RESUMO
OBJECTIVE: To measure the impact of the peer-led training for chronic patients on their health status and behaviors. DESIGN: Descriptive, transversal pretest and posttest quantitative approach. PLACEMENT: Andalusia. PARTICIPANTS: Nine hundred sixty-four patients with Diabetes, fibromyalgia and heart failure, trained at the School of Patients between 2013 and 2015. INTERVENTIONS: Peer-training intervention for self-efficacy for chronic patients. MAIN MEASUREMENT: Self-reported health status, activity limitation, diet and physical activity. Statistical analysis included descriptive and bivariate statistics, correlation coefficient and net gains for paired variables. RESULTS: Health status improved after the training, with less limitations and better diet and physical activity, with significant differences by sex, chronic illness, education level and marriage status. Improvement areas where identified for the training strategy, with special attention on the needs of more vulnerable groups (women, people with less education level). CONCLUSIONS: The peer training had a positive impact, with differences depending on social profiles. 1-year and 2-years posttest measurements are needed and a qualitative study is required in order to better evaluate the peer-led strategy and to adapt it to participants' needs and expectations.
Assuntos
Doença Crônica , Comportamentos Relacionados com a Saúde , Nível de Saúde , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupo AssociadoRESUMO
OBJECTIVE: To analyze the language and content of the questionnaire used in the Fertility Survey 2018, from a gender perspective. METHOD: Qualitative design based on a content analysis of the questionnaire used in the Fertility Survey 2018. Methodological recommendations and guides for gender-sensitive statistics were used, together with the comparison established with the Generations and Gender Survey. The categories of analysis were: language, sexual division of labor and fertility. The analysis procedure included the checklist and the incorporation of emerging variables specifically related to gender inequalities and biases. RESULTS: The questionnaire uses with some inclusive language, but maintains the generic use of masculine gender, reproduces gender stereotypes and uses male-female binomials as a single concept. It offers a limited perspective on sexual division of domestic and care labor, horizontal and vertical segregation in the workplace, gender differences between the access and control of resources. In relation to fertility, it reproduces gender inequalities and biases that build a normalized and idealized vision on having children, do not reflect the differential impact of pregnancy and parenting on women's health and prioritize the biological dimension of motherhood and fatherhood. CONCLUSIONS: The Spanish Fertility Survey needs to improve its gender sensitivity, reflect the heterogeneous biological, socio-economic and structural dimensions of fertility and explore deeper into the differential elements that generate inequalities and gender biases.
Assuntos
Fertilidade , Idioma , Criança , Feminino , Humanos , Masculino , Gravidez , Fatores Sexuais , Comportamento Sexual , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
The aim of this study was to assess the psychological impact among healthcare workers who stand in the frontline of the SARS-CoV-2 crisis and to compare it with the rest of healthcare professionals, by means of a systematic review of Western publications. The systematic review was carried out in PubMed, Scopus and Web of Science databases and 12 descriptive studies were reviewed. The European and American quantitative studies reported moderate and high levels of stress, anxiety, depression, sleep disturbance and burnout, with diverse coping strategies and more frequent and intense symptoms among women and nurses, without conclusive results by age. In the first line of assistance the psychological impact was greater than in the rest of the health professionals and in the Asian area. It is necessary to go deeper into the emotional experiences and professional needs for emotional support in order to design effective interventions for protection and help.
El objetivo de este estudio fue conocer el impacto psicológico entre el personal sanitario de primera línea en la asistencia a pacientes con SARS-CoV-2 y compararlo con el resto de profesionales sanitarios, a través de una revisión sistemática de la producción científica en el ámbito occidental. La revisión se realizó en las bases PubMed, Scopus y Web of Science y se seleccionaron 12 artículos. Los estudios cuantitativos realizados en Europa y EE. UU. refirieron niveles moderados y altos de estrés, ansiedad, depresión, alteración del sueño y burnout, con estrategias de afrontamiento diversas y síntomas más frecuentes e intensos entre mujeres y enfermería, sin resultados concluyentes por edad. En la primera línea de asistencia, el impacto fue mayor que en el resto de profesionales sanitarios y que en el ámbito asiático. Se requiere profundizar en las experiencias emocionales y necesidades profesionales de apoyo emocional, para diseñar intervenciones eficaces de protección y ayuda.
RESUMO
OBJECTIVE: To explore women's emotional accounts of induced abortion, analyzing qualitative scientific publications. METHOD: Qualitative systematic review of 19 studies published in PubMed, Science Direct and Scopus from 2010 onwards. The articles based on qualitative research design were revised using inductive content analysis. RESULTS: The analysis identified three main themes regarding women's emotional experiences: access to abortion, emotional impact during medical assistance, and individual, relational and sociocultural determinants. The studies showed the variability in women's emotional accounts, mainly determined by the following factors: Access and waiting times, health system, type of intervention, degree of awareness and participation regarding the use of technical and medical technologies, interaction with health professionals, and specificity of individual, relational and sociocultural context. The main emotional difficulties were related to the ethical conflict, the decision-making, the relation with the social and health system and stigma. As main facilitating aspects, women highlighted autonomy in decision-making and emotional support, while barriers referred to social rejection and negative messages perceived from the political, social and health system. CONCLUSIONS: The emotional accounts around induced abortion depend on individual and relational factors, as well as on health assistance, all mediated by gender inequalities and bias. Improvements in health assistance refer to an integral and individualized attention, adapted to women's needs.
Assuntos
Aborto Induzido , Emoções , Feminino , Pessoal de Saúde , Humanos , Gravidez , Pesquisa Qualitativa , Estigma SocialRESUMO
The aim of this study was to assess the psychological impact among healthcare workers who stand in the frontline of the SARS-CoV-2 crisis and to compare it with the rest of healthcare professionals, by means of a systematic review of Western publications. The systematic review was carried out in PubMed, Scopus and Web of Science databases and 12 descriptive studies were reviewed. The European and American quantitative studies reported moderate and high levels of stress, anxiety, depression, sleep disturbance and burnout, with diverse coping strategies and more frequent and intense symptoms among women and nurses, without conclusive results by age. In the first line of assistance the psychological impact was greater than in the rest of the health professionals and in the Asian area. It is necessary to go deeper into the emotional experiences and professional needs for emotional support in order to design effective interventions for protection and help.
Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , Ansiedade/etiologia , Atenção à Saúde , Depressão/epidemiologia , Depressão/etiologia , Feminino , Pessoal de Saúde , Humanos , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologiaRESUMO
OBJECTIVE: To evaluate a peer-training intervention for women with breast cancer, from a gender perspective: to discover the results of the intervention and examine in-depth the personal experiences of patients and health professionals participating in the training activity. METHOD: Mixed method multicentre design completed in 2017 in Andalusia (Spain), with a pre and post evaluation questionnaire with 102 patients, measuring life style, limitations, use of health services, communication with professionals and self-management; and content analysis of semi-structured interviews and focus groups with 21 patient-trainers and 5 health professionals, looking at experiences, needs and suggestions for improvement. RESULTS: The patients described a good general health status, with improvements of: diet quality (7 in pre-test to 7.7 in post-test), limitations for daily life (from 1.93 to 1.64 points), self-efficacy (from 6.46 to 7.42 points). Age, civil status and level of education generated statistically significant differences, with more improvement in more vulnerable social profiles. Participants revealed the benefits of the peer-training at a personal, relational, psycho-emotional and socio-cultural level and expressed how the training changed their experiences around identity-construction and gender roles. The improvement dimensions related to organization, evaluation and continuity. CONCLUSIONS: The peer-training intervention is a positive experience for women's physical, relational and emotional health and, from a gender perspective, it represents an opportunity, at both individual and group level, to negotiate and deconstruct gender roles when living with breast cancer.
Assuntos
Neoplasias da Mama/terapia , Educação de Pacientes como Assunto/métodos , Grupo Associado , Autocuidado/psicologia , Autoeficácia , Adulto , Idoso , Neoplasias da Mama/psicologia , Doença Crônica , Feminino , Pessoal de Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Participação do Paciente , Pesquisa Qualitativa , Apoio Social , EspanhaRESUMO
BACKGROUND AND OBJECTIVE: To look at transplant coordinators' professional narratives and explore their emotional experiences, coping strategies, needs and demands in relation to the donation interview. MATERIALS AND METHODS: Exploratory, transversal, multicenter design, using grounded theory, qualitative approach and content analysis of open-ended questionnaire and semistructured interviews with 22 transplant coordinators from the Andalusian Public Health System. Categories of analysis: Transplant coordination: perceptions, functions, impact and consequences; Positive/gratifying aspects and negative/ difficult aspects; Donation interview; Coping strategies; Needs, demands and suggestions. RESULTS: Transplant coordinators maintain a polarized perspective on their work, which they describe as a challenge and an opportunity. They highlight both their satisfaction and professional commitment as their work difficulties and requirements, which represent stress factors with an impact on professionals' perceptions, life styles, identity or physical and psychical life. Most gratifying work aspects refer to professional excellence, successful transplants and relationship with patients and their families. The donation interview is considered to be the most stressful moment, in response to which coordinators develop different emotional paths, conditioned by their experience, families' response to donation and its interpretation by the health team and professional (self) evaluation. Main professional demands are training strategies, group therapies and institutional support. CONCLUSIONS: The complexity and emotional intensiveness of transplant coordination require special interventions aiming to enable professionals towards an improvement of their emotional heath and management.
Assuntos
Emoções , Satisfação no Emprego , Transplante de Órgãos/psicologia , Papel Profissional , Obtenção de Tecidos e Órgãos , Adulto , Estudos Transversais , Feminino , Teoria Fundamentada , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Relações Profissional-Família , Pesquisa QualitativaRESUMO
INTRODUCTION: The objective was to explore, discuss and synthesize the emotional experiences of health professionals during the process of organ procurement and transplantation. METHODS: A systematic review was made in Medline, Science Direct and the Virtual Library of the Andalusian Public Health System, selecting 16 original articles for inclusion in the review, with qualitative evaluation and narrative synthesis. RESULTS: The results revealed the main use of qualitative methodology, and 4emergent themes were identified: working in organ procurement and transplantation; the transition of professional roles; emotional experiences; and, coping strategies and emotional management. This systematic review revealed the complex and diverse character of professionals' emotional experiences as well as the importance of the interpersonal relationship. CONCLUSIONS: Intense emotional experiences related to the sense of responsibility, the work challenge and coping strategies based on reward searching explained important contradictions and tensions about professional roles and functions, especially during the donation interview.
Assuntos
Atitude do Pessoal de Saúde , Transplante de Órgãos/psicologia , Obtenção de Tecidos e Órgãos/métodos , Adaptação Psicológica , Emoções , Humanos , Estresse Ocupacional/etiologia , Transplante de Órgãos/métodosRESUMO
El artículo analiza la representación de la relación médico-paciente en artículos publicados en el periódico ABC y explora la producción de significados de género del encuentro terapéutico durante los años ochenta, una etapa de renovación y cambios estructurales en la asistencia sanitaria española. El análisis histórico del discurso periodístico en ABC reveló la proyección social de una relación médico-paciente como acto humanitario y de amor, según los testimonios de los médicos que contribuyeron al debate en este medio y que, con frecuencia, mostraron su resistencia ante la reforma sanitaria y la preocupación por los cambios estructurales, así como por la organización y calidad de la asistencia. La crítica a la desnaturalización y burocratización de la relación médico-paciente fue secundada, a partir de 1984, por pacientes y periodismo especializado. Sus opiniones contrarias a la Ley de Sanidad de 1986 se agudizaron ante el amparo que la norma daba a los derechos de los pacientes. Las líneas discursivas conservadoras del ABC reflejaron la resistencia simbólica ante la reforma sanitaria, la moralización de la salud-enfermedad, la hegemonía de la profesionalización médica masculina y la invisibilización y subalternidad de las mujeres sanitarias.(AU)
The article analyzes the representation of the doctor-patient relationship in articles published in ABC newspaper and explores the production of gender meanings of the therapeutic encounter during the eighties, a period of renewal and structural changes in Spanish health care. The historical analysis of ABC journalistic discourse revealed the social projection of a doctor-patient relationship as a humanitarian act of love, according to the testimonies of the doctors. They frequently showed their resistance to health reform and concern for the changes in structural reorganization and quality of care. From 1984, patients and some journalists also criticize the bureaucratization of the doctor-patient relationship. The protection that the 1986 Health Law gave to the patients rights increased published opinions against the Health Law. The conservative discursive lines of the ABC reflected the symbolic resistance to health reform, the moralization of health-disease, the hegemony of male medical professionalization and the invisibility and subalternity of female health workers.(AU)
Assuntos
Humanos , Masculino , Feminino , Relações Médico-Paciente , História do Século XX , Democracia , Qualidade da Assistência à Saúde , Sistemas de Saúde , Espanha , História da MedicinaRESUMO
Objetivo: Analizar el lenguaje y el contenido del cuestionario utilizado en la Encuesta de Fecundidad 2018 en España, desde una perspectiva de género. Método: Diseño cualitativo basado en el análisis de contenido del cuestionario empleado en la Encuesta de Fecundidad 2018, utilizando recomendaciones y guías metodológicas para estadísticas con perspectiva de género y la comparación con el cuestionarioGenerations and Gender Survey.Las categorías de análisis fueron: lenguaje, división sexual del trabajo y fecundidad. El procedimiento de análisis se basó en comprobar las variables incluidas en las guías a modo de lista de comprobación(checklist)e incorporando variables emergentes específicamente relacionadas con desigualdades y sesgos de género. Resultados: El cuestionario emplea algunos términos inclusivos, pero mantiene el uso del masculino como genérico, reproduce estereotipos de género y engloba binomios masculino-femenino en un concepto único. Identifica de manera limitada la división sexual del trabajo doméstico y de cuidados, la segregación horizontal y vertical en el ámbito laboral, y las diferencias por sexo entre acceso y control de los recursos. En relación con la fecundidad, reproduce desigualdades y sesgos de género que construyen una visión normalizada e idealizada sobre el hecho de tener descendencia, invisibilizan el impacto diferencial del embarazo y la crianza para la salud de las mujeres y priorizan la dimensión biológica de la maternidad y la paternidad. Conclusiones: La Encuesta de Fecundidad requiere mejorar su sensibilidad de género, recoger la diversidad de factores biológicos, socioeconómicos y estructurales condicionantes de la fecundidad, y profundizar en los elementos diferenciales generadores de desigualdades y sesgos de género. (AU)
Objective: To analyze the language and content of the questionnaire used in the Fertility Survey 2018, from a gender perspective. Method: Qualitative design based on a content analysis of the questionnaire used in the Fertility Survey 2018. Methodological recommendations and guides for gender-sensitive statistics were used, together with the comparison established with the Generations and Gender Survey. The categories of analysis were: language, sexual division of labor and fertility. The analysis procedure included the checklist and the incorporation of emerging variables specifically related to gender inequalities and biases. Results: The questionnaire uses with some inclusive language, but maintains the generic use of masculine gender, reproduces gender stereotypes and uses male-female binomials as a single concept. It offers a limited perspective on sexual division of domestic and care labor, horizontal and vertical segregation in the workplace, gender differences between the access and control of resources. In relation to fertility, it reproduces gender inequalities and biases that build a normalized and idealized vision on having children, do not reflect the differential impact of pregnancy and parenting on women's health and prioritize the biological dimension of motherhood and fatherhood. Conclusions: The Spanish Fertility Survey needs to improve its gender sensitivity, reflect the heterogeneous biological, socio-economic and structural dimensions of fertility and explore deeper into the differential elements that generate inequalities and gender biases. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Sexismo , 57425 , Perspectiva de Gênero , Fertilidade , Inquéritos e Questionários , Espanha , Inquéritos EpidemiológicosRESUMO
Objetivo: Explorar las vivencias emocionales de las mujeres en torno a la interrupción voluntaria del embarazo (IVE) a través de la producción científica cualitativa existente. Método: Revisión sistemática cualitativa basada en la búsqueda bibliográfica de estudios publicados desde 2010 en PubMed, Science Direct y Scopus. Se incluyeron 19 artículos con diseño cualitativo que se revisaron usando análisis de contenido de tipo inductivo. Resultados: Se identificaron tres temas principales en torno a las experiencias emocionales: acceso a la IVE, impacto emocional durante la asistencia sanitaria y aspectos individuales, relacionales y socioculturales condicionantes de la vivencia. Los estudios mostraron la variabilidad de las experiencias emocionales, con los siguientes factores determinantes: acceso y tiempos de espera, características y funcionamiento del sistema sanitario, procedimiento de intervención, grado de presencia y participación de las pacientes en relación a aspectos técnicos y uso de tecnologías médicas, interacción con el personal sanitario y aspectos individuales, relacionales y socioculturales específicos. Las principales dificultades emocionales se relacionaron con el conflicto ético, la toma de decisiones, la relación con el entorno social y sanitario, y la experiencia del estigma. Como elementos facilitadores se refirieron la autonomía en la toma de decisiones y el apoyo emocional; como barreras, las manifestaciones del rechazo social y los mensajes negativos del entorno político, sanitario y sociofamiliar. Conclusiones: Las experiencias emocionales en la IVE dependen de factores individuales, relacionales y asistenciales, vertebrados por desigualdades y sesgos de género. En el ámbito asistencial, el potencial de mejora reside en una atención sanitaria integral e individualizada, adaptada a las necesidades de las pacientes. (AU)
Objective: To explore women's emotional accounts of induced abortion, analyzing qualitative scientific publications.Method: Qualitative systematic review of 19 studies published in PubMed, Science Direct and Scopus from 2010 onwards. The articles based on qualitative research design were revised using inductive content analysis. Results: The analysis identified three main themes regarding women's emotional experiences: access to abortion, emotional impact during medical assistance, and individual, relational and sociocultural determinants. The studies showed the variability in women's emotional accounts, mainly determined by the following factors: Access and waiting times, health system, type of intervention, degree of awareness and participation regarding the use of technical and medical technologies, interaction with health professionals, and specificity of individual, relational and sociocultural context. The main emotional difficulties were related to the ethical conflict, the decision-making, the relation with the social and health system and stigma. As main facilitating aspects, women highlighted autonomy in decision-making and emotional support, while barriers referred to social rejection and negative messages perceived from the political, social and health system. Conclusions: The emotional accounts around induced abortion depend on individual and relational factors, as well as on health assistance, all mediated by gender inequalities and bias. Improvements in health assistance refer to an integral and individualized attention, adapted to women's needs. (AU)
Assuntos
Humanos , Feminino , Gravidez , Aborto Induzido , Emoções , Pessoal de Saúde , Pesquisa Qualitativa , Estigma SocialRESUMO
El objetivo de este estudio fue conocer el impacto psicológico entre el personal sanitario de primera línea en la asistencia a pacientes con SARS-CoV-2 y compararlo con el resto de profesionales sanitarios, a través de una revisión sistemática de la producción científica en el ámbito occidental. La revisión se realizó en las bases PubMed, Scopus y Web of Science y se seleccionaron 12 artículos. Los estudios cuantitativos realizados en Europa y EE. UU. refirieron niveles moderados y altos de estrés, ansiedad, depresión, alteración del sueño y burnout, con estrategias de afrontamiento diversas y síntomas más frecuentes e intensos entre mujeres y enfermería, sin resultados concluyentes por edad. En la primera línea de asistencia, el impacto fue mayor que en el resto de profesionales sanitarios y que en el ámbito asiático. Se requiere profundizar en las experiencias emocionales y necesidades profesionales de apoyo emocional, para diseñar intervenciones eficaces de protección y ayuda. (AU)
The aim of this study was to assess the psychological impact among healthcare workers who stand in the frontline of the SARS-CoV-2 crisis and to compare it with the rest of healthcare professionals, by means of a systematic review of Western publications. The systematic review was carried out in PubMed, Scopus and Web of Science databases and 12 descriptive studies were reviewed. The European and American quantitative studies reported moderate and high levels of stress, anxiety, depression, sleep disturbance and burnout, with diverse coping strategies and more frequent and intense symptoms among women and nurses, without conclusive results by age. In the first line of assistance the psychological impact was greater than in the rest of the health professionals and in the Asian area. It is necessary to go deeper into the emotional experiences and professional needs for emotional support in order to design effective interventions for protection and help. (AU)
Assuntos
Humanos , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Infecções por Coronavirus/epidemiologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Depressão/epidemiologia , Depressão/etiologia , Pessoal de Saúde , Pandemias , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologiaRESUMO
OBJETIVO: Evaluar una actividad formativa entre iguales para pacientes con cáncer de mama desde la perspectiva de género; conocer los resultados y profundizar en las experiencias de pacientes y profesionales sanitarios participantes. MÉTODO: Diseño multicéntrico mixto (Andalucía, 2017) con un cuestionario de evaluación pretest/postest con 102 pacientes formadas, midiendo hábitos de vida, limitaciones, uso y comunicación con los servicios sanitarios, y autocuidados; y con un análisis de contenido de entrevistas individuales y grupales (con 21 pacientes formadoras y 5 profesionales), centradas en experiencias, necesidades y propuestas de mejora. RESULTADOS: Las pacientes describen una buena salud general, con mejoras en dieta (7 a 7,7 de prestest a postest), limitaciones (se redujeron de 1,93 a 1,64 puntos) y autoeficacia (aumentó de 6,46 a 7,42 puntos), con diferencias significativas por edad, estado civil y nivel de estudios (mayor mejoría entre los perfiles más vulnerables). Las participantes reflejaron los beneficios de la formación en los aspectos personal, relacional, psicoemocional y sociocultural, y expresaron cambios en sus modelos identitarios y de vivencias de roles de género tras la formación. Los ámbitos de mejora fueron las cuestiones organizativas, de evaluación y continuidad de la estrategia formativa. CONCLUSIONES: La estrategia formativa es una experiencia con resultados positivos en la salud física, relacional y emocional de las participantes, y desde la perspectiva de género se constituye como una oportunidad, individual y compartida, para (re)negociar o deconstruir roles de género, en torno a la experiencia del cáncer de mama
OBJECTIVE: To evaluate a peer-training intervention for women with breast cancer, from a gender perspective: to discover the results of the intervention and examine in-depth the personal experiences of patients and health professionals participating in the training activity. METHOD: Mixed method multicentre design completed in 2017 in Andalusia (Spain), with a pre and post evaluation questionnaire with 102 patients, measuring life style, limitations, use of health services, communication with professionals and self-management; and content analysis of semi-structured interviews and focus groups with 21 patient-trainers and 5 health professionals, looking at experiences, needs and suggestions for improvement. RESULTS: The patients described a good general health status, with improvements of: diet quality (7 in pre-test to 7.7 in post-test), limitations for daily life (from 1.93 to 1.64 points), self-efficacy (from 6.46 to 7.42 points). Age, civil status and level of education generated statistically significant differences, with more improvement in more vulnerable social profiles. Participants revealed the benefits of the peer-training at a personal, relational, psycho-emotional and socio-cultural level and expressed how the training changed their experiences around identity-construction and gender roles. The improvement dimensions related to organization, evaluation and continuity. CONCLUSIONS: The peer-training intervention is a positive experience for women's physical, relational and emotional health and, from a gender perspective, it represents an opportunity, at both individual and group level, to negotiate and deconstruct gender roles when living with breast cancer
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/epidemiologia , Autogestão/educação , Educação em Saúde/métodos , Avaliação de Eficácia-Efetividade de Intervenções , Perspectiva de Gênero , Educação de Pacientes como Assunto/organização & administração , Autoeficácia , Inquéritos e Questionários/estatística & dados numéricosRESUMO
OBJETIVO: Evaluar el impacto de la formación entre iguales de la Escuela de Pacientes sobre la salud autopercibida y los hábitos de vida de las personas con enfermedades crónicas. DISEÑO: Descriptivo, transversal de evaluación cuantitativa pretest/postest. EMPLAZAMIENTO: Andalucía. PARTICIPANTES: Novecientos sesenta y cuatro pacientes con diabetes, fibromialgia e insuficiencia cardíaca participantes en la Escuela de Pacientes entre 2013 y 2015. INTERVENCIONES: Sesión de formación para formadores en autocuidados para personas con enfermedades crónicas. Mediciones principales: Se usó un cuestionario que midió salud autopercibida, limitaciones, dieta y actividad física. El análisis estadístico fue descriptivo, bivariante, de correlaciones y de ganancias netas. RESULTADOS: Tras realizar la formación se observó una mejoría de la salud, con menos limitaciones y mejor dieta y ejercicio físico, con diferencias estadísticamente significativas en función del sexo, enfermedad, nivel de estudios y estado civil. Se plantean propuestas de mejora de la estrategia formativa, con atención a las necesidades específicas de los colectivos más vulnerables: mujeres y personas con menor nivel educativo. CONCLUSIONES: El impacto de la formación fue positivo y diferencial en función de los perfiles de participantes. Se recomienda profundizar en los resultados, a través de metodología cualitativa, realizar mediciones postest posteriores y adaptar la estrategia formativa a la heterogeneidad de las necesidades de la población formada
OBJECTIVE: To measure the impact of the peer-led training for chronic patients on their health status and behaviors. DESIGN: Descriptive, transversal pretest and posttest quantitative approach. PLACEMENT: Andalusia. PARTICIPANTS: Nine hundred sixty-four patients with Diabetes, fibromyalgia and heart failure, trained at the School of Patients between 2013 and 2015. INTERVENTIONS: Peer-training intervention for self-efficacy for chronic patients. Main measurement: Self-reported health status, activity limitation, diet and physical activity. Statistical analysis included descriptive and bivariate statistics, correlation coefficient and net gains for paired variables. RESULTS: Health status improved after the training, with less limitations and better diet and physical activity, with significant differences by sex, chronic illness, education level and marriage status. Improvement areas where identified for the training strategy, with special attention on the needs of more vulnerable groups (women, people with less education level). CONCLUSIONS: The peer training had a positive impact, with differences depending on social profiles. 1-year and 2-years posttest measurements are needed and a qualitative study is required in order to better evaluate the peer-led strategy and to adapt it to participants' needs and expectations
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Comportamentos Relacionados com a Saúde , Nível de Saúde , Educação de Pacientes como Assunto/métodos , Estudos Transversais , Necessidades e Demandas de Serviços de Saúde , Grupo AssociadoRESUMO
Introducción: El objetivo de este artículo fue explorar, analizar y sintetizar las experiencias emocionales de profesionales sanitarios de donación y trasplantes. Método: Se realizó una revisión sistemática cualitativa en Medline, Science Direct y la Biblioteca Virtual del Sistema Sanitario Público de Andalucía. Se seleccionaron 16 artículos originales, realizando una evaluación cualitativa y síntesis narrativa. Resultados: Se identificó el uso mayoritario de métodos cualitativos y 4 temáticas emergentes: trabajar en donaciones y trasplantes; la transición de roles profesionales; vivencias emocionales, y afrontamiento y mejora de la gestión emocional. Se reflejaron la complejidad y la pluralidad de las vivencias emocionales y la centralidad del enfoque relacional. Conclusiones: Las intensas experiencias emocionales en torno a la responsabilidad vivida, la asunción del trabajo como un gran reto y la búsqueda de recompensas como principal estrategia de afrontamiento aparecieron como factores explicativos de importantes contradicciones y tensiones de roles y funciones, con especial relevancia durante la entrevista de donación
Introduction: The objective was to explore, discuss and synthesize the emotional experiences of health professionals during the process of organ procurement and transplantation. Methods: A systematic review was made in Medline, Science Direct and the Virtual Library of the Andalusian Public Health System, selecting 16 original articles for inclusion in the review, with qualitative evaluation and narrative synthesis. Results: The results revealed the main use of qualitative methodology, and 4emergent themes were identified: working in organ procurement and transplantation; the transition of professional roles; emotional experiences; and, coping strategies and emotional management. This systematic review revealed the complex and diverse character of professionals emotional experiences as well as the importance of the interpersonal relationship. Conclusions: Intense emotional experiences related to the sense of responsibility, the work challenge and coping strategies based on reward searching explained important contradictions and tensions about professional roles and functions, especially during the donation interview
Assuntos
Humanos , Atitude do Pessoal de Saúde , Transplante de Órgãos/psicologia , Obtenção de Tecidos e Órgãos/métodos , Adaptação Psicológica , Emoções , Esgotamento Profissional/etiologia , Transplante de Órgãos/métodosRESUMO
OBJECTIVE: To identify the attributes used by chronically-ill patients to describe physicians' competence in the public healthcare system in Andalucia. METHODS: A total of 147 chronically-ill patients and their relatives were included in this qualitative study. Focal groups and in-depth interviews were performed in health centers and outpatient centers in Granada, Malaga, Seville, Cadiz and Cordoba between 2007 and 2008. Content analysis was carried out using Nudist Vivo. RESULTS: The participants defined medical competence as combining elements of technical ability and knowledge (awareness of and interest in the disease, continuity of follow-up and requesting specific tests) with interpersonal skills related to communication, information (informing, listening, trust, prompting questions) and attention (courtesy, cordiality, respect, interest and approachability). Primary care was expected to provide a close relationship, personalized treatment, information, drug prescription, and referral to specialized care. Specialized care was expected to provide an accurate diagnosis and appropriate treatment, information and follow-up. Highly valued aspects of emergency care were symptom relief, accurate diagnosis, referral to specialists and courtesy. CONCLUSIONS: Chronically-ill patients based their evaluation of medical competence on technical and interpersonal skills.
Assuntos
Doença Crônica , Competência Clínica , Satisfação do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atenção à Saúde , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários , Terminologia como Assunto , Adulto JovemRESUMO
ANTECEDENTES Y OBJETIVO: Conocer las experiencias en la práctica profesional de equipos de coordinación de trasplantes y explorar sus vivencias emocionales, estrategias de afrontamiento, necesidades y demandas en relación con la entrevista de donación. MATERIALES Y MÉTODOS: Diseño exploratorio, transversal, multicéntrico, con metodología cualitativa, basado en la teoría fundamentada y análisis de contenido de cuestionarios con preguntas abiertas y entrevistas semiestructuradas, realizado con 22 profesionales pertenecientes a equipos de coordinación de trasplantes del Sistema Sanitario Público de Andalucía. Las categorías empleadas en el análisis fueron: trabajo de coordinación: percepciones, funciones, impacto y consecuencias; aspectos positivos/gratificantes y negativos/difíciles de la coordinación de trasplantes; la entrevista de donación; estrategias de afrontamiento; necesidades, demandas y propuestas. RESULTADOS: Los equipos de coordinación de trasplantes tienen una visión polarizada sobre su trabajo, que describen como reto y oportunidad, evidenciando, por una parte, su satisfacción y compromiso profesional y, por otra parte, las dificultades y exigencias que representan factores de estrés con impacto en sus percepciones, estilos de vida, identidad profesional o salud física y psíquica. Los aspectos más gratificantes se relacionan con la excelencia profesional, trasplantes exitosos y la relación con pacientes y familiares. La entrevista de donación es el momento de mayor estrés, ante el cual se generan diferentes rutas emocionales, condicionadas por la experiencia en la coordinación, la respuesta familiar y su interpretación y la autoevaluación profesional. Las principales demandas profesionales se orientan hacia estrategias formativas, terapia grupal y apoyo institucional. CONCLUSIONES: Ante la complejidad e intensidad emocional del trabajo de coordinación, se requieren intervenciones de capacitación para mejorar la salud y gestión emocional de sus profesionales
BACKGROUND AND OBJECTIVE: To look at transplant coordinators professional narratives and explore their emotional experiences, coping strategies, needs and demands in relation to the donation interview. MATERIALS AND METHODS: Exploratory, transversal, multicenter design, using grounded theory, qualitative approach and content analysis of open-ended questionnaire and semistructured interviews with 22 transplant coordinators from the Andalusian Public Health System. Categories of analysis: Transplant coordination: perceptions, functions, impact and consequences; Positive/gratifying aspects and negative/ difficult aspects; Donation interview; Coping strategies; Needs, demands and suggestions. RESULTS: Transplant coordinators maintain a polarized perspective on their work, which they describe as a challenge and an opportunity. They highlight both their satisfaction and professional commitment as their work difficulties and requirements, which represent stress factors with an impact on professionals' perceptions, life styles, identity or physical and psychical life. Most gratifying work aspects refer to professional excellence, successful transplants and relationship with patients and their families. The donation interview is considered to be the most stressful moment, in response to which coordinators develop different emotional paths, conditioned by their experience, families' response to donation and its interpretation by the health team and professional (self) evaluation. Main professional demands are training strategies, group therapies and institutional support. CONCLUSIONS: The complexity and emotional intensiveness of transplant coordination require special interventions aiming to enable professionals towards an improvement of their emotional heath and management
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Emoções , Satisfação no Emprego , Transplante de Órgãos/psicologia , Papel Profissional , Obtenção de Tecidos e Órgãos , Estudos Transversais , Teoria Fundamentada , Estilo de Vida , Relações Profissional-Família , Pesquisa QualitativaRESUMO
Objetivo: Analizar opiniones de menores sobre el concepto de salud, centros y profesionales sanitarios así como recomendaciones en forma de consejos sobre promoción de salud. Métodos: Estudio transversal con cuestionario online dirigido a menores de 14 años de edad. Se utilizó una versión adaptada del cuestionario Kid's Hospital, el cual contiene preguntas abiertas y cerradas. Resultados: Contestaron al cuestionario 358 menores, de los cuales 225 fueron niñas (61,3%). La edad media global fue de 9,2(DE 2,61). Asocian buena salud con la ausencia de enfermedad (n=165, 46,1%) y estar en forma (n=151, 42,2%) ; sobre experiencias de la última visita al médico, reconocen el papel de ayuda y mediación de estos profesionales (n=233, 65,1%); destacan la ayuda y la recuperación como lo mejor de la atención, y como lo peor los pinchazos y el dolor padecido. De los consejos emitidos para promoción de salud destacan aquellos sobre alimentación (n=233, 62,3%). Conclusiones: Los cuestionarios online a menores, constituyen una forma útil de recolección de información. Así, estas consultas directas permiten la participación de los niños y niñas o de los menores y proporcionan información útil para adecuar las intervenciones de cara a fomentar la promoción entre iguales, así como sobre sus preferencias en el diseño de intervenciones.
Objective: To analyze opinions of minors regarding the concept of health, health centers, and professionals, as well as providing them with recommendations on health promotion in the form of health promotion advice. Methods: A cross-sectional survey with an online questionnaire aimed to kids below 14. An adapted version of Kid's Hospital questionnaire was utilized, which has both open and closed questions. Results: 358 minors answered the questionnaire, 225 of which were girls (61.3%). The mean global age was 9.2 years (SD 2.61). They associated good health with the absence of illnesses (n=165, 46.1%) and being in shape (n=151, 42.2%). Regarding their experiences about their last doctor's appointment, they acknowledged the aiding and mediation role of these professionals as the best features of the assistance (n=233, 65.1%) and the pain suffered and syringe jabs as the worst ones. They also highlighted healthy eating advice from the health promotion advice given (n=233, 62.3%). Discussion: Online questionnaires for minors are a useful data collection tool. These direct queries allow them to participate and provide useful information to adequate medical interventions in order to develop actions for health promotion, as well as taking their opinions into account when designing interventions.
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Objetivos: El consumo de alcohol entre jóvenes es un problema de salud pública, condicionado en gran parte por los medios de comunicación y la publicidad. El objetivo de este estudio es analizar los mensajes publicitarios de alcohol difundidos en radio y televisión en España y conocer su potencial influencia en los adolescentes. Métodos: Análisis cuantitativo y cualitativo de la publicidad emitida en radio y TV, entre 1 de diciembre de 2006 y 9 de enero de 2007, a través de los siguientes pasos: seleccionar emisoras y canales TV; identificar y grabar la publicidad de programas de radio y TV dirigidos a los y las adolescentes; seleccionar y analizar los spots y cuñas radiofónicas. Las variables del estudio cuantitativo han sido: minutos dedicados a la publicidad de alcohol; análisis de audiencias en la población adolescente; y análisis del número de cuñas emitidas. La parte cualitativa se ha centrado en: marca y eslogan, público al que se dirige, estética, protagonistas del anuncio, valores que se transmiten, carga emocional del mensaje. Resultados: Se detectan 914 anuncios publicitarios de bebidas alcohólicas en TV. El 100% de los programas y eventos deportivos analizados presentan marcas de alcohol. El 26% de los spots y el 50% de las cuñas radiofónicas se dirigen específicamente a los jóvenes y todos muestran una imagen positiva del alcohol, valores de libertad, rebeldía y éxito. Conclusiones: Los adolescentes están expuestos a recurrentes mensajes positivos sobre el alcohol. La información y prevención son medidas claves para combatir la convivencia naturalizada con el alcohol
Objective: Alcohol drinking among adolescents is a problem of public health and it is highly conditioned by media and advertising. The objective of this study is to analyze Spanish television and radio alcohol advertising and promotions and to identify their potential influence on adolescents. Methods: A qualitative and quantitative analysis was made of radio and TV alcohol advertising, emitted between 1 December 2006 and 9 January 2007. The methodological steps were: channel and radio station selection; recording of radio and TV programmes directed to adolescents; selection and analysis of TV and radio spots. The variables in the quantitative analysis were: minutes of advertising, audience analysis in the young people; number of radio spots. The qualitative study referred to: brand and slogan, public to which it is directed, advertising protagonists, values and emotional content of the message. anuncio Results: There were identified 914 TV alcohol advertising. 100% of analyzed programs and sport events included alcohol advertise, with spots being the most usual strategy. 26% of spots were specifically directed to adolescents and all showed a positive image of alcohol. 50% of radio commercials sent values like freedom, diversion, social and sexual success. Conclusions: Adolescents are exposed to recurrent positive messages about alcohol, so information and prevention turn extremely important to reduce the naturalized image of alcohol drinking
Assuntos
Humanos , Masculino , Feminino , Adolescente , Publicidade/legislação & jurisprudência , Publicidade , Controle da Publicidade de Produtos , Bebidas Alcoólicas/estatística & dados numéricos , Bebidas Alcoólicas , Comportamento do Adolescente/psicologia , Psicologia do Adolescente/organização & administração , Psicologia do Adolescente/estatística & dados numéricos , Medicina Preventiva/organização & administração , Alcoolismo/prevenção & controle , Saúde Pública/métodos , Saúde Pública/tendências , Mídia Audiovisual/ética , Mídia Audiovisual/legislação & jurisprudência , Mídia Audiovisual/normas , 25783/métodos , 24960/métodos , 24960/estatística & dados numéricosRESUMO
Justificación: La epidemia de gripe H1N1 marcó el mapa sanitario epidemiológico del invierno 2009-2010. Objetivo: Conocer las opiniones de la población general, de los grupos de riesgo y del personal sanitario, sobre la epidemia de gripe. Diseño: cualitativo, estudio exploratorio. Metodología: 10 grupos focales en 3 CCAA, con 51 participantes. Análisis de contenido. Resultados principales: Las actitudes y opiniones de la población general y de los grupos de riesgo evolucionan a lo largo del proceso, desde un estado de preocupación inicial motivado por la sobreinformación y estado de alerta impulsado desde los medios de comunicación, hacia la reducción de la percepción de riesgo, la falta de confianza en las fuentes de información y la necesidad de mayor implicación de las autoridades y fuentes formales. Conclusión: Las autoridades deben apoyarse en sistemas de información avanzados, preparar al personal sanitario, coordinar e implicar a todos los sectores (AU)
Introduction: The H1N1 influenza pandemic of 2009-2010 has important health, social and media repercussions. Objective: to identify the opinions of the general population, risk groups and medical personnel on the 2009-2010 influenza epidemic. Design: Exploratory study, qualitative methodology. Methods: 10 focus groups in 3 Spanish regions with 51 participants. Content analysis. Main results: The attitudes and opinions of the general population and risk groups gradually change from a state of initial concern, caused by the social alert promoted by the media to a reduced perceived risk. The lack of trust in the information sources and the need for a greater involvement of the authorities also appear. Conclusion: The authorities must rely on advanced information systems, train personnel of health services and organize their work on coordination and involvement of all sectors (AU)