Biographical Narrative Research From the Perspective of the Science of Unitary Human Beings: A Methodological Approach.

Narrating or storytelling is a fundamental practice for human survival and a means for finding meaning in experiences and for enhancing self-understanding. The use of story has been present in nursing since its origins. Biographical narrative has rarely been used as a research method in nursing, and there are no examples conceptualizing biographical narrative research methods within a unitary science perspective. The purpose of this paper is to describe one specific narrative methodological approach-the biographical narrative research method-and to link the method to the science of unitary human beings as a means of creating a unitary understanding of the storied nature of human-health experiences.

Salud mental colectiva: una revisión del concepto en la literatura académica de Brasil, Colombia y España / Collective mental health: a review of the concept in the academic literature of Brazil, Colombia, and Spain

Resumen La noción de salud mental colectiva hace referencia a una propuesta alternativa a la perspectiva biomédica y conductual que ha ido adquiriendo centralidad en las publicaciones académicas de Brasil, España y Colombia, especialmente en las dos últimas décadas. Con el fin de comprender el sentido que adquiere dicha noción, se realizó un análisis del concepto desde una revisión narrativa que empleó criterios intencionados para la selección del material. Se identificaron matices particulares en cada país y/o sus problemáticas asociadas, en estrecha conexión con las particularidades históricas y socioculturales de cada escenario. Las violencias relacionadas con las lógicas manicomiales (Brasil, España) y aquellas derivadas del conflicto armado y la violencia política (Colombia) son las problemáticas en las que la salud mental colectiva aporta orientaciones epistemológicas y modelos de prácticas para el acompañamiento en contextos de sufrimiento social. El deslinde entre lo colectivo y lo comunitario es el principal reto conceptual que emerge de la intersección entre la salud mental y la salud colectiva.

Abstract INTRODUCTION: The notion of collective mental health refers to an alternative proposal to the biomedical and behavioral perspective that has been gaining centrality in academic publications in Brazil, Spain, and Colombia, especially in the last two decades. METHOD: In order to understand the meaning acquired by this notion, an analysis of the concept was carried out through a narrative review that used intentional criteria for the selection of the material. RESULTS: nuances were identified in each country and/or its associated problems, in close connection with the historical and socio-cultural particularities of each scenario. Violence related to asylum logic (Brazil, Spain), and those derived from armed conflict and political violence (Colombia) are the problems where collective mental health provides epistemological and practical guidelines for accompaniment in contexts of social suffering. CONCLUSION: the delimitation between the collective and the community is the main conceptual challenge that emerges from the intersection between mental health and collective health.

¿Qué se preguntan las enfermeras/os sobre el aborto? Una revisión panorámica / O que as enfermeiras se perguntam sobre o aborto? Uma revisão panorâmica / What are nurses asking about abortion? An overview review

Objetivo: Analizar las preguntas, metodologías y tendencias en investigaciones realizadas por enfermeras/os, con el fin de identificar los intereses disciplinares y posibles derivaciones en el desarrollo del conocimiento y las prácticas de cuidado. Metodología: Revisión panorámica en las bases de datos: Scielo, BVS, PubMed y Redalyc, con una ventana de búsqueda de 2008 a 2020, en idiomas español, inglés y portugués. Se incluyeron 33 artículos, produc-to de la búsqueda con términos de: MeSH, Nursing Care, Abortion, Abortion Applicants. Además, se emplearon expresiones en español sobre: cuidado de enfermería; enfermería; el aborto; el aborto y cuidado de enfermería en la salud pública; aborto inducido y cuidado de enfermería sobre salud mental; aborto criminal y salud mental; y, cuidado de enfermería frente a solicitantes de aborto. Análisis: Se observó una relación entre el tipo de estudios y el contexto jurídico de los países en que se realizaron. Son relevantes los estudios respecto de las actitudes, creencias y prácticas de enfermería en torno al aborto, poniendo el foco en la subjetividad de los profesionales de la disciplina. Resaltan los estudios cualitativos, haciendo acopio de teorías y conceptos de procedencia multidisciplinar y solo marginalmente de aquel-la producida por la disciplina de enfermería. Conclusiones: Las preguntas más frecuentes que se hacen las enfermeras/os sobre el aborto se dirigen especialmente a examinar las formas en que se provee el cuidado de enfermería a las mujeres que pasan por esta experiencia; del mismo modo se evidencia el correlato en las experiencias emocionales y dilemas éticos para el personal de enfermería, constituyéndose en un fenómeno controversial. Lo expuesto anteriormente implica para la disciplina de enfermería ampliar el repertorio para el abordaje epistemológico de este fenómeno, con miradas críticas transdisciplinares, que consideren el contexto social, cultural y normativo, con el fin de enriquecer la investigación disciplinar, que tenga efectos sobre la práctica profesional y los procesos de formación

Objective: Analyze the questions, methodologies and tendencies made in nursing research, with the purpose of identifying the disciplinary interests and possible derivations in the de-velopment of knowledge and care practices. Methodology: Scoping review in the databases: Scielo, BVS, Pubmed and Redalyc, with a search window from 2008 to 2020, in Spanish, English and Portuguese. Thirty-three articles were included, resulting from the search of the terms: MeSH, Nursing Care, Abortion, Abortion Applicants. Furthermore, the following Spanish expressions were used: nursing care; nursing; abortion; abortion and nursing care in public health; induced abortion and mental health nursing care; criminal abortion and men-tal health; and, nursing care for abortion applicants. Analysis: A relationship was observed between the type of studies and the legal context of the countries in which these were con-ducted. The studies about the attitudes, beliefs and nursing practices regarding abortion are relevant, focusing on the subjectivity of the professionals of this discipline. The qualitative studies stand out, gathering theories and concepts from multidisciplinary sources, and only marginally those from the nursing discipline. Conclusions: The most frequently asked ques-tions that nurses have about abortion are specially directed to examine the ways in which nursing care is provided to women who undergo this experience; similarly, the correlation between the emotional experiences and the ethical dilemmas for the nursing personnel is evi-denced, constituting a controversial phenomenon. The forementioned implies for the nursing discipline to broaden the repertoire for the epistemological approach of this phenomenon, with transdisciplinary critical views, that consider the social, cultural and regulatory context, in order to enrich the disciplinary research, having effects on the professional practice and the training processes

Objetivo: Analisar as questões, metodologias e tendências nas pesquisas realizadas pelos enfermeiros, a fim de identificar interesses disciplinares e possíveis derivações no desen-volvimento de práticas de conhecimento e cuidado. Metodologia: Revisão panorâmica nas bases de dados: Scielo, VHL, PubMed e Redalyc, com uma janela de pesquisa entre 2008 e 2020, em espanhol, inglês e português. Foram incluídos 33 artigos, produto da pesquisa com termos: MeSH, Nursing Care, Abortion, Abortion Applicants. Além disso, foram utilizadas expressões em espanhol: cuidado de enfermería, enfermería, aborto, aborto e cuidado de enfermería e salud pública; aborto inducido e cuidado de enfermería e salud mental; aborto criminal e salud mental e cuidado de enfermería, solicitantes de aborto. Análise: Observou-se relação entre o tipo de estudo e o contexto jurídico dos países em que foram realizados. Estu-dos sobre atitudes, crenças e práticas de enfermagem em torno do aborto são relevantes, com foco na subjetividade dos profissionais da disciplina. Destacam-se estudos qualitativos, cole-cionando teorias e conceitos de origem multidisciplinar e apenas marginalmente produzidas pela disciplina de enfermagem. Conclusões: As perguntas mais frequentes das enfermeiras sobre o aborto visam especialmente examinar as formas como a assistência de enfermagem é prestada às mulheres que passam por essa experiência; da mesma forma, evidencia-se a correlação entre experiências emocionais e dilemas éticos para o pessoal de enfermagem, tornando-se um fenômeno controverso. Os achados implicam à disciplina de enfermagem ampliar o repertório para a abordagem epistemológica desse fenômeno, com perspectivas críticas transdisciplinares, que considerem o contexto social, cultural e normativo, a fim de enriquecer a pesquisa disciplinar, com efeitos na prática profissional e nos processos formativos

Reconciliación y salud mental colectiva. La reincorporación de los excombatientes de las FARC-EP en Colombia, 2020 / Reconciliation and Collective Mental Health. The Reincorporation of FARC-EP Ex-combatants in Colombia, 2020

Resumen Un desafío en Colombia, a partir de la firma del Acuerdo de Paz con las FARC-EP, es retejer los vínculos rotos entre excombatientes y sociedad, aspiración presente en propuestas de desarme, desmovilización y reincorporación; reconciliación y salud mental. Desde una investigación cualitativa con excombatientes, familiares y vecinos, se presentan aspectos relacionados con el ingreso, permanencia y reincorporación y las contradicciones del retorno a la vida civil. Incumplimientos, incertidumbre, ausencia de un relato de corresponsabilidad, estigma y reaprendizaje de los códigos de la vida social, entre otros, son examinados desde los encuentros cotidianos con comunidades receptoras en contextos rurales.

Abstract A challenge in Colombia, since the signing of the Peace Agreement with the FARCEP, is to reweave the broken links between ex-combatants and society, an aspiration present in proposals for disarmament, demobilization, and reincorporation; reconciliation and mental health. From qualitative research with ex-combatants, family members, and neighbors, aspects related to the entry, permanence, and reincorporation, and the contradictions of the return to civilian life are presented. Non-compliance, uncertainty, absence of a narrative of co-responsibility, stigma, and re-learning of the codes of social life, among others, are examined from daily encounters with receiving communities in rural contexts.

Research Care and Teaching Care Research in the Faculty of Nursing at Universidad de Antioquia. Testimonies and Legacies in 70 years of Institutional Life, 1950-2020.

The development of care research and its teaching in the Faculty of Nursing at Universidad de Antioquia cannot be understood outside the context in which it emerges and from the trajectory of its leading players. This is how this article will present a synthesis of the future of research, with its principal milestones and events in institutional history, in dialogue with the trajectories of four teaching nurses, protagonists of key moments in said history and living testimony of 70 years of institutional life. This panorama seeks to constitute a referent for strategic reflection, which inspires new generations to meet the research challenges and teach care research.

Research Care and Teaching Care Research in the Faculty of Nursing at Universidad de Antioquia. Testimonies and Legacies in 70 years of Institutional Life, 1950-2020

The development of care research and its teaching in the Faculty of Nursing at Universidad de Antioquia cannot be understood outside the context in which it emerges and from the trajectory of its leading players. This is how this article will present a synthesis of the future of research, with its principal milestones and events in institutional history, in dialogue with the trajectories of four teaching nurses, protagonists of key moments in said history and living testimony of 70 years of institutional life. This panorama seeks to constitute a referent for strategic reflection, which inspires new generations to meet the research challenges and teach care research.

El desarrollo de la investigación del cuidado y de su enseñanza en la Facultad de Enfermería de la Universidad de Antioquia no puede ser entendido por fuera del contexto en que emerge y de la trayectoria de sus protagonistas. En este artículo se presentará una síntesis del devenir de la investigación, con sus principales hitos y acontecimientos en la historia institucional, en diálogo con las trayectorias de cuatro enfermeras docentes, protagonistas de momentos claves de dicha historia y testimonio vivo de 70 años de vida institucional. Este panorama pretende constituir un referente para la reflexión estratégica que inspire a las nuevas generaciones para responder a los retos de la investigación y la enseñanza de la investigación del cuidado

O desenvolvimento da pesquisa do cuidado e seu ensino na Faculdade de Enfermagem da Universidade de Antioquia não podem ser compreendidos fora do contexto em que se inserem e da trajetória de seus protagonistas. É assim que este artigo apresentará uma síntese da evolução da pesquisa, com seus principais marcos e acontecimentos na história institucional, em diálogo com as trajetórias de quatro enfermeiras professoras, protagonistas de momentos chaves de dita história e testemunho vivo de 70 anos de vida institucional. Este panorama pretende constituir um ponto de referência para a reflexão estratégica, que inspire as novas gerações a responder aos desafios da investigação e do ensino da investigação em cuidados.

Los aportes del enfoque biográfico narrativo para la generación de conocimiento en Enfermería / The contributions of narrative biographical approach for generating nursing knowledge

Este artículo tiene como propósito presentar las posibilidades de la investigación con enfoque biográfico narrativo para el conocimiento en enfermería, el cual ha tenido su mayor desarrollo a partir de la lógica deductiva propia del paradigma positivista que acompañó su nacimiento como disciplina. Para ello, se presenta una panorámica de los fundamentos epistemológicos, ontológicos, praxiológicos y metodológicos del enfoque, así como sus usos en enfermería a partir del rastreo de investigaciones realizadas en los últimos años, mostrando las posibilidades que ofrece y las preguntas potenciales que pueden ayudar a resolver en relación con el cuidado de la vida

This article has the purpose to present the possibilities of research with biographical narrative approach to nursing knowledge, which has had its greatest development from the own deductive logic of the positivist paradigm that accompanied its birth as a discipline. To do this, an overview of and epistemological, ontological, praxiológical and methodological approach and its uses in nursing starting from tracking researches conducted in recent years is presented , showing the possibilities that offer and potential questions that can help resolve regarding life care

Investigar el cuidado comunitario de la vida a través de las artes plásticas. Una experiencia en contexto rural / Investigate the community care for life through the plastic arts. An experience in rural context

Resumen Objetivo: Presentar los principales aprendizajes de la incorporación del arte como mediador, en una investigación sobre memorias de cuidado campesino alrededor del alimento y la producción agrícola. Materiales y métodos: Investigación cualitativa, orientada por la Investigación - Acción - Participativa (IAP), que desarrolló entrevistas, observación participante y cartografía social, en diálogo con técnicas artísticas para la producción de datos y para la difusión de hallazgos. Resultados: Se describen los aportes del arte a la construcción de las memorias mediante la incorporación de un objeto con fuerte carga simbólica, para materializarlas y favorecer su difusión concretada en la obra plástica "Memorias sobre machetes". Discusión: Aunque no fue su intención, la experiencia se acerca con el movimiento emergente de Investigación basada en el arte, lo que se expresó en rupturas y articulaciones desde el punto de vista de la técnica artística, del proceso investigativo y el diálogo transdisciplinar arte-enfermería. Conclusiones: 1) Fortalecimiento del patrón de conocimiento estético en enfermería, 2) Fortalecimiento de la investigación cualitativa desde los aportes del arte, 3) Reconocimiento de las voces que se encuentran en las márgenes del sistema social y 4) Aportes estratégicos del arte para la construcción de memorias.

Abstract Objective: To present the main learnings of the incorporation of art as a mediator in a research about reports of farmer care around food and agricultural production. Materials and methods: A qualitative research oriented by Participatory Action Research (PAR) was conducted. Interviews, participant observation and social mapping, in dialogue with artistic techniques for the production of data and the dissemination of findings, were developed. Results: The contributions of art to the construction of the reports are described through the incorporation of an object with a strong symbolic load, to be materialized and encourage their dissemination embodied in the sculpture "Memorias sobre machetes". Discussion: Although it was not its intention, the experience is close to the emerging movement of research based on the art, which was expressed in breaks and joints from the artistic technique point of view, the investigative process and the transdisciplinary dialog between art and nursing. Conclusions: 1) Strengthening of the pattern of aesthetic knowledge in nursing, 2) Strengthening of the qualitative research from the contributions of art, 3) Recognition of the voices that are found in the margins of the social system and 4) Strategic art Inputs for the construction of reports.

Significado de la salud mental para un grupo de mujeres en contextos de violencia política, Antioquia, 2015-2016 / Meaning of mental health for a group of women in contexts of political violence, Antioquia, 2015-2016

El objetivo de este artículo es describir el significado que le asignan a la salud mental un grupo de mujeres que han vivido en contextos de violencia política en Antioquia, Colombia. Para esto la metodología de La investigación se desarrolló en el marco de una experiencia de extensión universitaria alrededor del tejido, la memoria y la salud mental. Siguiendo la orientación de un paradigma comprensivista y una perspectiva cualitativa, se realizó observación participante, grupos focales y revisión de material documental derivado de la experiencia, consistente en narrativas tejidas y relatorías. El análisis estuvo guiado por una lógica inductiva emergente. Durante el proceso se resguardó el respeto a la autonomía y la confidencialidad de las mujeres participantes. Como resultados podemos establecer que el significado de la salud mental guarda relación con el perdón, el apoyo social, la construcción de la dupla memoria/olvido y el mantenimiento del núcleo familiar. Para estas mujeres, la salud mental significa tener una vida tranquila en la que son constructoras de paz en sus territorios y buscan día a día tejer nuevas memorias a través de la palabra y el apoyo social que le proporcionan sus pares. De este modo, podemos concluir que la salud mental en contextos de violencia política supera la mirada biomédica y se articula al mundo simbólico y social, donde se producen las subjetividades. Para la enfermería esto conlleva hacia un cuidado "situado" y singular, basado en las necesidades y en los contextos donde se producen y se reinventan dichas subjetividades.

The article's goal is to describe the meaning assigned to mental health by a group of women who have lived in political violence contexts. This way, the research methodology was developed within the framework of a university extension experience around weave, memory and mental health. Participative observation, focus groups and documentary material review from the extension project (woven narratives and Proceedings) was carried out, following a comprenhensive paradigm and a qualitative perspective. The analysis was guided by emergent inductive logic. During the process, respect for autonomy and participating women confidentiality was saveguarded. As results we can affirm meaning of mental health that emerges is linked to forgiveness, social support, the construction of the memory/oblivion and the maintenance of the family nucleus. To these women, mental health means having a quiet life in which they are builders of peace in their territories and seek day by day weaving new memories through the word and social support provided by their peers. This way the conclusions of mental health in political violence contexts exceeds the biomedical and is expressed in subjectivities. To nursing, this implies a move towards an intregral care based on the needs and the subjectivity of people who have lived in these context

Vida cotidiana y conflicto armado en Colombia: los aportes de la experiencia campesina para un cuidado creativo / Daily Life and Armed Conflict in Colombia: Contributions to Creative Care Based on the Peasant Experience / Vida cotidiana e conflito armado na Colômbia: contribuiçóes da experiência camponesa para o cuidado criativo

Objetivo: describir la manera como el conflicto armado prolongado se instaló y modificó la vida cotidiana de un grupo de familias campesinas y cómo los eventos de violencia política son percibidos y articulados en las relaciones familiares y vecinales y en las trayectorias de vida personal. Materiales y métodos: estudio de caso en San Francisco, oriente antioqueño (Colombia), que combinó elementos del método etnográfico y biográfico. Resultados: la cotidianidad campesina, escenario de reproducción personal y social, se va configurando entre la habituación que produce un conflicto armado prolongado y lo sorpresivo que impone su dinámica, de tal manera que las personas deben reinventar cotidianamente su vida. El sufrimiento aparece en función de los significados particulares que se asignan a los eventos, más que a las generalizaciones de la cronología oficial del conflicto. Conclusión: la transformación de la vida cotidiana campesina se configura en el devenir de formas endógenas de enfrentar lo ajeno, lo nuevo y lo desconocido para darle un lugar, resignificar la experiencia y seguir construyendo la vida en interacción con otros, en un proceso de reinvención permanente de tiempos, espacios y relaciones microsociales por parte de los sujetos, que constituyen elementos centrales para generar cuidados de la salud mental creativos y singulares.

Objective: Describe how the prolonged armed conflict came about and changed daily life for a group of peasant families and how events involving political violence are perceived and tied in with relations between family members and neighbors and with the course of personal life. Materials and Methods: This is a case study done in San Francisco, in eastern Antioquia (Colombia). It combines elements of the ethnographic and biographical method. Findings: Everyday peasant life, the scenario for personal and social reproduction, is shaped by the accustomedness that comes with a prolonged armed conflict and the surprises imposed by its dynamics, which means people must reinvent their lives on a daily basis. Suffering is more a function of the particular meaning assigned to events, than generalizations of the official chronology of the conflict. Conclusion: The change in everyday peasant life is influenced by endogenous ways of dealing with what is foreign, new and unknown, so as to give it a place, to assign new meaning to the experience, and to continue to build a life in interaction with others. This is a process to permanently reinvent time, space and micro-social relations on the part of those concerned, who are crucial to generating creative and unique mental health care.

Objetivo: descrever a maneira como o conflito armado prolongado foi instalado e modificou a vida cotidiana de um grupo de famílias camponesas e como os eventos de violência política são percebidos e articulados nas relaçóes familiares e entre vizinhos e nas trajetórias de vida pessoal. Materiais e métodos: estudo de caso em San Francisco, leste da Antioquia (Colômbia), que combinou elementos do método etnográfico e biográfico. Resultados: a cotidianidade camponesa, cenário de reprodução pessoal e social, vai sendo configurada entre a habituação que produz um conflito armado prolongado e o surpreendente que impóe sua dinâmica, de tal maneira que as pessoas devem reinventar cotidianamente sua vida. O sofrimento aparece em função dos significados particulares que designam aos eventos, mais do que às generalizaçóes da cronologia oficial do conflito. Conclusão: a transformação da vida cotidiana camponesa se configura no devir de formas endógenas de enfrentar o alheio, o novo e o desconhecido para dar-lhe um lugar, ressignificar a experiência e continuar construindo a vida em interaçóes com outros, num processo de reinvenção permanente de tempos, espaços e relaçóes microssociais por parte dos sujeitos que constituem elementos centrais para gerar cuidados da saúde mental criativos e singulares.

[The power of the notion of resistance in the mental health field: a case study on the life of rural communities whitin the Colombian armed conflict]. / La potencia de la noción de resistencia para el campo de la salud mental: un estudio de caso sobre la vida campesina en el conflicto armado colombiano.

The objective of this study is to identify individual, family and/or community responses of resistance within protracted armed conflict. We conducted a case study with members of rural communities in the municipality of San Francisco, in the eastern area of Antioquia, Colombia, combining biographical and ethnographical approaches. The primary results show that, along with the suffering generated by the experience of armed conflict, rural community members also display a repertoire of multiple and diverse resistance strategies. Resistance is for them an active response and a way to re-weave the fabric torn by the experience. As a type of affirmative opposition, resistance is a powerful category for the entire mental health field, in that it highlights the creativity and capacity for transformation of individuals. In this way, the category allows for overcoming the limits of the conventional biomedical view that tends to pathologize individual and social responses in scenarios of severe distress.

La potencia de la noción de resistencia para el campo de la salud mental: Un estudio de caso sobre la vida campesina en el conflicto armado colombiano / The power of the notion of resistance in the mental health field: a case study on the life of rural communities whitin the Colombian armed conflict

El objetivo de este estudio es identificar las respuestas individuales, familiares y/o comunitarias para resistir en un contexto de conflicto armado prolongado. Se realizó un estudio de caso con población campesina de San Francisco, oriente antioqueño colombiano, que combinó los enfoques etnográfico y biográfico. Los principales resultados muestran que, a la par del sufrimiento, los campesinos desplegaron un repertorio de resistencias múltiples y diversas, como expresión de respuesta activa y estrategia para re-tejer los hilos rotos que dejó dicha experiencia. La resistencia, en su carácter de oposición afirmativa, es una categoría potente para el campo de la salud mental, toda vez que resalta la creatividad y la capacidad de transformación de las personas, permitiendo superar los límites de la mirada biomédica convencional que tiende a patologizar las respuestas individuales y sociales en escenarios de sufrimiento intenso.(AU)

The objective of this study is to identify individual, family and/or community responses of resistance within protracted armed conflict. We conducted a case study with members of rural communities in the municipality of San Francisco, in the eastern area of Antioquia, Colombia, combining biographical and ethnographical approaches. The primary results show that, along with the suffering generated by the experience of armed conflict, rural community members also display a repertoire of multiple and diverse resistance strategies. Resistance is for them an active response and a way to re-weave the fabric torn by the experience. As a type of affirmative opposition, resistance is a powerful category for the entire mental health field, in that it highlights the creativity and capacity for transformation of individuals. In this way, the category allows for overcoming the limits of the conventional biomedical view that tends to pathologize individual and social responses in scenarios of severe distress.(AU)

La potencia de la noción de resistencia para el campo de la salud mental: Un estudio de caso sobre la vida campesina en el conflicto armado colombiano / The power of the notion of resistance in the mental health field: a case study on the life of rural communities whitin the Colombian armed conflict

El objetivo de este estudio es identificar las respuestas individuales, familiares y/o comunitarias para resistir en un contexto de conflicto armado prolongado. Se realizó un estudio de caso con población campesina de San Francisco, oriente antioqueño colombiano, que combinó los enfoques etnográfico y biográfico. Los principales resultados muestran que, a la par del sufrimiento, los campesinos desplegaron un repertorio de resistencias múltiples y diversas, como expresión de respuesta activa y estrategia para re-tejer los hilos rotos que dejó dicha experiencia. La resistencia, en su carácter de oposición afirmativa, es una categoría potente para el campo de la salud mental, toda vez que resalta la creatividad y la capacidad de transformación de las personas, permitiendo superar los límites de la mirada biomédica convencional que tiende a patologizar las respuestas individuales y sociales en escenarios de sufrimiento intenso.

The objective of this study is to identify individual, family and/or community responses of resistance within protracted armed conflict. We conducted a case study with members of rural communities in the municipality of San Francisco, in the eastern area of Antioquia, Colombia, combining biographical and ethnographical approaches. The primary results show that, along with the suffering generated by the experience of armed conflict, rural community members also display a repertoire of multiple and diverse resistance strategies. Resistance is for them an active response and a way to re-weave the fabric torn by the experience. As a type of affirmative opposition, resistance is a powerful category for the entire mental health field, in that it highlights the creativity and capacity for transformation of individuals. In this way, the category allows for overcoming the limits of the conventional biomedical view that tends to pathologize individual and social responses in scenarios of severe distress.

La potencia de la noción de resistencia para el campo de la salud mental: un estudio de caso sobre la vida campesina en el conflicto armado colombiano. / [The power of the notion of resistance in the mental health field: a case study on the life of rural communities whitin the Colombian armed conflict].

The objective of this study is to identify individual, family and/or community responses of resistance within protracted armed conflict. We conducted a case study with members of rural communities in the municipality of San Francisco, in the eastern area of Antioquia, Colombia, combining biographical and ethnographical approaches. The primary results show that, along with the suffering generated by the experience of armed conflict, rural community members also display a repertoire of multiple and diverse resistance strategies. Resistance is for them an active response and a way to re-weave the fabric torn by the experience. As a type of affirmative opposition, resistance is a powerful category for the entire mental health field, in that it highlights the creativity and capacity for transformation of individuals. In this way, the category allows for overcoming the limits of the conventional biomedical view that tends to pathologize individual and social responses in scenarios of severe distress.

Salud mental y violencia política. Atender al enfermo psiquiátrico o reconocer al sujeto de la micropolítica / Mental Health and Political Violence. Care of Psychiatric Patient or Acknowledge of the Micropolitics of the Subject

Resumen Introducción: La violencia política es un fenómeno, presente en todo el mundo, que involucra de manera creciente a la población civil, especialmente en países de medianos y bajos ingresos. Es una situación prioritaria en el campo de la salud colectiva, por sus múltiples y complejos efectos para la salud física y mental y los ecosistemas humanos y sociales. El objetivo es presentar las principales tendencias, que coexisten en la investigación y la práctica, en la forma de comprender los efectos en salud mental, incluyendo la mirada biomédica del trauma psiquiátrico y la incorporación de la dimensión colectiva de dichas afectaciones, resultante del diálogo de disciplinas de la salud y las ciencias sociales. Métodos: Revisión de producción investigativa de la relación violencia política-violencia colectiva y salud mental en bases de datos internacionales y centros de documentación universitarios y de organizaciones no gubernamentales nacionales, en una delimitación temporal que ocupa la última década del siglo xx y la primera de este siglo, bajo los nominadores trauma, guerra, conflicto armado y violencia política. Resultado: Se muestran las limitaciones de la generalización explicativa del trauma psiquiátrico para entender la compleja incidencia de la violencia política en salud mental. Los constructos que incorporan las dimensiones social, política y colectiva amplían dicha comprensión y expanden, conceptual y metodológicamente, el saber de la salud mental, reorientando sus preguntas. Conclusiones: Se esboza una ruta superadora de la mirada epidemiológica biomédica, individualizada y de corto plazo, conducente a su desmedicalización, y al reconocimiento de que, más que enfermos, las personas y comunidades que sufren los efectos de la violencia política son sujetos potentes para poner en escena alternativas que les permitan transformar y realizar la vida que sueñan.

Abstract Introduction: Political violence is a global phenomenon, especially in low- to middle-income countries. This phenomenon increasingly involves civilians. This situation is a priority in collective health, as it produces multiple and complex effects on physical and mental health, and human and social ecosystems. The objective of this article is to present the main tendencies that coexist in research and practice on the understanding of the effects of political violence on mental health. The biomedical approach of psychiatric trauma and the wider perspective of social sciences, which incorporate the collective dimension of these effects, are also taken into account. Methods: Review of research determines the relationship with political violence / collective violence and mental health in international databases and national documentation centers, academics and NGOs within the last decade of the twentieth century, and the first of this century under the headings of trauma, war, armed conflict and political violence. Results: The limitations of general explanations of psychiatric trauma in understanding the complex effects of political violence on mental health are shown. The constructs that incorporate social and collective dimensions increase this comprehension of these effects and knowledge of mental health, both conceptually as methodologically. Conclusions: In a political violence context it urgent to change attitudes about mental health. It is a way to overcome the biomedical, individualistic, and short term epidemiology, and to remove medication from mental health. This means acknowledging that people who experience the effects of political violence effects are not sick. They are powerful people who can transform and produce the life they dream of.

Care and social suffering: nursing within contexts of political violence / Cuidado y sufrimiento social: la enfermería en contextos de violencia política / Cuidado e sofrimento social: a enfermagem em contextos de violência política

In light of the armed conflict and political violence in Colombia, the contribution of nursing professionals is fundamental in caring for individuals, families, and communities, whose experience because of these types of events has been devastating, not only for their physical health, but for their psychic and emotional stability. Due to this, we give way to some brief considerations on the armed conflict and political violence in Colombia. Thereafter, the notion of social suffering is included as a perspective that broadens the horizon of care within this context, then we review the elements that characterize the perspectives and domains of nursing and the possibilities offered by the new epistemological tendencies to reflect on life, as a central focus of care, from the proposals by Afaif Meleis; and, finally we discuss the role of nursing professionals in the restitution of the dignity of those who have experienced the consequences of the armed conflict.

A raíz del conflicto armado y la violencia política en Colombia, es fundamental el aporte de los profesionales de enfermería en el cuidado de los individuos familias y comunidades, cuya experiencia por este tipo de eventos ha sido devastadora, no solo para su salud física, sino para su estabilidad síquica y emocional. Por eso, se da inicio con unas breves consideraciones sobre el conflicto armado y la violencia política en Colombia. Posteriormente, se incluye la noción de sufrimiento social, como perspectiva que amplía el horizonte del cuidado en este contexto, luego se revisan los elementos que caracterizan las perspectivas y dominios de la enfermería y las posibilidades que brindan las nuevas tendencias epistemológicas, para reflexionar sobre la vida, como foco central del cuidado, desde los planteamientos de Afaif Meleis; y, finalmente se habla del papel de los profesionales de enfermería en la restitución de la dignidad de aquellos que han experimentado las consecuencias del conflicto armado.

Este artigo procura gerar uma reflexão a respeito do potencial contribua dos profissionais de enfermagem, no cuidado dos indivíduos, famílias e comunidades, que experimentaram eventos tão devastadores como os derivados do conflito armado e a violência política. Para cumprir o propósito, dá-se início com umas breves considerações sobre o conflito armado e a violência política em Colômbia. Posteriormente, inclui-se a noção de sofrimento social, como perspectiva que amplia o horizonte do cuidado neste contexto, depois se revisam os elementos que caracterizam as perspectivas e domínios da enfermagem e as possibilidades que brindam as novas tendências epistemológicas, para reflexionar sobre a vida, como foco central do cuidado, desde as propostas de Afaif Meleis. E, finalmente se fala do papel dos profissionais de enfermagem na restituição da dignidade daqueles que experimentaram as conseqüências do conflito armado.

[Mental Health and Political Violence. Care of Psychiatric Patient or Acknowledge of the Micropolitics of the Subject]. / Salud mental y violencia política. Atender al enfermo psiquiátrico o reconocer al sujeto de la micropolítica.

INTRODUCTION: Political violence is a global phenomenon, especially in low- to middle-income countries. This phenomenon increasingly involves civilians. This situation is a priority in collective health, as it produces multiple and complex effects on physical and mental health, and human and social ecosystems. The objective of this article is to present the main tendencies that coexist in research and practice on the understanding of the effects of political violence on mental health. The biomedical approach of psychiatric trauma and the wider perspective of social sciences, which incorporate the collective dimension of these effects, are also taken into account. METHODS: Review of research determines the relationship with political violence / collective violence and mental health in international databases and national documentation centers, academics and NGOs within the last decade of the twentieth century, and the first of this century under the headings of trauma, war, armed conflict and political violence. RESULTS: The limitations of general explanations of psychiatric trauma in understanding the complex effects of political violence on mental health are shown. The constructs that incorporate social and collective dimensions increase this comprehension of these effects and knowledge of mental health, both conceptually as methodologically. CONCLUSIONS: In a political violence context it urgent to change attitudes about mental health. It is a way to overcome the biomedical, individualistic, and short term epidemiology, and to remove medication from mental health. This means acknowledging that people who experience the effects of political violence effects are not sick. They are powerful people who can transform and produce the life they dream of.

Los derechos civiles de las personas con discapacidad mental en Colombia: una actualización tardía y restringida / Civil rights of persons with mental disabilities in Colombia: a late and restricted update

Introducción: La producción legislativa y la aplicación del derecho son el resultado de la relación de fuerzas y del consenso entre los miembros de la comunidad jurídica, la sociedad civil y los profesionales. El conocimiento de los instrumentos internacionales de promoción de derechos y el ordenamiento jurídico interno en el campo de la salud mental deben permitir a los profesionales y técnicos asumir su papel de veedores para que la brecha entre las declaraciones formales y las prácticas efectivas sea cada vez menor. Su prioridad guarda relación con la creciente carga personal, económica y social; además de la fuerte carga de estigma y discriminación de la que han sido objeto las personas señaladas como enfermas mentales. Objetivo: Analizar los alcances de la Ley 1306 de junio de 2009, específicamente en lo atinente a los derechos civiles de las personas con discapacidad mental, en el marco de las convenciones internacionales suscritas por el país. Resultados: Aunque persisten grandes inconsistencias formales y prácticas para hacer efectivos los derechos de las personas con discapacidad mental, se emprende un camino, aún restringido, en su reconocimiento gradual. Conclusiones: Es urgente la acción y el fortalecimiento de la movilización social, a fin de asumir los desafíos y posibilidades del marco normativo y de lograr instalar la diversidad y pluralidad como condición de una real sociedad democrática...

Introduction: Legislative production and law enforcement are the results of the balance of power and consensus among members of the legal community, civil society, and professionals. The knowledge of international instruments for promoting rights and domestic law in the field of mental health should enable technical professionals to assume their role as providers in order to reduce the gap between formal statements and actual practices. This priority is related to the growing personal, economic and social burden, in addition to the heavy burden of stigmatization and discrimination targeted at persons who have been identified as mentally ill. Objective: To analyze the scope of “Law 1306” of June 2009, specifically as it regards the civil rights of persons with mental disabilities, within the framework of international conventions signed by the country. Results: Although major formal and practical inconsistencies persist in making effective the rights of persons with mental disabilities, there is a beginning —still modest— in their gradual recognition. Conclusions: It is urgent to act and to strengthen social mobilization in order to face the challenges and the possibilities of the normative framework and to achieve the development of diversity and plurality as a condition of a real democratic society...