Expectations of patients awaiting lung transplantation: A qualitative study.

AIM: The main aim of the present study is to examine the expectations and feelings of people awaiting lung transplantation. BACKGROUND: The assessment of the benefits of lung transplant should consider, among other things, the subjective perceptions of patients about the procedure, especially in relation to the context and to their values, goals and expectations. This is an issue that has not been studied in depth, especially in Spain. DESIGN: Exploratory qualitative study. METHODS: Data were collected through semi-structured interviews during the period of being on the waiting list for transplantation. Thematic analysis of the data was supported by the Atlas.ti software. RESULTS: The study population comprised 16 patients awaiting lung transplant, a number sufficient to reach data saturation. Four categories were identified to describe patients' feelings and expectations: (1) reasons for undergoing the transplant, (2) expectations about life post-transplant, (3) emotional state, and (4) relationship with the healthcare team. CONCLUSIONS: Patients have high expectations of lung transplantation. They see it as offering them a second chance at life, although the future creates uncertainty. The healthcare professionals are identified as key actors, providing essential support and information throughout the various stages of the process. Future research should explore recipients' experiences of lung transplant at later stages. RELEVANCE TO CLINICAL PRACTICE: It is important to adapt care through all the lung transplant process, which is accompanied by intense and complex emotions since the beginning. Thus, providing social and psychological support from the beginning may contribute to their health status, helping them deal with all the emotions and feelings experienced, and find balance between expectations and reality. PATIENT OR PUBLIC CONTRIBUTION: Sixteen patients awaiting lung transplant were interviewed. Interview transcripts were returned to participants to check for accuracy with their experiences.

The experience of giving birth in a hospital in Spain: Humanization versus technification.

AIM: To explore and describe the experiences of women giving birth in a tertiary public hospital, with special focus on experiences related to humanized care and women's participation in decision making. METHOD: This is a qualitative phenomenological study through semi-structured interviews to postpartum women giving birth in a tertiary hospital between January and May 2017. Data were analysed through content analysis. RESULTS: The two overarching themes emerged were the professional-information dyad and privacy. Subthemes of the first main theme were the therapeutic relationship, decision-making, feeding the baby, procedures, and the time factor. Subthemes of the second topic were the feelings generated by the hospital environment, the delivery room, and the maternity ward. CONCLUSIONS: If the therapeutic relationship is good, technology is not seen as dehumanising but rather as necessary to ensure continuing safety. "Humanising" material resources are not a priority for women in the birth process and are little used. Privacy was experienced as being a particularly intense need, which women called for throughout the healthcare process.

Patient Safety Culture in European Hospitals: A Comparative Mixed Methods Study.

BACKGROUND: Poorly organized health systems with inadequate leadership limit the development of the robust safety cultures capable of preventing consequential adverse events. Although safety culture has been studied in hospitals worldwide, the relationship between clinician perceptions about patient safety and their actual clinical practices has received little attention. Despite the need for mixed methods studies to achieve a deeper understanding of safety culture, there are few studies providing comparisons of hospitals in different countries. PURPOSE: This study compared the safety culture of hospitals from the perspective of nurses in four European countries, including Croatia, Hungary, Spain, and Sweden. DESIGN: A comparative mixed methods study with a convergent parallel design. METHODS: Data collection included a survey, participant interviews, and workplace observations. The sample was nurses working in the internal medicine, surgical, and emergency departments of two public hospitals from each country. Survey data (n = 538) was collected with the Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative date was collected through 24 in-depth interviews and 147 h of non-participant observation. Survey data was analyzed descriptively and inferentially, and content analysis was used to analyze the qualitative data. RESULTS: The overall perception of safety culture for most dimensions was 'adequate' in Sweden and 'adequate' to 'poor' in the other countries with inconsistencies identified between survey and qualitative data. Although teamwork within units was the most positive dimension across countries, the qualitative data did not consistently demonstrate support, respect, and teamwork as normative attributes in Croatia and Hungary. Staffing and workload were identified as major areas for improvement across countries, although the nurse-to-patient ratios were the highest in Sweden, followed by Spain, Hungary, and Croatia. CONCLUSIONS: Despite all countries being part of the European Union, most safety culture dimensions require improvement, with few measured as good, and most deemed to be adequate to poor. Dimension level perceptions were at times incongruent across countries, as observed patient safety practices or interview perspectives were inconsistent with a positive safety culture. Differences between countries may be related to national culture or variability in health system structures permitted by the prevailing European Union health policy.

Understanding to humanise: Teaching nurses' experience with caring for Mapuche patients.

BACKGROUND: The Mapuche are a minority group living in small communities in southern Chile. Due to many variables, such as poverty and cultural factors, they are susceptible to inequalities in education and healthcare. PURPOSE: To describe nurse educators' experiences of caring for Mapuche people in primary care centers in Chile. METHODS: A descriptive qualitative study was performed with nine female nurse educators who supervised nursing students in clinical placement. Data were obtained through semi-structured interviews. Triangulation was achieved through consensus among the researchers. RESULTS: The analysis yielded two themes: Cultural sensitivity and Humanisation of care. Nurse educators respect Mapuche beliefs and practices about health and treatment and adapt clinical interventions accordingly. Nurse educators are committed to integrate Mapuche spiritual and cultural needs into the biomedical model, aiming to build a genuine person-centered relationship with patients and to promote transcultural nursing models with students. CONCLUSIONS: Culturally competent professionals are needed to train nurses about the demands of a globalized and culturally diverse world. Training is required in both humanized care competencies and cross-cultural nursing. Improving cultural competence among nurses and nurse educators would improve patients' health outcomes and would allow preventative intervention, therefore reducing treatment failures and further complications.

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence.

WHAT IS KNOWN ON THE SUBJECT: A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT: INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM: To explain how people with a serious mental illness perceive and experience their sexuality. METHOD: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS: Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

'Staying alive' with antiretroviral therapy: a grounded theory study of people living with HIV in Peru.

BACKGROUND: To achieve an optimal quality of life through chronic disease management, people living with HIV (PLHIV) must adhere to antiretroviral therapy (ART). ART has been available throughout Peru since 2004 without cost in all regions; yet only 60% (43 200) of PLHIV receive ART and 32% are virally suppressed. Despite the low adherence, little is known about the experience of PLHIV with ART adherence in the context of Latin America. METHODS: A constructivist grounded theory design was used to understand the ART adherence experiences of PLHIV in Northern Peru. Unstructured interviews were conducted with 18 participants resulting in theoretical saturation. All interviews were recorded, immediately transcribed and analysed concurrently with data collection using constant comparative analysis with Atlas.ti (V.8) software. Rigour was maintained through openness, reflexivity, audit trail, memo writing, debriefings, member checks and positionality. RESULTS: The core category 'staying alive' emerged through the interaction of four categories, including: (1) overcoming barriers; (2) working with the healthcare team; (3) tailoring self-care strategies; and (4) appreciating antiretrovirals. Adherence is not a spontaneous outcome, instead, the surprise of HIV diagnosis transitions to living with HIV as a chronic disease. The healthcare team helps PLHIV realise ART is their life source by enhancing, supporting and facilitating self-care and overcoming barriers. CONCLUSION: Adherence emerges from experiential learning as PLHIV recognised ART as their life source in balance with their desire to continue living a normal life. Social support and healthcare team interventions help PLHIV implement tailored self-care strategies to overcome personal, social, and structural barriers to adherence. Healthcare professionals need to recognise the challenges confronted by PLHIV as they learn how to continue living while trying to stay alive.

Student's satisfaction and intercultural competence development from a short study abroad programs: A multiple cross-sectional study.

Nurses should be culturally competent to care appropriately to all patient groups. Whilst there are many opportunities to obtain clinical experiences, there are less curriculum-based opportunities to develop cultural competencies. This multiple cross-sectional study aimed to explore the development of intercultural awareness, knowledge, and competence in two different nursing students' groups (2016 and 2017 program edition) during a one-week study abroad program hosted by a European network of 14 higher education institutions. A questionnaire was designed specifically for the study and reliability established. Factor analysis confirmed three dimensions: perceived benefits, satisfaction, and acquisition of learning outcomes. Fifty-eight students (71.6%) completed the questionnaire for the April 2016 group, and 60 (88.2%) from the April 2017 group. There were minimal differences in responses between the two groups which suggested perceived benefits were retained one year later. Ratings were high for perceived satisfaction, perceived benefits; and the learning outcomes with regard to cultural competencies. Overall, the one-week program was considered a success and students would recommend it to others. This study concludes that a short, one-week study abroad program enabled nursing students to develop individually as well as develop cultural competencies in healthcare.

Final-year nursing students called to work: Experiences of a rushed labour insertion during the COVID-19 pandemic.

The first COVID-19 case was confirmed in China in December 2019, and countries around the world rapidly diagnosed new cases from January 2020 onwards. The World Health Organization (WHO) declared an international emergency, characterising it as a pandemic in March 2020. In Spain, final-year Medicine and Nursing students were recruited to reinforce the healthcare system. Using a qualitative phenomenological approach we aimed to clarify the experiences of these final-year year nursing students employed to provide nursing care during the COVID-19 pandemic in Spain. A total of 20 interviews were conducted with final-year students from six universities who were employed by Catalan Hospitals. Data was analyzed using Colaizzi's method. Analysis identified the meta-category 'feeling the commitment' from the interaction of two categories, 'facing the unknown' and 'being and feeling like a nurse', and five subcategories. Students felt highly committed to fighting the COVID-19 pandemic, volunteering to work as nurses despite facing the unknown and not yet having finished their studies. Future Spanish nursing programmes should include 'pandemic and disaster management' content to increase students' preparedness for such scenarios.

Student satisfaction with content and language integrated learning in nursing education: A cross-sectional study.

Content and language integrated learning is an evidenced approach focused on teaching content in which the language is learnt implicitly, facilitating internationalization. The purpose of this study was to determine nursing student satisfaction with a clinical skills course taught in English in a non-English speaking country. It includes the exploration of variables, barriers, benefits, and competence acquisition as perceived by the students. A cross-sectional study was conducted using a self-reported questionnaire administered to students who had completed the Clinical Skills course during the 2016/17 and 2017/18 academic years (n = 159). The students did not perceive the lessons in English as a barrier to acquisition of knowledge and clinical skills (mean 1.08; SD 1.64), and they were satisfied with the lessons received (mean 4.04; SD 1.65). Most students considered that receiving lessons in English adds value to their training process (mean 4.04; SD 2.35), and most agreed that it would benefit them in future (mean 4.48; SD 1.75). From the outcomes of our investigation we conclude that the content and language integrated learning approach should be maintained in future courses owing to the evidenced benefits, which may advance professional internationalization and the nursing competence development of students, leading to high student satisfaction.

Participants' safety versus confidentiality: A case study of HIV research.

Background When conducting qualitative research, participants usually share lots of personal and private information with the researcher. As researchers, we must preserve participants' identity and confidentiality of the data. Objective To critically analyze an ethical conflict encountered regarding confidentiality when doing qualitative research. Research design Case study. Findings and discussion one of the participants in a study aiming to explain the meaning of living with HIV verbalized his imminent intention to commit suicide because of stigma of other social problems arising from living with HIV. Given the life-threatening situation, the commitment related to not disclosing the participant's identity and/or the content of the interview had to be broken. To avoid or prevent suicide, the therapist in charge of the case was properly informed about the participant's intentions. One important question arises from this case: was it ethically appropriate to break the confidentiality commitment? Conclusion confidentiality could be broken if a life-threatening event is identified during data collection and participants must know that. This has to be clearly stated in the informed consent form.

El climaterio y las inmigrantes ecuatorianas: una experiencia natural en manos de otros / The menopause and immigrant Equadorian women: a natural experience in the hands of others

Introducción: El modelo biomédico describe la menopausia como un problema de salud. Los científicos sociales sostienen que se trata de un proceso biológico normal individual cuya experiencia viene determinada por factores culturales. Objetivo: Comprender la experiencia de la menopausia entre las inmigrantes ecuatorianas que viven en Barcelona (España). Diseño: Estudio cualitativo fenomenológico hermenéutico. Trece mujeres ecuatorianas menopáusicas fueron entrevistadas en sus hogares durante el período 2008-2009. Las entrevistas fueron transcritas textualmente y analizadas siguiendo el proceso hermenéutico. Resultados: Cuatro dominios interrelacionados fueron identificados: Una experiencia individual natural, ser mujer, mi sexualidad en manos de otros, ser vs. sentirse mayor. Conclusión: la menopausia entre las inmigrantes ecuatorianas aparece como un evento natural repleto de falsos mitos y tabúes en cuya construcción influyen sustancialmente la biomedicina y el contexto social (AU)

Introduction: The menopause has been described as a medical problem in many Western countries. Contrarily, the menopause is considered a normal biological process by social scientists who argue that the experience of the menopause is individual and shaped by cultural factors. Purpose: to understand the experience of the menopause among Ecuadorian immigrant women living in Barcelona (Spain). Design: Qualitative study using the hermeneutic phenomenology perspective. Thirteen Ecuadorian menopausal women were interviewed in their home during 2008-2009. Interviews were transcribed verbatim and analyzed using the hermeneutic process. Results: Four inter-related themes were identified: a natural experience, being a woman, my sexuality in the hands of others, being vs. feeling old. Conclusion: The menopause among Ecuadorian immigrant women appears to be a natural event full of false myths and taboos dominated by biomedicine and the social context (AU)

[The climacteric and biomedicine: reflections from nursing and the sociology of health and illness disciplines]. / El climaterio y la biomedicina: reflexiones desde la enfermería y la sociología de la salud y la enfermedad.

This article critically examines the biomedical model and how it has influenced the social construction of the meaning of the menopause. This model has been criticized as reductionist since it understands people as entities made of several parts that can be studied separately. Contrarily for nursing, people are formed by several parts in direct relation with the environment and themselves. Therefore, it is not posible to understand people's reality without considering social factors. The menopause has been described in various biomedical texts as a phenomenon similar to a disease, with severe symptoms and negative connotations. However the experiences and meanings that women ascribe to this stage of their life are varied and not always negative. In order to offer appropriate care, it is important for nursing to think about the role of social interaction in constructing the meaning individuals attribute to phenomena.

El climaterio y la biomedicina: reflexiones desde la enfermería y la sociología de la salud y la enfermedad / The climacteric and biomedicine: reflections from nursing and the sociology of health and illness disciplines

Examen de forma crítica del modelo biomédico y cómo ha influido en la construcción del significado del climaterio en la sociedad. Este modelo ha sido tachado de reduccionista al entender a las personas como entes formados por diversas partes que pueden estudiarse por separado. De forma contraria, para la enfermería, las personas están formadas por diversas partes todas ellas en relación directa con el entorno y consigo mismas. Por lo tanto, no puede entenderse la realidad de los sujetos y abordar determinadas situaciones sin tener presentes sus características sociales. El climaterio ha sido descrito en diversos textos biomédicos como un fenómeno similar a una patología, con una sintomatología propia y cargado de connotaciones negativas, fruto de la influencia social. Sin embargo, las experiencias y significados que las mujeres atribuyen a esta etapa de sus vidas son variados y no siempre negativos. Para enfermería es importante reflexionar sobre el rol que juega la interacción social a la hora de construir el significado que las personas atribuyen a los fenómenos para poder ofrecer cuidados apropiados (AU)

This article critically examines the biomedical model and how it has influenced the social construction of the meaning of the menopause. This model has been criticized as reductionist since it understands people as entities made of several parts that can be studied separately. Contrarily, for nursing, people are formed by several parts in direct relation with the environment and themselves. Therefore, it is not posible to understand people’s reality without considering social factors. The menopause has been described in various biomedical texts as a phenomenon similar to a disease, with severe symptoms and negative connotations. However, the experiences and meanings that women ascribe to this stage of their life are varied and not always negative. In order to offer appropriate care, it is important for nursing to think about the role of social interaction in constructing the meaning individuals attribute to phenomena (AU)

El análisis de los datos cualitativos: un proceso complejo / The analysis of qualitative data: a complex process

Este artículo muestra la complejidad del análisis de los datos cualitativos a partir de las ideas sobre el método planteadas por Morin y surge fruto del proceso analítico llevado a cabo durante la elaboración de nuestras tesis doctorales. Nuestra experiencia parte del método de las comparaciones constantes y representa un desafío dotado de contradicciones complementarias, donde los datos se agrupan y desagrupan, se integran y se desintegran de acuerdo con los principios hologramático, dialógico y recursivo. Como resultado establecemos las siguientes fases del proceso de análisis: 1) "El todo": desarrollando ideas; 2) Del todo a las partes: separando y agrupando; 3) De lo particular a lo general: re-agrupando; 4) Descomponer el todo en sus partes sin perder el todo: integrando y relacionando; 5) Relacionar las partes que dan sentido al todo: identificando la categoría central (AU)

This article shows the complexity of the analysis of qualitative data according to Morin's method and they are the result of the analytical process carried out during the development of our PhD thesis. Our experience begins with the constant comparison method and represents a challenge endowed with complementary contradictions, where data is grouped and ungrouped, integrated and disintegrated according to the hologrammatic, dialogic and recursive principles. As a result we establish the following analytical phases: 1) "The all": developing the ideas; 2) From "the all" to the parts: separating and clustering; 3) From particular to general: regrouping; 4) Undoing "the all" into its parts without losing "the all": integrating and relating; 5) Joining the parts that make sense of "the all": identifying the core category (AU)

[Burns, new challenges to take on]. / Quemaduras. Nuevos retos que plantearse.

This article concerns a transversal descriptive study which shows the characteristics of burns treated in a Primary Health Care Center in an urban environment in Barcelona from 19 July 2005 unti 11 August 2007 (N=93). Patients younger than 15 were excluded from this study. 88% (82; CI of 95% 81,47-94,59) of the burns treated were caused by a thermal agent. Kitchen cooking oil ranks first as the cause of burns (24; 27%, CI of 95% 17,99-36,01). 70% of the burns studied had signs of superficial skin damage (65, CI of 95% 60,70-79,30). 61% (57; CI of 95% 51,70-70,30) of these burns were located on upper extremities The average recorded body surface burned was 0.0076% (median = 0,005%, range = 0,0001-0,5000%). The greatest number of wounds were observed among men aged 31 to 45 (17%; 16; CI of 95% 9,38-24,62). Educational health programs which focus on prevention of, and first aid care for, burns are needed. Studies like this one may prove useful when starting preventive or educational strategies.

[Pharmaceutical characteristics of oral anti-diabetes medicines]. / Características farmacológicas de los antidiabéticos orales.

An update regarding the principles of hyperglycemia pharmaceuticals used in daily practice, analyzing their form of administration, their adverse effects, counter indications, and interactions.

Quemaduras. Nuevos retos que plantearse / Burns, new challenges to take on

Estudio descriptivo transversal que muestra las características de las quemaduras atendidas en un Centro de Atención Primaria (CAP) de ámbito urbano en Barcelona durante el periodo comprendido desde 19/7/2005 hasta 11/8/2007 (N=93). Los pacientes menores de 15 años fueron excluidos. El 88% (82; IC del 95% 81,41-94,59) de las quemaduras se debió a un agente térmico. El aceite de cocina es el primer elemento causal (24; 27%; IC del 95% 17,99-36,01). El 70% de las heridas señaló dérmicas superficiales (65; IC del 95% 60,70-79,30). El 61% (57; IC del 95% 51,70-70,30) se localizó en EESS (extremidades superiores). La superficie corporal quemada media registrada indicó 0,0076% (mediana=0,005%; rango=0,0001-0,5000%). El mayor número de heridas se observó en los varones de 31 a 45 años (17%; 16; IC del 95% 9,38-24,62). Se precisan programas de educación para la salud centrados en la prevención y actuación ante una quemadura. Estudios como éste pueden resultar útiles a la hora de iniciar estrategias preventivas o educativas (AU)

This article concerns a transversal descriptive study which shows the characteristics of burns treated in a Primary Health Care Center in an urban environment in Barcelona from 19 July 2005 until 11 August 2007 (N=93). Patients younger than 15 were excluded from this study. 88% (82; IC of 95% 81,41-94,59) of the burns treated were caused by a thermal agent. Kitchen cooking oil ranks first as the cause of burns (24; 27%; IC of 95% 17,99-36,01). 70% of the burns studied had signs of superficial skin damage (65; IC of 95% 60,70-79,30). 61% (57; IC of 95% 51,70-70,30) of these burns were located on upper extremities. The average recorded body surface burned was 0.0076% (median=0,005%; range=0,0001-0,5000%). The greatest number of wounds were observed among men aged 31 to 45 (17%; 16; IC of 95% 9,38-24,62). Educational health programs which focus on prevention of, and first aid care for, burns are needed. Studies like this one may prove useful when starting preventive or educational strategies (AU)