"I drink less and that's no small matter": a qualitative descriptive study of a managed alcohol program evaluation in Barcelona.

Background: The concurrence of homelessness and alcohol use disorder (AUD) has negative consequences in affected individuals. Managed alcohol programs (MAPs), a harm reduction strategy based on providing regular doses of alcohol to individuals with AUD, have emerged as a potential solution to reduce alcohol-related harms.Objectives: This study examined the impact of a MAP implemented in Barcelona on patterns of alcohol and other psychoactive substance use, health, and quality of life among people who use drugs and were experiencing homelessness. The research also incorporated a gender perspective and focused on individuals who had accessed a residential center.Methods: A descriptive qualitative design was used, employing semi-structured interviews with eight participants who were enrolled in the MAP (three women, five men) and four program professionals. Thematic analysis was used to analyze the resulting data.Results: The domains guiding the study appeared as outcome themes: patterns of use of alcohol and other substances, health, quality of life and impact on female-identified participants. Participants reported improved health due to reduced consumption of alcohol and other substances, better anxiety management, and reconnection to health services. The participants reported enhanced quality of life, including feeling safer, and better use of time, which had been spent on meeting their basic needs. Women reported that a key benefit of the program was living in a sexism-free environment.Conclusion: These results appear to demonstrate that harm reduction strategies prioritizing basic needs and adopting a gender-sensitive perspective can positively impact the health and quality of life of people experiencing homelessness with AUD.

El rol de la enfermería en el ámbito de la salud pública / The role of the nurse in the field of public health

Objetivo: Conocer el rol de las enfermeras que trabajan en el campo de la salud pública y la diferencia respecto al rol de atención familiar y comunitaria en el contexto de Cataluña, a través de experiencias y perspectivas de profesionales del ámbito de la salud pública. Método: Estudio cualitativo fenomenológico descriptivo. Realización de 14 entrevistas a informantes clave del campo de la salud pública y del ámbito comunitario, seleccionadas mediante propositivo de máxima variación. Análisis de contenido mediante metodología temática y creación de categorías a partir de la triangulación de resultados. Resultados: Se analizan las competencias profesionales y las funciones que realiza la enfermería en el ámbito de la salud pública. La mayoría de las funciones propias se correspondieron con las funciones relacionadas en «el cuidado» y de los la «visión global» de salud. La indeterminación de las funciones y roles relacionada con la desigualdad de género conlleva un bajo reconocimiento de la profesión y una falta de adecuación de la categoría profesional, reflejados en una escasa presencia de la enfermería en posiciones de gestión en salud pública. Aunque se comparten competencias con la enfermería familiar y comunitaria, se encuentran también diferencias. Conclusiones: Este estudio ha permitido profundizar en el rol de la enfermería de salud pública, poco conocido. Se evidencia la necesidad de definir sus roles y funciones para evitar las desigualdades y aumentar su reconocimiento.(AU)

Objective: Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. Method: Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. Results: The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to “care” and the “global vision” of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. Conclusions: This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.(AU)

[Factors involved in the development of the community projects. Observational study of the Catalonian primary care centers AUPA network]. / Factores que facilitan y dificultan el desarrollo de los proyectos comunitarios. Estudio observacional de la red AUPA de centros de atención primaria de Cataluña.

OBJECTIVE: To describe the characteristics of the AUPA Health Centres network, identify the favourable elements and the obstacles when carrying out community projects (CP), the impact of belonging to the AUPA network, and the types of support members expect from the AUPA Network. DESIGN: A cross-sectional, descriptive and analytical study with analysis of information using quantitative and qualitative techniques. LOCATION: Primary Care. PARTICIPANTS: 15 centres of Primary Care belonging to the AUPA network before January 2006. PRINCIPAL MEASUREMENTS: Variables regarding the characteristics of the Health Centres, professionals, CP, facilitators and obstacles of the CP, usefulness, expectations and impact of belonging to the AUPA network. PRINCIPAL RESULTS: The majority of centres are teaching and receive methodological external support. The majority of CP are in initial phases of development and the most used methodology is Community Oriented Primary Care (COPC). The projects have the support of the community and intersectorial collaboration. Nursing is the group most involved. The factors that influence development of the CP are the motivation of the professionals, previous training in community care, management support and the participation of key personnel and the community. The community centres require more time to work on CP, methodological support from experts, better professional recognition, support by the Health Centre management and companies. CONCLUSIONS: It is necessary to motivate professionals, promote knowledge in community care, giving recognition and support by the institutions and by the community. Work benefits are perceived from the network: sharing experiences, commitment and gaining knowledge.

Factores que facilitan y dificultan el desarrollo de los proyectos comunitarios. Estudio observacional de la red AUPA de centros de atención primaria de Cataluña / Factors involved in the development of the community projects. Observational study of the Catalonian primary care centers AUPA network

Objetivo: Describir las características de los equipos de atención primaria (EAP) de la red Actuant Units per a la Salut (AUPA, ‘Actuando Unidos por la Salud’), conocer los elementos facilitadores y obstáculos para realizar proyectos comunitarios (PC), el impacto de participar en la red AUPA y las expectativas respecto a ésta. Diseño: Estudio transversal, descriptivo y analítico con recogida de datos mediante técnicas cuantitativas y cualitativas. Emplazamiento: Centros de atención primaria. Participantes: Quince EAP adscritos a la red AUPA antes de enero de 2006.Medidas principales : Variables referentes a las características de los EAP, profesionales, PC, facilitadores y obstáculos del PC, utilidad, expectativas e impacto de pertenecer a la red AUPA. Resultados principales: La mayoría de los centros son docentes y reciben apoyo metodológico externo. Los PC están en fases iniciales de desarrollo y la metodología más utilizada es atención primaria orientada a la comunidad (APOC). Los proyectos cuentan con participación de la comunidad y colaboración intersectorial. Enfermería es el colectivo más implicado. Los factores influyentes en el desarrollo del PC son la motivación de los profesionales, la formación previa en atención comunitaria (AC), el apoyo de dirección y la participación de personas clave y de la comunidad. Se pide más tiempo laboral para trabajar en AC, apoyo metodológico por expertos, mayor reconocimiento profesional, apoyo directivo del EAP y de la empresa. Conclusiones: Hace falta motivar profesionales, fomentar el conocimiento en AC y dar reconocimiento y apoyo de las instituciones y de la comunidad. Se percibe un beneficio del trabajo en red: compartir experiencias, compromiso y adquisición de conocimientos (AU)

Objective: To describe the characteristics of the AUPA Health Centres network, identify the favourable elements and the obstacles when carrying out community projects (CP), the impact of belonging to the AUPA network, and the types of support members expect from the AUPA Network. Design: A cross-sectional, descriptive and analytical study with analysis of information using quantitative and qualitative techniques. Location Primary Care. Participants15 centres of Primary Care belonging to the AUPA network before January 2006.Principal Measurements Variables regarding the characteristics of the Health Centres, professionals, CP, facilitators and obstacles of the CP, usefulness, expectations and impact of belonging to the AUPA network. Principal Results: The majority of centres are teaching and receive methodological external support. The majority of CP are in initial phases of development and the most used methodology is Community Oriented Primary Care (COPC). The projects have the support of the community and intersectorial collaboration. Nursing is the group most involved. The factors that influence development of the CP are the motivation of the professionals, previous training in community care, management support and the participation of key personnel and the community. The community centres require more time to work on CP, methodological support from experts, better professional recognition, support by the Health Centre management and companies. Conclusions: It is necessary to motivate professionals, promote knowledge in community care, giving recognition and support by the institutions and by the community. Work benefits are perceived from the network: sharing experiences, commitment and gaining knowledge (AU)

Aportaciones de la atención primaria y la salud pública al desarrollo de la salud comunitaria / Contributions of primary care and public health to the development of community health

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Análisis de la demanda en los servicios de urgencias de Barcelona / Analysis of demand in the emergency services of Barcelona

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