Access to the Health Care System of Undocumented Moroccan Migrant Slum Dwellers in Southern Spain: A Qualitative Study.

Spain has grown economically due to the recent boosts in the industrial sector, the agricultural sector, construction and services. Those who carry out agricultural tasks are mainly undocumented immigrants living in marginal neighborhoods. OBJECTIVES: to know the perception of undocumented Moroccan migrants living in marginal neighborhoods regarding access to the Public Health System. METHODS: A qualitative method with a phenomenological approach was used to get closer to the experience of the participants in the study. In this work, 24 semi-structured interviews were conducted following a guide with a set of open questions to facilitate an in-depth discussion of the topics of interest. The participants were given an informed consent form, which guaranteed anonymity and confidentiality regarding the information obtained. For this, codes were used to identify them. The data were stored, managed, classified, and organized with the ATLAS-ti 9 software. RESULTS: access and use of health services by the immigrants in the study was difficult due to communication problems related to language and culture, the discriminatory attitude and lack of cultural competence of health personnel, and the location of the neighborhoods (which were marginal far from urban centers), as well as the lack of transportation to health centers. CONCLUSIONS: it is an ethical imperative of the Health System to offer greater attention to the population in situations of extreme vulnerability, implement intercultural mediators and train health professionals in cultural competence.

"Nurses and health professionals facing female genital mutilation: a qualitative study ".

BACKGROUND: Transnational migratory movements make Spain a country with a very diverse population, including women and girls from countries where Female Genital Mutilation (FGM) is practiced. Given this reality, we set out to carry out a qualitative study to identify the knowledge, attitudes and skills of health professionals regarding FGM. METHOD: Qualitative study with a content analysis approach. Forty-seven health professionals with the profiles of Nursing, Family Medicine, Pediatrics, Midwifery and Gynecology and Obstetrics were purposively selected. Data were collected through semi-structured in-depth interviews and focus groups. The qualitative content analysis approach was used for data analysis. The study was conducted in the years 2019 and 2022. RESULTS: Although most professionals are aware of the current legislation on FGM in Spain, only a few of them are aware of the existence of the FGM prevention protocol in Castilla-La Mancha. This lack of knowledge together with the perception that FGM belongs to the private sphere of women, contributes to the loss of opportunities to identify and prevent FGM. CONCLUSION: Health professionals' training, especially midwives and pediatricians, is essential to the identification and action against Female Genital Mutilation.

The Perception of Nurses about Migrants after the COVID-19 Pandemic: Close Contact Improves the Relationship.

Nurses have faced during the COVID-19 pandemic a tough professional situation in which they have had to work in a resource-limited context and with a high probability of COVID-19 transmission. In today's multicultural societies, care for immigrant patients is also included. In our study, we have delved into the perception of hospital nurses towards migrant people in the context of the COVID-19 pandemic. We used a qualitative methodology with a phenomenological approach. Semi-structured interviews were conducted with 16 nurses. Seven categories emerged and were distributed in the three blocks of the interviews: (a) perception before the pandemic: prejudices make a mark and communication problems; (b) perception after the pandemic: prejudices weaken and communication worsens; and (c) how to improve care: improve communication, more nurses, and no need for training. The approach in the interpersonal relationship between nurses and patients during the pandemic has improved health care. Proposals arise to overcome the language barrier such as the incorporation of intercultural translators-mediators and professionals of foreign origin. There is a lack of awareness of the need for training in cultural competence on the part of the nurses in the study.

Nutritional Health Education in Pregnant Women in a Rural Health Centre: Results in Spanish and Foreign Women.

The dietary behaviour of pregnant women, as well as the socio-cultural conditions in which pregnancy takes place, influence obstetric outcomes. To analyse the influence of socioeconomic factors and dietary habits on obstetric outcomes in Spanish and foreign pregnant women living in a rural environment, a population-based, prospective-observational study in a cohort of Spanish and foreign pregnant women in the town of Yepes, in the province of Toledo, Spain was conducted. Foreign pregnant women are ecodependent on their partners, have secondary education and low socioeconomic level. Spanish pregnant women have secondary education, a medium socio-economic level, live with their partners and are economically independent. Moreover, 85% of Spanish pregnant women gave birth at term and reached a gestational age of 40 ± 1.83 weeks. However, only 55% of foreign pregnant women reached a gestational age of 39.72 ± 2.28 weeks. Through health education, pregnant women in this geographical area of Castilla la Mancha, Spain, adopted bicultural dietary patterns, thus reaching the prescribed diet of 2000 Kcal. Through this diet, both Spanish and foreign pregnant women maintained albumin and plasma protein levels within the established range, with no significant differences in obstetric outcomes among pregnant women in the study.

Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review.

When assessing the fragility that characterizes the health of an immigrant person, a culturally competent transformation of the nurse-patient teaching-learning process is necessary. Therefore, it is considered essential to incorporate cultural competence and intercultural communication in higher nursing education. OBJECTIVE: To determine the content and knowledge of cultural competence and intercultural communication offered in higher education in nursing courses. DESIGN: The Campinha-Bacote model of cultural competence was used as the primary reference. METHOD: A scoping review was conducted about studies published in the period 2003 and 2020. The research was conducted between May and October 2020. More than a hundred documents (books, chapters, articles, conference proceedings) have been consulted. RESULTS: Undergraduate nursing courses and postgraduate education move toward promoting cultural competence and sensitivity through teaching strategies. CONCLUSIONS: Teaching projects that combine multiple competencies are more effective, including teacher training. A predominant element is a need for continuous and transversal projects. University nursing education must adapt culturally competent curricula.

Female Genital Mutilation: Knowledge and Skills of Health Professionals.

BACKGROUND: Female genital mutilation (FGM) is any process that injures female genitals for non-medical reasons and is a violation of women's human rights. An important number of women from countries where FGM is performed are arriving to Western countries. Health professionals are important for detecting cases of FGM. No surveys to assess knowledge, attitudes and practices on FGM among healthcare professionals has been conducted in Castilla la Mancha (Spain) until now. METHODS: The main goal of the study is assessing knowledge, attitudes and perceptions of healthcare professionals in relation to FGM. A cross-sectional descriptive study was conducted based on self-administered online surveys to nurses, midwives, family doctors, pediatricians, obstetrics and gynecologists. RESULTS: In total, 1168 professionals answered the surveys. Just 13.9% indicated that they had received training in FGM, however just 10.7% correctly identified the three types of FGM, 10.7% the countries where it is usually practiced, 33.9% knew the legislation in Spain and only 4.4% found a case of FGM during their professional practice. Regarding the knowledge about protocols, 8.64% of the sample indicated to know one of them. CONCLUSION: The present study demonstrate that it is necessary to improve the training and awareness of healthcare professionals related to FGM in Castilla la Mancha.

Neuropsychological Study in Patients with Spinal Cord Injuries.

The present investigation was designed to determinate the nature, pattern, and extent of cognitive deficits in a group of participants with subacute and chronic spinal cord injury (SCI). METHODS: A cross-sectional study was conducted in both patients with subacute and chronic SCI. Different cognitive functions were evaluated through a neuropsychological protocol designed for this purpose, taking into account the patient's emotional state. RESULTS: A total of 100 patients suffering a spinal cord injury were evaluated. There were no differences between the two groups when age, sex, level of education, and region of origin were studied. The chronic injured patients obtained lower scores in the neuropsychological evaluation protocol respective to the subacute injured patients. CONCLUSIONS: Subjects with chronic spinal cord injury presented a cognitive profile that differed greatly in the number of altered cognitive functions as well as in their magnitude from the subacute spinal cord injured patient profile. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration in society.

Facilitating Factors of Professional Health Practice Regarding Female Genital Mutilation: A Qualitative Study.

Introduction: According to figures released by UNICEF (United Nations Children's Fund), more than 200 million girls and women have suffered female genital mutilation (FGM) in 30 African and Middle East countries. An increasing number of African women who come from ethnic groups where FGM is practised are arriving in Western countries. Healthcare professionals play a fundamental role in its prevention. Goals: To learn about the factors that healthcare professionals consider as facilitators for prevention and action when faced with female genital mutilation. Methods: A cross-sectional descriptive study developed on the basis of the qualitative methodological perspective, where 43 healthcare professionals participated. A series of analysis dimensions were established, based on which, the interview and discussion group scripts were designed. Results: Addressing FGM requires a series of structural adaptations of the healthcare system that facilitate the recording and monitoring of cases, both for treatment and for prevention. In addition, it is necessary to establish coordination between the healthcare, social services and education sectors. Conclusions: The existence of a protocol of action and training in its use is one of the key tools to take into account.

Attitudes towards Immigration among Students in the First Year of a Nursing Degree at Universities in Coimbra, Toledo and Melilla.

Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student nurses (n = 624), using the Attitude towards Immigration in Nursing scale. Results: Nursing students showed some positive attitudes towards immigration, such as that immigrants should have the right to maintain their customs or that immigrants should have free access to healthcare and education, in contrast to some negative attitudes, such as that crime rates have increased due to immigration or that immigrants receive more social welfare assistance than natives. Significant differences in attitudes were revealed between students from the three universities. Discussion: Training in transcultural nursing is necessary for all nursing students in order to reduce negative attitudes towards the immigrant population and increase the awareness and sensitivity of future healthcare staff in caring for patients of all backgrounds.

Nutritional habits and levels of physical activity during pregnancy, birth and the postpartum period of women in Toledo (Spain): study protocol for a two-year prospective cohort study (the PrePaN study).

INTRODUCTION: Pregnant women who eat a balanced diet usually practice physical activity (PA) regularly; there are many studies on PA during pregnancy and the results for the mother and baby. However, the guideline for PA during pregnancy is very general and is not quantified. The primary objective of this study is to examine the nutritional habits and levels of PA of women during pregnancy and the postpartum period. Second, it will determine the effects of these aspects on the mother and newborn baby. Its third objective is to identify the factors which influence the practice of PA during this phase. METHODS AND ANALYSIS: Se trata de un estudio prospectivo de cohortes que dura 2 años, f rom de septiembre de 2018 para setiembre del 2020 La muestra será reclutado en tres Atención Primaria centros en el área de salud de Toledo (España). Las participantes serán mujeres embarazadas de 18 a 40 años. Ancianos que deben asistir a todos los controles durante el embarazo y el período posparto. La PA se cuantificará utilizando la acelerometría, mientras que los hábitos nutricionales y el ejercicio físico se evaluarán mediante cuestionarios validados. Se registrarán los síntomas del embarazo y el período posparto, junto con los parámetros bioquímicos y los datos antropométricos. Los resultados primarios se determinarán en las mujeres embarazadas: aumento de peso, incidencia de diabetes mellitus gestacional, preeclampsia e hipertensión inducida por el embarazo. Los resultados secundarios incluyen la duración del embarazo y el peso al nacer, la puntuación de Apgar (1 min / 5 min), el tipo de reanimación (I / II / III / IV) y el pH de la sangre del cordón umbilical en los recién nacidos. DISCUSSION: Although the beneficial effects of PA during pregnancy are known, there is a need to perform studies that quantify the amount of PA undertaken by women during pregnancy and the postpartum period. The objective of such studies is to establish science-based individualised guidelines for PA for women during this stage of their lives.

Actitudes ante la inmigración del alumnado de una escuela de enfermería de Portugal / Attitudes towards the immigration of students from a nursing school in Portugal / Atitudes em relação à imigração dos alunos de uma escola de enfermagem de Portugal

Marco contextual: La diversidad cultural está presente en todas las sociedades. Las enfermeras deben ser culturalmente competentes para dispensar cuidados de calidad. Objetivo: Validar la Escala de Actitud hacia la Inmigración en Enfermería (EAIE) al portugués y conocer las actitudes ante la inmigración del alumnado del primer curso del grado de una escuela de Enfermería de Portugal. Metodología: Estudio descriptivo, exploratorio y analítico, con traducción y adaptación transcultural de la EAIE al portugués, constituida por 39 ítems. Participaron 143 estudiantes. Resultados: Buena consistencia interna de la escala medida con el a de Cronbach (0,94). Con el análisis unifactorial de la escala, y de cada ítem separado se identificaron diferencias actitudinales significativas entre hombres y mujeres en 6 ítems, y entre grupos de edad en 2 ítems. Conclusión: Las actitudes de una parte del alumnado no son favorables al reconocimiento pleno de los derechos en el uso de los recursos sociosanitarios de los inmigrantes. Consideramos necesario profundizar en la formación en competencia cultural y en el Derecho Universal a la Salud.

Background: Cultural diversity is present in all societies. Nurses must be culturally competent to provide quality care. Objective: To validate the Scale of Attitude toward Immigration in Nursing (EAIE) in Portuguese and to know the attitudes toward the immigration of the first-year undergraduate students of a nursing school in Portugal. Methodology: Descriptive, exploratory, and analytical study, with the translation and transcultural adaptation of the EAIE to the Portuguese language, composed of 39 items. The participants were 143 students. Results: Scale with a good internal consistency, assessed with Cronbach's a (0,94). With the univariate analysis of the scale and each separate item, significant attitudinal differences were identified between men and women in 6 items, and among age groups in 2 items. Conclusion: The attitudes of a portion of the students are not favorable to the full recognition of the rights of health and social resources of the immigrants. It is necessary to develop the training in cultural competence and the Universal Right to health.

Enquadramento: A diversidade cultural está presente em todas as sociedades. Os enfermeiros devem ser culturalmente competentes para prestar cuidados de qualidade. Objetivo: Validar a Escala de Atitude em Relação à Imigração na Enfermagem (EAIE) para português e conhecer as atitudes face à imigração dos estudantes do 1º ano da licenciatura de uma escola de enfermagem de Portugal. Metodologia: Estudo descritivo, exploratório e analítico, com aplicação da EAIE, traduzida e adaptada culturalmente para a língua portuguesa, composta por 39 items. Participaram no estudo 143 estudantes. Resultados: Boa consistência interna da escala medida com o a de Cronbach (0,94). Com a análise unifatorial da escala e de cada item em separado identificaram-se diferenças significativas de atitude entre homens e mulheres em 6 itens e entre grupos etários em 2 itens. Conclusão: As atitudes de uma parte dos estudantes não mostram um reconhecimento inequívoco dos direitos dos imigrantes aos recursos sociossanitários. Consideramos necessário aprofundar a formação em competência cultural e sobre o Direito Universal à Saúde.