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1.
Midwifery ; 77: 37-44, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31254962

RESUMO

AIM: To explore the experience of both the mothers and the fathers regarding the care received during delivery in cases of stillbirth. DESIGN: A hermeneutic phenomenological study based on semi-structured interviews with eleven mothers and fathers who experienced stillbirth. PARTICIPANTS: A purposive sample was recruited in Hospital XXX of XX and through a local pregnancy loss support organization. METHODS: Interviews were recorded and transcribed verbatim and analysed using inductive thematic analysis. FINDINGS: Four main categories identified: 1) denial of grief, 2) the life and death paradox, 3) guilt, and 4) go through and overcome the loss. The parents manifested a lack of recognition of their loss and their parenthood. Although the midwife was the highest valued professional, not all the experiences were positive and the parents would have appreciated being accompanied by trained people with good communication skills. They also referred to in-hospital logistic barriers that complicated the process, as well as the fact that these births occurred in the same place where healthy deliveries were attended. CONCLUSION: Findings highlight the importance of tailoring support systems according to mothers' and fathers' needs. Promoting social and institutional recognition of this kind of loss and training healthcare professionals in the accompaniment of this type of mourning is useful to plan comprehensive care to facilitate the initiation and subsequent evolution of healthy mourning.


Assuntos
Pai/psicologia , Mães/psicologia , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Natimorto/psicologia , Adaptação Psicológica , Adulto , Luto , Pai/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Mães/estatística & dados numéricos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/estatística & dados numéricos , Espanha/epidemiologia , Natimorto/epidemiologia
2.
Rev Lat Am Enfermagem ; 26: e3102, 2018 Nov 29.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30517587

RESUMO

OBJECTIVE: to identify the predictive variables or the massive transfusion triggers in severely traumatized patients through the existing scales. METHOD: a review of the literature was carried out using the Scoping Review method across the electronic databases CINAHL, MEDLINE, LILACS, the Cochrane and IBECS libraries, and the Google Scholar search tool. RESULTS: in total, 578 articles were identified in the search and the 36 articles published in the last ten years were included, of which 29 were original articles and 7 review articles. From the analysis, scales for massive transfusion and their predictive triggers were examined. CONCLUSION: the absence of universal criteria regarding the massive transfusion triggers in traumatized patients has led to the development of different scales, and the studies on their validation are considered relevant for the studies about when to initiate this strategy.


Assuntos
Transfusão de Sangue , Hemorragia/terapia , Ferimentos e Lesões/terapia , Pressão Sanguínea , Serviços Médicos de Emergência , Humanos , Sístole , Índices de Gravidade do Trauma
3.
Midwifery ; 66: 127-133, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30170265

RESUMO

AIM: To explore the experiences of midwives regarding the attention given during labour in late foetal death. DESIGN: Qualitative research using a hermeneutic-interpretative phenomenological approach was carried out. Data were collected through focus groups, audio-recorded, transcribed verbatim, and analyzed using the van Manen approach. SETTING AND PARTICIPANTS: Three focus group with a purposive sample of 18 midwives from 10 public hospitals and 1 primary health centre in Madrid, Spain were conducted. FINDINGS: Two main themes were identified: Professionals for Life Not Death; and Organizing the Work Without Guidelines. Midwives felt there is a lack of social awareness related to the possibility of antepartum death that keeps the mourning hidden and affects the midwives´ practice during the late foetal death process. Midwives recognize difficulties in coping with a process that ends in death: organizations are not prepared for these events (not suitable rooms), there is lack of training to cope with them, and lack of continuity in the attention received by the parents when they are discharged. CONCLUSION: Midwives need to be trained in mourning and communication skills to guarantee good practice when attending late foetal death. Intervention guidelines and support mechanisms are required, not only for the parents, but also for the healthcare professionals.


Assuntos
Morte Fetal , Trabalho de Parto/psicologia , Enfermeiras Obstétricas/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Cuidados Paliativos na Terminalidade da Vida/métodos , Cuidados Paliativos na Terminalidade da Vida/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/psicologia , Pesquisa Qualitativa , Espanha
4.
Clin Nurs Res ; : 1054773818791096, 2018 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-30051736

RESUMO

The aim of this study was to explore the experience of Spanish people living with rheumatoid arthritis (RA) and the support these people received from health professionals, particularly nurses. Nineteen patients with >1 year diagnosis, disease activity moderate or severe (DAS28 > 3.2), and already treated with disease-modifying antirheumatic drugs (DMARDs) were interviewed. A thematic analysis was performed to interpret the discourses. The difficulties of symptom management; the need for home-adaptations, the difficulties of living with a deteriorating self-image; and the reluctant reliance on medication to control their disease were the main themes that emerged from the discourse analysis of this study. Nurses appeared to have a limited role in RA patients care, and focused primarily on giving information and training for biological therapies. RA patients in Spain would benefit from having contact with specialist nurses who could empower them to self-manage their disease, as happens in other countries.

5.
Enferm. clín. (Ed. impr.) ; 28(2): 81-88, mar.-abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171685

RESUMO

Objetivo: Este trabajo tiene como objeto explorar las vivencias de las personas que transitan por el proceso de una colostomía. Método: Abordaje metodológico descriptivo de tipo cualitativo y con un encuadre fenomenológico, a través de entrevistas en profundidad. Seis mujeres y 12 hombres, entre 38 y 86 años de edad, fueron entrevistados antes y después de la cirugía, entre los 3 y los 6 meses posteriores a la intervención. Los discursos fueron grabados y transcritos verbatim y analizados siguiendo las 3 etapas de Taylor y Bogdan: de descubrimiento en progreso, de codificación de los datos y refinamiento de la comprensión del tema de estudio, y de relativización de los descubrimientos. Resultados: El cáncer de colon y la colostomía suponen cambios en la vivencia de la esfera privada, en la que se introduce este componente vital con connotaciones de «estigma». Se observa que la percepción del deterioro de la imagen corporal no está relacionada con el sexo sino más bien con la edad, con la situación laboral, con el tipo de trabajo que realiza el individuo y con el contexto social y cultural al que se pertenece. Conclusiones: La reconstrucción del mapa de relaciones del individuo, como estrategia de adaptación al proceso, se interrelaciona con factores sociales, culturales, de manejo del estoma y con la capacidad del individuo para la resolución efectiva de problemas (AU)


Objective: The purpose of this paper is to explore the experience of people who go through the process of a colostomy. Method: Methodological approach of qualitative type and with a phenomenological framework, through in-depth interviews. Six women and 12 men, between 38 and 86 years of age, were interviewed before and after surgery, between 3 and 6 months after the intervention. The discourses were recorded and transcribed verbatim and analyzed following the 3 stages of Taylor and Bogdan: finding in progress, data coding and refinement of the understanding of the subject of study, and relativisation of the findings. Results: Colon cancer and colostomy involve changes in a person's experience of privacy, and the connotations of "stigma" that can be attached to this vital element. It has been observed that the perception of deteriorated body image does not relate to an individual's gender, but rather to their age, work situation, type of work and social and cultural context. Conclusions: The reconstruction of an individual's relationship map, as a strategy for adapting to the process, is interrelated with social, cultural, and stoma management factors, and with their capacity for effective problem solving (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Colostomia/enfermagem , Neoplasias do Colo/enfermagem , Neoplasias do Colo/psicologia , Identificação Social , Imagem Corporal/psicologia , Pesquisa Qualitativa
6.
Enferm Clin ; 28(2): 81-88, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29453156

RESUMO

OBJECTIVE: The purpose of this paper is to explore the experience of people who go through the process of a colostomy. METHOD: Methodological approach of qualitative type and with a phenomenological framework, through in-depth interviews. Six women and 12 men, between 38 and 86 years of age, were interviewed before and after surgery, between 3 and 6 months after the intervention. The discourses were recorded and transcribed verbatim and analyzed following the 3 stages of Taylor and Bogdan: finding in progress, data coding and refinement of the understanding of the subject of study, and relativisation of the findings. RESULTS: Colon cancer and colostomy involve changes in a person's experience of privacy, and the connotations of "stigma" that can be attached to this vital element. It has been observed that the perception of deteriorated body image does not relate to an individual's gender, but rather to their age, work situation, type of work and social and cultural context. CONCLUSIONS: The reconstruction of an individual's relationship map, as a strategy for adapting to the process, is interrelated with social, cultural, and stoma management factors, and with their capacity for effective problem solving.


Assuntos
Colostomia/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Rev. latinoam. enferm. (Online) ; 26: e3102, 2018. graf
Artigo em Inglês | LILACS | ID: biblio-978597

RESUMO

Objective to identify the predictive variables or the massive transfusion triggers in severely traumatized patients through the existing scales. Method a review of the literature was carried out using the Scoping Review method across the electronic databases CINAHL, MEDLINE, LILACS, the Cochrane and IBECS libraries, and the Google Scholar search tool. Results in total, 578 articles were identified in the search and the 36 articles published in the last ten years were included, of which 29 were original articles and 7 review articles. From the analysis, scales for massive transfusion and their predictive triggers were examined. Conclusion the absence of universal criteria regarding the massive transfusion triggers in traumatized patients has led to the development of different scales, and the studies on their validation are considered relevant for the studies about when to initiate this strategy.


Objetivo identificar as variáveis preditivas ou os desencadeantes de transfusão maciça em pacientes com trauma grave através das escalas existentes. Método foi realizada uma revisão da literatura utilizando o método Scoping Review, nas bases de dados eletrônicas CINAHL, MEDLINE, LILACS, nas bibliotecas Cochrane e IBECS, e a ferramenta de busca do Google Scholar. Resultados foram identificados 578 artigos na pesquisa no total, dos quais foram incluídos os 36 artigos publicados nos últimos dez anos, sendo 29 artigos originais e 7 artigos de revisão. A partir da análise, foram examinadas as escalas de transfusão maciça e seus desencadeantes preditivos. Conclusão a falta de critérios universais com relação aos desencadeadores de transfusão em maciça em pacientes traumatizados levou à criação de diferentes escalas, sendo os estudos sobre sua validação considerados importantes para as estudos sobre quando iniciar essa estratégia.


Objetivo identificar las variables predictivas o los triggers de transfusión masiva en el paciente traumatizado grave a través de las escalas existentes. Método se realizó una revisión de la literatura mediante el método Scoping Review, en las bases de datos electrónicas CINAHL, MEDLINE, LILACS, las bibliotecas Cochrane e IBECS, y el buscador Google Scholar. Resultados un total de 578 artículos fueron identificados en la búsqueda, de los cuales, se incluyeron un total de 36 publicados en los últimos diez años, distribuidos en 29 originales y 7 de revisión. Del análisis, se examinaron las escalas de transfusión masiva y sus triggers predictivos. Conclusión la inexistencia de criterios universales respecto a los triggers de transfusión masiva en el paciente traumatizado ha traído consigo la creación de diferentes escalas, donde los estudios de validación de las mismas se detectan como relevantes para la investigación sobre cuando iniciar esta estrategia.


Assuntos
Humanos , Pressão Sanguínea/efeitos dos fármacos , Transfusão de Sangue/métodos , Serviços Médicos de Emergência , Hemorragia/terapia
8.
Rev Enferm ; 38(7-8): 46-51, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26449000

RESUMO

UNLABELLED: Although practical training has always been important in Nursing, it has reached a new dimension in the European Higher Education Area. This has involved adapting the syllabus, where one of the new features is considering clinical practice as an independent subject and also including the concept of competence as a result of the students' learning. The figure of the tutor becomes one of the key factors and therefore their activities and competencies must be defined. OBJECTIVE: To enumerate and prioritize, by agreement, the main activities and competences by the tutor of clinical practices in the Comunidad Autónoma de Madrid should posses. METHODOLOGY. Quantitative focus, analysis by group of experts between 2010 and 2013. RESULTS. A total of 510 nurses have participated, 17 panels of experts have met and consensus has been reached on 22 competencies and 12 activities. CONCLUSIONS: The description of activities and competencies can be extremely useful for selecting, evaluating and developing nursing clinical practice tutors, becoming a baseline and reducing the subjectivity in the development of tutors according to the new demands of the European Higher Education Area.


Assuntos
Competência Clínica , Educação em Enfermagem/normas , Docentes de Enfermagem , Espanha
9.
Rev Lat Am Enfermagem ; 23(2): 352-60, 2015.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-26039308

RESUMO

OBJECTIVE: to analyze the scientific literature on home-based family care of people with severe mental illness. METHOD: integrative review of 14 databases (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI COnNECT, LILACS, PsycINFO, PubMed, SciELO, and Scopus) searched with the key words "family caregivers", "severe mental illness", and "home" between 2003 and 2013. RESULTS: of 787 articles retrieved, only 85 met the inclusion criteria. The articles appeared in 61 journals from different areas and disciplines, mainly from nursing (36%). The countries producing the most scientific literature on nursing were Brazil, the UK, and the US, and authorship predominantly belonged to university centers. A total of 54.12% of the studies presented quantitative designs, with descriptive ones standing out. Work overload, subjective perspectives, and resources were the main topics of these papers. CONCLUSIONS: the international scientific literature on home-based, informal family care of people with severe mental disorder is limited. Nursing research stands out in this field. The prevalent topics coincide with the evolution of the mental health system. The expansion of the scientific approach to family care is promoted to create evidence-based guidelines for family caregivers and for the clinical practice of professional caregivers.


Assuntos
Cuidadores , Assistência Domiciliar , Transtornos Mentais/enfermagem , Humanos , Índice de Gravidade de Doença
10.
Rev. latinoam. enferm ; 23(2): 352-360, Feb-Apr/2015. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: lil-747162

RESUMO

OBJECTIVE: to analyze the scientific literature on home-based family care of people with severe mental illness. METHOD: integrative review of 14 databases (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI COnNECT, LILACS, PsycINFO, PubMed, SciELO, and Scopus) searched with the key words "family caregivers", "severe mental illness", and "home" between 2003 and 2013. RESULTS: of 787 articles retrieved, only 85 met the inclusion criteria. The articles appeared in 61 journals from different areas and disciplines, mainly from nursing (36%). The countries producing the most scientific literature on nursing were Brazil, the UK, and the US, and authorship predominantly belonged to university centers. A total of 54.12% of the studies presented quantitative designs, with descriptive ones standing out. Work overload, subjective perspectives, and resources were the main topics of these papers. CONCLUSIONS: the international scientific literature on home-based, informal family care of people with severe mental disorder is limited. Nursing research stands out in this field. The prevalent topics coincide with the evolution of the mental health system. The expansion of the scientific approach to family care is promoted to create evidence-based guidelines for family caregivers and for the clinical practice of professional caregivers. .


OBJETIVO: analisar a produção científica sobre o cuidado familiar de pessoas com transtorno mental grave em casa. MÉTODO: revisão integrativa de 14 bases de dados (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI Connect, LILACS, PsycInfo e PubMed, SciELO, e Scopus), com as palavras-chave "cuidadores familiares", "TMG" (transtornos mentais graves ) e "casa", realizada entre 2003 e 2013. RESULTADOS: dos 787 artigos retornados, somente 85 atenderam os critérios de inclusão. Os artigos vieram de 61 periódicos de diferentes áreas e disciplinas, principalmente de enfermagem (36%). Os países com maior produção científica sobre enfermagem foram o Brasil, o Reino Unido e os Estados Unidos, e a autoria era predominantemente de centros universitários. Um total de 54,12% dos estudos apresentou delineamento quantitativo, e os descritivos se destacaram. Os principais temas desses trabalhos foram sobrecarga de trabalho, perspectivas subjetivas e recursos. CONCLUSÕES: a produção cientifica internacional sobre o cuidado familiar informal de pessoas com doenças mentais graves em casa é limitada. A pesquisa em enfermagem se destaca nesse campo. Os temas prevalentes coincidem com a evolução do sistema de saúde mental. Estimula-se a expansão da abordagem científica do cuidado familiar de modo a encontrar evidências para criar guias para cuidadores familiares e para a prática clínica de cuidadores profissionais. .


OBJETIVO: analizar la producción científica sobre el cuidado familiar de la persona con trastorno mental grave en el hogar familiar. MÉTODO: revisión integradora en 14 bases de datos (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, IME, ISOC, JBI ConNECT, LILACS, PsycInfo, PubMed, SciELO y Scopus), con las palabras clave "cuidadores familiares", "TMG" y "hogar"; realizada entre 2003 y 2013. RESULTADOS: de 787 artículos recuperados, sólo 85 cumplieron con los criterios de inclusión. Los artículos procedieron de 61 revistas de diferentes áreas y disciplinas destacando la disciplina de enfermería (36%). Los países con mayor producción científica sobre enfermería fueron Brasil, Reino Unido y EEUU. En la autoría predominaron los centros universitarios. El 54,12% de los estudios presentó diseño cuantitativo, sobresaliendo los descriptivos. Las temáticas destacadas fueron sobrecarga, perspectivas subjetivas y recursos. CONCLUSIONES: la producción científica internacional sobre el cuidado informal familiar de la persona con trastorno mental grave, en el contexto del hogar familiar, es limitada. En este campo, destaca la investigación de enfermería. Las temáticas prevalentes coinciden con la evolución del sistema de salud mental. Se estimula la ampliación del abordaje científico del cuidado familiar con el fin de encontrar evidencias para la elaboración de guías de cuidadores familiares y para la práctica clínica de cuidadores profesionales. .


Assuntos
Humanos , Feminino , Adipogenia , Adipócitos/metabolismo , Células-Tronco Adultas/fisiologia , Androgênios/fisiologia , Di-Hidrotestosterona/farmacologia , Testosterona/fisiologia , Antagonistas de Androgênios/farmacologia , Androgênios/farmacologia , /metabolismo , Proteína beta Intensificadora de Ligação a CCAAT/genética , Proteína beta Intensificadora de Ligação a CCAAT/metabolismo , Proteínas Estimuladoras de Ligação a CCAAT/genética , Proteínas Estimuladoras de Ligação a CCAAT/metabolismo , Células Cultivadas , Flutamida/farmacologia , Expressão Gênica , Metabolismo dos Lipídeos , PPAR gama/genética , PPAR gama/metabolismo , Receptores Androgênicos/metabolismo , Transdução de Sinais , Testosterona/farmacologia
11.
Metas enferm ; 14(7): 68-74, sept. 2011. tab
Artigo em Espanhol | IBECS | ID: ibc-96919

RESUMO

El presente trabajo pretende dar a conocer el desarrollo metodológico de un muestreo teórico en una investigación cualitativa fenomenológica sobre el análisis de la corporeidad en los trasplantados de corazón (TC). Para ello se encuadra metodológicamente el estudio en primera instancia, para posteriormente exponer la estrategia de muestreo. Encuadre metodológico del estudio: el abordaje metodológico se realizó bajo el paradigma cualitativo y diseño fenomenológico. La técnica empleada fue la entrevista en profundidad. Ámbito de estudio: Hospital Universitario Puerta de Hierro-Majadahonda, Madrid. Estrategia de muestreo: la selección de informantes se inició con un estudio exploratorio, seguido de dos muestreos teóricos, basados en la recopilación de la información obtenida y al incipiente análisis teórico de la misma. Se llevaron a cabo 22 entrevistas: 12 a informantes trasplantados de corazón, con edades comprendidas entre 27 y 70 años; y 10 a informantes familiares. A modo de conclusiones se señala que el dinamismo que se establece en el proceso de la investigación cualitativa introduce la necesidad constante de replantear el muestreo inicial y los sucesivos, para conseguir un discurso que abarque la comprensión del fenómeno estudiado (AU)


The present work aims to determine the methodological development of a theoretical sampling in a qualitative phenomenological study on the analysis of the notion of corporeity in patients who have undergone a heart transplant. For this purpose, the study is first presented as part of the method s framework and then it goes on to present the sampling strategy. Methodological framework of the study: the methodological approach was carried out under a qualitative paradigm and phenomenological design. The technique used was an in-depth interview. Scope of the study: Puerta de Hierro University Hospital, Majadahonda, Madrid. Sampling strategy: Informant selection was started with an exploratory study, followed by two theoretical samplings which based on the compilation of the information obtained and the incipient theoretical analysis of such information. 22 interviews were carried out: 12 to informants who had undergone a heart transplant, aged between 27 and 70 years; and 10 family informants. As conclusion it is important to point out that the dynamism established in the qualitative research process introduces the constant need to take a new approach to the initial sampling and to future samplings in order to achieve a discourse that embraces the comprehension of the studied phenomena (AU)


Assuntos
Ciências da Saúde , Transplante de Coração/psicologia , Imagem Corporal/psicologia , Amostragem , Efeito Idade , Pesquisa Qualitativa
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