How do women suffering from multiple chemical sensitivity experience the medical encounter? a qualitative study in Spain.

PURPOSE: Multiple Chemical Sensitivity is a condition principally suffered by women. As with fibromyalgia and chronic fatigue syndrome, Multiple Chemical Sensitivity is usually included among the so called "contested illnesses", defined as illnesses whose cause, diagnosis, prevalence and even existence are subject to controversy. This article seeks to explore how women with Multiple Chemical Sensitivity experience this contested illness, through their own descriptions of diagnostic processes, search for treatment and encounters with different health professionals. We aim to observe these experiences in detail and to identify aspects that could improve care for Multiple Chemical Sensitivity sufferers. METHOD: Qualitative design. We performed personal in-depth interviews, which were recorded and transcribed to conduct a qualitative content analysis supported by Atlas.ti-7. SUBJECTS/PATIENTS: 22 women diagnosed with Multiple Chemical Sensitivity in Spain. RESULTS: Two main categories were identified in the interviews: (1) unavoidable barriers: patients' exposure to chemicals and the absence of treatment, and (2) Skepticism on the part of care providers and lack of recognition in the process of diagnosis. CONCLUSION: Training and above all awareness raising strategies are needed to address health professionals' prejudices regarding the existence of contested illnesses such as Multiple Chemical Sensitivity. These prejudices hinder diagnosis and medical follow-up, and add negative emotions to the physical limitations already suffered by patients.IMPLICATIONS FOR REHABILITATION Multiple Chemical SensitivityIt is important to promote a compassionate and empathetic attitude among health providers, in order to avoid rejection and delegitimization of the experiences of women with Multiple Chemical Sensitivity.Multiple Chemical Sensitivity protocols should be developed and implemented to give skills to health professionals to assist patients with Multiple Chemical Sensitivity.These protocols should include avoidance of exposure to chemicals present in healthcare facilities.Training programs for health providers should include not only knowledge, but awareness raising about the characteristics and severity of contested illnesses such as Multiple Chemical Sensitivity.Health providers should avoid stigmatizing patients by psychologizing their symptoms and be aware of the existence of stereotypes regarding women suffering from Multiple Chemical Sensitivity.

Multiple struggles in fighting violence against women: implications among Romani women leaders in Spain.

BACKGROUND: Violence against women (VAW) is a central issue in gender studies and one that has united feminist activists from around the world. But this does not mean that this struggle is singular: indeed, one can say that there are many, diverse and sometimes even contradictory struggles occurring throughout the world. OBJECTIVES: To identify and analyze the different struggles faced by women from Roma organizations in Spain in relation to VAW and their work with affected women. METHODS: Twelve semi-structured interviews were conducted among women actively involved in Roma associations in different Spanish cities, in 2015. An inductive thematic analysis was used to analyze the empirical materials. RESULTS: Our analysis resulted in three themes that captured different struggles that women from Roma organizations have faced: 'between persistence and rupture of restrictive gender norms', 'invisibility and normalization of violence against women' and 'willingness and trust in daily work with women'. The activities related to VAW carried out by the interviewed women were more related to their personal initiatives and abilities than to strategies proposed by the organizations they work for. CONCLUSIONS: The results show the need to support the initiatives of Romani women and their own struggles related to identity. This is what makes them true promoters of social change and, more specifically, change related to gender relations both within and outside of their communities.

[Validation of the Spanish Version of Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS)]. / Validación de la versión española del cuestionario Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS).

BACKGROUND: At the international level PREMIS -"Physician Readiness to Manage Intimate Partner Violence Survey"- is amongst the most comprehensive instruments to evaluate primary health care professionals' readiness. The aim of this study is to assess the reliability, internal consistency and construct validity of the Spanish version of this questionnaire. METHODS: After translation, back translation and assessment of content validity of the questionnaire, 200 questionnaires were distributed to medical doctors and nurses working in 15 primary health care centres located in 4 autonomous regions (Comunidad Valenciana, Castilla León, Murcia, Cantabria), in 2013. Cronbach's alpha, intraclass correlation and rho Spearman coefficients were calculated. RESULTS: the Spanish version of PREMIS encompasses 64 items. Cronbach's alpha coefficient was greater than or close to 0.7 in most of indices. Intraclass correlation coefficient of 0.87 and Spearman coefficient of 0.67 showed a high reliability. All correlations for the scale of Opinions, which is the only one that was considered factorial structure of the questionnaire PREMIS, were higher than 0.30. CONCLUSIONS: the Spanish version of PREMIS obtained good internal validity, high reliability and predictive self-reported capacity of medical practitioners and nurses in Intimate Partner Violence cases in PHC centers.

Validación de la versión española del cuestionario Physician readiness to manage intimate partner violence survey (PREMIS) / Validation of the Spanish version of Physician readiness to manage intimate partner violence survey (PREMIS)

Fundamentos: El Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) es uno de los cuestionarios más completos en el contexto internacional para la valoración de la capacidad de respuesta frente a la violencia del compañero íntimo por los profesionales de Atención Primaria de Salud. El objetivo de este estudio fue determinar la fiabilidad, consistencia interna y validez de constructo de la versión española de este cuestionario. Métodos: Tras la traducción, retrotraducción y valoración de la validez de contenido del cuestionario, se distribuyeron en una muestra de 200 profesionales de medicina y enfermería de 15 centros de atención primaria de 4 Comunidades Autónomas en 2013 (Comunidad Valenciana, Castilla León, Murcia y Cantabria). Se calcularon los coeficientes alfa de Cronbach, los de correlación intraclase y rho de Spearman (test-retest). Resultados: la versión española del PREMIS incluyó 64 ítems. El coeficiente α de Cronbach fue superior a 0,7 o muy cercano a ese valor en la mayoría de los índices. Se obtuvo un coeficiente de correlación intraclase de 0,87 y un coeficiente de Spearman de 0,67 que muestran una fiabilidad alta. Todas las correlaciones observadas para la escala de opiniones, la única tratada como estructura factorial en el cuestionario PREMIS, fueron superiores a 0,30. Conclusiones: el PREMIS en español obtuvo una buena validez interna, alta fiabilidad y capacidad predictiva de las prácticas auto-referidas por médicos(as) y enfermeros(as) frente a casos de violencia del compañero íntimo en centros de atención primaria (AU)

Background: At the international level PREMIS - 'Physician Readiness to Manage Intimate Partner Violence Survey'- is amongst the most comprehensive instruments to evaluate primary health care professionals’ readiness. The aim of this study is to assess the reliability, internal consistency and construct validity of the Spanish version of this questionnaire. Methods: After translation, back translation and assessment of content validity of the questionnaire, 200 questionnaires were distributed to medical doctors and nurses working in 15 primary health care centres located in 4 autonomous regions (Comunidad Valenciana, Castilla León, Murcia, Cantabria), in 2013. Cronbach’s alpha, intraclass correlation and rho Spearman coefficients were calculated. Results: the Spanish version of PREMIS encompasses 64 items. Cronbach’s alpha coefficient was greater than or close to 0.7 in most of indices. Intraclass correlation coefficient of 0.87 and Spearman coefficient of 0.67 showed a high reliability. All correlations for the scale of Opinions, which is the only one that was considered factorial structure of the questionnaire PREMIS, were higher than 0.30. Conclusions: the Spanish version of PREMIS obtained good internal validity, high reliability and predictive self-reported capacity of medical practitioners and nurses in Intimate Partner Violence cases in PHC centers (AU)