Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis.

ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.

Many healthcare workers experience images or 'flashbacks' of traumatic experiences from their work during the COVID-19 pandemic.To ensure that individual needs are met, there is a need to tailor and refine current psychological support measures and their use for healthcare workers.The imagery-competing task intervention was perceived as acceptable, indicating its potential utility as a help measure to reduce intrusive memories after trauma.

'Life should go on': a qualitative inquiry of parental reactions, experiences, and perceived needs following adolescents' recent traumatic exposure.

Background: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11-16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11-16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child's reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent-child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.

Parents of teenagers exposed to traumatic events struggle to understand trauma and feel isolated.Parents feel pressured to resume life as it was before, leading to conflictual child­parent interaction.Psychoeducation, stigma, and school involvement could be early intervention targets.

Supervisión en una Unidad de Clínica de Adultos de un Centro de Salud Mental Universitario: Un Estudio Cualitativo del Proceso

Introducción: Las supervisiones clínicas cumplen un rol esencial dentro de la formación profesional del psicólogo clínico. Se han desarrollado diferentes modelos de supervisión, sin embargo, pocos estudios abordan el cómo se desarrolla el proceso de supervisión propiamente tal. Objetivo: Describir las dinámicas de supervisión clínica grupal en la Unidad de Adultos del Servicio de Psicología Integral de una Clínica Universitaria, que proporciona atención psicológica a la comunidad. Metodología: Estudio cualitativo descriptivo y de alcance transversal, en una muestra de 5 sesiones de supervisión videograbadas, cuya interacción verbal fue sometida a análisis de contenido convencional. Resultados: Se distinguen aspectos de la apertura del proceso de supervisión, en el cual se identifica una dificultad variable de los supervisados para formular preguntas de supervisión, dificultad enmarcada en un contexto de involucramiento afectivo de los supervisados. Se identifican intervenciones de los miembros del equipo de supervisión: una transversal de validación de la experiencia del supervisado; e intervenciones durante el proceso de supervisión, como, por ejemplo, preguntas dirigidas a revisar "la experiencia" del supervisado durante la atención del caso; "construcción de hipótesis comprensivas del caso", y la entrega de "sugerencias para el abordaje terapéutico" del caso en específico, y/o que pueden ser aplicados a otros casos.

Background: Clinical supervision plays an essential role in the professional training of clinical psychologists. Different supervision models have been developed; however, few studies address how the ongoing process of supervision is developed. Objective: To describe the dynamics of clinical group supervision at the Adult Unit of the Clinical Psychology Service of a University Clinic, which provides psychological care to the community. Methodology: A descriptive qualitative study of cross-sectional scope, in a sample of 5 video-recorded supervision sessions, whose verbal interaction was subjected to conventional content analysis. Results: Aspects of the opening of the supervision process are distinguished, in which a different degree of difficulties of the supervisees to formulate supervision questions is identified, a difficulty framed in a context of affective involvement of the supervisees. Interventions by members of the supervision team are identified: a validation of the supervisee's experience which is present each one supervision process; and specific interventions during the supervision process, for example, questions aimed at reviewing «the experience» of the supervisee during the care of the case; «construction of comprehensive hypotheses of the case», and the delivery of «suggestions for the therapeutic approach» of the specific case, and/or that can be applied to other ones.

Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora / People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic

Antecedentes y objetivo: La Organización Mundial de la Salud declaró a la infección por COrona VIrus Disease 19 (COVID-19) como pandemia y recomendó, como medida preventiva, el distanciamiento social. Esto afectó a todos los tratamientos médico-clínicos, incluidos los relacionados con el proceso de rehabilitación física. El objetivo fue describir las percepciones sobre el proceso de rehabilitación debido a las modificaciones experimentadas por las personas con discapacidad motora de un hospital de rehabilitación durante la pandemia por COVID-19. Pacientes y métodos: Diseño cualitativo. La muestra elegida fue por conveniencia y el análisis de datos fue por análisis temático, el cual permite identificar, analizar y reportar temas relevantes. Las entrevistas se realizaron a pacientes atendidos en la División de Kinesiología. Criterios de inclusión: adultos> 18 años, diagnóstico de discapacidad motora, en tratamiento kinésico ≥ 1 mes de forma ambulatoria, con alta temprana de internación o internados en el momento de la realización del estudio y firma del consentimiento informado. Criterios de exclusión: alta kinésica por motivos diferentes a la COVID-19 y diagnóstico de enfermedad psiquiátrica. Resultados: La muestra se compuso de 16 participantes. El 31,2% era de sexo femenino. Doce presentaron diversas alteraciones neurológicas y 4, secuelas de amputación. Se identificaron 4 temas principales: importancia de la rehabilitación, modificaciones/interrupción del tratamiento, actividades de la vida diaria y telerrehabilitación. Conclusiones: Se describieron las percepciones sobre el proceso de rehabilitación y el impacto en las modificaciones experimentadas en las personas con discapacidad motora. Destacamos la importancia de la telerrehabilitación como un recurso alternativo.(AU)

Background and objective: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical–clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. Patients and methods Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. Inclusion criteria: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. Exclusion criteria: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. Results: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. Conclusions: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.(AU)

Teorías subjetivas sobre el tiempo de espera y experiencias de la parentalidad adoptiva / Subjective theories about waiting time and experiences from adoptive parenting

Resumen El proceso de adopción comprende cambios importantes en las familias adoptivas, pues implica una reestructuración y adaptación a una nueva organización del sistema familiar. Durante este proceso los padres elaboran expectativas y creencias respecto a cómo comportarse frente a los cambios y adaptarse a sus hijos, desde donde dirigen sus prácticas de crianza. La percepción del tiempo que tenga cada persona posee un papel en cómo se desarrolla la identidad tanto individual como familiar, pues las experiencias pasadas, vivencias actuales y expectativas del futuro influyen en sus acciones. Por lo tanto, es posible decir que los padres adoptivos elaboran teorías subjetivas sobre este proceso y especialmente en relación con el tiempo de espera de la adopción, explicaciones que podrían incidir en la forma en que enfrentan este nuevo desafío y se preparan para la parentalidad. El presente estudio tuvo por objetivo comprender las teorías subjetivas sobre el tiempo de espera y las experiencias de la parentalidad adoptiva. Participaron diez madres y padres adoptivos mediante entrevistas episódicas individuales. Se analizaron los datos obtenidos utilizando técnicas de tres procedimientos de análisis: de contenido basado en la Teoría Fundamentada, específico para las teorías subjetivas y de la perspectiva temporal. De los hallazgos se destacan teorías subjetivas de contenido emocional ansioso durante el proceso de adopción. Además, contar con una red de apoyo, compartir experiencias con otros padres y el uso de estrategias personales son las principales estrategias de adaptación de los padres adoptivos que les permiten sobrellevar los sentimientos negativos durante el proceso.

Abstract The adoption process includes important changes in adoptive families, since it implies a restructuring and adaptation to a new organization of the family system. The path to parenthood entails changes at levels of mental, physical and social health, which in the case of adoptive parents, the challenges are greater or are altered in some way due to the unique characteristics of their experiences and the obstacles they face. To these challenges are added the usual stressors that parents face, such as changes in roles, increased stress, lack of sleep, alterations in the relationship and intimacy of the couple and difficulties that arise in raising their children. On the other hand, time is configured as a concrete dimension through which life develop. The relationship between objective time and subjective or psychological time will shape the perception of time that each person has, which has a role in how both individual and family identity develops. This is because people´s actions are influenced by past experiences, current experiences and future expectations. One of the areas of the adoption process that has not yet been deepened is the waiting time, the period of time between obtaining the suitability and assignment of the minor to the adoptive family, which can be considered important for the future family depending on how adoptive parents face it, this because the way in which the adoption process is experienced impacts both the path to parenthood and post-adoption adaptation. In fact, it confirms that waiting time influences the psychological well-being of adoptive parents. Therefore, it is possible to say that adoptive parents elaborate subjective theories about this process and especially in relation to the waiting time for adoption, explanations that could influence the way in which they face this new challenge and prepare for parenthood. The present study aimed to understand subjective theories about the waiting time and experiences of adoptive parenting. Ten adoptive mothers and fathers participated in this study through individual episodic interviews. The data obtained were analyzed using techniques of three analysis procedures: content based on Grounded Theory, specific for subjective theories and time perspective.

Experiencias de docentes y estudiantes en la educación remota de emergencia: oportunidades para mejorar la educación del pregrado en medicina / Faculty and student experience during remote emergency education: opportunities for improving undergraduate medical education

Introducción: Los ciclos clínicos de pregrado representan los escenarios principales en los que los estudiantes de medicina consolidan los conocimientos. Sin embargo, a principios de 2020, la mayoría de los estudiantes fue confinada en sus domicilios debido a la pandemia por el SARS-CoV-2. Los procesos formativos continuaron desde los hogares por medio de la educación remota de emergencia, una modalidad de enseñanza basada en el uso intensivo de la tecnología que, a pesar de hacerse de manera improvisada, respondió a la situación educativa de urgencia. El propósito de este estudio fue indagar la experiencia educativa de estudiantes y docentes que se encontraban en los años clínicos de pregrado de la carrera de medicina con el fin de identificar las oportunidades de mejora en la enseñanza a partir de la crisis sanitaria vivida. Sujetos y métodos: Se realizó un estudio cualitativo de carácter descriptivo con la técnica de grupos focales. El análisis se basó en la reducción de datos, en la triangulación entre estamentos y en la bibliografía del tema. Resultados: Se realizaron 16 grupos focales con un total de 148 participantes. Se identificaron cuatro categorías generales: a) enseñanza y aprendizaje; b) evaluación de la práctica clínica; c) identidad profesional, y d) sugerencias en busca de mejoras en la formación de los médicos Conclusiones: Las reflexiones reconocen la necesidad de incorporar las tecnologías digitales de una manera planeada y diseñada en conjunto por expertos y docentes para adaptarlas a las necesidades de los contextos educativos, y continuar con modelos híbridos o combinados para mejorar la educación médica.(AU)

Introduction: During medical education, undergraduate clinical cycles represent the main scenarios where students consolidate knowledge. However, in the early 2020s, most students were confined to their homes due to the SARS-Cov-2 pandemic. In this situation, the digital network allowed the educational processes to continue from their homes through remote emergency education (REE), a teaching modality based on the intensive use of technology that, despite having been improvised, responded to the emergency educational situation. Therefore, this study aimed to investigate the educational experience of students and teachers in the undergraduate clinical years of the medical degree in order to identify opportunities for improvement in teaching after the health crisis. Subjects and methods: A descriptive qualitative study was carried out with a phenomenological approach through the focus group technique. The qualitative analysis was based on data reduction and triangulation between strata and subject literature. Results: Sixteen focus groups were integrated with a total of 148 participants. Four categories were identified: a) teaching and learning; b) evaluation of clinical practice; c) professional identity, and d) suggestions for improvement in the training of physicians. Conclusions: The reflections lead to recognizing the need to incorporate digital technology designed by experts and teachers to adapt them to the real needs of the educational contexts and to continue with a hybrid or combined model that supports the improvement of medical education.(AU)

Psychosocial resources underlying disaster survivors' posttraumatic stress symptom trajectories: insight from in-depth interviews with mothers who survived Hurricane Katrina.

Background: Weather-related disasters, including hurricanes, are becoming more frequent and severe due to climate change. Vulnerable populations, such as people with low income and racial and ethnic minorities, are particularly prone to increased levels of physical harm and psychiatric adversity from weather-related events.Objectives: We aimed to explore psychosocial resources and coping of survivors with three different posttraumatic stress symptom (PTSS) trajectories (High-Decreasing, Moderate-Decreasing, and High-Stable), after Hurricane Katrina across two different time points: F1 (1-year post-disaster) and F3 (12 years post-disaster).Method: Participants in this multi-method study were part of a larger cohort of the Resilience in Survivors of Katrina (RISK) project. Transcripts of interviews completed at the two time points were analysed using two qualitative methods, combining thematic analysis and narrative analysis, and providing both breadth of perspectives with the depth of specific case studies.Results: Sixteen survivors completed interviews at both F1 and F3. From our in-depth analysis of the data, we derived five inductive themes: 'Hope,' 'Adaptive vs maladaptive avoidance,' 'Emotional delay,' 'Acceptance, Finding Meaning and Being in the Moment,' and 'Coping strategies.' Survivors with High-Decreasing and Moderate-Decreasing PTSS trajectories experienced hope for future, accepted the hurricane and its results, and found efficient ways to cope with their situation. Survivors with High-Stable PTSS trajectories tended to express a lack of hope for future and struggled to be mindful and accept the hurricane and its harm. Unlike survivors with High-Decreasing and Moderate-Decreasing PTSS trajectories, survivors with High-Stable PTSS trajectories also reported less social and family support and faced more discrimination and racism.Conclusion: There are factors beyond individual-level psychosocial resources that may shape post-disaster resilience. When supporting survivors after a weather-related disaster, it is essential to provide ongoing psychological, financial, and physical assistance to bolster these resources.

After Hurricane Katrina, survivors with different posttraumatic stress symptom trajectories reported different levels of hope, mindfulness, and willingness to talk about the hurricane, emotional processing, and coping strategies.These experiences varied over time for survivors in all three trajectories.Survivors who report ongoing high levels of symptoms should be offered additional support to bolster these psychosocial resources.

Violencia de género: perspectiva de condenados y de psicólogos/as de instituciones penitenciarias. Análisis cualitativo con grupos focales / Intimate Partner Violence: perspective of convicts and psychologists of penitentiary institutions. A Qualitative analysis with focus groups

La violencia de género es un proceso complejo en el cual intervienen variables individuales, relacionales y contextuales. El presente estudio tiene como objetivo explorar las estrategias de afrontamiento y dinámicas relacionales en situaciones conflictivas en condenados por violencia de género con sus parejas. Se realizaron grupos focales con condenados por violencia de género (12 participantes) y con profesionales de la psicología (4 participantes). Los datos se exploraron mediante análisis temático siguiendo el Modelo Ecológico Anidado. El grupo de condenados muestra roles de autoridad y superioridad sobre la mujer, sensación de vulnerabilidad y rechazo ante el marco jurídico existente, miedo a sufrir arrestos por querer continuar con la relación, la necesidad de control de la pareja impulsada por lo celos, la justificación o negación de responsabilidad en las situaciones violentas o instrumentalización de los hijos/as en común. Los profesionales señalan aspectos culturales que facilitan esquemas y roles violentos en la dinámica de pareja, problemas de comunicación, negación o baja conciencia del delito, entre otros temas. Los resultados son de especial interés tanto para los profesionales que deseen conocer o profundizar en la temática como para quienes trabajen en la intervención y/o prevención en violencia de género.(AU)

Intimate Partner Violence is a complex process in which indi-vidual, relational and contextual variables intervene. The aim of this study was to explore coping strategies and relational dynamics in conflict situa-tions involving people convicted of intimate partner violence with their partners. Focus groups were conducted with convicted intimate partner violence offenders (12 participants) and with psychology professionals (4 participants). The data were explored through thematic analysis following the Nested Ecological Model. The group of convicted perpetrators showed roles of authority and superiority over the woman, a feeling of vulnerability and rejection of the existing legal framework, fear of being arrested for wanting to continue the relationship, the need to control the partner driven by jealousy, justification or denial of responsibility in violent situations or instrumentalization of the children in common. The professionals point out cultural aspects that facilitate violent patterns and roles in the couple's dynamics, communication problems, denial or low awareness of the crime, among other issues. The results are of special interest both for profession-als who wish to learn or deepen their knowledge on the subject, as well as for those who work in intervention and/or prevention of intimate partner violence.(AU)

[People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic]. / Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora.

BACKGROUND AND OBJECTIVE: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical-clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. PATIENTS AND METHODS: Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. INCLUSION CRITERIA: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. EXCLUSION CRITERIA: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. RESULTS: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. CONCLUSIONS: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.

A qualitative study of the reasons for low patient safety incident reporting among Indonesian nurses / Um estudo qualitativo das razões para baixa notificação de incidentes de segurança do paciente entre enfermeiros indonésios / Un estudio cualitativo de las razones de la baja notificación de incidentes de seguridad del paciente entre las enfermeras de Indonesia

ABSTRACT Objectives: to investigate the reasons for low patient safety incident reporting among Indonesian nurses. Methods: this qualitative case study was conducted among 15 clinical nurses selected purposively from a public hospital in Lampung, Indonesia. Interview guidelines were used for data collection through face-to-face in-depth interviews in July 2022. The thematic approach was used to analyze the data. Results: in this present study, seven themes emerged (1) Understanding incident reporting; (2) The culture; (3) Consequences of reporting; (4) Socialization and training; (5) Facilities; (6) Feedback; and (7) Rewards and punishments. Final Considerations: these findings should be considered challenges for the patient safety committee and hospital management to increase patient safety incident reporting, particularly among nurses in the hospital.

RESUMO Objetivos: investigar os motivos da baixa notificação de incidentes de segurança do paciente entre enfermeiros indonésios. Métodos: este estudo de caso qualitativo foi conduzido entre 15 enfermeiros clínicos selecionados intencionalmente de um hospital público em Lampung, Indonésia. Utilizou-se roteiro de entrevista para a coleta de dados por meio de entrevistas presenciais em profundidade em julho de 2022. A abordagem temática foi utilizada para análise dos dados. Resultados: neste estudo, emergiram sete temas: (1) Compreender a comunicação de incidentes; (2) A cultura; (3) Consequências da notificação; (4) Socialização e treinamento; (5) Instalações; (6) Comentários; e (7) Recompensas e punições. Considerações Finais: esses achados devem ser considerados desafios para o comitê de segurança do paciente e a gestão hospitalar para aumentar a notificação de incidentes de segurança do paciente, principalmente entre os enfermeiros do hospital.

RESUMEN Objetivos: investigar las razones de la baja notificación de incidentes de seguridad del paciente entre las enfermeras de Indonesia. Métodos: este estudio de caso cualitativo se llevó a cabo entre 15 enfermeras clínicas seleccionadas intencionalmente de un hospital público en Lampung, Indonesia. Se utilizó un guión de entrevista para la recolección de datos a través de entrevistas presenciales en profundidad en julio de 2022. Se utilizó el enfoque temático para el análisis de datos. Resultados: en este estudio surgieron siete temas: (1) Comprender la notificación de incidentes; (2) La cultura; (3) Consecuencias de la notificación; (4) Socialización y capacitación; (5) Instalaciones; (6) Comentarios; y (7) Recompensas y Castigos. Consideraciones Finales: estos hallazgos deben ser considerados desafíos para el comité de seguridad del paciente y la gerencia del hospital para aumentar la notificación de incidentes de seguridad del paciente, especialmente entre las enfermeras del hospital.

Perceção dos estudantes de enfermagem sobre a formação pedagógica na prevenção da sintomatologia musculosquelética: estudo qualitativo / Percepción de estudiantes de enfermería sobre la formación pedagógica en la prevención de la Sintomatología Musculoesquelética: estudio cualitativo / Perception of nursing students on pedagogical training in the prevention of musculoskeletal symptomatology: qualitative study

The training of students in higher education and specifically in the nursing degree hasbeen the object of study by the professors. It is part of nursing practice to respect the student's decision-making process and provide the right to information, promoting the acquisition of skills thatallow them to make responsible choices for their future. The objective of this investigation was toknow the perspective of nursing students, regarding their involvement in pedagogical training onmusculoskeletal symptoms. A qualitative, exploratory, and descriptive study was carried out usingthe focus group method with six nursing students. Qualitative analysis was performed accordingto Bardin and the mental map was performed using FreeMind® software. Students revealed satisfaction with the real interest in their learning with reflection on the acquisition of skills in termsof knowledge about musculoskeletal symptoms and the need for critical thinking in the nursingprofession.(AU)

La formación de los estudiantes en la educación superior y específicamente en la licen-ciatura en enfermería ha sido objeto de estudio por parte de los profesores. Es parte de la prácticade enfermería respetar el proceso de toma de decisiones del estudiante y brindarle el derecho a lainformación, promoviendo la adquisición de competencias que le permitan tomar decisiones responsables para su futuro. El objetivo de esta investigación fue conocer la perspectiva de los estudiantes de enfermería, en cuanto a su participación en la formación pedagógica sobre los síntomasmusculoesqueléticos. Sé realizó un estudio cualitativo, exploratorio y descriptivo mediante el método de grupos focales con seis estudiantes de enfermería. El análisis cualitativo se realizó segúnBardin y el mapa mental se realizó con el software FreeMind®.Los estudiantes revelaron satisfacción con el interés real en su aprendizaje con la reflexión sobre la adquisición de habilidades encuanto al conocimiento sobre los síntomas musculoesqueléticos y la necesidad del pensamiento crítico en la profesión de enfermería(AU)

A formação dos estudantes no ensino superior e especificamente no curso licenciatura emenfermagem tem sido objeto de estudo por parte dos professores. Faz parte da prática de enfermagem, respeitar o processo de decisões do estudante e facultar o direito à informação, promovendo aaquisição de competências que permitem realizar escolhas responsáveis para a sua tomada de decisão futura. O objetivo desta investigação foi o conhecer a perspetiva dos estudantes de enfermagem,relativamente ao seu envolvimento na formação pedagógica sobre sintomatologia músculoesquelética. Foi realizado um estudo qualitativo, exploratório e descritivo, através do método de gruposfocais com 6 estudantes de enfermagem. A analise qualitativa foi realizada segundo Bardin e o mapamental através do software FreeMind®. Os estudantes revelaram uma satisfação com o interessereal na sua aprendizagem com reflexão na aquisição de competências ao nível de conhecimentosobre a sintomatologia musculosquelética e a necessidade de um pensamento crítico na profissãode enfermagem.(AU)

Características de los docentes clínicos cirujano-dentistas más valorados por la comunidad odontológica / Characteristics of the most valued surgeon- dentist clinical professors by the odontological community

Introducción: Frente al complejo escenario de la atención clínica odontológica surge la siguiente pregunta: ¿el docente clínico valorado tiene un perfil definido? La búsqueda de un docente clínico ideal para el propósito del logro de competencias en sus estudiantes suele ser una difícil tarea. El objetivo de este estudio es determinar las características de docentes clínicos considerados expertos según la apreciación de la comunidad odontológica.Sujetos y métodos.Se realiza un estudio observacional y descriptivo. El instrumento de recolección consiste en una encuesta aplicada en la Escuela de Odontología de la Pontificia Universidad Católica de Chile, que recoge las cualidades de un docente clínico experto y se aplica a los tres estamentos de la comunidad odontológica: estudiantes, docentes clínicos y directivos.Resultados.Entre los resultados obtenidos se considera que el mayor número de características asociadas a los docentes valorados es de índole personal, y destacan también los aspectos pedagógicos.Conclusiones.Estos antecedentes nos llevan a reflexionar sobre la práctica docente que llevamos a cabo y las necesidades de los estudiantes en la clínica, dando valor al clima de enseñanza-aprendizaje y, en particular, a los aspectos personales del docente clínico. (AU)

Introduction: Faced with the complex scenario in dental clinical care, the following question arises: Does the valued clinical professor have a defined profile? The search for an ideal clinical teacher for the purpose of achieving competencies in their students is usually a difficult task. The objective of this study is to determine the characteristics of clinical teachers considered experts according to the appreciation of the odontological community.Subjects and methods.An observational and descriptive study is carried out. The method used to collect data consists of a survey applied in the School of Dentistry of Universidad Católica de Chile that gathers the qualities of an expert clinical teacher and is applied to the three levels of the odontological community: students, clinical teachers and directors.Results.Among the outcomes, it is considered that the greatest number of characteristics associated with the valued teachers are of a personal nature, and the pedagogical aspects also stand out.Conclusion.These findings leads us to reflect on the teaching-learning practice that we carry out and the needs of the students in the clinic, giving value to the teaching-learning environment, particularly on the personal aspects of the clinical teacher. (AU)

Empoderamiento de las enfermeras durante la pandemia de COVID-19 en una unidad de nueva creación / Empowerment of nurses during the COVID-19 pandemic at a newly created unit

Objetivo: explorar la vivencia de empoderamiento de las enfermeras en una unidad de semicríticos creada durante la primera ola de la pandemia por COVID-19 en el Hospital Fundación Althaia y comprender los factores que influyeron en él. Método: estudio cualitativo de tipo fenomenológico efectuado de marzo a mayo de 2020. Se incluyó a las 25 enfermeras que habían trabajado en la unidad en periodos continuados de, al menos, dos semanas. Se realizó un muestreo intencional de diferentes perfiles demográficos y laborales hasta la saturación de datos. Se llevó a cabo observación participante durante ocho semanas y entrevistas semiestructuradas tras el cierre de la unidad. Se analizó el contenido latente con soporte del software Atlas Ti versión 8.4 y triangulación de investigadoras. Resultados: se entrevistó a ocho enfermeras. Se establecieron 37 códigos distribuidos en nueve agrupaciones y dos temas finales. Refirieron un aumento del empoderamiento. Se identificaron como factores que lo promovieron el trabajo en equipo, el aprendizaje, la toma de conciencia de la visión holística de la Enfermería, el impacto en la organización, el reconocimiento social e institucional y el deber moral. Se encontró como factores que lo dificultaron: el desconocimiento inicial, los recursos materiales y estructurales y el soporte institucional recibido. Conclusiones: se identificaron factores estructurales, psicológicos y relacionales que influyeron en el empoderamiento de las enfermeras. Estos hallazgos pueden contribuir a mejorar la organización de los servicios de salud y los cuidados enfermeros en situaciones similares.(AU)

Objective: to explore the empowerment experience of nurses at a Semi-critical Care Unit created during the first wave of the COVID-19 pandemic at the Fundación Althaia hospital, and to understand the influential factors. Method: a qualitative phenomenological study conducted from March to May 2020. The 25 nurses who had worked in the unit for continuous periods of at least two weeks were included. There was purposive sampling of different demographic and occupational profiles until data saturation. Participant observation was conducted for eight weeks, and semistructured interviews after unit closure. The latent contents were analysed with support by the Atlas Ti software, version 8.4, and investigator triangulation. Results: eight nurses were interviewed; 37 codes were determined, distributed in nine groups and two final subjects. They reported an increase in empowerment. The driving factors for this were identified as: teamwork, learning, awareness of the holistic vision of Nursing, impact on organization, social and institutional recognition, and moral duty. The hindering factors found were: initial lack of knowledge, material and structural resources, and the institutional support received. Conclusions: structural, psychological and relational factors were identified as having impact on nursing empowerment. These findings can contribute to improving the organization of health services and nursing care in similar situations.(AU)

Percepciones del paciente en realimentación tras cirugía colorrectal. Un estudio cualitativo

Introducción: El conocimiento obtenido a partir de las experiencias de los pacientes favorece una atención de calidad. El objetivo de este estudio cualitativo es conocer la percepción de los pacientes sobre su realimentación tras una cirugía colorrectal, y los factores condicionantes en relación con dicho proceso. Material y Método: En base a la directriz de Standards for Reporting Qualitative Research, se realiza un estudio cualitativo a partir de una entrevista de 8 preguntas de término abierto realizada a 20 pacientes seleccionados por un método de variación máxima de muestreo. Se realizó análisis temático. Resultados: Se identificaron cuatro dimensiones principales (con subtemas respectivos) que condicionan la alimentación en el postoperatorio: 1. propósitos del paciente tras la alimentación (búsqueda de alta, hidratación, búsqueda de salud, finalizar ayuno, deambulación); 2. propiedades y características de los alimentos (sazón, presentación, temperatura, porciones, consistencia, favoritos); 3. factores del paciente (físicos, psicológicos); y 4. relación equipo de salud-paciente (confianza, complacencia, información, agradecimiento). Conclusión: El proceso de ingesta de alimentos en este contexto está condicionado por las cuatro dimensiones mencionadas. Sería importante considerarlas al momento de crear y ejecutar pautas y guías de alimentación adaptadas a los pacientes.

Introduction: Knowledge obtained from the experiences of patients favors quality care. The aim of this study is to know the perception of patients regarding refeeding after colorectal surgery, and particular factors that condition postoperative intake from their perspective. Materials and Method: Based on the guideline of Standards for reporting qualitative Research, a qualitative study was constructed from an interview with 8 open-ended questions to 20 patients selected by a maximum sampling variation method. Thematic analysis was carried out. Results: Four main dimensions were identified that determine feeding in the postoperative period: 1. patient's goals after feeding (search for discharge, hydration, search for health, end fasting, ambulation); 2. properties and characteristics of food (seasoning, presentation, temperature, portions, consistency, favorites); 3 patient factors (physical, psychological); and 4. health team-patient relationship (trust, complacency, information, gratitude). Conclusion: The process of food intake in this context is conditioned by the four dimensions mentioned. It would be important to consider them when creating and executing feeding guidelines adapted to patients.

Percepciones del cuidado espiritual de enfermería por pacientes recuperados por Covid-19. Una exploración fenomenológica

Objetivo: Explorar el cuidado espiritual brindado por los profesionales de enfermería en el servicio de emergencia del Hospital General Machala desde la perspectiva de los pacientes infectados por Covid-19. Material y Métodos: Investigación cualitativa, fenomenológica. Se utilizó un muestro intencional para seleccionar a 8 pacientes recuperados por Covid-19. La recolección de los datos se obtuvo mediante entrevistas semiestructurada a profundidad. La transcripción se realizó manualmente lo antes posible. Para el análisis de los datos se utilizó el método creado por Colaizzi. Resultados: Se obtuvieron cuatro categorías principales: 1) Factores de sufrimiento espiritual en los pacientes con Covid-19; 2) Necesidades espirituales de los pacientes con Covid-19; 3) Satisfacción del cuidado espiritual brindado por enfermería; y, 4) Principales barreras percibidas del cuidado Espiritual. Conclusión: Se evidenció que los pacientes recuperados por Covid-19 percibieron experiencias tanto positivas como negativas relacionado con el cuidado espiritual, siendo este un componente clave para evaluar las necesidades espirituales. Sugerimos utilizar los hallazgos encontrados en este estudio para que futuras investigaciones desarrollen un programa estructurado y supervisado por expertos para mejorar el cuidado espiritual en la atención sanitaria.

Objective: To explore the spiritual care provided by the nursing professionals in the emergency service of the Hospital General Machala from the perspective of patients infected by Covid-19. Material and Methods: Qualitative, phenomenological research. An intentional sample was used to select 8 patients recovered from Covid-19. Data collection was obtained through in-depth semi-structured interviews. Transcription was done manually as soon as possible. For data analysis, the method created by Colaizzi was used. Results: Four main categories were obtained: 1) Factors of spiritual suffering in patients with Covid-19; 2) Spiritual needs of Covid-19 patients; 3) Satisfaction of the spiritual care provided by nursing; and, 4) Main barriers perceived to spiritual care. Conclusion: It was shown that patients recovered from Covid-19 perceived both positive and negative experiences related to spiritual care, this being a key component to assess spiritual needs. We suggest using the findings found in this study for future research to develop a structured program supervised by experts to improve spiritual care in health care.

Experiencia del personal sanitario durante la primera ola de Covid-19 en España: un estudio cualitativo con grupos focales / Experience of health workers during the first wave of Covid-19 in Spain: a qualitative study with focus groups

Objetivo: Analizar la experiencia de los profesionales que atendieron en primera línea a los pacientes infectados durante la primera ola de la pandemia de COVID-19. Material y Métodos: Los participantes fueron reclutados entre médicos y enfermeras de varios hospitales y centros de salud en España. Sus narrativas se obtuvieron a través de tres grupos focales. Se empleó la metodología cualitativa, de acuerdo con sus principios exploratorios, inductivos y etnográficos. Resultados: La experiencia del personal sanitario se clasificó en seis categorías: La reacción y organización de los sanitarios, el material y las pruebas, los aspectos emocionales en relación con la asistencia, los conflictos éticos, la gestión sanitaria de la pandemia y el papel social de los sanitarios. Conclusiones: Los sanitarios adoptaron un rol proactivo durante la pandemia. Se señalan las vulnerabilidades y las fortalezas de la asistencia. Los aspectos que tiene que ver con la regulación emocional de los sanitarios resultan claves para el funcionamiento asistencial. (AU)

Objectives: to analyze the experience of health professionals who provided first-line care to infected patients during the COVID-19 pandemic during the first wave. Material and Methods: Participants were recruited from among physicians and nurses in several hospitals and health centers in Spain. Narratives were obtained through three focus groups. Qualitative methodology was used according to exploratory, inductive, and ethnographic principles. Results: The experience of the health personnel was classified into six categories: The reaction and organization of health workers, materials and tests, emotional aspects of care, ethical conflicts, health management of the pandemic, and the social role of health workers. Conclusions: Healthcare workers took a proactive approach during the pandemic. Weaknesses and strengths in the provision of health care were. The capacity of emotional self-regulation of the health care workers is shown to be key to the ability of the health care system to continue operating. (AU)

[A qualitative study on nurses' experiences with social stigma in the context of COVID-19]. / Estudio cualitativo sobre las experiencias de las enfermeras en cuanto a estigma social en el contexto de la COVID-19.

AIM: This study aimed to examine the social stigma experienced by healthcare workers caring for people diagnosed with COVID-19. METHODS: This research employed a qualitative-phenomenological approach. It was conducted at the COVID centers of the Hail region, Kingdom of Saudi Arabia. Both purposive and snowball sampling were used, resulting in 15 participants. However, saturation was identified in the 11th participant. Interviews were conducted online through a Zoom platform, with at least 50min per participant. Thematic analysis was used in analysing the data. RESULTS: The nurses recorded four themes and three subthemes based on one-on-one interviews. These themes included (1) Labeling nurses as "COVID Nurses," with a subtheme of frustration, (2) "Fear of the unknown," with a subtheme of "uncertainties," (3) Nurses' need for support, and (4) the Love for the profession, with a subtheme of "nurses' worth." CONCLUSION: Nurses who cared for patients diagnosed with COVID-19 experienced stigma. They were labeled "COVID Nurses." They experienced fear of the unknown and uncertainties and felt they needed support. Despite these experiences, the nurses felt fulfilled as they have a high regard for their profession. The experiences of these nurses call for intervention to help them before, during, and after any health-related crisis. In this context, nurses will be prepared mentally and emotionally to face the challenges in their career.

Relatos de vida que elaboran personas vegetarianas sobre el acompañamiento y planificación nutricional

RESUMEN Las dietas vegetarianas pueden proveer beneficios para la salud, prevención y tratamiento de enfermedades, siendo adecuadas en todas las etapas del ciclo vital cuando es correctamente asesorada por un profesional especialista en nutrición, entre los que se encuentran las nutricionistas, a fin de prevenir déficits en nutrientes críticos. Debido a esto, resulta relevante identificar la percepción que elaboran sobre el rol del nutricionista las personas vegetarianas que no han contado con asesoría y planificación nutricional profesional. Se realizó un estudio cualitativo centrado en los relatos de vida, donde participaron 10 personas vegetarianas residentes de Coquimbo y La Serena durante el año 2019, seleccionados mediante un muestreo bola de nieve, lo que implicó producir información cualitativa a través de una entrevista semi estructurada. Posteriormente se utilizó análisis cualitativo de contenido, producto de este análisis surgen dos grandes categorías. Como primera categoría el rol biopsicosocial del profesional nutricionista y segunda categoría sugerencias desde los vegetarianos para la atención. Del análisis se destaca la importancia del profesional nutricionista en el abordaje de personas vegetarianas o veganas, quienes esperan de los profesionales un vínculo efectivo con su comunidad mediante instancias de educación alimentaria, asesorías a bajo costo, el desarrollo de competencias técnicas y personales tales como, la actualización continua y la atención empática. Los hallazgos de este estudio pueden ser tomados como guía para la formación y actualización de profesionales, además de proponer medidas nutricionales en el campo de la salud pública y atención contextualizada a personas vegetarianas.

Abstract Vegetarian diets can provide benefits for health, prevention, and treatment of diseases and are appropriate at all stages of the life, when properly advised by specialists in nutrition, to prevent deficits in critical nutrients. Because of this, it is relevant to identify the perception of the role of the nutritionist among vegetarians who have not received professional nutritional advice and planning. A qualitative study focused on life stories was conducted, where 10 vegetarians living in Coquimbo and La Serena participated during 2019, selected through snowball sampling, which involved producing qualitative information through a semi-structured interview. Subsequently, qualitative content analysis was used, and two main categories emerged from this analysis. The first category was the biopsychosocial role of the professional nutritionist, and the second category was suggestions from vegetarians for care. The analysis highlights the importance of the professional nutritionist in the approach to vegetarians or vegans, who expect from professionals an effective link with their community through instances of food education, low-cost advice, the development of technical and personal skills such as continuous updating and empathetic care. The findings of this study can be taken as a guide for the training and updating of professionals, in addition to proposing nutritional measures in the field of public health and contextualized care for vegetarians.

Reações contratransferenciais de psicoterapeutas frente a uma paciente borderline em psicoterapia: um estudo qualitativo / Countertransferential reactions of psychotherapists towards a borderline patient in psychotherapy: a qualitative study

A contratransferência (CT) é um elemento do relacionamento terapêutico que possui valor clínico, especialmente com pacientes com personalidade borderline (PB). Este estudo, qualitativo e exploratório, visou identificar os sentimentos despertados em psicoterapeutas frente a um caso de paciente com PB, buscando compreendê-los em relação às características da paciente ou da sua narrativa, bem como explorar de que forma a CT seria idealmente manejada. Oito psicoterapeutas assistiram ao vídeo de uma sessão real com paciente com PB e, após, responderam a uma entrevista. As transcrições das entrevistas foram analisadas com o método Consensual Qualitative Research (CQR). Os dados organizaram-se em relação às facetas da CT, características da paciente que mobilizam afetos, e manejo da CT. Os resultados sugerem que pacientes com PB tendem a suscitar sentimentos intensos, vinculados a sua história e seu funcionamento em situação observacional, apontando para a viabilidade do método para o estudo empírico da CT. Resultados de estudos como esse podem ser utilizados como guia para jovens terapeutas compreenderem o mundo interno dos seus pacientes. A validação empírica de hipóteses clínicas fortalece a teorização e enriquece a prática psicanalítica.(AU)

Countertransference (CT) is an element of the therapeutic relationship that has clinical value, especially with borderline personality patients (BP). This qualitative and exploratory study aimed to identify the feelings aroused in psychotherapists in the case of a BP patient, seeking to understand them in relation to the patient's characteristics or her narrative, as well as exploring how the CT would be ideally managed. Eight psychotherapists watched the video of a real session with a BP patient and responded to an interview. The interview transcripts were analyzed using the Consensual Qualitative Research (CQR) method. The data were organized in relation to the facets of the CT, characteristics of the patient that mobilize affections, and management of the CT. The results suggest that patients with BP tend to elicit intense feelings, linked to their history and functioning, in an observational situation, pointing to the feasibility of the method for the empirical study of CT. Results from studies like this one can be used as a guide for young therapists to understand the inner world of their patients. Empirical validation of clinical hypotheses strengthens theorization and enriches psychoanalytic practice.(AU)

La contratransferencia (CT) es un elemento de la relación terapéutica que tiene valor clínico, especialmente en pacientes con personalidad límite (BP). Este estudio cualitativo y exploratorio tuvo como objetivo identificar los sentimientos que despiertan los psicoterapeutas en el caso de un paciente con BP, buscando comprenderlos en relación con las características de la paciente o su narrativa, así como explorar cómo se manejaría idealmente la CT. Ocho psicoterapeutas vieron el video de una sesión real y luego respondieron a una entrevista. Las transcripciones de las entrevistas se analizaron utilizando el método de Investigación Cualitativa Consensual (CQR). Los datos se organizaron en relación a las facetas del CT, características del paciente que movilizan afectos y manejo de la CT. Los resultados sugieren que los pacientes con BP tienden a provocar sentimientos intensos, ligados a su historia y funcionamiento, en una situación de observación, lo que apunta a la viabilidad del método para el estudio empírico de la CT. Los resultados de estudios como este pueden usarse como una guía para que los terapeutas jóvenes comprendan el mundo interior de sus pacientes. La validación empírica de hipótesis clínicas fortalece la teorización y enriquece la práctica psicoanalítica.(AU)

Estudio cualitativo sobre las experiencias de las enfermeras en cuanto a estigma social en el contexto de la COVID-19 / A qualitative study on nurses’ experiences with social stigma in the context of COVID-19

Objetivo:El objetivo de este estudio fue examinar el estigma social experimentado por los trabajadores sanitarios que cuidan a las personas diagnosticadas de COVID-19.Métodos:Este estudio utilizó un enfoque cualitativo-fenomenológico, y fue realizado en los centros de COVID-19 de la región de Hail, en el Reino de Arabia Saudita. Se utilizó un muestreo intencional y de bola de nieve, obteniéndose una muestra de 15 participantes. Sin embargo, se identificó saturación en el 11.° participante. Las entrevistas se llevaron a cabo utilizando una plataforma Zoom, empleando al menos 50 minutos por participante. Para analizar los datos se empleó un análisis temático.Resultados:Las enfermeras registraron cuatro temas y tres subtemas basados en entrevistas individuales. Dichos temas incluyeron: (1) el etiquetado de las enfermeras como «enfermeras COVID», con un subtema de frustración; (2) el «miedo a lo desconocido», con un subtema de «incertidumbres»; (3) la necesidad de apoyo de las enfermeras, y (4) el amor por la profesión, con un subtema de «valía de las enfermeras».Conclusión:Las enfermeras que cuidaron a los pacientes diagnosticados de COVID-19 experimentaron estigma. Fueron etiquetadas como «enfermeras COVID». Experimentaron miedo a lo desconocido e incertidumbres, sintiendo que necesitaban apoyo. A pesar de estas experiencias, las enfermeras se sintieron satisfechas, ya que tienen en alta estima su profesión. Las experiencias de dichas enfermeras solicitan una intervención de ayuda antes, durante y después de la crisis sanitaria. En este contexto, las enfermeras estarán preparadas a nivel mental y emocional para enfrentarse a los retos de su carrera.

Aim:This study aimed to examine the social stigma experienced by healthcare workers caring for people diagnosed with COVID-19.Methods:This research employed a qualitative-phenomenological approach. It was conducted at the COVID centers of the Hail region, Kingdom of Saudi Arabia. Both purposive and snowball sampling were used, resulting in 15 participants. However, saturation was identified in the 11th participant. Interviews were conducted online through a Zoom platform, with at least 50min per participant. Thematic analysis was used in analysing the data.Results:The nurses recorded four themes and three subthemes based on one-on-one interviews. These themes included (1) Labeling nurses as “COVID Nurses,” with a subtheme of frustration, (2) “Fear of the unknown,” with a subtheme of “uncertainties,” (3) Nurses’ need for support, and (4) the Love for the profession, with a subtheme of “nurses’ worth.”Conclusion:Nurses who cared for patients diagnosed with COVID-19 experienced stigma. They were labeled “COVID Nurses.” They experienced fear of the unknown and uncertainties and felt they needed support. Despite these experiences, the nurses felt fulfilled as they have a high regard for their profession. The experiences of these nurses call for intervention to help them before, during, and after any health-related crisis. In this context, nurses will be prepared mentally and emotionally to face the challenges in their career.