Patient Safety Culture: Nurses' Perspective in the Hospital Setting.

(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure.

Bienestar mental perinatal: el miedo como emoción movilizadora de técnicas de resiliencia / Perinatal mental wellbeing: fear as a mobilizing emotion for resilience techniques

Objetivo: Analizar las experiencias en torno a los sentimientos y emociones de las gestantes como eje movilizador, y las estrategias resilientes desarrolladas durante el periodo de pandemia y pospandemia de COVID-19 en España. Personas/Material y método: Diseño cualitativo, fenomenológico. Se realizaron entrevistas semiestructuradas a mujeres que dieron a luz en pandemia y pospandemia en España. Resultados: El miedo estaba presente en todas las narrativas, ocasionando un cambio en las expectativas. Asímismo, destaca el carácter multifactorial que llevó a las gestantes a tomar decisiones y acciones que nunca se habían planteado. El miedo a la falta de seguridad física, a la aceptación social o a la violencia obstétrica obstaculizaron la experiencia positiva del nacimiento. A pesar de la situación de vulnerabilidad a la que se enfrentaron, como respuesta adoptaron técnicas de resiliencia. Conclusiones: El miedo es una emoción frecuente en la gestación y parto –acentuada en pandemia–; sin embargo, puede transformarse en la medida en que existen ciertas características de las mujeres y del entorno. Las diversas técnicas resilientes permiten resignificar positivamente emociones no gratas. El buen trato, la empatía y la información son aspectos que propician experiencias positivas. (AU)

Objective: To analyze the experiences around the feelings and emotions of pregnant women as a mobilizing axis and the resilience strategies developed during the pandemic and post-pandemic period by COVID-19 in Spain. Persons/Materials and method: Qualitative, phenomenological design. Semi-structured interviews were conducted with women who gave birth during pandemic and post-pandemic periods in Spain. Results: Fear was present in all narratives, which caused a change in expectations. Likewise, the multifactorial nature that led them to make decisions and take actions they had never considered before stands out. Fear of lack of physical security, social acceptance or obstetric violence hindered the positive birth experience. Despite the vulnerable situation they faced, in their response they adopted resilience techniques. Conclusions: Fear is a frequent emotion in gestation and childbirth - accentuated in pandemic - however it can be transformed to the extent that certain characteristics of the women and the environment exist. The different resilience techniques allow us to positively re-signify unpleasant emotions. Good treatment, empathy and information are aspects that promote positive experiences. (AU)

Experiencia del embarazo y parto en casa durante la pandemia de Covid-19 / Experience of pregnancy and home birth during the Covid-19 pandemic

En los últimos años, se ha mostrado un creciente interés por dar a luz en entornos seguros, aunque menos medicalizados, como son las salas de atención al "parto natural" que ya funcionan en algunos hospitales. Sin embargo, la opción de parir en casa, en caso de embarazo de bajo riesgo, no está contemplada en el sistema sanitario público de salud. A raíz de la pandemia del Covid, ha aumentado la demanda de parto en casa y en Cataluña se ha triplicado. Con la intención de profundizar en la decisión del lugar donde dar a luz, se entrevista en profundidad a una mujer primípara durante el confinamiento. El relato sigue un hilo conductor: inicio de la gestación, vivencias durante el embarazo, aparición de la pandemia y el final del parto. Conclusión: la elección de parir en casa, en el caso que nos ocupa, se forja a partir de constatar la imposibilidad de cumplir con su deseo de un parto natural dada la situación generada por la Pandemia de COVID-19. La información facilitada por las matronas ha sido clave en el empoderamiento para la toma de esta decisión. (AU)

In recent years, there has been a growing interest in giving birth in safe environments, although less medicalized, such as the "natural delivery" rooms that already operate in some hospitals. However, the option of giving birth at home is not contemplated within the public health system for low-risk pregnancies. As a result of the Covid pandemic, the demand for home birth has increased and in Catalonia it has tripled. With the intention of deepening the decision of where to give birth, a primiparous woman is interviewed in depth during confinement. The story follows a common thread: the beginning of pregnancy, experiences during pregnancy, the onset of the pandemic and the end of childbirth. Conclusion: the choice to give birth at home, in the present case, it is forged after verifying the impossibility of fulfilling her desire for a natural childbirth due the situation generated by the COVID-19 Pandemic. The information provided by midwives has been a key in empowering she in order to make this decision. (AU)