Photovoice: An active learning tool with community nursing students.

OBJECTIVE: To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community. METHODS: A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data. RESULTS: Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action". CONCLUSIONS: Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.

[Reacciones de las mujeres ante el folleto del Programa de Detección Precoz del Cáncer de Mama.] / Women's reactions upon reading a leaflet on Breast Cancer Screening Program.

OBJECTIVE: Breast cancer screening (BCS) leaflets are important for outreach and dissemination of BCS programs. Knowing how women perceive these leaflets is relevant to better understand their attitude towards BCS. The objective of this paper was to explore women's reactions regarding BCS leaflet. METHODS: A simple descriptive qualitative design was performed involving women aged between forty and sixty years of age in Asturias (Spain). Twenty-six semi-structured interviews were conducted with women of different socioeconomic profiles in 2018. Thematic analysis was carried out. RESULTS: Reading the leaflet elicited positive emotions such as peace of mind, well-being or gratitude, in addition to fear or anxiety. The women expressed various beliefs about breast cancer (highly prevalent and high survival rates), about BCS (a program aimed at prevention, a normative activity among their peers) and about the relevant role of health services and the media. Ambivalent attitudes towards BCS were detected, related to emotions. CONCLUSIONS: The emotional response after reading the brochure is ambivalent, although most of the women express positive emotions. Women compare the information with previous beliefs, especially regarding breast cancer (BC) and BCS. It is important to understand how certain emotions (especially negative ones) are closely related to the attitude towards BCS.

OBJETIVO: El folleto del Programa de Detección Precoz del Cáncer de Mama (PDPCM) es una importante herramienta de difusión de ese programa. Conocer la percepción de las mujeres sobre ese material informativo es relevante para entender mejor su actitud hacia el PDPCM. El objetivo del estudio fue explorar las reacciones de las mujeres respecto al folleto del PDPCM. METODOS: Se realizó un estudio cualitativo descriptivo en mujeres de entre cuarenta y sesenta años en Asturias (España). Se realizaron veintiséis entrevistas semiestructuradas a mujeres de diferentes perfiles socioeconómicos en 2018. Se realizó un análisis de contenido para identificar inductivamente las categorías emergentes. RESULTADOS: La lectura del folleto despertó emociones positivas como tranquilidad, bienestar o gratitud, pero también miedo o inquietud. Las mujeres expresaron diversas creencias sobre el CM (enfermedad muy prevalente y de elevada supervivencia), sobre el PDPCM (programa dirigido a la prevención y que suponía una actividad normalizada en su entorno) y sobre el relevante papel de los servicios de salud y los medios de comunicación. Se detectaron actitudes ambivalentes hacia el PDPCM y estas actitudes estaban relacionadas con las emociones. CONCLUSIONES: La respuesta emocional al leer el folleto es ambivalente, aunque la mayoría de las mujeres expresan emociones positivas. Las mujeres comparan la información con sus creencias previas, especialmente respecto al CM y al PDPCM. Es importante entender cómo ciertas emociones (especialmente las negativas) están estrechamente relacionadas con la actitud hacia este programa.

Perception of care from the perspective of nursing students: A study using photovoice, storytelling and poetry.

BACKGROUND: The Higher Education in Nursing requires providing students with skills such as critical and reflective thinking about the actions to be carried out so that they are capable of providing humanised and quality care in an increasingly complex and technified society. Participatory teaching methodologies promote the development of these skills. OBJECTIVES: to explore the potential of photovoice, storytelling and poetry as instruments capable of encouraging reflection. To identify through images (photovoice) and poetic narratives (storytelling and poetry) the perception that students of the nursing degree express about nursing care. DESIGN: qualitative study in the framework of the socio-critical paradigm, using photovoice, storytelling and poetry in the field of care. PARTICIPANTS: first-year undergraduate nursing students at two Spanish universities in the academic year 2021-2022. METHODOLOGY: 48 images were shown and students were asked to select one, write a narrative and generate a short poem connected to the image. Subsequently, a content analysis was conducted of those poems evoked by the five photographs most chosen by the students. The analysis was supported by qualitative data analysis software. A total of 67 contributions from 67 students were analysed. RESULTS: the concepts addressed in the poems and the compositions generated reveal how critical humanist thinking and reflection on the subject of care developed. The topics identified were care, accompaniment throughout the life cycle, working on the basis of values and caring for small details as subcategories of nursing care. CONCLUSION: The combination of different tools in university education has encouraged reflection and enabled students to identify for themselves the importance of humanised care. Working on the theoretical foundation in an active way can reduce the gap between theory and practice and foster the empowerment of the nursing identity.

Reacciones de las mujeres ante el folleto del Programa de Detección Precoz del Cáncer de Mama / Women’s reactions upon reading a leaflet on Breast Cancer Screening Program

Fundamentos: El folleto delPrograma de Detección Precoz del Cáncer de Mama (PDPCM) es una importante herramienta dedifusión de ese programa. Conocer la percepción de las mujeres sobre ese material informativo es relevante para entender mejor suactitud hacia el PDPCM. El objetivo del estudio fue explorar las reacciones de las mujeres respecto al folleto del PDPCM. Métodos: Se realizó un estudio cualitativo descriptivo en mujeres de entre cuarenta y sesenta años en Asturias (España). Serealizaron veintiséis entrevistas semiestructuradas a mujeres de diferentes perfiles socioeconómicos en 2018. Se realizó un análisisde contenido para identificar inductivamente las categorías emergentes. Resultados: La lectura del folleto despertó emociones positivas como tranquilidad, bienestar o gratitud, pero también miedo oinquietud. Las mujeres expresaron diversas creencias sobre el CM (enfermedad muy prevalente y de elevada supervivencia), sobreel PDPCM (programa dirigido a la prevención y que suponía una actividad normalizada en su entorno) y sobre el relevante papel delos servicios de salud y los medios de comunicación. Se detectaron actitudes ambivalentes hacia el PDPCM y estas actitudes estabanrelacionadas con las emociones. Conclusiones: La respuesta emocional al leer el folleto es ambivalente, aunque la mayoría de las mujeres expresan emocionespositivas. Las mujeres comparan la información con sus creencias previas, especialmente respecto al CM y al PDPCM. Es importanteentender cómo ciertas emociones (especialmente las negativas) están estrechamente relacionadas con la actitud hacia este programa.(AU)

Background: Breast cancer screening (BCS) leaflets are important for outreach and dissemination of BCS programs. Knowinghow women perceive these leaflets is relevant to better understand their attitude towards BCS. The objective of this paper was toexplore women’s reactions regarding BCS leaflet. Methods: A simple descriptive qualitative design was performed involving women aged between forty and sixty years of age inAsturias (Spain). Twenty-six semi-structured interviews were conducted with women of different socioeconomic profiles in 2018. Thematicanalysis was carried out. Results: Reading the leaflet elicited positive emotions such as peace of mind, well-being or gratitude, in addition to fear or anxiety. The women expressed various beliefs about breast cancer (highly prevalent and high survival rates), about BCS (a program aimedat prevention, a normative activity among their peers) and about the relevant role of health services and the media. Ambivalentattitudes towards BCS were detected, related to emotions. Conclusions: The emotional response after reading the brochure is ambivalent, although most of the women express positiveemotions. Women compare the information with previous beliefs, especially regarding breast cancer (BC) and BCS. It is important tounderstand how certain emotions (especially negative ones) are closely related to the attitude towards BCS. KEYWORDS: Early detection of cancer; Leaflet; Breast cancer; Emotions; Qualitative research; Health knowledge, attitudes, practice.(AU)

Felicidad / Felicidade / Happiness

The purpose of this editorial is to reflect, as micro-story, on the spaces where we seek happiness in our culture immersed in the digital age.(AU)

El propósito de esta editorial es reflexionar, en forma de micro-relato, sobre los espaciosdonde buscamos la felicidad en nuestra cultura sumergida en la era digital.(AU)

O objetivo deste editorial é refletir, sob a forma de uma micro-história, sobre os espaçosonde procuramos a felicidade na nossa cultura imersa na era digital

Nursing Students' Perception about Gender Inequalities Presented on Social Networks: A Qualitative Study.

During the COVID-19 pandemic, gender inequalities in nurses have been exacerbated through the images shown on social networks. This study aimed to explore and describe nursing students' experiences and perceptions about gender inequalities in nurses during the COVID-19 pandemic. A descriptive qualitative study was carried out in two universities in 264 undergraduate nursing students. The photovoice method was used to guide the study. Results: Two main categories and four subcategories were described from the data: "gender-related stereotypes", with "male leadership in a female profession" and "sexualization of female nurses" and "women's vulnerability in the pandemic" with "the gender gap in the face of increased risk of contagion " and "women's emotional fragility". Over the years, care has been considered a female task, and nursing continues to be thought of in this way. The nurse has been discriminated against, poorly considered as a professional, and, as a woman, subjected to gender roles.

El Análisis de Redes Sociales desde la perspectiva Enfermera: una aproximación teórico-empírica / Social Network Analysis from the nurse perspective: A theoretical-empirical approach

El ámbito de la salud es uno de los entornos más relacionales que la ciencia conoce, pero raramente se analizan los contactos entre actores. La Teoría de Redes conceptualiza al individuo como parte de una estructura a la cual nutre y de la cual se nutre. El Análisis de Redes Sociales (ARS) es el método que da soporte a la Teoría de Redes. En el siguiente trabajo se plantean los objetivos de (i) dar a conocer la Teoría de Redes y su justificación en el contexto de salud, (ii) describir el ARS, (iii) mostrar investigación en salud con aplicación del ARS, (iv) presentar la evolución del ARS en la Enfermería Española. Entre las principales conclusiones se resalta que (i) el ARS se centra en la estructura y la entidad social como unidad de análisis, (ii) las redes son causa y efecto de los resultados de salud, (iii) existen investigaciones con ARS aplicadas al cuidado y lideradas por enfermeras, y (iv) para consolidar el conocimiento y el uso del paradigma del ARS es necesario crear redes cohesivas de investigadores y profesionales multidisciplinares.(AU)

The field of health is one of the most relational environments that science knows, but the contacts between actors are rarely analyzed. The Theory of Networks conceptualizes the individual as part of a structure to which he nourishes, and from which he nourishes himself. Social Network Analysis (SNA) is the method that supports Network Theory. In the following work the objectives of (i) to present the Theory of Networks and their justification in the health context are presented, (ii) to describe the SNA, (iii) to showresearch in health with application of the SNA, (iv) present the evolution of SNA in Spanish Nursing. Among the main conclusions it is highlighted that (i) the SNA focuses on the structure and the social entity as the unit of analysis, (ii) the networks are the cause and effect of the health outcomes, (iii) there are SNA investigations applied to the care and led by nurses, and (iv) to consolidate the knowledge and use of the SNA paradigm, it is necessary to create cohesive networks of researchers and multidisciplinary professionals.(AU)

Conocimientos, creencias y actitudes de los estudiantes universitarios hacia ladonación de órganos: Un estudio cualitativo / Conhecimento, crenças e atitudes de estudantes universitários em relação àdoação de órgãos: Um estudo qualitativo / Knowledge, beliefs and attitudes of university students towards the organ donation: A qualitative study

Both vascularized composite transplants and allogeneic transplants, as they depend ondonations, are due to psychosocial factors that, knowing them, allow us to take appropriate educa-tional attitudes. Objective: to explore the knowledge, beliefs and attitudes of nursing and computerscience students regarding the donation and transplantation of organs and vascularized compoundallogeneic transplants. Material and methods: exploratory research with qualitative approach.Semi-structured interviews with 10 nursing and computer science students. Results: three catego-ries: knowledge, showing disinformation; beliefs such as that there is nothing after death, that do-nation is altruistic and that their professions help raise awareness; and attitudes such as that theytend to talk about death openly, but not about donation. Discussion: university students are aware,but they are not well informed, finding evidence such as that religion or donating blood or marrowdoes not influence to be an organ donor and knowing recipients or someone with some disfigure-ment and talking about death does influence. Conclusions: there are beliefs that favor the donationof organs and vascularized composite tissue in university students, but also a significant misinfor-mation and a lack of dialogue about becoming a donor that damages said donation and the educa-tional role in this regard at a professional level.(AU)

Tanto los trasplantes como los alotrasplantes compuestos vascularizados, al depender dedonaciones, obedecen a factores psicosociales que conociéndolos permiten tomar actitudes educa-cionales acordes. Objetivo: explorar los conocimientos, creencias y actitudes de estudiantes de en-fermería e informática respecto a la donación y trasplante de órganos y alotrasplantes compuestosvascularizados. Material y métodos: estudio exploratorio desde una aproximación cualitativa. En-trevistas semiestructuradas a 10 estudiantes de enfermería e informática. Resultados: tres categorías:conocimientos, mostrando desinformación; creencias como que no hay nada después de morir, quela donación es altruista y que sus profesiones ayudan a concienciar; y actitudes como que suelenhablar de la muerte de forma abierta, pero no de donación. Discusión: los universitarios están con-cienciados, pero no están bien informados, encontrando evidencias como que la religión o donarsangre o médula no influyen para ser donante de órganos y conocer receptores o alguien con algunadesfiguración y hablar de la muerte sí influye. Conclusiones: existen creencias que favorecen la do-nación de órganos y tejido compuesto vascularizado en los universitarios, pero también una desin-formación importante y una falta de diálogo sobre hacerse donante que perjudica dicha donación yla función educadora en este aspecto a nivel profesional.(AU)

Tanto os transplantes como os alotransplantes compostos vascularizados, por depende-rem de doações, devem-se a fatores psicossociais que, conhecendo-os, nos permitem tomar atitudeseducativas adequadas. Objetivo: explorar os conhecimentos, crenças e atitudes dos estudantes deenfermagem e computação em relação à doação e transplante de órgãos e aos alotransplantes com-postos vascularizados. Material e métodos: Estudo exploratório a partir de uma exploração qualita-tiva. Entrevistas semiestruturadas com 10 estudantes de enfermagem e informática. Resultados: trêscategorias: conhecimento, mostrando desinformação; crenças como que não há nada depois damorte, que a doação é altruísta e que suas profissões ajudam a aumentar a consciência; e atitudestais como falar sobre a morte abertamente, mas não sobre doação. Discussão: os universitários estãocientes, mas não estão bem informados, encontrando evidências como a religião ou a doação desangue ou medula óssea não influenciam ser um doador de órgãos, mas conhecer os destinatáriosou alguém com uma desfiguração e falar sobre a morte, sim. Conclusões: existem crenças que favo-recem a doação de órgãos e tecidos compostos vascularizados em universitários, porém há tambémuma desinformação significativa e uma falta de diálogo sobre como tornar-se doador, o que é pre-judicial para esta doação e à educação sobre este assunto como futuros profissionais.(AU)

The Feelings of Nursing Students during the COVID-19 Confinement: Narrative-Based Nursing and Poetry-of-Care Perspectives.

(1) Background: Experiences involve feelings, which, in turn, produce meaning that can become a subjectively lived experience. Therefore, the study of experiences and feelings is essential. INTRODUCTION: We examined the role of narrative-based nursing (NBN) and the poetry of care (PC). OBJECTIVE: To reflect upon the emotions and feelings experienced by nursing students during confinement induced by COVID-19. (2) Methods: This is a qualitative study with a focus on reflexive anthropology, NBN, and PC. SETTING AND PARTICIPANTS: The non-probabilistic sample of incidental, casual, or accessibility type. It consists of 198 students completing their first degree in nursing (the academic year of 2019-2020) of the University of Alicante. (3) Results: Three main categories were considered in the research: For the 'first day', 21 subcategories were identified, and uncertainty was the most frequently noted feeling. For the 'most significant day', 22 subcategories were found, with the explosion of feelings being the most frequent. For the 'last day', 15 subcategories were recorded, with the feeling of relief being the most common. CONCLUSIONS: The NBN and PC are relevant therapeutic tools that facilitate reflection and promote awareness of feelings.

The Impact of COVID-19 Pandemic on Health Inequities: A Photovoice Study With Nursing Students.

INTRODUCTION: The COVID-19 pandemic has an amplified impact on vulnerable populations. Also, aspects related to health inequalities are insufficiently taught in higher education. This study aims to promote reflection in nursing students on the impact of the COVID-19 pandemic on vulnerable populations affected by health inequities. METHODOLOGY: A photovoice method was used. Undergraduate nursing students (Spain and United Kingdom) took and explained photographs using SHOWED models. RESULTS: 108 students participated. Two-domain summary themes were created: The COVID-19 pandemic has impacted ethnic minorities and socioeconomically vulnerable groups, and Proposals to respond to the negative impact on ethnic minorities and socioeconomically vulnerable groups. DISCUSSION: The students identified negative health scenarios by linking COVID-19 with aspects of work, salary, and housing of these two specific populations. Holistic actions were also proposed to protect their health. As future health professionals, they must recognize these communities and work to eliminate inequalities.

Violence in Dating Relationships: Validation of the CADRI Questionnaire in a Young Adult Population.

Dating violence in the young adult population is reaching alarming levels. However, the instruments used to measure it and their results are still heterogeneous. The main aim of this study was to validate the Conflict in Adolescent Dating Relationships Inventory questionnaire for a young adult Spanish university population aged between 19 and 25 years old, and to describe the types of violence perpetrated and suffered. MATERIAL AND METHODS: Observational, descriptive, cross-sectional study. A validity analysis was carried out through a confirmatory factor analysis. The relative frequencies for each type of violence and the Chi2 test for two dichotomous variables were used to describe the different types of violence perpetrated and suffered. RESULTS: The sample consisted of 976 young adults aged 19-25 years old (M = 21.7 years. SD = 1.8). The confirmatory factor analysis had an adequate structure and a good fit to the model. The types of violence perpetrated and suffered were described according to the sex of the participants, with significant differences found for verbal-emotional violence and physical violence exerted. CONCLUSIONS: The confirmatory factor analysis allowed us to consider the application of the questionnaire to be correct for the study population.

Baby-led weaning: Health professionals 'knowledge and attitudes and parents' experiences from Spain. A mixed methods approach.

Baby-led weaning or self-regulated small chunk feeding by the baby has emerged as an alternative to the traditional method of complementary feeding. Parents and healthcare professionals often differ in the benefits and drawbacks about it. The research aims were to describe the knowledge of health professionals about complementary feeding and baby-led weaning (BLW) method and the attitudes towards its recommendation, and to explore the knowledge, experiences and attitudes of parents who have used this method to feed their children. A mixed methods research was carried out. A questionnaire was completed by 38 health professionals and 10 interviews were conducted with participating mothers. A total of 52.6% of health professionals recommended initiating complementary feeding at 6 months of age, a guideline followed by the mothers who used BLW. Some 86.8% of the professionals knew the BLW method and 76.3% knew its benefits, but the mothers consulted mainly informal sources of information sources to learn about and implement it. The health professionals stated that it facilitated family transition, enabled the infant to adapt better to flavours and textures, promoted chewing and the development of fine motor skills, improved growth and might also be a protective factor against obesity. The mothers noted that the method was natural, encouraged infant autonomy and promoted healthy eating habits. The health professionals expressed varied opinions concerning the risks entailed in the method. The main conclusions are that the majority of health professionals participating in the study know the BLW method, its benefits; however, they do not recommend it in all cases. Mothers listen to the advice of professionals but continue to rely on other informal sources of information.

Contribution of students to nursing practice settings during clinical training: Design and validation of a questionnaire.

BACKGROUND: A validated questionnaire to measure the contributions of nursing students to clinical settings could potentially assist in the improved management of students in healthcare institutions. AIM: To develop and test the psychometric properties of the questionnaire 'Nursing Student Contributions to Clinical Settings' (CEEEC, Spanish acronym for 'Contribuciones de los Estudiantes de Enfermería a los Entornos Clínicos'). DESIGN: Instrument design and psychometric testing. PARTICIPANTS/SETTINGS: A multicentre study involving 1,098 nursing professionals from three universities and five hospitals of Spain, between January 2019 and March 2020. METHODS: The study was carried out in two phases. Phase 1 involved the questionnaire design by experts (n = 28), which required a review of the available literature, cognitive interviews and Delphi rounds, and a preliminary validity study, which included a pilot test with responses from a sample of nurses (n = 143). Phase 2 involved a formal validation with a wider sample of nurses (n = 927), including factor analysis and a study of convergent validity with the Practice Environment Scale-Nursing Work Index and Health Sciences-Evidence Based Practice. RESULTS: Experts selected 42 items on student contributions. After cognitive interviews, three items were eliminated and seven failed to reach the minimum content validity index (78%). Based on the remaining 32 items, the discrimination index of each item was calculated, and those with <0.3, eight items were sequentially eliminated. The resulting questionnaire contained 24 items grouped into a single factor, which explained 41% of the variance. The internal consistency was excellent (Cronbach's alpha: 0.94), and the convergent validity was confirmed. CONCLUSIONS: A 24-item questionnaire was designed and validated to measure the contributions of nursing students to clinical practice settings. IMPACT: Most hospitals are also teaching centres where nursing students undergo clinical practice. The application of this test will provide insight into the nursing professionals' perception of the students' role.

Photovoice and dramatisation in the classroom with nursing students: An exploratory study to raise awareness of the cultural and social dimensions of violence against women.

BACKGROUND: Active teaching methodologies that incorporate students' feelings and beliefs and encourage them to reflect upon and critically think about certain variables, are extremely useful to teachers. OBJECTIVE: To explore the potential of dramatisation and photovoice technologies as instruments to stimulate nursing students to reflect upon violence against women in society, thereby encouraging critical thinking and debate in a participatory way. DESIGN: This was a qualitative, descriptive-exploratory study which used the participatory action research approach. PARTICIPANTS: Forty fourth-year students enrolled in the Nursing undergraduate degree at the University of Alicante in Spain. METHODS: The photovoice technique was used to record images from a dramatisation which served as the basis to represent scenes from the everyday life of people who are subjected to physical and psychological violence. These photographs were then debated and analysed by the students. We used MAXQDA® software and the guidelines published by Giorgi to aid our data analysis. RESULTS: Four main categories emerged; the 'violence against women'. The 'victim' and 'abuser' categories considered 'emotions', 'feelings', 'attitudes', and 'behaviours'. The fourth category that emerged was 'social viewpoints'. CONCLUSIONS: Photovoice-dramatisation raised awareness among the students and allowed them to reflect upon these behaviours and to critically think about the cultural and social dimensions of violence against women. The use of both of these techniques in practical and theoretical contexts to train students can help to nurture social commitment when faced with this problem.

Emotions, Feelings, and Experiences of Social Workers While Attending to Vulnerable Groups: A Qualitative Approach.

Social workers in the community setting are in constant contact with the suffering experienced by the most vulnerable individual. Social interventions are complex and affect social workers' emotional well-being. The aim of this study was to identify the emotions, feelings, and experiences social workers have while attending to individuals in situations of vulnerability and hardship. A qualitative methodology based on hermeneutic phenomenology was used. Six interviews and two focus group sessions were conducted with social workers from the community social services and health services of the Andalusian Public Health System in the province of Almería (Spain). Atlas.ti 8.0 software was used for discourse analysis. The professionals highlighted the vulnerability of certain groups, such as the elderly and minors, people with serious mental problems, and people with scarce or no economic resources. Daily contact with situations of suffering generates a variety of feelings and emotions (anger, sadness, fear, concern). Therefore, more attention should be paid to working with the emotions of social workers who are exposed to tense and threatening situations. Peer support, talking, and discussions of experiences are pointed out as relevant by all social workers. Receiving training and support (in formal settings) in order to learn how to deal with vulnerable groups could be positive for their work and their professional and personal quality of life.

Creencias y prácticas alimentarias en embarazo y puerperio: aplicación del Modelo de Tradiciones de Salud / Beliefs and dietary practices in pregnancy and the puerperium: application of the Health Traditions Model

OBJETIVO: Describir las creencias y prácticas culturales relacionadas con la alimentación durante el embarazo y puerperio en mujeres adultas (mayores de 60 años) en dos culturas diferentes, aplicando el Modelo de Tradiciones de Salud. MÉTODO: Se llevó a cabo un estudio cualitativo. Participaron 16 mujeres residentes durante su embarazo/parto/puerperio en un área rural de Braga (Portugal), o León (España). La técnica de recogida de información fue la entrevista semiestructurada. Se hizo un análisis de contenido, siguiendo el Modelo de Tradiciones de Salud. RESULTADOS: Se identificaron creencias y prácticas relacionadas con la alimentación, encaminadas a proteger, mantener y recuperar la salud de la madre/recién nacido, desde la esfera física/mental/espiritual (9 dimensiones interrelacionadas). CONCLUSIÓN: Se describieron creencias y prácticas alimentarias en embarazo/puerperio de mujeres mayores, constatando el papel de la cultura en las mismas. Se consideraron 9 dimensiones interrelacionadas, y el rol relevante de familiares/allegadas. Estos datos pueden ayudarnos a planificar acciones de salud maternal en la actualidad, participativas (familia/comunidad), corregir ciertas prácticas, y proporcionar cuidados congruentes con la cultura de las mujeres. Ello puede ayudar a transformar creencias, o valores y actitudes que incardinan una determinada forma cultural en la enfermería

OBJECTIVE: To describe the cultural beliefs and practices related to food during pregnancy and the puerperium in adult women (over 60 years old) in two different cultures by applying the Health Traditions Model. METHOD: A qualitative study was carried out with the participation of 16 women resident during their pregnancy / childbirth / puerperium in a rural area of Braga (Portugal), and León (Spain). The information collection technique was the semi-structured interview. A content analysis was made, following the Health Traditions Model. RESULTS: Beliefs and dietary practices related to feeding were identified, aimed at protecting, maintaining and recovering the health of the mother / newborn, from the physical / mental / spiritual sphere (9 interrelated dimensions). CONCLUSION: Eating beliefs and practices in pregnancy / puerperium of older women were described, confirming the role of culture in them. 9 interrelated dimensions were considered, as well as the relevant role of family / relatives. These data can help us plan for current, participatory (family / community) maternal health actions, correct certain practices, and provide care consistent with the culture of women. This can help transform beliefs, or values and attitudes that embody a certain cultural form in nursing

Exploring The Netley British Red Cross Magazine: An example of the development of nursing and patient care during the First World War.

Netley Hospital played a crucial role in caring for the wounded during the nineteenth century and twentieth century, becoming one of the busiest military hospitals of the time. Simultaneously, Florence Nightingale delved into the concept of health and developed the theoretical basis of nursing. This research aims to describe the experiences related to nursing and patient care described in The Netley British Red Cross Magazine during the First World War. The analysis displays different nurses' roles and the influence of environmental factors in the delivery of the soldiers' care. There are indications that Nightingale's ideas would have infiltrated the nursing practices and other aspects of the soldiers' recovery at Netley. The history of the Netley Red Cross Hospital shows the theoretical and practical advancement of nursing care towards a holistic approach.

Doença inflamatória intestinal: percepções dos pacientes e dos profissionais de saúde sobre a tomada de decisão compartilhada / Enfermedad inflamatoria intestinal: percepciones de los pacientes y de los profesionales de la salud sobre la toma de decisiones compartida / Inflammatory bowel disease: patients' and professionals' perceptions of shared decision-making

Resumo Objetivo Descrever as percepções de implementação da lei 41/2002 sobre a autonomia do paciente com doença inflamatória intestinal e profissionais em relação à tomada de decisão compartilhada. Métodos Estudo qualitativo e descritivo, utilizando abordagem fenomenológica. Foram realizadas entrevistas semiestruturadas em dez pacientes pertencentes à Associação de Pacientes com Doença de Crohn e Colite Ulcerativa de Zamora (Espanha), e grupo focal com sete gastroenterologistas e enfermeiros da clínica de ostomia e unidade de gastroenterologia hospitalar do Hospital Virgen de la Concha de Zamora. Foi realizada análise do conteúdo temático dos dados. Resultados Surgiram duas categorias principais e sete subcategorias: Informação (com conhecimento dos profissionais e dos pacientes, confiança no profissional, tempo e atitude em relação à informação) e Tomada de decisão compartilhada (com atitude em relação à informação, enfrentamento/resignação e apoio às decisões). A tomada de decisão compartilhada é um processo complexo, onde não somente a informação é o principal benefício para os pacientes, mas outras questões como apoio, tempo de doença ou emergência são importantes para a decisão do paciente. Conclusão Descrever as percepções dos pacientes e dos profissionais sobre a tomada de decisões compartilhadas, que as viam como um processo complexo. Melhorar as informações fornecidas aos pacientes sobre sua doença e seus direitos pode influenciar a participação na tomada de decisão compartilhada e modificar atitudes. Os pacientes não adotaram permanentemente um papel ativo ou passivo em relação à tomada de decisão compartilhada, mas, por múltiplos fatores, oscilaram entre os papéis. Consequentemente, é importante que os profissionais de saúde se envolvam no processo de compreensão dos pacientes e de suas necessidades para facilitar a tomada de decisão compartilhada. Além disso, é necessário maior investimento por parte das autoridades para garantir continuidade dos cuidados e desenvolver unidades multidisciplinares para doenças inflamatórias intestinais como forma de melhorar a tomada de decisão compartilhada.

Resumen Objetivo Describir las percepciones de la implementación de la ley 41/2002 sobre la autonomía del paciente con enfermedad inflamatoria intestinal y profesionales con relación a la toma de decisiones compartida. Métodos Estudio cualitativo y descriptivo, que utiliza el enfoque fenomenológico. Se realizaron entrevistas semiestructuradas a diez pacientes pertenecientes a la Asociación de Pacientes con Enfermedad de Crohn y Colitis Ulcerosa de Zamora (España); y un grupo focal de siete gastroenterólogos y enfermeros de la clínica de ostomía y de la unidad de gastroenterología hospitalaria del Hospital Virgen de la Concha de Zamora. Se realizó un análisis del contenido temático de los datos. Resultados Surgieron dos categorías principales y siete subcategorías: Información (con conocimiento de los profesionales y de los pacientes, confianza en el profesional, tiempo y actitud con relación a la información) y Toma de decisiones compartida (con actitud respecto a la información, enfrentamiento/resignación y apoyo a las decisiones). La toma de decisiones compartida es un proceso complejo en el que no solamente la información es el principal beneficio para los pacientes, sino que también hay otras cuestiones importantes para la decisión del paciente, como el apoyo, el tiempo de enfermedad o la emergencia. Conclusión Describir las percepciones de los pacientes y de los profesionales sobre la toma de decisiones compartida, que era vista como un proceso complejo. Mejorar la información ofrecida a los pacientes sobre su enfermedad y sus derechos puede influir en la participación de la toma de decisiones compartida y modificar actitudes. Los pacientes no adoptaron un papel permanentemente activo o pasivo respecto a la toma de decisiones compartida, sino que oscilaban entre los dos papeles debido a múltiples factores. Por lo tanto, es importante que los profesionales de la salud se involucren en el proceso de comprensión de los pacientes y de sus necesidades para facilitar la toma de decisiones compartida. Además, son necesarias mayores inversiones por parte de las autoridades para garantizar una continuidad de los cuidados y desarrollar unidades multidisciplinarias para enfermedades inflamatorias intestinales como forma de mejorar la toma de decisiones compartida.

Abstract Objective To describe perceptions of implementing law 41/2002 on patient autonomy in inflammatory bowel disease patients and professionals in relation to shared decision-making. Methods Qualitative descriptive study using a phenomenological approach. We conduced semi-structured interviews to 10 patients belonging to the Association of Patients with Crohn's Disease and Ulcerative Colitis in Zamora (Spain) as well as focus group to 7 gastroenterologists and nurses from the ostomy clinic and inpatient gastroenterology unit at the Virgen de la Concha Hospital in Zamora. Data thematic content analysis was performed. Results Two main categories and seven sub-categories emerged: Information (with professionals' and patients' knowledge, trust in the professional, time and attitude to information) and Shared decision-making (with attitude to information, coping-resignation and support for decisions). Shared decision-making is a complex process where not only the information is the main value for the patients, but other issues like support, time of illness or emergency are important for patient decision. Conclusion To describe patients' and professionals' perceptions of shared decision-making, who saw it as a complex process. To improve the information provided to patients about their illness and their rights can influence participation in shared decision-making and change attitudes. Patients did not permanently adopt an active or passive role in relation to shared decision-making, but instead oscillated between roles depending on multiple factors. Consequently, it is important for health professionals to engage in the process of understanding patients and their needs to facilitate shared decision-making. In addition, greater investment by the authorities is needed to ensure continuity of care and create multidisciplinary inflammatory bowel disease units as measures to improve shared decision-making.

Percepciones y deseos sobre el parto en gestantes a término en Zamora / Perceptions and wishes about delivery of full-term pregnant women in Zamora

OBJETIVO: Describir las percepciones y deseos sobre el parto en un grupo de gestantes a término de Zamora. MÉTODO: Estudio cualitativo de carácter fenomenológico. Participantes y ámbito de estudio: embarazadas de 37-38 semanas, centros de salud Zamora Sur y Santa Elena (Zamora). Recogida de datos: entrevistas semiestructuradas, hasta llegar a saturación de datos (16 entrevistas). Análisis de datos: análisis de contenido temático. RESULTADOS: Los sentimientos maternos variaron desde la alegría hasta el miedo o el estrés. Las entrevistadas manifestaron no sentirse capaces de soportar el dolor del parto. Las necesidades que sintieron como más importantes fueron contar con apoyo y acompañamiento en el parto (sobre todo de su pareja) y recibir buen trato de los sanitarios. CONCLUSIONES: La importancia y la repercusión del parto para la mujer no solo atiende al ámbito biológico, sino en gran medida también al mental, al emocional y al social. En él intervienen múltiples factores que lo condicionan: los sentimientos maternos, su capacidad de afrontar el dolor del parto, sus necesidades, sus cambios realizados, el apoyo con el que cuentan y los profesionales sanitarios que atienden a la mujer

OBJECTIVE: To describe perceptions and wishes regarding childbirth in a group of full-term pregnant women in Zamora. METHOD: Qualitative study of phenomenological character. Participants and scope of study: pregnant women (37-38 weeks), Zamora Sur and Santa Elena health centres (Zamora, Spain). Data collection: semi-structured interviews, until data saturation (16 interviews). Data analysis: analysis of thematic content. RESULTS: The maternal feelings varied from joy to fear or stress. The interviewees said they did not feel capable of enduring the pain of childbirth. The needs that they felt most important were having support and accompaniment during delivery (especially of their partner) and receiving good treatment from the healthcare workers. CONCLUSIONS: The importance and repercussion of childbirth for women are not only biological, but also largely mental, emotional and social. It is conditioned by multiple factors: maternal feelings, their ability to deal with the pain of childbirth, their needs, the changes they have made, the support they have and the health professionals who care for them

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model.

BACKGROUND AND PURPOSE: The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. PURPOSE: To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger's Sunrise Model. METHODS: Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. RESULTS: Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). IMPLICATIONS FOR PRACTICE: The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.