Violencia en el lugar de trabajo desde la percepción de profesionales de enfermería en un servicio de emergencia pediátrica / Violence in the workplace from the perception of nursing professionals in a pediatric emergency service

Introducción: Los profesionales de la salud tienen un mayor riesgo de sufrir lesiones físicas, sexuales o psicológicas debido a la violencia en el lugar de trabajo ocupando su rol al brindar cuidados de salud hacia el paciente pediátrico en casos de Emergencia. Los incidentes en los que el profesional es abusado, amenazado o agredido en las circunstancias relacionadas con su trabajo implican un desafío explícito o implícito a su seguridad, bienestar o salud. Objetivo: Explorar la percepción de profesionales de enfermería sobre la violencia laboral en el desempeño y ejecución de actividades orientadas al cuidado de salud de Enfermería en la Emergencia Pediátrica. Método: Investigación cualitativa de diseño fenomenológico, el estudio se realizó en profesionales de Enfermería del servicio de Emergencia Pediátrica con una muestra de 32 participantes, distribuidas en 4 grupos focales. Se diseñó una guía de preguntas semiestructuradas sobre los aspectos percibidos en el ámbito del trabajo del profesional que fueron recopiladas mediante archivos de voz y notas de campo, los resultados fueron analizados identificando las fuentes de la violencia en el lugar de trabajo. Resultados: Con la recopilación de datos de los participantes, la investigadora principal analizará la forma en que se presenta la violencia laboral desde la percepción de profesionales de Enfermería determinando los riesgos presentes para brindar recomendaciones y diseñar un plan de acción que ayuda a prevenir la violencia. (AU)

Introduction: Healthcare professional face a higher risk of experiencing physical, sexual, or psychological injuries due to violence in the workplace fulfilling their role in providing health care to a pediatric patient in emergency cases. Incidents where professionals are abused, threatened, or assaulted in circumstances related to their work pose an explicit or implicit challenge to their safety, well-being, or health.Objective: To explore the perception of nursing professionals regarding workplace violence in the performance and execution of healthcare activities in Pediatric Emergency Nursing. Method: Qualitative research with a phenomenological design. The study was conducted among nursing professionals in the Pediatric Emergency Service, with a sample size of 32 participants divided into 4 focus groups. A semi-structured questions were designed to gather perceptions about various aspects of their work, that were collected through voice recordings and field notes. The results were analyzed to identify the sources of violence in the workplace. Results: Through the data collected from the participants, the lead researcher analyzed the manifestation of workplace violence as perceived by nursing professionals. This analysis determined the existing risks and provided recommendations for designing an action plan to prevent violence. (AU)

Risk Factors for the Mental Health of Adolescents from the Parental Perspective: Photo-Voice in Rural Communities of Ecuador.

Mental health in adolescence is a very important topic worldwide, especially in rural areas. The implementation of Participatory Action Research (PAR) through the photo-voice method was a way to encourage adults to recognize problematic situations (at personal, family or community levels) that threaten the well-being of adolescents, but that in everyday life may go unnoticed by parents and caregivers. Our study aimed to identify risk factors for mental health in adolescents living in rural communities of Ecuador from the parental perspective through photographs and focus group discussions. The study sought to raise awareness of this issue at the family and community levels. The photo-voice method was conducted with the participation of 29 parents. The photographs and the collaborative construction of meanings allowed parents to have a better understanding about the importance of mental health and its benefit for adolescents. The principal risk factors mentioned by parents were stress, sleep deprivation, tiredness, poverty, difficulties in continuing education and alcohol consumption. In conclusion, we point out the importance of this intervention to explore the knowledge and understanding of the topic by parents as well as to communicate information that demystifies false beliefs around mental health.

Strategies to Prevent and Cope with Adolescent Dating Violence: A Qualitative Study.

BACKGROUND: Dating violence has attracted scholarly interest from many fields because of its implications for adolescents' health. This study aimed to learn which strategies adolescents use to address and prevent dating violence. METHODS: Eight focus group discussions were analyzed, which included a total of 78 adolescents between 13 and 17 years old who had the signed consent of their parents or guardians. RESULTS: The findings showed that the majority of adolescents lacked effective mechanisms to manage violence in their dating relationships, which were characterized by immaturity, a lack of trust in their families, and unrecognized relationship violence. CONCLUSIONS: Assessing roles and relationships, as well as coping mechanisms, is a valid way to approach adolescents and explore how they perceive interaction during dating and which strategies are used most frequently to prevent violence.

La Investigación en la enfermería en Venezuela / The Venezuelan nursing research

El objetivo del presente escrito es aportar una visión actualizada sobre la investigación en enfermería venezolana. Los análisis se sustentaron en la revisión exhaustiva de la literatura científica, bases de datos, repositorios nacionales y la revisión de fuentes documentales (históricas o legales) de acceso público. Como hechos relevantes podemos mencionar la observación de un progreso en la investigación a partir del año 2000 vinculado a las características de la educación universitaria, existencia de políticas estatales para impulsar la investigación en el país, creación de programas para estimular la investigación científica y el rol activo de las universidades en la producción del conocimiento. Los progresos en producción científica alcanzados hasta 2011 se vieron afectados por problemas sociales, económicos y políticos que impactaron negativamente la producción científica en el país.(AU)

The aim of this study is to provide an updated vision on Venezuelan nursing research. The analyzes were based on the exhaustive review of the scientific literature, databases, national repositories and documentary sources (historical or legal) with public access. As relevant finding we observe a progress in research from the year 2000 linked to the characteristics of university education, existence of state policies to promote research in the country, creation of programs to stimulate scientific research and the active role of universities in the production of knowledge. The advances in scientific production achieved up to 2011 were affected by social, economic and political problems. These aspects impacted negatively the scientific production in the country.(AU)

Adolescent Dating Violence: Results of a Mixed Study in Quito, Ecuador.

Dating violence is a public health problem affecting people worldwide. This study evaluated the occurrence of different types of adolescent dating violence using a mixed analysis of each data source. The present study addresses the following research questions: does the occurrence of the types of violence analyzed in the quantitative phase match with the narratives obtained in the qualitative phase? and does the additional information obtained in the qualitative phase improve the understanding of the analyzed phenomenon?In the quantitative phase, 410 participants (aged 13 to 19 years) answered a questionnaire based on the Modified Conflict Tactics Scale, while in the qualitative phase, 26 participated in two focus groups. Data were collected from May to June 2019. Written informed consent was obtained from the parents or legal guardians of those who had agreed to participate. The present research was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Ecuador. The results were divided on: prevalence of dating violence based on age groups and gender, management and resolution of dating conflicts, victimization and perpetration of intimate partner violence, factors favoring intimate partner violence and acceptance of abuse. The results were analyzed via triangulation and indicated that adolescents were involved in the perpetration and victimization of psychological as well as mild and severe physical violence. An analysis of the contributing factors revealed a strong tendency toward the acceptance of the traditional gender model. Challenging these models is crucial to deconstruct hierarchical models, develop conflict resolution skills, and promptly identify abusive behaviors that affect emotional development. The combination of different methodological approaches improved the understanding of the phenomenon studied.

Workplace violence in the health sector: validez y adaptación del instrumento al idioma español, en el contexto ecuatoriano para tipos de violencia / Workplace violence in the health sector: adaptation and validation of the questionnaire for types of violence in the ecuadorian context

Uno de los objetivos de la encuesta "Workplace Violence in the Health Sector" es investigar los factores que pueden contribuir a la violencia en el lugar de trabajo en el sector de salud en varios países del mundo para la toma de políticas públicas apropiadas. A pesar de que el inglés sea un idioma universal, en la práctica genera limitaciones para aplicarlo sobre todo en los países de América Latina. Esta investigación tiene como propósito validar el contenido, y constructo para que la encuesta se pueda aplicar en los países cuya lengua oficial es el español. Se emplearon las técnicas cualitativas y cuantitativas para validar el instrumento, con la revisión de expertos se validó la semántica e idioma. A través del el Alpha de Cronbach de 0,96 se puede aseverar la confiabilidad de este para medir la violencia de trabajo en el sector de la salud de los países de habla hispana.

The purpose of the survey "Violence in the workplace in the health sector" is to obtain information on the factors that could contribute to the workplace violence in the health sector within different countries of the world. Collecting data on the problem is therefore important of the appropriate public policy making. Despite of English is considered widely the universal language, in practice it generates limitations to apply especially in Latin American countries. This research aims to validate the content, and construction for the survey to the application in countries where Spanish is an official language. Qualitative and quantitative techniques were used to validate the questionnaire; experts review validated the semantics and language construction. The global inventory (Cronbach's alpha = 0.96) indicated good reliability to measure the workplace violence in the health sector for Spanish-speaking countries.

Percepciones subjetivas del personal de enfermería sobre la Violencia en el lugar de trabajo, resultados preliminares / Workplace Violence among nursing staff subjective perceptions, preliminary results

ABSTRACT Introduction: Several studies have established the prevalence of workplace violence in the health sector being the nursing staff more likely to experience physical and non-physical violence than other health workers. Objective: Thus, we aimed to research the perceptions of workplace violence in nursing staff in association to type of violence, perpetrators, consequences and protecting measures available in the health institutions. Methods: The study was conducted with a phenomenological method in a major hospital in Quito, Ecuador. N=13/210 professional nurses were selected from a convenience sample and, before starting the discussion, were given information consent forms to sign. The considered selection criteria were being professional, over age 18, and being employers at the hospital as minimum 2 years. The technique selected in data collection was Focus Group Discussion. Results: showed that nursing staff had clarity about what constitutes violence in the workplace such as understanding about the magnitude of the problem, nurses affected by verbal abuse and threats mostly tried to ignore the situation because they considered this to be a typical incident in the workplace, they did not report the situation and it has caused underregistration. The aggressors were mostly staff members, supervisors and relatives of patients. Conclusion: The evidence allowed us to admit that the situation is a significance problem in magnitude and severity. Our recommendations will be oriented toward the implementation of a preventative and minimizing aggression program in the Hospital(AU)

RESUMEN Introducción: Varios estudios han establecido la prevalencia de la violencia en el lugar de trabajo en el sector salud, y es el personal de enfermería quien tiene más probabilidades de sufrirla. Objetivo: Investigar las percepciones de la violencia en el lugar de trabajo en profesionales de la enfermería en asociación con el tipo de violencia, perpetradores, consecuencias y medidas de protección disponibles en las instituciones de salud. Métodos: Estudio fenomenológico en un hospital de especialidades de Quito, Ecuador. N = 13/210 enfermeras profesionales se seleccionaron en una muestra de conveniencia. Antes de comenzar la discusión, se les proporcionaron los formularios de consentimiento informado. Los criterios de selección fueron: ser profesionales, mayores de 18 años y empleadas en el hospital con tiempo mínimo de 2 años. La técnica seleccionada en la recopilación de datos fue Grupo Focal de Discusión. Resultados: El personal de enfermería tenía claridad sobre lo que constituye violencia en el lugar de trabajo, como la comprensión de la magnitud del problema, las enfermeras afectadas por el abuso verbal y las amenazas intentaban ignorar la situación porque consideraban que se trataba de un incidente típico en el lugar de trabajo. No informaron la situación y causó un subregistro. Los agresores eran en su mayoría miembros del personal, supervisores y familiares de pacientes. Conclusión: La evidencia permitió admitir que la situación es un problema de importancia en magnitud y gravedad. Las recomendaciones estarán orientadas a la implementación de un programa preventivo en el hospital(AU)

Jivi indigenous peoples: family functioning and health care, an analysis from Community Health Nursing practices / Indígenas Jivi: función familiar y cuidado de la salud, un análisis en la práctica de Enfermería en Salud Comunitaria

ABSTRACT Objective To explore the meaning of beliefs and practices related to family functioning and health care in a Venezuelan indigenous group. Materials and Methods A qualitative research study was conducted using a focused-ethnography (FE) method. The techniques implemented during data collection were focus group and observer-as-participant. Twenty-seven people distributed into four groups were included in the study. The qualitative content analysis method was selected for the interpretation stage. Results The most significant findings revealed that Jivi people's customs were mixed with modern practices. Cultural practices such as maternity and childbirth are processes in which the formal healthcare system has a secondary role. Moreover, participants showed flexibility in terms of responsibilities without association to sex. Conclusion Training of human resources with an intercultural approach is a measure that could strengthen the practices of ethnic groups in terms of healthcare.

RESUMEN Objetivo Explorar el significado de las creencias y prácticas relacionadas con la función familiar y el cuidado de salud en un grupo indígena venezolano. Métodos Se realizó una investigación cualitativa razonada con el método de Etnografía Enfocada (EE), las técnicas implementadas fue el grupo focal y la observación participante. Participaron N=27 personas distribuidas en cuatro grupos. El método seleccionado para la fase de interpretación fue el Análisis Cualitativo de Contenido. Resultados Los hallazgos mostraron que las creencias del pueblo Jivi se mezclaron con las prácticas modernas; las prácticas culturales como la maternidad y el parto se asumieron como un proceso en el cual el Sistema de Salud formal tiene una relación secundaria. Además, los participantes mostraron flexibilidad de responsabilidades sin referencia al género. Conclusión Una medida para fortalecer las prácticas de los grupos étnicos en términos de atención de salud es la capacitación de recursos humanos en el enfoque intercultural.

Jivi indigenous peoples: family functioning and health care, an analysis from Community Health Nursing practices.

OBJECTIVE: To explore the meaning of beliefs and practices related to family functioning and health care in a Venezuelan indigenous group. MATERIALS AND METHODS: A qualitative research study was conducted using a focused-ethnography (FE) method. The techniques implemented during data collection were focus group and observer-as-participant. Twenty-seven people distributed into four groups were included in the study. The qualitative content analysis method was selected for the interpretation stage. RESULTS: The most significant findings revealed that Jivi people's customs were mixed with modern practices. Cultural practices such as maternity and childbirth are processes in which the formal healthcare system has a secondary role. Moreover, participants showed flexibility in terms of responsibilities without association to sex. CONCLUSION: Training of human resources with an intercultural approach is a measure that could strengthen the practices of ethnic groups in terms of healthcare.

Experiencias de enfermeras en prevención de la violencia de género y asistencia a mujeres afectadas / Experiences of nursing in prevention of gender violence and assistance of women affected

Introducción: la violencia de género es un problema de salud pública que afecta a la población femenina. Por esta razón, se hace necesaria la participación activa de todos los miembros del equipo de salud en los procesos de prevención, detección, referencia, manejo y seguimiento de los casos. Objetivo: explorar las experiencias del personal de enfermería que labora en centros de atención primaria con relación al rol de la profesión en la prevención y asistencia de la violencia de género. Métodos: investigación cualitativa realizada en Valencia, Venezuela. Las participantes n=7 enfermeras pertenecientes a dos centros de atención primaria de la Universidad de Carabobo. Se utilizó la entrevista semi-estructurada para la recolección de la información y el método de Mayring para el análisis cualitativo de los datos. Resultados: en la mayoría del personal entrevistado se observó desconocimiento para asumir la prevención y asistencia del problema. Sin embargo, se evidenció en n=1/7 de las entrevistas realizadas una relación positiva entre la existencia de líneas de acción para el abordaje de la violencia de género en población infantil y adolescente, formación educativa en el área y el adecuado abordaje. Conclusiones: es necesaria la implementación de un programa de entrenamiento dirigido al personal de enfermería, impulsar el diseño de líneas de acción en ambos centros y fortalecer las iniciativas existentes para ofrecer una adecuada asistencia a niñas, adolescentes y mujeres en situación de violencia(AU)

Introduction: gender violence is a public health problem that affecting women's health. Therefore, an active participation from health team during the process of primary prevention, cases assessment, reference, handle, and follow-up is required. Objective: to explore experiences in nursing staff at the primary health centers in relation to the role play of this profession in the prevention and assistance of gender violence. Methods: it was a qualitative research carried out in Valencia, Venezuela. The participants were n=7 nurses of two primary health centers at the University of Carabobo. To the data collection semi-structure interview was conducted and Mayring's methods in the step of qualitative data analysis. Results: it was evident a positive relation between existence of guidelines to the approach of gender violence in children and adolescent population; educative formation of the nursing staff in the topic and an appropriate assistance of the victims in one of the health centers under study. However, it was observable with the others group of nurses interviewed lack of knowledge to assume the prevention and assistance of the problem. Conclusions: is necessary the implementation of training program for the nursing staff; promote the design of guidelines in both university health centers and strengthen the existing initiatives to provide an appropriate assistance to the children, teenagers and adult women in a violence situation(AU)

A complexity-based approach to batterer intervention programmes.

This paper was aimed at providing opinion by adopting a complexity-based approach to coordinating nursing science and psychology concerning psycho-educational intervention for batterers regarding their partner or ex-partner. Improving both disciplines' interrelationship should facilitate implementing relevant action, thereby engendering motivation for change in participants and modifying sexist attitudes and beliefs. The document has analyzed the importance of coordinating scientific disciplines' action and defined guidelines for an approach involving intervention as well as highlighting implications for practice and research.

La mujer en la organización comunitaria y su articulación con instituciones del sector público y privado / Women in the community organization and their articulation with institutions of the public and private sector

Resumen El objetivo del presente estudio fue describir las vivencias de un grupo de mujeres pertenecientes a organizaciones comunitarias durante los procesos de negociación, diálogo y participación con instituciones del sector público y privado que prestan servicio a la ciudadanía. Corresponde a una investigación cualitativa razonada con el método fenomenológico; se seleccionaron intencionalmente cuatro participantes residentes en una comunidad urbana del municipio de Valencia, Estado Carabobo, Venezuela. La información se obtuvo a través de entrevistas semi-estructuradas. Para la sistematización de la información, se utilizó el programa computacional Atlas ti Versión Demo, el cual facilitó la formación de unidades de sentido y la estructuración de la experiencia. Los resultados señalaron que un factor de protección para las mujeres estudiadas fue el apoyo que proporciona el grupo familiar, ya que facilitó la presencia de este grupo en el escenario de la vida pública. La consolidación de las organizaciones comunitarias les ha permitido acceder a las estructuras de poder para obtener recursos o servicios en bien del colectivo. En cuanto a los procesos de articulación con las instituciones, la protesta y la presión predominaron en los discursos como la forma para convenir los recursos, los bienes y los servicios cuando sus solicitudes no fueron tomadas en cuenta.

The objective of this study was to describe the experiences of a group of women from communal organizations during the processes of negotiation, dialogue and participation with institutions of the private and public sector which lend a service to the citizenship. It belongs to a qualitative investigation reasoned with the phenomenological method; four participants were selected, from an urban community in the municipality of Valencia, Carabobo State, Venezuela. The information was obtained through semi-structured interviews. For the systematization of the information, the computer program Atlas ti Demo Version was used, which made possible the formation of units of sense and the structure for the experience. The results showed that a protection factor for studied women was the support from their family group, which facilitated the presence of this group in the public life. The consolidation of community organizations has allowed them to get access to the structures of power to obtain resources or goods for the collective sake. As for the articulation processes with the institutions, protest and pressure were dominant in the discourses as the way to agree about the resources, the goods and services when their requests were not taken seriously.

O objetivo do presente estudo foi descrever as vivências de um grupo de mulheres pertencentes a organizaçõescomunitárias durante os processos de negociação, diálogo e participaçãocom instituições do setor público e privado que prestam serviçoà cidadania. Corresponde a uma pesquisa qualitativa razoada com o método fenomenológico; selecionaram-se intencionalmente, quatro participantes residentes em uma comunidade urbana do município de Valencia, Estado de Carabobo, na Venezuela. A informação se obteve através de entrevistas semiestruturadas. Para a sistematização da informação se utilizou o programa computacional Atlas ti Versão Demo, o que facilitou a formação de unidades de sentido e a estruturação da experiência. Os resultados assinalaram que um fator de proteção para as mulheres estudadas, foi o apoio que proporciona o grupo familiar, já que facilitou a presençadeste grupo no cenário da vida pública. A consolidação das organizaçõescomunitárias, permitiu-lhes aceder àsestruturas de poder para obter recursos ou serviços para o bem-estar coletivo. No que se refere aos processos de articulaçãocom as instituições, o protesto e a pressão, predominaram nos discursos como a forma para conseguir os recursos, bens e serviçosquando as suas solicitaçõesnãoforam tomadas em consideração.

Un análisis sobre programas de intervención con hombres que ejercen violencia de género / An analysis about the working of batterer intervention programs

Este ensayo tiene como finalidad ofrecer una visión analítica sobre el funcionamiento de los programas de intervención con hombres que ejercen violencia de género los cuales han sido creados para prestar intervención psicoeducativa a hombres que ejercen violencia hacia su pareja o expareja. En el escrito se estiman dos partes. La primera, explica el funcionamiento de los programas de intervención en agresores tomando como base la experiencia de tres países (España, Costa Rica y Chile) de igual manera se presenta la limitación y la potencialidad observada en los diferentes programas. En la segunda parte del ensayo, se reflexiona sobre las implicaciones para la práctica multidisciplinar (AU)

The aim of this paper was to offer an analytical view about the working of the batterer intervention programs which have been opened for the psycho-educational intervention of men that used the violence toward their partner or ex-partner. This essay was organized in two broad thematic areas. First, it was explained the working into the batterer intervention programs, as reference the experience of three countries (Spain, Costa Rica and Chile) were used. Also, in this section was presented the limitation and potentiality observed in these programs. The second part of this paper was a reflection about the implications to the multidisciplinary practice (AU)

Grupo Focal de discusión como herramienta para el estudio de las relaciones de género en miembros de una comunidad urbana / Focus Group discussion as tool to study gender relations in urban community members

Objetivo: Esta investigación cualitativa con perspectiva de género tiene como meta mostrar la utilidad del Grupo Focal de discusión en el estudio de los factores que influyen en las relaciones de género partiendo de las concepciones de los miembros de una comunidad urbana. La metodología incluyó la realización de un grupo focal con un total de n=5 mujeres y n=5 hombres, todos pertenecientes a la comunidad seleccionada para el estudio. Para la sistematización de los datos se manejó Atlas ti 6.2 (versión Demo) y en la etapa de razonamiento de los testimonios fue usado análisis del discurso. Los resultados mostraron: Las relaciones de género basadas en el modelo de género tradicional representan un riesgo para la salud física y mental del grupo estudiado. Las demostraciones de hombría, individualidad y promiscuidad en el género masculino ponen su salud en riesgo. En el género femenino la sumisión puede desencadenar baja autoestima, sentimientos de culpa y sufrimiento mental. Conclusiones: Este estudio describe cómo grupo focal de discusión representó una herramienta efectiva durante el ejercicio de la enfermería comunitaria, ya que este tipo de técnica promueve el dialogo y el intercambio con miembros de la comunidad(AU)

Aim: This qualitative research with gender perspective aims to illustrate the usefulness of Focus Group Discussion in the study of factors influencing gender relations, based on the conceptions of urban community members. The methodology included focus groups with n=5 women and n=5 men members of the community selected. For the systematization of the data handled Atlas ti 6.2 (Demo) and the stage of reasoning of the testimony was used discourse analysis. The results showed: Gender relations based on the traditional gender represent a risk to physical and mental health of the group being studied. Demonstration of manhood, individuality and promiscuity in the male gender, put them in such risk. In female gender submissiveness may trigger low self-esteem, blaming and mental suffering. Conclusions: This study describes how Focal Group Discussion represented an effective tool during the exercise of community nursing because this kind of technique promoted dialogue and exchange with community members(AU)

A complexity-based approach to batterer intervention programmes / Programas de intervención con agresores por violencia doméstica desde la perspectiva de la complejidad

This paper was aimed at providing opinion by adopting a complexity-based approach to coordinating nursing science and psychology concerning psycho-educational intervention for batterers regarding their partner or ex-partner. Improving both disciplines' interrelationship should facilitate implementing relevant action, thereby engendering motivation for change in participants and modifying sexist attitudes and beliefs. The document has analyzed the importance of coordinating scientific disciplines' action and defined guidelines for an approach involving intervention as well as highlighting implications for practice and research.

Con este ensayo pretendemos brindar nuestras reflexiones sobre las coordinaciones que podrían generarse en la enfermería y la psicología durante la intervención psicoeducativa a hombres que ejercen violencia hacia su pareja o ex pareja, desde la perspectiva de la complejidad. La tesis que aquí defendemos es que al optimizar la interrelación entre ambas disciplinas, se facilita la puesta en práctica de acciones que impactan positivamente la motivación al cambio en estos hombres, y en consecuencia, la modificación de actitudes y creencias sexistas. En el escrito se estiman dos fases: la primera plantea un análisis sobre la importancia de la articulación de acciones entre disciplinas científicas; la segunda fase delimita las pautas de actuación de cada disciplina en los procesos de intervención así como las implicaciones para la práctica profesional y la investigación.