"La ruptura en el cuidado": Experiencias de mujeres madres con abuso de alcohol y su atención en México / "The break in care": Mothers' experiences with alcohol abuse and care in Mexico

RESUMEN Este artículo se propone analizar las experiencias sobre la maternidad y los cuidados de mujeres madres que asisten a grupos de apoyo mutuo en la Ciudad de México y el Estado de México para autoatender los daños asociados al alcohol. A partir del marco conceptual de la salud colectiva y la perspectiva de género, se concibe que la condición de género y socioeconómica inciden en la determinación social del alcoholismo y en el proceso salud-enfermedad-atención-cuidado. Desde este enfoque, de mayo de 2020 a enero de 2021, se realizó un estudio cualitativo, en el que se entrevistó a diez mujeres elegidas bajo ciertos criterios y se realizó observación no participante en un grupo femenino Alcohólicos Anónimos. Entre los principales resultados, se reconoce una trayectoria de abuso de alcohol y su atención, concatenada con la trayectoria de cuidados. Este hallazgo delimitó la categoría de "ruptura en el cuidado" para develar el maltrato, la precarización de vida y salud de las mujeres y sus hijos e hijas.

ABSTRACT This article aims to analyze the experiences related to motherhood and care among mothers who attend mutual support groups to address alcohol-related harm in Mexico City and the State of Mexico. Drawing on the conceptual framework of collective health from a gender perspective, we contend that socioeconomic and gender-related factors influence the social determination of alcoholism and the health-disease-attention-care process. A qualitative study was conducted between May 2020 and January 2021, which included interviews with ten women who were selected based on specific criteria, as well as non-participant observation in a women's Alcoholics Anonymous group. The main findings show how trajectories of alcohol abuse and its management are interconnected with trajectories of care. From there, it was possible to identify a "break in care," a category that sheds light on mistreatment and the precariousness of life and health of women and their children.

Scope review of human caring for patients by head nurses / 中华医院管理杂志

Objective:To explore the current practice of head nurses′ human caring for patients at home and abroad, and integrate those effective measures and effect evaluation methods, so as to provide reference for nursing administrators.Methods:A framework was built on the scope review method proposed by Arksey and O′Malley, and such search terms as head nurse/nursing administrator, human caring/care/human-based, sick person/patient, nursing supervisory/charge nurse/head nurse/nurse administrator/nurse manager/nurse executive, empathy/care/compassion, patient/client were used. CNKI, Wanfang database, VIP, Chinese Medical Association Journal Full-text Database, Medical Knowledge Network (PubMed, Elsevier, Springer, Wiley, OVID, EBSCO) and the Cochrane Library were searched from their initiation to November 29, 2022. Two researchers independently screened and extracted basic characteristics of the literature, as well as the measures used by the head nurses to implement human caring for patients and the effect evaluation tools.Results:A total of 57 articles were included. This paper reviewed the measures of human caring for patients at both levels of head nurses as direct caregivers and as organizers.The measures at the level of direct caregivers included implementing human caring in their ward rounds, creating a caring atmosphere, setting up a head nurse reception day, interviewing the care needs of patients and their families, innovating working methods based on the perspective of human caring, and caring communication with patients and their families; measures at the level of organizers included building a nursing human caring mode with specialist characteristics, building a human caring mode for different patient groups, strengthening the training of nurses′ human caring ability and literacy, building a caring environment and atmosphere, simplifying the nursing work process, and establishing a continuous and diversified nurse-patient communication mode, continuing human caring for discharged patients, organizing participation of nurses in social practices of human caring, setting up caring posts, and conducting care supervision and quality control. Patient satisfaction survey was used to evaluate the practical effects of human caring, but the evaluation objects were nurses or nursing services.Conclusions:Head nurses play an important role in the implementation of human caring, and a variety of measures can be taken to directly or indirectly implement human caring for patients. It is suggested to build more human caring modes to cover more specialties and patient groups, and improve the patient satisfaction evaluation tools with head nurses as the evaluation object.

Dyadic transmission of depression in the elderly people with disabilities to caregiver burden: Multiple mediating roles of caring ability and resilience / 中南大学学报(医学版)

OBJECTIVES@#The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden.@*METHODS@#A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested.@*RESULTS@#Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P<0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden (P<0.01). Caregiver's caring ability was positively correlated with caregiver's resilience (P<0.01), and both were negatively correlated with caregiver burden (both P<0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively.@*CONCLUSIONS@#Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.

Social Ethical Reflection on COVID-19 Epidemic from the Perspective of Caring Ethics / 中国医学伦理学

COVID-19 has caused global concern and called for emergency response measures. In this continuous epidemic crisis, ethics has suffered unprecedented huge impact and challenges. It is the responsibility of contemporary ethics to reflect on the moral dilemma existing in itself and in the world. Therefore, ethics must stand the test and provide legitimate reasons for how to give full play to relevance and availability in this global crisis. The theory of rule ethics, which focuses on the realization of moral obligations and rights, is obviously unable to adapt to the response to the demand for ethical responsibility in special periods. The ability to take moral actions against others requires the intervention of "empathy" and "care" factors to realize the possibility of changing from heteronomy to self-discipline. Caring ethics emphasizes that "empathy" and "care" should be wisely regarded as an important value under the COVID-19 epidemic, so as to minimize the possible of the COVID-19 spread and its mutation and escalation in daily interpersonal communication, and create more meaningful ethical relationships with others by being responsible for and caring for others. At the same time, caring ethics further emphasizes that ignoring the cognition may lead to continuous psychological impact, making it difficult to reconstruct a harmonious social psychological situation.

Experiences of psychiatric nurses caring for mental healthcare users with a comorbid disorder

Background: Caring for mental healthcare users (MHCUs) with a comorbid disorder of human immunodeficiency virus (HIV) and schizophrenia has always been challenging and requires expertise, skill, intuition and empathy. Objectives: The objective of this study was to explore and describe the experiences of psychiatric nurses caring for MHCUs with a comorbid disorder of HIV and schizophrenia. Method: A qualitative, exploratory, descriptive and contextual research design was used. Eight participants were selected through purposive sampling for individual in-depth interviews to collect data. Thematic analysis was used to analyse data. Results: Three themes emerged from this study. The first theme is that the psychiatric nurses experienced deep frustration because they were capable but unable to manage MHCUs with HIV and schizophrenia because of poor infrastructure and other contributing barriers. The second theme identified that the psychiatric nurses experienced discrimination against MHCUs compromising their holistic recovery. Lastly, the psychiatric nurses identified the need for health care workers in general hospitals and communities and families of MHCUs with a comorbid disorder to be educated in mental health issues to ensure continuous medical care. Conclusion: The results of this study showed that psychiatric nurses became exhausted when trying to cope with difficult nursing situations. The challenges they faced had negative consequences for the mental health of the psychiatric nurses and compromised patient care. Contribution: This study adds knowledge to nursing practice, nursing education and nursing research by implementing recommendations to mitigate the challenges of psychiatric nurses caring for MHCUs with HIV and schizophrenia.

Política sexual e ativismo de HIV/Aids: a experiência da Loka de Efavirenz / Sexual politics and HIV/AIDS activism: the experience of Loka de Efavirenz

RESUMO Este artigo descreve e analisa, de uma perspectiva etnográfica, como as pessoas participantes da Coletiva Loka de Efavirenz percebem, vivenciam e enfrentam os efeitos da Aids em seu cotidiano, com vistas a contribuir para o entendimento das novas formas de ativismo em HIV/Aids que emergiram na década de 2010 no Brasil e sua relação com processos de subjetivação e construção de redes informais de cuidado. Mostra-se como os membros da Loka se articulam como sujeitos atravessados pelo estigma de HIV/Aids, reivindicando o exercício de suas sexualidades e identidades marcadas por gênero, raça e classe. Desse modo, adentram a disputa por direitos por meio da produção de conhecimento e de ações que adquirem força na produção de uma rede de cuidado para além dos serviços de saúde. A análise das práticas e elaborações da Coletiva realça a Aids como lente privilegiada para situar desafios, lutas, discussões e debates que atravessam os modos de regulação das práticas erótico-sexuais e das expressões de gênero, refletindo tensões e transformações sociais mais amplas.

ABSTRACT This article describes and analyzes, from an ethnographic perspective, how people participating in the Loka de Efavirenz Collective perceive, experience, and face the effects of AIDS in their daily lives, in order to contribute to the understanding of the new forms of HIV/AIDS activism that emerged in the 2010s in Brazil and their relationship as processes of subjectivation and construction of informal care networks. We show how the members of Loka articulate themselves as subjects crossed by the HIV/AIDS stigma, claiming the exercise of their sexualities and identities marked by gender, race, and class. In this way, they enter the dispute for rights through the production of knowledge and actions that acquire strength in the production of a network of care beyond health services. The analysis of the Collective's practices and elaborations highlights AIDS as a privileged lens to situate the challenges, struggles, discussions, and debates that cut across modes of regulating erotic-sexual practices and gender expressions, reflecting broader social tensions and changes.

Family members' experiences of caring for a relative with substance-induced psychosis disorder

Background: When there is a lack of resources in the community to support deinstitutionalisation,family members of a relative diagnosed with substance-induced psychosis disorder (SIPD) are the most affected and vulnerable. Nevertheless, family members' care is still largely unacknowledged in the mental health sector in low- and middle-income countries. Furthermore, no prior research could be found on family members' experiences caring for a relative with SIPD in Giyani, Limpopo province, South Africa. Objectives: To explore and describe family members' experiences caring for a relative with SIPD. Method: The study employed a qualitative research design using interpretative phenomenological analysis as the research method. Telephonic interviews were conducted and analysed. Eight family members were selected to participate in the study using a purposive sampling technique. Results: The analysis of data led to the emergence of the following themes: family members experienced caring for a relative with SIPD as a destabilising responsibility; they experienced acceptance and support from significant others and the community and solace in prayer. Participants also expressed they experienced a need for support from government structures in order to care for a relative with SIPD. Conclusion: The study's findings highlighted the family members' experiences of caring for a relative with SIPD and the role of the family, community and government structures in caring for an individual with SIPD. It is evident from the challenges experienced that the family members need external interventions to develop healthy coping strategies. Contribution: This study adds knowledge to nursing practice, nursing education and nursing research by promoting effective coping amongst family members caring for a relative with SIPD.

Qualitative research on the elements of the diversified caring bank framework system based on long-term care insurance system / 中国实用护理杂志

Objective:To explore the elements of the diversified caring bank based on long-term care insurance system to provide a basis for the construction of diversified caring bank framework system.Methods:The phenomenological research method was adopted to conduct semi-structured interviews with 15 nursing management personnel in pension institutions in Suzhou and Suzhou long-term care insurance policy implementation management personnel in March to May 2021. NVivo 11 was used to manage interview data, and applied Colaizzi 7-step analysis to conduct inductive analysis and extract the themes.Results:The elements of the diversified caring bank based on long-term care insurance system were divided into three main modules: diversified caring personnel, diversified caring content and diversified incentive measures. The diversified caring personnel module included full-time and part-time caring personnel. Diversified caring content included six elements: daily life assistance, professional life caring, professional medical caring, communication and emotional support, emergency caring and special disease caring. Diversified incentive measures module included two elements: labor currency and "benefit" care currency.Conclusions:The diversified caring personnel provides continuous power for disabled caring; diversified caring content provides ways to meet the various needs of the disabled elderly; diverse incentives are effective ways to attract and stabilize the caring workforce.

Opportunities and challenges of long-term care in China--from time bank to diversified caring bank / 中国实用护理杂志

Long-term care is a long-term guarantee mechanism to meet the care needs of the old adults and ensure the quality of life. Among them, the professionalism and stability of the care team is a key factor to ensure the development of long-term care work. This paper analyzes the possible reasons for slow development of time bank with volunteers as the main body in the process of localization, and constructs a new model of diversified caring bank from the construction of care team, so as to promote the high-quality and sustainable development of long-term care in China.

The self-care ability of dementia patients and family caregivers′ care burden: the mediating role of caring ability of caregivers / 中国实用护理杂志

Objective:To explore the mediating effect of caring ability of family caregivers on dementia patients′ self-care ability and family caregiver burden.Methods:A total of 113 dementia caregivers of dementia patients recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Mental Health Center from September 2020 to January 2021 were selected, and the Barthel Index, Family Caregiver Task Inventory and Zarit Burden Interview were used to capture their responses on dementia patients′ self-care ability, caring ability, and caregiver burden.Results:The score of self-care ability of dementia patients was (75.19 ± 28.56), and scores of caring ability and care burden of caregivers were 9.00(4.00, 15.00) and (33.78 ± 16.53), respectively. The self-care ability of dementia patients was negatively associated with caring ability and care burden of caregivers ( r=-0.424, -0.420, both P<0.01), and the caring ability and care burden were positively correlated ( r=0.605, P<0.01). The intermediary effect of dementia caregivers' caring ability between patients' self-care ability and caregivers' care burden is significant. The indirect effect was -0.107 and the total effect was -0.187. The indirect effect accounted for 57.22% of the total effect. Conclusions:Caring ability of family caregivers mediates the relationship between self-care ability of dementia patients and caregivers' care burden.The caring ability may be used as an intervening target for future studies.

A qualitative study on the experience and feeling of home care aides who take part in nighttime caring / 中国实用护理杂志

Objective:To explore the experience and true feeling of home care aides during nighttime caring at the first beginning stage of this program, find the difficulty of it and provide constructive suggestions for improvement.Methods:Semi-structed interviews were used to collect the data of 16 home care aides who were taking part in nighttime caring. Colaizzi phenomenological analysis was used to process and analyze the data.Results:Three themes were extracted by classifying and analyzing the details of the interview: the service content of nighttime care was easy, but had many constraint conditions; the caregivers had diversified emotional experience during nighttime care; the elderly would like to enjoy nighttime care, but they were unwilling to pay by themselves.Conclusions:Nighttime caring project deepens the service content of home-based care. But the nighttime care project needs to be standardized. We should establish risk prevention measures to guarantee the benefit and security of both home caregivers and care-receivers, changing the opinions of consumption among the elderly, increasing the amount of subsidy to enlarge the expansion of nighttime care and improve the equality of this caring program.

El valor del cuidado del ambiente potenciado desde el vínculo didáctico madre-Tierra en estudiantes de la educación media colombiana / The value of caring for the environment enhanced from the mother-Earth didactic bond in students of Colombian high school / O valor de cuidar do meio ambiente aprimorado a partir do vínculo de ensino mãe-Terra em estudantes da média colombiana

RESUMEN El objetivo de esta investigación cualitativa, que se apoya en el paradigma hermenéutico, es analizar desde la perspectiva de estudiantes de la educación media el reconocimiento del "valor del cuidado" que realizan sus madres cotidianamente para sostener la vida en el hogar como fundamento en el diseño de estrategias basadas en procesos de aprendizaje de asimilación y acomodación de Piaget, a fin de potenciar el vínculo didáctico madre-Tierra. Se entrevistaron 45 estudiantes de la Institución Educativa Alfonso Builes Correa, del municipio de Planeta Rica, departamento de Córdoba, y se identificaron sus conocimientos sobre el tema ambiental, el valor del cuidado en sus acciones cotidianas y la asociación con la madre-Tierra. Los resultados muestran que pocos estudiantes asumen una postura sistémica del ambiente e, igualmente, que en sus prácticas diarias no relacionan el cuidado materno como potencialidad para cuidar el ambiente; sin embargo, al someterlos a situaciones problematizadoras fueron capaces de relacionarlo. Se concluye que el análisis de las realidades del contexto desde una reflexión crítica permite armonizar la relación humanidad-naturaleza hacia nuevas formas de habitar para sustentar la vida en y del planeta.

ABSTRACT The objective of this qualitative research, which is based on the hermeneutical paradigm, is to analyze from the perspective of high school students the recognition of the "value of care" that their mothers carry out on a daily basis to sustain life at home as a foundation in the design of strategies based on Piaget's assimilation and accommodation learning processes, in order to enhance the mother-Earth didactic bond. 45 students from the Alfonso Builes Correa Educational Institution, from the municipality of Planeta Rica, state of Córdoba, were interviewed and their knowledge on the environmental issue, the value of care in their daily actions and the association with mother-Earth were identified. The results show that few students assume a systemic position of the environment and, likewise, that in their daily practices they do not relate maternal care as a potential to care for the environment; however by subjecting them to problematic situations, they were able to relate it. It is concluded that the analysis of the realities of the context from a critical reflection allows harmonizing the relationship between humanity and nature towards new ways of inhabiting to sustain life on and of the planet.

RESUMO O objetivo desta pesquisa qualitativa, que se baseia no paradigma hermenêutico, é analisar na perspectiva de estudantes do ensino médio o reconhecimento do "valor do cuidado" que suas mães realizam no dia a dia para sustentar a vida em casa como uma fundação em desenho de estratégias a partir dos processos de aprendizagem de assimilação e acomodação de Piaget, de forma a potencializar o vínculo didático mãe-Terra. Foram entrevistados 45 alunos da Instituição de Ensino Alfonso Builes Correa, do município de Planeta Rica, departamento de Córdoba, e identificados seus conhecimentos sobre a questão ambiental, o valor do cuidado no cotidiano e a associação com a mãe-Terra. Os resultados mostram que poucos alunos assumem uma postura sistémica do meio ambiente e, da mesma forma, que em suas práticas cotidianas não relacionam o cuidado materno como uma potencialidade para cuidar do meio ambiente; no entanto, ao submetê-los a situações problemáticas, eles foram capazes de relaciona-lo. Conclui-se que a análise das realidades do contexto a partir de uma reflexão crítica permite harmonizar a relação entre a humanidade e a natureza para novas formas de habitar para sustentar a vida no e no planeta.

Recursos parentales en familias con hijos sordos / Parental Resources in Families with Deaf Children

Resumen Este artículo describe los recursos parentales que las familias con hijos sordos construyen para promover y potencializar el desarrollo del niño. Es un estudio mixto de corte transversal, se entrevistó a cinco madres oyentes de niños sordos, incluye datos de una encuesta sociodemográfica de un grupo de 245 niños sordos de Colombia. Se concluye que el asumir la discapacidad desde el diagnóstico, la búsqueda de apoyo institucional, enfocarse en las capacidades de sus hijos, reorganizar las rutinas y responsabilidades familiares, la mirada positiva al futuro y la perseverancia, la espiritualidad son algunos de los recursos parentales empleados por las madres.

Abstract This article describes the parental resources that families with deaf children build to promote and potentialize child's development. It is a mixed cross-sectional study. Five hearing mothers of hearing-impaired children were interviewed, including data from a sociodemographic survey of a group of 245 hearing-impaired children from Colombia. It is concluded that by assuming disability from diagnosis, the search for institutional support, by focusing on the capacities of their children, by reorganizing family routines, and responsibilities, a positive look to the future and perseverance, spirituality are some of the parental resources employed by mothers.

A função do cuidar e os vínculos / The caring function an its links / El papel del cuidado y los lazos

O autor pretende discutir alguns aspectos da função do cuidar. Do lugar do psicoterapeuta, que precisa acolher, tanto as demandas explícitas do paciente, como ouvir as mensagens que ecoam dos traumas e das vivências não elaboradas. Do lugar do paciente que busca ajuda para os seus sofrimentos psíquicos, sofrimentos estes que às vezes o impede de reconhecer as dores que também infringe. Quer na vivência dual das sessões de psicoterapia, quer na ressonância provocada pela vivência das terapias grupais, é em um lento processo de reconhecimento e elaboração que surgem as possibilidades de cuidar. Assim, cuidar é dar o suporte necessário para o processo entre o (re) conhecimento de sua dor, seus vínculos, e se (re) conhecer como sujeito histórico, possibilitando o desenvolvimento de novos recursos psíquicos, para as elaborações necessárias.

The author intends to discuss some aspects of the caring function. From the psychotherapist's position that needs to welcome both the explicit demands of the patient and listen to the messages echoing from the traumas and experiences that have not been worked out. From the patient's side, looking for help to solve his psychological sufferings, in such way that, sometimes, it prevents him/her from recognizing the pain that he/she infringes. Both as experience dual existence of psychotherapy sessions and the resonance provoked by the group therapies which involves a slow process of recognition and elaboration that emerges from the possibilities of taking care. So, caring means giving the necessary support to the process between acknowledge of the pain, its links and (re) discovering him herself as a historical subject, enabling the development of new psychic resources for the necessary elaborations.

El autor tiene la intención de discutir algunos aspectos de la función asistencial. Desde el lugar del psicoterapeuta, que debe aceptar tanto las demandas explícitas del paciente como escuchar los mensajes que resuenan del trauma y las experiencias poco elaboradas. Desde el lugar del paciente que busca ayuda para sus sufrimientos psíquicos, estos sufrimientos que a veces le impiden reconocer los dolores que también inflige. Tanto en la experiencia dual de las sesiones de psicoterapia como en la resonancia provocada por la experiencia de las terapias grupales, es en un lento proceso de reconocimiento y elaboración que surgen las posibilidades del cuidado. Por lo tanto, tener cuidado es proporcionar el apoyo necesario para el proceso entre (re) conocer su dolor, sus vínculos y (re) conocerse a sí mismos como un sujeto histórico, permitiendo el desarrollo de nuevos recursos psíquicos para las elaboraciones necesarias.

Uma mãe desamparada, uma criança que pede socorro e a "rede" que tece cuidados / A helpless mother, a child who calls for help, and the "network" that cares / Una madre desamparada, un niño que pide socorro y la "red" que teje cuidados

RESUMO Esse artigo aborda a complexidade que é construir linha de trabalho entre equipamentos públicos de territorios diferentes, onde situações de desamparos predominam. Descreve o que foi possível alinhar entre os equipamentos e profissionais de diferentes formações para dar o suporte básico a uma dupla de mãe e filha para seguirem em frente. O Atendimento da dupla realizou-se em Unidade Básica de Saúde por solicitação da Pediatra da criança, que aos quatro anos apresenta recusa em se alimentar e em aceitar os cuidados básicos que a mãe propicia, confrontando-a, o que aumenta as desorganizações psíquicas e incertezas da mãe diante dos próprios fantasmas. A história pregressa desta, são de perdas significativas precocemente, em 2004 é diagnosticada como esquizofrênica, engravida em 2013, o pai da criança a rejeita. Nada exige deste, cria sua filha fazendo todos os tipos de sacrifícios. Constata-se deterioração dos vínculos familiares, e, em tempos de vínculos incertos, a vulnerabilidade parece rondar como um fantasma aqueles cujo desamparo os condenou. Utilizamos o aporte teórico será da Psicanálise Clássica e dos que se dedicam ao estudo da Psicanálise das Configurações Vinculares.

ABSTRACT This article addresses the complexity of building a line of work between public facilities in different territories, where situations of helplessness predominate. It describes what it was possible to align between equipment and professionals from different backgrounds to provide the basic support for a mother and daughter to move on. Their care took place in the Basic Health Unit at the request of the child's pediatrician. At four years of age, the child refused to eat and accept the basic care that the mother provided, confronting her. That increased the mother's psychic disorganization and uncertainties while facing her own demons. The mother's history shows significant losses at early age. In 2004, she was diagnosed as schizophrenic, then she got pregnant in 2013 and the child's father rejected it. No one demanded anything from him, and the mother raised her daughter making all kinds of sacrifices. Family bonds were deteriorating and, in times of uncertain bonds, vulnerability seemed to prowl around those whose helplessness had condemned them. The theoretical contribution used is from Classical Psychoanalysis and those dedicated to the study of Psychoanalysis of Bonding Configurations.

RESUMEN Este articulo aborda la complejidad que es construir una línea de trabajo entre los diversos equipos públicos de territorios diferentes, donde situaciones de desamparados predominan. Describe aquello que fue posible alinear entre los equipos de profesionales de diferentes formaciones para dar un soporte básico a una dupla de madre e hija para seguir adelante. La atención a la dupla se realizado en una Unidad Básica de Salud a pedido del Pediatra del niño, que a los cuatro años presenta un rechazo a se alimentar y aceptar los cuidados básicos que la madre le provee, confrontándola, lo que aumenta la desorganización psíquica e incertezas de la madre frente a sus propios fantasmas. La historia anterior de la misma estaba teñida de perdidas significativas precoces, en 2004 es diagnosticada de esquizofrénica, en 2013 ella queda encinta y el padre rechaza el embarazo. Ella nada le exige y cría su hija haciendo una serie de sacrificios. Se constata un deterioro dos vínculos familiares, e, em tempos de incertezas nos vínculos, la vulnerabilidad parece rondar como un fantasma aquellos cuya desamparo los condeno. Utilizamos la contribución teórica del Psicoanálisis Clásico y los que se dedican al Psicoanálisis de las configuraciones vinculares.

A relação de gênero como fator determinante na escolha do cuidador domiciliar de pessoas dependentes / The gender relationship as a determining fator in the choice of the domiciliary care of dependente persons / La relación de género como factor determinante en la elección del cuidado domiciliar de personas dependientes

Objetivo: compreender a relação de gênero como fator determinante na escolha do cuidador domiciliar de pessoas dependentes. Método: trata-se de um estudo descritivo com abordagem qualitativa, realizada com cuidadores domiciliares de pessoas dependentes de uma área assistida por uma Unidade de Saúde da Família no município de Petrolina. Resultados: participaram da pesquisa 13 cuidadores domiciliares através de uma entrevista semiestruturada sendo possível identificar que alguns fatores estão condicionados com a escolha do responsável pela implementação do cuidado e que a questão de gênero está intimamente atrelada na eleição do cuidador. Conclusão: na perspectiva desse estudo, foi possível constatar a presença marcante da figura feminina como detentora do cuidar. A mulher é culturalmente responsabilizada pela prestação do cuidado. Os resquícios de uma cultura machista contribuíram na conceituação de que o cuidar se tornasse um sinônimo de atribuições domésticas embutidas na mulher que, por sua vez, tem sua prática subestimada

Objective: To understand the gender relation as a determining factor in the choice of the caregiver domicile of dependent people. Method: This is a descriptive study with a qualitative approach, carried out with home caregivers of people dependent on an area assisted by a Family Health Unit in the city of Petrolina. Results: 13 home caregivers participated in the study through a semi-structured interview it is possible to identify that some factors are conditioned by the choice of the person responsible for the implementation of the care and that the gender issue is closely tied to the caregiver's election. Conclusion: In the perspective of this study, it was possible to verify the remarkable presence of the female figure as custodian. The remnants of a macho culture contributed to the conceptualization that caring became a synonym for domestic duties, being underestimated in their practices and embedded in women

Objetivo: Comprender la relación de género como factor determinante en la elección del cuidador domiciliar de personas dependientes. Método: Se trata de un estudio descriptivo con abordaje cualitativo, realizado con cuidadores domiciliares de personas dependientes de un área asistida por una Unidad de Salud de la Familia en el municipio de Petrolina. Resultados: Participaron de la investigación 13 cuidadores domiciliares a través de una entrevista siendo es posible identificar que algunos factores están condicionados con la elección del responsable por la implementación del cuidado y que la cuestión de género está ligada en la elección del cuidador. Conclusión: En la perspectiva de ese estudio, fue posible constatar la presencia de la figura femenina como poseedora del cuidar. Los restos de una cultura machista contribuyeron en la conceptualización de que el cuidar se convirtiera en un sinónimo de atribuciones domésticas y embutida en la mujer

HUMANistic Caring: An approach for meeting the care needs of Filipino gay and lesbian older persons

@#Quality care is a basic human right and a core foundation for a patient's health, recovery, and well-being. In the current Philippine context, gay and lesbian older persons face gender-care disparities in the caring dynamism. Until now, their care needs are not articulated in the country's basic nursing curriculum. Consequently, the care approach is incongruent, biased, and risky. In response to this gender-care disparity, participatory action research (PAR) was used to identify this cohort's care needs and their meaning by developing a nursing care hub called the ‘Gay Care Center’ for older gays and lesbians. This paper focuses on describing: (a) the current situation of nursing care among the gay and lesbian older persons; (b) the meaning of care needs from their perspective; and (c) the Gay Care Center's tailored approach and services to meet their care needs. Multiple sources were utilized to collect data: focus group discussions, in-depth interviews, and observations. Data were then analyzed using Mayring's qualitative content analysis. Findings revealed that caring practices for older gays and lesbians could only be effective, satisfying, and holistic when the meaning of their individual needs are sensitively listened to, understood, and met. This led to the coined term HUMANistic caring, a new approach that emerged as their preferred mode of care. It is recommended that extensive gender-care training be conducted among gerontological nurses, and this be incorporated in the nursing curriculum to ensure that the provision of care is safe, respectful, humane, and just.

Blood donor caring and retention: detail management of plateletpheresis venipuncture / 中国输血杂志

【Objective】 To strengthen the detail management of plateletpheresis venipuncture so as to reduce repeated puncture and further retain apheresis donors. 【Methods】 1 930 donations, involving 324 donors(including 92 first-time donors), with conventional venipuncture from October 1, 2018 to September 30, 2019 (controls) were compared with 1 873 donations, involving 353 donors(including 101 first-time donors), with optimized venipuncture from October 1, 2019 to September 30, 2020(experiment). The repeated puncture rate of the two groups and that contributed by rotating and fixed phlebotomists, respetively, the profile of donors suffered several repeated puncture and the re-donation rate of first-time apheresis donors were analyzed. 【Results】 The rate of secondary puncture in the experimental group(1.07%, 20/1 873) was lower than that in the control group(3.52%, 68/1 930)(P0.05). Control group fixed blood collection nurses had secondary puncture rate(1.85%, 16/863)lower than rotation blood collection nurses(4.87%, 52/1 067)(P<0.05). Experimental group of the same blood donor observation period occurred 1, 2 and above the rate of secondary puncture [5.10%(18/353)、0.28%(1/353)] were lowerthan the control group [10.19%(33/324)、4.01%(13/324)] (P<0.05). the re-donation rate of first-time platelet donors(67.33%, 68/101)was higher in experimental group than in control group(50.00%, 46/92)(P<0.05). 【Conclusion】 The repeated puncture rate has been significantly decreased by strengthening the detail management of apheresis venepuncture, which promotes, caring for blood donors and conducive to the recruitment and retention of apheresis donors.

Empatía y cuidado profesional: esbozos de una relación problemática / The role of empathy in professional care

Introducción: tres paradigmas actuales acerca del cuidado profesional en medicina sitúan a la empatía como la actitud básica necesaria para lograr un cuidar de otros que respete la dignidad de las personas atendidas en los servicios de salud. Sin embargo, los conceptos de empatía difieren en estos paradigmas, algo que parece ser reflejo de la confusión general que existe respecto a esta noción. Por otro lado, hay quienes critican el que se pretenda reducir a ella la actitud fundamental del cuidar de otros. Además de esto, existen formas de comprender la medicina que, eventualmente. Métodos: a partir de estos tres paradigmas de cuidado, se profundiza en las teorías acerca de la empatía más importantes de la actualidad. El método que se utiliza es de análisis filosófico de los datos provenientes de las formas de comprender el cuidado profesional. Resultados: existen formas muy distintas de comprender la noción de empatía no solo desde paradigmas que gravitan en torno al cuidado profesional, sino también dentro de la filosofía. Las comprensiones de la noción son incluso disímiles, lo que hace imposible avanzar en la enseñanza y en el diálogo con respecto a la posición de la empatía en el cuidado. Se propone la noción fenomenológica de empatía que la sitúa en la esfera de las facultades espirituales del sujeto. Conclusiones: la empatía es un elemento relevante del cuidado profesional, pero parece no poder situarse en el centro del mismo como actitud básica. Es una herramienta útil que podría ser enseñada y evaluada en la educación médica, siempre y cuando se trabaje con una noción unívoca de ella.

Introduction: Abstract Introduction: Three current paradigms of professional health services situate empathy as the fundamental attitude necessary to respects the dignity of those serve. However, current concepts of empathy differ widely in these paradigms, something that seems to reflect the general confusion regarding this notion. On the other hand, there are those who criticize the attempt to reduce to it to the fundamental attitude of caring for others. Methods: From these three paradigms of healthcare, the most important current theories of empathy will be treated. The method employs a philosophical analysis of the data coming from the ways of understanding professional care. Results: there are very different ways of understanding the notion of empathy not only in healthcare, 9 but in philosophy as well. The understanding of the notion varies greatly, making it impossible to reach consensus in teaching and dialogue with respect to the role of empathy in health care. The proposal is to use a phenomenological approach to empathy which places it in the sphere of the subject's spiritual faculties. Discussion: empathy is a relevant element of professional healthcare, but not central as a fundamental attitude. It is a useful tool that could be taught and evaluated in medical education, as long as it is applied with a common understanding.

Dificuldade em atividades de vida diária e necessidade de ajuda em idosos: discutindo modelos de distanciamento social com evidências da iniciativa ELSI-COVID-19 / Dificultad en actividades de la vida diaria y la necesidad de ayuda en ancianos: discutiendo modelos de distanciamiento social com evidencias de la iniciativa ELSI-COVID-19 / Difficulty in performing activities of daily living and the need for help in older adults: evidence on social distancing models from the ELSI-COVID-19 initiative

Resumo: Analisar se idosos com dificuldade ou necessidade de ajuda para desempenhar atividades básicas ou instrumentais de vida diária estão mais distanciados socialmente em tempos de COVID-19. Participaram das entrevistas telefônicas 4.035 idosos participantes da 2ª onda do Estudo Longitudinal de Saúde dos Idosos Brasileiros (ELSI-Brasil). Classificou-se a dificuldade, necessidade e recebimento de ajuda em: (1) independentes; (2) com dificuldade e não precisa de ajuda; (3) com dificuldade, precisa e recebe ajuda de pessoa de dentro de casa; (4) com dificuldade, precisa e recebe ajuda de pessoa de fora de casa; e (5) com dificuldade, precisa, mas não recebe ajuda. O distanciamento social foi categorizado como não saiu de casa nos últimos 7 dias, saiu de casa para atividades essenciais e saiu de casa para atividades não essenciais. Modelo de regressão multinomial controlado por idade, sexo, escolaridade e região do Brasil foi utilizado. Permaneceram mais distanciados socialmente os idosos que apresentavam dificuldade, necessitavam e recebiam ajuda de pessoa de dentro (odds ratio - OR = 2,34; IC95%: 1,25-4,39) ou de fora de casa (OR = 3,94; IC95%: 2,24-6,92). A idade aumentou a chance de não sair de casa (OR = 1,06; IC95%: 1,03-1,09) e ser homem a diminuiu (OR = 0,48; IC95%: 0,33-0,70). Viver na Região Sul aumentou a chance dos idosos saírem para atividades essenciais (OR = 1,77; IC95%: 1,01-3,10). Idosos com dificuldade, que precisam e recebiam ajuda de pessoas de dentro ou de fora de casa não saíram de casa nos últimos 7 dias. Mesmo com o distanciamento social, esses idosos podem não ter sua exposição ao COVID-19 reduzida, enfraquecendo a teoria do distanciamento social seletivo.

Resumen: Analizar si los ancianos con dificultad o necesidad de ayuda para desempeñar actividades básicas (ABVD) o instrumentales de la vida diaria (AIVD) están más distanciados socialmente en tiempos de COVID-19. Participaron en las entrevistas telefónicas 4.035 ancianos de la encuesta de la segunda fase del Estudio Brasileño Longitudinal del Envejecimiento (ELSI-Brasil). Se clasificó la dificultad, necesidad y recepción de ayuda en: (1) independientes; (2) con dificultad y no necesita ayuda; (3) con dificultad, necesita y recibe ayuda de una persona de dentro de casa; (4) con dificultad, necesita y recibe ayuda de persona de fuera de casa; y (5) con dificultad, necesita, pero no recibe ayuda. El distanciamiento social fue categorizado como: no salió de casa en los últimos 7 días, salió de casa para actividades esenciales y salió de casa para actividades no esenciales. Se usó un modelo de regresión multinomial controlado por edad, sexo, escolaridad y región de Brasil. Permanecieron más distanciados socialmente los ancianos que presentaban dificultad, necesitaban y recibían ayuda de una persona de dentro (odds ratio - OR = 2,34; IC95%: 1,25-4,39) o de fuera de casa (OR = 3,94; IC95%: 2,24-6,92). La edad aumentó la oportunidad de no salir de casa (OR = 1,06; IC95%: 1,03-1,09) y el sexo masculino disminuyó (OR = 0,48; IC95%: 0,33-0,70). Estar en la Región Sur aumentó la oportunidad de que los ancianos salgan para actividades esenciales (OR = 1,77; IC95%: 1,01-3,10). Los ancianos que necesitan ayuda de personas de dentro o de fuera de casa no salieron de casa en los últimos 7 días. Incluso con distanciamiento social, los ancianos que reciben ayuda de personas no distanciadas no tienen su exposición reducida a la COVID-19, lo que debilita la teoría del distanciamiento social selectivo.

Abstract: To analyze whether the older adults with difficulty or need of help to perform basic or instrumentals activities of daily living are more socially distanced in times of COVID-19. A total of 4,035 older adults participated in the telephone interviews from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Difficulty, need and receiving help were classified into: (1) independents; (2) had difficulty without need for care; (3) had difficulty, needed and have received care from someone within their household; (4) had difficulty, needed and have received care from someone outside their household; and (5) had difficulty and needed care but did not receive it. Social distancing was categorized as follows: did not leave their houses in the last 7 days, left their houses for essential activities and went out for non-essential activities. Multinomial regression model adjusted for age, sex, schooling and great geographical region was performed. Older adults who had difficulty, needed and have received help from within their homes (odds ratio - OR = 2.34 95%CI: 1.25-4.39) or from outside their homes (OR = 3.94; 95%CI: 2.24-6.92) were more socially distanced. Age increased the odds of not going out (OR = 1.06; 95%CI: 1.03-1.09) while be men reduced it (OR = 0.48; 95%CI: 0.33-0.70). Living in the South of Brazil has increased the odds of the respondents going out for essential activities (OR = 1.77; 95%CI: 1.01-3.10). Older adults who had difficulty, needed and have received help from within or outside their homes did not leave their homes in the last 7 days. Even with social distancing, these older adults can not have their exposure to COVID-19 reduced, weakening the theory of selective social distancing.