"Nursing (Her) Storytelling": An Ethnographic Fiction Proposal for Exploring Feminist Health Activism in Spain.

The aim of this article is to share theoretical and methodological reflections on a project on feminist epistemologies and health activism. Based on the analysis of 12 life stories and 1 group interview, an approach based on ethnographic fiction is proposed through the creation of a serial story in podcast format. This approach helps in generating emotions to facilitate understanding and awareness of the issues raised and in showing everyday practices as ways of constructing knowledge. It also avoids turning life stories into academic artifacts with little transformational capacity.

Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction.

AIMS AND OBJECTIVES: To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours after myocardial infarction. BACKGROUND: Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. DESIGN: The study used a multicentre, quasi-experimental, pre-post design without a control group. METHODS: Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification (NOC) outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon's functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student's t-tests for related samples. The results of the study are reported in compliance with the TREND Statement. RESULTS: A total of 132 patients completed the intervention. The indicators for each NOC outcome and the variations in scores before and after the intensive follow-up showed a statistically significant improvement (p-value = 0.000). Compliance Behaviour: Prescribed Diet (pre = 3.7; post = 4.1); Compliance Behaviour: Prescribed Activity (pre = 3.9; post = 4.3); Compliance Behaviour: Prescribed Medication (pre = 3.9; post = 4.7). CONCLUSION: Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients. To facilitate patients' self-efficacy, the use of health education tools such as a cardiovascular self-care notebook can also be helpful. RELEVANCE TO CLINICAL PRACTICE: This study highlights the benefits of intensive, protocolised, comprehensive patient follow-up in primary care during the first few months after an acute myocardial infarction (AMI). Primary care nurses train patients in cardiovascular self-care. PATIENT OR PUBLIC CONTRIBUTION: Patients were not involved in either the design or the carrying out of the study. However, at the end of the study, they participated in an evaluation process about the utility of the research study and their satisfaction with it. This process was carried out using an ad hoc survey consisting of 10 questions assessing the nursing care and follow-up inputs that were received.

Chronic cardiovascular nursing care in Spanish primary care: A qualitative study.

AIMS: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self-efficacy in cardiovascular self-care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow-up. METHODS: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi-structured interviews. A thematic analysis was applied using the data. RESULTS: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. CONCLUSIONS: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease.

Nursing Diagnoses of Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Research Protocol for a Qualitative Synthesis.

Although previously developed qualitative studies have explored the experience of illness of individuals with myalgic encephalomyelitis/chronic fatigue syndrome, these findings have not been undertaken for the purpose of enabling the identification of nursing care needs in such patients. This study aims to identify NANDA-I nursing diagnoses of adults with myalgic encephalomyelitis/chronic fatigue syndrome based on a qualitative literature review of their experience of illness. The protocol includes: searches in the electronic databases Medline, Embase, CINAHL, PsycINFO, SCI-EXPANDED, SSCI, SciELO, LILACS, and Cuiden; and manual searches in specialised journals and the references of the included studies. The authors will systematically search qualitative research studies published in databases from 1994 to 2021. Searches are limited to studies in Spanish and English. All stages of the review process will be carried out independently by two reviewers. Any disagreements shall be resolved through joint discussions, involving a third reviewer if necessary. The findings will be synthesised into a thematic analysis informed by the Domains and Classes of the NANDA-I Classification of Nursing Diagnoses, which will then serve to identify nursing diagnoses. This review will enable nursing professionals to identify the care needs of individuals with myalgic encephalomyelitis/chronic fatigue syndrome by taking into consideration their experience of illness in its entirety.

Validación por expertos del contenido del diagnóstico enfermero de NANDA-I Fatiga (00093) / Expert Validation of the Content for the NANDA-I Nursing Diagnosis of Fatigue

Introducción: La fatiga constituye un importante problema de salud que precisa de una adecuada valoración, diagnóstico y planificación de cuidados enfermeros centrados en quienes la sufren. Objetivo: Validar el contenido del diagnóstico enfermero NANDA-I Fatiga (00093) en la versión incluida en una base de datos clínica. Métodos: Estudio descriptivo y exploratorio de validación de contenido diagnóstico mediante expertos siguiendo la propuesta de Fehring. El ámbito de estudio fue España. La recogida de datos se realizó entre los meses de junio 2019-marzo 2020. Los expertos participantes disponían de experiencia y formación en el uso de lenguajes estandarizados enfermeros. Resultados: De las 13 Características Definitorias con las que cuenta el diagnóstico incluido en la base de datos, siete fueron validadas como mayores, cinco como menores y una no fue validada. Los 16 Factores Relacionados del diagnóstico fueron validados. El Índice de Validez de Contenido del diagnóstico fue de 0,81. Conclusiones: El diagnóstico obtuvo un Índice de Validez de Contenido elevado. Los componentes del diagnóstico NANDA-I Fatiga (00093) en la versión de la base de datos clínica guardan correspondencia con los presentes en el diagnóstico NANDA-I Fatiga (00093) en la Clasificación NANDA-I 2018-2020. Se considera que la investigación actual contribuye a incrementar la precisión diagnóstica al identificar Características Definitorias claves de la presencia del diagnóstico. Al tiempo valida Factores Relacionados influyentes en el diagnóstico no incorporados en los componentes del diagnóstico NANDA-I Fatiga (00093) en la edición de la Clasificación NANDA-I 2018-2020(AU)

Introduction: Fatigue is an important health concern that requiring appropriate assessment, diagnosis and nursing care planning focused on those who suffer from it. Objective: To validate the content of NANDA-I nursing diagnosis of fatigue (00093) in the version included in a clinical database. Methods: Descriptive and exploratory study of diagnostic content validation by experts following Fehring's proposal. The setting of the study was Spain. Data collection was carried out between June 2019 and March 2020. The participating experts had experience and training in the use of standardized nursing languages. Results: Of the thirteen characteristics that define the diagnosis included in the database, seven were validated as major, five as minor and one was not validated. All sixteen related factors of the diagnosis were validated. The content validity index of the diagnosis was 0.81. Conclusions: The diagnosis obtained a high content validity index. The components of the NANDA-I diagnosis of fatigue (00093) in the clinical database version correspond with those present in the NANDA-I diagnosis of fatigue (00093) in the NANDA-I Classification 2018-2020. The current research is considered to contribute with an increase in diagnostic accuracy by identifying key defining characteristics for the diagnosis. At the same time, it validates related factors that have an influence on the diagnosis but are not incorporated among the components of the NANDA-I diagnosis of fatigue (00093) in the 2018-2020 edition of the NANDA-I Classification(AU)

Sentirse vulnerable (o no): repensando la noción de grupo vulnerable / Feeling vulnerable (or not): rethinking the notion of vulnerable group

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Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Chemical Sensitivity: Illness Experiences.

Fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity can be considered contested illnesses. The questioning of the status of these conditions as real diseases reduces feelings of legitimacy in those affected. The purpose of this study was to analyze subjectivity construction processes in people with these diseases. A qualitative exploratory study was conducted from the perspective of hermeneutic phenomenology and ethnosociology. We used life stories for compiling data (13 informants were interviewed face-to-face), and sociological discourse analysis was developed. Three main categories were identified: (a) self and grieving; (b) images and practices relating to fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity; and (c) relationships with health professionals. This study shows that daily experiences of people living with these diseases are marked by stigmatization processes. The ultimate purpose of nursing care for people with these conditions should be to reduce their vulnerability and exclusion.

Reliability and Repeatability of the Instrument for the Assessment of Stress in Nursing Students (ASNS).

Background and objectives: Stress in nursing students is a very common experience, especially when they face clinical practice. The aims of this study were to perform a transcultural adaptation and to examine the reliability and repeatability of the Instrument for the Assessment of Stress in Nursing Students for a Spanish population. Methods: A test-retest analysis was carried out in two face-to-face sessions with the students with a lapse of 10 days between the two sessions. A cross-sectional descriptive study was carried out between the months of May and June 2018. Sixty-four nursing students were recruited with a consecutive sampling method that targeted individuals in the freshman class. Results: A good internal consistency was shown for the total score (α = 0.8861) and for each of the six domains. The test-retest reliability, using the Wilcoxon paired test, was not significant, indicating no differences between the total scores or the domain scores (p ≥ 0.05). Finally, Bland and Altman plots of visual distributions did not show differences between the total scores and the domain scores. Conclusion: The Instrument for the Assessment of Stress in Nursing Students was shown to be a reliable tool for measuring stress factors among Spanish nursing students.

[Qualitative research on the conceptualization around the frequent attendance by primary medical staff]. / Investigación cualitativa sobre la conceptualización de la hiperfrecuentación por parte del personal médico de atención primaria.

BACKGROUND: The frequent attendance is a worrying phenomenon for the health systems of Western countries, due the high work load it generates and its high costs in material and human resources. This work aims to study the meanings, categories and practices that general practitioners build around the frequent attendance. METHODS: Qualitative study, based on a socio-subjective approximation, through in-depth interviews. Eight interviews were conducted with Primary Health Care physicians in Madrid. The discourses were examined from a pragmatist perspective. RESULTS: The figure of the Primary Health Care physician is at the intersection of professional and institutional contradictory logic, which generates high levels of professional malaise. The social and psychological aspects appear in a confused way, due the consideration of the non-physical aspects as outside the realm of medicine. Frequent attendance is problematic because: it is situated in the center of the sign-symptom dichotomy. its management requires so much time. it requires a comprehensive approach. it avoids the medical performance as a professional who diagnosed and establishes an etiological treatment. These problems eventually can lead to conflict in the professional-patient relationship. CONCLUSIONS: The meanings for the frequent attendance will vary significantly depending on the socio-subjective positions, so the approach proposed here could help to understand the complexity of a problem that is built within the relationships between particular subjects crossed by different institutional dynamics, labour disputes, career paths and ideologies.

Prevención del síndrome de Burnout entre los profesionales enfermeros / Prevention of the Burnout Syndrome in nursing professionals

El presente trabajo es una propuesta de intervencióndestinada a prevenir el síndrome deburnout entre los profesionales de Enfermeríaque trabajan en centros hospitalarios. Tomandocomo metodología básica la Investigación-acciónparticipativa, se propone un modelo degestión participativo como instrumento para disminuirel burnout de las enfermeras/os y aumentarla calidad de los cuidados prestados porlas instituciones sanitarias

This paper proposes an intervention to preventthe appearance of burnout syndrome amongnursing professionals working in medical centres.Taking “participative research-action” asmethodology, we propose a participative managementmodel as an instrument to reduceburnout in nurses and to increase the quality ofcare rendered in healthcare institutions

[Practical nursing training in the University School of Nursing of the Community of Madrid. Opinion of students and health professionals. Qualitative study with discussion groups]. / La formación práctica en enfermería en la Escuela Universitaria de Enfermería de la Comunidad de Madrid. Opinión de los alumnos y de los profesionales asistenciales. Un estudio cualitativo con grupos de discusión.

BACKGROUND: In the nursing schools, the contrast between what is taught in the classrooms and what is practiced at the health care centers usually creates a great deal of confusion on the part of the students. The objective of this research is to ascertain the opinion of the students and of the professionals at the health care centers where they are doing their training with regard thereto in order to detect their problems and see what differences exist between primary and specialized care. METHODS: This research was conducted throughout the first half of 2000 employing qualitative methodology, by means of four discussion groups comprised of students, former students, primary care training advisors and nursing professionals at the hospitals where the students of the school in question are doing their nursing training. The initial involvement employed was indirect. RESULTS: The comments of the nursing students and of their training advisors with regard to the practice nursing during the diploma studies reveal dissatisfaction on the part of both of these groups. In all of the groups point out anxiety as the leading factor involved in their teaching as well as learning activities and during professional training. The lack of identification as a group of professionals seems to be related to the lack of recognition on the part of the others, the demand for a degree being granted for their college studies and for the setting up of specialities would contribute to their social recognition and, as a result thereof, to their identification as a professional group. CONCLUSIONS: Until a solution is provided to the anxiety which the nursing professionals feel with regard to their professional practice, which they pass on to their students during nursing training, it will not be possible to achieve a higher degree of satisfaction with nursing training experiences either on the part of the training advisors or on the part of the students.

La formación práctica en enfermería en la Escuela Universitaria de Enfermería de la Comunidad de Madrid. Opinión de los alumnos y de los profesionales asistenciales. Un estudio cualitativo con grupos de discusión / The opinion of nursing students and professionals concerning nursing training in the Community of Madrid, Spain: a discussion groups study

Fundamentos: En las escuelas de enfermería el contraste entre lo que se enseña en las aulas y lo que se practica en los centros asistenciales suele provocar en los alumnos una gran confusión. El objetivo de esta investigación es conocer la opinión de los estudiantes y de los profesionales de los centros asistenciales en los que realizan sus prácticas clínicas acerca de las mismas, para detectar sus problemas y ver si existen diferencias existen entre atención primaria y atención especializada. Métodos: La investigación se realizó durante el primer semestre del año 2000 con metodología cualitativa, a través de cuatro grupos de discusión, formados por alumnos, exalumnos, tutores de atención primaria y profesionales de enfermería de los hospitales en los que se realizan las prácticas. La intervención inicial utilizada fue indirecta. Resultados: El discurso de los estudiantes de enfermería y de sus tutores, sobre las prácticas durante la diplomatura muestra la insatisfacción de ambos colectivos. En todos los grupos aparece la angustia como protagonista de sus actividades tanto docentes como discentes y asistenciales. La falta de reconocimiento social condiciona su falta de identificación como colectivo, y ambos que la angustia esté presente. El reconocimiento de la licenciatura para sus estudios universitarios y el desarrollo de las especialidades contribuiría a su reconocimiento social y a su identificación como colectivo profesional. Conclusiones: Mientras no se resuelva la angustia que los profesionales de enfermería tienen, y que trasladan a los alumnos durante la realización de las prácticas, no se podrá alcanzar mayor nivel de satisfacción con las mismas, ni por parte de los tutores ni por parte de los alumnos (AU)

Background: In the nursing schools, the contrast between what is taught in the classrooms and what is practiced at the health care centers usually creates a great deal of confusion on the part of the students. The objective of this research is to ascertain the opinion of the students and of the professionals at the health care centers where they are doing their training with regard there to in order to detect their problems and see what differences exist between primary and specialized care. Methods: This research was conducted throughout the first half of 2000 employing qualitative methodology, by means of four discussion groups comprised of students, former students, primary care training advisors and nursing professionals at the hospitals where the students of the school in question are doing their nursing training. The initial involvement employed was indirect. Results: The comments of the nursing students and of their training advisors with regard to the practice nursing during the diploma studies reveal dissatisfaction on the part of both of these groups. In all of the groups point out anxiety as the leading factor involved in their teaching as well as learning activities and during professional training. The lack of identification as a group of poffesionals seems to be related to the lack of recognition on the part of the others, the demand for a degree being granted for their college studies and for the setting up of specialties would contribute to their social recognition and, as a result thereof, to their identification as a professional group. Conclusions: Until a solution is provided to the anxiety which the nursing professionals feel with regard to their professional practice, which they pass on to their students during nursing training, it will not be possible to achieve a higher degree of satisfaction with nursing training experiences either on the part of the training advisors or on the part of the students (AU)