Desafios relacionados ao clima organizacional da equipe de enfermagem de um hospital público - percepção dos enfermeiros / Challenges related to the organizational climate of the nursing team in a public hospital - nurses' perception

Resumo O ambiente organizacional está relacionado com o grau de motivação de seus colaboradores. Essa percepção é essencialmente sentida, não se vê e nem se toca, mas tem uma existência real. Este estudo objetiva identificar as dificuldades e potencialidades relacionadas ao clima organizacional dos servidores de enfermagem de um hospital público do Distrito Federal. Metodologicamente foi realizado um estudo descritivo e exploratório caracterizado por uma abordagem qualitativa. A análise de conteúdo temática conduziu a três dimensões interpretativas: ambiente e condições de trabalho; comunicação, relacionamento interpessoal e fluxos de trabalho; e motivação para a melhoria do ambiente de trabalho. Os resultados apontam para um déficit de recursos humanos, escassez de recursos materiais, insumos, estrutura física precária, além de problemas de relacionamento interpessoal, como a (des)valorização do profissional enfermeiro e da enfermagem. Os desafios postos para os gestores estão para além da dimensão técnica e estrutural, da complexidade tecnológica dos equipamentos sem manutenção, desdobra-se pela dimensão humana, pelos sentimentos e pelas necessidades não atendidas (de valorização) da enfermagem, que precisa ser cuidada, valorizada, ouvida e vista no seu processo de cuidar.

Abstract The organizational climate is related to the degree of motivation of its employees. This perception is essentially felt, it is neither seen nor touched, but it is real. This study aims to identify difficulties and potentialities related to the organizational climate of the nursing staff at a public hospital in the Federal District. Methodologically, a descriptive and exploratory study was carried out characterized by a qualitative approach. The thematic content analysis led to three interpretative dimensions: environment and working conditions; communication, interpersonal relationship and work flows; motivation to improve the work environment. The results indicate a deficit of human resources, scarcity of material resources, supplies, precarious physical structure, in addition to interpersonal relationship problems, such as the (de)valuation of professional nurses and nursing. The challenges posed to managers go beyond the technical and structural dimension, the technological complexity of equipment without maintenance, as it unfolds through the human dimension, feelings and unmet needs (of appreciation) of nursing, which needs to be cared for, valued, heard and seen in their care process.

Peplau's theory for telenursing with the family of patients with COVID-19

Introduction: The care challenges brought about by the COVID-19 pandemic required nurses to have new skills in coping with health demands. In addition, this professional emerges as an important tool through the therapeutic relationship. Thus, they can be seen as a bridge of support between family members and patients. Objective: To know the perspective of nurses on telenursing as therapeutic in the context of family members of patients with COVID-19 and to discuss in the light of Peplau's theory of interpersonal relationships. Materials and Methods: Cross-sectional, exploratory study with a qualitative approach to the data, carried out in a private general hospital in Teresina-PI, in 2022, with a semi-structured interview. Followed by a reflective structure with the use and philosophical theoretical construct of Hildegard Peplau's theory of interpersonal relationships, from 1952. Results: Nurses perceive remote assistance as an important tool for meeting the psychological and social needs of the family of patients with COVID-19. On the occasion, the nurses look at the patients' relatives experiencing the therapeutic relationship through information mediated by telenursing, which included the description of the main daily care, among other information. Discussion: Peplau's theory of interpersonal relationships gives meaning to the experience of telenursing from the perspective of nurses. Conclusion: The perspective of nurses on the remote therapeutic relationship with family members of patients diagnosed with COVID-19 infection involved bonding and welcoming as points of development of trust, which brought positive results to family members, given the uncertainties experienced during the pandemic.

Introducción: Los desafíos de salud planteados por la pandemia de COVID-19 exigieron nuevas habilidades de las enfermeras para enfrentar las demandas de salud. Además, este profesional emerge como una herramienta importante a través de la relación terapéutica. Por tanto, pueden verse como un puente de apoyo entre familiares y pacientes. Objetivo: Comprender la perspectiva de los enfermeros sobre la teleenfermería como terapia en el contexto de familiares de pacientes con COVID-19 y discutir a la luz de la teoría de las relaciones interpersonales de Peplau. Materiales y Métodos: Estudio exploratorio transversal, con enfoque de datos cualitativos, realizado en un hospital general privado de Teresina-PI, en 2022, con entrevistas semiestructuradas. Seguido de una estructura reflexiva utilizando el constructo teórico filosófico de la teoría de las relaciones interpersonales de Hildegard Peplau, de 1952. Resultados: Los enfermeros perciben la asistencia remota como una herramienta importante para satisfacer las necesidades psicológicas y sociales de las familias de los pacientes con COVID-19. En esta ocasión, los enfermeros observan a los familiares de los pacientes que viven la relación terapéutica a través de informaciones mediadas por la teleenfermería, que incluye una descripción de los principales cuidados diarios, entre otras informaciones. Discusión: La teoría de las relaciones interpersonales de Peplau da sentido a la experiencia de teleenfermería desde la perspectiva de las enfermeras. Conclusión: La perspectiva de los enfermeros sobre la relación terapéutica a distancia con los familiares de los pacientes diagnosticados con infección por COVID-19 involucró el vínculo y la acogida como puntos de desarrollo de la confianza, lo que trajo resultados positivos para los familiares, dadas las incertidumbres vividas durante la pandemia.

Introdução: Os desafios assistenciais trazidos pela pandemia por COVID-19 exigiram dos enfermeiros novas habilidades no enfrentamento de demandas de saúde. Além disto, este profissional surge como importante ferramenta através do relacionamento terapêutico. Assim, podem ser vistos como uma ponte de apoio entre familiares e pacientes. Objetivo: Conhecer a perspectiva de enfermeiros sobre a telenfermagem como terapêutico no contexto de familiares de pacientes com COVID-19 e discutir à luz da teoria das relações interpessoais de Peplau. Materiais e Métodos: Estudo transversal, exploratório, de abordagem qualitativa dos dados, realizado em um hospital geral privado em Teresina-PI, em 2022, com entrevista semiestruturada. Seguido de estrutura reflexiva com utilização e construto teórico filosófico da teoria das relações interpessoais de Hildegard Peplau, de 1952. Resultados: Os enfermeiros percebem a assistência remota como importante ferramenta para o suprimento de necessidades psíquicas e sociais da família dos pacientes com COVID-19. Na oportunidade, os enfermeiros lançam o olhar sobre os familiares dos pacientes vivenciarem o relacionamento terapêutico por meio das informações mediadas pela telenfermagem que incluía a descrição dos principais cuidados diários dentre outras informações. Discussão: A teoria das relações interpessoais de Peplau dá sentido à experiencia da telenfermagem na perspectiva das enfermeiras. Conclusão: A perspectiva de enfermeiros sobre o relacionamento terapêutico remoto com familiares de pacientes diagnosticados com infecção por COVID-19 envolveu o vínculo e acolhimento como pontos de desenvolvimento de confiança, o que trouxe resultados positivos aos familiares, diante das incertezas vivenciadas durante a pandemia.

Association between parental control, peer relationship and aggressive behavior in junior high school students / 中国学校卫生

Objective@#To understand the interrelationships of parental control, peer relationship, and aggressive behavior in junior high school students, in order to provide a theoretical basis for preventing the occurrence of adolescent aggressive behavior.@*Methods@#During June to July, 2022, 2 564 students of grade one to grade three were selected from 6 junior high schools from each of Suzhou and Xuancheng cities in Anhui Province by using convenient cluster random sampling method, and then the questionnaire survey was administered, including the Chinese version of Parent Control Questionnaire, Chinese version of Buss & Perry Aggression Questionnaire and Adolescent Peer Relationship Questionnaire.@*Results@#Boys scored (185.31±27.49, 21.65±7.43, 21.77 ±8.18, 69.50±11.41, 72.39±11.53) higher than girls (178.21±25.13, 20.08±7.09, 20.61±7.62, 66.56± 11.14 , 70.95± 11.84 ) in parental control, father s psychological control, mother s psychological control, father s behavioral control, and mother s behavioral control ( t =8.63, 5.47, 3.70, 6.60, 3.12), while girls scored (48.41±11.26) higher in peer relationship than boys ( 47.13 ± 10.84 ) ( t =-2.95) ( P <0.01). The scores of first grade students in parental control, father s psychological control, mother s psychological control, father s behavior control, peer relationship, and aggressive behavior (184.67±27.18, 21.83± 7.29 , 22.15±8.07, 68.81±10.95, 50.21±9.57, 80.23±17.66) were higher than those of second gradestudents (180.98±25.46, 20.16±7.82, 20.21±7.55, 68.29±11.69, 45.47±11.67, 74.08±17.70) and third grade students (179.21±26.79, 20.53±7.22, 21.17 ± 8.06 , 66.81± 11.39 , 47.54±11.43, 75.75±16.29) ( F =9.44, 12.87, 13.61, 6.84, 42.85, 30.40, P <0.01). The scores of parental control and peer relationship were positively correlated with the scores of aggressive behavior ( r=0.22, 0.47, P <0.01). Peer relationship partially mediate the relationship between parental control and aggressive behavior, with a partial mediation effect value of 0.04, accounting for 26.39% of the total effect of parental control on aggressive behavior.@*Conclusions@#High parental control and poor peer relationship are both positively correlated with the level of aggressive behavior. The peer relationship of teenagers should be improved by establishing appropriate parenting style, tackling campus violence, and maintaining good social norms, in order to reduce the occurrence of aggressive behavior among adolescents.

Impact of the sense of security on interpersonal relationships among impoverished college students / 中国学校卫生

Objective@#To explore the impact of the sense of security on interpersonal relationships among impoverished college students, so as to provide empirical evidence for effective interpersonal communication cirsis prevention among impoverished college students.@*Methods@#In March 2023, a stratified random sampling method was used to select one university from Shanghai, Jiangsu, Henan, Anhui, Inner Mongolia, Gansu, Guangxi respatively. A total of 1 687 impoverished college students from 7 universities were surveyed using the Sense of Security Scale, Interpersonal Relationship Comprehensive Diagnosis Scale, Stress Perception Scale (SPS), and Mindfulness Attention Awareness Scale (MAAS). Moderated mediation effect analysis was performed using Model 7 in the SPSS macro program PROCESS.@*Results@#There was significant gender differences in the sense of security among impoverished college students (t=-2.31，P<0.05), and significant difference in interpersonal relationships by grade was observed (F=3.60，P<0.05). A sense of security was negatively associated with difficulties in interpersonal relationships among impoverished college students (β=-0.17, t=-9.27, P<0.01). Psychological stress partially mediates the relationship between the two, accounting for 19.54% of the total effect. Mindfulness regulates the first half of the path (β=0.10, t=5.32, P<0.01).@*Conclusions@#The sense of security shows impacts on interpersonal relationships among impoverished college students through psychological pressure. And it strengthens with the improvement of mindfulness level. Attention should be paid to cultivating a sense of security among impoverished college students, improving their level of mindfulness, and preventing interpersonal crisis due to excessive psychological pressure.

Investigating the Impact of Interpersonal and Presentation Skills Assessed by the AO Entrance Examination on Graduates: Insights from a Post-Graduation Survey / 医学教育

Background: The AO entrance examination for the Medical Course at Kochi Medical School aims to select candidates who are not only knowledgeable but also exhibit strong interpersonal and presentation skills. This study sought to determine the impact of the AO exam’s group work and presentation components on students’ success post-graduation.Methods: Clinical training supervisors’ evaluations of interpersonal and presentation abilities were compared between AO entrance exam candidates and other selected candidates.Results: AO entrants showed superior performance in establishing patient-physician relationships, participating in team medicine, and delivering case presentations compared to their counterparts.Discussion: The AO entrance examination at Kochi Medical School proves to be an effective tool for assessing candidates’ interpersonal and presentation skills, which are essential for medical practitioners.

Epidemiological characteristics of norovirus epidemics in Haidian District from 2015 to 2022 / 预防医学

Objective@#To understand the epidemiological characteristics of the norovirus epidemics in Haidian District, Beijing Municipality from 2015 to 2022, so as to provide insights into epidemic prevention and control.@*Methods@#The epidemiological characteristics, case data, and laboratory testing of norovirus epidemics were collected in Haidian District from 2015 to 2022, and the temporal distribution, spatial distribution, population distribution, and norovirus detection were analyzed using a descriptive epidemiological method.@*Results@#A total of 208 norovirus epidemics involving 3 530 cases were reported in Haidian District from 2015 to 2022, with a median attack rate of 25.00% (interquartile range, 18.35%). The main pathogens detected were type GⅡ, accounting for 87.98% (183 cases), and the main transmission mode was interpersonal transmission, accounting for 93.27% (194 cases). Norovirus epidemics peaked from March to June and October to December, accounting for 44.71% (93 epidemics) and 44.23% (92 epidemics), and predominantly occurred in schools and preschool institutions, accounting for 51.92% (108 epidemics) and 40.38% (84 epidemics). The median age of norovirus infected cases was 8 (interquartile range, 13) years. There were 1 920 males and 1 610 females, with a ratio of 1.19︰1. The positive rates of case specimens, key population specimens and environment smeared specimens in epidemic units were 74.32%, 13.91% and 5.86%, respectively.@*Conclusions@#The norovirus epidemics in Haidian District from 2015 to 2022 was mainly caused by type GⅡ and spread from person to person. The epidemics peaked in winter and spring, and schools and preschool institutions were the key units of prevention and control.

Psychological abuse and neglect in relation to mobile phone addiction in junior high school students： path analysis of self-esteem and interpersonal alienation / 四川精神卫生

BackgroundMobile phone addiction has attracted widespread attention in society， and psychological abuse and neglect is an important factor in predicting mobile phone addiction， whereas limited research has been done to evaluate its impact on mobile phone addiction. ObjectiveTo explore the correlation of psychological abuse and neglect with mobile phone addiction， and to test the pathway of self-esteem and interpersonal alienation， so as to provide references for preventing and curbing mobile phone addiction in junior high school students. MethodsIn May 2022， a cluster sampling was utilized to select 800 students in two middle schools in a county of Hainan Province， and all students were assessed using Child Psychological Abuse and Neglect Scale （CPANS）， Mobile Phone Addiction Index （MPAI）， Rosenberg Self-esteem Scale （SES） and Interpersonal Alienation Scale of Adolescent StudentsAlienation Scale. Pearson correlation analysis was adopted to determine the correlation among the above-mentioned scales， and Process Macro 3.5 for SPSS was used to test the mediation effect. ResultsCPANS score was negatively correlated with SES score （r=-0.278， P<0.01）， and positively correlated with Interpersonal Alienation Scale score and MPAI score （r=0.471， 0.372， P<0.01）. SES score was negatively correlated with Interpersonal Alienation Scale score and MPAI score （r=-0.438， -0.196， P<0.01）. Interpersonal Alienation Scale score was positively correlated with MPAI score （r=0.392， P<0.01）. Interpersonal alienation （indirect effect value was 0.104） played a mediation role in the relationship between psychological abuse and neglect and mobile phone addiction. Self-esteem and interpersonal alienation exhibited a chained mediation effect on the relationship between psychological abuse and neglect and mobile phone addiction （indirect effect value was 0.026）， accounting for 6.99% of the total effect. ConclusionPsychological abuse and neglect can not only directly predict mobile phone addiction， but also can indirectly affect mobile phone addiction through separate mediation of interpersonal alienation or chained mediation of self-esteem and interpersonal alienation. ［Funded by High-level Talent Project of Hainan Natural Science Foundation （number， 721RC511）］

Practical Research on the Teaching of "Medical Interpersonal Communication" Integrate into the Red Doctor’s Spirit for Students Majoring in Public Health Management / 中国医学伦理学

The red doctor’s spirit is an important spiritual guidance for the cultivation of medical talents during the development of medical and health services in China. The teaching reform, which is oriented towards position competence, requires that students majoring in public health management should not only master solid medical knowledge and professional skills, but also possess an ability to handle medical public relations, such as shaping an excellent image of the organization, improving the medical interpersonal communication, and managing public relations crisis. Under the guidance of inheriting the red gene and innovating the medical education, the driving force of learning should be "serving the people to improve their health" led by "political firmness" , the learning goal "striving for perfection" inspired by "excellent technology" , and the working criterion "respecting patients, involving full participation and shouldering public responsibility" embodied in "making selfless dedication and helping the wounded and dying" . The article based on the characteristic culture of red medicine in the Air Force Medical University, applied the teaching method of role-playing case simulations to explore the teaching practice road of "theory-experience-practice-reflection" .

Relação entre o autoconceito de pré-adolescentes e resolução de conflitos interpessoais / The relationship between pre-adolescent children's self-concept and interpersonal conflict resolution / Relations entre le concept de soi des preadolescents et la résolution des conflicts / Relación entre el autoconcepto en preadolescentes y la resolución de conflictos interpersonales

Resumo: Pesquisas têm evidenciado relações entre estratégias de resolução de conflitos e variáveis como idade, sexo, nível socioeconômico e cultura. Porém, a relação das estratégias com aspectos do funcionamento psicológico como o autoconceito tem sido pouco investigada, especialmente na pré-adolescência. Esta pesquisa tem como objetivo verificar a existência de relações entre as estratégias de resolução de conflitos de pré-adolescentes e o seu autoconceito. Estas foram analisadas por meio das respostas dos participantes sobre o que fariam em situações de conflito descritas no Children's Action Tendency Scale (CATS). O questionário contém dez situações de conflito, ao final dos quais se pede que seja descrita a reação a cada uma. O autoconceito foi avaliado por meio das respostas dos participantes às vinte afirmações da Escala Multidimensional de Autoconceito para pré-adolescentes (AF5) sobre autoconceito e relações interpessoais. Os dados obtidos passaram por testes de correlação, verificando-se a associação entre estratégias como a assertiva e dimensões do autoconceito.

Abstract: Studies have shown relationships between conflict resolution strategies and variables including age, socioeconomic status, sex, and culture. However, the relationship between these strategies and aspects of psychological functioning such as self-concept has been little investigated, especially in pre-adolescence. This research aimed to verify the existence of relationships between the conflict resolution strategies reported by pre-adolescent children and their self-concept. The strategies were analyzed by the participants' answers about what they would do in ten conflict situations described in a questionnaire. These answers were categorized according to the type of reaction informed. Self-concept was assessed using the participants' responses to the 20 statements from the AF5 Self-Concept Questionnaire on self-concept and interpersonal relationships. The data obtained were tested for correlation, verifying the association between reported strategies such as assertiveness and self-concept dimensions.

Résumé : La recherche a montré des relations entre stratégies de résolution des conflits et des variables telles qu'âge, sexe, et culture. Cependant, la relation entre les stratégies et des aspectes du fonctionnement psychologique tels que concept de soi a été peut étudié, notamment à la préadolescence. Cette recherche visait à vérifier l'existence de relations entre les stratégies de résolution de conflits rapportées par les préadolescents et leur concept de soi. Les stratégies ont été vérifiées à travers les réponses des participants sur ce qu'ils feraient dans des situations conflictuelles décrites dans le Children's Action Tendency Scale, Le questionnaire contient dix situations conflictuelles et on leur a demandé de décrire leur réaction à chacune d'elles. Le concept de soi a été mesuré à travers de réponses des participants à l'Échelle multidimensionnelle du concept de soi pour des préadolescents sur leur autoreprésentation et leur relations interpersonnelles. Les données obtenues ont été soumis à des tests de corrélation, vérifiant la relation entre les stratégies rapportées comme la afirmation et la dimension du concept de soi.

Resumen: Estudios han demostrado las relaciones entre las estrategias de resolución de conflictos y las variables como edad, sexo, nivel socioeconómico y cultura. Sin embargo, la relación de estas estrategias con aspectos del funcionamiento psicológico como el autoconcepto ha sido poco investigada, sobre todo en cuanto a la adolescencia. Esta investigación tuvo como objetivo comprobar la existencia de relaciones entre las estrategias de resolución de conflictos de preadolescentes y su autoconcepto. Las estrategias se analizaron desde las respuestas de los participantes sobre qué harían en situaciones de conflictos descritas en Children's Action Tendency Scale . El cuestionario contiene diez situaciones de conflicto, y el participante describía su reacción ante la situación. El autoconcepto se evaluó mediante las respuestas de los participantes a veinte afirmaciones de la Escala Multidimensional de Autoconcepto para preadolescentes respecto al autoconcepto y relaciones interpersonales. Los datos obtenidos se sometieron a pruebas de correlación para comprobar si existe relación entre algunas estrategias, como la asertividad y las dimensiones del autoconcepto.

Alma Gêmea: Adaptação da Romantic Beliefs Scale / Alma gemela: Adaptación de la Romantic Beliefs Scale / Soul mate: Adaptation of the Romantic Beliefs Scale

Resumo A Romantic Beliefs Scale (RBS) foi desenvolvida para acessar crenças sobre romantismo, que podem impactar na formação e qualidade de relacionamentos românticos. Tais crenças podem ser acessadas por meio de quatro fatores que representam o amor romântico ideal, sendo elas: Um e único, Idealização, Amor à primeira vista e Amor encontra uma maneira. Este estudo buscou evidências de validade para a RBS em um contexto brasileiro baseadas na estrutura interna e relações com as variáveis satisfação com o relacionamento e personalidade (Cinco Grandes Fatores e Investimento Emocional). Responderam a um questionário on-line 818 brasileiros com média de idade de 30,7 anos (DP= 14,1), sendo 73,2% mulheres. A escala apresentou evidências de validade baseadas na estrutura interna do instrumento e na relação com outras variáveis, e melhor ajuste a um modelo de fator de segunda ordem explicando os quatro fatores da escala original. Foram encontradas correlações positivas entre os fatores da RBS-Brasil e os fatores de personalidade Extroversão, Socialização e Realização, a Satisfação com o relacionamento e o Investimento emocional.

Abstract The Romantic Beliefs Scale (RBS) was developed to assess beliefs about romanticism, that can impact the formation and quality of romantic relationships. These beliefs can be assessed using four factors that represent the ideal romantic love, which are: One and only, Idealization, Love at first sight, and Love finds a way. This study sought evidence of validity for the RBS in a Brazilian context based on internal structure and relationships with the variables relationship satisfaction and personality (Big Five Factors and Emotional Investment). A total of 818 Brazilians with an average age of 30.7 years (SD= 14.1) responded to an online questionnaire, of which 73.2% were women. The scale showed satisfactory evidence of validity based on the internal structure and relation with other variables, and best fit to a second-order factor model explaining the four factors of the original scale. Positive correlations were found between the factors of RBS and personality factors Extraversion, Agreeableness and Consciousness, Relationship satisfaction and Emotional investment.

Resumen La Romantic Beliefs Scale (RBS) fue desarrolló para evaluar las creencias sobre el romanticismo, las cuales pueden afectar la formación y calidad de las relaciones románticas. Estas creencias pueden ser accedidas a través de cuatro factores que representan el amor romántico ideal, los cuales son: Único, Idealización, Amor a primera vista y Amor encuentra un camino. Este estudio buscó evidencias de validez para el RBS en un contexto brasileño basadas en la estructura interna y relaciones con variables como la satisfacción con la relación y la personalidad (Cinco Grandes Factores e Inversión Emocional). Respondieron a un cuestionario 818 brasileños con una media de edad de 30.7 años (DE= 14.1), de los cuales el 73.2% eran mujeres. La escala mostró evidencias de validez basadas en la estructura interna del instrumento y en la relación con otras variables, y un mejor ajuste a un modelo factorial de segundo orden que explica los cuatro factores de la escala original. Se encontraron correlaciones positivas entre los factores de RBS-Brasil y los factores de personalidad Extraversión, Amabilidad y Realización, así como con la Satisfacción con la relación e Investidura emocional.

Beethoven y su sobrino: El peligro que es el otro

1). La vida de Ludwig van Beethoven experimentó un cambio existencial al morir su hermano y dejar a su hijo Karl en tutoría compartida con su madre Johanna. 2). Casi sin haber tenido relación con su sobrino, se desencadena una necesidad emocional intensa e inesperada de convertirse en su único tutor, objetivo que consigue derrotando legalmente a su madre. 3). La relación Beethoven-Karl se desarrolla plagada de disputas, vigilancia, exigencias, control, como si el compositor viviera por vez primera lo que siempre se había negado, llegar a ser padre. 4). El intento de suicidio del sobrino le señala a Beethoven que convertirse en padre significa permitir que el hijo llegue a ser diferente a las arrogantes y desmesuradas ambiciones y expectativas personales, pero esta señal extrema fue insuficiente para hacerle entender que el otro siempre es un peligro porque muestra una verdad oculta intolerable y dolorosa del propio sí-mismo.

Ludwig van Beethoven's life underwent an existential change when his brother died and left his son Karl in shared tutorship with his mother Johanna. 2. Almost without having had any relationship with his nephew, an intense and unexpected emotional need to become his sole guardian is triggered, an objective that he achieves by legally defeating his mother. 3. The Beethoven-Karl relationship develops plagued by disputes, surveillance, demands, control, as if the composer were experiencing for the first time what he had always denied himself, becoming a father.4. The nephew's suicide attempt points out to Beethoven that becoming a father means allowing the son to become different from the arrogant and inordinate personal ambitions and expectations, but this extreme signal was insufficient to make him understand that the other is always a danger because it shows a hidden and painful truth of one´s own self.

Comunicación interpersonal de médicos-docentes en las prácticas formativas de un pregrado de medicina

Introducción: La comunicación es una competencia esencial en los currículos médicos, y es fundamental en modelos de atención centrados en el paciente. Las prácticas clínicas, eje en la formación médica, son escenarios de interacciones docente-estudiantes-pacientes; en ellas, los estudiantes aprenden a comunicarse con el paciente de la mano de sus profesores. El objetivo del estudio fue comprender la comunicación de médicos-docentes en prácticas clínicas de un pregrado de medicina. Metodología: Investigación cualitativa desde el marco interpretativo del interaccionismo simbólico y el análisis bajo los lineamientos de la teoría fundamentada. Se entrevistaron quince médicos docentes de cursos clínicos. Las entrevistas se grabaron, transcribieron y codificaron por unidades de sentido. Resultados: Del análisis emergen diferentes visiones del estudiante e interés por los elementos comunicativos con este y el paciente y la reflexión de la práctica docente. Los docentes son conscientes del rol de modelaje para el aprendizaje de los estudiantes; consideran a los pacientes como seres vulnerables, generosos, agradecidos, que representan el recurso más valioso para la enseñanza; con ellos desarrollan su doble misión de resolver problemas de salud y enseñar. Conclusiones: Los docentes, en la interacción con los estudiantes y pacientes, transforman una práctica más instruccional y disciplinar a una centrada en los sujetos y sus necesidades. La regulación del currículo y la normativa de las instituciones de salud genera tensiones a los docentes entre el quehacer médico y el deseo de enseñar.

Introduction: Communication is an essential skill in medical curricula and crucial in patient-centered care models. Resident experience is fundamental in medical training. These experiences offer teacher-student-patient interactions where students learn about doctor-patient communication directly from their preceptors. The objective of the study was to understand doctor-teacher communication during clinical practices in an undergraduate medical program. Methodology: Qualitative research undertaken from the interpretive framework of Symbolic Interactionism andanalysis under Grounded Theory guidelines. Fifteen (15) clinical-course medical doctors were interviewed. The interviews were recorded, transcribed, and coded by meaning units. Results: Different student views emerged, including student interest in student-patient communicative aspects as well as their own thoughts on teaching. Teachers are aware of their role as models in student learning; they see patients as vulnerable, generous, grateful people that represent the most valuable asset in their teaching endeavor; with them, teachers develop their dual mission, that is, solving health-related problems and teaching. Discussion and conclusions: During their interaction with students and patients, teachers transform an essentially instructional and disciplined practice into one centered on the patient and their needs. The stress doctors face when addressing the medical task itself versus their desire to teach is compounded by curriculum guidelines and health agency norms. This is, in fact, part of the hidden curriculum that influences student learning

Gênero e violência nos relacionamentos afetivo-sexuais entre adolescentes / Gender and violence in affective-sexual relationships among adolescents

O objetivo deste estudo foi compreender as relações entre gênero e violência nos relacionamentos afetivo-sexuais de adolescentes. Para tanto, foram realizados grupos focais com 29 adolescentes, estudantes do 9o ano do ensino fundamental e EJA de três escolas públicas de uma cidade no interior do Rio Grande do Sul. Os participantes tinham entre 13 e 17 anos de idade. Os dados coletados foram submetidos à Análise Temática Reflexiva, o que possibilitou a elaboração de dois temas. No primeiro, a violência apresentou-se como ferramenta para a construção das masculinidades. A violência física ocupa um lugar central no imaginário desses jovens, sendo uma via de descarga para agressividade, bem como uma prática sujeita a sanções legais. No segundo tema, a violência evidenciou-se como um dispositivo de coerção e amedrontamento das meninas adolescentes. Foi possível observar que as situações de violência são onipresentes nas vivências das adolescentes, sendo mais intensas no contexto dos relacionamentos e após o término. Conclui-se que a violência é um importante marcador das desigualdades de gênero nos relacionamentos entre adolescentes, colocando as meninas adolescentes em situação de desvantagem em relação aos meninos.

The aim of this study was to understand the relationship between gender and violence in adolescents' affective-sexual relationships. Focal groups were carried out with 29 adolescents, students of the 9th year of elementary school and EJA from three public schools in a city in the interior of Rio Grande do Sul. The participants were between 13 and 17 years old. The collected data were submitted to Reflexive Thematic Analysis, which allowed the elaboration of two themes. In the first theme, violence was a tool for the construction of masculinities. Physical violence particularly occupies a central place in the imagination of these adolescents, being a way of discharge for aggression, as well as a practice subject to legal sanctions. In the second theme, violence was a tool of coercion and intimidation of adolescent girls. It was possible to observe that situations of violence are omnipresent in the experiences of adolescents, being more intense in the context of relationships and after the breakup. We conclude that violence is an important marker of gender inequalities in relationships between adolescents, placing adolescent girls at a disadvantage compared to boys.

Ter alguém com quem contar: A percepção de adolescentes acerca do amor e do suporte do(a) parceiro(a) amoroso(a) / Have somebody to count on: Adolescents' perception about love and support from a romantic partner

Embora interações com amigos e parceiros amorosos ganhem importância na adolescência, ainda há controvérsias acerca da profundidade e da qualidade da vinculação amorosa. Buscou-se avaliar a percepção de setenta adolescentes gaúchos (12 a 18 anos), de escolas públicas e privadas de Porto Alegre e Canoas/RS, acerca do amor e do suporte do(a) parceiro(a) amoroso(a), e verificar suas associações com características sociodemográficas. Aplicou-se individualmente, em sala de aula, um questionário de dados sociodemográficos, o Inventário de Qualidade dos Relacionamentos Interpessoais e a Escala Triangular do Amor ­ Versão Reduzida. Os dados obtidos foram digitados em planilha no SPSS e analisados por meio de estatística descritiva e correlacional (Correlação de Spearman e comparação entre grupos via teste de Mann-Whitney, considerando as variáveis gênero, faixa etária, renda familiar, religião, escolaridade e presença ou não de relação sexual). Os adolescentes perceberam seus relacionamentos como importantes, considerando-os boa fonte de suporte, apresentando altos índices de intimidade, paixão e comprometimento e baixo nível de conflito. Encontrou-se associação positiva entre comprometimento e profundidade e intimidade e suporte, assim como entre maior idade e maior comprometimento. Ter relacionamento sexual associou-se a maior percepção de conflito e paixão. Os relacionamentos amorosos mostraram ser fonte de suporte para o desenvolvimento saudável desses adolescentes.

Although interactions with friends and romantic relationships become important during adolescence, there is still controversy about the depth and quality of adolescents' attachment to their romantic partners. The present study aimed to evaluate the adolescents' perception of love and their romantic partner's support, as well as to verify its possible associations with sociodemographic characteristics. Seventy adolescents (12 to 18 years old) from South Brazil, enrolled in public and private schools of Porto Alegre and Canoas/RS, fulfilled individually, at school, a sociodemographic data questionnaire, the Quality of Relationships Inventory and the Triangular Love Scale ­ Reduced Version. The collected data were entered into a spreadsheet in SPSS. Descriptive and correlational statistics analysis were performed (Spearman correlation and comparison between groups via Mann-Whitney test, considering the variables gender, age group, family income, religion, education level, and the presence or absence of sexual intercourse). The adolescents perceived their romantic relationships as important, as a good source of support, showing high levels of intimacy, passion and commitment, and low levels of conflict. A positive association was found between commitment and depth, and intimacy and support, as well as higher age and more advanced levels of commitment. Having a sexual relationship was associated with a higher perception of conflict and passion. Romantic relationships proved to be a source of support for the healthy development of these adolescents.

Relações de amizade nos transtornos alimentares: revisão integrativa da literatura / Friendship relationships in eating disorders: an integrative literature review / Relaciones de amistad en los trastornos alimentarios: revisión integradora

Ainda é desconhecido o papel da amizade enquanto constitutiva da rede de apoio social nos transtornos alimentares (TAs). Esta revisão integrativa teve por objetivo analisar a produção científica sobre relações de amizade em pessoas com TAs. Foram consultadas as bases PubMed/MEDLINE, LILACS, PsycINFO, Web of Science e EMBASE, de 2010 a 2020. Dos 1126 artigos recuperados, 15 preencheram os critérios de elegibilidade. A maioria tem abordagem qualitativa e delineamento transversal, sem indicar referencial teórico. Aspectos qualitativos das relações de amizade foram associados com redução da frequência e intensidade de sintomas quando o vínculo era considerado de boa qualidade. Já amizades que envolviam comentários depreciativos e influências negativas acerca do corpo e hábitos alimentares foram considerados fatores de risco para desencadeamento dos transtornos. Investir na qualidade dos relacionamentos entre pares pode contribuir para fortalecer a rede de proteção social e reduzir a vulnerabilidade psicossocial de adolescentes com risco para desenvolver TAs. (AU)

There is still little knowledge about the role of friendship within the social support network in eating disorders (EDs). This integrative review aimed to analyze the scientific production about friendship relationships in people with EDs. The literature review was conducted using the PubMed/MEDLINE, LILACS, PsycINFO, Web of Science, and EMBASE databases in the period from 2010 to 2020. Among the 1126 articles retrieved, 15 met the eligibility criteria, most with a qualitative approach and cross-sectional design, without indicating a theoretical framework. The qualitative aspects of friendship were associated with a reduced frequency and intensity of symptoms when the bond was considered to be of good quality. On the other hand, friendships that involved derogatory comments and negative influences related to body image and eating habits emerged as potential risk factors for triggering disorders. Investing in the quality of peer relationships can contribute to strengthening the social safety net and reducing the psychosocial vulnerability of adolescents at higher risk for developing EDs. (AU)

El papel de la amistad como constitutiva de la red de apoyo social en los trastornos alimentarios (TAs) es aún desconocido. Este estudio tiene como objetivo analizar la producción científica sobre las relaciones de amistad en personas con TAs. Se consultaron las bases PubMed/MEDLINE, LILACS, PsycINFO, Web of Science e EMBASE, entre 2010 y 2020. De los 1126 artículos recuperados, 15 cumplían los criterios de elegibilidad. La mayoría tiene enfoque cualitativo y diseño transversal, sin indicar el marco teórico. Los aspectos cualitativos de las relaciones de amistad se asociaron con una menor frecuencia/intensidad de los síntomas cuando el vínculo se consideraba de buena calidad. Amistades que implicaban comentarios despectivos e influencias negativas sobre el cuerpo y los hábitos alimentarios se consideraron factores de riesgo. Invertir en la calidad de las relaciones entre pares puede contribuir a reforzar la red de protección social y reducir la vulnerabilidad de adolescentes con riesgo de desarrollar TAs. (AU)

Factors related to academic performance in medical students / Factores relacionados con el desempeño académico en estudiantes de medicina

Abstract Introduction Academic performance in medical students can be influenced by several factors, including those related to mental health and family relationships. Objective To examine the factors affecting academic performance in medical students, specifically considering potential diagnoses of depression. Method A survey was conducted among 747 fourth-year medical students. The survey included questions on sociodemographic variables, mental health, and well-being. The Patient Health Questionnaire (PHQ) was utilized, encompassing sections on depression, anxiety, panic, eating habits, alcohol consumption, and the Stress Perception Scale. Academic performance was assessed based on students' Grade Point Average (GPA). Descriptive statistics, Pearson correlation coefficients, and a linear regression model were employed for data analysis. Results The study revealed several variables significantly associated with GPA. Age (r = -.388), financial situation (r = .241), relationships with cohabitants (r = .165), and relationships with peers (r = .217) were found to have a correlation with academic performance. Additionally, repeating a course was found to be significantly associated with a person's GPA (r = .518) even after controlling for depression. Discussion and conclusion The findings indicate that robust mental health, a favorable financial situation, and positive interpersonal relationships are crucial for achieving optimal academic performance in medical students. These results emphasize the need to address mental health concerns, promote a supportive social environment, and provide financial assistance to enhance the educational outcomes of medical students.

Resumen Introducción El desempeño académico de los estudiantes de medicina puede verse influenciado por varios factores, entre ellos los relacionados con la salud mental y las relaciones familiares. Objetivo Examinar los factores que afectan el desempeño académico en estudiantes de medicina, considerando específicamente los posibles diagnósticos de depresión. Método Se realizó una encuesta entre 747 estudiantes de cuarto año de la carrera de medicina. La encuesta incluyó preguntas sobre variables sociodemográficas, salud mental y bienestar. Se utilizó el Cuestionario de Salud del Paciente (PHQ), que comprende secciones sobre depresión, ansiedad, pánico, hábitos alimentarios, consumo de alcohol y la Escala de Percepción del Estrés. El desempeño académico se evaluó con base en el promedio de calificaciones (GPA) de los estudiantes. Se emplearon estadísticas descriptivas, coeficientes de correlación de Pearson y un modelo de regresión lineal para el análisis de datos. Resultados El estudio reveló varias variables significativamente asociadas con el GPA. Se encontró que la edad (r = -.388), la situación financiera (r = .241), las relaciones con los convivientes (r = .165) y las relaciones con los compañeros (r = .217) tenían correlación con el rendimiento académico. Además, se encontró que repetir un curso estaba significativamente asociado con el GPA de una persona (r = .518) incluso después de controlar la depresión. Discusión y conclusión Los hallazgos indican que una salud mental sólida, una situación financiera favorable y relaciones interpersonales positivas son cruciales para lograr un desempeño académico óptimo en los estudiantes de medicina. Estos resultados enfatizan la necesidad de abordar los problemas de salud mental, promover un entorno social de apoyo y brindar asistencia financiera para mejorar los resultados educativos de los estudiantes de medicina.

Composição de grupo de diálogo sobre o tema gênero e sexualidade nas escolas / Composition of a dialogue group on the theme of gender and sexuality in schools / Composición de un grupo de diálogo sobre el tema de género y sexualidad en las escuelas

Considerando-se os desafios da composição de grupos de diálogos em temas socialmente polêmicos, este estudo teve como objetivo apresentar as estratégias utilizadas para compor um grupo de diálogo a partir da metodologia do Projeto de Conversações Públicas entre pessoas com distintas opiniões sobre a abordagem do tema da diversidade sexual e de gênero nas escolas brasileiras. As transcrições das audiogravações das conversas preparatórias e dos encontros grupais e as anotações de diário de campo compuseram o corpus de análise deste estudo. A análise temática de conteúdo serviu para o destaque das seguintes estratégias consideradas úteis para a composição grupal: 1) Reconhecendo as pessoas envolvidas no conflito; 2) Entrando em contato com pessoas-chave; 3) Recrutando participantes reservas; 4) Pensando formas alternativas de presença no grupo; 5) Reconhecendo quem precisaria estar na conversa; 6) Flexibilidade com relação a entrada de novas/os participantes; 7) Lidando com os estereótipos com relação as/aos facilitadoras/es; 8) Co-construindo estratégias para maior adesão grupal. Esses eixos analíticos foram discutidos a partir da literatura da área.

Considering the challenges of composing dialogue groups in polemic issues, this study aimed to present the strategies used to compose a dialogue group based on the methodology of the Public Conversations Project among people with different opinions on the approach to the topic of sexual and of gender in Brazilian schools. Transcripts of audio recordings of preparatory conversations and group meetings and field diary notes composed the corpus of analysis of this study. The thematic content analysis served to highlight the following strategies considered useful for group composition: 1) Recognizing the people involved in the conflict; 2) Contacting key people; 3) Recruiting reserve participants; 4) Thinking about alternative forms of presence in the group; 5) Recognizing who would need to be in the conversation; 6) Flexibility regarding the entry of new participants; 7) Dealing with stereotypes regarding facilitators; 8) Co-building strategies for greater group membership. The selected material was discussed based on the literature in the area.

Considerando los desafíos de la composición de grupos de diálogo, este estudio tuvo como objetivo presentar las estrategias utilizadas para la composición de un grupo de diálogo basado en la metodología del Proyecto Conversaciones Públicas entre personas con opiniones diferentes sobre el abordaje del tema sexual y de género en las escuelas brasileñas. Transcripciones de grabaciones de audio de conversaciones preparatorias y reuniones grupales y notas del diario de campo componen el corpus de análisis de este estudio. El análisis de contenido temático sirvió para resaltar las siguientes estrategias consideradas útiles para la composición del grupo: 1) Reconocimiento de las personas involucradas en el conflicto; 2) Ponerse en contacto con personas clave; 3) Reclutamiento de participantes de reserva; 4) Pensar en formas alternativas de presencia en el grupo; 5) Reconocer quién debería estar en la conversación; 6) Flexibilidad en la entrada de nuevos participantes; 7) Abordar los estereotipos sobre los facilitadores; 8) Estrategias de co-construcción para una mayor membresía del grupo. El material seleccionado se discutió con base en la literatura en el área.

Violencias huérfanas contra las mujeres en relaciones de pareja transitorias de estudiantes en universidades colombianas

La violencia en relaciones transitorias y de noviazgo puede considerarse una violencia huérfana en Colombia por su falta de reconocimiento y protección jurídica. El objetivo de esta investigación cualitativa fue analizar la violencia en las relaciones de pareja, incluyendo noviazgo y otras relaciones equiparables a éste, en Colombia. Se empleó la teoría fundamentada. La información se recopiló mediante ocho grupos focales con 63 estudiantes de universidades en las ciudades de Medellín, Quibdó, Pereira y Cali. Con frecuencia establecen relaciones transitorias de pareja donde existen diferentes formas de violencia naturalizadas, que requieren medidas legislativas específicas para su protección.

Dating violence in Colombia, can be considered an orphan violence because it lacks right to justice due it does not occur within the family, or in stable couples. The objective of this qualitative research was to analyze violence in intimate partner relationships, by including dating and other temporary relationships comparable to dating, in Colombia. Grounded theory was used. Information was collected through eight focus groups with 63 university students in the following cities: Medellin, Quibdó, Pereira, and Cali. They frequently establish transitory relationships where different forms of violence against women, that are naturalized and require specific legislative measures for their prevention and protection.

Adaptación y validación argentina de la Cross Cultural Children Trust Beliefs Scale / Argentinean Adaptation and Validation of the Cross-Cultural Children Trust Beliefs Scale

Resumen El estudio de la confianza interpersonal es crucial para el desarrollo psicosocial humano. Se ha observado que, durante la niñez, favorece el comportamiento moral y prosocial, los vínculos de amistad, la competencia social, la experiencia de emociones positivas y el rendimiento académico, entre otros aspectos. El presente trabajo tuvo por objetivo adaptar y validar la Cross Cultural Children Trust Beliefs Scale (CCCTBS), a fin de poder evaluar este constructo en población argentina. La muestra incluyó 348 niños (51.2 % mujeres; 48.8 % varones), de entre 8 y 12 años de edad (m = 10.58; DE = 1.31), quienes completaron la CCCTBS y una escala de apego. Se consiguió una versión conceptual y semánticamente equivalente a la original, con buenas propiedades psicométricas. La escala argentina conserva el mismo número de ítems y replica el modelo operacional de partida, constituido por tres bases principales de la confianza: fiabilidad (α = .76; ω = .80), confianza emocional (α = .72; ω = .78) y honestidad (α = .78; ω = .83). Las puntuaciones de la CCCTBS correlacionaron positiva y significativamente con la medida de apego seguro, lo que aporta evidencias de su validez nomológica.

Abstract The study of interpersonal trust is crucial for human psychological development. It has been observed that it enhances moral and prosocial behavior during childhood, as well as friendship bonds, social competence, experience of positive emotions and academic performance, among others. This research aimed to adapt and validate the Cross-Cultural Children Trust Beliefs Scale (CCCTBS), to assess this construct in the Argentine population. The sample included 348 children (51.2 % female; 48.8 % male) aged 8 to 12 years (m = 10.58; SD = 1.31), who completed the CCCTBS and an attachment scale. A version, conceptually and semantically equivalent to the original was obtained, with good psychometric properties. The Argentine scale retains the same number of items and replicates the starting operational model, consisting of three main bases of trust: reliability (α = .76; ω = .80), emotional trust (α = .72; ω = .78) and honesty (α = .78; ω = .83). The CCCTBS scores correlated positively and significantly with the secure attachment measure, providing evidence of its nomological validity.

Estratégia saúde da família como espaço de insatisfação e satisfação profissional / Family health strategy as a place for job dissatisfaction and satisfaction / La estrategia de salud familiar como espacio de insatisfacción y satisfacción profesional

Os fatores que interferem na satisfação e insatisfação dos profissionais que atuam na Estratégia Saúde da Família são diversos e de inúmeras características. O objetivo do estudo foi identificar os fatores de satisfação e insatisfação de profissionais da Estratégia de Saúde da Família do município de Forquilhinha/SC. Trata-se de um estudo de métodos mistos, descritivo e exploratório, realizado com 15 profissionais da saúde de três Unidades de Saúde por meio de entrevista semiestruturada. Os dados foram analisados segundo a análise de conteúdo temática com o auxílio do software Atlas.ti. Os resultados geraram 72 categorias, vinculados a cinco subcategorias, associados a duas categorias. Os grupos fatores de insatisfação e satisfação encontrados envolvem a atuação na rotina diária, estrutura e serviços das unidades e do sistema de saúde, os direitos trabalhistas, a organização dos elementos de atuação, e as relações interpessoais com os colegas, usuários e gestores. A satisfação é indicada, principalmente, pela relação com os colegas e pela divisão de tarefas entre os profissionais. Em contrapartida, a falta de reconhecimento e desvalorização, além da sobrecarga trabalho, são os principais motivos de insatisfação. Os aspectos geradores de satisfação e insatisfação dos profissionais são múltiplos e até mesmo ambíguos e podem colaborar para prejuízo ou melhoria da prestação do cuidado a saúde.

The factors that interfere with the satisfaction and dissatisfaction of professionals working in the Family Health Strategy are diverse. The objective of the study was to identify the factors of satisfaction and dissatisfaction of professionals of the Family Health Strategy in the municipality of Forquilhinha (SC). This is a mixed-methods, descriptive and exploratory study, carried out with 15 health professionals from three health units by means of semi-structured interviews. The data were analyzed according to thematic content analysis, with the help of the Atlas.TI 9.0 software. The results generated 72 codes, linked to five subcategories, associated with two categories. The groups of dissatisfaction and satisfaction factors found involve: the performance in the daily routine, structure and services of the units and the health system, labor rights, the organization of the performance elements, and the interpersonal relationships with colleagues, users and managers. Satisfaction is indicated mainly by the relationship with colleagues and the division of tasks among professionals. On the other hand, the lack of recognition and the devaluation, besides the work overload, are the main reasons for dissatisfaction. The aspects that generate satisfaction and dissatisfaction among professionals are multiple and even ambiguous and can contribute to hinder or improve health care delivery.

Los factores que interfieren en la satisfacción o en la insatisfacción de los profesionales que actúan en la Estrategia de Salud Familiar son diversos. El objetivo de este estudio fue identificar los factores de satisfacción e insatisfacción de los profesionales de la Estrategia de Salud Familiar del municipio de Forquilhinha (Santa Catarina, Brasil). Se trata de un estudio de métodos mixtos, descriptivo y exploratorio, realizado con 15 profesionales sanitarios de tres unidades de salud mediante entrevistas semiestructuradas. Los datos se analizaron según el análisis de contenido temático con la ayuda del software Atlas.TI 9.0. Los resultados generaron 72 categorías, vinculadas a cinco subcategorías, asociadas a dos categorías. Los factores de insatisfacción y satisfacción encontrados tienen que ver con la actuación en la rutina diaria, la estructura y los servicios de las unidades y del sistema de salud, los derechos laborales, la organización de los elementos de actuación y las relaciones interpersonales con los compañeros, los usuarios y los gestores. La satisfacción está indicada principalmente por la relación con los compañeros y el reparto de tareas entre los profesionales. Por otro lado, la falta de reconocimiento y la desvalorización, además de la sobrecarga de trabajo, son los principales motivos de insatisfacción. Los aspectos que generan satisfacción e insatisfacción de los profesionales son múltiples, incluso ambiguos, y pueden perjudicar o mejorar la prestación de la asistencia sanitaria.