Measuring the perception of quality physical education in Latin American professionals / Medindo a percepção de profissionais latino-americanos sobre a qualidade da educação física / Midiendo la percepción de profesionales latinoamericanos acerca de la Calidad de la Educación Física

Abstract An unsteady plan for curriculum development and supportive issues in physical education (PE) has created confusion among professionals. The purpose of this research is to investigate the factors perceived as important in the development of quality physical education (QPE) by professionals in Latin American (LA) countries. A questionnaire consisting of 24 items based on QPE was responded by 468 professionals collected from 6 LA cities. An exploratory factor analysis (EFA) of the 24 items using ML extraction and direct oblimin rotation were applied, and the retained 17 items were clustered in a three factor solution referred to as, Development and Supportive Elements for QPE in School (DSFQPE) (α = .935), Core Value of QPEtabl (CVPE) (α = .890), and Curriculum Arrangement of Physical Activities (CAPA) (α = .850). The retained items indicated excellent properties and the basic framework as perceived by professionals from PE in LA countries as important in the investigation of QPE.

Resumo Um plano instável para o desenvolvimento de currículos e questões de apoio na educação física (PE) criou confusão entre os profissionais. O objetivo desta pesquisa é investigar os fatores percebidos como importantes no desenvolvimento da educação física de qualidade (QPE) por profissionais de países da América Latina (AL). Um questionário composto por 24 itens com base no QPE foi respondido por 468 profissionais coletados em 6 cidades da América Latina. Uma análise fatorial exploratória dos 24 itens usando extração ML e rotação obliminar direta foram aplicados, e os 17 itens retidos foram agrupados em uma solução de três fatores denominada Elementos de Desenvolvimento e Suporte para QPE na Escola (DSFQPE) (α = 0,935), Valor essencial do QPE (CVPE) (α = 0,890) e Arranjo Curricular das Atividades Físicas (CAPA) (α = 0,850). Os itens retidos indicaram propriedades excelentes e o referencial básico percebido pelos profissionais de EF em países da América Latina como importante na investigação do PEQ.

Resumen Un plan inestable para el desarrollo curricular y aspectos de apoyo para la educación física (EF) han creado confusión entre los profesionales. El propósito de esta investigación es investigar los factores percibidos como importantes en el desarrollo de la educación física de calidad (EFC) por profesionales en países de América Latina (AL). Un cuestionario que consta de 24 ítems basados en EFC fue respondido por 468 profesionales recolectados en 6 ciudades de LA. Se aplicó un Análisis factorial exploratorio de los 24 ítems que utilizan extracción ML y rotación oblicua directa, y los 17 ítems retenidos se agruparon en una solución de tres factores denominada Elementos de desarrollo y de apoyo para EFC en la escuela (EDAEFC) (α = 0,935); Valor principal de EFC (CVPE) (α = 0,890) y Arreglo del plan de actividades físicas (CAPA) (α = 0,850). Los ítems retenidos indicaron excelentes propiedades y el marco básico es percibido por los profesionales de EF en los países de AL como importante en la investigación de EFC.

La narrativa como estrategia didáctica para una aproximación al proceso de la muerte / Narrative strategy for an approach to the process of death

Objetivos: Explorar, a partir de una experiencia didáctica basada en la práctica reflexiva, la narrativa sobre una experiencia personal vivida en torno a la muerte, de estudiantes de 2º curso de Grado en enfermería. Comprender el proceso en torno a la muerte y su transcendencia en la práctica de los cuidados enfermeros. Métodos: Estudio cualitativo con un enfoque fenomenológico hermenéutico. Los participantes de este estudio fueron estudiantes de "Comunicación terapéutica" de 2º curso de Grado en enfermería, reclutados en el aula, en la 2ª sesión de la asignatura. Su participación fue voluntaria ya que el estudiante pudo elegir entre 4 temas distintos. Los datos fueron colectados a través de escritura reflexiva. Se analizaron los textos mediante análisis de contenido cualitativo semántico. Resultados: Se identificaron unidades de significado que revelaron la estructura del fenómeno de estudio. Posteriormente, se agruparon en 8 categorías de las que emergieron 6 temas: Impacto de la noticia; Despedida; Evocación; Afrontamiento; Creencias y valores; Crecimiento personal. Conclusiones: Tomar consciencia de la propia vivencia en torno a la muerte permite precisar aspectos significativos que pueden enriquecer los cuidados profesionales. Reconocer las conductas observadas durante el proceso de duelo contribuye al acompañamiento sensible de las personas en procesos en torno a la muerte. El relato pedagógico, como estrategia didáctica, es útil en la formación enfermera ya que posibilita la comprensión de significados y del impacto ante situaciones complejas. La reflexión sobre las experiencias vividas y el contraste con la literatura permite guiar el proceso del cuidado comprensivo (AU)

Objectives: Based on teaching experience of reflective practice, we aim to explore the description about personal experiences around death in second degree nursing students. We intend to understand the environment process of death, and its importance in nursing care. Methods: Qualitative study with a hermeneutic phenomenological approach. Participants in this study were students of "Therapeutic communication" recruited in the classroom, during the 2nd lesson of the subject. Participation was voluntary and each student could choose between 4 different topics. Data was collected using reflective writing. The texts were analyzed using qualitative content analysis with semantic approach. Results: Several units of meaning were identified and subsequently grouped in 8 categories where 6 different topics emerged: Impact of the notice; Farewell; Evocation; Coping; Beliefs and values; Personal growth. Conclusions: Raising awareness of own experiences in the process of death can help to define relevant aspects that may improve professional care. The recognition of the behaviors observed during the grieving process contributes to optimize the sensitive accompaniment of people in processes around death. The pedagogical chronicle, as a teaching strategy, is useful in nursing education given that allows the comprehension of the significance and impact of complex situations. Reflection on the lived experiences and contrasting them with the literature allows guiding the process of comprehensive (AU)

Verbalized desire for death or euthanasia in advanced cancer patients receiving palliative care.

OBJECTIVE: We aimed to address the prevalence of desire-to-die statements (DDSs) among terminally ill cancer patients in an acute palliative care unit. We also intended to compare the underlying differences between those patients who make desire-to-die comments (DDCs) and those who make desire-for-euthanasia comments (EUCs). METHOD: We conducted a one-year cross-sectional prospective study in all patients receiving palliative care who had made a DDC or EUC. At inclusion, we evaluated symptom intensity, anxiety and depression, and conducted a semistructured interview regarding the reasons for these comments. RESULTS: Of the 701 patients attended to during the study period, 69 (9.8%; IC 95% 7.7-12.3) made a DDS: 51 (7.3%) a DDC, and 18 (2.5%) an EUC. Using Edmonton Symptom Assessment Scale (ESAS) DDC group showed higher percentage of moderate-severe symptoms (ESAS > 4) for well-being (91 vs. 25%; p = 0.001), depression (67 vs. 25%; p = 0.055), and anxiety (52 vs. 13%; p = 0.060) than EUC group. EUC patients also considered themselves less spiritual (44 vs. 84%; p = 0.034). The single most common reason for a DDS was pain or physical suffering, though most of the reasons given were nonphysical. SIGNIFICANCE OF RESULTS: Almost 10% of the population receiving specific oncological palliative care made a DDC (7.3%) or EUC (2.5%). The worst well-being score was lower in the EUC group. The reasons for both a DDC and EUC were mainly nonphysical. We find that emotional and spiritual issues should be identified and effectively addressed when responding to a DDS in terminally ill cancer patients.

Comunicación y Bienestar en paciente y cuidador en una unidad de cuidados paliativos / Communication and well-being in patients and caregivers in a palliative care unit

Objetivo: Explorar si en pacientes y cuidadores existe una relación entre la comunicación y el bienestar, durante el ingreso en una Unidad de Cuidados Paliativos. Método: Se evaluó a 32 pacientes ingresados en la Unidad de Cuidados Paliativos del Hospital de la Santa Creu i San Pau de Barcelona, mediante una entrevista en la que se registraba si el paciente se comunicaba con el cuidador, si le transmitía su preocupación principal y si estaba satisfecho con la comunicación que mantenía. Se evaluó, asimismo, a 25 cuidadores de esos pcientes utilizando mismo formato de entrevista. Para evaluar el bienestar en el paciente, se usaron los ítems de depresión, ansiedad y bienestar de la escala ESAS. Para evaluar el bienestar del cuidador, se utilizó el HAD. Resultados: Se observó que los pacientes que decían no estar satisfechos con la comunicación mostraban mayor puntuación en el ítem de depresión que los que sí estaban satisfechos, pero esta diferencia no alcanzó la significación estadística. Por otra parte, se observó que el nivel de depresión que los que sí estaban satisfechos, pero esta diferencia no alcanzó la significación estadística. Por otra parte, se observó que el nivel de depresión era mayor en pacientes y cuidadores en aquellos casos en los que el paciente era consciente de la evolución de su enfermedad. Conclusiones: Los datos no apoyan la idea de que la comunicación guarda relación con el bienestar. No obstante, el reducido tamaño de la muestra evaluada y el que algunos indicadores utilizados para evaluar el bienestar puedan no ser adecuados para la situación podrían haber dificultado que se observase dicha relación. Por otro lado, los datos encontrados ponen de manifiesto la importancia de estudiar la relación entre bienestar y comunicación cuando el paciente es conocedor de su situación (AU)

Objetive: The aim of the study is to know the relationship between communication and well-being, both in patient and caregiver, when patient is assisted in Palliative Care Unit. Method: Thirty-two patients were assessed at the Palliative Care Unit. Method: Thirty-two patients were assessed at the Palliative care Unit in hospital de la Santa Creu I Sant Pau at Barcelona, using a structured interview. The following features were registered;: whether the patient maintained a communication with his/her caregiver; whether the patient told to the caregiver his/her main concern, and whether the patient was satisfied with this communication. Using the same structured interview, 25 caregivers of the patients (one by patient) were also assessed. Well being in patients was assessed by the anxiety, depression and well-being items form the ESAS scale. Well-being in caregivers was assessed by the HAD. Results: Patients who were not satisfied with communication had higher scores in depression than patients who were satisfied, although this difference did not reach statistical significance. On the other hand, depression levels were higher in patients and caregivers in those cases were patient was aware of his/her state. Conclusion: although the expected relationship between communication and well-being has not been observed, it is discussed that this could be done by some methodological limitations of the study (such as the low number of cases assessed and the use of measure tools which could not be suitable for this situation). Thus, more studies analyzing communication and well-being are needed. Furthermore, data provided by the study highlight that the relationship between communication and well-being must be carefully studied in patients who are aware of the evolution of their disease (AU)

Impact of ABO incompatibility on allogeneic peripheral blood progenitor cell transplantation after reduced intensity conditioning.

BACKGROUND: Most studies indicate that ABO incompatibility has no effect on the clinical outcome after allogeneic peripheral blood progenitor cell (PBPC) transplantation (allo-PBPCT). However, it carries additional risks of hemolytic reactions, delayed red blood cell (RBC) engraftment, and pure red cell aplasia (PRCA). Data on these events after reduced intensity conditioning (RIC) regimens are limited, but recent studies have suggested a higher transplant-related mortality (TRM) and morbidity in this setting. STUDY DESIGN AND METHODS: We investigated the impact of ABO-matching on the outcome of 77 patients included in a prospective RIC allo-PBPCT protocol, focusing on engraftment, transfusion requirements, graft-versus-host disease, TRM, and survival. RESULTS: There were 17 (22%) minor and 8 (10%) major ABO-incompatible transplants. No graft failures were observed. After major ABO-incompatible grafts, RBC engraftment was delayed, longer thrombocytopenia periods were documented, and transfusion requirements increased. A transient mild hemolysis occurred in 10 patients, 7 (41%) minor and 3 (37%) major ABO-mismatched. A PRCA was observed in a O+ patient with a pretransplant anti-Jka, grafted from an A + Jka+ donor. Graft-versus-host disease, disease progression, and TRM were not affected by ABO matching. CONCLUSION: ABO incompatibility was not associated with clinically relevant hemolysis after the RIC protocol used and did not impair the clinical outcome. PRCA was only observed in one patient, with a non-ABO RBC allo-antibody.