Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla / Advocacy for Roma health: in-service training of professionals from the Seville Health District

Se describe la experiencia de un taller cuyo objetivo fue capacitar a profesionales para abogar por la salud de la población gitana. La abogacía por la salud es recomendada por organismos internacionales y expertos en salud pública para superar las inequidades en salud. Participaron 16 profesionales de tres centros de salud de barrios con una alta densidad de población gitana, en riesgo de exclusión social. El taller se organizó en tres sesiones dirigidas a sensibilizar, dar a conocer el marco conceptual y metodológico de la abogacía, y diseñar un plan de abogacía. Se pone de manifiesto la utilidad de este espacio de reflexión y análisis, y la necesidad de abogar por la salud de la población gitana, junto a otros agentes gitanos/as y sectores comunitarios, identificando oportunidades y utilizando los recursos comunitarios. Futuras investigaciones deben profundizar en el desarrollo de planes de abogacía intersectoriales y difundirlos, para facilitar su implementación en otros contextos de características similares

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics

[Advocacy for Roma health: in-service training of professionals from the Seville Health District]. / Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla.

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.

Pornography Influence Among Young Students: Adaptation and Validation of Pornography Consumption Inventory into Spanish.

This manuscript intends to adapt and validate Pornography Consumption Inventory (PCI) into Spanish in a sample of 211 young students who admitted to consume pornography. They completed a questionnaire that referred to sociodemographic characteristics, sexual behavior and PCI. Results showed a factorial structure of the scale with good data fit, composed of 13 items divided into three dimensions, i.e., emotional avoidance, sexual curiosity, and excitement seeking and sexual pleasure. These factors were positively interrelated and presented excellent internal consistency reliability. Some gender differences were observed, so that men presented higher scores in the three dimensions than women.

Implementing a cultural competence training as a psychopolitical empowerment process.

The cultural competence training (CCT) of health care professionals represents a useful resource to face the challenges involved in health care assistance for multicultural populations. However, the traditional perspective has shown limited results, as it does not consider professionals in their contexts and avoids continuous assessment processes. In response to these limitations, we describe a model of CCT implemented by two professors of the Faculty of Nursing at the University of Seville in Spain as a psychopolitical empowerment process, and exemplified by the experience of the emergency nurses at the Virgen Macarena Hospital. This process adds the notion of power to traditional CCT and uses dialogic learning to: (a) state a mission and develop critical thinking; (b) take stock of the actions for change and increase the capacity of nurses to respond; and (c) motivate nurses to plan the future and take action. As a result, professionals become a learning community, able to develop a new professional identity and role, and can also implement actions for the transformation of health care settings.

Nursing diagnosis of grieving: content validity in perinatal loss situations.

PURPOSE: To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. METHODS: Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. FINDINGS: The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. CONCLUSION: The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation.

Experiencias de niños hospitalizados en unidades de pediatría del Hospital Virgen Macarena / Experiences of the children hospitalized in the paediatric units of the Virgen Macarena Hospital

Objetivo: describir las características de las enfermeras percibidas por los niños y niñas, y conocer la valoración que hacen de las actividades y recursos durante su ingreso hospitalario. Método: se realizó un estudio descriptivo con utilización de técnicas cualitativas. Participaron 24 niños ingresados en la Unidad de Preescolares y Hemato-Oncología. Se les realizó una entrevista semiestructurada en una sala de juegos. El análisis de contenido de la entrevista se realizó siguiendo el método de Giorgi (1997). Resultados: Los niños percibieron a las enfermeras como personas cercanas y amigables, que informaban bien y cuya función principal era cuidarlos y devolverlos buenos a su hogar. Plantearon que los uniformes del personal de enfermería debían diseñarse con colores alegres. En cuanto a la valoración de recursos y actividades lúdicas, reclamaban entretenimiento y espacios abiertos para jugar. Los menús hospitalarios fueron motivos de crítica por la mayoría de los niños y, en cuanto a los pijamas existía diversidad de opiniones en cuanto a las preferencias. Conclusiones: Es importante recoger las opiniones de los niños para identificar sus necesidades. Además, dada la importancia que conceden al juego, debería considerarse su utilidad para trasmitir información o para recogerla (AU)

Objective: To describe children's perceptions about nursing characteristics and to know children's valuation of the activities and resources employed during their hospital stay. Method: A descriptive study by means of qualitative techniques was done. 24 children hospitalized in the Infant and Hemato-Oncological Unit participated. To collect the information, a semi structured interview was done at the playroom. The content analysis of the interviews was done following Giorgi's method (1997). Results: Children perceived nurses as close and friendly, and as people who gave properly the information. Respect nurses' missions, children considered that they were to take care of them, and to restore them back to home. Children also suggested that nursing uniforms should be more colourful. According to the valuation of the activities and resources employed during their hospital stay, children claimed for more entertainment and open spaces to play. Hospital meals were criticised by the majority of children, and there was a diversity of opinions respect to their preferences for the pyjamas design. Conclusions: It is important to collect children's opinions, in order to identify their needs. Also, because of the importance that children give to play, it should be considered useful to give or collect information(AU)

Afrontamiento del estrés ocupacional entre profesionales de enfermería hospitalaria desde la investigación acción participativa / Coping with occupational stress among nursing staff by participatory action research

Objetivo. Describir una práctica colaborativa centrada en el afrontamiento del estrés en profesionales de enfermería hospitalaria. Método. La práctica se centra en la contextualización de los problemas y en el diseño e implementación de acciones usando el enfoque psicopolítico y la metodología de investigación acción participativa (IAP). Método. Los participantes han sido profesionales de enfermería de 4 unidades de medicina interna del Hospital Universitario Virgen Macarena de Sevilla. Se ha utilizado el cuestionario ISTAS, entrevistas y grupos de discusión, mediante los cuales enfermeras e investigadores han valorado, definido, propuesto e implementado diferentes acciones para mejorar sus condiciones de trabajo. Resultados. Las situaciones problemáticas identificadas con el cuestionario se relacionan con las exigencias psicológicas, el conflicto de roles y la estima. La principal causa del estrés en los profesionales es la falta de personal, según la opinión de los supervisores. En los grupos de discusión se decide intervenir sobre tres situaciones: a) necesidad de presencia continua del celador en las unidades para la movilización de pacientes no autónomos; b) necesidad de controlar el horario de visitas y el número de familiares que acompañan a los pacientes, y c) necesidad de mejorar los registros de las actividades implantados al personal de enfermería. Conclusiones. Entre las fortalezas del uso del enfoque psicopolítico y de la IAP en el contexto hospitalario destacan la movilización de los profesionales y el desarrollo de conciencia crítica. Entre las debilidades, las barreras derivadas de la rigidez del modelo burocrático. Estas barreras suponen un desafío para el cambio y el desarrollo organizacional(AU)

Objective. To describe a collaborative practice focused on coping with the occupational stress among nursing staff in a hospital setting. Method. These practices focus on the contextualization of the problems and the design and implementation of actions using the psychopolitical model and the participatory action research (PAR) methodology. Participants were the nurses of 4 units of internal medicine at the public hospital "Virgen Macarena" in Seville. We have used the ISTAS questionnaire, interviews and discussion groups through which nurses and researchers have assessed, defined, proposed and implemented different actions in order to improve their work conditions. Conclusions. Among the strength of the psychopolitical model and PAR in a hospital context we must emphasize on the mobilization of professionals and the development of a critical consciousness. Among the weakness, those derived from bureaucratic processes. These barriers imply a challenge for change and organizational development(AU)

[Coping with occupational stress among nursing staff by participatory action research]. / Afrontamiento del estrés ocupacional entre profesionales de enfermería hospitalaria desde la investigación acción participativa.

OBJECTIVE: To describe a collaborative practice focused on coping with the occupational stress among nursing staff in a hospital setting. METHOD: These practices focus on the contextualization of the problems and the design and implementation of actions using the psychopolitical model and the participatory action research (PAR) methodology. Participants were the nurses of 4 units of internal medicine at the public hospital "Virgen Macarena" in Seville. We have used the ISTAS questionnaire, interviews and discussion groups through which nurses and researchers have assessed, defined, proposed and implemented different actions in order to improve their work conditions. RESULTS: Problematic situations detected by the questionnaires are associated to psychological demands, role conflicts and esteem. The main cause of stress in healthcare professionals is the lack of staff, according to the opinion laid by supervisors. In the discussion groups, nurses accorded to get involved in three situations: a) the need of the continuous presence of an orderly to move patients which aren't autonomous; b) the need of controlling visit hours and the number of accompanying people with each patient; and c) the need to improve the registration of the activities assigned to nursing staff. CONCLUSIONS: Among the strength of the psychopolitical model and PAR in a hospital context we must emphasize on the mobilization of professionals and the development of a critical consciousness. Among the weakness, those derived from bureaucratic processes. These barriers imply a challenge for change and organizational development.

[Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge]. / Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta.

OBJECTIVE: To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. METHOD: A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). RESULTS: Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. CONCLUSIONS: Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced.

Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta / Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge

Objetivo. Conocer las necesidades de los cuidadores principales de los pacientes portadores de un desfibrilador automático implantable (DAI) durante el ingreso en la Unidad Coronaria del Hospital Virgen Macarena y tras el alta hospitalaria. Método. Estudio cualitativo descriptivo. Se realizó mediante entrevistas semiestructuradas y abiertas. El análisis de contenido de las entrevistas se realizó siguiendo el método de Giorgi (1997). Resultados. Participaron 12 sujetos. Durante la hospitalización destacó la escasa comunicación entre los cuidadores principales y los profesionales de enfermería, su falta de participación en los cuidados y sus dificultades para asimilar la información acerca del DAI. Tras el alta, el miedo y la necesidad de sobreproteger al paciente marcaron los primeros días. El posterior seguimiento en la unidad de ritmo facilitó el proceso de adaptación y la confianza en el DAI. Conclusiones. Sería necesario incluir en la planificación de cuidados al paciente la atención a las necesidades de información y apoyo emocional de los familiares, y que los profesionales de enfermería participasen en el proceso de transmitir la información acerca del DAI y sus posibles complicaciones. Ello permitiría una información progresiva y personalizada, con el fin de preparar el alta y facilitar el ajuste a la nueva situación. Se debería modificar la duración de los horarios de visitas en función de las circunstancias de cada paciente y su familia. Sería necesario poner en marcha estrategias que favorezcan la comunicación entre los cuidadores y los profesionales de enfermería

Objective. To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. Method. A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). Results. Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. Conclusions. Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced

Evaluación de la calidad asistencial y posterior ajuste a la nueva situación tras el implante de un desfibrilador en pacientes ingresados en la Unidad Coronaria del Hospital Virgen Macarena (Sevilla) / Evaluation of the quality of care in implantable cardioverter defibrillator recipients and their adjustment to this therapy in the Coronary Unit of the Hospital Virgen Macarena (Sevilla)

Objetivos. Evaluar la calidad asistencial de enfermería percibida por las personas receptoras de un desfibrilador automático implantable (DAI) ingresadas en la Unidad Coronaria del Hospital Virgen Macarena, e identificar los principales problemas y necesidades que tienen tras el alta, al objeto de mejorar la práctica clínica de enfermería y el proceso de ajuste a la nueva situación. Método. Estudio cualitativo. A 10 sujetos se les realizaron entrevistas semiestructuradas, cuyo guión incluía las dimensiones del modelo SERVQUAL para evaluar la calidad asistencial, y abiertas, para explorar el proceso de ajuste a la nueva situación. Para el análisis de contenido de las transcripciones aplicamos el método de Giorgi (1997). Resultados. Las dimensiones de calidad asistencial mejor valoradas fueron la capacidad de respuesta de enfermería a las necesidades que presentan en el ingreso hospitalario y la empatía. En contraste, algunos aspectos de la tangibilidad relacionados con las visitas de los familiares son los que obtienen una evaluación más negativa. Tras el alta, los pacientes expresaron limitaciones derivadas de cambios físicos, psicológicos y sociales. Estos resultados corroboran los obtenidos en otros estudios que señalan las dificultades en el ajuste a la nueva situación. Conclusiones. Es preciso introducir medidas de mejora durante la hospitalización encaminadas a corregir las deficiencias observadas en la dimensión de tangibilidad y a facilitar la adaptación a la nueva situación. Sería necesario planificar el alta progresivamente durante la hospitalización para paliar el miedo y desconocimiento que genera en los pacientes el readaptar los estilos de vida a la terapia con el DAI

Objectives. To evaluate the quality of nursing care perceived by patients receiving implantable cardioverter defibrillators (ICD) hospitalized in the Coronary Unit of the Hospital Virgin Macarena (Sevilla) and to identify the main problems and needs of these patients after discharge in order to improve clinical nursing practice and patients' adjustment to ICD therapy. Method. A qualitative study was performed. In 10 patients, semi-structured interviews that included the dimensions of the SERVQUAL model were used to evaluate the quality of care, while open interviews were used to explore the process of adjusting to ICD therapy. Content analysis of the transcripts was performed following Giorgi's (1997) method. Results. The quality dimensions receiving the highest rating were nurses' responsiveness to patients' needs on admission and empathy. By contrast, some aspects of tangibility related to family visits received the lowest rating. After hospital discharge, patients reported that they experienced limitations as a consequence of physical, psychological and social changes. These findings corroborate those of other studies that highlight patients' difficulties in adjusting to ICD therapy. Conclusions. Measures aimed at correcting the deficiencies found in the dimension of tangibility and facilitating adaptation to the implantation of ICD should be introduced. During hospitalization, patients should be progressively prepared for discharge to alleviate the fear and lack of knowledge about lifestyle changes required after ICD implantation