Explorando los significados y experiencias de las enfermeras españolas en torno a la compasión / Exploring the meanings and experiences of spanish nurses regarding compassion

OBJETIVO: Describir cómo las enfermeras españolas definen la compasión y cómo se refleja en su formación y práctica, qué factores influyen en su desarrollo y de quién/es la reciben. MÉTODO: Estudio descriptivo transversal. La población de estudio fueron enfermeras (asistenciales, gestoras y docentes-investigadoras) y estudiantes de cuarto curso del Grado en Enfermería residentes en España. Se realizó un muestreo intencional por conveniencia; recogida de datos mediante cuestionario online compuesto por preguntas cerradas/abiertas, entre marzo y junio de 2014. Los datos cuantitativos fueron analizados de manera descriptiva. Se realizó un análisis temático de las respuestas a las preguntas abiertas. RESULTADOS: Se recogieron 173 cuestionarios, de los cuales un 55,5% fue cumplimentado por enfermeras asistenciales. La compasión se define mayoritariamente como conciencia profunda del sufrimiento de los otros y deseo de aliviarlo, en sintonía con la vulnerabilidad, rol de abogacía enfermera y empatía. Las participantes consideran que la compasión puede enseñarse (69,9%) y es importante para la práctica enfermera (96,6%). Los valores culturales (49,7%) y la experiencia personal con relación a la compasión (34,7%) son claves en su desarrollo. Es recibida fundamentalmente de compañeros y pacientes y sólo en un 0,6%, de gestores. CONCLUSIONES: La compasión es considerada por las enfermeras un elemento central de su práctica. Se precisa crear entornos de práctica asistencial que propicien el desarrollo de la atención compasiva y donde las enfermeras perciban compasión de sus gestores

AIM: To describe how Spanish nurses define compassion and identify the way this understanding determines educational and clinical practice. We also report on the factors that influence their development of compassion and the sources from whom they receive compassion. METHODS: A cross-sectional research design with study population of nurses (clinicians, managers, teachers and researchers) and finalist student nurses living in Spain. A convenient sample was recruited through the authors' networks. An on-line survey, with both close and open questions, was used for data collection (March - June 2014). A descriptive quantitative analysis and a thematic qualitative analysis was used. RESULTS: 173 participants completed the on-line survey, 55% being clinical nurses. Participants defined compassion as the deep awareness of others' suffering and the inner motivation to relieve it. This attitude is in coherence with the concepts of vulnerability, advocacy role and empathy. Compassion can be taught (69,9%) and is central for clinical practice (96%). Cultural values (49,7%) and personal experiences related with compassion (34,7%) are key elements in its development. Compassion is received mainly from colleagues and patients and only in a 0,6% from managers. CONCLUSIONS: Compassion is considered by nurses as a central element in nursing practice. So, it is necessary to recreate care practice environments that encourage the development compassionate care and where nurses perceive compassion from their managers

Puppet show: teatro de marionetas para trabajar competencias comunicativas en el grado en Enfermería / A puppet show to work on communication skills at the nursing degree

Objetivos: trabajar competencias básicas en comunicación terapéutica y construcción de relaciones de cuidado en estudiantes del Grado en Enfermería. Metodología: actividad de simulación de alta fidelidad realizada dentro de la asignatura de Psicosociología de los Cuidados, en 2º curso del Grado en Enfermería, mediante la dramatización con marionetas. Se utilizaron marionetas para crear experiencias realistas y espontáneas de simulación mediante teatro de títeres a partir de cuatro casos o guiones teatrales. La actividad fue evaluada en términos de satisfacción y adecuación a los criterios de aprendizaje a través de nueve ítems medidos con una escala Likert de 1-5. Resultados: participaron 143 estudiantes. La evaluación resultó muy satisfactoria con medias por encima de cuatro puntos en términos de adecuación a los criterios de aprendizaje, creatividad y novedad de la propuesta y dinamización por parte de la profesora-instructora. Conclusiones: las marionetas resultan un recurso excepcional para trabajar simulación de una manera innovadora y creativa en un entorno seguro, lo que permite al estudiante superar la vergüenza e interaccionar con el paciente-instructor de igual a igual. Es una técnica eficaz que moviliza emocionalmente y que resulta factible para trabajar con grupos grandes e inexpertos en habilidades comunicativas

Objectives: to work on the basic skills on therapeutic communication and building care relationships among Nursing Degree students. Methodology: an activity of high-fidelity simulation, conducted within the subject Psychosociology of Care, in the 2nd year of the Nursing Degree, through dramatization with puppets. These puppets were used in order to create realistic and spontaneous simulation experiences through a puppet show based on four cases or play scripts. The activity was evaluated in terms of satisfaction and suitability to the learning criteria through nine items, measured with a Likert Scale from 1 to 5. Results: there was participation by 143 students. The evaluation was very satisfactory, with mean scores >4 in terms of suitability to the learning criteria, creativity and novelty in the approach, and dynamization by the professor-trainer. Conclusions: puppets represent an exceptional resource to work on simulation in an innovative and creative way, in a safe environment; this allows the student to overcome embarrassment and interact with the professor-trainer on equal terms. This is an effective technique for emotional mobilization, and it allows to work with large groups without experience in communication skills

Educación en competencias / Nursing competency-based education

La educación basada en competencias, como eje central de la reforma universitaria en el marco europeo de la educación superior, ha supuesto un cambio sustancial a la hora de entender y poner en práctica la función docente. En este contexto, debería plantearse el rol docente en términos de competencias, contemplando aspectos de colaboración entre todos los actores del proceso educativo, así como aspectos éticos íntimamente ligados a la función docente. La educación en competencias implica promover espacios de reflexión crítica sobre nuestro desarrollo disciplinar y autonomía profesional, así como sobre los valores y responsabilidades implícitas en la función docente

Competency-Based Education is the central axis of European Higher Education university reform. It has introduced substantial changes in how we understand and perform university teaching. In this context, it is mandatory to rethink the teaching role in terms of competencies, taking into account the cooperation among different actors involved in the teaching process, together with ethical aspects linked to the teaching function. Nursing Competency-Based Education requires a critical reflection of the discipline's development, professional autonomy, together with the values and responsibilities implied in the teaching process

Critical points in the experience of spouse caregivers of patients who have suffered a stroke. A phenomenological interpretive study.

AIMS: To explore and document the experiences and values of spouse caregivers of stroke survivors. To gain more in-depth knowledge of how the act of caring and the adaption process affects caregiving spouses. MATERIALS AND METHODS: Phenomenological, qualitative study. This study included spouses of stroke survivors who also served as primary caregivers. Individual, semi-structured, in-depth interviews were conducted, transcribed, and analysed using a thematic content analysis as proposed by Giorgi. Data was analysed and managed using Atlas-ti (version 7.0). This study was approved by our institution´s Complejo Hospitalario de Caceres Ethics and Research Committee. RESULTS: Spouse caregivers of stroke survivors undergo a process of disruption in their private lives and relationships, marked by their caregiving duties. The experiences of spouses caring for stroke survivors is condensed into topics and subtopics: "Caregiving and that´s all" summarizes the sense of having no life horizons and also caregiver impossibility of moving away from caring role. Otherwise, "Breaking the couple´s life together" enlightens the further consequences of stroke in couples shared live biography, which needs to be understood and rebuilt. Finally, "Going through the (non) loss alone" alludes to how spouses reinterpret meaning of loss, which is not appreciated by others and that refers to the balance between stroke survival and any acquired global disability. CONCLUSIONS: A comprehensive approach to the couple (family), from a psycho-socio-emotional and relational perspective, is essential for ensuring adequate quality of life for people who suffered a stroke as well as their caregivers. Spouses-caregivers must be considered as individuals living a transition process due to their unexpected disrupting change, which nurses should address through a comprehensive and integrated approach focused on transition care. Care resources must be adapted to the interpretation that the spouses have of their caregiving role and their relationship with the different components of the caregiving process.

El Reto del Malvavisco: trabajando competencias de trabajo en equipo, liderazgo y resolución de problemas / The Marshmallow Challenge: Working on skills for teamwork, leadership, and problem solving

Según la orden CIN (CIN/2134/2008) y el Libro Blanco de Enfermería, el personal docente ha de trabajar con los estudiantes de Enfermería en cuatro dominios diferentes: valores profesionales, habilidades de comunicación y relaciones interpersonales, toma de decisiones en la práctica clínica y gestión del trabajo en equipo. En el marco de la pedagogía basada en el juego se planteó introducir en el aula el Reto del Malvavisco como una actividad para reflexionar y profundizar sobre aspectos de trabajo en equipo, fomentando las capacidades de colaboración, liderazgo distribuido, empatía y creatividad desde un planteamiento lúdico y a través de situaciones cotidianas alejadas del plano clínico. Se trabajó con estudiantes del Grado de Enfermería de tercer curso, en la asignatura de Prácticas Tuteladas III. La actividad consistió primeramente en trabajar habilidades de trabajo en equipo y liderazgo compartido a través del juego para, posteriormente, transferir el conocimiento generado a una situación clínica mediante la resolución de un caso. La actividad fue evaluada por los estudiantes de forma muy positiva. Consideraron que introducir el juego en el aula es una forma muy creativa y muy útil para desarrollar habilidades que pueden implementar posteriormente en el desempeño de su rol profesional (AU)

According to 'orden CIN' (CIN/2134/2008) and the White Paper on Nursing, the teaching staff must work with Nursing students on four different areas: professional values, communication skills and interpersonal relations, decision making in clinical practice, and teamwork management. In the setting of game-based pedagogy, the introduction in the classroom of the 'Marshmallow Challenge' was considered a useful activity to reflect and delve into teamwork aspects, promoting the skills of collaboration, shared leadership, empathy and creativity from a recreational approach and through everyday situations away from the clinical level. This work was conducted with Nursing Degree students in their third year, within the subject Tutored Practices III. The activity consisted primarily in working on teamwork and shared leadership skills through the game, and subsequently translating the knowledge generated into a clinical situation by solving a case. The activity was evaluated very positively by students; they considered that introducing the game in the classroom was a very creative and useful manner to develop skills that can be subsequently implemented in the performance of their professional role (AU)

Foto-elicitación: una herramienta útil para investigar la gestión de la vulnerabilidad de las mujeres sin hogar / Photoelicitation: a useful tool to investigate management of the vulnerability of homeless women

Objetivo: El propósito de este artículo es analizar el uso de la foto-elicitación como herramienta para explorar la gestión de la vulnerabilidad de las mujeres sin hogar. Métodos: Estudio cualitativo orientado desde la teoría fundamentada. La foto-elicitación se empleó en la recogida de datos desarrollada de febrero de 2015 a febrero de 2017. Se seleccionaron mediante muestreo intencional 5 mujeres mayores de 18 años residentes en 4 centros de acogida de la red de atención a personas sin hogar de Madrid. Las participantes hicieron uso de cámaras fotográficas o teléfonos móviles para representar con imágenes su experiencia de vivir en la calle y en el centro de acogida. Reveladas las fotografías se exploró cara a cara su significado mediante entrevista. En el análisis de datos se describió el contenido manifiesto de las imágenes para luego su contraste con el contenido latente producido por las informantes durante la entrevista. Resultados: Solo 3 mujeres de las participantes completaron la técnica. En el análisis del material discursivo y visual producido se hallaron construcciones teóricas que sirvieron para profundizar en el conocimiento de categorías/subcategorías previamente construidas, por ejemplo ‘Los buenos profesionales’, ‘Los lugares seguros de la calle’ y ‘Los peligros de la calle’. Conclusiones: La foto-elicitación permite aproximarse a la experiencia de las participantes con mínimas imposiciones, cediéndoles buena parte del control sobre la producción de datos. No obstante, es una técnica exigente para participantes e investigadores que requiere de una profunda reflexión antes de su puesta en marcha (AU)

Aims: The proposal of the manuscript is to provide a methodological reflection on the use of photo-elicitation as a data gathering strategy to explore vulnerability management among homeless women. Methods: A grounded theory study was carried out. Photo elicitation was one of the data gathering techniques used between February 2015 and February 2017. Five women were selected through intentional sampling. All of them were over 18 years old and residents in 4 shelters within the Madrid Care for the Homeless network. Participants used disposable cameras or mobile phones to record their experiences living in the shelters or on the street through photographs. An interview was conducted with each participant in order to explore the meaning of the photos after they were developed. Data analysis comprised, firstly, describing the obvious content of the photos and, secondly, comparing it with the latent content provided by participants during the interviews. Results: Only 3 women finished the task. Through data analysis some theoretical proposals were discovered, which contributed to a deeper knowledge of some previously established categories and subcategories such as: ‘The good professionals’, ‘The safe places in the street’ and ‘The threats in the street’. Conclusions: Photo-elicitation enabled an approach to participants’ experiences with minimal imposition, allowing them much of the control over the data production. However, it is a demanding technique that requires deep reflection before its implementation, on the part of both participants and researchers (AU)

Photoelicitation: a useful tool to investigate management of the vulnerability of homeless women. / Foto-elicitación: una herramienta útil para investigar la gestión de la vulnerabilidad de las mujeres sin hogar.

AIMS: The proposal of the manuscript is to provide a methodological reflection on the use of photo-elicitation as a data gathering strategy to explore vulnerability management among homeless women. METHODS: A grounded theory study was carried out. Photo elicitation was one of the data gathering techniques used between February 2015 and February 2017. Five women were selected through intentional sampling. All of them were over 18 years old and residents in 4 shelters within the Madrid Care for the Homeless network. Participants used disposable cameras or mobile phones to record their experiences living in the shelters or on the street through photographs. An interview was conducted with each participant in order to explore the meaning of the photos after they were developed. Data analysis comprised, firstly, describing the obvious content of the photos and, secondly, comparing it with the latent content provided by participants during the interviews. RESULTS: Only 3 women finished the task. Through data analysis some theoretical proposals were discovered, which contributed to a deeper knowledge of some previously established categories and subcategories such as: "The good professionals", "The safe places in the street" and "The threats in the street". CONCLUSIONS: Photo-elicitation enabled an approach to participants' experiences with minimal imposition, allowing them much of the control over the data production. However, it is a demanding technique that requires deep reflection before its implementation, on the part of both participants and researchers.

Exploring Nurses' Meaning and Experiences of Compassion: An International Online Survey Involving 15 Countries.

PURPOSE: In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries. DESIGN: A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey. RESULTS: The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion. DISCUSSION AND CONCLUSION: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected. IMPLICATIONS FOR PRACTICE: Further research is needed to explore the country and culture differences in the enactment of compassion.

«Ruleta de emociones»: el juego como estrategia para la educación emocional en el Grado de Enfermería / The wheel of emotions: a game as a strategy for emotional education in the nursing degree

Un reto en la formación de estudiantes de Enfermería es potenciar el desarrollo transversal de competencias emocionales que les permitan comprender y regular adecuadamente las emociones. Para potenciar la reflexión sobre el papel de las emociones en la conducta profesional, se diseñó un taller dinamizado mediante el juego «Ruleta de emociones». Previamente se entregaron dos cuestionarios para activar la reflexión. Participaron 16 estudiantes de cuarto curso trabajando 14 emociones. Durante la actividad los estudiantes discriminaron emociones y analizaron comportamientos. Evaluaron la experiencia como enriquecedora. Las prácticas tuteladas son un laboratorio para testar competencias emocionales. Los métodos reflexivos constituyen herramientas potentes para tomar conciencia de las emociones propias y de otros. La ruleta de emociones estimula a identificar emociones experimentadas y a analizar la forma de gestionarlas

To strengthen the transversal development of emotional skills, allowing to understand and adjust emotions adequately, represents a challenge in the training of Nursing students. In order to strengthen the reflection on the role of emotions in professional behaviour, a dynamic workshop has been designed through the «Wheel of Emotions» game. Two questionnaires were previously handed out in order to activate reflection. Sixteen (16) students in their fourth year participated in the game, working on 14 emotions. During the activity, students distinguished between emotions and analyzed different behaviours. They assessed the experience as rewarding. Guided practices are a laboratory for testing emotional skills. Reflective methods represent powerful tools to become aware of our own emotions as well as the emotions of others. The Wheel of Emotions encourages to identify the emotions experienced, and to analyze the way to manage them

[Impact on quality of life in caregivers of stroke survivors]. / Impacto en la calidad de vida en cuidadores de supervivientes de un ictus.

UNLABELLED: Stroke is the first cause of disability in adults. Often, the care falls on the family and can affect their quality of life. AIM: To determine the health-related quality of life and the level of caregiver burden of a patient after a stroke. METHOD: Descriptive and cross-sectional study. Caregivers, who had cared for a patient for more than six months and without pay, were included. This study had been approved by the Ethics Committee. Variables collected: sociodemographic, EuroQol-5D questionnaire, Zarit scale, mood and sleep problems. RESULTS: Forty-eight caregivers were included, with a mean age of 55.63 (SD: 13.48) and the majority were women (70.8%). The mean time of the care was 28.8 months (SD: 28.68), with 58% stated having a depressed mood, 31% had burden, and 89.6% had sleep problems. The dimensions that presented problems (moderate and severe) in the EQ-5D were pain-discomfort (66.7%) and anxiety-depression (68.8%). The score on the visual analog scale rating of quality of life was associated with a worse mood (75.5 vs. 32, p=0.0028), with the pain (81.94 vs. 38, p<0.001), and Zarit scale (r:<0.334, p=0.020). CONCLUSIONS: The role of caregivers of stroke patients often falls on women. To be a caregiver affects the quality of life, mainly in the pain-discomfort and anxiety-depression dimensions, regardless of the functional status of the patient. Nurses must identify the psychopathological needs and develop strategies on the prevention of the risk of burnout.

Caring to achieve the maximum independence possible: a synthesis of qualitative evidence on older adults' adaptation to dependency.

AIMS AND OBJECTIVES: To understand the process of adaptation to dependency in older adults and their families. BACKGROUND: Dependency and family care giving are attracting the attention of policymakers, service providers and researchers. DESIGN: An interpretative synthesis of qualitative studies has been conducted. METHODS: An extensive search without time and idiom limitations was conducted using the main databases (MEDLINE, CINAHL, EMBASE, PsycINFO, SSCI, LILACS, CUIDEN, Cochrane Library and JBI): personal communication from expert panel was used to detect filters strategies to find qualitative studies; these strategies were combined with search terms for dependence in older adults. The studies (2164 potentially relevant papers) were judged by two reviewers based on reading title, abstract, keywords and/or full text (English, Spanish, French and Portuguese) to determine their inclusion. After, 203 papers were critically appraised by two reviewers (disagreements were resolved by discussions). Finally, the synthesis of the 20 studies with best interpretative character was carried out based on the principles and procedures of Grounded Theory. RESULTS: The findings were related to the process of adaptation to dependency, the factors and the strategies used, the emotions, perceptions and feelings of care givers and older adults. The central category that emerged was 'Caring to achieve the maximum independence possible', and this could be seen as a transition period in which older adults and their families progressed in a mutually determined adaptation process. This category is made up of several redefinitions of concepts, phases, adaptation strategies and final responses to the process. CONCLUSIONS: The findings show the interconnected nature of physical, material, social and emotional aspects of care; and the profound social impact of providing and receiving care. Relevance to clinical practice. The nurses can assist families and older adults to enhance adaptation to dependency, anticipating and helping to redefine the concepts of care.

Versión española del cuestionario de calidad de vida para niños y adolescentes con cardiopatías (PedsQL TM) / The spanish version of the health-related quality of life questionnaire for children and adolescents with heart disease (PedsQL TM)

Introducción y objetivos. Adaptar al español el cuestionario de calidad de vida Pediatric Quality of Life Inventory (PedsQLTM) (Módulo General y Módulo Cardiaco, versión 3.0). Métodos. Metodología de traducción directa e inversa. La entrevista cognitiva se utilizó para probar la versión previa al test. Se realizó la evaluación de las propiedades psicométricas de la versión española. Resultados. La nueva versión contiene algunos cambios de formato con intención de facilitar la lectura de los enunciados y la comprensión de las instrucciones de respuesta (versión para niños de 5-7 años). Se identificaron algunos problemas de «descontextualización» en relación con el desarrollo evolutivo de los niños en las versiones para los niños más pequeños y sus padres (2-4 y 5-7 años). El porcentaje de ítems sin respuesta osciló entre 0 y el 5,9%. Se encontraron efectos techo elevados, especialmente en el Módulo Cardiaco, donde osciló en un 19-48,6%. La consistencia interna fue > 0,7, excepto en la dimensión de Apariencia Física y Funcionamiento Escolar en los niños. Los grados de acuerdo entre la información dada por los niños y la dada por los padres fueron en general muy altos. Se observó una tendencia de descenso de las puntuaciones en todas las escalas en relación con la gravedad de la cardiopatía, pero sólo en algunas dimensiones las diferencias fueron estadísticamente significativas. Conclusiones. La versión española del PedsQLTM presenta algunas diferencias con la versión original, concretamente con las dimensiones de Funcionamiento Escolar y Apariencia Física, como se observó en las entrevistas cognitivas. Por otro lado, no se ha demostrado que tenga validez predictiva (AU)

Introduction and objectives. To adapt the Pediatric Quality of Life Inventory (PedsQLTM) (General Module and Cardiac Module, 3.0 version) into Spanish. Methods. Forward and back translation methodology. Cognitive interviewing was used to check the pre-test version. Psychometric properties were computed for the PedsQLTM Cardiac Module Scales. Cross-informant variance between children and parents was assessed. Results. The Spanish version has some format changes to make it easier to read and to clarify response choices (version for 5-7 years age group). Some semantically complex terms were replaced with synonyms and others illustrated with examples. Some "out of context" problems were identified with respect to some items (version for children 2-4 and 5-7 years). The percentage of missing item responses ranged from 0% to 5.9%. A high ceiling effect was found, especially in the Cardiac Module, which ranged from 19% to 48.6%. Internal consistency was higher than 0.7, except for Physical Appearance Scale and School Functioning in children. Agreement between information given by children and parents was generally very high. A decreasing trend in scores on all scales was observed in relation to the severity of heart disease, but the differences were only statistically significant in some dimensions. Conclusions. The Spanish version of the PedsQLTM differs somewhat from the original version, particularly on the School Functioning and Physical Appearance Scales, as observed in cognitive interviews. Predictive validity was not demonstrated (AU)

The Spanish version of the health-related quality of life questionnaire for children and adolescents with heart disease (PedsQL(TM)).

INTRODUCTION AND OBJECTIVES: To adapt the Pediatric Quality of Life Inventory (PedsQL(TM)) (General Module and Cardiac Module, 3.0 version) into Spanish. METHODS: Forward and back translation methodology. Cognitive interviewing was used to check the pre-test version. Psychometric properties were computed for the PedsQL(TM) Cardiac Module Scales. Cross-informant variance between children and parents was assessed. RESULTS: The Spanish version has some format changes to make it easier to read and to clarify response choices (version for 5-7 years age group). Some semantically complex terms were replaced with synonyms and others illustrated with examples. Some "out of context" problems were identified with respect to some items (version for children 2-4 and 5-7 years). The percentage of missing item responses ranged from 0% to 5.9%. A high ceiling effect was found, especially in the Cardiac Module, which ranged from 19% to 48.6%. Internal consistency was higher than 0.7, except for Physical Appearance Scale and School Functioning in children. Agreement between information given by children and parents was generally very high. A decreasing trend in scores on all scales was observed in relation to the severity of heart disease, but the differences were only statistically significant in some dimensions. CONCLUSIONS: The Spanish version of the PedsQL(TM) differs somewhat from the original version, particularly on the School Functioning and Physical Appearance Scales, as observed in cognitive interviews. Predictive validity was not demonstrated.

Modelos enfermeros como marcos de referencia para el análisis de datos cualitativos / Nursing models as reference frameworks for the analysis of qualitative data

El análisis de los datos cualitativos es un proceso complejo que depende,en gran parte, de la sensibilidad interpretativa o teórica del investigador. Para potenciar esta sensibilidad teórica, una de las estrategias más comunes es la consulta de la literatura en busca de marcos conceptuales de referencia. Sin embargo, la utilización de los marcos de referencia ha de realizarse de manera crítica y justificada,respetando el proceso inductivo sin que suponga una limitación para la generación de teoría a partir de los datos. Las grandes teorías enfermeras, las de rango medio y las situacionales-específicas constituyen marcos conceptuales de elección para que la investigación en cuidados se desarrolle en congruencia con los valores y pilares filosóficos de la disciplina enfermera.En este artículo se describen las fases del proceso de investigación cualitativa y, mediante un ejemplo práctico, se ilustra cómo utilizar los modelos conceptuales enfermeros como marcos de referencia en cada una de ellas (AU)

The analysis of qualitative data is a complex process that greatly depends on the researcher’s interpretive or theoretical sensitivity. In orderto boost this theoretical sensitivity, one of the most common strategies is the consultation of the literature in search of reference conceptual frameworks. However, the use of reference frameworks has to be carried out in a critical and justified manner, respecting the induction process without this representing a limitation for the generation of theory from the data. The large nursing theories, the middle range theories and the situational-specific theories constitute the conceptual frameworks of choice for care research to be developed in accord with the values and philosophical pillars of the nur -sing field.This article describes the phases of the qualitative research process and,using a practical example, illustrates how conceptual nursing models can be used as reference frameworks in each one of these phases (AU)

Research protocol: a synthesis of qualitative studies on the process of adaptation to dependency in elderly persons and their families.

BACKGROUND: Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. OBJECTIVES: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment.A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice.The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. DISCUSSION: This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts.