Family Caregivers' Experiences during the COVID-19 Pandemic: Qualitative Study.

Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers' context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in the community during the pandemic. Design: Qualitative research, phenomenological approach. Setting: Primary healthcare centers in Madrid region (Spain). Participants: 21 family caregivers. Methods: Purposive and theoretical sampling was used to recruit caregivers across nurses from primary healthcare centers. Participants were interviewed using a semi-structured interview guide to explore the caring experience. Interview transcripts were evaluated using thematic analysis. Results: The findings were categorized into two themes: "Caregivers during lockdown-providing care in a time of adversity" and "Caregiving toward normality". The sub-themes identified were the re-structuring of before-care services and the introduction of new care approaches, managing the dependent person's health problems, looking after oneself, and dealing with adversity. To adapt to the new normal, strategies were put in place designed to recover confidence and trust, reincorporate assistance, and reconnect with others. Conclusions: Care intensified during the pandemic. Caregivers took on the task without assistance, focusing on preventing contagion and protecting themselves to be able to continue giving care.

Socially assistive robots in health and social care: Acceptance and cultural factors. Results from an exploratory international online survey.

AIM: This study explored the views of an international sample of registered nurses and midwives working in health and social care concerning socially assistive robots (SARs), and the relationship between dimensions of culture and rejection of the idea that SARs had benefits in these settings. METHODS: An online survey was used to obtain rankings of (among other topics) the extent to which SARs have benefits for health and social care. It also asked for free text responses regarding any concerns about SARs. RESULTS: Most respondents were overwhelmingly positive about SARs' benefits. A small minority strongly rejected this idea, and qualitative analysis of the objections raised by them revealed three major themes: things might go wrong, depersonalization, and patient-related concerns. However, many participants who were highly accepting of the benefits of SARs expressed similar objections. Cultural dimensions of long-term orientation and uncertainty avoidance feature prominently in technology acceptance research. Therefore, the relationship between the proportion of respondents from each country who felt that SARs had no benefits and each country's ratings on long-term orientation and uncertainty avoidance were also examined. A significant positive correlation was found for long-term orientation, but not for uncertainty avoidance. CONCLUSION: Most respondents were positive about the benefits of SARs, and similar concerns about their use were expressed both by those who strongly accepted the idea that they had benefits and those who did not. Some evidence was found to suggest that cultural factors were related to rejecting the idea that SARs had benefits.

Nursing Diagnoses of Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Research Protocol for a Qualitative Synthesis.

Although previously developed qualitative studies have explored the experience of illness of individuals with myalgic encephalomyelitis/chronic fatigue syndrome, these findings have not been undertaken for the purpose of enabling the identification of nursing care needs in such patients. This study aims to identify NANDA-I nursing diagnoses of adults with myalgic encephalomyelitis/chronic fatigue syndrome based on a qualitative literature review of their experience of illness. The protocol includes: searches in the electronic databases Medline, Embase, CINAHL, PsycINFO, SCI-EXPANDED, SSCI, SciELO, LILACS, and Cuiden; and manual searches in specialised journals and the references of the included studies. The authors will systematically search qualitative research studies published in databases from 1994 to 2021. Searches are limited to studies in Spanish and English. All stages of the review process will be carried out independently by two reviewers. Any disagreements shall be resolved through joint discussions, involving a third reviewer if necessary. The findings will be synthesised into a thematic analysis informed by the Domains and Classes of the NANDA-I Classification of Nursing Diagnoses, which will then serve to identify nursing diagnoses. This review will enable nursing professionals to identify the care needs of individuals with myalgic encephalomyelitis/chronic fatigue syndrome by taking into consideration their experience of illness in its entirety.

Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey.

AIM: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. METHOD: A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated. RESULTS: Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. CONCLUSION: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.

A New Instrument for Measuring Dietary Knowledge in Patients With Diabetes: Psychometric Testing of the CoNOCidiet-Diabetes.

PURPOSE: To determine the psychometric properties of the CoNOCidiet-Diabetes, a new instrument based on nursing outcome "Knowledge: prescribed diet." METHODS: Methodological design. The participant were 359 patients diagnosed with diabetes visiting 27 primary healthcare centers in Spain. Reliability (internal consistency and test-retest), validity (convergent criterion validity, concurrent content validity and known-groups validity), and sensitivity to change was tested. FINDINGS: CoNOCidiet-Diabetes has shown evidence of acceptable psychometric properties as instrument but some items should be revised. CONCLUSIONS: This research provides a new instrument developed to specifically measure dietary knowledge in individuals with diabetes. IMPLICATIONS: For nursing practice: The literalness of the CoNOCidiet-Diabetes with the nursing outcome "Knowledge: prescribed diet" facilitate its measurement using the patient's statements.

OBJETIVO: Determinar las propiedades psicométricas del CoNOCidiet-Diabetes, un nuevo instrumento basado en el resultado enfermero "Conocimiento: dieta prescrita". MÉTODOS: Diseño metodológico. Los participantes fueron 359 pacientes diagnosticados de diabetes que acudieron a 27 centros de atención primaria de salud en España. Se comprobó la fiabilidad (consistencia interna y test-retest), la validez (validez de criterio convergente, validez de contenido concurrente y validez de grupos conocidos) y la sensibilidad al cambio. RESULTADOS: El CoNOCidiet-Diabetes ha mostrado evidencias de tener unas propiedades psicométricas aceptables como instrumento, pero algunos ítems deben ser revisados. CONCLUSIONES: Esta investigación proporciona un nuevo instrumento desarrollado para medir específicamente el conocimiento sobre dieta en personas con diabetes. IMPLICACIONES PARA LA PRÉCTICA ENFERMERA: La literalidad del CoNOCidiet-Diabetes con el resultado enfermero "Conocimiento: dieta prescrita" facilita la medición de este último utilizando las declaraciones del paciente.

The Importance of Being a Compassionate Leader: The Views of Nursing and Midwifery Managers From Around the World.

INTRODUCTION: Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion. METHODOLOGY: A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving. RESULTS: Four overarching themes capture the study's results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership. DISCUSSION: Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients.

Development and Content Validation of a NOC-Based Instrument for Measuring Dietary Knowledge in Patients with Diabetes: CoNOCidiet-Diabetes.

PURPOSE: To construct a questionnaire for measuring knowledge of a diabetic diet and validate its contents. METHODS: This study was carried out in three stages: (a) generation of items, (b) apparent and content validation, (c) cognitive pilot test. FINDINGS: An 88-item questionnaire was obtained with a content validity index and a representativeness index of 0.87. The experts modified the items that did not reach the preset values. The cognitive test was shown to be feasible, with good exploratory values of reliability and concurrent validity. CONCLUSIONS: The CoNOCidiet-Diabetes questionnaire was obtained from the NOC outcome "Knowledge: Prescribed Diet" and its contents were validated. IMPLICATIONS FOR NURSING PRACTICE: This research shows the usefulness of the NOC for generating tools to measure health outcomes sensitive to nursing interventions.

Establishing Technical Values for Nursing Diagnoses in Primary Healthcare.

PURPOSE: To establish technical values for nursing diagnoses in primary healthcare with which to weight the delivery of care based on criteria of complexity and relevance. METHODS: A three-phase cross-sectional descriptive study: (1) establishing and weighting of the assessment criteria of technical values, (2) scoring of the assessment criteria per diagnosis, and (3) assigning technical values. FINDINGS: Diagnoses were ordered on the scoring scale obtained and a technical value of 1 to 4 was assigned according to their quartile. CONCLUSIONS: Having a technical value for each nursing diagnosis helps to measure the diversity and complexity of care. IMPLICATIONS FOR NURSING PRACTICE: Technical values may contribute to improving nursing management indicators, as they incorporate a quantitative view into the assessment process.

OBJETIVO: Definir un valor técnico para los diagnósticos enfermeros en Atención Primaria que permita ponderar la prestación de cuidados en base a criterios de complejidad y relevancia. MÉTODOS: Estudio descriptivo transversal realizado en 3 fases: 1) definición y ponderación de los criterios de valoración del valor técnico, 2) puntuación de los criterios de valoración por diagnóstico, 3) asignación del valor técnico. RESULTADOS: Se ordenaron los diagnósticos en la escala de puntuación obtenida y se asignó un valor técnico del 1 al 4 en función del cuartil. CONCLUSIONES: Disponer de un valor técnico de cada diagnóstico enfermero permite dimensionar la diversidad y la complejidad de los cuidados. IMPLICACIONES: El valor técnico puede contribuir a mejorar los indicadores de gestión de servicios enfermeros al añadir una visión cuantitativa al proceso evaluativo. PALABRAS CLAVE: diagnóstico de enfermería; terminología normalizada de enfermería; Atención Primaria de salud; indicadores de calidad de la atención de salud; indicadores de gestión.

Photoelicitation: a useful tool to investigate management of the vulnerability of homeless women. / Foto-elicitación: una herramienta útil para investigar la gestión de la vulnerabilidad de las mujeres sin hogar.

AIMS: The proposal of the manuscript is to provide a methodological reflection on the use of photo-elicitation as a data gathering strategy to explore vulnerability management among homeless women. METHODS: A grounded theory study was carried out. Photo elicitation was one of the data gathering techniques used between February 2015 and February 2017. Five women were selected through intentional sampling. All of them were over 18 years old and residents in 4 shelters within the Madrid Care for the Homeless network. Participants used disposable cameras or mobile phones to record their experiences living in the shelters or on the street through photographs. An interview was conducted with each participant in order to explore the meaning of the photos after they were developed. Data analysis comprised, firstly, describing the obvious content of the photos and, secondly, comparing it with the latent content provided by participants during the interviews. RESULTS: Only 3 women finished the task. Through data analysis some theoretical proposals were discovered, which contributed to a deeper knowledge of some previously established categories and subcategories such as: "The good professionals", "The safe places in the street" and "The threats in the street". CONCLUSIONS: Photo-elicitation enabled an approach to participants' experiences with minimal imposition, allowing them much of the control over the data production. However, it is a demanding technique that requires deep reflection before its implementation, on the part of both participants and researchers.

Validación por expertos del contenido del diagnóstico enfermero de NANDA-I Fatiga (00093) / Expert Validation of the Content for the NANDA-I Nursing Diagnosis of Fatigue

Introducción: La fatiga constituye un importante problema de salud que precisa de una adecuada valoración, diagnóstico y planificación de cuidados enfermeros centrados en quienes la sufren. Objetivo: Validar el contenido del diagnóstico enfermero NANDA-I Fatiga (00093) en la versión incluida en una base de datos clínica. Métodos: Estudio descriptivo y exploratorio de validación de contenido diagnóstico mediante expertos siguiendo la propuesta de Fehring. El ámbito de estudio fue España. La recogida de datos se realizó entre los meses de junio 2019-marzo 2020. Los expertos participantes disponían de experiencia y formación en el uso de lenguajes estandarizados enfermeros. Resultados: De las 13 Características Definitorias con las que cuenta el diagnóstico incluido en la base de datos, siete fueron validadas como mayores, cinco como menores y una no fue validada. Los 16 Factores Relacionados del diagnóstico fueron validados. El Índice de Validez de Contenido del diagnóstico fue de 0,81. Conclusiones: El diagnóstico obtuvo un Índice de Validez de Contenido elevado. Los componentes del diagnóstico NANDA-I Fatiga (00093) en la versión de la base de datos clínica guardan correspondencia con los presentes en el diagnóstico NANDA-I Fatiga (00093) en la Clasificación NANDA-I 2018-2020. Se considera que la investigación actual contribuye a incrementar la precisión diagnóstica al identificar Características Definitorias claves de la presencia del diagnóstico. Al tiempo valida Factores Relacionados influyentes en el diagnóstico no incorporados en los componentes del diagnóstico NANDA-I Fatiga (00093) en la edición de la Clasificación NANDA-I 2018-2020(AU)

Introduction: Fatigue is an important health concern that requiring appropriate assessment, diagnosis and nursing care planning focused on those who suffer from it. Objective: To validate the content of NANDA-I nursing diagnosis of fatigue (00093) in the version included in a clinical database. Methods: Descriptive and exploratory study of diagnostic content validation by experts following Fehring's proposal. The setting of the study was Spain. Data collection was carried out between June 2019 and March 2020. The participating experts had experience and training in the use of standardized nursing languages. Results: Of the thirteen characteristics that define the diagnosis included in the database, seven were validated as major, five as minor and one was not validated. All sixteen related factors of the diagnosis were validated. The content validity index of the diagnosis was 0.81. Conclusions: The diagnosis obtained a high content validity index. The components of the NANDA-I diagnosis of fatigue (00093) in the clinical database version correspond with those present in the NANDA-I diagnosis of fatigue (00093) in the NANDA-I Classification 2018-2020. The current research is considered to contribute with an increase in diagnostic accuracy by identifying key defining characteristics for the diagnosis. At the same time, it validates related factors that have an influence on the diagnosis but are not incorporated among the components of the NANDA-I diagnosis of fatigue (00093) in the 2018-2020 edition of the NANDA-I Classification(AU)

Case study: community nursing care plan for an elderly patient with urinary incontinence and social interaction problems after prostatectomy.

PURPOSE: The purpose of this paper is to show nursing procedures and standardized languages in care provided by community nurses to a patient affected by urinary incontinence after a prostatectomy. DATA SOURCES: Data were extracted from patient interviews during various consultations with the community nurse, and from electronic health records. The care plan was based on available scientific evidence. DATA SYNTHESIS: Clinical reasoning was used to select NANDA-I diagnoses, nursing outcomes classification, and nursing interventions classification. CONCLUSIONS: Urinary incontinence problems have a physical, psychological, and social development impact on people who suffer from this condition.

[Ineffective sexuality pattern in an adolescent: nursing approach in primary health care]. / Patrón sexual ineficaz en un adolescente: abordaje enfermero en atención primaria.

Adolescent is a phase of continual physiological, psychological and social adaptation. It is during this time that young people tend to have their first sexual experiences. Sexual dysfunctions are characterized by important clinical changes in sexual desire and/or by psycho-physiological changes in the sexual response cycle. Premature ejaculation is one of the most frequent sexual dysfunction amongst men, with a higher prevalence in the younger population compared to other populations. The clinical case is presented of a 17 year-old male who experienced difficulties during his sexual relations. It is discussed whether his condition was a sexual dysfunction or ineffective sexual pattern. The care plan which was developed in nursing consultation was described for ineffective sexual pattern; the pending nursing treatment incorporated activities recommended by scientific evidence. Finally, the role of primary health care nursing professionals is pointed out in the detection and approach of sexual problems in adolescents.

Sentirse vulnerable (o no): repensando la noción de grupo vulnerable / Feeling vulnerable (or not): rethinking the notion of vulnerable group

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Explorando los significados y experiencias de las enfermeras españolas en torno a la compasión / Exploring the meanings and experiences of spanish nurses regarding compassion

OBJETIVO: Describir cómo las enfermeras españolas definen la compasión y cómo se refleja en su formación y práctica, qué factores influyen en su desarrollo y de quién/es la reciben. MÉTODO: Estudio descriptivo transversal. La población de estudio fueron enfermeras (asistenciales, gestoras y docentes-investigadoras) y estudiantes de cuarto curso del Grado en Enfermería residentes en España. Se realizó un muestreo intencional por conveniencia; recogida de datos mediante cuestionario online compuesto por preguntas cerradas/abiertas, entre marzo y junio de 2014. Los datos cuantitativos fueron analizados de manera descriptiva. Se realizó un análisis temático de las respuestas a las preguntas abiertas. RESULTADOS: Se recogieron 173 cuestionarios, de los cuales un 55,5% fue cumplimentado por enfermeras asistenciales. La compasión se define mayoritariamente como conciencia profunda del sufrimiento de los otros y deseo de aliviarlo, en sintonía con la vulnerabilidad, rol de abogacía enfermera y empatía. Las participantes consideran que la compasión puede enseñarse (69,9%) y es importante para la práctica enfermera (96,6%). Los valores culturales (49,7%) y la experiencia personal con relación a la compasión (34,7%) son claves en su desarrollo. Es recibida fundamentalmente de compañeros y pacientes y sólo en un 0,6%, de gestores. CONCLUSIONES: La compasión es considerada por las enfermeras un elemento central de su práctica. Se precisa crear entornos de práctica asistencial que propicien el desarrollo de la atención compasiva y donde las enfermeras perciban compasión de sus gestores

AIM: To describe how Spanish nurses define compassion and identify the way this understanding determines educational and clinical practice. We also report on the factors that influence their development of compassion and the sources from whom they receive compassion. METHODS: A cross-sectional research design with study population of nurses (clinicians, managers, teachers and researchers) and finalist student nurses living in Spain. A convenient sample was recruited through the authors' networks. An on-line survey, with both close and open questions, was used for data collection (March - June 2014). A descriptive quantitative analysis and a thematic qualitative analysis was used. RESULTS: 173 participants completed the on-line survey, 55% being clinical nurses. Participants defined compassion as the deep awareness of others' suffering and the inner motivation to relieve it. This attitude is in coherence with the concepts of vulnerability, advocacy role and empathy. Compassion can be taught (69,9%) and is central for clinical practice (96%). Cultural values (49,7%) and personal experiences related with compassion (34,7%) are key elements in its development. Compassion is received mainly from colleagues and patients and only in a 0,6% from managers. CONCLUSIONS: Compassion is considered by nurses as a central element in nursing practice. So, it is necessary to recreate care practice environments that encourage the development compassionate care and where nurses perceive compassion from their managers

Foto-elicitación: una herramienta útil para investigar la gestión de la vulnerabilidad de las mujeres sin hogar / Photoelicitation: a useful tool to investigate management of the vulnerability of homeless women

Objetivo: El propósito de este artículo es analizar el uso de la foto-elicitación como herramienta para explorar la gestión de la vulnerabilidad de las mujeres sin hogar. Métodos: Estudio cualitativo orientado desde la teoría fundamentada. La foto-elicitación se empleó en la recogida de datos desarrollada de febrero de 2015 a febrero de 2017. Se seleccionaron mediante muestreo intencional 5 mujeres mayores de 18 años residentes en 4 centros de acogida de la red de atención a personas sin hogar de Madrid. Las participantes hicieron uso de cámaras fotográficas o teléfonos móviles para representar con imágenes su experiencia de vivir en la calle y en el centro de acogida. Reveladas las fotografías se exploró cara a cara su significado mediante entrevista. En el análisis de datos se describió el contenido manifiesto de las imágenes para luego su contraste con el contenido latente producido por las informantes durante la entrevista. Resultados: Solo 3 mujeres de las participantes completaron la técnica. En el análisis del material discursivo y visual producido se hallaron construcciones teóricas que sirvieron para profundizar en el conocimiento de categorías/subcategorías previamente construidas, por ejemplo ‘Los buenos profesionales’, ‘Los lugares seguros de la calle’ y ‘Los peligros de la calle’. Conclusiones: La foto-elicitación permite aproximarse a la experiencia de las participantes con mínimas imposiciones, cediéndoles buena parte del control sobre la producción de datos. No obstante, es una técnica exigente para participantes e investigadores que requiere de una profunda reflexión antes de su puesta en marcha (AU)

Aims: The proposal of the manuscript is to provide a methodological reflection on the use of photo-elicitation as a data gathering strategy to explore vulnerability management among homeless women. Methods: A grounded theory study was carried out. Photo elicitation was one of the data gathering techniques used between February 2015 and February 2017. Five women were selected through intentional sampling. All of them were over 18 years old and residents in 4 shelters within the Madrid Care for the Homeless network. Participants used disposable cameras or mobile phones to record their experiences living in the shelters or on the street through photographs. An interview was conducted with each participant in order to explore the meaning of the photos after they were developed. Data analysis comprised, firstly, describing the obvious content of the photos and, secondly, comparing it with the latent content provided by participants during the interviews. Results: Only 3 women finished the task. Through data analysis some theoretical proposals were discovered, which contributed to a deeper knowledge of some previously established categories and subcategories such as: ‘The good professionals’, ‘The safe places in the street’ and ‘The threats in the street’. Conclusions: Photo-elicitation enabled an approach to participants’ experiences with minimal imposition, allowing them much of the control over the data production. However, it is a demanding technique that requires deep reflection before its implementation, on the part of both participants and researchers (AU)

Patrón sexual ineficaz en un adolescente: abordaje enfermero en atención primaria / Ineffective sexuality pattern in an adolescent: Nursing approach in primary health care

La adolescencia es una etapa de continua adaptación fisiológica, psicológica y social. Es durante este tiempo cuando los jóvenes suelen tener sus primeras experiencias sexuales. Los trastornos sexuales se caracterizan por alteraciones clínicas importantes del deseo sexual y/o por cambios psicofisiológicos en su ciclo de respuesta. La eyaculación precoz es una de las alteraciones sexuales más frecuentes en hombres, presentando una prevalencia mayor en jóvenes que en otros grupos etarios. Se presenta el caso clínico de un varón de 17 años que manifiesta dificultades durante sus relaciones sexuales. Se discute sobre el diagnóstico diferencial entre las etiquetas diagnósticas disfunción sexual y patrón sexual ineficaz Se describe el plan de cuidados desarrollado en consulta de enfermería ante el problema patrón sexual ineficaz, incorporándose, en el tratamiento enfermero a realizar, las actividades recomendadas por la evidencia científica. Finalmente se señala el papel de los profesionales enfermeros de atención primaria en la detección y abordaje de los problemas sexuales en adolescentes (AU)

Adolescent is a phase of continual physiological, psychological and social adaptation. It is during this time that young people tend to have their first sexual experiences. Sexual dysfunctions are characterized by important clinical changes in sexual desire and/or by psycho-physiological changes in the sexual response cycle. Premature ejaculation is one of the most frequent sexual dysfunction amongst men, with a higher prevalence in the younger population compared to other populations. The clinical case is presented of a 17 year-old male who experienced difficulties during his sexual relations. It is discussed whether his condition was a sexual dysfunction or ineffective sexual pattern. The care plan which was developed in nursing consultation was described for ineffective sexual pattern; the pending nursing treatment incorporated activities recommended by scientific evidence. Finally, the role of primary health care nursing professionals is pointed out in the detection and approach of sexual problems in adolescents (AU)