Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

La historia de vida de la enfermera Águeda Medina Soto como elemento clave dela relevancia de la cultura de los cuidados en la enfermería de Jaén / A história de vida da enfermeira Águeda Medina Soto como elemento chave darelevância da cultura do cuidado na enfermagem em Jaén / The life story of the nurse Águeda Medina Soto as a key element of the relevance of the culture of care in nursing in Jaén

In this proposal we present a feminist critical analysis of the importance that nurses haveplayed, being the life story of the nurse Águeda Medina Soto an example of her relevance in Jaén.In this sense, the methodology that facilitates the study of our recent past is life history, this beingpart of a critical-reflective intergenerational analysis, establishing cause-effect between personal experiences, society and Nursing. In addition, linking it with the gender perspective, it provides uswith another necessary analysis to reflect on how society was formed, the access and limitationsthat were presented to women of the time for incorporation into the nursing branch, in addition tothe difference structural and recognition of sex-gender roles between women and men who exercised these trades (nurses and interns respectively). The results obtained show the usefulness offered by the life history, to make visible the differences both structural, academic and sex-genderdifferentiated practices associated with nurses and practitioners. In turn, make visible the socialrelevance of nurses within the health field in the culture of care, through the case of nurse Águeda.(AU)

En esta propuesta presentamos un análisis crítico feminista de la importancia que hanjugado las enfermeras, siendo la historia de vida de la enfermera Águeda Medina Soto un ejemplo de su relevancia en Jaén. En este sentido, la metodología que nos facilita el estudio de nuestro pasado reciente es la historia de vida, siendo esta, parte de un análisis intergeneracional crítico-reflexivo, estableciendo causa-efecto entre las experiencias personales, la sociedad y la Enfermería. Además, enlazándolo con la perspectiva de género, nos presta otro un necesario análisis para reflexionarsobre cómo se conformaba la sociedad, el acceso y limitaciones que se presentaban a las mujeres dela época para la incorporación en la rama de enfermería, además de la diferencia estructural y dereconocimiento de los roles sexo-genéricas entre las mujeres y hombres que ejercían dichos oficios(enfermeras y practicantes respectivamente). Los resultados obtenidos muestran la utilidad queofrece la historia de vida, para visibilizar las diferencias tanto estructurales, académicas y prácticasdiferenciadas sexo-genéricas asociadas a las enfermeras y los practicantes. A su vez, visibilizar larelevancia social de las enfermeras dentro del ámbito sanitario en la cultura de los cuidados, a travésdel caso de la enfermera Águeda.(AU)

Nesta proposta apresentamos uma análise crítica feminista da importância que os enfermeiros têm desempenhado, sendo a história de vida da enfermeira Águeda Medina Soto um exemplo da sua relevância em Jaén. Nesse sentido, a metodologia que facilita o estudo do nosso passadorecente é a história de vida, fazendo parte de uma análise intergeracional crítico-reflexiva, estabelecendo causa-efeito entre experiências pessoais, sociedade e Enfermagem. Além disso, articulando-acom a perspectiva de gênero, nos fornece mais uma análise necessária para refletir sobre como seformou a sociedade, os acessos e limitações que se apresentavam às mulheres da época para incorporação ao ramo da enfermagem, além da diferença estrutural e reconhecimento dos papéis sexogênero entre mulheres e homens que exerciam esses ofícios (enfermeiros e estagiários, respectivamente). Os resultados obtidos mostram a utilidade oferecida pela história de vida, para tornar visíveis as diferenças estruturais, acadêmicas e práticas diferenciadas de gênero associadas a enfermeiros e profissionais. Por sua vez, visibilizar a relevância social dos enfermeiros da área da saúde nacultura do cuidado, através do caso da enfermeira Águeda.(AU)

Experiencias de mujeres infectadas con COVID-19 durante el embarazo / Experiences of women infected with COVID-19 during pregnancy

Objetivo: Conocer las experiencias vividas de mujeres gestantes ante el diagnóstico de la enfermedad COVID-19. Material y métodos: Estudio cualitativo fenomenológico. Se realizaron 6 entrevistas en profundidad a mujeres embarazadas y puérperas que sufrieron COVID-19 durante la evolución de su embarazo. El acceso a las 6 participantes se realizó por medio de la consulta de la matrona, en sus centros sanitarios de referencia. Se aplicó un análisis de contenido. Resultados: Se detectan cinco emociones relacionadas con la infección por COVID-19, en el embarazo y puerperio: miedo, ansiedad, soledad, culpabilidad y tristeza. El seguimiento profesional a las embarazadas durante la cuarentena en la mayor parte de los casos no se realiza si- guiendo los protocolos establecidos. El apoyo recibido por las mujeres se sustenta en dos pilares: uno ejecutivo, realizado por la pareja y o familia, y otro el medio, por el que reciben el apoyo tanto profesional como fami- liar, donde el teléfono y las redes sociales han sido cruciales. En la mayo- ría de los casos se demanda más información sobre la enfermedad y sus efectos en el embarazo. Conclusiones: La infección por COVID-19 en el embarazo originó en la muestra del estudio una serie de sentimientos negativos que se vieron potenciados por el efecto del aislamiento y la falta de información y de apoyo sanitario. (AU)

Objective: To know the lived experiences of pregnant women before the diagnosis of the COVID-19 disease. Material and methods: Qualitative phenomenological study. 6 in-depth interviews were conducted with pregnant and postpartum women who suffered from COVID-19 during the evolution of their pregnancy. Access to the 6 participants was made through the midwife’s consultation, in their reference health centers. A content analysis was applied. Results: Five emotions related to COVID-19 infection are detected, in pregnancy and postpartum: fear, anxiety, loneliness, guilt and sadness. Professional follow-up of pregnant women during quarantine in most cas- es is not carried out following established protocols. The support received by women is based on two pillars: one executive carried out by the couple and/or family and the other the means by which they receive both profes- sional and family support, where the telephone and social networks have been crucial. In most cases, more information about the disease and its effects on pregnancy is required. Conclusions: COVID-19 infection in pregnancy caused a series of nega- tive feelings in the study sample that were enhanced by the effect of iso- lation, lack of information and health support. (AU)

Breastfeeding at 1, 3 and 6 Months after Birth According to the Mode of Birth: A Correlation Study.

BACKGROUND: Breastfeeding is a determinant of child and maternal health. However, evidence is limited on how mode of birth influences breastfeeding. Research aim: To examine the mode of birth and breastfeeding duration and the type of lactation at one, three and six months after birth in XXX, during 2017. METHODS: Correlation study on breastfeeding duration and type of lactation during the six months after birth, and mode of birth, in a randomised sample. Women ≥18 years of age with term singleton infants, were included. Collected data through interviews and hospital records. Pearson's and Spearman's correlation analyses were conducted. SPSSv21 and α = 0.05 were used. RESULTS: Breastfeeding duration was shorter in women with greater parity (-0.055 **) (p < 0.01) and epidural analgesia (0.057 **) (p < 0.01), and longer in mothers with episiotomy (-0.267 **) (p < 0.01). Episiotomy was associated with breastfeeding at one month (0.112 **) (p < 0.01), and at six months (0.347 *) (p < 0.01). The prevalence of breastfeeding was lower in women who received epidural analgesia at three months (-0.140 **) (p < 0.01) and higher at six months (0.013 **) (p < 0.01). The percentages of breastfeeding at three months were significantly greater in women with no perineal tears (2.1) (p < 0.05). At six months, small rates of breastfeeding were found in women with greater parity (0.051 **) (p < 0.01). No significant association was detected, neither between the type of lactation and the mode of birth, nor between breastfeeding duration and the mode of birth. CONCLUSIONS: Epidural analgesia, episiotomy, perineal tears and parity influence the type of lactation and duration of breastfeeding during the six months after birth. The results suggest no association between the type of lactation and the mode of birth or between breastfeeding duration and the mode of birth.

Umbilical cord separation time, predictors and healing complications in newborns with dry care.

OBJECTIVE: The objective of this study was to explore the umbilical cord separation time, predictors, and healing complications from birth until the newborn was one month old. DESIGN: A quantitative longitudinal observational analytical study by stratified random sample was adopted. SETTING: Public health system hospitals in southern Spain and at newborns' homes. PARTICIPANTS: Between April 2016 and December 2017, the study included 106 neonates born after 35-42 weeks of gestation whose umbilical cord was cured with water and soap and dried later as well as newborns without umbilical canalisation whose mothers enjoyed a low-risk pregnancy. METHODS: The data collection procedure comprised two blocks: from birth to the time of separation of the umbilical cord and from cord separation to the first month of life of the newborn. Umbilical cord separation time was measured in minutes; socio-demographic and clinical characteristics were measured by means of questionnaires, and the external diameter of the umbilical cord was measured using an electronic stainless-steel calliper and trailing roller. RESULTS: The mean umbilical separation time: 6.61 days (±2.33, IC 95%:6.16-7.05). Incidence of omphalitis was 3.7%; granuloma was 8.6%. Separation time predictors were wetting recurrence, birth weight, intrapartum antibiotics, birth season, and Apgar < 9 (R2 = 0.439 F: 15.361, p <0.01). CONCLUSION: The findings support the World Health Organization recommendations: dry umbilical cord cares is a safe practice that soon detaches the umbilical cord, taking into account the factors studied that will vary the length of time until the umbilical cord is separated.

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study.

AIM: To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check-up and who decide to legally terminate the pregnancy. BACKGROUND: When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient-centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. METHODS: A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi-structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. RESULTS: The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow-up after discharge. CONCLUSION: Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post-loss follow-up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. RELEVANCE TO CLINICAL PRACTICE: During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.

Is It Possible to Become a Nurse in a Refugee Camp?

The history of the Western Sahara has been marked by several events that have contributed to the protracted refugee situation in which the Sahrawi people have found themselves since 1975: the Spanish colonization and the subsequent decolonization process, the armed struggles between the indigenous population and the states of Morocco and Mauritania to occupy Western Saharan territory, assassinations and repression of the Sahrawi population, and the economic interests of external agents with regards to mineral resources. Twenty-five years ago, in the hostile environment of the Sahrawi refugee camps, a nursing school was founded. Essentially depending on foreign aid, this school has been responsible for training nursing professionals to meet the healthcare needs of the population. The aim of this paper is to provide an approach to the origin and evolution of nursing education for the Sahrawi refugee camps. The Sahrawi are the only refugee camps in the world to host such nursing schools.

Is it possible to become a midwife in a refugee camp?

The historical backdrop of Western Sahara has meant that, for the last 43 years, part of its indigenous population has survived in refugee camps located in the Algerian desert. International aid from abroad has become the main source of sustenance for all people living in this hostile environment. Since the beginning of this type of settlement, the Sahrawi Arab Democratic Republic has been concerned with creating the necessary infrastructures to meet the health needs of the people living in these conditions. As a result, the Ahmed Abdel-Fatah School of Nursing was created in the Sahrawi refugee camps, which began to train midwives to care for women during the stages of pregnancy, childbirth and postpartum in 2002. The aim of this paper is to provide an approach to the origin and evolution of midwifery education for the Sahrawi refugee camps, in the only school of nursing that exists worldwide in a refugee camp.

Dry care versus chlorhexidine cord care for prevention of omphalitis. Systematic review with meta-analysis / Cura a seco versus cura com clorexidina para prevenção da onfalite. Revisão sistemática com metanálise / Cura seca frente a cura con clorhexidina para prevención de onfalitis. Revisión sistemática con metaanálisis

ABSTRACT Objective: to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis. Method: systematic review with meta-analysis. Clinical trials comparing dry care with the application of clorexidine to evaluate omphalitis were selected. Methodological quality was evaluated using the Consolidated Standards of Reporting Trials. Results: the joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group (RR=0.58, CI: 0.53-0.64). However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births (RR=0.82, CI: 0.64-1.05), in countries with a low infant mortality rate (RR=0.8, CI: 0.5-1.28), or at chlorhexidine concentrations below 4% (RR=0.55, CI: 0.31-1). Chlorhexidine acted as a protective factor at a concentration of 4% (RR=0.58, CI: 0.53-0.64), when applied in cases of home births (RR=0.57, CI: 0.51-0.62), in countries with a high infant mortality rate (RR=0.57, CI: 0.52-0.63). Conclusion: dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate.

RESUMO Objetivo: comparar o efeito da cura a seco e da aplicação de clorexidina no cordão umbilical de recém-nascidos em risco de desenvolver onfalite. Método: revisão sistemática com metanálise. Foram selecionados os ensaios clínicos que comparavam a cura a seco com a aplicação de clorexidina para avaliar a onfalite. A qualidade metodológica foi avaliada com Consolidated Standards of Reporting Trials. Resultados: a análise conjunta dos estudos mostra uma redução significativa do risco de onfalite no grupo da clorexidina em comparação com a cura a seco (RR=0,58; IC 0,53-0,64). Entretanto, na análise por subgrupos, a cura com clorexidina não reduziu o risco de onfalite em nascimentos hospitalares (RR=0,82; IC: 0,64-1,05), nos países com baixa taxa de mortalidade infantil (RR=0,8; IC: 0,5-1,28), ou com concentrações de clorexidina abaixo de 4% (RR=0,55; IC: 0,31-1). A clorexidina atuou como fator de proteção na concentração de 4% (RR=0,58; IC: 0,53-0,64), aplicada em nascimentos no domicílio (RR=0,57; IC: 0,51-0,62), em países com taxas de mortalidade infantil elevadas (RR=0,57; IC: 0,52-0,63). Conclusão: a cura a seco é eficaz em países com baixa taxa de mortalidade infantil e em nascimentos no contexto hospitalar. No entanto, a cura com clorexidina 4% protege contra a onfalite nos nascimentos domiciliares, em países com elevada mortalidade infantil.

RESUMEN Objetivo: comparar el efecto de la cura seca y de la aplicación de clorhexidina en el cordón umbilical de los recién nacidos en el riesgo de desarrollo de onfalitis. Método: revisión sistemática con metaanálisis. Se seleccionaron ensayos clínicos que compararan la cura seca con la aplicación de clorhexidina evaluando la onfalitis. Calidad metodológica evaluada con Consolidated Standards of Reporting Trials. Resultados: el análisis conjunto de los estudios muestra una reducción significativa del riesgo de onfalitis en el grupo de clorhexidina en comparación con cura seca (RR=0,58; IC: 0,53-0,64). Sin embargo, en el análisis por subgrupos, la cura con clorhexidina no aportó reducción del riesgo de onfalitis en nacimientos hospitalarios (RR=0,82; IC: 0,64-1,05) en países con baja tasa de mortalidad infantil (RR=0,8; IC: 0,5-1,28), ni a concentraciones de clorhexidina inferiores al 4% (RR=0,55; IC: 0,31-1). La clorhexidina actuó como factor protector a concentraciones del 4% (RR=0,58; IC: 0,53-0,64), aplicada en nacimientos en el hogar (RR=0,57; IC: 0,51-0,62), en países con elevada mortalidad infantil (RR=0,57; IC: 0,52-0,63). Conclusión: la cura seca es eficaz en países con baja tasa de mortalidad infantil y nacimientos en ámbito hospitalario. Sin embargo, la cura con clorhexidina al 4% protege de onfalitis en nacimientos en el hogar, en países con elevada mortalidad infantil.

Developing digital educational materials for nursing and sustainability: The results of an observational study.

BACKGROUND: There is limited European literature on nursing and sustainability; nursing students are poorly prepared on the connections between resources, climate change, sustainability, and health, so they must acquire knowledge and develop skills and competencies in this field. The use of digital technologies and teaching via E-learning has grown, and has been widely adopted as a learning method for nursing. OBJECTIVES: The aim of the current study was to test and evaluate digital educational materials on environmental sustainability and health, in the context of university nursing education in different European countries. DESIGN: An observational cross-sectional design. SETTINGS: University of Plymouth, University of Jaén, and University of Esslingen for Nursing Degree Studies. PARTICIPANTS: 299 nursing students: 161 students from University of Jaén; 106 from Plymouth; and 32 from Esslingen. 22 professional evaluators with different profiles were recruited: Teachers, Clinical professionals, Delphi Experts, and Technical Experts. METHODS: We conducted a piloting and validation process. The materials were designed and adapted to the NurSusTOOLKIT Sustainability Literacy and Competency framework. Evaluation was developed by professionals and students. We used the Spanish Standard for the assessment of Digital Educational Material Quality at University level questionnaire. All students provided informed consent prior to taking part in the learning and evaluation. RESULTS: The overall evaluations of materials by students and professionals were 7.98±1.28 and 8.50±1.17, respectively. The Ability to generate learning was scored higher among students (mean difference: 0.84; 0.22-1.47; p=0.008). In the overall assessment by students, statistically significant differences were found between the three universities (Welch: 11.69, p<0.001). CONCLUSIONS: Students, professionals, and technical experts considered the materials to be very good quality, especially regarding the quality of contents, format, and design. For students, these materials can generate reflection and learning regarding environmental and health issues during nursing training.

Competencias profesionales de las matronas suecas y españolas: un estudio cualitativo de sus percepciones / Professional skills of Swedish and Spanish midwives: a qualitative study of their perceptions

OBJETIVOS: Conocer y comparar las percepciones que poseen las matronas de España y Suecia acerca de sus competencias profesionales en la atención al parto, así como la formación académica recibida al respecto y los cuidados prestados durante el parto normal. MATERIAL Y MÉTODOS: Estudio cualitativo de corte fenomenológico con entrevistas individuales semiestructuradas realizado a 12 matronas que trabajaban en el área de partos. Se llevó a cabo un muestreo por conveniencia y en bola de nieve para acceder a las participantes. El análisis de contenido se basó en categorías analíticas preestablecidas, triangulándolas entre los investigadores y teniendo en cuenta el procedimiento clásico propuesto por Huberman y Miles. RESULTADOS: En los discursos de los participantes se observan diferencias y similitudes. Por un lado, los informantes españoles refieren tener conocimientos y desarrollos competenciales de forma parcial, por lo que requieren más formación, y realizan una atención al parto donde la comunicación y las técnicas son prioritarias. Sin embargo, las matronas suecas reflejan pocos conocimientos competenciales, y otorgan importancia al parto humanizado. CONCLUSIONES: Las matronas españolas conocen sus competencias y abogan por un despliegue total de las mismas en atención primaria y hospitalaria, donde la carencia de innovación radica en la falta de recursos humanos, materiales y formativos. Las profesionales suecas desconocen sus competencias; sin embargo, albergan un amplio campo de actuación, donde realizan intervenciones basadas en evidencias. Igualmente, manifiestan la necesidad de más formación en emergencias obstétricas

OBJECTIVES: To know and compare the perceptions that midwives' from Spain and Sweden have about their professional competences in delivery care, received education and procedures to assist a normal childbirth. MATERIALS AND METHODS: Qualitative and phenomenological study with semi structured and individual interviews performed with 12 midwives' who worked in delivery area. Convenience and snowballing sampling was performed to access the participants. Content analysis was based in pre-established analytic categories, triangulated among the researchers and taking into account the classic procedure proposed by Huberman & Miles. RESULTS: In the speeches of the participants we could observe differences and similarities. On the one hand, Spanish informants refer to know and develop their competences partially, to require more education and to assist childbirth where communication and techniques are the priority. However, Swedish midwives' do have less knowledge about their competences, giving importance to humanized childbirth. CONCLUSIONS: Spanish midwives' know their competences, claiming a total development of them in outpatient clinics and hospitals, where lack of innovation is due to the deficiency of human, educative and time resources. Swedish professionals don't know their competences, however, they have a large field of action, where they perform interventions based on evidence. Furthermore they refer the need of more education in emergency situations

Miastenia gravis y maternidad / Myasthenia gravis and pregnancy

OBJETIVOS: Conocer el imaginario de las mujeres embarazadas sobre la maternidad. MATERIAL Y MÉTODO: Estudio llevado a cabo con metodología cualitativa. La información se generó mediante entrevistas semiestructuradas y se realizó un análisis sociológico de los discursos. Los sujetos de estudio fueron 10 mujeres embarazadas de 36-37 semanas de gestación. Se atendió a los aspectos éticos y legales. RESULTADOS: La decisión de ser madre es, en ocasiones, poco explícita: la maternidad aparece como destino femenino, enaltecida por ser fuente de nuevas experiencias y satisfacciones, pero también relacionada con un aumento de las obligaciones y las responsabilidades, con las consiguientes repercusiones en la vida personal y laboral. Las mujeres expresan inseguridad e incertidumbre ante el nuevo papel requerido: el de madre. El instinto maternal aparece en el imaginario de las mujeres, pero no el paternal. CONCLUSIONES: La fuerte asociación entre maternidad e identidad femenina en el orden cultural y simbólico hegemónico actúa como motor en la decisión de ser madre. El instinto maternal aparece en el imaginario de las mujeres para dar una explicación naturalista al rol de madre. Surge la preocupación acerca de las estrategias necesarias para conciliar la vida laboral con la familiar: las renuncias laborales están relacionadas con la naturalización del rol de madre. La maternidad es una experiencia individual contextualizada en un entorno social, cultural, histórico, económico y laboral. Estudiar las creencias y los valores de una sociedad androcéntrica nos permitirá conocer las interacciones que se dan en ella, y reconocer a las mujeres como agentes capaces de construir nuevos significados. Una madre no nace, se hace

OBJECTIVES: To know how pregnancy, delivery and postpartum period are affected by myasthenia gravis and to analyze the management of the disease during this period. METHODS: A bibliographic search has been done in CINAHL, PubMed, Science Direct, Scopus, Proquest, Lilacs, Scielo, Cochrane Plus, Cuiden Plus and IME databases. RESULTS: We have chosen 40 articles. Myasthenia in pregnancy is associated to an increased risk of preterm delivery, premature ruptured membranes and neonatal mortality. Instrumental labor is recommended to avoid maternal weakness. Breastfeeding is not contraindicated if maternal disease is well-controlled. CONCLUSIONS: Myasthenia gravis increases the risk of complications during this period. Pregnancy has to be planned in advance. Fetal monitoring is essential

Currículum enfermero y estrategias pedagógicas en materia de sostenibilidad medioambiental en los procesos de salud y cuidado / Curriculum nurse and strategies training on environmental sustainability and climate change

Fundamentos: Las enfermeras deben ser conocedoras de cómo afecta el cambio climático a la salud. Para la obtención de estos conocimientos es necesario definir las competencias a adquirir y las estrategias pedagógicas que afronten la sostenibilidad medioambiental en la formación de Enfermería. Objetivo: Describir las dimensiones que debe incluir la formación enfermera en materia de sostenibilidad medioambiental, cambio climático y cuidados de salud y determinar las estrategias pedagógicas más adecuadas. Métodos: Se realizó una revisión narrativa de publicaciones sobre sostenibilidad medioambiental en relación a enfermería y cuidados de salud de los últimos 10 años. Se diseñaron estrategias de búsqueda para quince bases de datos de enfermería y ciencias de la salud. Los resultados se sistematizaron en matrices de datos. Resultados: La formación enfermera en sostenibilidad medioambiental debe incluir contenidos sobre globalización, impacto ambiental, promoción de salud, uso de recursos y gestión adecuada de residuos, alimentos e influencias de los procesos de producción, los efectos del tabaquismo y los efectos ambientales en la salud de la infancia. Los enfoques educativos más adecuados para incluir la sostenibilidad medioambiental en la formación enfermera son la Investigación-Acción Participativa y el aprendizaje basado en problemas. Conclusiones: La formación enfermera en materia de sostenibilidad medioambiental debe incluir competencias en diferentes niveles: en lo individual, comprendiendo los fundamentos y el alcance del problema y actuando consecuentemente en el ámbito profesional y en el personal, y en el plano social, Enfermería tiene un papel clave en la promoción de la salud medioambiental (AU)

Background: Nurses should be knowledgeable about how it affects climate change to health. To acquire this knowledge it is necessary to define competencies and educational strategies that tackle environmental sustainability in nursing training. Objective: To describe the dimensions that should be included in nurse education in the field of environmental sustainability, climate change and health care and determine the most appropriate pedagogical strategies. Methods: A narrative review of publications on environmental sustainability in relation to nursing and health care in the last 10 years has been carried out. Search strategies have been designed for fifteen databases of Nursing and Health Sciences. The results were systematized in a data arrays. Results: Training nurse in environmental sustainability should include contents about globalization, environmental impact, promotion of health, use of resources and proper management of waste, food and influences of production processes, the effects of smoking and environmental effects on the health of children. Educational approaches more appropriate to include environmental sustainability in the nurse training are the Participatory Action Research and problem-based learning. Conclusion: The training nurse on environmental sustainability should include competencies at different levels: individual, understanding the rationale and scope of the problem and acting accordingly in the professional field and in the personnel; and at the social level, nursing has a key role in the promotion of environmental health (AU)

Incontinencia Urinaria en mujeres de Jaén: Estudio de prevalencia / Urinary incontinence in Jaén woman: Prevalence study

Objetivo: conocer la prevalencia de la incontinencia urinaria (IU) en mujeres de la ciudad de Jaén (España) y su distribución por edad e identificar el tipo de IU que padecen. Metodología: se diseñó un estudio descriptivo y transversal. Participaron 379 mujeres adscritas a los centros de salud de la ciudad de Jaén de entre 30 y 80 años de edad que acuden a consulta de Enfermería. Se estimó la prevalencia y el tipo de IU con el cuestionario de versión española del International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Resultados: la prevalencia encontrada fue del 43,3%. El número de casos con pérdida de orina presenta una pendiente positiva con la edad. Respecto al tipo de incontinencia 12,2% (20) era de urgencias, un 60,4% (99) de esfuerzo, un 17,1% (28) mixta y otras IU un 10,4%. Conclusión principal: la prevalencia de la IU en mujeres de Jaén aumenta con la edad. El tipo de IU más frecuente es la IU de esfuerzo. Las mujeres con IU presentan mayor pérdida de calidad de vida

Objective: knowing the prevalence of urinary incontinence (UI) in women from the city of Jaen (Andalusia, Spain) and its distribution by age, in addition to identify the type of UI they sufferers. Methods: a descriptive cross-sectional study was designed, in which 379 women participated; all they assigned to Health Centers in the city of Jaen, with ages between 30 and 80; who attend nursing consultation. The prevalence and type of UI was estimated with the Spanish version of the questionnaire International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results: the prevalence found in the study was 43.3%; the number of cases with loss of urine has a positive slope with age. Regarding the type of incontinence 12.2% (20) was urge incontinence, 60.4% (99) was stress incontinence, 17.1% (28) UI mixed and other 10.4%. Conclusions: the prevalence of UI of women in Jaén increases with age. The most common type of IU is stress. Women with UI have greater loss of quality of life

Análisis del embarazo adolescente: miradas cualitativas a los casos de Bucaramanga y Jaén / Analysis of adolescent pregnancy: a qualitative approach at the cases of Bucaramanga and Jaén

Anualmente millones de jóvenes menores de edad quedan embarazadas, exponiéndose a una serie de riesgos biológicos relacionados con la gestación y a diversas consecuencias sociales. Objetivos: Conocer las percepciones y los imaginarios de las adolescentes frente al embarazo a temprana edad, en una región de Andalucía (España) y otra de Colombia. Material y métodos: Se realizó un estudio cualitativo con enfoque fenomenológico. Se entrevistó a 31 mujeres adolescentes en diferentes periodos del embarazo y el posparto. El contacto con las participantes se efectuó a través de servicios públicos sociales o sanitarios de cada uno de los contextos de estudio. Se llevó a cabo un análisis de contenido de las categorías emergentes, mediante un proceso cíclico, reflexivo, flexible y metódico, adaptado del procedimiento propuesto por Miles y Huberman. Resultados: Se han identificado elementos en común en la maternidad adolescente, independientemente del contexto en el que se desarrolla. Las percepciones y creencias sobre un embarazo adolescente están poco definidas y desarrolladas. Algunas jóvenes interpretaron su embarazo y maternidad en términos positivos y de cumplimiento de un proyecto de vida, aunque las implicaciones negativas fueron más argumentadas. Conclusiones: Los resultados de este estudio ponen de relieve la complejidad de las creencias y percepciones hacia el embarazo adolescente. Las intervenciones en salud sexual y reproductiva dirigidas a la población adolescente deberían tener en cuenta esta diversidad de sentimientos y conductas (AU)

Every year millions of underage girls become pregnant and are exposed to a series of biological risks associated with pregnancy and a variety of social consequences. Objective: The objective of this study is to know the perceptions and imaginary of the adolescents on the pregnancies at early age, in a region of Andalusia (Spain) and another region of Colombia. Materials and methods: A qualitative study with phenomenological approach was conducted. We interviewed 31 adolescent women in different periods of pregnancy and postpartum. Contact with the participants is carried out through public social services or health of each of the contexts of study. We realized a content analysis of the emergent categories, across a cyclical, reflective, flexible and methodical, adapted process of the procedure proposed by Miles and Huberman. Results: We have identified some elements in common in the adolescent maternity, independently of the context in which it develops. Perceptions and beliefs about a teenage pregnancy are poorly defined and developed. Some young women interpret its pregnancy in positive terms and they think that they fulfill a life project although the negative implications are more argued. Conclusions: Our results highlight the complexity of beliefs and perceptions toward pregnancy in adolescence. Sexual and reproductive health interventions targeting adolescent population should take into account the variety of feelings and behaviors (AU)

Sexual and reproductive health beliefs and practices of female immigrants in Spain: a qualitative study.

BACKGROUND: Sexuality and reproduction are two areas that have been dealt with differently over time and across cultures. Immigrant women resident in Spain, are largely of childbearing age and have some specific needs. Female immigrants have specific beliefs and behaviors which may influence how they approach to the Spanish sexual and reproductive health services. There is less visibility of the health problems presented by women immigrants. This article aims to shed light on the sexual and reproductive health beliefs and experiences of female immigrants in a region of southern Spain. METHODS: A descriptive study design with qualitative data collection and analysis methods were used. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women's perception and beliefs about their sexual and reproductive health. Thirteen interviews were conducted in 2013 with a multi-ethnic sample of female immigrants, currently all are residing in Andalusia. Interview topics included questions about awareness and beliefs about sexuality and reproduction. Content analysis was used. RESULTS: We have found that female immigrant brings along all of her beliefs, opinions, attitudes and behaviors regarding sexuality, contraceptives, what is "correct" and what is not, etc. The sexual behavior is conditioned by the prevailing social rules of country of origin, and these rules act ambivalently. In general, knowledge of contraceptive methods was big, but there were perceptions that reproductive health was woman's domain, due to gender norms and traditional family planning geared exclusively towards women. CONCLUSION: Results suggest that women's behavior is influenced by the precepts of their origin societies. Therefore, sexual and reproductive health processes should be adapted and incorporated into our society, with special attention being paid to the immigrant population.

Emotional state of primigravid women with pregnancy susceptible to prolongation.

OBJECTIVE: This study sought to know the perception of the emotional state of women with pregnancy susceptible to prolongation. METHODOLOGY: The research was conducted with qualitative descriptive methodology, founded on in-depth individual interviews of 7 gestants susceptible to prolongation, with ages between 21 and 32 years and duration of the pregnancy comprised between 40+5 and 41+4 weeks. RESULTS: The emotional state varies throughout the pregnancy; once the probable date of delivery has passed, the emotional well-being is altered by fear of pain during delivery, possible complications, and caring for the newborn, presenting a state of nervousness due to the imminent delivery. In addition, the women described the need for the presence of a companion during and after the delivery. CONCLUSION: Fear can affect negatively the subjective experience of the pregnancy during its final phase, the delivery process, and the transition to maternity in gestants with pregnancy susceptible to prolongation. These women need support and specific education from the midwife according to their individual needs.

Percepción de síntomas en primigestas con embarazo en vías de prolongación / Perception of simptoms in primigravid with post-term pregnancy

Durante el embarazo acontecen importantes cambios psicológicos, fisiológicos y socio-culturales que influyen en la gestante, la manera en la que ella vive esos cambios repercute de forma directa en su vivencia sobre la maternidad. Con el objetivo de conocer la percepción de síntomas presentes en la fase final del embarazo se llevó a cabo una investigación con metodología cualitativa de tipo fenomenológico, fundamentada en entrevistas individuales a siete gestantes en vías de prolongación que tuvieran como hospital de referencia el Complejo Hospitalario de Jaén. Resultados: los síntomas percibidos por las embarazadas en vías de prolongación han sido escasos, el dolor en la parte baja del abdomen y el aumento de la micción nocturna son los más repetidos. Conclusiones: conocer la percepción de síntomas de las gestantes en esta fase final del embarazo nos ayuda a prestar una atención integral hacia la promoción de la salud física en las mujeres embarazadas

Many biological, somatic, psychological and social factors take place in pregnancy. Some of them influence in pregnant women: the way they affront those changes, it will have repercussions on motherhood. We therefore conducted a qualitative research methodology, descriptive phenomenological. It is based on depth individual interviews to pregnant women who are in process of extension. They had the Jaén hospital as a reference with the aim to know the perception of symptoms. The results obtained indicate that preceived sympthoms by the pregnant women have been scare, pain and the increase of the night micturition are the most repeated. Conclusions: To know the perception of symptoms of pregnancy-way extension can help us to provide comprehensive care to promote physical health in pregnant women

Estado emocional de mujeres primigestas con embarazo en vías de prolongación / Estado emocional de mulheres primigestas com gravidez em via de prolongamento / Emotional state of primigravid women with pregnancy susceptible to prolongation

Objetivo. Conocer la percepción del estado emocional de las mujeres con embarazo en vías de prolongación. Metodología. Se llevó a cabo una investigación con metodología cualitativa descriptiva, fundamentada en entrevistas individuales en profundidad a siete gestantes en vías de prolongación, con edades entre los 21 y 32 años y una duración del embarazo comprendida entre 40+5 y 41+4. Resultados. El estado emocional varía a lo largo del embarazo, una vez pasada la fecha probable de parto. En este sentido, el bienestar emocional se ve alterado por el miedo que es genera el dolor del parto, a las posibles complicaciones y al cuidado del recién nacido, por lo que presentan un estado de nerviosismo por el parto inminente. Las mujeres, además, necesitan de la presencia de un acompañante durante el parto y después del mismo. Conclusión. El miedo puede afectar negativamente la experiencia subjetiva del embarazo en la fase final del mismo, al proceso de trabajo del parto y a la transición hacia la maternidad en las gestantes con embarazo en vías de prolongación. Estas mujeres necesitan el apoyo y educación específica por parte de la enfermera matrona según sus necesidades individuales...

Objective. This study sought to know the perception of the emotional state of women with pregnancy susceptible to prolongation. Methodology. The research was conducted with qualitative descriptive methodology, founded on in-depth individual interviews of 7 gestants susceptible to prolongation, with ages between 21 and 32 years and duration of the pregnancy comprised between 40+5 and 41+4 weeks. Results. The emotional state varies throughout the pregnancy; once the probable date of delivery has passed, the emotional well-being is altered by fear of pain during delivery, possible complications, and caring for the newborn, presenting a state of nervousness due to the imminent delivery. In addition, the women described the need for the presence of a companion during and after the delivery. Conclusion. Fear can affect negatively the subjective experience of the pregnancy during its final phase, the delivery process, and the transition to maternity in gestants with pregnancy susceptible to prolongation. These women need support and specific education from the midwife according to their individual needs...

Objetivo. Conhecer a percepção do estado emocional das mulheres com gravidez em via de prolongamento. Metodologia. Levou-se a cabo uma investigação com metodologia qualitativa descritiva, fundamentada em entrevistas individuais em profundidade a 7 gestantes em via de prolongamento, com idades entre os 21 e 32 anos e uma duração da gravidez compreendida entre 40+5 e 41+4. Resultados. O estado emocional varia ao longo da gravidez, uma vez passada a data provável de parto, o bem-estar emocional se vê alterado pelo medo à dor do parto, às possíveis complicações e ao cuidado do recém nascido, apresentando um estado de nervosismo pelo parto iminente. As mulheres ademais descrever a necessidade da presença de um acompanhante durante o parto e depois do mesmo. Conclusão. O medo pode afetar negativamente à experiência subjetiva da gravidez na fase final do mesmo, ao processo de trabalho do parto e à transição para a maternidade nas gestantes com gravidez em via de prolongamento. Estas mulheres precisam o apoio e educação específica por parte da enfermeira matrona segundo suas necessidades individuais...