Barreras en la implementación de los resultados de investigación en la práctica / Barriers for the implementation of research outcomes in practice

Objetivo: identificar las barreras para la aplicación de la investigación en la práctica, por parte de académicos y estudiantes universitarios de Enfermería.Métodos: estudio descriptivo transversal. Se incluyeron n= 27 académicos (toda la plantilla eligible) y n= 229 estudiantes de Enfermería seleccionados aleatoriamente. Se administró una cédula de datos sociodemográficos y formativos, y la escala The Barriers, que integra características del profesional, características de la organización, calidad de la investigación, presentación y accesibilidad de la información, y la percepción de que la cantidad de investigación fue “aplastante”. Una mayor puntuación desde 1 a 4 refleja el mayor grado en que cada factor es percibido como una barrera.Resultados: participaron 17 académicos y 229 estudiantes. En el grupo de académicos las barreras mayormente identificadas fueron “La Enfermería no se siente con suficiente autoridad como para cambiar los cuidados al paciente” (media= 3,17; DE= 0,80) y “La Enfermería ve en la investigación pocos beneficios para su actividad profesional” (media= 3,11; DE = 0,85). Mientras que en el de estudiantes fueron “La cantidad de información de investigación es aplastante” (media= 2,36; DE= 1,23) y “Las instalaciones no resultan adecuadas para su implementación”. Los académicos identificaron significativamente más barreras que los estudiantes (p< 0,001) en todos los factores, excepto la calidad de la investigación (p= 0,676).Conclusiones: prevalecieron las barreras para el uso de investigación relacionadas con los factores de características de la organización y de los profesionales, lo cual es congruente con las reportadas por otros estudios realizados en profesionales y/o estudiantes de Enfermería. (AU)

Objective: to identify the barriers for the application of research in practice, by Nursing academics and university students.Methods: a descriptive cross-sectional study, including n=27 academics (all the eligible staff) and n= 229 Nursing students randomly selected. A questionnaire on sociodemographic and training data was administered, and the Barriers scale, which integrates characteristics of the professional, characteristics of the organization, quality of research, presentation and accessibility of information; and the perception that the amount of research is “overwhelming”. A higher score from 1 to 4 shows the higher degree in which each factor is perceived as a barrier.Results: the study included 17 academics and 229 students. In the group of academics, the most identified barriers were: “Nursing staff does not feel they have enough authority in order to change the care for a patient” (mean= 3.17; SD= 0.80) and “The Nursing staff sees limited benefits in research for their professional activity” (mean= 3.11; SD = 0.85). On the other hand, the most identified barriers in the student group were: “The amount of research information is overwhelming” (mean= 2.36; SD= 1.23) and “The premises are not adequate for its implementation”. Academics identified a significantly higher number of barriers than students (p< 0.001) for all factors, except for Quality of research (p= 0.676).Conclusions: there was a prevalence of barriers for the use of research associated with the characteristics of the organization and the professionals, which coincided with those reported by other studies conducted with Nursing professionals and/or students. (AU)

Percepción de educación sexual en adolescentes institucionalizados con carencia de cuidado parental / Perception of Sexual Education in Institutionalized Adolescents with Lack of Parental Care

Resumen Objetivo: Conocer las percepciones sobre la educación sexual en adolescentes institucionalizados con carencia de cuidado parental. Materiales y Métodos: Estudio exploratorio cualitativo en el cual se analizaron siete entrevistas, tres dirigidas a adolescentes con carencia de cuidado parental y cuatro a cuidadores principales. Para la interpretación de datos se realizó análisis de contenido, y se utilizó el software MAXQDA Analitics Pro 2020. Resultados: Resultaron ocho subcategorías, las cuales se agruparon en tres grandes categorías, el adolescente institucionalizado, percepción desde el cuidador principal y percepción de recursos disponibles. Los resultados muestran dos posibles características de los adolescentes en esta condición, la necesidad de ser institucionalizado, debido a la carencia de cuidado parental, así como la posible experimentación de eventos traumáticos con repercusiones sobre la salud. Por otra parte, desde la percepción del cuidador se observa la construcción del concepto de sexualidad del adolescente, la cual ocurre generalmente en el entorno escolar o a través de la exposición de elementos audiovisuales fuera de este. Por otra parte, se observa la falta de reconocimiento de los derechos sexuales y reproductivos de los adolescentes, asi como de los procesos de educación sexual por cuidadores principales. Finalmente se identifican algunos recursos disponibles que pueden ser la base para el desarrollo de estrategias que promuevan la educación sexual integral. Conclusión: El análisis permitió identificar que los adolescentes en esta condición carecen de un sistema idóneo que les permita construir un concepto de sexualidad más integral, recordando que esta no se limita a su expresión a través de la genitalidad. Las instituciones ponen especial atención a los aspectos relacionados con la protección social como la alimentación, vestido, educación y atención médica, sin embargo, no se evidencian estrategias o acciones específicas que fomenten la educación sexual, ya sea por tabúes, miedo o incapacidad de proveerla.

Abstract Objective: To identify the perceptions of sexual education in institutionalized adolescents with lack of parental care. Materials and methods: Study with exploratory qualitative approach. Seven interviews were analyzed, three addressed to adolescents with lack of parental care and four to their main caregivers. The MAXQDA Analytics Pro 2020 software was used to interpret the data through content analysis method. Results: The analysis resulted in eight subcategories that were grouped into three large categories: the institutionalized adolescent, perception from the main caregiver and perception of available resources. The results show two possible characteristics of adolescents in this condition, such as the need to be institutionalized due to lack of parental care, as well as the possibility of experiencing traumatic events that have repercussions on adolescent´ health. On the other hand, from the perception of the caregiver, it is observed how the concept of sexuality is constructed, which generally occurs in the school environment or through the exposure of audiovisual elements. On the other hand, there is a lack of recognition of the sexual and reproductive rights of adolescents, as well as the processes of sexual education by main caregivers. Finally, some available resources are identified that can be the basis for strategies development that promote comprehensive sexual education. Conclusion: The analysis of the interviews allow to identify that adolescents in this condition lack an adequate system that will allow them to build a more comprehensive concept of sexuality, remembering that it is not limited to its expression through genitality. Institutions pay special attention to aspects related to social protection such as food, clothing, education, and medical care, however, there are no specific strategies or actions that promote sex education, either due to taboos, fear, or inability to provide it.

Prevención primaria del VIH en población inmigrante: análisis de concepto / Prevenção primária do HIV na população imigrante: análise conceitual / Primary HIV prevention in the immigrant population: concept analysis

The strategies established for HIV prevention directed at immigrant populations are diverse and not very specific about the characteristics of these groups. Objective: To analyze the concept of "primary prevention of HIV in the immigrant population". Methodology: The steps suggested by Walker and Avant were followed, so a structured review of the literature in dictionariesand databases (Embase, Pubmed and Ebsco) was carried out. Results: There is no evidence of theexistence of a definition on the specific term, so a proposal is made that encompasses the strategiesidentified in the literature, specific in this population. Conclusions: primary prevention of HIV inmigrants is identified as a great opportunity to strengthen coverage of universal access to vulnerablepopulations, as well as being a complex process that requires a multidisciplinary approach in structural, biomedical and behavioral areas that are developed with the axis being adaptations to cultural needs. (AU)

Las estrategias establecidas para la prevención de VIH dirigidas a poblaciones inmigrantes, son diversas y poco específicas sobre las características de estos grupos. Objetivo: Analizar elconcepto de “prevención primaria del VIH en población inmigrante”. Metodología: Se siguieron lospasos sugeridos por Walker y Avant, por lo que Se realizó una revisión estructurada de la literaturaen diccionarios y bases de datos (Embase, Pubmed y Ebsco). Resultados: No se reporta evidencia dela existencia de una definición sobre el termino especifico, por lo que se realiza una propuesta queenglobe las estrategias identificadas en la literatura, especifica en esta población. Conclusiones: laprevención primaria del VIH en migrantes se identifica como una gran oportunidad para fortalecerla cobertura de acceso universal a poblaciones vulnerables, además de ser un proceso complejo querequiere de un abordaje multidisciplinario en esferas estructurales, biomédicas y conductuales quese desarrollen con el eje ser de adaptaciones a las necesidades culturales. (AU)

As estratégias estabelecidas para a prevenção do HIV direcionadas às populações imigrantes são diversas e pouco específicas sobre as características desses grupos. Objetivo: Analisar o conceito de "prevenção primária do HIV na população imigrante". Metodologia: Foram seguidas asetapas sugeridas por Walker e Avant, sendo realizada uma revisão estruturada da literatura emdicionários e bancos de dados (Embase, Pubmed e Ebsco. Resultados: Não há evidências da existência de uma definição sobre o termo específico, portanto é feita uma proposta que engloba as estratégias identificadas na literatura, específicas nessa população. Conclusões: A prevenção primária doHIV em migrantes é identificada como uma grande oportunidade para fortalecer a cobertura doacesso universal a populações vulneráveis, além de ser um processo complexo que requer uma abordagem multidisciplinar em áreas estruturais, biomédicas e comportamentais desenvolvidas com oeixo sendo adaptações às necessidades culturais. (AU)

Modelo de Conducta Sexual Segura en Adolescentes con Carencia de Cuidado Parental / Safe Sexual Behavior Model of Adolescents with Parental Care Absence

El presente artículo propone un modelo para explicar la conducta sexual segura en adolescentes con carencia de cuidado parental (CCP), a través del método de subestructuración teórica de Dulock y Holzmer. El modelo propuesto incluye las características demográficas del adolescente con CCP tales como: edad, sexo, eventos potencialmente traumáticos, tipo y tiempo de CCP. La resiliencia psicológica y variables estructurales, específicamente la relación con el cuidador principal y la calidad del cuidado recibido. Además, contiene variables previamente estudiadas como la información, motivación, autoeficacia e intención para la conducta sexual segura. La propuesta permite identificar las variables que intervienen en el comportamiento sexual seguro en adolescentes que se encuentran en esta condición, lo que permite profundizar en este fenómeno para el futuro desarrollo de intervenciones o políticas en materia de educación sexual y reproductiva en adolescentes vulnerables.(AU)

This article proposes a model to explain safe sexual behavior in adolescents with Lack of Parental Care (LPC), using the substruction strategy. The proposed model includes demographic characteristics of PCA adolescents, like age, sex, potentially traumatic events and time since LPC. Psychological resilience and structural variables specifically relationship whit the caregiver and quality of care. Furthermore, includes previously studied variables like information, motivation, self-efficacy and intention for safe sexual behavior. This model identifies variables that intervene in safe sexual behavior in adolescents LPC, which allows to develop knowledge about this phenomenon and to inform the development of interventions and policies regarding sexual health in vulnerable adolescents.(AU)

Percepciones sobre el uso del condón en migrantes haitianos en la frontera noroeste de México / Perceptions of condom use in Haitian migrants on the northwestern border of México

Resumen Objetivo: Identificar las percepciones sobre el uso de condón en migrantes haitianos en la frontera noroeste de México. Materiales y métodos: Estudio de enfoque cualitativo y diseño etnográfico, en el abordo a siete migrantes haitianos en la zona fronteriza de la ciudad de Mexicali, Baja California, México, con quienes se desarrolló una entrevista semiestructurada, la información fue analizada por el programa NVivo, para comprender frecuencia y estructura de los datos; posteriormente se realizó un proceso de categorización, interpretación y teorización del fenómeno de estudio. De un total de 281 unidades de análisis, se realizó un proceso de categorización, que permitió estructurar dos categorías, seis subcategorías y 12 códigos. Resultados: Se identifica que el uso del condón en migrantes haitianos, es interpretado como un elemento de protección a la salud sexual en la prevención de embarazos no planeados; no obstante, se identifican barreras y consecuencias del uso a nivel personal, cultural y religioso. La construcción de la idea de usarlo, recae en el tipo de relación y nivel de confianza que se tiene de la pareja sexual por lo que estar casado o vivir en concubinato, exime de la obligación o del compromiso social de usar el condón. Así mismo la idea de protección, no refleja la preocupación sobre la transmisión de las ITS. Conclusiones: El condón se percibe como un elemento de importancia para la prevención de embarazos no planeados y del VIH, sin embargo, la presencia de factores personales, sensoriales e ideológicos limitan el uso constante del condón; por lo que el desarrollo de intervenciones culturalmente adaptadas, a la población de migrantes haitianos, en el contexto de la frontera norte de México, pueden fortalecer el uso del condón y la prevención del VIH

Abstract Objective: To identify the perceptions of condom use in Haitian migrants in the northwestern border of Mexico. Materials and methods: Study with a qualitative approach and ethnographic design, on board seven Haitian migrants in the border area of the city of Mexicali, Baja California, Mexico, with whom a semi-structured interview was developed, the information was analyzed by the NVivo program, to understand the frequency and structure of the data; later a process of categorization, interpretation and theorization of the study phenomenon was carried out. Out of a total of 281 units of analysis, a categorization process was carried out, which made it possible to structure two categories, six subcategories and 12 codes. Results: It is identified that the use of condoms in Haitian migrants is interpreted as an element of protection of sexual health in the prevention of unplanned pregnancies; however, barriers and consequences of use are identified on a personal, cultural and religious level. The construction of the idea of using it relies on the type of relationship and level of trust that one has in the sexual partner, so being married or living in a common-law relationship exempts the obligation or social commitment of using the condom. Likewise, the idea of protection does not reflect the concern about the transmission of STIs. Conclusions: The condom is perceived as an important element for the prevention of unintended pregnancies and HIV, however, the presence of personal, sensory and ideological factors limit the constant use of the condom; Therefore, the development of culturally adapted interventions for the Haitian migrant population, in the context of the northern border of Mexico, can strengthen condom use and HIV prevention.

Discriminación social y conducta sexual de hombres que tienen sexo con hombres en América Latina: Una revisión sistemática / Social discrimination and sexual behavior of Latin American men who have sex with men: a systematic review / Discriminação social e comportamento sexual de homens latino-americanos que fazem sexo com homens: uma revisão sistemática

INTRODUCCIÓN: los hombres que tienen sexo con hombres (HSH) son víctimas de discriminación, lo cual los lleva a presentar conductas sexuales de riesgo. OBJETIVO: examinar la evidencia disponible sobre la asociación entre discriminación social y conducta sexual de riesgo en HSH de América Latina con y sin diagnóstico de VIH/sida. METODOLOGÍA: se realizó una revisión sistemática siguiendo los lineamientos PRISMA. Los criterios de inclusión fueron artículos de investigación en inglés y en español, sin restricción con respecto a los años de publicación; se construyeron cadenas de búsqueda. Las bases de datos utilizadas fueron: CONRYCIT, EBSCO, PUBMED, WEB OF SCIENCE, SCOPUS, CINAHL y ProQues. RESULTADOS: se incluyeron 12 estudios publicados entre los años 2000 a 2014. La evidencia científica sugiere que los participantes con y sin VIH/sida sufren algún tipo de discriminación que se relaciona con el coito anal sin protección

INTRODUCTION: men who have sex with other men (MSM) suffer discrimination, which leads to HIV/AIDS risky sexual behavior. OBJECTIVE: To examine the evidence available on the relationship between social discrimination and risky sexual behavior of adult Latin American MSM with and without a diagnosis of HIV/AIDS. METHODOLOGY: a systematic review was carried out following the PRISMA guidelines. The inclusion criteria were complete text research articles written in English and Spanish, with no restriction on the date of publication. Search chains were constructed. The articles were analyzed with what established in the HCPRDU assessment tool for quantitative studies. RESULTS: twelve studies published between 2000 and 2014 were included. The evidence suggests that the participants with and without a diagnosis of HIV/AIDS suffer some type of discrimination related to unprotected anal intercourse. CONCLUSIONS: the results evidence the lack of explanatory models that may improve the course of professional care practice

INTRODUÇÃO: homens que fazem sexo com homens (HSH) são vítimas de discriminação, o que leva a comportamentos sexuais de risco presentes. OBJETIVO: Examinar as evidências disponíveis sobre a associação entre discriminação social e comportamento sexual de risco entre HSH na América Latina com e sem diagnóstico de HIV / AIDS. METODOLOGIA: Uma revisão sistemática foi realizada seguindo o PRISMA diretrizes. Os critérios de inclusão foram artigos de pesquisa em Inglês e Espanhol, com nenhuma restrição sobre os anos de publicação; seqüências de pesquisa foram construídas. As bases de dados utilizadas foram: CONRYCIT, EBSCO, PubMed, Web of Science, Scopus, CINAHL e ProQues. RESULTADOS: 12 estudos publicados entre 2000 e 2014. A evidência científica sugere que os participantes com e sem o HIV / SIDA sofrem de alguma forma de discriminação relacionadas com o sexo anal foram incluídos. CONCLUSÃO: há uma falta de modelos explicativos para orientar a prática melhor atendimento profissional. Palavras-chave:discriminação socia

Facilitating and Inhibiting Factors of Sexual Behavior among Migrants in Transition from Mexico to the United States.

INTRODUCTION: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the most prevalent infectious diseases in the border region of Mexico due to the flow of migrants under desperate conditions, encouraging casual and unprotected sex. Since this has become a binational public health problem, it is important to understand the factors that predict these sexual behaviors. The aim of the current study was to investigate the facilitators and inhibitors of transition in the sexual behavior of migrants from two border regions on the Mexico-United States (US) border. METHODS: This was a predictive and cross-sectional study. A sample of 256 migrants in shelters for migrants on the border between Mexico and US were selected through systematic random sampling. Predictor variables investigated for effect on the safe sexual behavior (SSB) of the migrant were reasons for having sex; sexual attitudes; sexual machismo; knowledge about HIV; access to health services; and social discrimination. RESULTS: The sample was predominantly male (89.5%), with 46.1% reporting being single. The average age was 33.38 years (SD = 9.73) and the average number of years of education reported was 8.05 (SD = 3.37). A permissive sexual attitude and sexual machismo both correlated with condom use (rs = 0.130, p < 0.01 and rs = -0.174, p < 0.01, respectively). Regression analysis showed that a permissive sexual attitude decreased the practice of safe sex (ß = 0.17, t = 4.16, p < 0.001), as did sexual machismo (ß = -0.28, t = -4.83, p < 0.001) and HIV knowledge (ß = -0.11, t = -2.62, p = 0.006). DISCUSSION: It was found that access to health services did not influence the SSB of migrants, as suggested by the literature. However, a permissive sexual attitude, sexual machismo, and HIV knowledge were all variables capable of predicting SSB. It is recommended that the study is extended to study migrant populations from other parts of the border, as well undertaking as a qualitative approach to explore new variables.

Self-efficacy and Coping as Correlates of Migrant Safe Sexual Behavior to Prevent HIV.

Along the Mexico/United States border, migrants are at increased risk of HIV. The objective of our study was to investigate the relationship between two process indicators (self-efficacy to prevent HIV and coping with sexual risk) and safe sexual behaviors in migrants. A correlational design was used. Migrants were recruited from two cities on the northern border of Mexico. Transition theory informed the measurement of self-efficacy and coping process indicators. Three generalized linear models were built for each safe sexual behavior outcome: (a) partner communication, (b) use of condoms, and (c) safe sex. Of 311 migrants, indicators of self-efficacy and coping with sexual risk were associated with all three outcome measures of safe sexual behavior (p < .05). Process indicators explained 22.5% to 30.6% of the variance in the data. Therefore, self-efficacy to prevent HIV and coping ability are important correlates of migrant sexual risk behavior.