Primary health care: Nurses' meanings in a Colombian municipality

Introduction: Primary health care is a strategy that involves the different health professionals and other agents in the system who can influence the social determinants that affect human wellbeing. Objective: To know the meanings about primary health care of nursing professionals practicing in this field in a municipality of Colombia. Materials and Methods: Qualitative, exploratory, descriptive study. The research was conducted in a State Social Company (ESE for its acronym in Spanish) that provides primary health care services. Data was collected through semi-structured interviews. The sample consisted of 13 professionals. IRaMuTeQ software was used to help data interpretation. Results: 'Nurse' was the most frequent word. The content analyzed was categorized into four classes: 'Meanings about primary health care', 'nursing activities in primary health care', 'barriers encountered in primary health care', 'primary health care organization and work team'. Conclusions: Primary health care meaning is understood as the entry point of users into the health system and the one responsible for coordinating their passage through other points of the healthcare network according to users' health needs. In addition, primary health care is understood as the level of care at which essential health actions focused on the early detection of health risks and complications are carried out, so that health interventions can be planned, implemented, and evaluated on that basis.

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" .

Analysis of role adaptation and associated factors among college freshmen / 中国学校卫生

Objective@#To explore the influencing factors of role adaptation of college freshmen, so as to provide empirical support for developing adaptive education in college.@*Methods@#A cluster sampling method was used to select 3 126 freshmen from six universities of Hefei City and Wuhu City in Anhui Province in October 2022, who were investigated with Positive Psychological Capital Questionnaire (PPQ), Freshmen s Role Adaptability Scale, Connor Davidson Resilience Scale (CD-RISC) and Life Satisfaction Scale. Independent sample t-test and oneway ANOVA were used to compare the scores (caverage score of items) of various variables of college freshmen with different demographic characteristics. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation.@*Results@#There were statistically significant differences in scores of psychological capital, resilience, life satisfaction and role adaptation among college freshmen of different origin (large and mediumsized cities: ３.６３± ０.５４，３.７３±０.６４，３.４７±０.８０，３.１４±０.６５；county level city or county seat:３.５７±０.５２，３.６１±０.６３，３.３５±０.７５，３.０９±０.６３；villages and towns:３.５０±０.５０，３.５４±０.５８，３.２３±０.７５，３.０６±０.６０), whether in class committee (yes:３.６３±０.５２，３.６９±０.６０，３.４０± ０.７６ ，３.１８±０.５９； no:３.４３±０.５０，３.４８±０.６４，３.２５±０.７７，２.９３±０.６５), father s education level (junior high school or below:３.５２± ０.５１ ，３.５７±０.６１，３.２７±０.７５，３.０７±０.６１； senior high school or technical secondary school:３.６２±０.５３，３.６８±０.６３，３.４４±０.７８，３.１２±０.６３；junior college or above:３.６８±０.５６，３.７８±０.６４，３.５７±０.８０，３.１９±０.６８)，mother s education level(junior high school or below:３.５３±０.５１，３.５８±０.６１，３.２８±０.７５，３.０６±０.６０；senior high school or technical secondary school:３.６３±０.５５，３.７０±０.６３，３.４８±０.７８，３.１５±０.６６；junior college or above:３.７２±０.５４，３.８６±０.６５，３.６２±０.８３，３.２７±０.７０) ( F / t =11.89,21.89,23.02,3.83；10.08，9.20， 5.20 ，10.63；19.34，20.76，29.52，6.44；22.51，26.79，30.94，13.92， P <0.05). The differences of scores in resilience and role adaptation of different genders (boys:3.66±0.64, 3.12±0.65; girls:3.56±0.59, 3.05±0.58) and in life satisfaction whether being an only child (yes:3.40±0.79; no:3.33±0.76) among college freshmen were statistically significant ( t =4.51, 2.75, 2.35, P <0.05). Pearson correlation analysis showed that psychological capital, resilience and life satisfaction of college freshmen were positively correlated with role adaptation ( r =0.49, 0.49, 0.36), while psychological capital, resilience and role adaptation were positively correlated ( r =0.60, 0.59) and Psychological capital was positively correlated with resistance ( r =0.81)( P <0.01). The results of multiple linear regression analysis showed that gender, whether in class committee, psychological capital, resilience and life satisfaction were positively associated with role adaptation among college freshmen ( R 2=0.28, β =0.04, 0.10, 0.23, 0.26, 0.07， P <0.05).@*Conclusions@#Role adaptation of college freshmen is related with psychological capital, resilience and life satisfaction. Schools should strengthen mental health education to promote smooth role transition for college freshmen.

Image of nurses in Chile through children's drawings: An iconographic study / A imagem de enfermeiras(os) no Chile por meio de desenhos infantis: um estudo iconográfico / Imagen de enfermeras(os) en Chile a través del dibujo infantil: un estudio iconográfico

Abstract Objective To reveal the image of nursing professionals in Chile through the analysis of children's drawings. Method This is an exploratory qualitative study, involving the collection of information through nine drawings made by children aged between 7 and 10 years, using free technique, and then were analyzed with the Iconographic Method proposed by Erwin Panofsky. Results Most drawings depict clinical activities of nurses, focusing predominantly on the technical dimension of the profession. Although nursing is commonly associated with a mostly female occupation, permeated by gender stereotypes, some participants were able to identify the presence and importance of the male role in this professional field. No iconographic elements were identified that would reinforce stigmas associated with nursing professionals, such as the view that they are supporters, aides, or mere medical assistants. Conclusions and implications for practice Children's drawings serve as a reflection of the collective imagination of society. By studying them in relation to nursing, we can identify the advances of the profession and glimpse its near future. This research contributes to understanding the current image of the profession in society, and allows an analysis that goes further, helping to establish future directions and the evolution of this collective perception.

Resumo Objetivo Revelar a imagem do profissional de enfermagem no Chile por meio da análise iconográfica de desenhos infantis. Método Estudo qualitativo exploratório, envolvendo a coleta de informações por meio de nove desenhos elaborados por crianças com idades entre 7 e 10 anos, utilizando técnica livre e posteriormente examinados com base no Método Iconográfico proposto por Erwin Panofsky. Resultados A maioria retrata as atividades clínicas do enfermeiro, enfocando predominantemente em sua dimensão técnica. Embora a enfermagem seja comumente associada a uma ocupação majoritariamente feminina, permeada por estereótipos de gênero, alguns participantes conseguiram identificar a presença e a importância do papel masculino nesse campo profissional. Não foram identificados elementos iconográficos que reforçassem estigmas associados aos profissionais de enfermagem, como a visão de serem simples assistentes, ajudantes ou meros auxiliares dos médicos. Conclusões e implicações para a prática Os desenhos infantis são reflexo do imaginário coletivo da sociedade. Ao estudá-los em relação à enfermagem, podemos identificar avanços na profissão e vislumbrar seu futuro próximo. Esta pesquisa contribui para compreender a imagem atual da profissão na sociedade e possibilita uma análise que ajuda a estabelecer direções futuras e a evolução dessa percepção coletiva.

Resumen Objetivo Revelar la imagen de los profesionales de enfermería en Chile a través del análisis de dibujos infantiles. Método Estudio cualitativo exploratorio, que involucra la recolección de información a través de nueve dibujos en técnica libre realizados por niños entre siete y diez años, posteriormente analizados mediante el Método Iconográfico propuesto por Erwin Panofsky. Resultados La mayoría representa las actividades clínicas de las enfermeras, centrándose predominantemente en la dimensión técnica. Aunque la enfermería se asocia comúnmente a una ocupación mayoritariamente femenina, impregnada de estereotipos de género, algunos participantes identificaron la presencia y la importancia del papel masculino en la profesión. No se identificaron elementos iconográficos que reforzaran estigmas asociados a los profesionales de enfermería, como la visión de que son simples asistentes, ayudantes o meros auxiliares médicos. Conclusiones e implicaciones para la práctica Los dibujos son reflejo del imaginario colectivo de la sociedad. Al estudiarlos en relación con la enfermería, podemos identificar avances en la profesión y vislumbrar su futuro próximo. Esta investigación contribuye a comprender la imagen actual de la profesión en la sociedad y permite un análisis que ayuda a establecer las orientaciones futuras y la evolución de esta percepción colectiva.

Homens cuidadores informais de idosos dependentes no Brasil / Hombres cuidadores informales de ancianos dependientes en Brasil / Men as informal caregivers of dependent older adults in Brazil

O objetivo deste estudo foi compreender as motivações e as implicações do cuidado de familiares idosos dependentes realizado por homens. Com base em pesquisa qualitativa realizada entre julho e dezembro de 2018 em seis cidades nas cinco regiões brasileiras, foram entrevistados 11 homens que desempenham a tarefa de cuidadores informais. Eles assumiram essa tarefa em razão de as mulheres estarem exaustas e adoecidas, assim como por reciprocidade afetiva e marital. Os filhos manifestaram desconforto na administração de cuidados pessoais aos pais, enquanto os cônjuges apresentaram dificuldades com atividades domésticas. Os cuidadores solitários estavam cansados, com dores, privação do sono, sintomas depressivos e solidão. O suporte prestado por familiares e cuidadores formais mostrou-se valioso para amenizar o sofrimento dos cuidadores que relutavam em pedir ajuda. Há necessidade de os profissionais de saúde estarem atentos aos prestadores de cuidados informais aos familiares.

El objetivo de este estudio fue comprender las motivaciones y las implicaciones del cuidado de familiares ancianos dependientes realizado por hombres. A partir de una investigación cualitativa realizada entre julio y diciembre de 2018 en seis ciudades en las cinco regiones brasileñas, se entrevistaron 11 hombres que desempeñan la tarea de cuidadores informales. Los hombres asumieron esta tarea porque las mujeres estaban exhaustas y enfermas y por reciprocidad afectiva y marital. Los hijos manifestaron incomodidad en la administración de cuidados personales a los padres, mientras que los cónyuges presentaron dificultades con actividades domésticas. Los cuidadores solitarios estaban cansados, con dolores, privación de sueño, síntomas depresivos y soledad. El soporte prestado por familiares y cuidadores formales se mostró valioso para disminuir el sufrimiento de los cuidadores que titubeaban en pedir ayuda. Existe la necesidad de que los profesionales de salud estén atentos a los prestadores de cuidados informales a los familiares.

The objective of study was to understand the motivations and implications of care given by men for dependent elderly family members. Qualitative research happened between July and December 2018 in six cities in the five Brazilian regions, interviewing 11 men who perform tasks as informal caregivers. The men assumed this task because the women's exhaustion and sickness, added to affective and marital reciprocity. Their sons expressed discomfort in taking personal care of their parents, while the spouses had difficulties with domestic activities. Lonely caregivers were tired, in pain, sleep deprived, experiencing depressive symptoms and loneliness. Support provided by family members and formal caregivers proved to be valuable in alleviating the suffering of caregivers who were reluctant to ask for help. Health professionals are called to pay attention to informal care providers for family members.

O eu em nós: marcas e aproximações de uma diretora no processo psicoterápico / The self in us: marks and approaches of a director in the psychotherapeutic process / El yo dentro de nosotros: marcas y enfoques de una directora en el proceso psicoterapêutico

RESUMO O objetivo deste trabalho foi aprofundar as marcas e aproximações de uma diretora no processo psicoterápico. Trata-se de um estudo de caso psicodramático utilizando o registro documental de sessões de psicoterapia bipessoal de três pacientes atendidas anteriormente pela primeira autora e os relatos da própria autora sobre suas percepções nos atendimentos. Foram apresentadas reflexões que demonstram resultados positivos sobre as aproximações na relação psicoterapêutica mediante o humor, a poesia e a música como formas de conexão entre psicodramatista e cliente.

ABSTRACT The objective of this work was to deepen the approaches and distances of a director in the psychotherapeutic process. This is a psychodramatic case study that used the documentary record of bipersonal psychotherapy sessions of three patients previously attended by the first author and the author's own reports about her perceptions in the sessions. Reflections were presented that demonstrate positive results regarding the approaches in the therapeutic relationship, using humor, poetry, and music as means of connection between the psychodramatist and the client.

RESUMEN El objetivo de este trabajo fue profundizar los acercamientos y distancias de una directora en el proceso psicoterapéutico. Se trata de un estudio de caso psicodramático utilizando el registro documental de sesiones de psicoterapia bipersonal de tres pacientes atendidos previamente por la primera autora y los relatos de la propia autora sobre sus percepciones en las sesiones. Se presentaron reflexiones que demuestran resultados positivos en relación a las aproximaciones en la relación terapéutica, utilizando el humor, la poesía y la música como formas de conexión entre el psicodramatista y el cliente.

Competencia profesional de enfermeros en unidades de urgencias y emergencias: estudio de método mixto / Nurses' professional competencies in urgency and emergency units: A mixed-methods study / Competências profissionais dos enfermeiros de unidades de urgência e emergência: estudo de método misto

Objetivo: describir las competencias profesionales de los enfermeros que trabajan en urgencias y emergencias y comprender la percepción que tienen sobre las competencias esenciales para el desempeño y la actualización profesional. Método: estudio secuencial explicativo de métodos mixtos, realizado con enfermeros de urgencias y emergencias. Para obtener datos cuantitativos, se utilizó un cuestionario con 78 ítems, respondido por 39 enfermeros, que fueron analizados mediante estadística descriptiva y pruebas no paramétricas. Los datos cualitativos se obtuvieron a través de entrevistas semiestructuradas con 17 enfermeros, que fueron interpretados mediante el análisis temático de contenido inductivo. Los datos se combinaron por conexión. Resultados: se obtuvo un alto nivel de competencia en la autoevaluación de los enfermeros de urgencias y emergencias en el factor 2 - relaciones en el trabajo y un nivel más bajo en el factor 6 - excelencia profesional (p=0,036). Los datos cualitativos coincidieron positivamente con el factor relaciones en el trabajo, identificando la asociación entre conocimiento y experiencia práctica con las competencias, además de un escenario que carece de educación continua. Conclusión: a pesar de los altos niveles de competencia identificados en los enfermeros de urgencias y emergencias, el fortalecimiento de las estrategias educativas favorece el desarrollo y reconocimiento profesional.

Objective: to describe the professional competencies of nurses working in urgency and emergency services and to understand their perception of the essential competencies for professional performance and updating. Method: a sequential, mixed-methods and explanatory study, conducted with emergency nurses. To obtain the quantitative data, a questionnaire with 78 items was used, answered by 39 nurses and analyzed using descriptive statistics and non-parametric tests. In turn, the qualitative data were obtained through semi-structured interviews with 17 nurses, whose interpretation was based on inductive content thematic analysis. The data were combined by connection. Results: a high level of competence was obtained in the self-assessment of urgency and emergency nurses in Factor 2 - Relations at work and a lower level in Factor 6 - Professional excellence (p=0.036). The qualitative data corroborated positively with the "Relations at work" factor, identifying the association of knowledge and practical experience, with competencies beyond a scenario devoid of permanent education. Conclusion: despite the high levels of competence identified in emergency nurses, the strengthening of educational strategies favors professional development and recognition.

Objetivo: descrever as competências profissionais dos enfermeiros que atuam em urgência e emergência e compreender sua percepção a respeito das competências essenciais para a atuação e a atualização profissional. Método: estudo sequencial explanatório de métodos mistos, realizado com enfermeiros de urgência e emergência. Para a obtenção dos dados quantitativos, utilizou-se um questionário com 78 itens, respondidos por 39 enfermeiros, que foram analisados mediante estatística descritiva e testes não paramétricos. Já os dados qualitativos, foram obtidos por entrevista semiestruturada realizada com 17 enfermeiros, cuja interpretação deu-se pela análise temática de conteúdo indutiva. Os dados foram combinados por conexão. Resultados: obteve-se alto nível de competência na autoavaliação dos enfermeiros de urgência e emergência no fator 2 - relações no trabalho e menor nível no fator 6 - excelência profissional (p=0,036). Os dados qualitativos corroboraram de forma positiva com o fator relações no trabalho, identificando a associação do conhecimento e experiência prática com competências, além de um cenário desprovido de educação permanente. Conclusão: apesar de altos níveis de competência identificados nos enfermeiros de urgência e emergência, o fortalecimento de estratégias educacionais favorece o desenvolvimento e o reconhecimento profissional.

Rol del coordinador de enfermería en las subdirecciones de gestión del cuidado / The role of nursing coordinators within care management sub-directorates / Papel do coordenador de enfermagem nas subdiretorias de gestão assistente

Objetivo: El objetivo de esta reflexión fue explorar de acuerdo con la evidencia científica disponible, las funciones y atributos del rol de las enfermeras coordinadoras en atención cerrada. Desarrollo: En Chile la gestión del cuidado de enfermería para atención cerrada de establecimientos hospitalarios de mediana y alta complejidad se encuentra regulada por la norma general administrativa N° 19, con resolución exenta 1127 de 2007. A más de 15 años de su implementación se ha cuantificado una desigualdad en cuanto a estructura y alta heterogeneidad de las funciones enmendadas a través de la norma que las regula. A nivel internacional y nacional no existe consenso en relación con la estructura de enfermería y con ello el rol de coordinadoras de enfermería dentro de las subdirecciones de gestión del cuidado. Esta investigación demuestra divergencia en las estructuras de Enfermería y las definiciones con respecto a las coordinaciones de Enfermería, aspecto fundamental para la gobernanza de Enfermería. El estilo de liderazgo, motivación, comunicación efectiva, acompañamiento y el conocimiento de sistemas complejos, pueden determinar características de las enfermeras coordinadoras. Conclusiones: La definición y funciones del desarrollo del rol de la coordinación de enfermería es divergente. En la actualidad las estructuras son disímiles entre los establecimientos hospitalarios. Se sugiere establecer una estructura orgánica general desde el nivel central para la universalidad de las subdirecciones de enfermería, considerando las diferencias de acuerdo con carteras de servicios, complejidad y especialidad de los hospitales chilenos.

Objective: This reflection aimed to explore, based on the existing scientific evidence, the functions and attributes of the nurse coordinator's role in hospital care. Development: In Chile, nursing management for hospital care in medium- and high-complexity establishments is regulated by general administrative standard No. 19 through the exempt resolution 1127, 2007. More than 15 years after its implementation, some inequalities have been detected in its structure, as well as high heterogeneity in the functions that have been amended through the norm that regulates them. There is no consensus regarding the structure of nursing roles, whether at the international or national level; this includes the role of nursing coordinators within care management sub-directorates. This reflection reveals the divergence that exists among the structures of Nursing and the definitions related to nursing coordination, a fundamental aspect of governance in Nursing. Leadership style, motivation, effective communication, support, and knowledge of complex systems can determine the characteristics of nursing coordinators. Conclusions: The definition and functions of the nursing coordination role are divergent. Currently, the structures are dissimilar among hospital facilities. It is suggested that a general organizational structure is developed from a central level and universalized to all nursing sub-directorates, considering differences according to the service portfolios, complexity, and specialty of hospitals in Chile.

Objetivo: O objetivo desta reflexão foi explorar, de acordo com a evidência científica disponível, as funções e atributos da atuação dos enfermeiros coordenadores no cuidado fechado. Desenvolvimento: No Chile, a gestão da assistência de enfermagem para atendimento fechado em estabelecimentos hospitalares de média e alta complexidade é regulamentada pela norma administrativa geral nº 19, com isenção da resolução 1.127 de 2007. Mais de 15 anos após sua implementação, quantificou-se uma desigualdade em termos de estrutura e elevada heterogeneidade das funções alteradas pela norma que as regulamenta. A nível internacional e nacional não existe consenso em relação à estrutura de enfermagem e, portanto, ao papel dos coordenadores de enfermagem nas subdireções de gestão do cuidado. Esta reflexão demostra divergências nas estruturas e definições de enfermagem em relação à coordenação de enfermagem, um aspecto fundamental para a governança em enfermagem. O estilo de liderança, a motivação, a comunicação eficaz, o suporte e o conhecimento de sistemas complexos podem determinar características dos enfermeiros coordenadores. Conclusões: A definição e funções do desenvolvimento do papel da coordenação de enfermagem são divergentes. Atualmente, as estruturas são díspares entre os estabelecimentos hospitalares. Sugere-se estabelecer uma estrutura orgânica geral a partir do nível central para a universalidade das subdireções de enfermagem, considerando as diferenças segundo carteiras de serviços, complexidade e especialidade dos hospitais chilenos.

Enfermería de Práctica Avanzada en el Sistema de Salud: evolución, aceptación y reconocimiento / Advanced Practice Nursing in the Health System: evolution, acceptance and recognition

Introducción: se estima escasez de 5.9 millones de profesionistas de la salud a nivel mundial. La Enfermería de Práctica Avanzada (EPA), cuenta con conocimientos, competencias y habilidades clínicas específicas para actuar en situaciones de déficit de personal médico, tratando desde enfermedades agudas hasta crónico degenerativas, preservando tanto la salud mental como física. Objetivo: Determinar el desempeño de la Enfermería de Práctica Avanzada en el Sector Salud. Metodología: revisión sistemática sobre la EPA, que incluyó revisiones y artículos originales del periodo 2013-2022 en español e inglés, acerca de su desempeño: evolución, aceptación y reconocimiento. Para la identificación, cribado e inclusión de los artículos se utilizó el modelo PRISMA 2020. Resultados: de un total de 838 artículos identificados, se incluyeron 20 artículos y 7 de otras fuentes como citas y otros sitios web, obteniendo un total de 27 artículos de revisión, que abordan la evolución, la aceptación y reconocimiento. Se realizó análisis cualitativo. Conclusiones: el desempeño de EPA surge por las demandas poblacionales de atención primaria a la salud, diversos países ya cuentan con EPA, asistiendo a sus habitantes desde sus especialidades. La EPA es diversa y extensa, su profesionalización debe ser continua y permanente. En México falta camino para tomar la EPA como parte del equipo multidisciplinario

Abstract Introduction: About 5.9 millions healthcare professionals lack across the world. The Advanced Practice Nursing (APN), has specific knowledge, competences, and clinical abilities to act in medical absence, taking care from acute illness until chronic diseases, preserving both mental and physical health. Objective: To determine the Advanced Practice Nursing (APN) performance in the Health Sector. Methods: A systematic review about APN, including reviews and original articles from the period 2013-2022 in Spanish and English, about performance: evolution, acceptance and recognition. For the identification, screening, and inclusion of the articles the PRISMA 2020 model was used. Results: Of 838 total identified articles, 20 articles were included from the search and 7 from other sources such as citations and other websites, obtaining 27 total articles to be reviewed, which regard the evolution, acceptance and recognition. A qualitative analysis was performed. Conclusions: The APN performance arose because of demands for primary health care; several countries already have APN, providing care to inhabitants through their different specialties. APN is diverse and extensive, its professionalization must be continuous and permanent. In Mexico there is still some way to go to APN to take part in the multidisciplinary team.

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.

Supervisión de salud de niños/as con Síndrome de Down realizado por enfermera, desde la mirada de sus cuidadores / Caregivers' perspectives about the health supervision of children with Down Syndrome carried out by a nurse

INTRODUCCION: Los niños con Síndrome de Down (SD) y sus cuidadores requieren de una atención de salud multidisciplinaria que responda a sus necesidades desde una perspectiva integral. OBJETIVO: conocer las experiencias y expectativas que tienen los cuidadores de niños con SD en relación con los cuidados brindados por la enfermera durante el control de supervisión de salud infantil. METOLOGÍA: Estudio cualitativo fenomenológico, muestra intencionada de casos por criterios conformada por 11 cuidadores de niños con SD entre 0 y 9 años, que recibieron prestaciones en el Control de Salud Infantil. Se realizaron entrevistas semiestructuradas, los datos se analizaron siguiendo el esquema de reducción progresiva. Contó con la aprobación de la Dirección de Carrera de Enfermería, Universidad Santo Tomás (Temuco-Chile) (Acta 07-2018). RESULTADOS: se generaron dos categorías: "Experiencia de atención otorgada por la enfermera" y "Expectativas vinculadas a la atención proporcionada por la enfermera", se develó que los cuidadores de niños con SD perciben que los cuidados brindados por la enfermera durante la atención son insuficientes en relación con las necesidades que estos niños presentan. Esto estaría vinculado con la falta de conocimientos sobre esta condición y su abordaje integral. Con respecto a sus expectativas, refieren necesidad de acompañamiento, apoyo, educación y de profesionales de enfermería capacitados. CONCLUSIONES: urge abordar las brechas con respecto a las competencias del profesional de enfermería que realiza controles de salud del niño para poder entregar una atención de calidad a ellos y sus familias.

INTRODUCTION: Children with Down Syndrome (DS) and their caregivers require multidisciplinary health care that meets their needs from a comprehensive perspective. OBJECTIVE: to know the experiences and expectations that caregivers of children with DS have concerning the care provided by the nurse in the Child Health Supervision Attention. METHOD: A qualitative phenomenological study was conducted, an intentional sample of cases by criteria made up of 11 caregivers of children with DS between 0 and 9 years of age, who received benefits at the Child Health Control. Semi-structured interviews were carried out; the data were analyzed following the progressive reduction scheme. It had the approval of the Nursing Career Department, Santo Tomás University (Temuco-Chile) (Acta 07-2018). RESULTS: two categories were generated: "Experience of care provided by the nurse" and "Expectations linked to the care provided by the nurse", it was revealed that caregivers of children with DS perceive that the care provided by the nurse during the control is insufficient with the children's needs also, data showed a link to the lack of knowledge about this condition and its comprehensive approach. Regarding their expectations, they report the need for accompaniment, support, and education from the nurse, in addition to being a trained professional. CONCLUSION: It is urgent to address the gaps regarding the competencies of the nursing professional who performs child health checks to deliver quality care to them and their families.

Facilitadores y barreras para la implementación de un programa de enfermería de práctica avanzada en Chile / Facilitators and barriers in the implementation of advanced practice in nursing program

INTRODUCCIÓN: El desarrollo de la Enfermería de Práctica Avanzada se ha transformado en una tendencia global en las últimas décadas. Desde que esta formación de posgrado emergió en Estados Unidos ha trascendido a otros continentes y países. Si bien en la región de las Américas estos programas aún tienen un carácter incipiente, la Organización Panamericana de la Salud ha realizado esfuerzos constantes para relevar su aporte al logro del acceso universal de salud y al fortalecimiento de la atención primaria de salud y a la fuerza laboral de Enfermería. OBJETIVO: Este artículo presenta una reflexión acerca de la implementación de un programa de Práctica Avanzada en Chile, analizando facilitadores y desafíos del proceso. DESARROLLO: En respuesta a las necesidades del país y al contexto, la Escuela de Enfermería UC abrió su primer programa en 2021, específicamente en el área de la oncología, enfocado a abordar las brechas de acceso y cobertura en el área. Se plantean facilitadores y desafíos de la implementación que coinciden con lo que ocurre a nivel internacional CONCLUSIONES: Las fortalezas como los desafíos identificados proporciona una clara orientación para avanzar en la implementación y permiten proyectar estrategias basadas en evidencia y con pertinencia contextual, que consideren e integren las iniciativas exitosas publicadas y los logros obtenidos.

INTRODUCTION: The development of Advanced Practice Nursing has become a global trend in recent decades. Since this postgraduate training emerged in the United States, it has spread to other continents and countries. Although in the region of the Americas these programs are still incipient, the Pan American Health Organization has made constant efforts to highlight their contribution to the achievement of universal health access and to the strengthening of primary health care and the nursing workforce. OBJECTIVE: This article presents a reflection on the implementation of an Advanced Practice program in Chile, analyzing facilitators and challenges of the process. DEVELOPMENT: In response to the needs of the country and the context, the UC School of Nursing opened its first program in 2021, specifically in oncology, focused on addressing the gaps in access and coverage in the area. Facilitators and challenges of implementation are raised that coincide with what is happening internationally CONCLUSIONS: The strengths as well as the challenges identified provide clear guidance to advance implementation and allow projecting strategies based on evidence and with contextual relevance, which consider and integrate the successful initiatives published and the achievements obtained.

Pertinencia de enfermería, según las competencias percibidas por los graduados de la Universidad de Guayaquil

Fundamento: la pertinencia en salud se relaciona con la coherencia existente en un proyecto de intervención según las necesidades de sus beneficiarios; en ello es muy importante que el profesional posea facultades para combinar sus capacidades en el logro de un propósito determinado. Objetivo: determinar indicadores de empleabilidad según las competencias en graduados de la carrera de Enfermería de la Universidad de Guayaquil . Métodos: estudio descriptivo/explicativo con una muestra representativa de 136 graduados de los últimos cinco años, a los que se les aplica un instrumento validado por juicio de expertos (0,89: alfa de Cronbach). Se midieron 17 indicadores de empleabilidad interna y seis de empleabilidad externa. Resultados: los graduados de enfermería perciben la empleabilidad como atributos y competencias del ser, con habilidades de resolución de problemas, ser reflexivos, pensamiento crítico, conductas éticas y liderazgo efectivo. En relación con la empleabilidad externa los egresados se consideraron con competencias de atributos que los hacen competitivos en el entorno laboral de enfermería. Conclusiones: los graduados de la carrera de enfermería de la universidad de Guayaquil poseen los atributos y competencias de una empleabilidad interna y externa de acuerdo con los objetivos y perfiles del profesional de enfermería.

Foundation: the relevance in health is related to the existing coherence in an intervention project according to the needs of its beneficiaries; In this it is very important that the professional has the faculties to combine his capacities in the achievement of a certain purpose. Objective: to determine employability indicators according to the competencies in graduates of the Guayaquil University nursing career. Methods: descriptive/explanatory study with a representative sample of 136 graduates of the last five years, to whom an instrument validated by expert judgment (0.89: Cronbach's alpha) was applied. 17 indicators of internal employability and six of external employability were measured. Results Nursing graduates perceive employability as attributes and competencies of being, with problem-solving skills, being reflective, critical thinking, ethical behaviors, and effective leadership. In relation to external employability, graduates were considered to have attribute competencies that make them competitive in the nursing work environment. Conclusions: Nursing graduates from the Guayaquil University have the attributes and competencies of internal and external employability in accordance with the expectations of the objectives and the nursing professional's profiles.

Idealização da maternidade e herança psíquica: reflexões no contemporáneo / Idealization of motherhood and psychic heritage: reflections in the contemporary / Idealización de la maternidad y herencia psíquica: reflexiones en lo contemporáneo

Considerando as transformações na maternidade ao longo da história e a atual crise identitária na relação da mulher com a maternidade, ou seja, o conflito entre os ideais de maternidade relacionados à figura da mulher/mãe e as demandas contemporâneas de realização individual no trabalho, realizou-se este estudo transversal, exploratório-descritivo de abordagem qualitativa, cujo objetivo consistia em descrever e analisar, a partir da psicanálise de casal e família, a experiência de mães que abandonaram da carreira profissional para a dedicação exclusiva à maternidade. Foram entrevistadas oito mulheres de classe média, entre 30 e 50 anos, que eram mães e abandonaram suas carreiras profissionais para se dedicarem à maternidade. As entrevistas que compuseram os resultados foram transcritas e as análises de conteúdo temática apontaram as múltiplas exigências, tanto sociais, quanto relacionadas à herança psíquica, que trazem implicações para a construção identitária dessas mulheres. Concluímos que um processo de elaboração dessa herança exige uma rede vincular de apoio e pressupõe a desidealização da maternidade, entendendo-a como plural, tanto no sentido de ser múltipla e diversa, quanto no sentido de ser uma construção vincular.

Noticing the history transformations in motherhood, and the current identity crisis in the woman's relationship between femininity and maternity, that is, the conflict between the ideas of motherhood related to the figure of the woman/mother and the contemporary demands of individual realization at work, this exploratory-descriptive, cross-sectional, study of a qualitative approach was carried out, whose objective was to describe and analyze, from the perspective of psychoanalysis of the linking configurations, the experience of mothers who abandoned the professional career for the exclusive dedication to motherhood. Eight middle-class women, aged between 30 and 50, who were mothers and abandoned their professional careers to dedicate themselves to motherhood-retirar, were interviewed. The interviews that composed the results were transcribed, and thematic content analyses pointed out the multiple demands, both social and related to psychic heritage, which have implications for the identity construction of these women. We conclude that an elaboration of this heritage requires a link network of support and presupposes the non-idealization of motherhood, understanding it as plural, both in the sense of being multiple and diverse, and in the sense of being a bonding construction.

Considerando los cambios en la maternidad a lo largo de la historia y la actual crisis de identidad en la relación de la mujer con la maternidad, es decir, el conflicto entre los ideales de maternidad relacionados con la figura de la mujer/madre y las demandas contemporáneas de realización individual en el trabajo, se realizó este estudio transversal, exploratorio-descriptivo de abordaje cualitativo, cuyo objetivo consistía en describir y analizar, a partir del psicoanálisis de las configuraciones vincular, la experiencia de madres que abandonaron de la carrera profesional para la dedicación exclusiva a la maternidad. Fueron entrevistadas ocho mujeres de clase media, entre 30 y 50 años. que eran madres y abandonaron sus carreras profesionales para dedicarse a la maternidad-retirar. Las entrevistas que compusieron los resultados fueron transcritas y los análisis de contenido temático señalaron las múltiples exigencias, tanto sociales, como relacionadas a la herencia psíquica, que traen implicaciones para la construcción identitaria de esas mujeres. Concluimos que un proceso de elaboración de esa herencia exige una red vincular de apoyo y presupone la desidealización de la maternidad, entendiéndola como plural, tanto en el sentido de ser múltiple y diversa, como en el sentido de ser una construcción vincular.

Adaptarnos para sobrevivir. Requerimientos de un nuevo paradigma / Adapting to survive. Requirements for a new paradigm

A lo largo de la historia, el rol del bioquímico en el laboratorio clínico ha ido mutando, adaptándose a nuevos paradigmas, consecuencia del avance de la tecnología1 y la informática, de la presión externa ejercida por las empresas proveedoras de reactivos que reducen el tiempo útil de los equipos, aumentando su tasa de recambio, de una medicina más compleja que impone nuevos desafíos diagnósticos y de los cambios sociales que se ven reflejados en una alteración en el orden de los valores adoptado por las nuevas generaciones de profesionales que conviven con otras, provocando "turbulencia generacional" en los lugares de trabajo. Los laboratorios necesitan hoy someterse a una reingeniería de sus procesos, descartar aquellos que no agreguen valor, que causan fugas innecesarias de insumos, personas y tiempo e intervenir la cultura organizacional de manera integral, para adaptarse a las exigencias que la actualidad requiere, donde la calidad, la seguridad y la sostenibilidad son los principales protagonistas )AU)

Over time, the role of the biochemist in the clinical laboratory has been changing, adapting to new paradigms, as a consequence of the advance of technology and informatics, of the external pressure exerted by the companies supplying reagents that reduce the useful time of the equipment, increasing its replacement rate, of a more complex medicine that imposes new diagnostic challenges, and of social changes that are reflected in an alteration in the values adopted by the new generations of professionals who coexist with others, causing "generational turbulence" in the workplace. Laboratories today need to reengineer their processes, eliminate those that do not add value, that cause unnecessary waste of supplies, people and time, and intervene in the organizational culture in a comprehensive manner, in order to adapt to the demands of today's world, where quality, safety, and sustainability are the main drivers (AU)

Diferencias en los niveles de sexismo en estudiantes de educación física según variables sociodemográficas / Differences in the levels of sexism in physical education students according to sociodemographic variables / Diferenças nos níveis de sexismo em estudantes de educação física segundo variáveis sociodemográficas

El sexismo es el conjunto de creencias y características que son socialmente consideradas apropiadas para hombres y mujeres, en el caso de los varones, actividades asociadas a la fuerza, virilidad, entre otras características, mientras que a las damas se ligan actividades como la belleza, expresión corporal, entre otras. El objetivo de la presente investigación fue analizar las diferencias en el sexismo en los estudiantes en formación de pedagogía en educación física de una Universidad de Santiago de Chile según diversas variables sociodemográficas. Para ello se aplicó el Inventario de Sexismo Ambivalente (ISA) a 201 participantes. Los resultados evidenciaron bajos niveles de sexismo, los niveles de sexismo hostil y benevolente disminuyen conforme avanza la carrera y que los hombres puntúan más alto que las mujeres los dos tipos de sexismo. Se concluye que el sexo, año de carrera, orientación sexual y las creencias religiosas influyen en los niveles de sexismo de los estudiantes de Educación Física.

Sexism is the set of beliefs and characteristics that are socially considered appropriate for men and women, in the case of men, activities associated with strength, and virility, among other features, while the ladies are related to activities such as beauty and body expression, among others. The objective of the present research was to analyze the differences in sexism among the students in pedagogy training in physical education at the University of Santiago de Chile according to various sociodemographic variables. The Ambivalent Sexism Inventory (ASI) was applied to 201 participants. The results showed low levels of sexism, the levels of hostile and benevolent sexism decrease as the career progresses, and that men score higher than women in the two types of sexism. It is concluded that sex, career year, sexual orientation, and religious beliefs influence the sexism levels of physical education students.

Sexismo é o conjunto de crenças e características que são socialmente consideradas apropriadas para homens e mulheres, no caso dos homens, atividades associadas à força, virilidade, entre outras características, enquanto as mulheres estão ligadas a atividades como beleza, expressão corporal, entre outras. O objetivo da presente pesquisa foi analisar as diferenças no sexismo nos estudantes em formação de pedagogia em educação física de uma Universidade de Santiago do Chile segundo diversas variáveis sociodemográficas. Para este fim, o Inventário do Sexismo Ambivalente (ISA) foi aplicado a 201 participantes. Os resultados mostraram baixos níveis de sexismo, com níveis de sexismo hostil e benevolente diminuindo à medida que o curso avançava, e que os homens pontuavam mais alto que as mulheres em ambos os tipos de sexismo. Conclui-se que gênero, ano de estudo, orientação sexual e crenças religiosas influenciam os níveis de sexismo dos estudantes de Educação Física.

Abordaje y Percepción de las y los Odontólogos Frente a Casos de Violencia Física contra la Mujer en Contexto Intrafamiliar/Compañero Íntimo en Chile / Chilean Dentist's Perception and Action Towards cases of Physical Violence Against Women in a Domestic/Intimate Partner Context

La violencia de género física y/o sexual afecta a más del 30 % de las mujeres del mundo y Chile, impactando la salud de todos. Tanto la Organización Mundial de la Salud, como la literatura, sugieren abordar esta problemática desde la salud pública, con énfasis en sus trabajadores. Los odontólogos tendrían un especial rol, debido a la ubicación de éste tipo de lesiones y mayor exposición. Mas, no consideran pertinencia frente a la problemática y su abordaje es deficiente. Nuestro objetivo es conocer cómo los odontólogos de Chile perciben y abordan este tipo de casos, mediante un estudio descriptivo y transversal a odontólogos suscritos a las redes sociales del Colegio de Cirujanos Dentistas de Chile, previa aprobación de su directiva 2021 y del Comité de Ética de la Facultad de Odontología UdeC (C.E.C. Nº19/21). Bajo consentimiento informado, se aplicó una encuesta sociodemográfica sobre la percepción y abordaje de los odontólogos frente a casos de violencia física contra la mujer en contexto de Violencia Intrafamiliar/ Compañero íntimo. Participaron 175 dentistas. El 53 % ha encontrado estos casos durante el ejercicio profesional y más del 80 % percibe un rol activo frente a la problemática. Sin embargo, el 74 % presenta dificultad en la detección de lesiones y el 78 % en la derivación a redes de apoyo. El 91 % no recibió formación al respecto durante el pregrado, pero les interesa adquirir mayores conocimientos. Los dentistas de Chile se encuentran expuestos a este tipo de casos y perciben un rol activo. Sin embargo, presentan dificultad en su detección y abordaje y podrían beneficiarse de formación adicional al respecto.

Physical and/or sexual gender violence affects more than 30 % of women in the world and in Chile, impacting everyone's health. Both, WHO and the literature, suggest addressing this problem from public health, with an emphasis on its workers. Dentists would have a special role, due to the location of this type of injury and greater exposure. But, they do not consider relevance and their approach is deficient. Our objective is to know how dentists in Chile perceive and approach this type of case. Descriptive and cross-sectional study of dentists subscribed to College of Dental Surgeons of Chile´s social networks, prior approval of its 2021 directive and the Ethics Committee of the UdeC School of Dentistry (C.E.C. Nº19/21). Under informed consent, a sociodemographic survey was applied on the perception and approach of dentists in cases of physical violence against women in the context of Domestic Violence/ Intimate Partner. 175 dentists participated. 53 % have encountered these cases during professional practice and more than 80 % perceive an active role in dealing with the problem. However, 74 % have difficulty in detecting injuries and 78 % in referral to support networks. 91 % did not receive training in this regard during undergraduate studies, but are interested in acquiring more knowledge. Chilean dentists are exposed to this type of cases and perceive an active role. However, they are difficult to detect and treat and could benefit from additional training in this regard.

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.

COVID-19 Pandemic and the Role of Control Room in the Tertiary Care Hospital

COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.

Examining the correlation between sexual and reproductive health stigmatization level and gender perception: a case of a university in Turkey - a descriptive cross-sectional study

Abstract BACKGROUND Stigmatization, which emerges depending on the sexual behavior of young individuals, leads to negative health and social outcomes, such as shame, social marginalization, violence, and mental health morbidity. Objective: This study aimed to examine the correlation between the level of sexual and reproductive health stigma and gender perception in female university students. DESIGN AND SETTING: This descriptive cross-sectional study was conducted at the Faculty of Health Sciences of a university in Turkey. METHODS: The data of this study were collected from digital media between July and October 2020 from a study population of 385 students. The data were collected using the Personal Information Form, including the socio-demographic characteristics of students, the Sexual and Reproductive Health Stigmatization Scale in Young Women and the Perception of Gender Scale. Descriptive statistics, independent samples t-test, analysis of variance, and Pearson's correlation test were used to assess the data. RESULTS: It was determined that there was a negative correlation between the Sexual and Reproductive Health Stigmatization Scale in Young Women and the Perception of Gender Scale (r = -0.173, P = 0.001). CONCLUSION: It was determined that as the gender perception in the young women who participated in the study increased, the sexual and reproductive health stigmatization level decreased. The sexual and reproductive health stigmatization levels of the participants were at an above average level, and gender perception was at a medium level.