Percepción del uso del humor por parte de enfermeras y pacientes en los servicios de salud mental / Perception of the use of humour by nurses and patients at Mental Health Units

Objetivo: conocer, en función de la literatura disponible, el significado del sentido del humor entre enfermeras y pacientes en el contexto de servicios de salud mental, así como determinar los factores que facilitan o dificultan el uso del sentido del humor en las unidades de salud mental. Métodos: se llevó a cabo una revisión narrativa en el periodo 2022-2023. Las búsquedas se realizaron en Pubmed, PsycINFO, LILACS y CINAHL, usando los descriptores: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, "psychiatric nursing”. Se incluyeron todo tipo de documentos que abordaran el tema según los objetivos, publicados desde 2012 hasta noviembre de 2022 en inglés, español o portugués. Se añadió un artículo traducido del coreano por su relevancia. Resultados: se incluyeron 10 manuscritos en la revisión. Los hallazgos sugieren que el sentido del humor se percibe como una herramienta esencial para fortalecer la relación entre enfermeras y pacientes en entornos psiquiátricos. No obstante, se destaca la existencia de factores que podrían conducir a un uso inapropiado del humor, llevando a la deshumanización de la atención y la posible ruptura del vínculo terapéutico. Conclusiones: es importante considerar cuidadosamente el empleo del humor en el contexto de la salud mental, para garantizar su efectividad sin comprometer la calidad asistencial. (AU)

Objective: based on the literature available, to understand the meaning of sense of humour between nurses and patients in the setting of Mental Health Units, as well as to determine the factors that facilitate its use, o make it difficult. Methods: a narrative review was conducted during the 2022-2023 period. Searches were conducted in Pubmed, PsycINFO, LILACS and CINAHL, using the descriptors: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, “psychiatric nursing”. All type of documents addressing this matter according to the objectives were included, published from 2012 until November 2022 in English, Spanish or Portuguese. An article translated from Korean was added due to its relevance. Results: ten (10) manuscripts were included in the review. Findings suggested that sense of humour was perceived as an essential tool in order to strengthen the relations between nurses and patients in psychiatric settings. However, it was highlighted that there are factors which could induce an inadequate use of humour, leading to dehumanization in care and a potential breach in the therapeutic link. Conclusions: it is important to carefully consider the use of humour in the mental health setting, in order to guarantee its effectiveness without compromising the quality of care. (AU)

La hegemonía del modelo biomédico desde las representaciones del personal de salud en el contexto de un modelo de atención en salud con enfoque intercultural en Chugchilán, Ecuador / The Hegemony of the Biomedical Model from the representations of health care worker in the context of a health care model with an intercultural approach in Chugchilán, Ecuador

Resumen Este artículo pretende conocer cómo se pone en práctica el enfoque intercultural en el contexto del Modelo de Atención Integral de Salud con enfoque Familiar, Comunitario e Intercultural en Chugchilán (Ecuador), mediante los conocimientos, percepciones y prácticas que aplica el equipo de salud en la atención materno-infantil. Estudio etnográfico, en que participaron 21 profesionales sanitarios entre profesionales indígenas -técnicos de atención primaria de salud- y no indígenas del Centro de Salud. Las técnicas llevadas a cabo fueron observación participante y entrevistas en profundidad. Los datos generados se analizaron mediante análisis del contenido temático. El análisis de los datos evidenció que la hegemonía del modelo biomédico operante podría constituir una limitación en el desarrollo del enfoque intercultural, sin embargo, el personal de salud indígena, desde su rol ambiguo y contrario al modelo biomédico, emerge como un elemento contrahegemónico y articulador real entre los saberes biomédicos e indígenas en contextos interculturales de atención-autoatención.

Abstract This article aims to discover the intercultural practical approach in the context of the Comprehensive Healthcare Model within family, community, and interculturality in Chugchilán, Ecuador, via the recognition of knowledge, perceptions, and practices applied by the health team in maternal and child care. In this ethnographic study 21 health professionals, both Indigenous and non-indigenous from Chugchilán Health Center have participated, among the Indigenous health care workers were the primary health care technicians. The techniques applied were participant observation and in-depth interviews. The observed scenarios were the Health Center and excursion with community to record their daily life experiences. The generated data were examined using thematic content analysis. It showed that the operating biomedical hegemonic model could constitute one of the main limitations in the development of the intercultural approach. Even though Indigenous healthcare team holds an ambiguous and sometimes contrary role to the biomedical model, it has emerged as a counter-hegemonic element and real conciliator between biomedical and indigenous knowledge in intercultural contexts of care-self-care.

Adolescents and Young Adults Evaluating a Website for Affective-Sexual Information and Education: Multicenter Cross-Sectional Study.

BACKGROUND: Today's young people have long been demanding a paradigm shift in the emotional and sexual education they receive. While for them, affective-sexual and gender diversity is already a reality, the sexual and reproductive health professionals they encounter lack sufficient training. The digital devices and affective-sexual education websites aimed at today's young people must also be thoroughly evaluated. The website Sexe Joves is a website on sexuality by the Department of Health of the Government of Catalonia (Spain). It is designed for people aged 14 to 25 years. It currently needs to undergo a process of evaluation. Affective-sexual education aimed at young people must stem from their participation and the whole range of sexual and gender diversity in order to reach the entire population equally. OBJECTIVE: The aim of this study was to evaluate the website Sexe Joves as a source of affective-sexual health information, education, and communication for young people. It takes into account sex, gender identity, sexual orientation, socioeconomic status, and location within Catalonia (urban, semiurban, and rural areas). METHODS: This was an observational, descriptive, and cross-sectional study that forms part of a larger mixed methods study. An ad hoc questionnaire was used to collect data. In total, 1830 participants were included. The study was carried out simultaneously in all the territorial administrations of Catalonia. RESULTS: Almost 30% of the sample obtained were young people who experience affective-sexual and gender diversity. Of those surveyed, only 14.2% (n=260) said they were familiar with the website and of these, 6.5% said they used it (n=114). The website content rated most indispensable was on sexual abuse, harassment, and violence, followed by sexually transmitted infections; 70.5% (n=1200) reported that they visit pornographic websites. CONCLUSIONS: The results of this study will contribute to the design of new strategies for the website Sexe Joves, a public health resource, in order to improve affective sexual education for young people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192416586.

Protective factors of ethical conflict during a pandemic-Quali-Ethics-COVID-19 research part 2: An international qualitative study.

AIMS AND OBJECTIVES: To determine which factors can be considered protective of ethical conflicts in intensive care unit healthcare professionals during a pandemic. BACKGROUND: The COVID-19 pandemic gave rise to new ethical concerns in relation to the management of public health and the limitations on personal freedom. Continued exposure to ethical conflict can have a range of psychological consequences. DESIGN: A qualitative design based on phenomenological approach. METHODS: A total of 38 nurses and physicians who were regular staff members of Barcelona and Milan's public tertiary university hospitals and working in intensive care units during the first wave of the COVID-19 pandemic. Semi-structured online in-depth interviews were conducted. A thematic analysis was performed by two independent researchers following the seven steps of Colaizzi's methods. We adhere COREQ guidelines. RESULTS: One theme 'Protective factors of ethical conflict in sanitary crisis' and four subthemes emerged from the data: (1) knowledge of the infectious disease, (2) good communication environment, (3) psychological support and (4) keeping the same work team together. CONCLUSIONS: Four elements can be considered protective factors of ethical conflict for healthcare professionals during a sanitary crisis. While some of these factors have already been described, the joint identification of this set of four factors as a single element is, in itself, novel. This should help in ensuring the right mechanisms are in place to face future pandemics and should serve to improve institutional organisation and guarantee safe and high-quality patient care in times of healthcare crisis. RELEVANCE TO CLINICAL PRACTICE: Future strategies for the prevention of ethical conflict during sanitary crises, pandemics or other catastrophes need to consider a set of four factors as a single element. These factors are the knowledge of the infectious disease, a good communication environment, psychological support and keeping the same work team together into joint consideration.

Percepção de sintomas osteomusculares e sua repercussão nas atividades de vida diária em intérpretes de língua de sinais / Musculoskeletal symptoms perception and its impact on language interpreters' daily lives

Resumo Objetivo: analisar a percepção de sintomas osteomusculares e sua repercussão nas atividades de vida diária referidas por intérpretes da língua brasileira de sinais (libras). Métodos: pesquisa qualitativa de natureza descritiva-analítica, utilizando a análise de conteúdo categorial temática. Foi aplicado questionário sociodemográfico e realizada entrevista semiestruturada com 12 profissionais intérpretes de libras, atuantes nas redes de ensino nos níveis fundamental, médio e superior do município de Goiânia, convidados via redes sociais, no primeiro semestre de 2021. Resultados: foram identificadas três categorias temáticas: percepção álgica, percepção de cansaço e atividades de vida diária. Os profissionais estavam trabalhando remotamente devido à pandemia da doença COVID-19, cujo regime permitiu uma flexibilização do processo de trabalho com aulas on-line, eventos, palestras e congressos a partir do domicílio do trabalhador. Houve um aumento expressivo da demanda física e psicológica, devido ao aumento das atividades a serem cumpridas e por estarem ausentes os limites entre ambiente de "trabalho" e "casa". Conclusão: os participantes apresentaram percepções negativas em todos os aspectos avaliados, evidenciando a existência de sobrecarga na atuação como intérprete de língua de sinais.

Abstract Objective: to analyze the perception of musculoskeletal symptoms and their repercussion in the activities of daily living reported by professional Brazilian sign language interpreters (LIBRAS). Methods: descritive-analytical qualitative research, using thematic categorical content analysis. We used a sociodemographic questionnaire and a semi-structured interview with 12 professional LIBRAS interpreters, working in the primary, secondary, and superior education in the municipality of Goiânia. They were invited via social media, in the first half of 2021. Results: we identified three thematic categories: pain perception, perception of tiredness, and activities of daily living. The professionals were working remotely due to the COVID-19 pandemic. This allowed flexibility in the work schedule, with online classes, events, lectures, and congresses participation from the worker's home. Conclusion: the participants had negative perceptions in all aspects evaluated, evidencing an overload in acting as a sign language interpreter in educational activities.

Tangency and multiple factors of violence against lecturer: nuances of the experience in pedagogical practices in health education / Tangenciamiento y multifactorialidad de la violencia contra el docente: situaciones vivenciadas en la práctica pedagógica en salud / Tangenciamento e multifatorialidade da violência contra o docente: nuances vivenciadas na prática pedagógica em saúde

ABSTRACT Objective: to identify factors that lead the teacher to experience violence in their pedagogical practice in health education. Method: research with a qualitative approach, based on the Grounded Theory, conducted with 11 professors of the nursing course of a public university in the central region of Brazil in 2020 and 2021. Online semi-structured interviews were analyzed partially in the light of the Constructivist Grounded Theory. Results: factors that lead lecturer to experience violence are characterized by institutional culture, gender, professor's perception of violence, and the triggers that drive students to commit violence. Social status and inequalities lead to positions of domination and, consequently, create a fertile ground for violence. Final Considerations: analyzing violence under Bourdieu's theory, it is clear that student violence towards lecturer and the reports contained in this study deserve pedagogical reflection. However, it is necessary to include these discussions as a background in teaching environments.

RESUMEN Objetivo: identificar los factores que hacen que el profesor experimente violencia en la práctica pedagógica en salud. Método: es una investigación de enfoque cualitativo realizada de 2020 a 2021 entre 11 docentes del curso de Enfermería de una universidad pública de la región central de Brasil, mediante entrevistas semiestructuradas en línea que fueron analizadas parcialmente a la luz de la Teoría Fundamentada en Datos Constructivista. Resultados: Los factores que llevan a los profesores a sufrir violencia están caracterizados por la cultura institucional, el género, la percepción de la violencia por parte de los profesores y los desencadenantes que incitan a los alumnos a practicar tal violencia. El origen social convertido en desigualdades desencadena posiciones de dominación y, en consecuencia, se constituye en un terreno fértil para la violencia. Consideraciones finales: Al analizar la violencia bajo los fundamentos de Pierre Bourdieu, es posible percibir que la violencia de los alumnos contra los profesores merece una reflexión desde el punto de vista pedagógico sobre los informes contenidos en las entrevistas. Sin embargo, es necesario insertar estos debates en las diferentes etapas de la enseñanza.

RESUMO Objetivo: identificar fatores que levam o professor a experienciar violência na prática pedagógica em saúde. Método: pesquisa de abordagem qualitativa ancorada no referencial da Teoria Fundamentada nos Dados com 11 docentes do curso de Enfermagem de uma universidade pública da região central do Brasil em 2020 e 2021. Entrevistas semiestruturadas online foram analisadas parcialmente à luz da Teoria Fundamentada nos Dados Construtivista. Resultados: fatores que levam os docentes a experienciar a violência são caracterizados por cultura institucional, gênero, percepção de violência pelo docente e gatilhos que ensejam os estudantes a praticarem violência. Origem social convertida em desigualdades desencadeia posições de dominação e, consequentemente, constitui-se em terreno fértil para a violência. Considerações finais: analisando a violência sob os fundamentos de Pierre Bourdieu, percebe-se que a violência de alunos contra professores merece pedagogicamente reflexões sobre os relatos contidos nas entrevistas. Contudo, faz-se necessário perpassar tais discussões como pano de fundo nos palcos de ensino.

Adolescents and Young Adults Evaluating a Website for Affective-Sexual Information and Education: A Mixed-Methods Study Protocol.

The website Sexe Joves is a website on sexuality of the Department of Health of the Government of Catalonia (Spain). This study aims to understand the experiences and opinions of people aged 14 to 25 regarding this website, taking into account sex, gender identity, sexual orientation, socioeconomic status and location within Catalonia (urban, semiurban and rural areas). With the objective of improving the website and adpating the resources allocated to it, this study evaluates whether this population is familiar with it and uses it, as well as the website's usability and accessibility (digital equity), usefulness and the relevance of its content. A parallel convergent triangulation design is used: a qualitative study using a social constructivist perspective, and an observational, descriptive and cross-sectional quantitative study. We conduct a discourse analysis of participants and use an "ad hoc" questionnaire to collect quantitative data. A descriptive analysis of all variables is carried out. Affective-sexual education aimed at young people must stem from their participation and the whole range of sexual and gender diversity in order to reach the entire population equally. This analysis will contribute to the design of new strategies for the wesbite Sexe Joves, a public health resource, in order to improve affective-sexual education for young people.

Tangency and multiple factors of violence against lecturer: nuances of the experience in pedagogical practices in health education.

OBJECTIVE: to identify factors that lead the teacher to experience violence in their pedagogical practice in health education. METHOD: research with a qualitative approach, based on the Grounded Theory, conducted with 11 professors of the nursing course of a public university in the central region of Brazil in 2020 and 2021. Online semi-structured interviews were analyzed partially in the light of the Constructivist Grounded Theory. RESULTS: factors that lead lecturer to experience violence are characterized by institutional culture, gender, professor's perception of violence, and the triggers that drive students to commit violence. Social status and inequalities lead to positions of domination and, consequently, create a fertile ground for violence. FINAL CONSIDERATIONS: analyzing violence under Bourdieu's theory, it is clear that student violence towards lecturer and the reports contained in this study deserve pedagogical reflection. However, it is necessary to include these discussions as a background in teaching environments.

Deafness in the Brazilian care policy: a genealogical analysis. / A surdez na política de saúde brasileira: uma análise genealógica.

Deafness can be understood from the clinical-therapeutic and the socio-anthropological perspectives. The study aims to perform a genealogical analysis of deafness; that is, an analysis of the practices of knowledge and power in Brazilian health policy. This is a qualitative, documentary study based on the theoretical assumptions of Foucault. Researchers selected 23 documents and conducted eight semi-structured interviews, which were also considered documents, with a non-probabilistic sample using the snowball technique. The genealogical analysis showed that health policies aimed at people with hearing impairment result from the power and knowledge relationships in the field of deafness, in which the medical-pathological discourse is seen as the real perspective, understanding deafness as a disability to be corrected. The socio-anthropological approach, which recognizes the deaf through the perspective of difference and the use of sign language, is a subject discourse that has not found space in health policy. The study highlighted the contradictions between the achievements related to the access to technologies and the propositions of the health sector, whose policy directs its actions exclusively to reach a listening standard, disregarding the multiplicity of deaf individuals.

A surdez é compreendida a partir de dois discursos - o clínico-terapêutico e o socioantropológico. O artigo objetiva realizar uma análise genealógica da surdez, ou seja, das práticas de saber e poder, na política de saúde brasileira. É uma pesquisa qualitativa, documental, que se baseia em pressupostos teóricos de Michel Foucault. Foram selecionados 13 documentos normativos e 10 informativos, assim como realizadas oito entrevistas semiestruturadas, com amostra não probabilística, utilizando-se a técnica bola de neve. A análise mostrou que as políticas de saúde voltadas às pessoas com deficiência auditiva são efeito das relações de poder e saber existentes no campo da surdez, no qual o discurso médico-patológico, que concebe a surdez como uma deficiência a ser corrigida, é tido como o discurso verdadeiro. O discurso socioantropológico, que reconhece o surdo pelo olhar da diferença e pelo uso da língua de sinais, é um discurso sujeitado, que não tem encontrado espaços na política de saúde. Foram colocados em evidência os contrassensos entre as conquistas ligadas ao acesso às tecnologias e as proposições do setor saúde, cuja política direciona suas ações exclusivamente para o alcance de uma norma ouvinte, desconsiderando a multiplicidade dos sujeitos surdos.

A surdez na política de saúde brasileira: uma análise genealógica / Deafness in the Brazilian care policy: a genealogical analysis

Resumo A surdez é compreendida a partir de dois discursos - o clínico-terapêutico e o socioantropológico. O artigo objetiva realizar uma análise genealógica da surdez, ou seja, das práticas de saber e poder, na política de saúde brasileira. É uma pesquisa qualitativa, documental, que se baseia em pressupostos teóricos de Michel Foucault. Foram selecionados 13 documentos normativos e 10 informativos, assim como realizadas oito entrevistas semiestruturadas, com amostra não probabilística, utilizando-se a técnica bola de neve. A análise mostrou que as políticas de saúde voltadas às pessoas com deficiência auditiva são efeito das relações de poder e saber existentes no campo da surdez, no qual o discurso médico-patológico, que concebe a surdez como uma deficiência a ser corrigida, é tido como o discurso verdadeiro. O discurso socioantropológico, que reconhece o surdo pelo olhar da diferença e pelo uso da língua de sinais, é um discurso sujeitado, que não tem encontrado espaços na política de saúde. Foram colocados em evidência os contrassensos entre as conquistas ligadas ao acesso às tecnologias e as proposições do setor saúde, cuja política direciona suas ações exclusivamente para o alcance de uma norma ouvinte, desconsiderando a multiplicidade dos sujeitos surdos.

Abstract Deafness can be understood from the clinical-therapeutic and the socio-anthropological perspectives. The study aims to perform a genealogical analysis of deafness; that is, an analysis of the practices of knowledge and power in Brazilian health policy. This is a qualitative, documentary study based on the theoretical assumptions of Foucault. Researchers selected 23 documents and conducted eight semi-structured interviews, which were also considered documents, with a non-probabilistic sample using the snowball technique. The genealogical analysis showed that health policies aimed at people with hearing impairment result from the power and knowledge relationships in the field of deafness, in which the medical-pathological discourse is seen as the real perspective, understanding deafness as a disability to be corrected. The socio-anthropological approach, which recognizes the deaf through the perspective of difference and the use of sign language, is a subject discourse that has not found space in health policy. The study highlighted the contradictions between the achievements related to the access to technologies and the propositions of the health sector, whose policy directs its actions exclusively to reach a listening standard, disregarding the multiplicity of deaf individuals.

[Dimensions of student violence against the teacher]. / Dimensões da violência do aluno contra o professor.

Violence against teachers is a global concern and has a negative impact on the development of society. In this context, this study aimed to review definitions of violence against teachers to develop an integrated consensus and conceptual model. A scoping review of the literature was carried out to include articles that could answer the guiding question of the study: "What are the definitions and dimensions of student violence against teachers in teaching?" The studies included in the review, it was identified that violence against the teacher can be defined as a set of actions and situations caused by students in an insidious or chronic way in the workplace and/or through digital medium, mediated by the perception of violence, the copping mechanism of the teacher and the organizational management of the violence. The integrated model of violence against teachers comprises conceptual antecedents, such as previous experience with violence against the teacher, the cultural definition of violence and the perception of victimization. Violence against teachers is a multidimensional construct that results from the interaction with the student in the organizational and social context. The consequences of violence against the teacher include psychological, emotional, biological, professional and social harm.

A violência contra o professor é uma preocupação global e traz impacto negativo para o desenvolvimento da sociedade. Nesse contexto, o estudo objetivou revisar definições de violência contra o professor para desenvolver consenso integrado e modelo conceitual. Foi realizada uma revisão de escopo de literatura para incluir artigos que pudessem responder à pergunta norteadora da pesquisa: "Quais são as definições e as dimensões da violência do aluno contra o professor no ensino?" Nos estudos incluídos na revisão, identificou-se que a violência contra o professor pode ser definida como o conjunto de ações e situações provocadas por estudantes de forma insidiosa ou crônica no local de trabalho e/ou meio digital, mediadas por percepção de violência, mecanismo de enfrentamento do professor e gestão organizacional da violência. O modelo integrado de violência contra o professor compreende antecedentes conceituais, como a experiência anterior com violência contra o docente, definição cultural de violência e percepção de vitimização. A violência propriamente dita contra o professor é um construto multidimensional que resulta da interação com o estudante nos contextos organizacional e social. As consequências da violência contra o professor incluem danos psicológicos, emocionais, biológicos, profissionais e sociais.

Dimensões da violência do aluno contra o professor / Dimensions of student violence against the teacher

Resumo A violência contra o professor é uma preocupação global e traz impacto negativo para o desenvolvimento da sociedade. Nesse contexto, o estudo objetivou revisar definições de violência contra o professor para desenvolver consenso integrado e modelo conceitual. Foi realizada uma revisão de escopo de literatura para incluir artigos que pudessem responder à pergunta norteadora da pesquisa: "Quais são as definições e as dimensões da violência do aluno contra o professor no ensino?" Nos estudos incluídos na revisão, identificou-se que a violência contra o professor pode ser definida como o conjunto de ações e situações provocadas por estudantes de forma insidiosa ou crônica no local de trabalho e/ou meio digital, mediadas por percepção de violência, mecanismo de enfrentamento do professor e gestão organizacional da violência. O modelo integrado de violência contra o professor compreende antecedentes conceituais, como a experiência anterior com violência contra o docente, definição cultural de violência e percepção de vitimização. A violência propriamente dita contra o professor é um construto multidimensional que resulta da interação com o estudante nos contextos organizacional e social. As consequências da violência contra o professor incluem danos psicológicos, emocionais, biológicos, profissionais e sociais.

Abstract Violence against teachers is a global concern and has a negative impact on the development of society. In this context, this study aimed to review definitions of violence against teachers to develop an integrated consensus and conceptual model. A scoping review of the literature was carried out to include articles that could answer the guiding question of the study: "What are the definitions and dimensions of student violence against teachers in teaching?" The studies included in the review, it was identified that violence against the teacher can be defined as a set of actions and situations caused by students in an insidious or chronic way in the workplace and/or through digital medium, mediated by the perception of violence, the copping mechanism of the teacher and the organizational management of the violence. The integrated model of violence against teachers comprises conceptual antecedents, such as previous experience with violence against the teacher, the cultural definition of violence and the perception of victimization. Violence against teachers is a multidimensional construct that results from the interaction with the student in the organizational and social context. The consequences of violence against the teacher include psychological, emotional, biological, professional and social harm.

Alcohol Use and Sexual Violence among Nursing Students in Catalonia, Spain: A Multicentre Cross-Sectional Study.

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229-6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551-5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332-3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.

Managing ethical aspects of advance directives in emergency care services.

BACKGROUND: In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient's advance directives and implement them. OBJECTIVES: To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. RESEARCH DESIGN, PARTICIPANTS, AND CONTEXT: This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. ETHICAL CONSIDERATIONS: This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients' anonymity and willingness to participate in the study were guaranteed. FINDINGS: There were four types of barriers that hindered the proper management of patients' advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals' decision-making. DISCUSSION: These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals' beliefs and the opinions of colleagues and family members, can also influence the professionals' final decisions. CONCLUSION: The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated.

Critical thinking in nursing clinical practice, education and research: From attitudes to virtue.

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.

Validation of the WHOQOL-Bref instrument in Brazilian sign language (Libras).

PURPOSE: The recognition of the Brazilian Sign Language (Libras) as the official language of the Brazilian deaf, in 2002, reaffirms the linguistic and cultural particularities of the deaf population. Therefore, there is a lack of a validated instrument for assessing the Quality of Life of deaf people using Libras. With authorization from the World Health Organization (WHO), a version of the WHOQOL-Bref in Libras was developed, called WHOQOL-Bref/Libras. However, its psychometric properties have not been examined as yet. Therefore, the purpose of this work is to perform the psychometric validation of the WHOQOL-Bref/Libras. METHODS: WHOQOL-Bref/Libras and a sociodemographic questionnaire were applied to 311 deaf people from the five Brazilian regions. To assess temporal stability, the questionnaire was readministered to 52 deaf people, over an interval of 2 weeks. RESULTS: WHOQOL-Bref/Libras demonstrated satisfactory psychometric values for reliability, discriminant and construct validity, temporal stability, and internal consistency. Cronbach's alpha coefficient showed satisfactory values for each of the WHOQOL-Bref domains: Physical health (0.641), Psychological (0.705), Environment (0.710), and Overall-Bref domains (0.873). The WHOQOL-Bref/Libras is the appropriate option to assess the quality of life of deaf people who communicate through Libras. CONCLUSION: WHOQOL-Bref/Libras had a satisfactory psychometric performance; therefore, it is a valid option that will provide autonomous participation for the deaf in quality of life investigations.

Associated Factors of Quality of Life in Prison Officers, Brazil.

This study analyzed factors associated with the quality of life (QoL) of prison officers (POs) in the Midwest Region of Brazil. POs in five penitentiary units participated in this cross-sectional study. Sociodemographic data were obtained through face to face interview and a World Health Organization Quality of Life abbreviated version (WHOQOL-BREF) questionnaire was applied to assess QoL. Student's t-test or ANOVA were used for bivariate analysis and multiple linear regression was applied for adjusted analysis. The domains used for outcomes were: physical, psychological, social relations, and the environment. The lowest score among WHOQOL-BREF domains was environment (59.9; 95%CI 58.0-61.5). After adjustment, the factors associated with the physical domain were 'female sex' and 'no history of workplace PO-PO violence'; factors associated with the psychological domain were 'female sex', 'without spouse', and 'no history of inmate-PO violence'; factors associated with the social relationships domain were 'female sex', 'work experience in years', 'no higher education', 'no private health insurance', and 'no history of inmate-PO violence'; and factors associated with environment domain were 'female sex', 'work experience in years', 'no private health insurance', and 'no history of PO-PO violence'. This study showed that female workers and those with a history of violence at work had worse QoL scores. This investigation highlights the importance of prison management in promoting QoL of POs, as well as support and development of strategies to prevent workplace violence.

Meaning and comfort factors in the paediatric intensive care unit from an adult perspective: a descriptive phenomenological study.

AIMS: To explore the meaning of comfort and know the factors that contribute to it from the point of view of the young adults who received care in a paediatric intensive care unit, the family of the patient and the interdisciplinary team attending the patient. FINDINGS: A total of 30 people were invited to participate in the focus groups; 24 did so. Thematic analysis yielded the following common categories: meaning of comfort, environmental factors in paediatric intensive care unit, family accompaniment during paediatric intensive care unit stay, management of information in the paediatric intensive care unit and, finally, the intimacy and privacy of the critically ill paediatric patient and their family. CONCLUSIONS: Paediatric intensive care unit professionals need to consider not only the environmental input that may lead to discomfort but also aspects such as continuous family accompaniment, the sharing of complete information with the family and the promoting of privacy.

Scale for the study of nursing students' perception of intimate partner violence: Adaptation and validation.

BACKGROUND: Intimate partner violence (IPV) is one of the most important challenges facing today's society. Health professionals, and nurses in particular, play a leading role in addressing this problem. Having an instrument to study Nursing students' perception of this type of violence may enable appropriate and necessary educational strategies for their pre-service training and help them identify and address IPV in their future careers. OBJECTIVES: To adapt and validate the IPV scale of Beccaria et al. (2011) in order to study nursing students' perception of IPV. METHOD: The original instrument (63 items) underwent back-translation. Statistical and metrical analysis in a sample of 1064 students of the four-year Nursing degree program at four public universities in Catalonia (Spain) were based on their responses to the Spanish version. RESULTS: The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis showed adequate internal consistency for each subscale in the instrument: Education (0.83); Identification of the Victim (0.72); Nursing Role and Values (0.78), and Identification of the Perpetrator (0.66). CONCLUSION: The translation, cultural adaptation and validation process of the original IPV scale resulted in a Spanish-language instrument (IPV scale Spanish version) with 32 items in four subscales. We concluded that the Spanish version of the instrument is reliable and valid, and that its implementation would enable the assessment of nursing students' perception of IPV situations.

Ethnographic analysis of communication and the deaf community's rights in the clinical context.

BACKGROUND: Communication is a key factor in the health system. In the case of Deaf Community healthcare interactions could be affected by communication and it can also have a negative impact on health and jeopardise some of their health rights. OBJECTIVES: Aims (i) know the communication access difficulties of deaf people in healthcare context (ii) determine how these difficulties violate their rights. METHODS: Ethnographical study. RESULTS: Subjects were 25 deaf adults (7 men; 18 women). Two themes were identified (1) barriers to information access - right to information; (2) communication barriers - right to privacy and to decide. CONCLUSIONS: Communication difficulties and access to information have an impact on the health of deaf people, and violate health rights. In addition, their language rights like a community are also violate. Impact statement: Research could have a positive impact on improvement to access, communication and safe in the Deaf Community, in a clinical context.