The Health Consequences of Neocolonialism for Latin American Immigrant Women Working as Caregivers in Spain: A Multisite Qualitative Analysis.

In Spain, most jobs available for Latin American immigrant women are in intimate labour (caregiving and domestic work). This work is usually performed under informal employment conditions. The objective of this study was to explain how the colonial logic mediates the experiences of Latin American women working in intimate labour in Spain, and the effects of such occupation on their health and wellbeing, using a decolonial theoretical framework. A multi-site secondary data analysis of qualitative data from four previous studies was performed utilizing 101 interviews with Latin American immigrant women working as caregivers in Spain. Three interwoven categories show how the dominant colonial logic in Spain creates low social status and precarious jobs, and naturalizes intimate labour as their métier while producing detrimental physical and psychosocial health consequences for these immigrant caregivers. The caregivers displayed several strategies to resist and navigate intimate labour and manage its negative impact on health. Respect and integration into the family for whom they work had a buffering effect, mediating the effects of working conditions on health and wellbeing. Based on our analysis, we suggest that employment, social, and health protection laws and strategies are needed to promote a positive working environment, and to reduce the impact of caregiving work for Latin American caregivers.

Determinants of Subjective Social Status and Health Among Latin American Women Immigrants in Spain: A Qualitative Approach.

This qualitative study was carried out to better understand factors that determine the subjective social status of Latin Americans in Spain. The study was conducted following a theoretical framework and forms part of broader study on subjective social status and health. Ten immigrant participants engaged in semi-structured interviews, from which data were collected. The study results show that socioeconomic aspects of the crisis and of policies adopted have shaped immigrant living conditions in Spain. Four major themes that emerged from the analysis were related to non-recognition of educational credentials, precarious working conditions, unemployment and loneliness. These results illustrate the outcomes of current policies on health and suggest a need for health professionals to orient practices toward social determinants, thus utilizing evaluations of subjective social status to reduce inequalities in health.

Genealogy as a critical toolbox: deconstructing the professional identity of nurses.

AIM: To discuss the Foucauldian concept of genealogy as a framework for understanding and transforming nurses' professional identity. BACKGROUND: The professional identity of nurses has primarily been defined by personal and interpersonal attributes and by the intradisciplinary dimensions of nursing, leading to its conceptualization as a universal, monolithic phenomenon. The Foucauldian genealogical perspective offers a critical lens to examine what constitutes this professional identity; Spanish nursing offers a historical case study of an active effort to impose an identity that fits the monolithic ideal. DATA SOURCES: Five of the 33 professional conduct manuals for nurses' training published from 1956-1976 during the Franco dictatorship in Spain and six interviews with nursing instructors or students at the time were analysed using a theoretical framework drawn from Foucault's writing. DISCUSSION: Foucault's genealogical framework considers practices of normalization and resistance as a means of understanding knowledge continuities and discontinuities, clarifying practices that constitute nurses' professional identity in a particular way in specific contexts and analysing the implications of this theoretical frame. IMPLICATIONS FOR NURSING: The genealogy concept offers valuable tools to determine how professional identities are constituted, questions assumptions about the profession and its professionals and envisions alternative approaches. This theoretical approach helps both scholars and practitioners understand, question and transform their practices as needed. CONCLUSION: The genealogical approach prioritizes analysis of the phenomenon over its description and challenges many unknown, forgotten, excluded and/or unquestioned aspects of identity from a position of diversity and complexity.

Relationship between subjective social status and perceived health among Latin American immigrant women / Relação entre status social subjetivo e saúde percebida entre mulheres imigrantes latino-americanas / Relacion entre el estatus social subjetivo y la salud percibida entre mujeres inmigrantes latinoamericanas

OBJECTIVE: to explore the relationship between socioeconomic status and subjective social status and explain how subjective social status predicts health in immigrant women. METHODS: cross-sectional study based on data from 371 Latin American women (16-65 years old) from a total of 7,056 registered immigrants accesse through community parthers between 2009-2010. Socioeconomic status was measured through education, income and occupation; subjective social status was measured using the MacArthur Scale, and perceived health, using a Likert scale. RESULTS: a weak correlation between socioeconomic and subjective social status was found. In the bivariate analysis, a significantly higher prevalence of negative perceived health in women with no education, low income, undocumented employment was observed. In the multivariate analysis, higher odds of prevalence of negative perceptions of health in the lower levels of the MacArthur scale were observed. No significant differences with the rest of the variables were found. CONCLUSIONS: the study suggests that subjective social status was a better predictor of health status than the socioeconomic status measurements. Therefore, the use of this measurement may be relevant to the study of health inequalities, particularly in socially disadvantaged groups such as immigrants. .

OBJETIVO: explorar a relação entre nível socieconômico e status social subjetivo e explicar como o status social subjetivo prediz a saúde em mulheres imigrantes. MÉTODOS: estudo transversal com observações baseadas em 371 mulheres latino-americanas (16-65 anos) de um total de 7.056 registradas, recrutadas por meio de parcerias entre os anos 2009 e 2010. O nível socioeconômico foi mensurado por meio de escolaridade, renda e profissão; o status social subjetivo foi mensurado utilizando-se a Escala MacArthur, e a saúde percebida, usando-se uma escala tipo Likert. RESULTADOS: encontrou-se fraca correlação entre o nível socioeconômico e o status social subjetivo. Na análise bivariada, observou-se prevalência significativamente mais alta de saúde percebida negativamente em mulheres sem escolaridade, baixa renda, desempregadas e com emprego informal. Na análise multivariada, observaram-se maiores chances de prevalência de saúde percebida negativamente, nos níveis mais baixos da escala MacArthur. Não foram encontradas diferenças significativas nas demais variáveis. CONCLUSÕES: o estudo sugere que o status social subjetivo foi um melhor preditor de status de saúde do que as mensurações de status econômico. Portanto, o uso dessa medida pode ser relevante para o estudo das desigualdades em saúde, particularmente nos grupos em desvantagem social, como os imigrantes. .

OBJETIVO: explorar la relación entre el estatus socioeconómico y el estatus social subjetivo y explicar en qué medida el estatus social subjetivo predice la salud en mujeres inmigrantes. MÉTODOS: estudio transversal. Observaciones basadas en 371 latinoamericanas (16-65 años) de un total de 7.056 empadronadas, captadas a través de asociaciones entre 2009-2010. El estatus socioeconómico se midió a través de educación, ingresos y ocupación; el estatus social subjetivo usando la Escala MacArthur; y la salud percibida mediante una escala de likert. RESULTADOS: se encontró una correlación débil entre el estatus socioeconómico y el social subjetivo. En el análisis bivariante se observó significativamente una prevalencia mayor de salud percibida negativa en las mujeres sin estudios, con ingresos bajos, desempleadas e indocumentadas. En el análisis multivariante, se observaron Odds de prevalencia de salud percibida negativa más elevadas en los niveles de la escala MacArthur más bajos. No se observaron diferencias significativas con el resto de las variables. CONCLUSIONES: el estudio sugiere que el estatus social subjetivo es un predictor mejor del estado de salud que las medidas del estatus socioeconómico. Por tanto, el uso de esta medida puede ser relevante para el estudio de las desigualdades en salud, particularmente en los grupos en desventaja social como los inmigrantes. .

Relationship between subjective social status and perceived health among Latin American immigrant women.

OBJECTIVE: to explore the relationship between socioeconomic status and subjective social status and explain how subjective social status predicts health in immigrant women. METHODS: cross-sectional study based on data from 371 Latin American women (16-65 years old) from a total of 7,056 registered immigrants accessed through community partners between 2009-2010. Socioeconomic status was measured through education, income and occupation; subjective social status was measured using the MacArthur Scale, and perceived health, using a Likert scale. RESULTS: a weak correlation between socioeconomic and subjective social status was found. In the bivariate analysis, a significantly higher prevalence of negative perceived health in women with no education, low income, undocumented employment was observed. In the multivariate analysis, higher odds of prevalence of negative perceptions of health in the lower levels of the MacArthur scale were observed. No significant differences with the rest of the variables were found. CONCLUSIONS: the study suggests that subjective social status was a better predictor of health status than the socioeconomic status measurements. Therefore, the use of this measurement may be relevant to the study of health inequalities, particularly in socially disadvantaged groups such as immigrants.

[Informal caretakers in Spain, their profile and care provided]. / Los cuidadores informales en España. Perfil y cuidados prestados.

The authors carried out a systematic search in main data bases and a methodological content review by paired authors about selected publications. The authors reviewed and analyzed 332 articles about informal caretakers and they chose 182 which complied with their selection criteria. The profile for informal caretakers of persons aged over 65 in Spain is identified as well as the type of care he/she provides. It is worth highlighting the introduction of a new factor in caretaking for the elderly during recent years at a national Spanish level, and since the 1990s on an international level: paid non-professional immigrant caretakers. This phenomenon makes the different traits which ethnic minority caretakers have reflect on the dynamics and the results of this study.

Valoracióny expectativas de las personas cuidadoras sobre los profesionales sociosanitarios / Assessment and expectations of caregivers regarding social and healthcare workers

El cuidado informal, recurso básico para el mantenimiento y recuperación de la salud, se encuentra en una situación crítica en España. Los cambios sociodemográficos y epidemiológicos de las últimas décadas exigen nuevas políticas sociosanitarias, programas institucionales y prácticas profesionales que respondan a las necesidades surgidas. En este artículo se explora cómo las personas cuidadoras en domicilio, de distintas generaciones y ambos géneros, valoran la actuación y apoyo de los profesionales sociosanitarios en su labor de cuidado a las personas dependientes. El estudio se basó en el paradigma crítico social y en particular, en la teoría postfeminista. La metodología fue cualitativa y desarrollada en la isla de Mallorca (España). Los participantes fueron hombres y mujeres cuidadores/as familiares en domicilio, residentes de medio urbano y de tres generaciones diferentes. Se efectuaron entrevistas individuales y grupos de discusión. Los resultados sugieren que los participantes no reconocen a los profesionales sociosanitarios como un recurso de apoyo. Las personas cuidadoras detectan en ellos una deficiencia de conocimientos sobre el paciente dependiente y de habilidades de relación terapéutica integral. Estas percepciones y las expectativas consecuentes, se hayan moduladas por el género y la generación de los participantes. La respuesta de las instituciones sociosanitarias parece no proteger a este colectivo, permitiendo la reproducción de discursos dominantes sobre la división sexual del trabajo doméstico, la naturalidad y gratuidad del trabajo femenino y la idónea y mayor responsabilidad de la familia ante el cuidado de sus dependientes

Informal care and basic resources for the maintenance and recovery of health is in a critical situation in Spain. Sociodemographic and epidemiological changes that have taken place in the last decades require new sociosanitary policies, institutional programmes, and professional practices that respond to these emerging needs. This paper explores how home caregivers, of different generations and both genders, assess the performance and support of sociosanitary workers in their task of caring for dependent individuals. The study was based on the critical social paradigm and in particular, on the post-feminist theory. Qualitative methodology developed in the island of Mallorca (Spain) was used. Participants were male and female home caregivers from three-different generations, who were looking after a close family member and who resided in an urban area. Individual interviews and discussion groups were held. Results suggest that participants do not acknowledge sociosanitary workers as a support resource. Caregivers detect inadequate understanding on the dependent patients and a lack of skills in the integral therapeutic relationship. The gender and generation of the participants modulate these perceptions and consequent expectations. The answer given by sociosanitary institutions does not appear to protect these group of workers, allowing the reproduction of dominant speeches on the sexual division of domestic chores, the naturality and gratuity of female work and the proper and greater responsibility of the family in the care of its dependent members

El impacto de cuidar en el bienestar percibido por mujeres y varones de mediana edad: una perspectiva de género / Impact of caregiving on middle-aged caregivers' perceived well-being: a gender perspective

Objetivo. Se explora la relación entre el género de las personas de mediana edad cuidadoras en domicilio y su percepción del impacto del cuidado en su salud y la de su familia en el actual contexto socioeconómico español. Método. El estudio, de orientación posfeminista, se desarrolló en la isla de Mallorca (España) a partir de entrevistas individuales y grupos focales con varones y mujeres cuidadores en domicilio, pertenecientes a 3 generaciones diferentes. Resultados. En las narrativas acerca del impacto percibido de los y las participantes, aparecen temáticas complejas como relaciones conflictivas entre las diversas personas de la familia participantes en el cuidado así como con la persona cuidada, y el impacto emocional es mayor en mujeres que en varones cuidadores. El impacto percibido y las estrategias adaptativas que ellos y ellas utilizan para afrontarlo se enmarca en los patrones y roles sexuales asignados en las sociedades patriarcales. Así, el género y la generación operan en la percepción del impacto en la salud física y psíquica, la dinámica familiar, la actividad laboral y el ocio y las relaciones sociales de las personas cuidadoras. Se discuten las implicaciones que estos resultados pueden tener para las políticas públicas y la práctica e investigación enfermeras

Objective. To explore the relationship between middle-aged caregivers' gender and the impact of caregiving on their health and families in the current socioeconomic context in Spain. Method. This study, which has a postfeminist perspective, was performed in the island of Majorca (Spain). Individual interviews in the home and focus groups with male and female caregivers belonging to three different generations were conducted. Results. Participants' narratives about the impact of caregiving on caregivers' perceived well-being revealed complex themes such as difficult relationships among caregivers and their families as well as conflicts with the person receiving care. The emotional impact was more intense in female than in male caregivers. The perceived impact and adaptive strategies utilized by caregivers were framed within the gender patterns and roles assigned by patriarchal societies. Gender and generation influence perceptions of the impact of caregiving on physical and psychological health, family dynamics, paid work, leisure activities, and social relationships among caregivers. The implications of these results for public policy and nursing practice and research are discussed

Mayores cuidando a mayores, una perspectiva de género y generación / Elders caring for elders, a gender and generational perspective

Exploramos cómo en el actual contexto socioeconómico español el género de las personas mayores cuidadoras de otros mayores influye en la percepción del cuidado realizado. Este estudio cualitativo tuvo una orientación posfeminista y fue desarrollado en Mallorca (España) a través de entrevistas individuales y grupos focales con hombres y mujeres cuidadores en domicilio de tres generaciones. En las narrativas de los y las participantes aparece un discurso radicalmente diferente de género en relación a las estrategias desarrolladas en el cuidado, la percepción del aislamiento social producido y en las demandas de ayuda expresadas. Se discuten las implicaciones que estos resultados pueden tener para las políticas públicas

This paper explores how in the current socio-economic Spanish context, the gender of main elderly caregivers who cares for other elders influences caregiving practice. This qualitative study had a postfeminist approach and was developed in Mallorca (Spain) by means of individual interviews and focus groups with male and female home caregivers from three generations. A radically different gender discourses are identified in the participants’ narrative in relation to strategies developed, perception of social isolation and demands expressed regarding caregiving. The implications of these results to public policy are discussed (AU)

El reto de investigar en enfermería: una reflexión sobre las universidades españolas y el contexto internacional / The challenge of investigation in nursing: reflection on Spanish universities and the international context

El trabajo hace una reflexión sobre los retos y posibilidades para el desarrollo de labores de investigación por enfermeras(os) docentes de universidades españolas. Para eso, utilizamos el ejemplo de las iniciativas implementadas en la Universitat de les Illes Balears y contrastamos esta realidad con la de Canadá y otros países, donde el proceso de asentamiento de la investigación en enfermería en el ámbito universitario ha sufrido un desarrollo positivo a lo largo de las últimas décadas. Para situar nuestra orientación teórica, analizamos inicialmente la gestión de la investigación como una forma de política de producción del conocimiento y apuntamos a las relaciones de poder que son intrínsecas al proceso de hacer investigación. Basados en estos distintos contextos, sugerimos que los departamentos y escuelas universitarias de enfermería deben elaborar una serie de estrategias para gestionar la investigación. De entre ellas, planteamos que la investigación debe ser gestionada en una dirección concreta que nos haga conscientes de cuáles son los temas clave a investigar, con qué recursos y para obtener qué resultados. Proponemos que existe una necesidad de una cultura de investigación para permitir que las(os) enfermeras(os) actúen como docentes de pleno derecho en lo que respecta a la participación en los diferentes planes en la carrera de investigación. Esto puede ser hecho a través de soporte institucional a los esfuerzos investigadores en crear y desarrollar proyectos, a través de un equilibrio entre la docencia y la investigación para el profesorado, facilitando la difusión de los resultados y estimulando la colaboración en la investigación con el entorno clínico. Este análisis sugiere que son muchos los esfuerzos necesarios para consolidar la investigación en enfermería en las universidades españolas, pero la ubicación de las escuelas y departamentos en la estructura universitaria genera una especial responsabilidad para estas instituciones. Desde nuestro punto de vista, este proceso debe ser presidido por una reflexión crítica sobre a quiénes beneficia el conocimiento producido por enfermería. Sin ello, no lograremos un avance que promocione la calidad de vida de la población y que haga de la investigación enfermera sinónimo de competencia y equidad (AU)