Violencia hacia el profesional de enfermería: una etnografía focalizada

RESUMEN Objetivo: Describir las experiencias del profesional de enfermería sobre la violencia experimentada en su trabajo. Material y Método: Estudio cualitativo con diseño etnográfico focalizado. Los participantes se seleccionaron utilizando un muestreo no-probabilístico por bola de nieve. Los datos se recolectaron a través de 25 entrevistas a profundidad vía telefónica entre enero y junio de 2018, en tres hospitales de Veracruz, México. El Modelo Interactivo de violencia en el lugar de trabajo diseñado por Chappell y Di Martino fue el referente teórico y la técnica de análisis temática fue con el apoyo del software QUIRKOS. Resultados: Las temáticas resultantes fueron: causas y tipos de agresión, reacción de la víctima ante la agresión y agresor. En su mayoría fueron mujeres (72%), del turno matutino (52%), de los servicios de urgencias y medicina interna (28%). El 68% refirió no haber denunciado la agresión a sus superiores e identificaron al médico como el principal agresor (44%), seguido por el familiar del paciente (20%). Conclusión: Es imperativo la implementación de estrategias para evitar la violencia laboral, así como la formación de pautas a seguir en caso de ser violentada/o.

ABSTRACT Objective: To describe the experiences of nursing professionals concerning workplace violence. Material and Method: Qualitative study with a focused ethnographic design. Participants were selected using non-probability snowball sampling. Data were collected through 25 in-depth telephone interviews between January and June 2018 in three hospitals of Veracruz, Mexico. The theoretical framework was based on the Interactive Model of workplace violence designed by Chappell and Di Martino and the QUIRKOS software was used for the thematic analysis. Results: Findings alluded to the causes and types of aggression, the victim's reaction to the aggression and the aggressor. Participants were mostly women (72%), who worked the morning shift (52%), in the emergency and the internal medicine services (28%). 68% indicated not having reported the aggression to their supervisors and identified the physician as the main aggressor (44%), followed by the patient's family members (20%). Conclusion: It is critical that hospitals implement strategies to avoid workplace violence, as well as guidelines that nurses and other healthcare professionals can follow in case of violence in the work setting.

RESUMO Objetivo: Descrever as vivências do profissional de enfermagem sobre a violência vivenciada em seu trabalho. Material e Método: Estudo qualitativo com desenho etnográfico focado. Os participantes foram selecionados por meio de amostragem não probabilística em bola de neve. Os dados foram coletados por meio de 25 entrevistas telefónicas em profundidade entre janeiro e junho de 2018, em três hospitais em Veracruz, México. O referencial teórico foi o Modelo Interativo de violência no trabalho desenhado por Chappell e Di Martino e a técnica de análise temática foi realizada com apoio do software QUIRKOS. Resultados: Os tópicos foram: causas e tipos de agressão, reação da vítima frente a agressão e o agressor. A maioria eram mulheres (72%), do turno da manhã (52%), dos serviços de emergência e clínica médica (28%). O 68% relatou não ter denunciado a agressão a seus superiores e apontaram o médico como o principal agressor (44%), seguido do familiar do paciente (20%). Conclusão: É imprescindível a implementação de estratégias para evitar a violência no trabalho, bem como a formação de diretrizes a serem seguidas em caso de violência.

Propiedades psicométricas y utilidad diagnóstica del ‘screening léxico para las afasias’ / Psychometric properties and diagnostic value of ‘lexical screening for aphasias’

Introducción. La evaluación del lenguaje en personas con lesión cerebral permite conocer si éstas requerirán o no rehabilitación de lenguaje. Debido a la importancia de una evaluación precisa, los instrumentos de evaluación deben ser válidos y fiables, con el fin de evitar diagnósticos equivocados y subjetivos. Objetivo. Validar el ‘screening léxico para las afasias’ (SLA) en una muestra de 58 individuos chilenos. Sujetos y métodos. Se construyó una prueba de lenguaje, tipo cribado, de 20 minutos de duración y basada en el modelo de procesamiento léxico de Patterson y Shewell de 1987. La muestra estuvo compuesta por dos grupos, 29 sujetos afásicos y 29 sujetos control, pertenecientes a distintos centros de salud de las regiones del Biobío y del Maule, Chile. Sus edades fluctuaban entre 24 y 79 años, y sus años de escolaridad, de 0 a 17. Se determinó validez discriminante, validez concurrente con la batería para la evaluación de los trastornos afásicos (BETA), fiabilidad, sensibilidad y especificidad. Resultados. El análisis estadístico mostró una alta validez discriminante (p < 0,001), aceptable validez concurrente media con la BETA (rs = 0,65), una alta fiabilidad media (alfa = 0,87), una moderada sensibilidad media (69%) y una alta especificidad media (86%). Conclusión. El SLA es válido y fiable para evaluar el lenguaje de personas con afasias, es sensible para detectar sujetos afásicos y es específico para descartar trastornos del lenguaje en personas con lenguaje normal (AU)

Introduction. Language assessment in persons with brain injury makes it possible to know whether they require language rehabilitation or not. Given the importance of a precise evaluation, assessment instruments must be valid and reliable, so as to avoid mistaken and subjective diagnoses. Aim. To validate ‘lexical screening for aphasias’ in a sample of 58 Chilean individuals. Subjects and methods. A screening-type language test, lasting 20 minutes and based on the lexical processing model devised by Patterson and Shewell (1987), was constructed. The sample was made up of two groups containing 29 aphasic subjects and 29 control subjects from different health centres in the regions of Biobío and Maule, Chile. heir ages ranged between 24 and 79 years and had between 0 and 17 years’ schooling. Tests were carried out to determine discriminating validity, concurrent validity with the aphasia disorder assessment battery, reliability, sensitivity and specificity. Results. The statistical analysis showed a high discriminating validity (p < 0.001), an acceptable mean concurrent validity with aphasia disorder assessment battery (rs = 0.65), high mean reliability (alpha = 0.87), moderate mean sensitivity (69%) and high mean specificity (86%). Conclusion. ‘Lexical screening for aphasias’ is valid and reliable for assessing language in persons with aphasias; it is sensitive for detecting aphasic subjects and is specific for precluding language disorders in persons with normal language abilities (AU)

Bioassay-guided isolation of an anti-ulcer compound, tagitinin C, from Tithonia diversifolia: role of nitric oxide, prostaglandins and sulfhydryls.

Tithonia diversifolia is a medicinal plant from the Municipality of Suchiapa, Chiapas, Mexico, that according to local folk medicine is considered useful in the treatment of gastric ulcers. The aim of the present study was to investigate the gastroprotective activity of T. diversifolia by using an ethanol-induced gastric ulcer experimental model in male Wistar rats. The results showed that T. diversifolia had gastroprotective activity, and that the dichloromethane extract had the highest protective activity (close to 90% when using doses between 10 to 100 mg/kg), and that further the compound tagitinin C isolated from this extract was the main active gastroprotective agent. Rats treated with tagitinin C suspended in Tween 80 at 1, 3, 10 and 30 mg/kg showed 37.7, 70.1, 100, and 100% gastroprotection, respectively. The effect elicited by tagitinin C (30 mg/kg) was not attenuated by pretreatment with either N(G)-nitro-L-arginine methyl ester (70 mg/kg, i.p.), a nitric oxide (NO) synthase inhibitor, N-ethylmaleimide (10 mg/kg, s.c.), a blocker of sulfhydryl groups, or indomethacin (10 mg/kg, s.c.), a blocker of prostaglandin synthesis, which suggests that the gastroprotective mechanism of action of this sesquiterpene lactone does not involve NO, sulfhydryl groups or prostaglandins.

[Syndromes or symptoms in the assessment of aphasic patients?]. / ¿Síndromes o síntomas en la evaluación de los pacientes afásicos?

The procedure generally used to diagnose aphasic patients consists of classifying them in one of the classic syndromes on the basis of the analysis of their symptoms. However, this taxonomy has several important problems, the main one being that it does not take into account the variability of aphasic patients, as there are many more disorder profiles than those included in the syndromes. In order to test the homogeneity of a sample of patients diagnosed with the classic taxonomy, 15 aphasic patients (5 Broca, 5 Wernicke and 5 Conduction) and 5 healthy controls were tested with nine comprehension and production tasks. Participants were aged 38 to 81 years old. The results indicate the existence of great variability in patients labeled with the same diagnosis, as revealed by the differences in within-group scores in each task, and a limited adjustment to the expected profile, with some patients showing symptoms allegedly corresponding to other syndromes. Our results call attention to the need to study each patient individually and interpret their disorders regardless of the syndromes.

¿Síndromes o síntomas en la evaluación de los pacientes afásicos? / Syndromes or symptoms in the assessment of aphasic patients?

El procedimiento generalmente empleado para diagnosticar a los pacientes afásicos consiste en analizar sus síntomas y en base a esos síntomas clasificarlos en uno de los síndromes clásicos. Sin embargo, esa taxonomía tiene algunos problemas importantes, el principal que no tiene en cuenta la variedad de pacientes afásicos existentes, ya que hay muchos más trastornos de los que recogen los síndromes. Con objeto de comprobar el grado de homogeneidad de una muestra de pacientes pertenecientes a diferentes síndromes, en este estudio se aplicaron nueve tareas de comprensión y producción oral a quince pacientes (cinco afásicos de Broca, cinco de Wernicke y cinco de Conducción) y a cinco personas sanas, con edades comprendidas entre 38 y 81 años. Los resultados muestran la existencia de una gran heterogeneidad entre los pacientes etiquetados bajo un mismo síndrome, tal como indica la variabilidad de puntuaciones dentro de los grupos en cada tarea. Por otra parte se observa un escaso ajuste al perfil esperado, ya que algunos pacientes presentan síntomas correspondientes a otros síndromes. Nuestros resultados sugieren la necesidad de estudiar a cada paciente de forma individual e interpretar sus trastornos independientemente de los síndromes (AU)

The procedure generally used to diagnose aphasic patients consists of classifying them in one of the classic syndromes on the basis of the analysis of their symptoms. However, this taxonomy has several important problems, the main one being that it does not take into account the variability of aphasic patients, as there are many more disorder profiles than those included in the syndromes. In order to test the homogeneity of a sample of patients diagnosed with the classic taxonomy, 15 aphasic patients (5 Broca, 5 Wernicke and 5 Conduction) and 5 healthy controls were tested with nine comprehension and production tasks. Participants were aged 38 to 81 years old. The results indicate the existence of great variability in patients labeled with the same diagnosis, as revealed by the differences in within-group scores in each task, and a limited adjustment to the expected profile, with some patients showing symptoms allegedly corresponding to other syndromes. Our results call attention to the need to study each patient individually and interpret their disorders regardless of the syndromes (AU)

Validación de los módulos semántico y pragmático de la batería de lenguaje objetiva y criterial (BLOC) en niños chilenos / Validation of semantic and pragmatic modules of the Criterial and Objective Language Battery (BLOC) in Chilean children

El objetivo de este trabajo fue analizar las propiedades psicométricas de los módulos semántico y pragmático de la Batería de Lenguaje Objetiva y Criterial (BLOC). El alfa de Cronbach en el módulo semántico fue 0,84 (n= 259) y 0,91 para el módulo pragmático (n= 142). Con análisis de componentes principales categóricos (CAPCAT) se obtuvieron soluciones unidimensionales, que explican un 41,65% y un 41,77% de la variabilidad, respectivamente. Por sexo no encontramos diferencias, y por nivel socioeconómico los participantes de nivel bajo presentaron un rendimiento menor sólo en el módulo semántico. Por edad, las diferencias fueron menores, ya que en los módulos se generaron 3 y 4 grupos homogéneos, pero con sobreposición entre las distintas edades. La poca discriminación probablemente se explique por el bajo rendimiento de la muestra chilena. Comparadas con España, las medianas del modulo semántico están por debajo del rendimiento por debajo de la norma, y las del módulo pragmático están por encima

The aim of this work was to analyse the psychometric properties of the semantics and pragmatics modules of the Objective and Criterial Language Battery (BLOC). For the semantics module (n= 259), Cronbach’s alpha was 0.84; for the pragmatics module (n= 142), Cronbach’s alpha was 0.91. A Categoric Principal Components Analysis (CAPCAT), produced unidimentional solutions, explaining 41.65% of the variance in the semantics module, and 41.77% in the pragmatics module. We did not find differences in performance by sex. By socio-economic status, lower status children performed worse than those of middle and higher status, but only in the semantics module. Differences by age were small, with both modules producing between 3 and 4 homogeneous groups with substantial overlap. Lack of discrimination is probably related to reduced variability due to low performance in the Chilean samples. Compared to Spain, medians in the semantics module were lower than expected (though medians in the pragmatics module were slightly higher)

[Validation of semantic and pragmatic modules of the Criterial and Objective Language Battery (BLOC) in Chilean children]. / Validación de los módulos semántico y pragmático de la Batería de Lenguaje Objetiva y Criterial (BLOC) en niños chilenos.

The aim of this work was to analyse the psychometric properties of the semantics and pragmatics modules of the Objective and Criterial Language Battery (BLOC). For the semantics module (n= 259), Cronbach's alpha was 0.84; for the pragmatics module (n= 142), Cronbach's alpha was 0.91. A Categoric Principal Components Analysis (CAPCAT), produced unidimentional solutions, explaining 41.65% of the variance in the semantics module, and 41.77% in the pragmatics module. We did not find differences in performance by sex. By socio-economic status, lower status children performed worse than those of middle and higher status, but only in the semantics module. Differences by age were small, with both modules producing between 3 and 4 homogeneous groups with substantial overlap. Lack of discrimination is probably related to reduced variability due to low performance in the Chilean samples. Compared to Spain, medians in the semantics module were lower than expected (though medians in the pragmatics module were slightly higher).