Harnessing the power of empathy, visual art and patient narratives to improve health literacy: An exploratory study.

ISSUE ADDRESSED: Health-related information can often be overwhelming for consumers, frequently infused with complex medical terminology that is difficult to understand and apply. Historically empathic connection, art and narratives have played key roles in communicating with diverse populations however collectively have received little recognition as a modality to improve health literacy. This study aimed to investigate the empathetic connection between art and patient narratives with a view to improve health literacy in the wider community. METHODS: Nine recently discharged patients and one carer from a regional hospital were paired with 10 tertiary visual arts students for interview. Each narrative was transformed into visual art and exhibited at a community art gallery. The Empathy Quotient (EQ), Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and self-completed questionnaires assessed empathy and functional well-being. Health literacy was evaluated through community response surveys post-exhibition exposure. RESULTS: Student artist participants' EQ Cognitive Empathy (EQ-CE) scores were associated with 'Emotional Reactivity' (EQ-ER) (p = .038). SF-36 scores revealed that role limitations due to physical health and emotional problems had the greatest impact on patient/carer participant's life at the time. The SF-36 General Health domain was associated with the EQ-ER total score (p = .044). Exhibition surveys revealed that 96.9% of observers had learnt something new about illness or injury. SO WHAT?: Although a relatively small study, our findings suggest patient/carer narratives and visual art is a simple yet effective modality for health service organisations to facilitate affective learning and improve health literacy when engaging with consumers.

Vocabulary and expressive morpho-syntax in individuals with Down syndrome: Links to narration.

BACKGROUND: Narrative ability is crucial for social participation in everyday and school life but involves different language abilities such as vocabulary and morpho-syntax. This is particularly difficult for individuals who display both language and cognitive impairments. Previous research has identified productive vocabulary as a possible key factor for narrative performance in individuals with Down syndrome. Considering a close connection between lexical and morpho-syntactic performance within language acquisition and the distinct impairments that individuals with Down syndrome display concerning their morpho-syntactic skills, the nature of a relation between vocabulary and narrative skills under the influence of grammatical deficits requires further investigation. METHODS: Narrations were obtained from 28 children and adolescents with Down syndrome (aged 10;0-20;1) using a non-verbal picture book. Narrative abilities were rated using the Narrative Scoring Scheme across seven narrative aspects (including macro- and microstructure). Vocabulary analyses and morpho-lexical context analyses including verb and conjunction enumerations, evaluation of verb position and MLU were conducted. Findings from the transcript analysis have been supplemented with data from standardized language measures evaluating expressive lexical and morpho-syntactic development. A multiple regression analysis was conducted to identify significant predictors for narrative outcome in the participants with Down syndrome. RESULTS: Lexical analyses revealed a high heterogeneity in production of subordinating conjunctions as a link between lexical and morpho-syntactic abilities. Comparisons of standardized and narrative data demonstrated differences in subordinate clause production depending on the elicitation setting. A multiple regression analysis identified the number of different verbs in the narrative task as the most significant predictor for narrative performance in individuals with Down syndrome. DISCUSSION AND IMPLICATIONS: The findings of this study contribute to the knowledge regarding factors that influence narrative performance in individuals with language impairment. A differentiated verb lexicon can be identified as the key ability for reaching advanced narrative skills in participants with Down syndrome. These findings are of clinical relevance for therapeutic and educational support and contribute to an understanding of the relation between strengths in vocabulary and morpho-syntactic weaknesses in individuals with Down syndrome within communicative participation.

Inquiring into conditions for engaging in narrative relations on a geriatric ward - how interpretation matters in everyday practices.

Drawing on data from ethnographic fieldwork and interprofessional focus group discussions, this study enquires into staff's everyday life on a geriatric ward to explore and understand conditions for engaging in narrative relations in in-patient geriatric care. Avoiding individualistic understandings of narrative practices, we applied a narrative-in-action methodology built on a relational understanding of narrativity, where individual narratives are not separated from social and cultural features. This helped us explore how individual interpretations of the conditions for everyday practices come together with broader social or cultural understandings to gain situated insights about how these are continuously related and reformed by one another in everyday situations of geriatric care. The findings offer insights into the opportunities to engage in narrative relations based on how healthcare staff on a geriatric ward interpret conditions for their practices, and how they act based on such interpretations. While some interpretations were associated with attitudes and activities encouraging narrative relations, others simultaneously thwarted narrative relations by enacting task-orientation, division, or a focus on measurable biomedical or function-related outcomes. Moreover, the findings suggest and discuss consequences of the tensions created as interpretations are enacted in everyday healthcare situations, thus questioning assumptions about conditions as something static and linear.

Wishes, beliefs, and jealousy: use of mental state terms in Cinderella retells after traumatic brain injury.

Introduction: Traumatic brain injury (TBI) negatively impacts social communication in part due to social cognitive difficulties, which may include reduced mental state term (MST) use in some discourse genres. As social cognitive difficulties can negatively impact relationships, employment, and meaningful everyday activities, assessing and treating these difficulties post-TBI is crucial. To address knowledge gaps, the present study examined MST use in the narrative retells of adults with and without severe TBI to compare between-group performance, evaluate changes over the first two years post-TBI, and investigate the impact of participant and injury-related variables. Methods: The total number of MSTs, ratio of MSTs to total utterances, and diversity of MSTs were identified in the Cinderella narratives of 57 participants with no brain injury and 57 with TBI at 3, 6, 9, 12, and 24-months post-TBI. Results: Reduced MST use in participants with TBI was found at 3, 6, 9, and 12-months post-TBI, but these reductions disappeared when story length (total utterances) was accounted for. Further, MST diversity did not differ between groups. Similarly, although the total number of MSTs increased over time post-TBI, no changes were observed in the ratio of MSTs to total utterances or MST diversity over time. Injury severity (post-traumatic amnesia duration), years of education, and verbal reasoning abilities were all related to MST use. Discussion: Overall, although individuals used fewer MSTs in complex story retells across the first year following severe TBI, this reduction reflected impoverished story content, rather than the use of a lower ratio of MSTs. Further, key prognostic factors related to MST use included injury severity, educational attainment, and verbal reasoning ability. These findings have important implications for social communication assessment and treatment targeting social cognition post-TBI.

Capitalist Heterotopia & Lost Social Utopia: Documenting Class, Work, and Migration in Post-Communist East-Central European Fiction.

Some of the most acclaimed novels from post-communist countries deal with communism through an anti-communist ethos. The emerging international canon of post-communist representations of communism and transition to capitalism has always sought to enfoce a convincing anti-communist ideal. Writers have only recently formulated critiques of the post-communist transition through what Boris Buden describes as post-communist cultures without social utopias. Those novels are not rooted in anti-communism but rather criticize the death of utopias following the fall of communism. Drawing on the Romanian case, we try to outline the heterotopias of capitalism in post-communism from the standpoint of novels on migration and work abroad, addressing contemporary understandings of capitalist realism, post-socialist realism, autofiction, and documented realism. Analysing novels by Liliana Nechit, Mihai Buzea, and Adrian Schiop, we reveal the subjective nature of the testimonial literature on migration and contrast it to the need to incorporate workers' agency into this literary process. While the description of Eastern European capitalism through novels about migration has become an indictment of communism and a subtle plea for a 'better' form of capitalism, the novels about internal migration recover a lost social utopia that ended with the 1989 collapse of Romanian communism.

Learning to teach with patients and caregivers: a focused ethnography.

BACKGROUND: Little is known about what happens when patients and caregivers are involved in an academic setting as co-teachers and how healthcare professionals approach a new model of partnership-based teaching. This study aimed to explore the learning and behavioural patterns of a group of healthcare professionals who were learning to teach with patients and caregivers as co-teachers in a post-graduate course. METHODS: A focused ethnographic study involving 11 health professionals was conducted. Data were collected through participatory observation during the course, individual semi-structured interviews, and a follow-up focus group. Taxonomic analysis was performed. RESULTS: Three categories were identified: 'group', 'role of narration' and 'applying co-teaching with patients and caregivers '. Specifically, heterogeneity, absence of hierarchies, and balanced relationships characterised the group dynamic and promoted partnership. Narration played a key role both in learning and in healthcare professionals' relationship with patients and caregivers and promoted emotional skills and self-awareness. Project planning and lessons simulations were essential aspects of the implementation process. CONCLUSIONS: This focused ethnography helped further understanding of the context of a specific project involving patients and caregivers as co-teachers in healthcare professional education. The development of emotional skills and self-awareness are the main learning patterns of co-teaching, and interprofessionalism and balanced relationships are the basis of the behavioural patterns. These patterns facilitated the involvement of patients and caregivers in health education.

Perceptions and Expectations of Youth Regarding the Respect for Their Rights in the Hospital.

Information obtained from children themselves regarding the characteristics of the ideal hospital that ensure well-being during a hospital stay is scarce. Here, we report the opinions, perceptions, and expectations of 700 children and adolescents about their experiences, assessed through a mixed-method research approach with age-appropriate questionnaires, three open-ended questions, and an analysis of optional pictorial and textual narratives. Most children indicated that, while they acknowledged the expertise of hospital staff, they also noted several shortcomings, e.g., insufficiently understandable medical information as well as emotional and cognitive support. The continuity of schooling and the right to suffer as little as possible were also critical issues. Adolescents valued in particular the quality of care and services provided, the hospital's adherence to equality and non-discrimination rights, and protection systems but negatively perceived several aspects related to play and participation. Significant differences in the co-occurrences of the most frequently used text terms with the keywords "hospital" and "child/adolescent" between age groups highlight variations in the way patients perceive and articulate their experiences within the hospital setting depending on the cognitive processes linked to age. In drawings, prevailing attention was placed on the physical context of the hospital room, with figures expressing mostly negative emotions. Specifically, in this regard, the main emotion in children was sadness, and, in adolescents, it was fear. Overall, these insights are pivotal in the context of our research objectives as they shed light on the nuanced preferences, needs, and perspectives of children and adolescents during their hospital stays. Recognizing the identified shortcomings, we propose recommendations emphasizing the improvement of medical communication clarity, enhancement of emotional and cognitive support, and the improvement of programs to avoid instructional gaps during hospital stays. Addressing these specific needs is critical for a more comprehensive approach to pediatric healthcare provision.

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry.

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly's (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal-"the emergency engulfed us", (2) practical/professional-"managing the pandemic", (3) social-"the strength of the team and people". Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management.

Manifestation of speech disfluencies in preschool Cantonese-English speaking bilingual children.

Stuttering is characterised by disruptions in speech fluency that normally emerges between the ages of 2 to 5 when children start to formulate sentences. Current stuttering identification in children is largely based on speech disfluency criteria (>3% stuttering-like disfluencies, SLDs) developed for monolingual English-speaking children. Research in a Western language context shows that application of the criteria for monolingual to bilingual children may result in false positive diagnosis of stuttering. The applicability of these criteria to children speaking languages typologically distinct from English remains unclear. This preliminary study focused on bilingual Cantonese-English-speaking children, aiming to explore the manifestations of the speech disfluencies in Cantonese (a syllable-timed language) and English (a stress-timed language) while accounting for language dominance/proficiency and speaking task. Nineteen typically fluent Cantonese-English bilingual preschoolers were recruited for this study and their speech samples were collected across different speaking tasks (i.e. conversation and narration), and languages (i.e. Cantonese and English). The types and frequency of speech disfluencies were compared across both languages and the speaking tasks. The results showed that between 21-68% of children showed higher than 3% SLDs across different languages and speaking tasks. Linear mixed-effect analysis revealed that the prevalence of SLDs is higher in English (less dominant language) than Cantonese (more dominant language), and the prevalence is also higher in narration than conversation. These findings suggest the need for tailored stuttering identification criteria for bilingual children speaking diverse languages and emphasise the importance of considering language dominance/proficiency and speaking task when assessing stuttering in bilingual populations.

Narrative Understanding as a Means of Understanding the Other: A Review of Andrea Smorti's Book Telling to Understand.

In this review I propose to discuss the contribution that Smorti's book makes to the study of autobiographical memory, since it examines the benefits that narratives provide to understanding human experience and the ability they offer in discovering and representing uncertainty. Andrea Smorti has long been engaged in the study of memory, autobiography, storytelling and psychology, as evidenced by his numerous studies mentioned in the book. Furthermore, in exploring the more purely psychological aspects of narratives, Smorti investigates the benefits that narratives offer to individual psychological well-being. Firstly published in Italian in 2018, Andrea Smorti's (2021) "Telling to Understand" is now available for the first time to the English-speaking public.

Development of a Digital Storytelling Intervention to Increase Breast, Cervical, and Colorectal Cancer Screening in the Hispanic/Latino Community: a Qualitative Evaluation.

Digital storytelling (DST) interventions may be one way to address disparities in cancer screening experienced by the Hispanic/Latino population. Digital stories are short, first-person narratives that include voice-over narration and images. With storytellers' permission, researchers can screen digital stories as a health intervention. Digital stories can inspire viewers to adopt or change their behavior, such as completing cancer screening. Rochester Healthy Community Partnership (a 20-year community-based participatory research partnership) together with eight Hispanic/Latino, Spanish speaking cancer survivors, co-survivors, or recently screened individuals, developed digital stories about breast, cervical, and colorectal cancer screening. Here, we describe our qualitative evaluation of the DST workshop. To understand what the storytellers thought viewers would find relatable in their digital stories, we applied Narrative Theory. We also assessed workshop successes and opportunities for improvement. We used the constant comparative method for data analysis. We learned that the storytellers anticipated their stories would be engaging and that viewers would connect with Hispanic/Latino cultural values. During the workshop, the storytellers felt like they were making an important contribution. The storytellers highlighted specific opportunities for improvement including sharing the stories more quickly after the workshop. Future research is needed to test whether this intervention follows the Narrative Theory causal pathway by persuading viewers to complete recommended cancer screenings.

Contemporary slave labor and subjectivity: psychosocial perspectives on the enslaved's narratives / Trabalho escravo contemporâneo e subjetividade: considerações psicossociais sobre narrativas de escravizado(a)s / Trabajo esclavo contemporáneo y subjetividad: consideraciones psicosociales sobre narrativas de personas esclavizadas

This study addresses the relation between subjectivity and contemporary enslaved labor from the enslaved workers' narratives in Brazil. A qualitative social research was carried out based on a constructionist perspective. We sought interaction with rescued workers and used (a) participant observation of workers' routine in an institutional project that supports them and a field diary, (b) semi-structured and open individual interviews with workers and a member of the team project. The fieldwork lasted a year and a half and the analysis followed Content Analysis. Freudian theory and Foucault's thought were used for interpretation, which managed to understand aspects of workers' experiences, exploitation characteristics, parental abandonment, as well as the tensions in self-classification as enslaved. The narratives pointed to a dramatic reality manifested in body exploitation, authoritarian abuses, violence, and negligence. At the same time, these narratives showed forms of worker resistance that calls for further investigations to increase knowledge on the subjective experiences of those who were enslaved.(AU)

O artigo aborda as relações entre subjetividade e trabalho escravo contemporâneo a partir da narrativa de trabalhadores(as) escravazados(as). Foi realizada uma pesquisa social qualitativa em uma perspectiva construcionista. Buscamos a interação com trabalhadores resgatados e realizamos a observação participante da rotina de trabalhadores atendidos em um projeto institucional, com diário de campo, e entrevistas individuais (semiestruturadas e abertas) com trabalhadores(as) e equipe do projeto institucional. O trabalho de campo durou um ano e meio, e a pesquisa foi realizada com o suporte da Análise de Conteúdo. Para a interpretação utilizamos aportes da teoria freudiana e do pensamento de Foucault, com os quais foi possível compreender aspectos das vivências dos trabalhadores, características da exploração, abandonos parentais e tensões em torno da autoclassificação como "escravo". As narrativas apontaram uma realidade dramática manifesta na exploração do corpo, em abusos autoritários, na violência e negligência. Ao mesmo tempo, as narrativas evidenciaram formas de resistência dos trabalhadores que convocam mais investigações para adensar o conhecimento sobre as experiências subjetivas desses que estão num lugar de escravizado(a).(AU)

Este artículo aborda la relación entre la subjetividad y el trabajo esclavo contemporáneo desde la narrativa de trabajadores esclavizados. Se realizó una investigación social cualitativa desde una perspectiva construccionista. Buscamos la interacción con los trabajadores liberados y utilizamos la observación participante de la rutina de los trabajadores atendidos en un proyecto institucional, diario de campo y entrevistas individuales (semiestructuradas y abiertas) con trabajadores y miembros del equipo del proyecto institucional. El trabajo de campo duró un año y medio, y se utilizó como apoyo el análisis de contenido. Para la interpretación se utilizaron aportes de la teoría freudiana y el pensamiento de Foucault, con lo que fue posible comprender aspectos de las vivencias de los trabajadores, características del escenario de explotación, abandono parental y las tensiones relacionadas con la autoclasificación "esclavo". Las narrativas apuntan a una realidad dramática manifestada en la explotación del cuerpo, abuso autoritario, violencia y abandono. Al mismo tiempo, evidenciaron formas de resistencia por parte de los trabajadores, que reclaman más investigaciones para profundizar en el conocimiento sobre las vivencias subjetivas de quienes se encuentran en esclavitud.(AU)

Desempenho de pré-escolares e escolares no protocolo ProNOH: aspectos macroestruturais / Performance of preschool and schoolchildren on the ProNOH protocol: macrostructure aspects

RESUMO Objetivo Investigar se o escore narrativo obtido por meio da aplicação do "Protocolo de Avaliação da Narrativa Oral de História (ProNOH)" permite discriminar os grupos etários estudados, bem como sua relação com o nível de coerência global da história. Método Participaram 97 pré-escolares e escolares com desenvolvimento típico de linguagem, entre 5 e 12 anos, ambos os sexos que frequentavam escola pública. Foi aplicado o "Protocolo de Avaliação da Narrativa Oral de História (ProNOH)" e calculado o escore narrativo na dimensão macroestrutural a partir dos elementos estruturais previstos no modelo da gramática de história. Esses mesmos elementos foram usados para obter o nível de coerência global da história, segundo proposta de análise de Spinillo e Martins (1997). Resultados Diferença estatisticamente significante foi encontrada entre os grupos etários, principalmente entre as idades fronteiriças de 5-6 anos, 7-8 anos, 9-10 anos e 11-12 anos. Correlação positiva e estatisticamente significante foi encontrada com a idade e o escore narrativo e a coerência global, bem como entre o escore narrativo e o nível de coerência global. Conclusão O protocolo mostrou ser útil para identificar o repertório de elementos típicos da gramática de história na narrativa oral como uma medida objetiva que diferenciou a narrativa oral de grupos etários. Os resultados indicaram ainda que o escore narrativo pode ser uma medida norteadora do nível de coerência da história, apesar deste valor não substituir uma análise específica.

ABSTRACT Purpose To investigate if the narrative score of the ProNOH protocol allows for discriminating age groups, as well as its relation with the global coherence level of the story. The performance of preschool and schoolchildren on the macrostructure aspects. Methods Participants were 97 preschoolers and schoolchildren with typical language development, aged between five and 12 years old, and both sexes who attended public schools. The "Protocolo de Avaliação da Narrativa Oral de História (ProNOH)" (Protocol for the Evaluation of Oral Storytelling) was applied and the narrative score in the macrostructure dimension was calculated with story grammar elements. These same story elements were used to obtain the global coherence level of the story, as proposed by Spinillo and Martins (1997). Results A statistically significant difference was found between age groups, mainly between the borderline ages of 5-6 years, 7-8 years, 9-10 years, and 11-12 years. Positive and statistically significant correlations were found between the narrative score and global coherence and age, as well as between the narrative score and global coherence. Conclusion The protocol proved to be useful for identifying the repertoire of typical story grammar elements as an objective measure that differs in oral narrative across age groups. The results also indicate that the narrative score can provide an idea about the global coherence of the story, although this value does not replace a specific analysis.

Approved or disregarded? Exploring arenas for narrative relations in geriatric care.

PURPOSE: The use of narration in healthcare has been accentuated as a response to the requested shift towards person-centred care. The notion of narrative relations refers to a process of involving several people in mutual and ongoing narrative exchange. This study aimed to explore how and where narrative relations may be adopted and enacted in everyday healthcare practice. METHODS: The study has a qualitative, explorative design. Seven interprofessional focus group discussions with healthcare staff were prompted by vignettes. A multidisciplinary team of healthcare staff (n = 31) were recruited on a geriatric ward. Data were analysed using a constant comparative method. RESULTS: A core theme shows how narrative relations are adopted and enacted both as part of an approved practice-the work procedures commonly approved as part of healthcare, and as a disregarded practice where covert but important narrative relations take place to support fundamental qualities of healthcare. Moreover, the findings consider arenas of healthcare practice where approved or disregarded practices are enacted in the clinic frontstage and the clinic backstage. CONCLUSIONS: Narrative relations may take place in different arenas of healthcare practice yet simultaneously become a cohesive force interconnecting those arenas and uphold continuity. Impeded narrative relations in one arena may have unintended consequences in another.

Realistic Consideration and Path Choice: Research on the Integration of Epidemic Narrative into College Students’ Ideological and Political Education / 中国医学伦理学

It takes a long time to repair the social damage caused by a major epidemic, which is both a rebuilding of social order and a long process of social psychology. How to reproduce the collective memory of major epidemic events through narration, start from the reality of the epidemic narrative to the should and finally back to practice, and use epidemic narrative as an educational means and carrier in ideological and political education, it will be a beneficial attempt to realize the unification of knowledge and practice in college students’ ideological and political education in the post-epidemic period. To integrate the epidemic narrative into the ideological and political education of college students, it is necessary to adhere to the mainstream ideological direction of the narrative, unblock the narrative channel, reasonably choose the narrative method and optimize the narrative content, adhere to student-oriented, and give full play to the educational function of students’ individual narration.

Models of activity in the narratives of people with schizophrenia. / Wzorce aktywnosci w narracjach osób chorych na schizofrenie.

OBJECTIVES: This article presents an analysis of the narratives of people with schizophrenia from the perspective of descriptions of activities. The goal is to look for changes in activity models under the influence of a psychotic crisis experience. METHODS: Three fragments of auto-narratives concerning periods: prior to illness, during illness and during remission periods, were compared. These were created after psychotic crisis. The narratives of 26 people with schizophrenia about their lives and self-perception during the aforementioned periods made up the research material. Linguistics textual analysis was conducted, distinguishing the determinants of six selected models of activity relating to sense of agency and intentionality of action. Frequency analysis and multivariable methods were applied to compare the relative frequency of their occurrence in narratives. RESULTS: Descriptions of activities during the illness are more strongly saturated with models of an extrinsic control site, impersonal control over action, avoidance, individual actions, states in comparison to the remission period, and in particular, descriptions of activity prior to the illness. CONCLUSIONS: The results of analysis of schizophrenia patients' narratives indicate a decreased sense of agency related to experiencing states of disorder (subjectively defined). This motivational deficit also concerns remission periods after the active phase of the illness, though to a lesser extent. Analysis of motivational models reveals differences of descriptions of own activity, indicating alterations in auto-narration and narrative identity under the influence of a psychotic crisis in a retrospective approach. These changes pertain to deep layers hidden in the relationship between the form of the narrative and its content. They indicate other images of oneself (self-positions or self-narrative voices) as a healthy, sick and in remission person - especially in terms of the perception of their own agency.

Historia de la hipertensión arterial: revisión narrativa / History of high blood pressure: narrative review

Introducción: La medición de la presión arterial es uno de los procedimientos más realizados en la práctica clínica. La presente revisión narrativa pretende sintetizar los aspectos relevantes que rodearon la definición de la hipertensión arterial, el recorrido histórico del tratamiento de esta y el aporte de los estudios a la disminución de la mortalidad por enfermedad cardiovascular en el tiempo. Metodología: Revisión narrativa de la historia de la hipertensión arterial, desde el reconocimiento de la presión arterial alta como un factor asociado al riesgo cardiovascular y la evolución histórica del tratamiento hasta los hallazgos significativos del estudio SPRINT, publicado en 2015. Resultados: Hasta hace aproximadamente 50 años la hipertensión arterial era conocida como una patología esencial, es decir, esta condición no siempre fue considerada como una enfermedad. El descubrimiento de la presión sanguínea ha sido atribuido a Stephen Hales, poeta, orador y sacerdote nacido en Inglaterra. La primera medición de la presión sanguínea e incidentalmente de la presión del pulso la realizó en 1733 en animales. Se describe el origen de la presión arterial, la hipertensión arterial, el camino recorrido para el reconocimiento de esta condición como enfermedad y posteriormente su tratamiento, hasta llegar al estudio SPRINT en 2015, el cual fue contundente en demostrar el beneficio de reducir la cifra de presión arterial sistólica objetivo en una población no diabética. Conclusión: Los resultados de esta revisión narrativa exponen cómo el reconocimiento de la presión arterial alta como un factor de riesgo cardiovascular permitió el avance en la investigación científica para determinar el tratamiento y las cifras de presión arterial que favorecen la reducción de la mortalidad y morbilidad por esta causa.

Background: Blood pressure measurement is one of the most performed procedures in clinical practice. This narrative review aims to expose the relevant aspects surrounding the definition of arterial hypertension, the historical path of its treatment, and the contribution of studies to the decrease in mortality due to cardiovascular disease over time. Methodology: Narrative review of the history of arterial hypertension from recognizing high blood pressure as a factor associated with cardiovascular risk to the historical evolution of treatment up to the SPRINT study published in 2015. Results: Until about 50 years ago, arterial hypertension was known as an essential pathology; this condition was not always considered a disease. The discovery of blood pressure has been attributed to Stephen Hales, a poet, orator and priest born in England. The first measurement of blood pressure and incidentally pulse pressure was made in 1733 in animals. The origin of blood pressure, arterial hypertension, and the path travelled for recognizing this condition as a disease and later its treatment until reaching the SPRINT study in 2015, which demonstrated the benefit of reducing the target systolic blood pressure figure in a non-diabetic population. Conclusion: This narrative review demonstrates that the recognition of high blood pressure as a cardiovascular risk factor allowed progress in scientific research to determine the treatment and blood pressure figures that favor the reduction of mortality and morbidity from this cause.

Investigación narrativa con niños y niñas: una reflexión teórico-metodológica / Narrative research with boys and girls: a theoretical-methodological reflection

(analítico) Se presenta una reflexión teórico-metodológica derivada de una investigación sobre experiencias de participación y subjetividades en niños y niñas, ubicados en contextos institucionales y comunitarios de tres países de la región. En oposición a los enfoques que asumen a estas personas como sujetos receptores per se, la metodología de este estudio adoptó la investigación narrativa, dada su potencialidad para que los participantes logren narrarse, conocerse y transformarse. De esta manera, en la primera parte, se propone un acercamiento ontológico, epistémico y metodológico a la investigación narrativa con niños y niñas. Luego, basados en el trabajo de campo del estudio, se abordan técnicas de investigación que favorecen la interacción horizontal para la generación de conocimiento con estas personas, desde lo dialógico y lo estético. Al final, se presentan las conclusiones.

(analytical) The article presents a theoretical-methodological reflection derived from research on experiences of participation and subjectivities in boys and girls, located in institutional and community contexts in three countries of the region. In opposition to the approaches that assume these people as receiving subjects per se, methodology of this study adopted narrative research, given its potential for the participants to narrate themselves, to know themselves and to transform themselves. Thus, in the first part, an ontological, epistemic and methodological approach to narrative research with children is proposed. Then, based on the field work of the study, research techniques that favor horizontal interaction for the generation of knowledge with these people are addressed, through the dialogic and the aesthetic. Finally, the conclusions are presented.

(analítico) O artigo apresenta uma reflexão teórico-metodológica derivada de pesquisas sobre experiências de participação e subjetividades em meninos e meninas, localizadas em contextos institucionais e comunitários em três países da região. Em oposição às abordagens que assumem essas pessoas como sujeitos receptores per se, a metodologia deste estudo adotou a pesquisa narrativa, dada a sua potencialidade de os participantes narrarem, conhecerem e se transformarem. Assim, na primeira parte, propõe-se uma abordagem ontológica, epistêmica e metodológica da pesquisa narrativa com crianças. Em seguida, com base no trabalho de campo do estudo, são abordadas técnicas de pesquisa que favorecem a interação horizontal para a geração de conhecimento com essas pessoas, a partir da dialógica e da estética. Ao final, são apresentadas as conclusões.

La transición de Nana en oncología: Narrativa y análisis de una situación de enfermería desde el sistema conceptual teórico-empírico / Nana's transition in oncology: Narrative and analysis of a nursing

Las relaciones de cuidado que se establecen entre el profesional de enfermería y la persona cuidada se evidencian en la 'situación de enfermería', la cual, puede ser narrada verbalmente para su análisis y reflexión. El objetivo fue describir la construcción y el análisis de una narrativa de una situación de enfermería mediante el sistema conceptual teórico empírico, y nueve patrones de conocimiento de enfermería. Se seleccionó una experiencia significativa de cuidado entre una profesional de enfermería y una mujer con cáncer de mama que experimenta la transición por el tratamiento oncológico. La narrativa de situación de enfermería se construyó a partir de la adaptación de las preguntas guía de Gómez y Gutiérrez, se analizó mediante el sistema conceptual teórico empírico y nueve patrones de conocimiento de enfermería. Como aporte, se presentó el análisis de los elementos Conceptual, Teórico y Empírico y de patrones de conocimiento de enfermería para evidenciar la necesidad de integrar los análisis de narrativas desde el conocimiento del otro y la base epistemológica de la disciplina de enfermería.

The care relationships that are damaged between the nursing professional and the cared person are evidenced in the 'nursing situation', which can be verbally narrated for analysis and reflection. The objective was to describe the construction and analysis of a nursing situation narrative through the empirical theoretical conceptual system, and nine patterns of nursing knowledge. A significant care experience was selected between a nursing professional and a woman with breast cancer who is undergoing the transition due to cancer treatment. The nursing situation narrative was built from the adaptation of the guiding questions of Gómez and Gutiérrez, it was analyzed through the empirical theoretical conceptual system and nine patterns of nursing knowledge. As a contribution, the analysis of the Conceptual, Theoretical and Empirical elements and patterns of nursing knowledge was presented to demonstrate the need to integrate the analysis of narratives from the knowledge of the other and the epistemological basis of the nursing discipline.