Propuestas para el abordaje de la violencia machista en el ámbito de la salud. Un análisis cualitativo / Proposals for approaching violence against women in health care. A qualitative analysis

Objetivo: Identificar cuáles son las propuestas de mejora respecto al abordaje de la violencia machista a través de la evaluación sobre la implementación del Protocolo para el Abordaje de la Violencia Machista en el ámbito de la salud en Cataluña del 2009 (PAVIM). Diseño: Estudio cualitativo de tipo etnográfico, 2019. Emplazamiento: Sistema sanitario público de Cataluña. Participantes: Ciento ochenta y un participantes, de los cuales: 104 profesionales de la salud, 43 entidades de mujeres o especificas en violencia machista y 34 expertas en salud o violencia machista. Método: Muestreo intencional. Se realizan 18 grupos focales y 34 entrevistas semiestructuradas. Evaluación con perspectiva de género e interseccional. Resultados: Los resultados se estructuran en las fases del PAVIM. Prevención: formación obligatoria para todo el equipo de profesionales y reconocida institucionalmente, con perspectiva de género e interseccional. Detección: estandarización de códigos diagnósticos para la violencia machista y mejora en la coordinación entre Atención Primaria y servicios de Urgencias, Pediatría y Atención a la Salud Sexual y Reproductiva. Atención y recuperación: equidad territorial en los recursos destinados a la atención de los casos de violencia machista (en las 9 regiones sanitarias de Cataluña) y mayor comunicación entre el ámbito de la salud y el asociativo. Conclusiones: Las propuestas de mejora identificadas son aquellas que han generado un mayor consenso entre participantes y de interés para la atención primaria. Como limitaciones destacan la temporalidad y la heterogeneidad del territorio catalán.(AU)

Objective: Identify improvement proposals for approaching violence against women through the evaluation of 2009s Protocol for approaching Violence Against Women in Health Care in Cataluña (PAVIM). Design: Qualitative ethnographic study, 2019. Setting: Public Health Care in Catalonia. Participants: One hundred eighty one participants, of which: 104 health care professionals, 43 women's associations and/or experts in violence against women and 34 experts on health and violence against women. Method: Intentional sampling. Eighteen focus groups and 34 semi-structured interviews. Evaluation with a gender and intersectional perspective. Results: Results are structured along PAVIM's phases. Prevention: mandatory and institutionally recognized training for the whole professional team, with a gender and intersectional perspective. Detection: diagnostic code standardization for violence against women and improve coordination between primary care, emergency service, pediatrics and Assistance to Sexual and Reproductive Health. Care and recovery: territorial equity in the applied resources on cases of violence against women care (in the 9 sanitary regions of Catalonia) and improves communication between health and associative fields. Conclusions: The improvement proposals identified are those that have generated a greater consensus among participants and are the most interesting to primary care. As limitations, stand out the temporality and heterogeneity of the Catalan territory.(AU)

[Proposals for approaching violence against women in health care. A qualitative analysis]. / Propuestas para el abordaje de la violencia machista en el ámbito de la salud. Un análisis cualitativo.

OBJECTIVE: Identify improvement proposals for approaching violence against women through the evaluation of 2009s Protocol for approaching Violence Against Women in Health Care in Cataluña (PAVIM). DESIGN: Qualitative ethnographic study, 2019. SETTING: Public Health Care in Catalonia. PARTICIPANTS: One hundred eighty one participants, of which: 104 health care professionals, 43 women's associations and/or experts in violence against women and 34 experts on health and violence against women. METHOD: Intentional sampling. Eighteen focus groups and 34 semi-structured interviews. Evaluation with a gender and intersectional perspective. RESULTS: Results are structured along PAVIM's phases. PREVENTION: mandatory and institutionally recognized training for the whole professional team, with a gender and intersectional perspective. Detection: diagnostic code standardization for violence against women and improve coordination between primary care, emergency service, pediatrics and Assistance to Sexual and Reproductive Health. Care and recovery: territorial equity in the applied resources on cases of violence against women care (in the 9 sanitary regions of Catalonia) and improves communication between health and associative fields. CONCLUSIONS: The improvement proposals identified are those that have generated a greater consensus among participants and are the most interesting to primary care. As limitations, stand out the temporality and heterogeneity of the Catalan territory.

Desarrollo de un índice de capacidad estructural para hospitales de agudos con cirugía oncológica / Development of a structural capacity index for oncological surgery in acute hospitals

Introducción El estudio del impacto de la estructura sobre los resultados se ha basado principalmente en el número de intervenciones. El objetivo de este trabajo fue desarrollar un índice de capacidad estructural para hospitales de agudos con cirugía oncológica. Métodos Estudio transversal por encuesta, relativa a las características estructurales de los centros que habían realizado alguna intervención quirúrgica de oncología digestiva en Cataluña en 2004. Se desarrolló un índice sobre la base de la maximización de la fiabilidad, y se seleccionaron las variables por sus características métricas y también conceptuales. Resultados De los 45 centros seleccionados se obtuvo respuesta válida de 37. El conjunto de variables incluidas en el índice (relacionadas con la docencia, la gestión de casos y la tecnología) presentó buenas propiedades métricas (alfa de Cronbach: 0,92 y correlación ítem-total >0,7).Conclusiones El índice desarrollado permite clasificar los centros hospitalarios atendiendo a sus especificidades tecnológicas, organizativas y de gestión (AU)

Introduction The study of the impact of structure on outcomes has mainly been focused on the number procedures. The aim of our study was to develop a structure capacity index for hospitals for oncological surgery. Methods Cross-sectional study by means of a questionnaire related to the structural characteristics of hospitals that had performed gastrointestinal oncological surgery in Catalonia during 2004. Variables were considered for the index according to their measurement and conceptual properties. Results A response was obtained from 37 out of 48 hospitals. Variables with good conceptual and measurement properties (Cronbach alpha 0.92 and Item-Total correlation >0.7) were included in the index. These variables were related to teaching, management and technology. Conclusions The index has acceptable levels of reliability and validity, and can be a useful tool to classify hospitals according to their technological characteristics and management strategies (AU)

[Development of a structural capacity index for oncological surgery in acute hospitals]. / Desarrollo de un índice de capacidad estructural para hospitales de agudos con cirugía oncológica.

INTRODUCTION: The study of the impact of structure on outcomes has mainly been focused on the number procedures. The aim of our study was to develop a structure capacity index for hospitals for oncological surgery. METHODS: Cross-sectional study by means of a questionnaire related to the structural characteristics of hospitals that had performed gastrointestinal oncological surgery in Catalonia during 2004. Variables were considered for the index according to their measurement and conceptual properties. RESULTS: A response was obtained from 37 out of 48 hospitals. Variables with good conceptual and measurement properties (Cronbach alpha 0.92 and Item-Total correlation >0.7) were included in the index. These variables were related to teaching, management and technology. CONCLUSIONS: The index has acceptable levels of reliability and validity, and can be a useful tool to classify hospitals according to their technological characteristics and management strategies.