Estilo de liderazgo situacional en el profesional de enfermería y su relación con factores laborales / Style of situational leadership in the nursing professional and its relationship with labor factors in a second level hospital, 2021 / Estilo de liderança situacional no profissional de enfermagem e sua relação com fatores de trabalho. hospital de segundo nível, 2021

RESUMEN Objetivo: Identificar el estilo de liderazgo situacional del profesional de enfermería y su relación con los factores laborales en un hospital de segundo nivel. Metodología: Se trata de un estudio descriptivo relacional de corte transversal. La población de estudio fueron 111 enfermeras, para la recolección de datos se utilizó el instrumento de Paul Hersey y Keneth Blanchard (1973), el cual consta de 12 situaciones. El instrumento del estudio se envió por correo electrónico y WhatsApp, y se utilizó el formato en papel para incrementar la tasa de respuesta. La información se procesó a través del programa SPSS V24. Resultados: Se obtuvo una tasa de respuesta del 56%. Los participantes tienen una edad media de 36 años y una DE 11,82. Hay un predominio del sexo femenino del 90,3%, el 36% tiene estudios a nivel de especialización y maestría. En cuanto a los años laborando, más del 40% tiene menos de 5 años. El estilo mayormente adoptado por el personal es el estilo participativo (E3) 42%, seguido del estilo persuasivo (E2) 37%, dirigir (E1) 13%, por último, el estilo delegar (E4) 8%. El estilo de liderazgo situacional no presentó asociación estadísticamente significativa con los años laborando y la preparación académica, ya que se obtuvo valores p> 0.05. Se evidencio una relación estadísticamente significativa entre los años de labor como profesional de enfermería y la preparación académica, con una p<0.05. Conclusión: El estilo de liderazgo predominante es el participativo y no se evidenció relación estadísticamente entre el estilo de liderazgo y los factores laborales.

ABSTRACT Objective: To identify the situational leadership style of the nursing professional and its relationship with work factors in a second-level hospital. Methodology: This is a descriptive, relational, cross-sectional study. The study population was 111 nurses; for data collection the instrument of Paul Hersey and Keneth Blanchard (1973), which consists of 12 situations, was used. The research instrument was sent by email and WhatsApp, and available in print to increase the response rate. The information was processed through the SPSS V24 program. Results: A response rate of 56% was obtained. The participants have a mean age of 36 years and a SD of 11.82. There is a female predominance of 90.3%, where 36% has studied at the specialization and master's level. Regarding the years working, more than 40% has worked less than 5 years. The style mostly adopted by the staff is the participative style (E3) 42%, followed by the persuasive style (E2) 37%, directing (E1) 13%, and finally, the delegative style (E4) 8%. The situational leadership style did not present a statistically significant association with the years of work and academic preparation, since p values> 0.05 were obtained. A statistically significant relationship was evidenced between the years of work as a nursing professional and academic preparation, with a p <0.05. Conclusion: The predominant leadership style is participative and there was no statistically evidenced relationship between leadership style and work factors.

RESUMO Objetivo: Identificar o estilo de liderança situacional do profissional de enfermagem e sua relação com fatores de trabalho em um hospital de segundo nível. Metodologia: Trata-se de um estudo descritivo relacional transversal. A população do estudo foi de 111 enfermeiros, para coleta de dados o instrumento de Paul Hersey e Keneth Blanchard (1973), que consiste em 12 situações. O instrumento de estudo foi enviado por email e WhatsApp, e o formato de papel foi utilizado para aumentar a taxa de resposta. As informações foram processadas através do programa SPSS V24. Resultados: Obteve-se uma taxa de resposta de 56%. Os participantes têm idade média de 36 anos de idade e DE de 11,82. Há predominância do sexo feminino de 90,3%, 36% têm estudos no nível de especialização e mestrado. Quanto aos anos de trabalho, mais de 40% têm menos de 5 anos. O estilo adotado principalmente pelos funcionários é o estilo participativo (E3) 42%, seguido pelo estilo persuasivo (E2) 37%, direto (E1) 13%, e por último, o estilo delegado (E4) 8%. O estilo de liderança situacional não apresentou associação estatisticamente significante com os anos de trabalho e preparação acadêmica, uma vez que foram obtidos valores p> 0,05.Foi evidenciada uma relação estatisticamente significativa entre os anos de trabalho como profissional de enfermagem e preparação acadêmica, com p<0,05. Conclusão: O estilo de liderança predominante é participativo e não houve relação estatística entre estilo de liderança e fatores de trabalho.

Representações sociais do autocuidado na percepção de homens com diabetes / Representaciones sociales del autocuidado en la percepción de hombres con diabetes / Social representations of self-care in the perception of men with diabetes

RESUMO Objetivo: compreender as representações sociais de homens com diabetes sobre o seu autocuidado. Método: abordagem processual das representações sociais com amostra por tipicidade (n=50), composta de homens atendidos num serviço ambulatorial mineiro. Coletaram-se dados de caracterização e realizaram-se entrevistas individuais em profundidade durante três meses. Foram tratados os dados, usando softwares SPPS versão 26, NVivo Pro11® e Iramuteq com análise de conteúdo (coeficiente de Pearson ≥0,70), e atendidos os requisitos ético-legais. Resultados: idade predominante ≥50 anos. Emergiram dos discursos duas categorias: 1) Possibilidade do diabetes: atitudes adotadas ou negligenciadas - enfocando adequações em hábitos alimentares; 2) Diabetes e autocuidado: prática social do cuidado enfocando a necessidade de controle da alimentação e prática de atividade física, visando à prevenção de complicações associadas. Conclusão: a adesão/negligência ao autocuidado evidenciadas remetem à necessidade de fortalecimento dos sistemas de apoio ao grupo referente às ações de prevenção de doença e promoção da saúde, visando a controle dos fatores de risco modificáveis e dos níveis glicêmicos e diagnóstico precoce para o adiamento/manejo das possíveis complicações.

RESUMEN Objetivo: comprender las representaciones sociales de hombres con diabetes sobre su autocuidado. Método: enfoque procesal de las representaciones sociales con muestreo por conveniencia (n=50), compuesta de hombres atendidos en un servicio ambulatorio de Minas Gerais-Brasil. Se recogieron datos de caracterización y se realizaron entrevistas individuales en profundidad durante tres meses. Fueron tratados los datos, usando softwares SPPS versión 26, NVivo Pro11® e Iramuteq con análisis de contenido (coeficiente de Pearson ≥0,70), y atendidos los requisitos ético-legales. Resultados: edad predominante ≥50 años. Surgieron, de los discursos, dos categorías: 1) Posibilidad de la diabetes: actitudes adoptadas u olvidadas - enfocando adecuaciones en hábitos alimenticios; 2) Diabetes y autocuidado: práctica social del cuidado enfocando la necesidad de control de la alimentación y práctica de actividad física, teniendo por objetivo la prevención de complicaciones asociadas. Conclusión: la adhesión/negligencia evidenciada al autocuidado remiten a la necesidad de fortalecimiento de los sistemas de apoyo al grupo referente a las acciones de prevención de enfermedad y promoción de la salud, buscando controlar los factores de riesgo modificables y los niveles glucémicos y diagnóstico precoz para el aplazamiento/manejo de las posibles complicaciones.

ABSTRACT Objective: to understand the social representations of men with diabetes concerning their self-care. Method: a procedural approach to social representations with sampling by typicity (N=50), composed of men treated in an outpatient service in Minas Gerais. The study collected characterization data and performed in-depth individual interviews for three months. The data were processed using the software SPPS version 26, NVivo Pro11®, and Iramuteq with content analysis (Pearson's coefficient ≥0.70), and ethical-legal requirements were met. Results: predominant age of 50 years. Two categories emerged from speeches: 1) possibility of diabetes: attitudes adopted or neglected - focusing on adjustments in eating habits; 2) Diabetes and self-care: social practice of care focusing on the need for food control and practice of physical activity, aimed at preventing complications associated. Conclusion: the adherence/neglect to self-care evidenced refer to the need to strengthen the support systems to the group regarding the actions of disease prevention and health promotion, aiming at control of modifiable risk factors and glycaemic levels and early diagnosis for the postponement/management of possible complications.

Number of public health nurses and COVID-19 incidence rate by variant type: an ecological study of 47 prefectures in Japan

BACKGROUND@#Community health activities by public health nurses (PHNs) are known to improve lifestyle habits of local residents, and may encourage the practice of infectious disease prevention behaviors during the COVID-19 pandemic. We investigated the association between prefecture-level COVID-19 incidence rate and the number of PHNs per population in Japan, by the COVID-19 variant type.@*METHODS@#Our data were based on government surveys where prefectural-level data are accessible to the public. The outcome variable was the COVID-19 incidence rate (i.e., the cumulative number of COVID-19 cases per 100,000 population for each variant type in 47 prefectures). The explanatory variable was the number of PHNs per 100,000 population by prefecture. Covariates included socioeconomic factors, regional characteristics, healthcare resources, and health behaviors. The generalized estimating equations of the multivariable Poisson regression models were used to estimate adjusted incidence rate ratio (IRR) and 95% confidence interval (CI) for the COVID-19 cases. We performed stratified analyses by variant type (i.e., wild type, alpha variant, and delta variant).@*RESULTS@#A total of 1,705,224 confirmed COVID-19 cases (1351.6 per 100,000 population) in Japan were reported as of September 30, 2021. The number of PHNs per 100,000 population in Japan was 41.9. Multivariable Poisson regression models showed that a lower number of PHNs per population was associated with higher IRR of COVID-19. Among all COVID-19 cases, compared to the highest quintile group of the number of PHNs per population, the adjusted IRR of the lowest quintile group was consistently significant in the models adjusting for socioeconomic factors (IRR: 3.76, 95% CI: 2.55-5.54), regional characteristics (1.73, 1.28-2.34), healthcare resources (3.88, 2.45-6.16), and health behaviors (2.17, 1.39-3.37). These significant associations were unaffected by the variant type of COVID-19.@*CONCLUSION@#We found that the COVID-19 incidence rate was higher in prefectures with fewer PHNs per population, regardless of the COVID-19 variant type. By increasing the number of PHNs, it may be possible to contain the spread of COVID-19 in Japan and provide an effective human resource to combat emerging infectious diseases in the future.

Building capacities for universal health care in the Philippines: Development and implementation of a leadership training program for public health nurses

@#Achievement of Universal Health Care (UHC) in the Philippines requires capable health workers who can navigate changes and lead in the local implementation of health system reforms. Public health nurses are in a strategic position to lead in UHC implementation as they constitute the largest cadre of health workers in the public health setting, and core concepts of UHC intersect with principles of public health nursing practice. This paper aims to describe the development and implementation of a leadership training program for public health nurses in the Philippines, in response to UHC. Document reviews of training reports and evaluations, including course site data analytics, and evaluation of the training program were done for the four cohorts of the course. The University of the Philippines Manila College of Nursing, with support from the Department of Health, responded to the increased demand of the Philippine health system for public health nurses with strong foundations and advanced skills by designing and offering a leadership development course specific to PHNs. From November 2019 to March 2022, a total of 183 participants from 17 regions completed the training. With the COVID-19 pandemic and dynamic changes in governance, the experiences of the project highlighted the need for flexibility in delivering the training program, updating module contents according to the latest developments, and improving course duration and evaluation. Barriers to course engagement and completion must be addressed for PHNs, their workplaces, clients, and the health system to benefit the most from the training.

Importancia del tamaño del efecto para la comparación de dos o más grupos en investigaciones en salud pública / The Importance of Effect Size for Comparing Two or More Groups in Public Health Research

Señor Editor: Muchos estudios en ciencias de la salud, con el objetivo de comparar las puntuaciones de una variable entre dos o más grupos (por ejemplo, sexo, nivel socioeconómico, nivel de instrucción, tipo de enfermedad, entre otras), recurren a la determinación de la existencia o no de diferencias estadísticamente significativas reportadas, fundamentalmente, a través de los valores del test de significancia de la hipótesis nula (NHST, por sus siglas en inglés), procedimiento que actualmente se encuentra en discusión.1,2 En este sentido, el NHST puede considerarse como un procedimiento insuficiente para la valoración de la importancia práctica de los resultados. Entre las limitaciones del NHST se pueden mencionar las siguientes: considerar solo el error máximo permitido para rechazar una hipótesis nula (Ho) de ausencia de diferencias estadísticamente significativas y la alta sensibilidad respecto al tamaño de la muestra, donde muestras grandes tienden a estar asociadas también con el rechazo de la Ho.3,4,5 Ante esta situación, se hace necesario el reporte de medidas del tamaño del efecto que permiten la cuantificación de la eficacia de diferentes niveles de una variable independiente. De esta manera, de acuerdo a lo sugerido por el Comité Internacional de Editores de Revistas Médicas,6 se busca complementar la información acerca de la existencia de diferencias estadísticamente significativas (obtenida a través del NHST) con información que indique la magnitud de tales diferencias...(AU)

A enfermagem de saúde pública e as políticas públicas de saúde: um estudo de caso / La enfermería de salud pública y las políticas públicas de salud: uno estudio de caso / Public health nursing and public health policies: a case study

Resumo Objetivos caracterizar as intervenções do enfermeiro especialista de saúde comunitária e de saúde pública de um Agrupamento de Centros de Saúde; identificar os principais fatores facilitadores para o desempenho das competências, e a contribuição para as políticas públicas de saúde. Método estudo de caso, com enfermeiros da especialidade em enfermagem de saúde comunitária e de saúde pública. Coleta de dados por meio de entrevista, no período de outubro a dezembro de 2019. A análise foi guiada por duas estratégias: partir das proposições teoréticas e trabalhar os dados emergentes; e duas técnicas: combinar padrões, "pattern matching" e construir explicações, "explanation building". Resultados a partir da matriz construída, surgiram dez proposições teoréticas, dez evidências emergentes, cinco padrões e cinco hipóteses explicativas. Sobressaem intervenções de vigilância epidemiológica, planeamento e gestão de projetos. A formação pessoal e a comunicação destacam-se como fatores facilitadores. Conclusão e implicações para a prática a intervenção do enfermeiro dessa especialidade apresenta uma dimensão centrada no planeamento e gestão de projetos, identifica e reflete os fatores facilitadores do desempenho das suas competências, enquanto aplicador de políticas públicas de saúde.

Resumen Objetivos caracterizar las intervenciones del enfermero especialista en salud comunitaria y salud pública de un Grupo de Centros de Salud, identificar los principales fatores facilitadores para el desempeño de competencias, y la contribución a las políticas públicas de salud. Método estudio de caso, con enfermeros especialistas en enfermería de salud comunitaria y de salud pública. Recolección de datos realizada por entrevista, de octubre a diciembre de 2019. El análisis estuvo guiado por dos estrategias: partiendo de las proposiciones teóricas y trabajando con los datos emergentes; y dos técnicas: combinación de patrones, "pattern matching" y construcción de explicaciones, "explanation building". Resultados De la matriz construida surgieron diez proposiciones teóricas, diez evidencias emergentes, cinco patrones y cinco hipótesis explicativas. Se destacan intervenciones de vigilancia epidemiológica, planificación y gestión de proyectos. El entrenamiento personal y la comunicación se destacan como factores facilitadores. Conclusión e implicaciones para la práctica La intervención del enfermero en estas especialidades presenta una dimensión centrada en la planificación y gestión de proyectos, identifica y refleja los factores facilitadores del desempeño de sus competencias, como aplicador de las políticas públicas de salud.

Abstract Objectives to characterize the interventions of specialist nurses of community health and public health of a Group of Health Centers, to identify the main facilitating factors for the performance of competences, and the contribution to public health policies. Method this is a case study carried out with nurses specialized in community health and public health nursing. Data were collected through interviews from October to December 2019. Analysis was guided by two strategies: starting from the theoretical propositions and working the data from the ground up; and two techniques: pattern matching and explanation building. Results from the constructed matrix, ten theoretical propositions, ten emerging evidences, five patterns and five explanatory hypotheses emerged. There are interventions for epidemiological surveillance, planning and project management. Personal training and communication stand out as facilitating factors. Conclusion and implications for practice the intervention of the nurses of these specialties presents a dimension centered on project planning and management identifies and reflects the facilitating factors of the performance of their competencies, as an applicator of public health policies.

As intervenções e responsabilidades do enfermeiro de saúde pública em Portugal: uma scoping review / The public health nurse's interventions and responsibilities in Portugal: a scoping review / Las intervenciones y responsabilidades del enfermero de salud pública en Portugal: una scoping review

Objetivo: revisar os estudos que referenciam as intervenções e responsabilidades do enfermeiro de saúde pública, desde a criação do Serviço Nacional de Saúde (SNS) Português em 1979, até aos nossos dias. Método: scoping review, seguindo a versão PCC - participants, concept and context, do The Joanna Briggs Institute. Consultamos bases de dados como a Biblioteca do Conhecimento Online, Scientific Eletronic Library Online, EBSCOhost Online Research Databases. O período de publicação foi de 1979 a 2018. Resultados: selecionamos quatro artigos publicados e seis dissertações de mestrado, entre 2010 e 2016. Os temas têm a ver com atividades e atuações dos enfermeiros, autonomia e competências, fundamentos normativos, perceções de equipas de saúde, transmissão e obtenção de informação em saúde. Conclusão: Os resultados apurados, mesmo que escassos, forneceram pistas para uma reflexão acerca do modo, tipo dos processos de intervenção, destes enfermeiros, que segundo a opinião de alguns deles, compreendem mais as suas competências do que as concretizam.

Objective: to review studies that refer to interventions and responsibilities of public health nurses, since the creation of the Portuguese National Health Service (NHS) in 1979, to the present day. Method: scoping review, following the PCC - participants, concept and context version of The Joanna Briggs Institute. We consulted databases such as the Biblioteca do Conhecimento Online, Scientific Electronic Library Online, EBSCOhost Online Research Databases. The publication period was from 1979 to 2018. Results: we selected four published articles and six master's dissertations, between 2010 and 2016. The subjects have to do with nurses' activities and actions, autonomy and competences, normative foundations, perceptions of nursing teams, health, transmission and collection of health information. Conclusion: The results, even if scarce, provided clues for a reflection on the mode, type of intervention processes of these nurses, who, according to some of them, understand their competences more than they concretize them.

Objetivo: revisar estudios que se refieren a intervenciones y responsabilidades de enfermeros de salud pública, desde la creación del Servicio Nacional de Salud de Portugal (SNS) en 1979, hasta la actualidad. Método: revisión de alcance, siguiendo el PCC - participantes, concepto y versión de contexto del Instituto Joanna Briggs. Consultamos bases de datos como Biblioteca do Conhecimento Online, Scientific Eletronic Library Online, EBSCOhost Online Research Databases. El período de publicación fue 1979 a 2018. Resultados: seleccionamos cuatro artículos publicados y seis disertaciones de maestría, entre 2010 y 2016. Los temas tienen que ver con las actividades, acciones de los enfermeros, autonomía y competencias, fundamentos normativos, percepciones de los equipos de enfermería, salud, transmisión y recopilación de información sanitaria. Conclusión: los resultados, aunque escasos, proporcionaron pistas para reflexionar sobre el modo, tipo de procesos de intervención de estos enfermeros, quienes, según algunos de ellos, entienden sus competencias más de lo que las concretan.

Competencia cultural de enfermeras en salud pública con población indígena / Cultural competence of nurses in public health with indigenous population

Resumen Objetivo: Identificar elementos de competencia cultural (CC) en las enfermeras en salud pública (ESP) cuando cuidan a población indígena emberá-chamí. Metodología: Etnografía interpretativa con observación participante y entrevistas en profundidad a diez colaboradores. Análisis de datos basado en la propuesta de Leininger con apoyo de los programas ATLAS.ti y Excel. Resultados: El patrón cultural permite identificar la capacidad de las ESP para analizar su propia cultura, conocer, comprender e interactuar con la cultura del indígena y mediar a través de comunicación caracterizada por empatía, adaptación del lenguaje verbal y no verbal que evidencian respeto por la singularidad indígena, en un contexto de armonía con las políticas institucionales basadas en la cultura indígena. Conclusión: La cc de ESP es un proceso amplio, tanto de ESP con la comunidad como de la articulación con políticas institucionales para atender la cosmovisión indígena.

Resumo Objetivo: Identificar elementos de competência cultural (CC) das enfermeiras da saúde pública (ESP) quando atendem à população indígena emberá-chamí. Metodologia: Etnografia interpretativa com observação participante e entrevistas em profundidade com dez colaboradores. Análise de dados baseada na proposta de Leininger com apoio nos programas ATLAS.ti e Excel. Resultados: O padrão cultural identifica a capacidade de ESP para analisar a sua própria cultura, conhecer, compreender e interagir com a cultura do indígena e mediar através da comunicação, caracterizada pela empatia, a adaptação da linguagem verbal e não verbal, mostrando respeito pela singularidade dos indígenas em um contexto de harmonia com as políticas institucionais baseadas nas culturas indígenas. Conclusão: A cc das ESP é um processo amplo, não apenas de esp com os indígenas, mas de articulação com políticas institucionais para abordar a visão do mundo indígena.

Abstract Objective: To identify elements of cultural competence (CC) in Public Health Nurses (PHN) when they care for indigenous embera-chami. Methodology: Interpretive ethnography with participant observation and deep interviews with ten contributors. Analysis of data based on the proposal Leininger with support of the ATLAS.ti and Excel programs. Results: The cultural pattern allows for identifying the PHN ability to analyze their own culture, to know, understand and interact with the indigenous culture and mediate through communication characterized by empathy, adaptation of verbal and non-verbal language, aspects that show respect for the indigenous singularity, in a context of harmony with the institutional policies based on indigenous culture. Conclusion: CC of PHN is a broad process, both PHN with the community and the articulation with institutional policies addressing the indigenous world view.

The Process of Structuring Community Health Needs by Public Health Nurses Through Daily Practice: A Modified Grounded Theory Study

PURPOSE: It is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs' daily practice.METHODS: Semistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.RESULTS: The participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.CONCLUSION: The application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.

Emotional Labor, Job Stress and Professional Quality of Life of Public Health Nurses according to the Employment Type / 간호행정학회지

PURPOSE: This study is a descriptive survey to identify emotional labor and job stress recognized in the course of administrative work, and how these affect the professional quality of life of public health nurses according to the employment type.METHODS: Data was collected through a survey of public health nurses conducted from Dec. 2018 to Jan. 2019 (N=232).RESULTS: The emotional labor of public health nurses was 3.27 out of 5 and full-time public health nurses had the highest scores. The job stress score was moderate at 2.45 out of four. The job stress of full-time nurses was also the highest. Among the sub-divisions of professional quality of life, compassion satisfaction was 3.55 out of five, while secondary traumatic stress was moderate at 2.48 and exhaustion at 3.01. Factors affecting compassion satisfaction were shown to be employment types and exhaustion. Factors affecting secondary traumatic stress were exhaustion, job stress and emotional labor. Factors affecting exhaustion were secondary traumatic stress and compassion satisfaction.CONCLUSION: The results of this study shows that full-time public health nurses in charge of nursing organizations at public health centers have extreme difficulty with excessive role responsibilities, resulting in high emotional labor intensity and high job stress.

Competencia cultural de las enfermeras en el área de salud pública: una metasíntesis / Cultural Competence of Nurses in the Field of Public Health: A Meta-Synthesis / Competência cultural dos enfermeiros na área da saúde pública: uma meta-síntese

Resumen Objetivo: explorar las experiencias y vivencias sobre la competencia cultural de enfermeras en salud pública. Metodología: metasíntesis cualitativa. Las bases utilizadas fueron: Medline, OvidNursing, OvidJournal, Embase y BVS-LILACS, publicados en inglés, español o portugués, entre 2009 y 2014. Se incluyeron diez estudios y fueron valorados usando el Critical Appraisal Skills Programme en español (CASPe). Se implementaron las tres fases del proceso de metaagregación en la extracción y síntesis de hallazgos. Resultados: los hallazgos fueron agregados en seis categorías y dos resultados: 1) paradojas en la atención de salud pública a personas de diversas culturas; 2) sobrepasando barreras: la osadía de las enfermeras de salud pública. Conclusión: las enfermeras vivenciaron y expresaron la competencia cultural desde lo paradójico que resulta el encuentro con el otro culturalmente diferente, manifestaron apertura a comprender y dar sentido a la cultura, aunque fue difícil generar intervenciones culturalmente competentes.

Abstract Objective: To explore the experiences and life events regarding the cultural competence in the public health practice. Methods: A qualitative meta-synthesis covering the databases Medline, OvidNursing, OvidJournal, Embase and BVS-LILACS, including papers in English, Spanish and Portuguese between 2009 and 2014. Ten studies were included and assessed by using the Critical Appraisal Skills Programme in Spanish (CASPe). The three stages of the meta-aggregation programme were applied to do the obtaining and synthesis of findings. Results: The findings were aggregated in six categories and two types of results: 1) paradoxes when providing public health care to people from different culture and 2) going beyond the barriers - the daring by the public health nurses. Conclusion: The nurses experienced and expressed their cultural competence from the paradoxical situation produced when encountering another culturally different people. They showed a stance open to both understand and make sense of the other's culture, even though it was hard to produce culturally competent interventions.

Resumo Objetivo: explorar as experiências e vivências sobre competência cultural de enfermeiras em saúde pública. Metodologia: meta-síntese qualitativa. As bases utilizadas foram: Medline, OvidNursing, OvidJournal, Embase e BVS-LILACS, publicados em inglês, espanhol ou português, entre 2009 e 2014. Dez estudos foram incluídos e valorados usando o Critical Appraisal Skills Programme em espanhol (CASPe). As três fases do processo de meta-agregação na extração e síntese de achados foram implementados. Resultados: os achados foram agregados em seis categorias e dois resultados: 1) paradoxos no atendimento de saúde pública a pessoas de diversas culturas; 2) ultrapassando barreiras: a ousadia das enfermeiras de saúde pública. Conclusões: as enfermeiras vivenciaram e expressaram a competência cultural desde o paradoxal que resulta o encontro com um outro culturalmente diferente, manifestaram apertura para compreender e dar sentido à cultura, embora fosse difícil gerar intervenções culturalmente competentes.

Muda o modelo assistencial, muda o trabalho da enfermeira na Atenção Básica? / Does the nurses' work change when the Primary Health Care change? / ¿Cambia el modelo asistencial, cambia el trabajo de la enfermera en la Atención Primaria de Salud?

Este estudo teve por objetivo identificar as atividades desenvolvidas pelas enfermeiras que atuam em Unidades Básicas de Saúde, incluindo unidades que ainda seguem o modelo assistencial orientado pela biomedicina e unidades que atuam com o modelo da Estratégia Saúde da Família. Pesquisa de abordagem qualitativa, com a utilização de triangulação para a coleta e análise dos dados obtidos por meio de entrevista e observação. Foram entrevistadas vinte enfermeiras de onze Unidades Básicas de Saúde, de quatro municípios da região Sul do Brasil, entre março a maio de 2013. Os achados mostram que o trabalho das enfermeiras, nas unidades investigadas, são semelhantes nos dois modelos assistenciais. Houve predomínio de práticas de cuidado, destacandose a realização de consultas, ações curativas e atividades prescritas em programas formulados pelo Ministério da Saúde. As entrevistas e observações realizadas revelaram diferentes realidades nas UBS pesquisadas, especialmente no que tange as condições de trabalho. Conclui-se que houve similaridade no trabalho das enfermeiras em ambos os modelos, com predomínio de ações fragmentadas. Ressalta-se que estudo foi realizado em um momento e região do país em que houve grande expansão da ESF, o que parece ter influenciado o resultado de pouca diferenciação no trabalho das enfermeiras que atuam nos dois modelos assistenciais. A replicação em outras regiões do país pode evidenciar resultados diferentes.

This study aimed to identify the activities developed by nurses in Basic Health Units, including units that are still under the care model guided by biomedicine as well as units that use the Family Health Strategy model. Research using qualitative approach, applying triangulation for the collection and analysis of data obtained through interviews and observation. Twenty nurses from eleven Basic Health Units in four municipalities in the southern region of Brazil were interviewed between March and May 2013. The findings show that nurses work in the two care model units under study are similar. There was a predominance of care practices, especially consultations, curative actions and activities in programs following directives by the Ministry of Health. Interviews and observations revealed different realities in the BHUs researched, especially regarding working conditions. It was concluded that there was similarity in the nurses' work in both models, with a predominance of fragmented actions. It is noteworthy that the study was carried out at a time and region of the country where there was a great expansion of the FHS, which seems to have influenced the results showing little differentiation in the work of the nurses under the two care models. Replication in other regions of the country may show different results.

Este estudio tuvo por objetivo identificar las actividades desarrolladas por las enfermeras que actúan en Unidades Básicas de Salud, incluyendo unidades que aún siguen el modelo asistencial orientado por la biomedicina y unidades que actúan con el modelo de la Estrategia Salud de la Familia. Investigación de abordaje cualitativo, con la utilización de triangulación para la recolección y análisis de los datos obtenidos por medio de entrevista y observación. Se entrevistó a veinte enfermeras de once Unidades Básicas de Salud, de cuatro municipios de la región Sur de Brasil, entre marzo y mayo de 2013. Los hallazgos muestran que el trabajo de las enfermeras, en las unidades investigadas, son similares en los dos modelos asistenciales. Se observó un predominio de prácticas de cuidado, destacándose la realización de consultas, acciones curativas y actividades prescritas en programas formulados por el Ministerio de Salud. Las entrevistas y observaciones realizadas revelaron diferentes realidades en las UBS investigadas, especialmente en lo que se refiere a las condiciones de trabajo. Se concluye que hubo similitud en el trabajo de las enfermeras en ambos modelos, con predominio de acciones fragmentadas. Se resalta que un estudio se realizó en un momento y región del país en que hubo gran expansión de la ESF, lo que parece haber influenciado el resultado de poca diferenciación en el trabajo de las enfermeras que actúan en los dos modelos asistenciales. La replicación en otras regiones del país puede evidenciar resultados diferentes.

Predictors of Quality of Life among Grandparents Raising Their Grandchildren: An Ecological Approach

PURPOSE: The purpose of this study is to examine factors affecting quality of life among grandparents raising their grandchildren. METHODS: This study carried out a secondary analysis of data from the 2014 Korean Longitudinal Study of Aging (KLoSA) and Statistics Korea. Data collected from 224 grandparents who reported raising their grandchildren were analyzed using descriptive statistics, independent t-test, ANOVA, pearson correlation coefficient, and multilevel regression analysis. RESULTS: The mean score of the participants' quality of life was 62.63. Significant predictors of quality of life of the grandparents included subjective health status, last year's total house income, number of last year's travels, frequency of last year's movie seeing, and number of children's parks per 100,000 population. CONCLUSION: These results suggest that public health nurses in improving quality of life of grandparents focus on children's parks and formal social supports as community factors as well as regular exercise as an individual factor in order to be more effective.

Mediating Effects of Self-leadership in the Relationship between Public Health Nurses' Organizational Culture and Their Job Performance

PURPOSE: The purpose of this research is to enhance organizational competitiveness of health centers as well as private medical institutions serving as public health and medical institutions. It tries to help them to cope with the requirements from health consumers, to enhance public health nurses' job performance. METHODS: After verifying the reliability of the tool, confirmatory factor analysis was used to detect a model, in which valid path coefficients exist among variables. The detected model was then selected as the subject and its validity was verified. Finally, a structural equation model was applied to verify whether the estimate was suitable for the purpose of this research. RESULTS: As for the nursing organizational culture, the public health nurses considered relation-oriented culture the most desirable. As for the self-leadership, they considered self-compensation the most desirable. It was found that mediating effects of self-leadership was partially significant. CONCLUSION: To enhance job performance, it is necessary to make a transition from the organizational culture to the relation-oriented culture and it is also necessary to develop a program capable of reinforcing self-leadership. In addition, it is necessary to conduct a research to verify whether such a developed self-leadership program is influential on job performance enhancement.

Blood pressure measurement training program and adherence of public health nurses to BP measurement guidelines

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the level of adherence of public health nurses to BP measurement guidelines based on their knowledge of the guidelines and skills in BP measurement before and after Blood Pressure Measurement Training Program (BPMTP).</p><p style="text-align: justify;"><strong>METHODS:</strong> An experimental pre- and post-test design using twostaged cluster randomization was conducted. 118 PHNs (mean age ± 38.45 years, mean years of experience ± 13.45 years; 84.1% women) from six districts in Manila were equally assigned to either the BPMTP group or control group. Structured instruments were used.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Demographic characteristics, current BP measurement practices, and level of adherence to BP measurement guidelines based on knowledge of the guidelines and skills in BP measurement were equivalent in both groups at baseline.Nurses in the BPMTP group showed improved adherence (p=<0.05) compared to nurses in the control group. Both groups did not show significant change in their skill on recording, interpretation, and referral (p=1.000).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study showed that Blood Pressure Measurement Training Package is feasible in improving adherence of nurses based on their increased knowledge of the BP measurement guidelines and skills in BP measurement. A larger-scale study is warranted to show that BPMTP can potentially improve clinical management of hypertension in public health clinics globally.</p>

A Comparative Study between American Public Health Nurse Core Competency and Community Health Nursing Practicum in a Province

PURPOSE: This study attempts to examine the extent to which competencies were identified in a Korean community nursing practice based on the 11 core competencies required by US health nurses. METHODS: This was a descriptive research study, and the subjects of this study were 11 students who were in a four-year nursing course. Data were collected by means of a questionnaire from October 19 to November 22, 2016. RESULTS: Core competencies in total were practiced in 60.0% to 98.5% of schools in Korea. Among these, competencies corresponding to the practice level of ‘high’ were identified as ‘communicating effectively with community nursing subjects and colleagues, and accepting various personal characteristics without criticism or prejudice’. On the other hand, competencies corresponding to the practice level of ‘low’ were identified as ‘to comply with social justice, public good, public health principles, and leadership in a community nursing practice’. CONCLUSION: This study can be used as a resource to categorize the competence of nursing students expected in the field of community nursing. Based on a careful review of core competencies with low practice, it is necessary to seek specific practical strategies to strengthen these competencies in the future.

Síndrome metabólico, factores de riesgo en niños y adolescentes con sobrepeso / Metabolic syndrome, risk factors in children and adolescents with overweight

INTRODUCCIÓN: se asocia al Síndrome Metabólico, la probabilidad de contraer enfermedad cardiovascular, hipertensión, resistencia a la insulina, diabetes y muerte prematura. OBJETIVO: evaluar la presencia de Síndrome Metabólico en niños y adolescentes con sobrepeso y establecer la prevalencia de los factores de riesgo asociados al Síndrome Metabólico. MÉTODOS: estudio transversal, descriptivo y analítico en niños y adolescentes con sobrepeso que acudieron a consulta de Endocrinología de los Hospitales Manuel Ascencio Villarroel y Albina Patiño de la ciudad de Cochabamba entre mayo a julio de 2015. Un total de 41 niños y adolescentes de 7 a 16 años de edad (24 hombres y 17 mujeres), fueron sometidos a evaluación antropométrica y laboratorial. RESULTADOS: la prevalencia de Síndrome Metabólico en niños y adolescentes fue de 41%; el componente más frecuente de SM fue el HDL bajo que alcanzó el 78%, seguido de hipertrigliceridemia con un 48.8 %. Se observa la existencia de una asociación altamente significativa (Sig. 0.021) en la determinación del Índice de HOMA con el sobrepeso y obesidad. De igual forma entre la Insulina y el Índice de HOMA (Sig. 0,009). Al relacionar los criterios para la determinación de Síndrome metabólico, el 41,7% de los pacientes con sobrepeso presenta un solo factor de riesgo, al igual que el 44,83% de los que presentan obesidad, los que presentan 2 factores de riesgo, los valores son similares entre la población que presenta sobrepeso y obesidad (41,7% y 41,4 % respectivamente). CONCLUSIONES: desarrollar hábitos y estilo de vida saludables a una edad temprana, para evitar las consecuencias del Síndrome Metabólico, además de reducir los costos de atención a pacientes con enfermedades cardiovasculares o Diabetes Mellitus tipo 2. De ahí la importancia de realizar estudios que confirmen el diagnóstico precoz.

INTRODUCTION: Metabolic Syndrome (SM) is associated with the probability developing cardiovascular disease, hypertension, insulin resistance, diabetes and premature death. OBJECTIVE: To evaluate the presence of Metabolic Syndrome in overweight children and adolescents and besides to establish the prevalence of risk factors associated with the Metabolic Syndrome. METHOD: It is a cross-sectional, descriptive and analytical study about overweight children and adolescents who were attended at Endocrinology service of the Manuel Ascencio Villarroel and Albina Patiño Hospitals in Cochabamba city during May to July 2015. A total of 41 children and adolescents of 7 to 16 years old (24 men and 17 women) were submitted to anthropometric and laboratory evaluation. RESULTS: The MS prevalence in children and adolescents was 41%; the most frequent component was low HDL, which reached 78%, followed by hypertriglyceridemia with 48.8%. It was observed the existence highly significant association (Sig. 0.021) in the determination of the HOMA Index with overweight and obesity. In the same way were between Insulin and the HOMA Index (Sig. 0.009). Relating the criteria for the determination of metabolic syndrome, 41.7% of the overweight patients presented a single risk factor, it is similar the 44.83% obesity patients, they presented 2 risk factors, The values are similar between the population that is overweight and obese (41.7% and 41.4%, respectively). CONCLUSIONS: It is important to developing healthy habits and lifestyle at an early form, to avoid the consequences of the Metabolic Syndrome, in addition to reducing the costs of care for patients with cardiovascular diseases or Type 2 Diabetes Mellitus. It is imperative to perform studies to confirming early diagnostic.

Implicatoins of youth bulling on mental health / Implicancias del bullying sobre la salud mental de los adolescentes

INTRODUCTION: Youth bullying is an international phenomenon that has similar mental health implications in different populations globally. The purpose of this literature review is to describe bullying and its impact on youths' mental health, examines the state of science on bullying interventions, and describes implications for nursing for addressing this problem. METHODOLOGY: Four international databases were searched for all English and Spanish language articles including youth bullying and mental health effects. Articles chosen for review included meta-analyses, and systematic and integrated reviews which focused on youth bullying and mental health. DISCUSSION/CONCLUSIONS: Findings indicated that youths who differed from their peers in some way are at high risk of being a victim of bullying. Victims of bullying can display externalizing behaviors such as aggression, but more commonly display internalizing behavior such as withdrawal, and increasing suicidality. Nurses, in schools or other community settings, as well as primary and acute care are well positioned to help identify victims of bullying and to intervene, potentially reducing or eliminating the long term negative mental health effects of bullying. Future research should focus on groups likely to be bullied but not yet extensively studied, like lesbian, gay, bisexual, queer, transgender youth and those with autism spectrum disorders. More effective interventions are needed to decrease the prevalence of bullying and reduce the effect of bullying on victims.

INTRODUCCIÓN: El bullying en adolescentes es un fenómeno internacional cuyas implicaciones sobre la salud mental son similares en distintas poblaciones a nivel global. El propósito de esta revisión bibliográfica es describir el concepto de bullying y su impacto sobre la salud mental de los jóvenes'. Asimismo, examinar el estado de la ciencia en relación con las intervenciones en casos de bullying y describir las implicaciones que tiene para la enfermería el abordaje de este problema. METODOLOGÍA: Se efectuó la búsqueda en cuatro bases de datos internacionales de todos los artículos escritos en inglés y en español que incluyeran efectos sobre la salud mental y bullying en adolescentes. Los artículos seleccionados para esta revisión incluyeron tanto metaanálisis como revisiones sistemáticas e integradas enfocadas de manera fundamental a los aspectos de bullying en adolescentes y la salud mental. DISCUSIÓN/CONCLUSIONES: Se encontró que aquellos jóvenes que tienen características diferentes de sus compañeros se encuentran de alguna manera en alto riesgo de ser víctimas de bullying. Estas víctimas pueden mostrar conductas de externalización como agresión, y conductas de internalización como retraimiento y más comúnmente, tendencias suicidas. Las enfermeras, tanto en escuelas como en otras instalaciones comunitarias, tanto en cuidados primarios como agudos se encuentran bien capacitadas para ayudar a identificar a las víctimas de bullying y para intervenir reduciendo potencialmente e incluso eliminando los efectos negativos del bullying sobre la salud mental a largo plazo. Las futuras investigaciones deberán centrarse en los grupos susceptibles de ser intimidados y los cuales aún no han sido suficientemente estudiados, como aquellos de jóvenes lesbianas, gays, bisexuales, transexuales y personas con trastornos del espectro autista. Intervenciones más eficaces para disminuir la prevalencia del bullying y reducir el efecto de la intimidación sobre las víctimas son necesarias.

The Effectiveness of a Cultural Competence Training Program for Public Health Nurses using Intervention Mapping

PURPOSE: This study evaluated the effects of a cultural competence training program for public health nurses (PHNs) using intervention mapping. METHODS: An embedded mixed method design was used. Forty-one PHNs (experimental: 21, control: 20) and forty marriage migrant women (MMW) (20, in each group) who were provided nursing care by PHN participated in the study. The experimental group was provided with a four-week cultural competence program consisting of an eight hour offline and online course, e-mail newsletters and social networking services (BAND). Transcultural Self-efficacy (TSE) of the PHNs, client-nurse trust, and satisfaction with nursing care of MMW were measured. Ten PHNs in the experimental group were interviewed after the experimental study. RESULTS: The experimental group showed a significantly greater improvement in TSE, client-nurse trust, and satisfaction with nursing care than did the control group. Six themes emerged from qualitative data: (a) Recognizing cultural differences, (b) Being interested in the multicultural policy, (c) Trying to communicate in MMW's own language, (d) Providing medical information using internet and smart phone, (e) Embracing culturally diverse people into society, and (f) Requiring ongoing cultural competence training. CONCLUSION: Cultural competence training enabled PHNs to provide culturally competent care and contribute to MMW's health outcomes.