Investigación-acción-participativa sobre empoderamiento en mujeres mayores: un análisis teórico-metodológico / Participatory Action Research on empowerment in older women: a theoretical-methodological analysis

Este artículo tiene como objetivo analizar conceptual y metodológicamente el uso de la investigación-acción-participativa (IAP), a través de una investigación de campo, con el fin de aumentar los conocimientos sobre el mismo, e ilustrar sus fortalezas y debilidades para favorecer su uso en Ciencias de la Salud.Dentro de la metodología cualitativa, la IAP se puede utilizar como herramienta de análisis del cambio y de transformación, cuyo objetivo es la emancipación y liberación de las personas que se encuentran en un determinado contexto social opresivo.Se realiza la valoración de este enfoque en base a una investigación de campo con mujeres mayores que buscaba mejorar su autocuidado a través del empoderamiento. Para ello, se desarrolló una IAP compuesta por 22 sesiones y dos llamadas telefónicas individuales donde se utilizaron herramientas de generación de datos cualitativas y cuantitativas; todo ello mediante la modalidad más crítica de la IAP. En un ejercicio de reflexividad, se detectan modificaciones y mejoras en la intervención para trabajar con mujeres mayores en futuras investigaciones.El análisis realizado permite generar nuevo conocimiento sobre la IAP para futuras investigaciones gracias a la identificación de puntos críticos: el vínculo generado, la adaptación de herramientas a las mujeres mayores y el manejo del elevado volumen de datos que se produce.(AU)

This article aims to conceptually and methodologically analyse the use of Participatory Action Research (PAR), through field research, in order to increase knowledge about it, and to illustrate its strengths and weaknesses to encourage its use in Health Sciences.Within qualitative methodology, PAR can be used as a tool for the analysis of change and transformation, whose objective is the emancipation and liberation of people who find themselves in an oppressive social context.The assessment of this approach is based on field research with older women who sought to improve their self-care through empowerment. For this purpose, PAR was undertaken, consisting of 22 sessions and two individual telephone calls where qualitative and quantitative data generation tools were used; all this through the most critical modality of PAR. In an exercise of reflexivity, modifications and improvements in the intervention were detected to work with older women in future research.The analysis carried out makes it possible to generate new knowledge on PAR for future research thanks to the identification of critical points: the link generated, the adaptation of tools to older women, and the handling of the high volume of data produced.(AU)

Promoting empowerment and self-care in older women through participatory action research: Analysis of the process of change.

AIM: To generate and understand the process of change in the empowerment of women from 60 to 80 years old through a Participatory Action Research. SPECIFIC AIM: To analyse the women participants' experiences concerning empowerment and self-care. DESIGN: We use the Participatory Action Research approach (in its critical option) in the Socio-critical Paradigm and applying the Kemmis and McTaggart Model. METHODS: A group of 10 women participants from 60 to 80 years old was created and developed the Participatory Action Research from June 2019 to May 2020. This group was involved in 22 group sessions, individual interviews, reflective diaries and triangulation with quantitative data. RESULTS: Findings were interpreted based on the Gestalt Self Theory. Women generated changes in their empowerment based on three characteristics (self-determination, self-esteem and self-confidence) and, consequently, in their self-care. They did so according to two distinct patterns of behaviour: Leader women and follower women. The former took the lead in transforming their realities and the latter observed them and evolved in a slower and more reflective manner. These changes had an impact on the most individual level (inner world) and went beyond that barrier, modifying in turn their immediate surroundings and the social level (outer world). CONCLUSIONS: The group of older women began to consider their needs and consider themselves as important once they worked on their self-determination, self-esteem and self-confidence; we show these are key aspects to work on their empowerment and promote their self-care. IMPACT: The patterns of behaviour and dimensions of empowerment detected may help in future research designs and emancipatory community interventions in this population group.

Participatory Action Research on empowerment in older women: A theoretical-methodological analysis.

This article aims to conceptually and methodologically analyse the use of Participatory Action Research (PAR), through field research, in order to increase knowledge about it, and to illustrate its strengths and weaknesses to encourage its use in Health Sciences. Within qualitative methodology, PAR can be used as a tool for the analysis of change and transformation, whose objective is the emancipation and liberation of people who find themselves in an oppressive social context. The assessment of this approach is based on field research with older women who sought to improve their self-care through empowerment. For this purpose, PAR was undertaken, consisting of 22 sessions and two individual telephone calls where qualitative and quantitative data generation tools were used; all this through the most critical modality of PAR. In an exercise of reflexivity, modifications and improvements in the intervention were detected to work with older women in future research. The analysis carried out makes it possible to generate new knowledge on PAR for future research thanks to the identification of critical points: the link generated, the adaptation of tools to older women, and the handling of the high volume of data produced.

Promoción de la actividad física en mujeres mayores. Un estudio cualitativo con perspectiva de género / Promoting physical activity in older women. A qualitative study with a gender perspective

Objetivos: Conocer las estrategias profesionales utilizadas para lapromoción y adherencia de la práctica de actividad física entre lasmujeres mayores. Metodología: Estudio cualitativo con enfoquesociocrítico feminista y perspectiva de género mediante 3 grupos focales y2 entrevistas en profundidad. Participaron 26 profesionales del ámbito deatención primaria y monitores de actividades físicas (el 54% enfermeras).Análisis interpretativo de contenido y uso del programa informáticoMAXQDA-18. Resultados: Surgieron 2 categorías y 7 subcategorías.Los/las profesionales definieron el vínculo que existe entre la actividadfísica y las mujeres mayores a partir de los estereotipos de géneroque perciben que se han ido construyendo histórica y culturalmentealrededor de ellas, centrados principalmente en el rol de cuidadoras y enla identidad social entre iguales. Utilizan estrategias para incentivar lapráctica de actividad física basadas en la comunicación, experimentación,personalización, fortalecimiento de redes comunitarias y suempoderamiento. Conclusiones: Las mujeres mayores actuales presentanun vínculo con la actividad física marcado por estereotipos de génerotradicionales más alejados de beneficios físicos, pero cercanos a interesessociales y de identidad. Los/las participantes se apoyan en las experienciasde estas mujeres para la toma de conciencia de su autocuidado a travésde la actividad física y de la socialización. Estos hallazgos, que relacionanla actividad física con los estereotipos femeninos de socialización entreiguales, así como la responsabilidad y cuidado de su propia salud, sonlos que pueden ayudar a los/las profesionales a conseguir la satisfacción yadherencia en las mujeres mayores con la práctica. (AU)

Objectives: To understand the professional strategies usedto promote and adherence to the physical activity practiceamong older women. Methodology: Qualitative study witha feminist socio-critical approach and gender perspectivethrough three focus groups and two in-depth interviews.Twenty-six primary care professionals and fitness instructorparticipated (54% nurses). Interpretative content analysis anduse of the MAXQDA-18 software. Results: Two categoriesand seven subcategories emerged. Professionals defined thelink between physical activity and older women based on thegender stereotypes they perceived to have been historicallyand culturally constructed focusing mainly on the role ofcaregivers and social identity among equals. They use strategiesto encourage physical activity practice based on communication,experimentation, personalisation, enhancing communitynetworks and their empowerment. Conclusions: Currentolder women present a link with physical activity markedby traditional gender stereotypes that are more distant fromphysical benefits but closer to social and identity interests.Participants draw on these women’s experiences of self-careawareness through physical activity and socialisation. Thesefindings, which link physical activity with female stereotypesof peer socialisation as well as responsibility and care for one’sown health, can help practitioners to achieve older women’ssatisfaction and adherence with the practice. (AU)

[Active-Murcia program: secondary analysis, with a gender perspective, on the quality of life of participating women.] / Programa Activa-Murcia: análisis secundario, con perspectiva de género, sobre la calidad de vida en mujeres participantes.

OBJECTIVE: Nowadays sedentarism has become a public health issue, as a matter of gender and age. Older women are more sedentary, which affects their Quality of life. The aim of this study was to evaluate the Activa-Murcia Program impact over the Quality of life in women participating in it. METHODS: Longitudinal retrospective descriptive study within a gender perspective was carried out, including women who had participated in the Activa-Murcia Program. A SF-36 Survey of Quality of Life has been evaluated, scoring age range in three different stages and the enviroment in which they live. An analysis of repeated measurements was carried aout using ANOVA, and the Bonferroni Test was used for the pairwise analysis. RESULTS: The sample included 1,140 women. "Overall health" dimension improved up to 3 points, except in women over 60. Score highed inversely proportional to their age in the following dimensions: "Vitality" in 9.9, 6.2 and 3.9; "Mental health" in 7.7, 5.6 and 3.7; "Declared health evolution" in 11.2, 8.6. and 7.6. Women between 30-44 years old living in rural areas and those over 60 living in urban areas did not improve in "Social functions". Dealing with "Emotional Role", women between 30-44 and women between 45-59 in urban areas improved (p<0.05). There was a statistical asociation between being highly aged and improving less in "Vitality", "Emotional Role" and "Mental health". CONCLUSIONS: As women were getting older improve less in the dimensions of quality of life; so that could show, among others, an empowerment deficit.

OBJETIVO: El sedentarismo es un problema de Salud Pública, influenciado por brechas de género y edad. Las mujeres mayores son más sedentarias, lo que repercute en su calidad de vida. El objetivo general de este trabajo fue evaluar el impacto del Programa Activa-Murcia sobre la calidad de Vida de las participantes en dicho programa. METODOS: Se realizó un análisis secundario con perspectiva de género de un estudio descriptivo longitudinal retrospectivo de una cohorte de mujeres que habían participado en el Programa Activa-Murcia, evaluándose las dimensiones del Cuestionario de Calidad de Vida SF-36 y las puntuaciones según tres franjas etarias y el ámbito en el que vivían. Se realizó un análisis de medidas repetidas mediante ANOVA, y para el análisis por pares se utilizó el Test de Bonferroni. RESULTADOS: La muestra la componían 1.140 mujeres. La dimensión "Salud General" mejoró alrededor de 3 puntos, excepto en las mayores de 60 años. Aumentaron las puntuaciones de forma inversamente proporcional a la edad en siguientes dimensiones: "Vitalidad", en 9,9, 6,2 y 3,9 puntos; "Salud Mental", en 7,7, 5,6 y 3,7 puntos; y "Evolución Declarada de Salud", en 11,2, 8,6 y 7,6 puntos. Las mujeres entre 30-44 años rurales y las mayores de 60 años urbanas no mejoraron en "Función Social". Sobre el "Rol Emocional", las mujeres entre 30-44 años y las mujeres entre 45-59 años de zona urbana mejoraban (p<0,05). Existió asociación estadísticamente significativa entre tener mayor edad y mejorar menos en "Vitalidad", "Rol Emocional" y "Salud Mental". CONCLUSIONES: Las mujeres mayores mejoran menos en las dimensiones de la calidad de vida, lo que podría indicar, entre otros motivos, un déficit de empoderamiento.

Programa Activa-Murcia: análisis secundario, con perspectiva de género, sobre la calidad de vida en mujeres participantes / Active-Murcia program: secondary analysis, with a gender perspective, on the quality of life of participating women

OBJETIVO: El sedentarismo es un problema de Salud Pública, influenciado por brechas de género y edad. Las mujeres mayores son más sedentarias, lo que repercute en su calidad de vida. El objetivo general de este trabajo fue evaluar el impacto del Programa Activa-Murcia sobre la calidad de Vida de las participantes en dicho programa. MÉTODOS: Se realizó un análisis secundario con perspectiva de género de un estudio descriptivo longitudinal retrospectivo de una cohorte de mujeres que habían participado en el Programa Activa-Murcia, evaluándose las dimensiones del Cuestionario de Calidad de Vida SF-36 y las puntuaciones según tres franjas etarias y el ámbito en el que vivían. Se realizó un análisis de medidas repetidas mediante ANOVA, y para el análisis por pares se utilizó el Test de Bonferroni. RESULTADOS: La muestra la componían 1.140 mujeres. La dimensión "Salud General" mejoró alrededor de 3 puntos, excepto en las mayores de 60 años. Aumentaron las puntuaciones de forma inversamente proporcional a la edad en siguientes dimensiones: "Vitalidad", en 9,9, 6,2 y 3,9 puntos; "Salud Mental", en 7,7, 5,6 y 3,7 puntos; y "Evolución Declarada de Salud", en 11,2, 8,6 y 7,6 puntos. Las mujeres entre 30-44 años rurales y las mayores de 60 años urbanas no mejoraron en "Función Social". Sobre el "Rol Emocional", las mujeres entre 30-44 años y las mujeres entre 45-59 años de zona urbana mejoraban (p < 0,05). Existió asociación estadísticamente significativa entre tener mayor edad y mejorar menos en "Vitalidad", "Rol Emocional" y "Salud Mental". CONCLUSIONES: Las mujeres mayores mejoran menos en las dimensiones de la calidad de vida, lo que podría indicar, entre otros motivos, un déficit de empoderamiento

OBJECTIVE: Nowadays sedentarism has become a public health issue, as a matter of gender and age. Older women are more sedentary, which affects their Quality of life. The aim of this study was to evaluate the Activa-Murcia Program impact over the Quality of life in women participating in it. METHODS: Longitudinal retrospective descriptive study within a gender perspective was carried out, including women who had participated in the Activa-Murcia Program. A SF-36 Survey of Quality of Life has been evaluated, scoring age range in three different stages and the enviroment in which they live. An analysis of repeated measurements was carried aout using ANOVA, and the Bonferroni Test was used for the pairwise analysis. RESULTS: The sample included 1,140 women. "Overall health" dimension improved up to 3 points, except in women over 60. Score highed inversely proportional to their age in the following dimensions: "Vitality" in 9.9, 6.2 and 3.9; "Mental health" in 7.7, 5.6 and 3.7; "Declared health evolution" in 11.2, 8.6. and 7.6. Women between 30-44 years old living in rural areas and those over 60 living in urban areas did not improve in "Social functions". Dealing with "Emotional Role", women between 30-44 and women between 45-59 in urban areas improved (p < 0.05). There was a statistical asociation between being highly aged and improving less in "Vitality", "Emotional Role" and "Mental health". CONCLUSIONS: As women were getting older improve less in the dimensions of quality of life; so that could show, among others, an empowerment deficit

Difficulties and motivations for physical exercise in women older than 65 years. A qualitative study.

OBJECTIVE: to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. METHOD: qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. RESULTS: the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. CONCLUSIONS: the ideological representation of gender determines the women's decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.

La experiencia del empoderamiento en mujeres mayores de 65 años. Estudio cualitativo / The experience of empowerment in women older than 65 years. Qualitative study

Objetivo: Conocer la experiencia del empoderamiento de un grupo de mujeres mayores de 65 años. Metodología: La muestra constaba de 5 mujeres que fueron seleccionadas mediante muestreo intencionado en las consultas de enfermería y medicina del Centro de Salud de Vistabella. Para ello, se realizó un estudio cualitativo de tipo fenomenológico, y el instrumento de obtención de datos fue la entrevista en profundidad, cuyo guion se elaboró a partir de las principales características del empoderamiento. Resultados: La información fue clasificada en cinco categorías de respuesta: "Autoestima", "Autodeterminación-Toma de Decisiones", "Autoconfianza", "Social" y "Educación". Esta última se trataba de una categoría emergente, las mujeres utilizaban la educación para justificar sus respuestas. Conclusiones: Las entrevistadas manifestaban tener baja autoestima, dificultades a la hora de llevar las riendas de su vida, inseguridades y una participación social escasa, lo que denotaba un déficit de empoderamiento. Relacionaban lo anterior con la educación que habían recibido, fundamentada en los mandatos de género que recluyen a las mujeres al ámbito privado y eliminan el principio de igualdad de oportunidades con respecto a los hombres (AU)

Objective: Know the empowerment’s experience of a group of women over 65 years. Methodology: the sample consisted of 5 women and was selected by purposeful sampling in Consultations of Nursing and Medicine on Primary Heath Care Center "Vistabella". We performed a Phenomenological Qualitative Study; data collection instrument was an in-depth interview, whose script was developed from the main characteristics of empowerment. Results: The information was classified in five categories response: "Self-Esteem", "Self-Determination-Decision Making", "Self-Reliance", "Social" and "Education". The latter was an emerging category, that women used the education to justify their answers. Conclusions: The respondents expressed low self-esteem, difficulty of holding the reins of his life, insecurities and limited social participation, which indicated a lack of empowerment. They related this with the education they had received, based on gender mandates that recluse women to the private sphere and eliminate the principle of equal opportunities to men (AU)

Difficulties and motivations for physical exercise in women older than 65 years. A qualitative study / Dificuldades e motivações para o exercício físico em mulheres idosas. Um estudo qualitativo / Dificultades y motivaciones para el ejercicio físico en mujeres mayores de 65 años. Un estudio cualitativo

ABSTRACT Objective: to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. Method: qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. Results: the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. Conclusions: the ideological representation of gender determines the women's decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.

RESUMO Objetivo: identificar dificuldades e motivações para a prática de exercício físico em mulheres com mais de 65 anos. Método: estudo qualitativo baseado na teoria fenomenológica com grupos focais e entrevistas em profundidade. A enfermagem selecionou 15 mulheres por amostragem intencional com critérios de idade, tempo dedicado ao exercício físico, independentes, sem deterioração cognitiva e sem contra-indicação para a atividade. Foram estudados dois grupos focais (um realizava menos de 150 minutos semanais de exercício físico e outro no mínimo 150 minutos semanais), além de cinco entrevistas em profundidade. Análise qualitativa dos dados mediante transcrição, codificação, categorização e verificação dos resultados. Resultados: as dificuldades para o início e desenvolvimento do exercício físico ficam circunscritas à percepção de má saúde e à falta de tempo livre, resultado da obrigação do cuidado, representado como um mandato de gênero. Porém, as motivações estão relacionadas à percepção de fortaleza, necessidade de socialização, percepção de autonomia e liberdade. Conclusões: a representação ideológica do gênero determina a decisão para realizar exercício. Conhecer o sentido e o significado que as mulheres dão à saúde e ao seu papel no âmbito sócio familiar, permite que as enfermeiras desenvolvam relações e intervenções para a prática do exercício físico.

RESUMEN Objetivo: Identificar dificultades y motivaciones para la práctica de ejercicio físico en mujeres mayores de 65 años. Método: estudio cualitativo basado en la teoría fenomenológica con grupos focales y entrevistas en profundidad. La enfermería seleccionó 15 mujeres por muestreo intencional utilizando criterios de: edad, tiempo dedicado al ejercicio físico, independencia, sin deterioro cognitivo y sin contraindicación para esta actividad. Se formaron dos grupos focales (uno realizaba menos de 150 minutos semanales de ejercicio físico y el otro al menos 150 minutos semanales) además de realizar cinco entrevistas en profundidad. Análisis cualitativo de los datos mediante transcripción, codificación, categorización y verificación de resultados. Resultados: las dificultades para el inicio y desarrollo del ejercicio físico quedan circunscritas a la percepción de mala salud y falta de tiempo libre; que es resultado de la obligación de cuidar, representado como una imposición de género. Sin embargo, las motivaciones están relacionadas con percepción de fortaleza, necesidad de socialización, percepción de autonomía y libertad. Conclusiones: la representación ideológica de género determina la decisión para realizar ejercicio. Conocer el sentido y significado que las mujeres dan a la salud y su papel en el ámbito socio familiar permite a las enfermeras desarrollar relaciones e intervenciones para incentivar la práctica del ejercicio físico.