Percepciones e implicaciones en personas con ostomías de eliminación. Revisión narrativa / Perceptions and implications in people with elimination ostomies. Narrative review / Percepções e implicações em pessoas com estomias de eliminação. Revisão narrativa

Introducción: Las personas que experimentan el tener una ostomía de eliminación como parte de un tratamiento clínico enfrentan cambios que impactan su calidad de vida, a nivel familiar, social, laboral y económico. Metodología: Revisión narrativa, que incluyó artículos de todos los diseños metodológicos en español, inglés y portugués, disponibles en las bases de datos Scopus, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar y repositorios universitarios, con términos de búsqueda MeSH "Ostomy and Rural Population and caregivers", de los últimos 10 años. Estos artículos surtieron análisis teórico para la construcción de categorías temáticas afines. Resultados: Las categorías temáticas obtenidas son: 1) significado de tener una ostomía: destino, estigma, cambio; 2) afectaciones en la calidad de vida: cambios físicos y de roles; 3) estrategias de afrontamiento: intervenciones integrales; 4) impacto de las intervenciones educativas: en el preoperatorio y para el cuidado; 5) importancia del autocuidado: facilita la adaptación; y 6) rol de los cuidadores: asumen la carga de cuidado. Conclusiones: Las personas con ostomías, sus cuidadores y familias experimentan diferentes cambios en las dinámicas y roles de vida, por lo cual requieren soporte en salud con apoyo emocional, en habilidades cognitivas e instrumentales.

Introduction: People who experience having an elimination ostomy as part of a clinical treatment face changes that impact their quality of life, at a family, social, work and economic level. Methodology: Narrative review, which included articles of all methodological designs in Spanish, English and Portuguese, available in the Scopus, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar and repository databases. university students, with MeSH search terms "Ostomy and Rural Population and caregivers", from the last 10 years. These articles provided theoretical analysis for the construction of re-lated thematic categories. Results: The thematic categories obtained are: 1) meaning of hav-ing an ostomy: fate, stigma, change; 2) effects on quality of life: physical and role changes; 3) coping strategies: comprehensive interventions; 4) impact of educational interventions: in the preoperative period and for care; 5) importance of self-care: it facilitates adaptation; and 6) role of caregivers: they assume the burden of care. Conclusions: People with ostomies, their caregivers and families experience different changes in life dynamics and roles, which is why they require health support with emotional support, cognitive and instrumental skills.

Introdução: As pessoas que experienciam uma ostomia de eliminação no âmbito de um trata-mento clínico deparam-se com alterações que impactam a sua qualidade de vida, a nível familiar, social, laboral e económico. Metodologia: Revisão narrativa, que incluiu artigos de todos os desenhos metodológicos em espanhol, inglês e português, disponíveis nas bases de dados Scop-us, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar e repositório. , com os termos de busca MeSH "Ostomia e população rural e cuidadores", dos últimos 10 anos. Esses artigos forneceram análises teóricas para a construção das categorias temáticas relacionadas.Resultados: As categorias temáticas obtidas são: 1) significado de ter uma estomia: destino, estigma, mudança; 2) efeitos na qualidade de vida: mudanças físicas e de papéis; 3) estratégias de coping: intervenções integrais; 4) impacto das intervenções educativas: no pré-operatório e no cuidado; 5) importância do autocuidado: facilita a adaptação; e 6) papel de cuidador: assumem o ônus do cuidado. Conclusões: As pessoas com ostomias, seus cuidadores e familiares vivenciam diferentes mudanças na dinâmica e nos papéis da vida, pelo que requerem apoio de saúde com suporte emocional, habilidades cognitivas e instrumentais.

Experiences and Perceptions in Dyads about Ostomy Care. Meta-synthesis of Qualitative Studies / Experiencias y percepciones en díadas sobre el cuidado con ostomías. Meta-síntesis de estudios cualitativos / Experiências e percepções em díades sobre os cuidados com a ostomia. Metassíntese de estudos qualitativos

Objective. To understand the experiences and perceptions of care dyads (person and caregiver) when having a permanent discharge ostomy. Methods. Meta-synthesis that followed the ENTREQ standards and was registered in PROSPERO CRD42020221755; It was developed in three phases: (i). Search for studies in academic search engines, with MeSH terms: [(Patients) AND (Ostomy)) AND (Caregivers)], including qualitative primary studies published between 2000 and 2020; (ii). Assessment of the methodological quality with the CORE-Q instrument and the credibility of qualitative findings under the guidelines of the Johanna Briggs Institute; and (iii). Comparative analysis according to the guidelines by Sandelowski and Barroso. Results. The work identified 664 studies; in screening, 35 passed to full-text analysis; 22 to methodological quality evaluation; and 10 to meta-synthesis. The study found 43 qualitative findings that constituted four categories: dyads perform instrumental and emotional care; ambivalent family caregiving feelings and actions; assertive and effective family care; and rejection of bodily changes and sexual dysfunction. These categories constitute the central meta-theme: "The dyads experience a life rupture, which is restored in a sea of ambivalent emotions and learning; at the same time, affective, instrumental and assertive care is constructed". Conclusions: People who experience having a permanent discharge ostomy express their rejection to the change in bodily image, alterations in sexual life and as a couple. Caregivers and families are the main source of support by being facilitators in self-care, through relationships of mutuality and reciprocity.

Objetivo. Comprender las experiencias y percepciones de las díadas del cuidado (persona y cuidador) al tener una ostomía de eliminación. Métodos. Meta-síntesis que siguió los estándares ENTREQ y contó con registro en PROSPERO CRD42020221755. Se desarrolló en tres fases: (i) Búsqueda de estudios en buscadores académicos, con términos MeSH: [(Patients) AND (Ostomy)) AND (Caregivers)], incluyendo estudios primarios cualitativos publicados entre los años 2000 al 2020; (ii) Valoración de la calidad metodológica con instrumento CORE-Q y de credibilidad de hallazgos cualitativos bajo lineamientos del JBI; y (iii) Análisis comparativo según los lineamientos los autores Sandelowski y Barroso. Resultados. Se identificaron 664 estudios; en el cribado 35 pasaron a análisis de texto completo, 22 a evaluación de calidad metodológica y 10 a meta-síntesis. Se identificaron 43 hallazgos cualitativos que constituyeron 4 categorías: las díadas desarrollan el cuidado instrumental y emocional; sentimientos y acciones de cuidado familiar ambivalentes; cuidado familiar asertivo y eficaz; y rechazo a los cambios corporales y disfunción sexual. Estas categorías constituyen el meta-tema central: "Las díadas viven una ruptura de vida, la cual se restaura en un mar de emociones y aprendizajes ambivalentes; a la vez, se construye un cuidado afectivo, instrumental y asertivo". Conclusión. Las personas que vivencian el tener una ostomía permanente de eliminación, expresan el rechazo al cambio en la imagen corporal, alteraciones en la vida sexual y de pareja. Los cuidadores y las familias se constituyen como la fuente principal de apoyo al ser facilitadores en el autocuidado, por medio de relaciones de mutualidad y reciprocidad.

Objetivo. Compreender as vivências e percepções das díades de cuidado (pessoa e cuidador) ao ter uma estomia de descarte. Métodos. Meta-síntese que seguiu os padrões do ENTREQ e foi registrada no PROSPERO CRD42020221755. Foi desenvolvido em três fases: (i) Busca de estudos em buscadores acadêmicos, com termos MeSH: [(Pacientes) AND (Ostomia)) AND (Cuidadores)], incluindo estudos qualitativos primários publicados entre 2000 e 2020; (ii) Avaliação da qualidade metodológica com o instrumento CORE-Q e credibilidade dos achados qualitativos sob as diretrizes do JBI; e (iii) Análise comparativa segundo as orientações dos autores Sandelowski e Barroso. Resultados. 664 estudos foram identificados; na triagem, 35 passaram para análise de texto completo, 22 para avaliação da qualidade metodológica e 10 para metassíntese. Foram identificados 43 achados qualitativos que constituíram 4 categorias: as díades desenvolvem o cuidado instrumental e emocional; sentimentos e ações ambivalentes de cuidado familiar; cuidado familiar assertivo e eficaz; e rejeição de alterações corporais e disfunção sexual. Essas categorias constituem o meta-tema central: "As díades vivem uma pausa na vida, que se restabelece em um mar de emoções e aprendizados ambivalentes; Ao mesmo tempo, constrói-se o cuidado afetivo, instrumental e assertivo". Conclusão. As pessoas que vivenciam uma estomia de remoção permanente expressam rejeição à mudança na imagem corporal, alterações na vida sexual e com o parceiro. Os cuidadores e as famílias constituem-se como principal fonte de apoio por serem facilitadores no autocuidado, por meio de relações de mutualidade e reciprocidade.

Modelación con teoría de grafos para la unidimensionalidad de un instrumento de evaluación / Modeling with graph theory to unidimensionality for an assessment instrument

En el marco de las políticas públicas en Colombia sobre calidad de la educación superior se encuentran los lineamientos para que el Estado reconozca los programas de pregrado como de alta calidad, entre tales lineamientos se consideran los sistemas de evaluación de los estudiantes basados en políticas institucionales claras y transparentes que propicien una identificación integral de las condiciones académicas y actitudinales de los estudiantes por lo que es imprescindible tecnificar y modernizar los procesos de evaluación para fortalecer la emisión de inferencias confiables sobre el logro académico. En este artículo se describe una aplicación de la Teoría de Grafos usando algunas de sus definiciones y teoremas básicos con la intención de potenciar su uso para el estudio del supuesto de unidimensionalidad de la Teoría de Respuesta al Ítem como alternativa para robustecer la evaluación. La unidimensional fue entendida en el sentido de la homogeneidad escalar y de criterio para las relaciones de orden definidas por la dominación tanto para ítems como para evaluados: para los ítems conforme al número de evaluados que los contestaron correctamente y a la dificultad; para los evaluados respecto al número de respuestas correctas y a la habilidad. Se aplicó la combinación de las dos teorías a un caso de estudio que contempla el instrumento de la prueba diagnóstica del Examen de Clasificación de Matemáticas Básicas en la Universidad Jorge Tadeo Lozano, con esto se ofrece un valor agregado porque se evidencian los resultados de forma algorítmica y visual con ayuda de herramientas informáticas especializadas.

In Colombia, public policies about quality of higher education involve student assessment systems as a relevant characteristic. These systems should have clear and transparent institutional policies requiring comprehensive identification of attitudinal and academic conditions about examinee performance. Consequently, on the way of continuous improvement of academic services offered by institutions of higher education, an assessment process adequately technified allowing valid inferences about academic achievement is required. In this sense, the Rasch measurement model of Item Response Theory is a modern alternative to strengthen educational measurement estimating the ability of the student and the difficulty of the item on a comparable scale. Unidimensionality, local independence and internal consistency are assumptions made in Rasch measurement model. Unidimensionality assumption has several definitions, one of them is the occurrence of a dominant factor influencing test performance. Another definition is considered in the present study. Here, unidimensionality was interpreted as scalar and criterial homogeneity for the order relations defined by domination for items and assessed applicants. Graph Theory is an ideal mathematical modelling approach to this assumption inasmuch as represent intangible interactions as required. In order to achieve this, Graph Theory and Item Response Theory were combined to examine the qualifying test for the Basic Mathematics subject at Jorge Tadeo Lozano University as a case study. This test was composed by 45 items divided in three blocks. With several combinations of these blocks, three virtual booklets were obtained each one comprising 30 of them. From the application of June 2011, a test sample of 509 responses chains was obtained. Three data bases were processed one for each booklet, the first spanned 175 responses chains, the second 170 and the third one 164. To begin with the exmination on the Rasch measurement model, the parameters reliability, separation, Cronbach Alpha and item residual correlation were estimated to gauge and determine performance test for getting acceptable values in each booklet applied. Tatsuoka was followed to undertake the path to unidimensionality from Graph Theory gathering a real case experience processed with suitable software. Additionally, the sensitivity of the order relation was verified through: 1) ordering by number of correct responses per item (1I order) and items difficulty (2I order); 2) ordering by number of correct responses per applicant (1E order) and estimated ability (2E order). Furthermore, the linear models were obtained collating these orders. In like manner, three Guttman scales and their adjacency matrices were schematized one for each booklet. Subsequently, the respective graphs were processed and represented using Gephi just as a specialized tool that enables running some algorithms like Force Atlas. Afterwards, the second power of each adjacency matrix was found using Matlab 2014b and domination matrices were calculated for both items and applicants in the aforementioned orders for a total of 12 matrices. Consistency index developed by Cliff was computed for the domination matrices. As a result, moderate consistency was observed. Significant domination for the entries of these matrices was analyzed through McNemar test in order to have an asymmetric dominance relation. Moreover, a reachable matrix was calculated for each one of these significant domination matrices as a limit ofa sequence of boolean powers. Finally, dominance hierarchies were illustrated with vertex degrees and compared with student maps by the means of Winsteps 3.73. The combination of Graph Theory and Item Response Theory allowed a deeper comprehension of unidimensionality assumption. Thereupon, universities can optimize their resources offering to applicant differential academic options per individual position in the ability scale. The results can be used to outline advantages for the applicants who can evidence their position in the ability scale and identify the different areas to improve.