specific material resources was not positively correlated with an increase in the price of a place in a public or subsidized nursing home. CONCLUSIONS: No unified regulations throughout Spain regulate the aspects that residential centers must comply with. There is a need to move towards a person-centered approach, providing an environment as close to home as possible. The regulation of minimum standards to be met by all nursing homes at the national level should not significantly impact prices.

Nontechnical skills training in intensive care units: Protocol for a systematic review and meta-analysis.

This study is aimed at describing a protocol for a systematic review and meta-analysis to assess the effect of nontechnical skills training on the acquisition of knowledge, skills or attitudes, and changes in behavior at the workplace, of healthcare professionals working in intensive care units (ICUs), as well as the effect on outcomes at an organizational level. We will search for original studies in the PubMed/Medline, Scopus, Web of Science, Science Direct, EMBASE and PsycINFO databases. Studies with a clinical trial or quasi-experimental design will be included. Two reviewers will independently screen and assess the included studies, with any disagreements being resolved by a third reviewer. We will summarize the findings using a narrative approach and, if possible, conduct a quantitative synthesis (meta-analysis). We will conduct the protocol following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines. The review will summarize the current evidence on nontechnical skills training in ICUs, examining satisfaction with the training program, improvements in knowledge about nontechnical skills and the adoption of safety behaviors, as well as improvement in outcomes for the organization, such as mortality rates, length of stay and cost indicators. We expect that the systematic review could indicate effective strategies for training ICU professionals in nontechnical skills and also determine whether these strategies really improve the safety culture and professional knowledge and behaviors, as well as patient outcomes and safety.

Validity and reliability of the measurement instrument of the nursing outcome health-related Physical Fitness (2004), proposed and transculturally adapted to the Spanish context.

BACKGROUND: Presently, physical inactivity is the main public health problem in many countries worldwide. Physical activity promotes the maintenance or improvement of one's physical condition. Physical fitness has been established as the main biological marker of the state of health of an individual, and therefore, there is a clear need to measure health-related physical fitness through the use of a reliable and valid instrument. This study is a continuation of the transcultural adaptation process and a new proposal of the nursing outcome Physical Fitness (2004), found in the 5th Edition of the Nursing Outcomes Classification. The objective of this study was to examine the validity and reliability of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context. METHODS: An instrumental study to validate the nursing outcome Physical Fitness (2004), from the 5th Edition of the Nursing Outcome Classification was carried out. It took place between the months of May, 2016 to May, 2017. On the first stage, the instrument proposed Health-Related Physical Fitness survey was administered to 160 adults who used the Health Services of Murcia, Spain by three independent evaluators. After 4 weeks, it was administered again to 33 participants to calculate the intra-rater reliability. Lastly, the SF-12v2 Health Survey was administered to obtain external evidence of validity. RESULTS: The inter-rater reliability of the nursing outcome proposed obtained high values (between 0.91-0.99) in the evaluations performed by the three evaluators. As for the intra-rater reliability, high values were obtained (0.94-1), except for the item "balance", which was moderate (0.56). Lastly, a positive and statistically significant correlation (p < 0.05) was obtained between the Physical Component Summary, and the dimensions Physical Functioning and General Health from the SF-12v2 Health Survey, and the global score of the Health-Related Physical Fitness proposed instrument. CONCLUSIONS: The validity and reliability results of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context, were adequate for its use by nurses with adults who use the Health Services of Murcia. However, this instrument must be analyzed with more diverse samples of health services users.

Adaptation of the Highly Sensitive Person Scale (HSP) and Psychometric Properties of Reduced Versions of the Highly Sensitive Person Scale (R-HSP Scale) in Spanish Nursing Students.

Sensory processing sensitivity (SPS) can be defined as a personality characteristic that includes the individual characteristics of sensitivity towards endogenous and exogenous stimuli. The differences in environmental sensitivity can play a crucial role in the academic context of health professionals, thus defining it as an area of research that must be addressed. The reduced scale for highly sensitive people (HSP) is a short (16 items) and adapted version of the original scale for highly sensitive people (HSP). This study aims to analyze the psychometric properties of reduced versions of the Highly Sensitive Person Scale (r-HSP Scale) in Spanish nursing students. Once the questionnaire was translated, its psychometric characteristics were analyzed. The Spanish version of the r-HSP scale was administered to 284 university students enrolled in the Nursing Degree. The results from the factorial analysis confirmed the structure of sensitiveness of six factors in our sample. This structure included the following dimensions: (1) Instability, (2) Surroundings, (3) Interaction with others, (4) Sensoperception, (5) Sensitivity, and (6) Insecurity. Additionally, the Cronbach's α values indicated that the Spanish version of the r-HSP scale had an adequate reliability (α = 0.702). The r-HSP scale is defined as a reliable, valid, and agile replica of the original structure of sensitivity in Spanish university students.

Valoración del recién nacido. Correlación del test de Apgar con la gasometría arterial al nacimiento / Assessment of the newborn. Correlation of the Apgar test with arterial blood gas at birth

Objetivo: Evaluar la correlación entre las puntuaciones del test de Apgar y los valores de la gasometría arterial al nacimiento. Metodología: Estudio descriptivo transversal de prevalencia realizado en el Hospital Universitario Rafael Méndez de Lorca (España). Los datos se obtuvieron del registro informático de datos clínicos, analizando como variable dependiente las puntuaciones del test de Apgar al minuto de vida, y como variables independientes el pH, la presión parcial de dióxido de carbono y el déficit de base, recogidos mediante gasometría de la arteria umbilical al nacimiento. El análisis estadístico adoptó un nivel de significación estadística de p <0,05 mediante la aplicación de pruebas paramétricas, como el coeficiente de correlación de Pearson, la t de Student para muestras independientes y la χ2 . Resultados: La muestra fue de 312 neonatos. Se observa una correlación significativa entre las puntuaciones del test de Apgar patológicas y la acidosis fetal (p= 0,006; odds ratio [OR]= 2,555), la hipercapnia (p= 0,004; OR= 2,675), el déficit de bases (p= 0,001; OR= 4,758) y la acidosis metabólica (p= 0,018; OR= 3,556) al nacimiento. Conclusiones: Se puede establecer una correlación entre el test de Apgar al minuto de vida y la gasometría arterial al nacimiento. Se observa una subestimación profesional en las puntuaciones de las acidosis respiratorias. (AU)

Objective: To evaluate the degree of correlation between the Apgar test scores and the arterial blood gas values at birth. Methodology: Observational, analytical, retrospective and prevalence study carried out at the Hospital Universitario Rafael Méndez (Spain) on a sample of 312 neonates. The data were obtained from the computerized registry of clinical data, analyzing the Apgar test scores at one minute of life as a dependent variable, and pH, pCO2 and base deficits collected by means of umbilical artery blood gases at birth as independent variables. Statistical analysis adopted a significance level of p <0.05 through the application of parametric tests such as Pearson's correlation coefficient, Student’s t-test for independent samples and χ2 . Results: A significant correlation is observed between pathological Apgar test scores and fetal acidosis (p= 0.006; Odds ratio [OR]= 2.555), hypercapnia (p= 0.004; OR= 2.675), base deficit (p= 0.001; OR= 4.758) and metabolic acidosis (p= 0.018; OR= 3.556) at birth. Conclusions: A correlation can be established between the Apgar test at minute of life and arterial blood gas at birth, observing a professional underestimation in the scores of respiratory acidosis. (AU)

[Impact of the duration of labor in the neonatal state measured by arterial blood gas at birth.] / Repercusión de la duración del parto en el estado neonatal medido a través de la gasometría arterial al nacimiento.

OBJECTIVE: The duration of labor has become a central axis of its clinical management, most of the studies that analyze its relationship with the neonatal state focus on indirect tests such as the Apgar test or admissions to the NICU. The aim of the study was to analyze the repercussions of the duration of labor on the condition of the neonates without added risk factors through a direct analysis test such as the umbilical artery blood gas test at birth. METHODS: An observational, analytical, retrospective, and prevalence study was conducted on a sample of 286 infants no previous risk factors obtained from the computerized clinical registry. For a confidence level of p<0.05, parametric tests such as Pearson's correlation coefficient and Chi-square were applied. RESULTS: Showed a significant negative correlation between umbilical artery pH values and delivery times (Dilation: R=-0.207; p=0.002 - Expulsive: R=-0.150; p=0.027 - Total delivery: R=-0.181; p=0.006). Presenting deliveries with times above the mean greater possibilities of fetal acidosis and hypercapnia in dilation (pH: OR=3.10; IC 1.64-5.51 - pCO2: OR=2.19; IC 1.23-3.89), the expulsive (pH: OR=2.24; IC 1.21-4.16 - pCO2: OR=1.77; IC 0.98-3.22) and the total duration (pH: OR=3.36, IC 1.84-6.13- pCO2: OR=2.53; IC 1.44-4.46). CONCLUSIONS: A significant association is was found between the prolongation of labor times and acidosis and neonatal hypercapnia.

OBJETIVO: La duración del parto se ha convertido en un eje central de su manejo clínico, la mayoría de estudios que analizan su relación con el estado neonatal se centra en pruebas indirectas como el test de Apgar o los ingresos en UCIN. El objetivo del estudio fue analizar las repercusiones de la duración del parto en el estado de los neonatos sin factores de riesgo añadidos a través de una prueba de análisis directo como es la gasometría de arteria umbilical al nacimiento. METODOS: Se diseñó un estudio observacional analítico, retrospectivo y de prevalencia realizado sobre una muestra de 286 neonatos sin factores de riesgo previos obtenida del registro clínico informático. Para un nivel de confianza de p<0,05 se aplicaron pruebas paramétricas como el coeficiente de correlación de Pearson y la Chi cuadrado. RESULTADOS: Mostraron una correlación significativa negativa entre los valores de pH de arteria umbilical y los tiempos del parto (Dilatación: R=-0,207; p=0,002 ­ Expulsivo: R=-0,150; p=0,027 - Totales de parto: R=-0,181; p=0,006). Presentando los partos con tiempos superiores a la media mayores posibilidades de acidosis fetal e hipercapnia en la dilatación (pH: OR=3,10; IC 1,64-5,51 - pCO2: OR=2,19; IC 1,23-3,89), el expulsivo (pH: OR=2,24; IC 1,21-4,16 - pCO2: OR=1,77; IC 0,98-3,22) y la duración total (pH: OR=3,36, IC 1,84-6,13- pCO2: OR=2,53; IC 1,44-4,46). CONCLUSIONES: Se constató una asociación significativa entre la prolongación de los tiempos del parto y la acidosis e hipercapnia neonatal.

Benefits of Dog-Assisted Therapy in Patients with Dementia Residing in Aged Care Centers in Spain.

(1) Background: Currently, the scientific evidence on the benefits of assisted therapy with dogs in dementia is not clear. In this study, we want to evaluate such benefits through a randomized controlled clinical trial in multiple centers across the country. (2) Methods: The participants were people over 65 years old with dementia, residing in senior centers in Spain (n = 334). The experimental group underwent assisted therapy with dogs based on the Comprehensive Cognitive Activation Program in Dementia, for 8 months, with weekly sessions of 45 min. Data were collected at the commencement, middle, and end of the program, to evaluate the aspects using the Mini-Examination Cognitive, the modified Bartell Index, the Cornell Scale for Depression in Dementia and the Neuropsychiatric Inventory. (3) Results: The results show significant improvements in the experimental group versus the control group in the affective (T1 = p 0.000; T2 = p 0.000) and behavioral (T1 = p 0.005; T2 = p 0.000) aspects, with the affective aspect displaying greater progress in participants with additional depressive (p = 0.022) or anxiety (p = 0.000) disorders, shorter institutionalization periods (r = -0.222, p = 0.004), and those undergoing complementary psychotherapy (p = 0.033) or alternative therapy (p = 0.011). (4) Conclusions: Dog therapy is effective in improving the affective and behavioral aspects of institutionalized patients with dementia.

Etno-obstetricias hospitalarias mixtas: Redes clínicas de transición hacia la humanización asistencial / Ethno-obstetrics combinations in hospitals: Clinical networks of transition towards healthcare humanization / Ethno-obstetrícias hospitaleiro mixed: Redes clínicas de transição para a humanização em saúde

OBJETIVO: El estudio analiza el grado de implementación de las nuevas coordenadas asistenciales humanistas dadas para la asistencia de los partos hospitalarios de bajo riesgo en España y su influencia en la generación de nuevas redes clínicas de cuidado. METODOLOGÍA: Se utilizó un enfoque etnográfico basado en la observación participante en un paritorio de un hospital del sistema sanitario estatal español, y en la realización de una serie entrevistas semiestructuradas a madres atendidas en dicho centro, se acumularon ochocientas setenta y cuatro horas de observación y veinte entrevistas. RESULTADOS: Los resultados muestran una metamorfosis hacia redes clínicas de asistencia del parto en clave humanista, transformación dibujada sobre el fondo de una dinámica asistencial todavía medicalizada. CONCLUSIONES: Se puede concluir que se están generando nuevas redes asistenciales mixtas a medio camino entre el intervencionismo y la humanización asistencial. Redes sujetas aún a las idiosincrasias y filosofías de los diferentes profesionales, pero que suponen un importante paso hacia una humanización percibida todavía como una trasgresión al orden clínicamente establecido

OBJECTIVE: This study analyzes the degree of implementation of the new humanist care guidelines for low risk childbirth at hospitals in Spain and their influence on the creation of new clinical care networks. METHODOLOGY: An ethnographic approach was used based on participant observation at a delivery room of the Spanish public healthcare system and on a series of semi structured interviews with mothers attended to at given center, resulting in eight hundred and seventy-four hours of observation and twenty mothers interviewed. RESULTS: Results show a shift towards networks of clinics offering humanist driven childbirth assistance, a transformation taking place over a background of a still medicalized care dynamics. CONCLUSIONS: One can conclude that new mixed care networks are being generated halfway between interventionism and assistance humanization, such networks being still subject to the idyossincrasies and philosophies of the different professionals involved, yet allowing to believe in an important step being taken towards a humanization that some may still regard as a transgression to the clinically established order

OBJETIVO: O estudo analisa o grau de implementação das novas coordenadas de assistência humanística dadas para a assistência de partos hospitalares de baixo risco em Espanha e sua influência na geração de novas redes de atendimento clínico. METODOLOGIA: Utilizou-se uma abordagem etnográfica baseada na observação participante em uma enfermaria do sistema de saúde do Estado espanhol e, na realização de uma série de entrevistas semi-estruturadas com mães atendidas naquele centro, foram acumuladas oitocentos e setenta e quatro horas de observação e vinte entrevistas. RESULTADOS: Os resultados mostram uma metamorfose para redes clínicas de assistência ao parto em uma chave humanista, uma transformação traçada sobre o pano de fundo de uma dinâmica assistencial ainda medicalizada. CONCLUSÕES: Pode-se concluir que novas redes de atenção mista estão sendo geradas a meio caminho entre o intervencionismo e o humanização da assistência. Redes ainda sujeitas às idiossincrasias e filosofias de diferentes profissionais, mas que representam um passo importante para um humanização ainda percebido como uma transgressão da ordem clinicamente estabelecida

Implementation of Assisted Therapy With Dogs in the Therapeutic Approach to People With Autistic Spectrum Disorder.

A holistic intervention is needed for individuals who suffer from autism spectrum disorders. Our objective was to work with these individuals in a multidisciplinary manner through the use of animal-assisted therapy, finding improvements in the experimental group as compared with the control group in the different evaluated areas.

¿Némesis obstétrica o disminución del riesgo? A debate bioético el abordaje intervencionista en los partos de bajo riesgo / Obstetric nemesis or decrease risk? A discussion bioethical the approach interventionist in low-risk deliveries / Nemesis obstétrica ou diminuição do risco? A debate bioético a abordagem intervencionista em partos de baixo risco

Resumen: Desde hace décadas el parto de bajo riesgo ha sido abordado, fundamentalmente en el ámbito clínico-hospitalario, desde una perspectiva intervencionista, caracterizada por la medicalización, tecnificación y mecanización asistencial. En este contexto se sitúa el presente estudio, cuyo objetivo ha sido explorar las limitaciones bioéticas de este paradigma asistencial intervencionista, mediante el análisis de su pragmatismo clínico frente a otros abordajes más humanistas. Para ello se ha llevado a cabo un profundo análisis documental en diferentes bases de datos del ámbito de las ciencias médicas y sociales, seleccionando tanto artículos de difusión científica como libros, declaraciones, estrategias y guías de práctica clínica. Los resultados muestran un patrón asistencial medicalizado, que parece incrementar las intervenciones no justificadas y con ello los efectos iatrogénicos en los partos de bajo riesgo. Se concluye que estamos ante una cultura del nacimiento que, en cierta medida, vulnera los principios bioéticos fundamentales, al subyugar la dignidad de la corporalidad femenina a intereses económicos contingentes e ideologías transhumanistas, biopolíticas y tayloristas cosificadoras.

Abstract: For decades in low-risk deliveries has been addressed, mainly in the clinical-hospital setting, from an interventionist perspective characterized by medicalization, mechanization and machining care. In this context the present study lies, whose aim was to explore the bioethical limitations of this interventionist paradigm of care through an analysis of its clinical pragmatism compared to other approaches more humanistic. For this it has conducted a thorough analysis of documents in different databases in the field of medical and social sciences, selecting both items of scientific diffusion as books, statements, strategies and clinical practice guidelines. The results show a medicalized care pattern appears to increase the iatrogenic effects in low-risk deliveries. We conclude that this is a culture of birth which, to some, it violates basic bioethical principles to subjugate the dignity of female corporeality to contingent economic interests and transhumanists, biopolitics and taylorist ideologies reifying.

Resumo: Por décadas o parto de baixo risco tem sido abordado, fundamentalmente no campo clinico-hospitalar, a partir de uma perspectiva intervencionista caracterizada pela medicalização, tecnificação e mecanização assitencial. Nesse contexto se situa o presente estudo, cujo objetivo tem sido explorar a limitações bioéticas desse paradigma assistencial intervencionista através da análise de seu pragmatismo clínico frente à outras abordagens mais humanistas. Para isto, fora realizada uma profunda análise documental em diferentes bases de dados no campo das ciências médicas e sociais, selecionando tanto artigos de divulgação científica como livros, declarações, estratégias e guias de prática clínica. Os resultados mostram um padrão assistencial medicalizado que parece intensificar as intervenções não justificadas e, por conseguinte, os efeitos iatrogénicos em partos de baixo risco. Conclui-se estamos diante de uma cultura de nascimento que, em certa medida, viola os princípios bioéticos fundamentais ao subjugar a dignidade da corporalidade feminina por interesses econômicos contingentes e ideologias transumanistas, biopolíticas e tayloristas reificantes.

Hablan las madres. La parte menos contada del aborto voluntario / Mother talk. Part unless told of voluntary abortion

El objetivo del artículo ha sido explorar las experiencias ligadas al síndrome postaborto en madres que se han sometido a un aborto voluntario. Se utilizó un enfoque fenomenológico de carácter cualitativo que recogiera las experiencias de las madres que se habían sometido a una interrupción voluntaria de su embarazo. La técnica de investigación fueron las entrevistas semiestructuradas realizadas a mujeres que habían contactado con diferentes asociaciones de ayuda de la Región de Murcia en busca de apoyo tras experimentar síntomas compatibles con el síndrome postaborto. Los testimonios hablan de mujeres que se aferran a argumentos utilitaristas o feministas para autojustificar la decisión de abortar, hablan de un sistema, en cierta medida, mercantilista que no parece tener una intencionalidad real de dar verdaderas opciones de vida. Muestra una experiencia que lejos de vivirse como un acto de libertad femenino se vive de manera traumática, desarrollándose toda una cascada sintomática fruto del sentimiento de pérdida. En este contexto, el recurso a lo espiritual se torna en la mejor herramienta para expiar la culpa. La experiencia de abortar no mejora la vida de las mujeres, muy lejos de ello supone un trauma difícil de olvidar que puede ser evitado con un asesoramiento adecuado que no aboque a las madres a la tragedia del aborto

The aim of the study was to investigate the experiences linked to the post-abortion syndrome in mothers who have had a voluntary abortion. A phenomenological qualitative approach to collect the experiences of mothers who had voluntarily interrupted their pregnancy was used. The research technique was the semistructured interviews with women who had contacted different association’s help of the Murcia region for support after experiencing symptoms consistent with post-abortion syndrome. The testimonies show feminist or utilitarian arguments to justify the decision to abort, they talk about a system, to some extent, mercantilist that has no real intention of giving real life choices. Experience shows that far from lived as an act of female freedom is experienced traumatically, developed symptoms following the sense of loss. In this context, the resource spiritual becomes the best tool to expiate guilt. The experience of abortion does not improve the lives of women; far from it is a trauma that can be avoided with proper advice to avoid the tragedy of abortion

[Mothers Talk. Part Unless Told of Voluntary Abortion]. / Hablan Las Madres. la Parte Menos Contada Del Aborto Voluntario.

The aim of the study was to investigate the experiences linked to the post-abortion syndrome in mothers who have had a voluntary abortion. A phenomenological qualitative approach to collect the experiences of mothers who had voluntarily interrupted their pregnancy was used. The research technique was the semistructured interviews with women who had contacted different association's help of the Murcia region for support after experiencing symptoms consistent with post-abortion syndrome. The testimonies show feminist or utilitarian arguments to justify the decision to abort, they talk about a system, to some extent, mercantilist that has no real intention of giving real life choices. Experience shows that far from lived as an act of female freedom is experienced traumatically, developed symptoms following the sense of loss. In this context, the resource spiritual becomes the best tool to expiate guilt. The experience of abortion does not improve the lives of women; far from it is a trauma that can be avoided with proper advice to avoid the tragedy of abortion.

The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain.

OBJECTIVES: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain). METHOD: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied. RESULTS: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation. CONCLUSIONS: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health.

The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain / O diálogo cultural na dimensão doméstica de atendimento em cuidadores imigrantes na Espanha / Diálogo cultural en la dimensión doméstica de cuidar en cuidadores inmigrantes en España

Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain).Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied.Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation.Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health.

Objetivos: determinar como o fenômeno da imigração influencia na resposta aos cuidados informais a nível doméstico por meio da atividade de um cuidador e analisar o diálogo cultural estabelecido na área habitacional de Múrcia (Espanha).Método: Trata-se de um estudo etnográfico, realizado em 26 cuidadores informais imigrantes. Como instrumentos de coleta de dados foram utilizadas entrevistas semiestruturadas e observação participante. Análise de conteúdo assistida MAXQDA-2 também foi aplicada.Resultados: a cuidadora imigrante é a principal consumidora de medicamentos tradicionais, estendendo essas práticas de saúde para o grupo doméstico. Um diálogo cultural é estabelecido no cuidado informal, caracterizado pela interculturalidade e adaptação mútua.Conclusões: identifica-se hibridização cultural nas cuidadoras informais imigrantes, intercâmbio e integração cultural: novas práticas de atendimento na saúde e comportamentos culturais em sistemas informais. Há uma transformação nos papéis familiares em atendimento em ambientes domésticos, aumentando a qualidade de vida e autocuidado. Eles representam uma alternativa à medicalização, promovendo a autogestão da saúde.

Objetivos: conocer cómo influye el fenómeno de la inmigración en la respuesta informal de cuidados a nivel doméstico a través de la actividad como cuidador y analizar el diálogo cultural que se establece en el ámbito domiciliario de Murcia (España).Método: se trata de un estudio etnográfico, realizado en 26 cuidadores informales inmigrantes. Como instrumentos de recogida de información utilizamos entrevista semiestructurada y observación participante. Se aplicó análisis de contenido asistido por MAXQDA-2.Resultados: La cuidadora inmigrante es la principal consumidora de medicinas tradicionales, extendiendo estas prácticas de salud al grupo doméstico, favoreciendo el pluralismo asistencial, pero fomentando también su invisibilidad. Se establece un diálogo cultural en el cuidado informal, caracterizado por interculturalismo y adaptación mutua.Conclusiones: se identifica hibridación cultural en las cuidadoras informales inmigrantes, intercambio e integración cultural: nuevas prácticas de atención a la salud y comportamientos culturales en los sistemas informales. Existe una transformación de roles familiares del cuidado en entornos domésticos, aumentando la calidad de vida, autoatención y autocuidado. Representan una alternativa a la medicalización, potenciando la autogestión de salud.

Enfermera Gestora de Casos del Servicio Murciano de Salud: un año de puesta en marcha del programa / Nurse Case Manager Murcia Health Service: a year of program implementation

Los objetivos que se plantean son describir los procesos claves de la enfermera gestora de casos (EGC) en un año de puesta en marcha del programa. Conocer el perfil sociodemográfico y clínico de la población diana y conocer la sobrecarga en el cuidador familiar. El estudio es observacional descriptivo y transversal en el Área IX de salud Murcia desde el 1 de junio de 2010 hasta 31 mayo de 2011. Se realiza mapa de procesos de la EGC, identificación de pacientes con OMI-AP y CIVITAS, y se realiza visita en consulta y/o domiciliaria para valoración inicial con datos sociodemográficos, 11 patrones funcionales de M. Gordon, y cuestionarios validados. El número de personas captadas es de 258 pacientes y 115 cuidadoras. La población con EPOC representa un 22,9%. El 63,9% de pacientes tienen valoración completa realizada. El patrón actividad y ejercicio es el más alterado. Los pacientes tienen una media de edad de 74 ± 15 años. Las mujeres predominan en la población diana general 54,7%. El 87,2% presenta algún grado de dependencia, existe un mayor porcentaje con dependencia severa. La media de edad de la cuidadora familiar, es 59 ± 13 años, de las cuales, el 40% de las cuidadoras familiares no tienen sobrecarga. La población captada supone un 5,3% de la población compleja. Desde la incorporación de la EGC, ha aumentado el registro de las valoraciones por patrones, tanto de pacientes como de cuidadoras. La población captada está envejecida, frágil, con un nivel de dependencia severo, preferentemente es mujer, con cuidadora familiar (mujer) donde son más frecuentes las que no tienen sobrecarga (AU)

The objectives of this paper are to describe the fundamental processes of the nurse case manager in a year of the program, to know the sociodemographic and clinical profile of the target population and the strain on the caregiver. Methodology: This observational, descriptive and transversal study has been made in the health area of Murcia IX from 1 June 2010 to 31 May 2011. It describes the process maps of the nurse case manager; patients are identified through OMI-AP software and CIVITAS. Home visits are conducted to measure the social and demographic patterns, to perform evaluation through M. Gordon functional patterns and to apply validated questionnaires. The number of people who enter into the program is 258 patients and 115 care givers. The population with chronic obstructive pulmonary disease represents 22.9% ; 63.9% of patients have made full assessment. Results: The functional pattern that measures activity and exercise is the most altered. Patients have a mean age of 74 ± 15 years. Women predominate in the overall target population 54.7%; 87.2% have some degree of dependence, there are a higher percentage of patients with severe dependence. The average age of caregivers is 59 ± 13 years, of which, 40 % of family caregivers are not overloaded. The target population represented 5.3% of the population more vulnerable. Since the introduction of case manager, registration of functional patterns in medical records of patients and caregivers has increased. The aging population is high, fragile, with a severe dependence level, preferably female, with family caregivers (women) without overloading conclusions (AU)

¿Por qué a mí? Instantáneas del momento del accidente en los amputados traumáticos / Why me? Snapshots of the time of the accident in traumatic amputees

Introducción: Describimos un momento crucial del itinerario vital de los amputados traumáticos. Objetivos: Describir y analizar las perspectivas elaboradas en torno al instante del accidente desde el punto de vista de los amputados traumáticos. Metodología: Estudio cualitativo de corte etnográfico. Participantes del estudio: 19 amputados en su mayor parte de origen traumático. Los datos se recogieron mediante entrevistas semiestructuradas, historias de vida y observación participante. Resultados: Aparece el concepto de "ser invulnerable", la imprevisibilidad de los accidentes y el papel de la casualidad y el azar en la tragedia. El arcaico debate del destino frente a la casualidad está presente. Conclusiones: Muchos moteros, con un estilo de vida ligado al ocio, experimentan el frenazo que supone el suceso, metafóricamente, de 100 a 0 km/h. Se evidencia la impronta en el imaginario de los amputados del poder de la ciencia encarnada en la cirugía y la inmortalidad del cuerpo como concepto

Introduction: we describe a turning point of the life course of traumatic amputees. Objectives: To describe and to analyze the aspects around the instant of the accident from the point of view of the traumatic amputees. Methodology: qualitative ethnographic. Study Participants: 19 amputees mostly of traumatic origin. Data were collected through semi-structured interviews, life histories and participant observation. Results: It appears the concept of "invulnerable", the unpredictability of accidents and the role of chance and randomness in the tragedy. The archaic discussion of fate versus chance is present. Conclusions: Many motorcyclist, with a lifestyle linked to leisure, experience the change of course, the slowdown that representing the event, metaphorically, from 100 to 0 km / h. There is a clear imprint on the imagination of the amputees about the power of science embodied in surgery and the concept of the immortality of the body