RESUMO
Objetivo: Analizar la relación entre Determinantes Sociales de la Salud (DSS) y discriminación en niños, niñas y adolescentes migrantes a partir de la información disponible en la literatura científica. Método: Revisión narrativa de estudios primarios publicados entre 2008 y 2021 en las bases de datos PubMed y Web of Science. Se utilizaron los descriptores "Psychological/Social Discrimination", "Racism", "Social Stigma", "Social Determinants of Health", "Public Health", "Health Equity", "Transients and Migrants", "Refugees", "Emigrants and Immigrants", "Undocumented Immigrants", "Child", "Adolescent", "Child, "Preschool". Los operadores booleanos utilizados fueron AND y OR. Se incluyeron artículos observacionales (analíticos o descriptivos) que evaluaran la relación entre discriminación racial y DSS, publicados en inglés o español. La población de estudio fueron niños, niñas y adolescentes. La selección de artículos se realizó siguiendo las recomendaciones PRISMA. La calidad de la evidencia fue evaluada mediante la herramienta MMAT. Resultados: De un total de 1249 artículos identificados, se incluyeron 55. La mayor cantidad de artículos identificó el efecto de la relación entre discriminación racial y migración en ámbitos de salud mental negativa. Fue escasa la evidencia respecto de determinantes estructurales, sin embargo, destaca la relación entre discriminación racial y el efecto moderador de la familia y la escuela. Conclusiones: Analizar la discriminación racial que perciben niños y niñas migrantes mediante un enfoque de DSS permite identificar áreas sensibles al desarrollo estrategias de reducción de inequidades en este grupo.
Objective: To analyze the relationship between Social Determinants of Health (SDH) and racial discrimination in migrant children and adolescents, based on the information available in the scientific literature. Method: Narrative review of primary studies published between 2008 and 2021 in PubMed and Web of Science databases. The descriptors "Psychological/Social Discrimination", "Racism", "Social Stigma", "Social Determinants of Health", "Public Health", "Health Equity", "Transients and Migrants", "Refugees", "Emigrants and Immigrants", "Undocumented Immigrants", "Child", "Adolescent", "Child", "Preschool" were using. The Boolean operators used were AND OR. We included observational articles (analytical or descriptive) that evaluated the relationship between racial discrimination and SDH, published in English or Spanish. The study population was children and adolescents. We select articles following the PRISMA recommendations. The evaluation of the quality of the evidence was made using MMAT. Results: Of a total of 1249 articles identified, 55 articles were included. The most significant number of articles identified the relationship between racial discrimination and migration on adverse mental health outcomes. Evidence regarding structural determinants was scarce; however, the relationship between racial discrimination and the moderating effect of family and school stands out. Conclusions: Analyzing racial discrimination as perceived by migrant children through a DSS approach allows us to identify sensitive areas to develop strategies to reduce inequities in this group.
RESUMO
Objetivo: Analizar críticamente la teoría de rango medio Symptom Management Theory y evaluar su utilidad en la investigación sobre multimorbilidad en ambientes comunitarios. Metodología: Análisis teórico según estrategia de subestructuración de Dulock, consistente en 4 pasos: identificación de constructos y conceptos; descripción de las relaciones; operacionalización de los conceptos con indicadores empíricos y representación pictórica y jerarquizada del modelo. Resultados: El modelo cuenta con una clara estructura jerárquica, vinculando el sistema teórico y operativo. Esta estructura teórica es coherente, sencilla y tiene un respaldo suficiente para ser aplicada en el estudio de la gestión de síntomas en usuarios portadores de multimorbilidad en ambientes comunitarios. Conclusiones: La teoría de rango medio Manejo del Síntoma es útil para el estudio de la multimorbilidad en contextos comunitarios.(AU)
Objective: To critically analyze the middle-range theory Symptom Management Theory and evaluate their utility in research on multimorbidity in community settings. Methodology: Theoretical analysis using Dulock's substruction strategy, consisting of four steps: identification of constructs and concepts, description of relationships, operationalization of concepts with empirical indicators, and hierarchical pictorial representation of the model. Results: The model's hierarchical structure is clear, effectively linking the theoretical and operational systems. This theoretical structure is coherent, straightforward, and sufficiently supported for its application in the study of symptom management in individuals with multimorbidity in community settings. Conclusions: The middle-range theory of Symptom Management is valuable for investigating multimorbidity in community contexts.(AU)
Assuntos
Humanos , Masculino , Feminino , Multimorbidade , Doença Crônica/mortalidade , Avaliação de Sintomas , Enfermagem , Cuidados de EnfermagemRESUMO
Objetivo principal: Explorar barreras y facilitadores percibidos por profesionales de salud en la atención a migrantes en Atención Primaria de Salud (APS) de Santiago de Chile en 2020. Metodología: Diseño cualitativo, estudio de caso. Se entrevistó a 10 profesionales de APS. Mediante análisis de contenido se determinaron patrones temáticos según Creswell. Se contó con aprobación del Comité de ética de Universidad Andrés Bello, Chile. Resultados principales: El idioma fue percibido como una de las principales barreras para la atención de salud de personas migrantes, así como también la falta de entrenamiento. Como facilitadores destaca la disponibilidad de herramientas tecnológicas para reducir brechas de comunicación y disposición por parte de los profesionales para establecer una relación terapéutica. Conclusión principal: La atención a migrantes en APS requiere estrategias de pertinencia cultural, considerando barreras como el idioma y la falta de entrenamiento, y aprovechando herramientas tecnológicas para una comunicación efectiva.(AU)
Main objective: To explore barriers and facilitators perceived by health professionals in the care of migrants in Primary Health Care (PHC) in Santiago de Chile in 2020. Methodology: Qualitative design, case study. Ten PHC professionals were interviewed. Content analysis was used to determine thematic patterns, according to Creswell. Approval was obtained from the Ethics Committee of Universidad Andrés Bello, Chile. Main results: Language was perceived as one of the main barriers to health care for migrants and a lack of training. The availability of technological tools to reduce communication gaps and the willingness of professionals to establish a therapeutic relationship were highlighted as facilitators. Main conclusion: Care for migrants in PHC requires culturally relevant strategies, considering barriers such as language and lack of training, and taking advantage of technological tools for effective communication.(AU)
Assuntos
Humanos , Masculino , Feminino , Competência Cultural , Migrantes , Atenção Primária à Saúde , Assistência ao Paciente , Barreiras de Comunicação , Chile , Pesquisa Qualitativa , EnfermagemRESUMO
OBJECTIVE: To describe the different perceptions about health rights for migrant population in Chile published on Twitter, concerning the first liver transplant carried out in Chile to a foreign national woman from Haiti, in September 2018. METHOD: Qualitative study, case analysis. The case corresponded to the first emergency liver transplant in a migrant woman in Chile. Opinions expressed on Twitter regarding this case were collected between September 29 and November 17 (n=339). Thematic analysis was performed using NVivo12 software, with codes defined conforming to the objective. RESULTS: According to the perceptions raised on Twitter, the right to access health services of the migrant population in Chile should be limited, and priority should be given to nationals. These opinions coexist with viewing health as a human right. There are also feelings of racism and discrimination towards this group. CONCLUSIONS: In Chile, there are different perceptions of what should grant rights of access to migrant health services. This situation can generate a worsening of stigmatization and vulnerability faced by migrants and a barrier to the policy's implementation, further exacerbating the presence of health inequities.
