Teaching Competencies in Nursing Professors: Visions of Students and Academics / Competencias docentes en profesores de Enfermería: visión de alumnos y académicos

Objective. This work sought to know the view of Nursing professors and students about the competencies the faculty staff must have to deploy their educational function with maximum quality and efficiency. Methods. Descriptive qualitative study through focus groups conducted with professors, students and recent Nursing career graduates from universities in Spain. Results. The importance of the proposed teaching competencies was delved into, highlighting the importance of professors knowing the context in which they teach, having the ability to self-evaluate their activity, and having adequate interpersonal communication skills, and deploy the teaching-learning process by performing proper planning, using new technologies, and knowing how to engage in teamwork. Moreover, a small discrepancy was detected in relation to disciplinary competence, which students felt was of importance, but which academics indicated is taken for granted in nursing professors; competencies directly related to the act of teaching must be enhanced. Conclusion.Practical unanimity was found between academics and students in affirming that the competencies investigated are important for adequate development of the teaching activity in nursing professors. In all cases, the urgent need was highlighted for nursing professors to have adequate teaching training to provide their students with formation of the highest quality.

Objetivo. Conocer la visión de profesores y alumnos de Enfermería acerca de las competencias que deben presentar los docentes para desplegar su función educativa con la máxima calidad y eficacia. Métodos. Estudio descriptivo cualitativo a través de grupos focales realizados con profesores, alumnos y recién egresados del Grado en Enfermería de universidades de España. Resultados. Se profundizó en la importancia de las competencias docentes propuestas, destacando la relevancia de que los profesores conozcan el contexto en el que desarrollan la docencia, tengan la habilidad de autoevaluar su actividad, dispongan de unas adecuadas habilidades de comunicación interpersonal, y desplieguen el proceso de enseñanza-aprendizaje realizando una correcta planificación, empleando las nuevas tecnologías y sabiendo trabajar en equipo. Por otro lado, se detectó una pequeña discrepancia con relación a la competencia disciplinar, a la que los estudiantes brindaron una gran importancia, pero que los académicos indicaron que se da por supuesta en los profesores enfermeros, debiendo ser potenciadas las competencias directamente relacionadas con el acto docente. Conclusión. Se ha hallado una práctica unanimidad entre académicos y estudiantes en afirmar que las competencias investigadas son importantes para un adecuado desarrollo de la actividad docente en los profesores de Enfermería. En todos los casos, se destacó la imperiosa necesidad de que los profesores de Enfermería dispongan de una adecuada capacitación docente para poder brindar a sus estudiantes una formación de la máxima calidad.

Prevalence, Socio-cultural Restrictions and Determinants of School Absenteeism during Menstruation among Adolescent School Girls in Bangalore

Introduction: Menstrual-related problems are one of the most common problems among adolescent girls and might adversely affect their performance in academic and other activities of daily life. Aims & Objectives: 1. To determine the prevalence of school absenteeism among adolescent school girls during menstruation. 2. To assess the restrictions which are imposed on adolescent school girls during menstruation. 3. To evaluate the various factors associated with school absenteeism during menstruation. Methods: A study was conducted by carrying out a questionnaire and focus group discussion between October 2019-January 2020 in seven schools of Bangalore city after obtaining the assent and informed consent signed by their parents. Result: The mean age of the girls was 14.45 ± 1.71. The proportion of school absenteeism during menstruation was (30.25%). The majority (89.25%) of the students among the school absentees missed one day of school during menstruation. Among the school absentees, pain/discomfort was one of the main reasons for missing school, accounting for (69.42%). (46.25%) of the students were restricted from any kind of religious activities. Pain during menstruation, shame, fear of leakage, lack of toilet or water supply, lack of a place to dispose of sanitary pads and absence of a private place to manage periods were some factors that were associated with school absenteeism during menstruation. Conclusion: Considerably high school absenteeism among adolescent girls due to menstruation was noted in this study, highlighting the need for improved interventions that reach girls at a young age.

Validación de dominios y competencias por grupos focales y juicio de expertos / Validation of domains and competencies by focus groups and expert judgment

Resumen El Consejo Mexicano de Ginecología y Obstetricia certifica a los especialistas para ejercer su especialidad y brindar una atención de alta calidad a las pacientes. En la actualidad, el Consejo está rediseñando el examen de Certificación en Ginecología y Obstetricia orientado a la evaluación de competencias profesionales a partir de las actividades profesionales confiables que permitan identificar los dominios de la competencia médica en un especialista. La competencia es una variedad de habilidades ejercidas a través de múltiples dominios o aspectos del desempeño profesional; sus descriptores requieren que contengan habilidades relevantes, contexto y la etapa o nivel de evaluación. Por su parte, los dominios son un conjunto de competencias clave. Este informe incluye los resultados de la primera validación en México de dominios y competencias para la evaluación de los ginecoobstetras a partir de una metodología cualitativa que comprende una revisión de la bibliografía, grupos focales, análisis de trabajos colegiados y validación por juicio de expertos. Los resultados se presentan divididos por los ocho dominios en los que se trabajó, se mencionan los comentarios más relevantes a discutir por los cuatro grupos focales. Éstos y la validación por expertos permitió reunir comentarios valiosos, coherentes y funcionales para el sistema de evaluación que quiere llevar a cabo el Consejo. Este ejercicio permitirá el posterior desarrollo de la tabla de especificaciones, reactivos o nuevos instrumentos de evaluación coherentes con un sistema de dominios, competencias y actividades profesionales confiables.

Abstract The Mexican Council of Gynecology and Obstetrics certifies specialists to practice their specialty and provide high-quality healthcare to patients. Currently, the Council is redesigning the Gynecology and Obstetrics Certification exam, oriented to the evaluation of professional competencies based on reliable professional activities that allow the identification of domains of a specialist's medical competencies. Competency can be defined as a variety of skills across multiple domains or aspects of professional performance. Its descriptors require to contain relevant skills, context, and the stage or level of assessment. Domains can be described as a set of competencies that are considered essential. This report includes the results of the first validation done in Mexico. The validation of domains and competencies for the evaluation of physicians in the area of Obstetrics and Gynecology is based on a qualitative methodology that includes a literature review, focus groups, analysis of collegiate works, and validation through expert judgment. The obtained results are divided into eight domains that mention the most relevant observations that were discussed by the four focus groups. The focus groups and the validation through expert judgment made it possible to gather valuable, coherent, and functional feedback for the evaluation system that the Council wants to carry out. This method will allow the subsequent development of the table of specifications, items, or new evaluation instruments congruent with a system of domains, competencies, and reliable professional activities.

Capacitação para o controle da hanseníase: avaliação e contribuições para a gestão / Training process for leprosy control: evaluation and contributions to management

RESUMO Este estudo tem o objetivo de apresentar a avaliação de um projeto de capacitação em serviço para profissionais de saúde nas ações de prevenção e controle da hanseníase, problematizando o modelo de avaliação adotado, com foco na utilização para a gestão em saúde. Foi realizada uma avaliação ex-post em 18 municípios prioritários brasileiros participantes das capacitações. Empregou-se a estratégia Rapid Evaluation Methods (REM), priorizando: a) abordagem colaborativa; b) técnicas qualitativas; e c) enfoque conceitual da translação do conhecimento. Foram realizadas 24 entrevistas grupais, envolvendo 278 participantes. A abordagem de ensino em serviço foi importante para revalorização das ações de prevenção e controle da hanseníase e para conferir um lugar privilegiado de discussão técnica, de reflexão e de mudanças na atenção primária e em sua relação com a especializada. Conclui-se que o modelo de avaliação possibilitou que as controvérsias e convergências surgissem, assim como as recomendações para ajustes da intervenção junto à gestão em tempo oportuno.

ABSTRACT This study aims to present the evaluation of an in-service training project for health professionals in leprosy prevention and control actions, questioning the adopted evaluation model, focusing on its use for health management. An ex-post evaluation was carried out in 18 priority Brazilian municipalities participating in the training project. Rapid Evaluation Methods (REM) strategy was employed, prioritizing: a) a collaborative approach; b) qualitative techniques; and c) a conceptual approach to knowledge translation. Twenty-four group interviews were carried out, involving 278 participants. The in-service teaching approach was important for revaluing leprosy prevention and control actions and to provide a privileged place for technical discussion, reflection and changes in primary health care and in its relationship with specialized care. It can be concluded that the evaluation model enabled controversies and convergences to emerge, as well as recommendations for managers to adjust the intervention timely.

Saúde mental na atenção básica: percepção dos Agentes Comunitários de Saúde / Mental health in primary care: perception of Community Health Workers

Resumo Introdução Os fluxos de encaminhamento dos pacientes portadores de transtornos mentais e o seu devido acolhimento representam um grande desafio na área da saúde mental. Objetivo Conhecer a percepção dos Agentes Comunitários de Saúde em relação aos usuários da saúde mental e suas atividades nesse campo. Método Estudo de ordem qualitativa utilizando a técnica de grupo focal. Os dados coletados foram transcritos e submetidos à Técnica de Análise Qualitativa de Conteúdo. Participaram do estudo 15 agentes de saúde. Resultados Os dados foram organizados utilizando os temas que se destacaram nos depoimentos dos Agentes Comunitários de Saúde e agrupados em três categorias selecionadas previamente: Conhecimento sobre Transtornos Mentais, Ações em Saúde Mental, Entraves dos Serviços. Conclusão Os agentes demonstraram interesse pelo trabalho com os pacientes, mas apontaram dificuldades envolvendo os diversos pontos da rede de atenção à saúde. Melhor preparação técnica e teórica dos agentes resultaria em ganhos para a equipe de saúde e para os pacientes. Apesar de contemplar a realidade de um município de médio porte, este estudo pode fornecer subsídios para a discussão sobre a assistência em saúde mental na atenção básica de saúde.

Abstract Background The referral flows of patients with mental disorders and their proper reception represent a major challenge in the mental health area. Objective To know the perception of Community Health Agents concerning mental health patients and their activities in this field. Method This is a qualitative study using the focus group technique. The collected data were transcribed and submitted to the Qualitative Content Analysis Technique. Fifteen health agents participated in the study. Results The data were organized using the themes that stood out in the testimonies of the Community Health Agents and grouped into three previously selected categories: Knowledge about Mental Disorders, Mental Health Actions, and Service Barriers. Conclusion The agents showed interest in working with patients but pointed out difficulties involving the different points of the healthcare network. Better technical and theoretical preparation of agents would result in gains for the health team and for patients. Despite considering the reality of a medium-sized municipality, this study can provide support for the discussion on mental health care in primary health care.

"Desculpe a demora!": métodos online como estratégia para desenvolvimento de pesquisas sobre maternidades / "Sorry for the delay!": online methods as a strategy for developing research on maternity

Resumo A partir da experiência de pesquisa com mulheres mães lésbicas e bissexuais e das dificuldades encontradas para realização de encontros síncronos para a coleta de dados, observou-se que métodos de pesquisa online assíncronos se apresentam como estratégias em potencial para esse grupo em específico, considerado de difícil acesso. Este trabalho visa retratar o percurso metodológico para desenvolvimento de pesquisa exploratória, com abordagem qualitativa, desenvolvida por meio de métodos online, utilizando-se de estratégias como entrevistas abertas e grupo focal online, por meio da mídia social WhatsApp.

Abstract From a research experience with lesbian and bisexual mothers and the difficulties found in the management of synchronous meetings for data collection among these women, it was found that asynchronous methods of online research are potential strategies for this group in specific, considered of difficult access. This work aims to demonstrate the methodological path to develop exploratory research, with a qualitative approach, by online methods, applying strategies such as open-ended interviews and online focus groups, by using WhatsApp as social media.

The unspoken plight of married adolescent girls in rural Tamil Nadu: Narrative summary on unmet sexual and reproductive health needs and barriers

Background: Young women who marry as adolescents face a number of sexual and reproductive health (SRH) issues. This study aimed to identify unmet SRH needs of adolescent girls and barriers they face in achieving them in rural Tamilnadu, India. Methodology: This qualitative study used narratives to understand participants and their immediate family’s SRH needs and barriers based on World Health Organization (WHO) guidelines. Totally, 14 in-depth interviews with young women and 14 focus group discussions with family members were conducted. The collected data were recorded digitally and transcribed verbatim and analysed by content analysis method. Results: Unmet SRH needs, primarily constituted of family planning methods, menstrual hygiene, sexual health, and Sexually Transmitted Diseases STD awareness. Barriers to healthcare access are societal stigma, taboos, intimate partner violence, and early marriage. Conclusions: The topic of family planning was taboo, menstruation as a negative influence on their daily activities, engaging in sexual activities was to provide sexual pleasure to their partners, to comply with their partners' wishes when under the influence of alcohol, and to produce children and lack of education regarding obtaining consent for sexual activity. We can conclude that it is important to understand how the SRH needs of adolescent girls can be met and need better-suited policies and services.

Perceptions on COVID-19 Vaccination among People Aged more than 50 years in Urban Field Practice Area of Department of Community Medicine in a Tertiary Care Teaching Hospital, Hyderabad: A Reflection from Focus Group Discussions

Background: Despite several efforts to limit the viral transmission, the COVID-19 vaccine has been the only “the ray of hope” to end the pandemic. However, vaccine hesitancy could reduce coverage and hinder herd immunity. People’s intention to get vaccinated can be shaped by several factors, including risk perception which, in turn, is influenced by effect. The need to acquaint oneself to the beliefs, concerns, and circumstances of one’s own population in the community becomes important for successful implementation of the program. Therefore, the present study was conducted to gain insights into perceptions of vaccination. Objectives: The objective is to understand the felicitating factors and hindering factors for acceptance of vaccines by the population among people aged 50 years in urban field practice area of the Department of Community Medicine in a Tertiary care teaching hospital, Hyderabad. Subjects and Methods: Data were extracted from audio recording of five focus group discussions that were conducted in the urban field practice care of a tertiary care teaching hospital in Hyderabad through open-ended questions. Categories, subcategories, and themes were created by deductive approach. Results: The motivating factors for vaccine acceptance were found to be fear of getting disease, wanting to return normalcy, and trust in treating doctors, whereas, barriers were fear of death due to vaccine, opacity in vaccine details, anxiety, and misinterpretation of adverse events. Conclusion: Having a clear understanding about the belief system of the target population could help in designing the guidelines for vaccination program to escalate the immunization and increase the acceptance.

Gestão e ambientes de trabalho na atenção primária à saúde: revisão de escopo / Gestión y entornos de trabajo en la atención primaria de salud: revisión del alcance / Management and work environments in primary health care: scope review

RESUMO Objetivo: identificar subsídios teóricos e empíricos sobre ambientes de trabalho na atenção primária à saúde (APS) em sua relação à saúde do trabalhador (questão preliminar) que indiquem elementos relativos à gestão (questão específica). Métodos: Scoping Review de seis etapas com consulta aos sujeitos, busca na literatura do período de 2010 a 2019 em seis bases de dados e bibliotecas virtuais com seleção de 21 artigos. A etapa complementar, de consulta, operacionalizou grupo focal com 14 trabalhadores da APS em um município do Sul do Brasil. Resultados: foram organizados em três categorias temáticas: i) Aspectos administrativos no ambiente de trabalho: dificuldades relacionadas à gestão; ii) Percepções sobre as relações de trabalho: barreiras entre equipe e gestão; e iii) Conflitos no ambiente de trabalho: estratégias de enfrentamento. Considerações finais: questões de ordem burocrática e de rotina da APS influenciam as relações interpessoais e os resultados alcançados, sendo fundamentais para o alcance de ambientes saudáveis de trabalho dos atores em cena. O suporte institucional, o diálogo e a possibilidade de exercer um trabalho pleno de sentido e valor é direito do trabalhador, reafirmando a promoção de ambientes de trabalho saudáveis na APS como prioridade ético-política.

RESUMEN Objetivo: identificar subsidios teóricos y empíricos sobre ambientes de trabajo en APS en su relación con la salud de los trabajadores (cuestión preliminar) que indiquen elementos relacionados con la gestión (cuestión específica). Métodos: Scoping Review de seis etapas con consulta a los sujetos, búsqueda bibliográfica en el período de 2010 a 2019 en seis bases de datos y bibliotecas virtuales con selección de 21 artículos. La fase complementaria, de consulta, consistió en un grupo de reflexión con 14 trabajadores de Atención Primaria de Salud en un municipio del Sur de Brasil. Resultados: organizados en tres categorías temáticas: Aspectos administrativos en el entorno laboral: dificultades relacionadas con la gestión; Percepciones sobre las relaciones laborales: barreras entre el equipo y la dirección; Conflictos en el entorno laboral: estrategias de afrontamiento. Consideraciones finales: las cuestiones burocráticas y rutinarias de la APS influyen en las relaciones interpersonales y en los resultados alcanzados, siendo fundamentales para el logro de ambientes de trabajo saludables de los actores en escena. El apoyo institucional, el diálogo y la posibilidad de ejercer un trabajo lleno de sentido y valor es un derecho del trabajador, reafirmando la promoción de ambientes de trabajo saludables en la APS como una prioridad ético-política.

ABSTRACT Objective: to identify theoretical and empirical subsidies on work environments in primary health care (PHC) in relation to workers' health (preliminary question) that indicate elements related to management (specific question). Methods: six-step Scoping Review with consultation with the subjects, literature search from 2010 to 2019 in six databases and virtual libraries with selection of 21 articles. The complementary stage, consultation, operated a focus group with 14 PHC workers in a municipality in southern Brazil. Results: they were organized into three thematic categories: i) Administrative aspects in the work environment: difficulties related to management; ii) Perceptions about labor relations: barriers between staff and management; and iii) Conflicts in the workplace: coping strategies. Final considerations: bureaucratic and routine PHC issues influence interpersonal relationships and the results achieved, being fundamental for achieving healthy work environments for the actors on the scene. Institutional support, dialogue and the possibility of carrying out work full of meaning and value are workers' rights, reaffirming the promotion of healthy work environments in PHC as an ethical-political priority.

Perception of Malaysian Undergraduate Medical Students Regarding Soft Skills: A Qualitative Study

@#Introduction: The cognitive and psychomotor abilities needed by physicians are widely addressed in the undergraduate medical curriculum; however, the attitude (affective domain) is rarely addressed. Soft skills refer to a person’s ability to communicate efficiently, collaborate, and have various personality traits that define people’s interactions. This study aimed to determine the perception of undergraduate medical students on soft skills. Methods: A total of twenty-four undergraduate medical students from our institution participated in this study. The students attended a one-hour lecture session about soft skills conducted by a clinician. Within a week of the lecture, we held four focus group discussions (FGDs). Each focus group consisted of six students. This qualitative study’s sample selection process was by the convenience sampling technique until participant numbers reached data saturation. Thematic analysis was used to interpret the transcripts of the FGDs. Results: Thirteen (54.1%) students had prior knowledge limited to some attributes of soft skills during high school and via community service. Introduction to soft skills specifically occurred to 18 (75.0%) students after joining the medical college. Ten (41.6%) students opined that empathy is the most essential, whereas nine (37.5%), four (16.6%), one (4.1%) mentioned that communication skills, teamwork, and time management, respectively, are essential soft skills for physicians. Conclusion: All undergraduate medical students (100%) enrolled in this study mentioned that soft skills are essential for physicians. Therefore, soft skills training must become an integral part of the undergraduate medical curriculum rather than merely a component of the hidden curriculum.

Grupos de medicação e experiência do adoecimento: compartilhamento de narrativas no contexto da atenção psicossocial / Medication groups and illness experience: sharing narratives in the context of psychosocial care

Resumo A experiência do adoecimento é entendida enquanto dimensão subjetiva, estruturada socialmente, sobre a doença e suas repercussões pessoais, referidas ao campo das práticas, crenças e valores compartilhados. O grupo de medicação discutido neste estudo estimulou a produção de narrativas sobre a experiência do adoecimento para abordar o empoderamento do usuário, a partir do diálogo sobre uso e manejo de psicotrópicos. Trata-se de um estudo qualitativo, descritivo-exploratório. A questão de pesquisa foi: Como a experiência do adoecimento é apresentada nas narrativas dos participantes dos grupos de medicação? Vinte e dois usuários de serviços comunitários de saúde mental e cinco familiares destes participaram de duas reuniões do grupo de medicação e três grupos focais. A análise dos resultados materializou-se na perspectiva da antropologia médica e da psicopatologia fenomenológica. As categorias de análise deste artigo são: experiência de participação em grupos de medicação, experiência de uso e manejo da medicação, experiência com o adoecimento e diagnóstico. As narrativas produzidas indicaram que os diálogos em grupo sobre medicamentos subsidiam a formulação e o compartilhamento de significados atribuídos à experiência do adoecimento mental e de seu tratamento medicamentoso. Deste modo, os grupos de medicação reforçaram a atuação conjunta de profissionais, familiares e usuários, ampliando as possibilidades de cuidado sensível à experiência vivida.

Abstract The illness experience is understood as the subjective dimension, socially structured, about the disease and its personal repercussions, referred to the field of shared practices, beliefs and values. The medication group discussed in this study stimulated the illness experience narratives production, to address the user's empowerment, starting from the dialogue about the psychotropics use and self-management. This is a qualitative, descriptive-exploratory study. The research question was: How is the illness experience presented in the narratives of medication groups participants? Twenty-two community mental health service users and five family members participated in two medication group meetings and three focus groups. The results analysis materialized from the perspective of medical anthropology and phenomenological psychopathology. The analysis categories in this article are: experience of participation in medication groups, use and medication self-management and experience of illness and diagnosis. The narratives produced indicated that group dialogues about medicines supports meaning formulate and sharing assigned to the mental illness experience and drug treatment. Therefore, these medication groups reinforced the joint performance of professionals, family members and users, expanding proposals of sensitive care to lived experience.

Estrés percibido en niños deportistas: Análisis de grupos focales / Perceived stress in children athletes: Analysis of focus groups

Resumen Con el objetivo de conocer los factores que los niños perciben como estresantes dentro de la práctica deportiva, se llevó a cabo una investigación de corte cualitativo y de diseño fenomenológico, en la cual se realizaron cuatro grupos focales en los que participaron un total de 41 niños deportistas de entre seis y doce años pertenecientes a las disciplinas de gimnasia artística, natación clavados o fútbol. Las entrevistas permitieron identificar factores que los niños perciben como estresantes en su práctica deportiva, que según lo reportado por ellos, se dividen en dos contextos: el entrenamiento y la competencia. En el entrenamiento, los factores que más mencionaron fueron las exigencias y el favoritismo por algunos niños del grupo por parte del entrenador, así como experimentar emociones negativas, entre ellas la falta de tiempo para realizar otras actividades y el cansancio físico. En el contexto de la competencia, reportaron experimentar emociones negativas y preocupación como los factores que más les generan estrés. Los hallazgos permiten corroborar que los niños deportistas perciben distintas situaciones de estrés asociadas con la práctica de su disciplina, por lo que es importante incluir en los programas deportivos, el entrenamiento en estrategias de afrontamiento. Es probable que si los niños aprenden a afrontar el estrés de manera adecuada, no solo tendrán una mejor salud física y emocional, sino también más éxito en su disciplina y disminuirán las tasas de abandono.

Abstract Doing physical activity carries multiple benefits both physical and psychological (Aparicio, Carbonell y Delgado, 2010); however, when competitive sports practice is being carried out, the athletes can find themselves with less favoring situations such as pressure, coach demands and a psychologically challenging, environment that may conduce them to stress states (Lucia et al., 2017). The athletes that present stress in their sports practice exteriorize some consequences that may include low quality performance, loss of sleep and appetite, decrease in satisfaction levels for sports training and increase in physical injuries (Abián-Vicén, Báguena y Abián, 2015). When the stress becomes chronic it becomes as predictor of burnout syndrome in sports (De Francisco, Arce, Vílcheza y Vales, 2016). Also, these consequences may result significative not only in sports training but in the personal life of the athletes, therefore, is important make an intervention for these athletes to avoid reaching chronic stressful states. However, there is little information on the factors that cause stress in child athletes because most of the research in the field has been developed in an older population that practices high-performance sports (Ramírez, 2015), so it isn't appropriate to use this foundation with children because their development stage is different and stress could have different sources and repercussions. In order to know the factors that children perceive as stressors in sports, a qualitative research and phenomenological design was carried out, in which four focus groups were carried out, in which a total of 41 children participated. The inclusion criteria to participate were being affiliated with sports centers of the Mexico City government, being between 6 and 12 years old and having participated in at least one competition or tournament. Children who did not want to collaborate or whose parents did not give consent for their participation were excluded. A comparative analysis was made for the codification and categorization of information that consists of three types of codification: open, axial and selective (Onwuegbuzie, Dickinson, Leech y Zoran, 2011). After the open codification analysis, five preliminary categories were detected, later, in the axial codification, the judges agreed that the five categories of stressors that the children reported were produced in two different contexts: training and competition, so these two were classified as the two major categories. Finally, after the axial coding, every one of these two major categories stayed conformed by five the subcategories: personal situations, coaches, peers, family and external situations. Every subcategory consists of various factors that produce stress to children. In training, the factors that children mentioned are the demands and favoritism by the coach; also to experiment negative emotions like fear, anger or frustration; lack of time to do recreational and academic activities; extreme physical tiredness; negative interaction with peers, violence or exclusion between peers, the demand of satisfactory results by their relatives and the perception of lack of infrastructure for suitable training. In the competitive context, children report that suffering negative emotions generated by the pressure of competition, concerns about their performance in the contest, unpredictable situations such as accidents or delays, uneasiness about the performance of other competitors, and being exposed to the judgments that people who attend the competition will make, were the factors that children consider as generators of stress. In future research, it will be advisable to take into account the time that children have been practicing the sport, since it is possible that the perception of stress changes with the years of training. We can also evaluate in groups of children who are at the same age, since the maturation process progresses rapidly during childhood. It will also be worth differentiating between individual and team sports athletes.

Aprendizaje significativo de bioseguridad a través de infografías interactivas / Meaningful learning about biosafety through interactive infographics

Introducción: La implementación de diversos recursos interactivos en el aula fomenta nuevas estrategias educativas y edifica experiencias innovadoras entre docentes y estudiantes. En este sentido, la infografía, como objeto de aprendizaje, complementa el contenido disponible en los entornos virtuales y genera ambientes de aprendizaje reflexivos, cooperativos y autónomos. Objetivo: Identificar las apreciaciones, actitudes, experiencias y perspectivas en relación con el aprendizaje significativo de bioseguridad mediante el uso de infografías. Métodos: Se realizó un estudio cualitativo a través de la técnica de grupos focales. Se preparó un guion entorno a las inquietudes obtenidas a partir de la retroalimentación y se formularon varias preguntas que fueron grabadas en audio. Para el análisis del discurso se definieron categorías básicas, las cuales se ajustaron conforme se revisaron los testimonios, según el método de la teoría fundamentada. Una vez identificadas las categorías se procedió a triangular el objetivo, los documentos y los estudios previos. Resultados: Se integró y analizó el contenido de la transcripción de los grupos focales. Se construyeron cuatro categorías básicas, que abarcaron la comprensión del estudiante con respecto a la función formativa del proceso, el empoderamiento de los estudiantes, el manejo de conflictos y algunas sugerencias de mejora desde la perspectiva del estudiante. Conclusiones: La técnica de grupos focales resultó una herramienta valiosa para conocer el desarrollo de nuevos contenidos digitales, a través de las infografias como una estrategia didáctica, evidente en procesos educativos dinámicos, flexibles, participativos y motivadores, que impulsan el aprendizaje significativo, el trabajo colaborativo y el pensamiento crítico(AU)

Introduction: Implementation of various interactive resources in the classroom encourages new educational strategies and builds innovative experiences among professors and students. In this respect, infographics, as a learning object, complements the content available in virtual environments and generates reflective, cooperative and autonomous learning environments. Objective: To identify appreciations, attitudes, experiences and perspectives regarding the meaningful learning of biosafety through the use of infographics. Methods: A qualitative study was carried out using the focus group technique. A script was prepared based on the concerns obtained from feedback, several questions were formulated and, later on, the answers were recorded on audio. For discourse analysis, basic categories were defined and adjusted as the testimonies were reviewed, based on the grounded theory method. Once the categories were identified, the objective, the documents and the previous studies were triangulated. Results: The contents of the focus groups' transcript were integrated and analyzed. Four basic categories were constructed, which included students' understanding of the formative function of the process, students' empowerment, management of conflicts, and some suggestions for improvement based on the students' perspective. Conclusions: The focus group technique was a valuable tool for learning about the development of new digital content, through infographics as a didactic strategy, a fact evident in dynamic, flexible, participatory and motivating educational processes that promote meaningful learning, collaborative work and critical thinking(AU)

Perceptions of senior nursing students regarding clinical decision-making / Percepciones de estudiantes avanzados de enfermería sobre la toma de decisiones clínicas / Percepções dos estudantes finalistas em enfermagem sobre a tomada de decisão clínica

ABSTRACT Objectives: to understand the perceptions of senior students in an undergraduate nursing course at a nursing college in Lisbon regarding skills related to clinical decision-making learned during their initial training. Methods: qualitative study, of an exploratory and descriptive nature. Data collection occurred by carrying out a focus group with eight senior students in an undergraduate nursing course. Data treatment applied content analysis, performed with twebQDA® software. Results: data were analyzed according to the four dimensions of Tanner's model of clinical judgment, and noticing and interpreting stood out as the most influential in clinical decision-making. Theoretical and clinical knowledge, validation of care planning, prioritization, and capacity to discuss and debate about situations emerged as the most representative skills. Final considerations: students make decisions by means of a complex process by using the knowledge and skills learned during their training.

RESUMEN Objetivo: comprender las percepciones de estudiantes avanzados de una escuela superior de enfermería de Lisboa sobre las competencias de toma de decisiones clínicas adquiridas en la formación inicial. Métodos: estudio cualitativo, exploratorio y descriptivo. Datos recolectados mediante focus group con 8 estudiantes avanzados de la carrera de licenciatura en enfermería. Datos analizados por análisis de contenido, utilizándose software webQDA® . Resultados: los datos fueron analizados según las cuatro dimensiones del modelo de toma de decisiones de Tanner, destacándose la Percepción y la Interpretación como las más influyentes en la toma de decisiones clínicas. Surgieron como competencias más representativas: el conocimiento teórico y clínico, la validación de la planificación de cuidados, la priorización y la capacidad de discusión y argumentación sobre las situaciones. Consideraciones Finales: los estudiantes toman decisiones aplicando un proceso complejo, utilizando el conocimiento y las competencias adquiridas durante su formación.

RESUMO Objetivo: compreender as percepções dos estudantes finalistas de uma escola superior de enfermagem de Lisboa sobre as competências de tomada de decisão clínica adquiridas na formação inicial. Métodos: estudo qualitativo de caráter exploratório e descritivo. A colheita de dados foi realizada por meio de um focus group, com 8 estudantes finalistas do curso de licenciatura em enfermagem. Na aná lise dos dados, recorreu-se à análise de conteúdo pelo software webQDA®. Resultados: os dados foram analisados segundo as quatro dimensões do modelo de tomada de decisão de Tanner, destacando-se a Percepção e a Interpretação como as mais influentes na tomada de decisão clínica. Emergiram como competências mais representativas: o conhecimento teórico e clínico, a validação do planejamento dos cuidados, a priorização e a capacidade de discussão e argumentação sobre as situações. Considerações Finais: os estudantes tomam decisões por meio de um processo complexo usando o conhecimento e as competências adquiridas na formação.

Depressão em mulheres idosas: representações sociais por meio de grupos focais / Depression in elderly women: social representations by focus groups / Depresión en las mujeres mayores: representaciones sociales por grupos de enfoque

O envelhecimento populacional é uma realidade mundial. A depressão é uma das doenças psiquiátricas mais frequentes em idosos, acometendo principalmente mulheres, relacionando-se com estado civil, baixa escolaridade, solidão, dentre outros fatores sociais. O presente estudo objetivou investigar as Representações Sociais (RS) de idosas sobre a depressão. Participaram da pesquisa 10 mulheres com idade média de 68,2 anos (DP=5). Foi realizada a técnica de grupos focais, com a utilização de um roteiro de entrevista semiestruturado e a realização de duas sessões, sendo uma com idosas participantes de grupos de convivência e outra com idosas não participantes de grupos prévios a este. Os resultados apontaram um conhecimento simplista sobre a manifestação da depressão e uma associação de representações mais negativas entre as idosas viúvas. As idosas participantes de grupos demonstraram um maior conhecimento sobre o tratamento da depressão, enquanto as não participantes de grupos mostraram uma crença na religiosidade e na fé.

Population aging is a worldwide reality. Depression is one of the most frequent psychiatric diseases in the elderly, affecting mainly women, relating to marital status, low education, loneliness, among other social factors. The present study aimed to apprehend the SR of elderly women about depression. Ten women with an average age of 68.2 years (SD=5) participated in the research. The focus group technique was performed with the use of a semi-structured interview script and two sessions, one with elderly participants from coexistence groups and the other with non-group participants. The results showed a simplistic knowledge about the manifestation of depression and an association of more negative representations among the widowed elderly. Elder group participants knowledge about the treatment of depression, while non-group participants showed a belief in religiosity and faith.

El envejecimiento de la población es una realidad mundial. La depresión es una de las enfermedades psiquiátricas más frecuentes en los ancianos, que afecta principalmente a las mujeres, en relación con el estado civil, la baja educación, la soledad, entre otros factores sociales. El presente estudio tuvo como objetivo aprehender la RS de las mujeres mayores sobre la depresión. Participaron diez mujeres con una edad promedio de 68.2 años (DP=5). La técnica del grupo focal se realizó con el uso de un guión de entrevista semiestructurada y dos sesiones, una con participantes ancianos de grupos de convivencia y la otra con participantes no grupales. Los resultados mostraron un conocimiento simplista sobre la manifestación de la depresión y una asociación de representaciones más negativas entre los ancianos viudos. Los participantes mayores del grupo mostraron un mayor conocimiento sobre el tratamiento, mientras que los participantes no grupales mostraron una creencia en la religiosidad y la fe.

Violencia hacia el profesional de enfermería: una etnografía focalizada

RESUMEN Objetivo: Describir las experiencias del profesional de enfermería sobre la violencia experimentada en su trabajo. Material y Método: Estudio cualitativo con diseño etnográfico focalizado. Los participantes se seleccionaron utilizando un muestreo no-probabilístico por bola de nieve. Los datos se recolectaron a través de 25 entrevistas a profundidad vía telefónica entre enero y junio de 2018, en tres hospitales de Veracruz, México. El Modelo Interactivo de violencia en el lugar de trabajo diseñado por Chappell y Di Martino fue el referente teórico y la técnica de análisis temática fue con el apoyo del software QUIRKOS. Resultados: Las temáticas resultantes fueron: causas y tipos de agresión, reacción de la víctima ante la agresión y agresor. En su mayoría fueron mujeres (72%), del turno matutino (52%), de los servicios de urgencias y medicina interna (28%). El 68% refirió no haber denunciado la agresión a sus superiores e identificaron al médico como el principal agresor (44%), seguido por el familiar del paciente (20%). Conclusión: Es imperativo la implementación de estrategias para evitar la violencia laboral, así como la formación de pautas a seguir en caso de ser violentada/o.

ABSTRACT Objective: To describe the experiences of nursing professionals concerning workplace violence. Material and Method: Qualitative study with a focused ethnographic design. Participants were selected using non-probability snowball sampling. Data were collected through 25 in-depth telephone interviews between January and June 2018 in three hospitals of Veracruz, Mexico. The theoretical framework was based on the Interactive Model of workplace violence designed by Chappell and Di Martino and the QUIRKOS software was used for the thematic analysis. Results: Findings alluded to the causes and types of aggression, the victim's reaction to the aggression and the aggressor. Participants were mostly women (72%), who worked the morning shift (52%), in the emergency and the internal medicine services (28%). 68% indicated not having reported the aggression to their supervisors and identified the physician as the main aggressor (44%), followed by the patient's family members (20%). Conclusion: It is critical that hospitals implement strategies to avoid workplace violence, as well as guidelines that nurses and other healthcare professionals can follow in case of violence in the work setting.

RESUMO Objetivo: Descrever as vivências do profissional de enfermagem sobre a violência vivenciada em seu trabalho. Material e Método: Estudo qualitativo com desenho etnográfico focado. Os participantes foram selecionados por meio de amostragem não probabilística em bola de neve. Os dados foram coletados por meio de 25 entrevistas telefónicas em profundidade entre janeiro e junho de 2018, em três hospitais em Veracruz, México. O referencial teórico foi o Modelo Interativo de violência no trabalho desenhado por Chappell e Di Martino e a técnica de análise temática foi realizada com apoio do software QUIRKOS. Resultados: Os tópicos foram: causas e tipos de agressão, reação da vítima frente a agressão e o agressor. A maioria eram mulheres (72%), do turno da manhã (52%), dos serviços de emergência e clínica médica (28%). O 68% relatou não ter denunciado a agressão a seus superiores e apontaram o médico como o principal agressor (44%), seguido do familiar do paciente (20%). Conclusão: É imprescindível a implementação de estratégias para evitar a violência no trabalho, bem como a formação de diretrizes a serem seguidas em caso de violência.

Representações sociais sobre uso de cannabis entre jovens: estudo comparativo / Social representações of cannabis use among youngsters: comparative study / Representaciones sociales de la cannabis entre los jóvenes: estudio comparativo

Buscou-se identificar e comparar as representações sociais sobre o consumo da maconha na perspectiva de dois grupos de jovens: frequentadores de uma universidade pública, e participantes não-universitários de um projeto social com oriundos de bairros periféricos. Os dados foram coletados em grupos focais, cada um com seis participantes, sendo a análise fundamentada na teoria das representações sociais e operacionalizada pela análise temática. Foram delimitadas categorias a posteriori: imagens da maconha, visão dos familiares, papel/lugar da maconha, motivação/influência para o uso, contexto de uso, posicionamento da escola/universidade e consequências. Observaram-se aproximações entre os grupos sobre a percepção de inocuidade da maconha por ser produto natural e a dificuldade de dialogar a respeito com os familiares, mas também diferenças, por exemplo, quanto a ser ou não a maconha porta de entrada para outras drogas. Discutir sobre a maconha ainda gera resistências e traz tabus, acentuando a necessidade de promoção de diálogos (AU).

We sought to identify and compare the social representations of marijuana use from the perspective of two groups of young people: those attending a public university, and non-university participants attending a social project with people from suburbs. Data were collected in focus groups, each with six participants, and the analysis was based upon the theory of social representations and carried out through thematic analysis. A posteriori categories were delimited: images of marijuana, family members' view, marijuana's role/place, motivation/influence for use, context of use, school/university positioning and consequences. There were similarities between the groups regarding the perception of the safety of marijuana as a natural product and the difficulty of talking about it within the family, but also differences, for example, as to whether or not marijuana is the gateway to other drugs. Discussing marijuana still generates resistance and brings taboos, accentuating the need to promote dialogues (AU).

Se buscó identificar y comparar representaciones sociales del consumo de marihuana desde dos grupos de jóvenes: los que asisten a una universidad pública y los participantes no universitarios en un proyecto social con personas de los barrios periféricos. Los datos se recolectaron en grupos focales, cada uno con seis participantes, y el análisis se basó en la teoría de las representaciones sociales mediante análisis temático. Se delimitaron categorías a posteriori: imágenes de la marihuana, visión de los familiares, rol/lugar de la marihuana, motivación/influencia para el uso, contexto de uso, posicionamiento de la escuela/universidad y consecuencias. Hubo similitudes en cuanto a la percepción de la seguridad de la marihuana y la dificultad de hablar con los familiares, pero también diferencias, por ejemplo, si la marihuana es o no la puerta de entrada. Hablar de la marihuana aún genera resistencias y trae tabúes, lo que acentúa la necesidad del diálogo (AU).

Ciência na TV: percepções de adolescentes de três cidades brasileiras / Science on TV: perceptions among adolescents in three Brazilian cities

Resumo Importante mediação de práticas culturais, a TV contribui na construção de representações sociais, incluindo a da ciência. Considerando que adolescentes são um dos seus principais públicos, visamos analisar de que forma os conteúdos televisivos podem contribuir para a construção de percepções sobre ciência nesses jovens. Realizamos 12 grupos focais com alunos de escolas públicas e privadas em três cidades brasileiras: Rio de Janeiro (RJ), Belo Horizonte (MG) e Belém (PA). Observamos que, embora estereótipos da ciência e dos cientistas tenham emergido nas discussões, os jovens demonstraram compreender a atividade científica de maneira mais aprofundada, assim como a própria programação televisiva.

Abstract Television is an important mediator of cultural practices and contributes to the construction of social representations, including representations of science. Considering that teenagers are a main target audience, here we analyze how TV content can help build perceptions of science among these young people. Twelve focus groups were held with students from public and private schools in three Brazilian cities: Rio de Janeiro, Belo Horizonte (Minas Gerais), and Belém (Pará). We observed that although stereotypes of science and scientists did emerge in the discussions, the students demonstrated a more detailed understanding of scientific activity, as well as the TV programming itself.

Ligas Acadêmicas na formação do profissional de saúde para o Sistema Único de Saúde: potencialidades e desafios / Academic Leagues in health care worker education for Brazil's Unified Health System: potential and challenges

Introdução: As Ligas Acadêmicas (LA) são associações estudantis que contribuem com o estreitamento da relação ensino-serviço-comunidade. Objetivo: Analisar as potencialidades e os desafios das Ligas Acadêmicas como dispositivos de aprendizagem a partir da percepção de alunos e egressos dos cursos da saúde de dois campi de uma universidade pública do Nordeste brasileiro, com modelos de ensino distintos. Métodos: Trata-se de um estudo qualitativo, cujos dados foram coletados por meio de Grupos Focais e analisados pela técnica de Análise de Conteúdo. Resultados: Foi identificado que, apesar dos desafios inerentes à gestão de pessoas, ao processo de normatização das Ligas e à necessidade de recursos financeiros para a realização das ações, as Ligas Acadêmicas, independentemente do modelo de ensino adotado pela instituição, desempenham importante papel na formação de profissionais de saúde com maior senso crítico, ampliada visão sobre o modo de promover saúde e maior atenção aos princípios e demandas do Sistema Único de Saúde. Conclusão: A partir dos resultados, sugere-se aos discentes e professores uma atuação que favoreça a superação de desafios e a troca de experiências para potencializar a formação complementar em saúde. Às instituições de ensino cabe o papel de acompanhamento das ações das Ligas para garantir e fortalecer a extensão universitária. (AU)

Introduction: Academic Leagues (AL) are student associations that help strengthen the teaching-service-community relationship. Objective: To analyze the potential and challenges of Academic Leagues as learning devices, based on the perception of students and graduates of health degree programs on two campuses at a public university in northeastern Brazil, which use different teaching approaches. Methods: This is a qualitative study, whose data were collected through Focus Groups and analyzed using the Content Analysis technique. Results: Despite the challenges posed by people management, the standardization of the Leagues and the need for financial resources for full operation, the Academic Leagues, regardless of the teaching model adopted by the institution, play an important role in education and training of health workers so that they can develop greater critical sense, broader vision on health promotion and greater attention to the principles and demands of the Unified Health System. Conclusion: The results showed that students and teachers are encouraged to take action to overcome challenges and to exchange experiences to enhance complementary health education. Educational institutions have the role of monitoring the actions of the Leagues to strengthen and ensure the offer of university extension activities. (AU)

Segurança alimentar e nutricional: significados construídos por líderes comunitários e moradores de um bairro popular de Salvador, Bahia, Brasil / Food and nutrition security: meanings developed by community leaders and residents of a low-income community in Salvador, Bahia State, Brazil / Seguridad alimentaria y nutricional: significados construidos por líderes comunitarios y residentes en un barrio popular de Salvador, Bahía, Brasil

Resumo: Este artigo tem como objetivo explorar os significados associados ao conceito de segurança alimentar e nutricional por moradores e líderes comunitários participantes de uma pesquisa-ação em segurança alimentar e nutricional, na região de Pau da Lima, Salvador, Bahia, Brasil, e como esses significados evoluíram ao longo do projeto. A análise se apoiou em mapas conceituais elaborados por 37 moradores e líderes comunitários participantes da oficina inicial do projeto, realizada em 2014, assim como nos resultados de um grupo focal realizado dois anos depois, junto a nove líderes comunitários e moradores que formaram o grupo nuclear da pesquisa-ação ao longo do projeto. Os resultados mostram que a segurança alimentar e nutricional, inicialmente percebida como uma questão individual e pautada na segurança sanitária e qualidade nutricional dos alimentos, se tornou uma questão política, como expressão das desigualdades e das relações de poder nas quais os indivíduos estão inseridos. Assim, a segurança alimentar e nutricional passou a se situar no campo de práxis dos líderes: o da luta política. Em comunidades onde há uma baixa cobertura de agentes comunitários de saúde e poucas lideranças para muitas pautas, a frágil inserção do conceito de segurança alimentar e nutricional e o baixo reconhecimento do direito à alimentação certamente constituem o maior desafio da participação social. Em tempos de retrocessos democráticos e desmantelamento dos programas de segurança alimentar e nutricional, é preciso interrogar-se sobre a construção de conteúdos e significados acerca do tema, para a ampliação e o fortalecimento da sua base social de luta.

Abstract: This article aims to explore the meanings associated with the concept of food and nutrition security by residents and community leaders participating in an action-research project in food and nutrition security in the community of Pau da Lima in Salvador, Bahia State, Brazil, and how these meanings evolved over the course of the project. The analysis was based on conceptual maps produced by 37 residents and community leaders participating in the initial workshop in 2014, and on the results of a focus group two years later with nine community leaders and residents that formed the core group for the action research throughout the project. The results show that food and nutrition security, initially perceived as an individual issue and based on the foods' health safety and nutritional quality, became a political issue as an expression of the inequalities and power relations in which the individuals were immersed. Food and nutrition security thus became part of the leaders' field of praxis and political struggle. In communities with low coverage by community health agents and few leaders for many agendas, the weak inclusion of the food and nutrition security concept and low recognition of the right to food were definitely the main challenge for social participation. In times of democratic setbacks and dismantling of food and nutrition security programs, it is necessary to analyze the development of contents and meanings on the theme in order to expand and strengthen the social base in this struggle.

Resumen: El objetivo de este artículo es explorar los significados asociados con el concepto de seguridad alimentaria y nutricional por parte de residentes y líderes comunitarios, participantes en una investigación-acción en seguridad alimentaria y nutricional en la región de Pau da Lima, Salvador, Bahía, y cómo esos significados evolucionaron a lo largo del proyecto. El análisis se apoyó en mapas conceptuales, elaborados por 37 residentes y líderes comunitarios participantes en el taller inicial del proyecto, realizado en 2014, así como en los resultados de un grupo focal, realizado dos años después junto a 9 líderes comunitarios y residentes que formaron el grupo central de la investigación-acción a lo largo del proyecto. Los resultados muestran que la seguridad alimentaria y nutricional, inicialmente percibida como una cuestión individual, y pautada en la seguridad sanitaria y calidad nutricional de los alimentos, se convirtió en una cuestión política, a la par que expresión de desigualdades y relaciones de poder en la que se encuentran los individuos. Así, la seguridad alimentaria y nutricional pasó a situarse en el campo de praxis de los líderes o de la lucha política. En comunidades donde hay una baja cobertura de agentes comunitarios de salud y pocos liderazgos para muchas pautas, la frágil inserción del concepto de seguridad alimentaria y nutricional, y el bajo reconocimiento del derecho a la alimentación, ciertamente constituyen el mayor desafío de la participación social. En tiempos de retrocesos democráticos y desmantelamiento de programas de seguridad alimentaria y nutricional, es necesario preguntarse acerca de la creación de contenidos y significados acerca de este tema, para la ampliación y el fortalecimiento de su base social de lucha.