Sleep Quality and Fatigue in Construction Workers: Effect of a Cognitive Behavioral Intervention.

BACKGROUND: In Chile, there is no specific information how affect the quality of sleep and fatigue to the construction workers. OBJECTIVE: To present the results of a cognitive behavioral intervention in construction workers aimed at reducing fatigue through improvement in sleep quality. METHODOLOGY: Pragmatic non-randomized clinical trial with follow-up. Sample of 180 workers from a construction company, organized in a control group and the intervention group belonging to five construction projects. CONCLUSION: Long-term effects are reflected in the third measurement of the Epworth scores, in the presence of fatigue. Those workers who received the cognitive behavioral intervention reduced their levels of sleepiness and fatigue.A multidisciplinary approach is required to study not only fatigue and sleep, but also other relevant aspects of health, since impact on accident rates, days lost from work, and quality of life.

Sleep quality in people with type 2 diabetes controlled at the primary level and its association with sociodemographic and clinical characteristics.

Type 2 diabetes (DM2) is one of the diseases that cause the highest premature mortality and disability worldwide. Sleep disturbances have been associated with the onset of metabolic disorders and increased levels of glycated haemoglobin in diabetics. OBJECTIVE: To evaluate the quality of sleep of people with type 2 diabetes and its association with sociodemographic, clinical, and metabolic characteristics. METHODS: Observational, cross-sectional, analytical study of 223 patients with DM2 between 20 and 64 years old, controlled in a primary health care centre in Chile. RESULTS: Most were women (66.4%), average age 54.7 years. Only 33% slept the required number of hours (7-9 h) to maintain health. Fifty-seven point seven percent were metabolically unbalanced (Hb1Ac > 7%). Seventy-five point two percent presented sleep problems of varying severity, which were associated with being a woman, night pain, nocturia, time of diagnosis of diabetes, and depressive symptoms. Persons with poor sleep quality were 73% more likely to be metabolically decompensated, however, this result was not statistically significant: OR = 1.73 (CI: 78-3.87). CONCLUSIONS: The high frequency of poor sleep quality and metabolic decompensation in the sample stands out, which could complicate DM2. The association between poor sleep quality and DM2 decompensation is inconclusive. Future research will contribute to elucidating the role of sleep in metabolic compensation and in the prevention of metabolic disorders.

Calidad del sueño en personas con diabetes tipo 2 controladas en el nivel primario y su asociación con características sociodemográficas y clínicas / Sleep quality in people with type 2 diabetes controlled at the primary level and its association with sociodemographic and clinical characteristics

La diabetes tipo 2 (DM2) es una de las enfermedades que causa mayor mortalidad prematura y discapacidad a nivel mundial. Las alteraciones del sueño se han asociado a la aparición de trastornos metabólicos y a mayores niveles de hemoglobina glucosilada en personas diabéticas.Objetivo:Evaluar la calidad del sueño de personas con DM2 y su asociación con características sociodemográficas, clínicas y metabólicas.Métodos:Estudio observacional, transversal, analítico en 223 personas con DM2 entre 20 y 64 años controladas en un centro de atención primaria de salud.Resultados:La mayoría eran mujeres (66,4%), edad promedio 54,7 años y solo el 33% duerme las horas necesarias (7 a 9 horas). Un 57,7% se encontraba metabólicamente descompensado (Hb1Ac>7%). Un 75,2% de los participantes presentó problemas de sueño de diversa gravedad, que se asoció a ser mujer, dolor nocturno, nicturia, tiempo de diagnóstico de la diabetes y síntomas depresivos. Las personas con mala calidad de sueño tuvieron 73% más probabilidad de estar descompensados metabólicamente, sin embargo, este resultado no fue estadísticamente significativo OR=1,73 (IC: 0,78-3,87).Conclusiones:Destaca la alta frecuencia de mala calidad de sueño y descompensación metabólica en la muestra, lo que podría complicar la DM2. No es concluyente la asociación entre mala calidad de sueño y descompensación de la DM2. Futuras investigaciones contribuirán a dilucidar el papel del sueño en la compensación metabólica y en la prevención de trastornos metabólicos.

Type 2 diabetes (DM2) is one of the diseases that cause the highest premature mortality and disability worldwide. Sleep disturbances have been associated with the onset of metabolic disorders and increased levels of glycated haemoglobin in diabetics.Objective:To evaluate the quality of sleep of people with type 2 diabetes and its association with sociodemographic, clinical, and metabolic characteristics.Methods:Observational, cross-sectional, analytical study of 223 patients with DM2 between 20 and 64 years old, controlled in a primary health care centre in Chile.Results:Most were women (66.4%), average age 54.7 years. Only 33% slept the required number of hours (7 to 9hours) to maintain health. Fifty-seven point seven percent were metabolically unbalanced (Hb1Ac>7%). Seventy-five point two percent presented sleep problems of varying severity, which were associated with being a woman, night pain, nocturia, time of diagnosis of diabetes, and depressive symptoms. Persons with poor sleep quality were 73% more likely to be metabolically decompensated, however, this result was not statistically significant: OR=1.73 (CI:78-3.87).Conclusions:The high frequency of poor sleep quality and metabolic decompensation in the sample stands out, which could complicate DM2. The association between poor sleep quality and DM2 decompensation is inconclusive. Future research will contribute to elucidating the role of sleep in metabolic compensation and in the prevention of metabolic disorders.

Viviendo la experiencia de cuidar a un familiar mayor y ser empleado: roles en conflicto / Living the experience of caring for an elderly relative and being employed: roles in conflict

Objetivo: Develar la experiencia vivida de personas que realizan el doble rol de cuidar a un familiar mayor dependiente y trabajar remuneradamente. Metodología: investigación cualitativa fenomenológica. Participaron 14 personas que asistieron a un programa de apoyo al trabajador-cuidador familiar, y que eran cuidadores de una persona mayor dependiente, de quienes se recogió la experiencia a través de una entrevista semiestructurada. Se entrevistó hasta alcanzar la saturación de significados. El análisis se realizó a través del método propuesto por Streubert. Resultados: el fenómeno se develó en la categoría comprensiva multiplicidad de roles compuesta por las subcategorías angustia/agobio y culpa. Conclusiones: resulta urgente visibilizar las consecuencias de la multiplicidad de roles y desarrollar políticas públicas para la conciliación de ellos (AU)

Objective: To reveal the lived experience of people who perform the double role of caring for a dependent elderly relative and working remuneratively. Methodology: qualitative phenomenological research of 14 people who participated in a family worker-caregiver support program, and were caregivers of a dependent elderly person, from whom the experience was collected through a semi-structured interview. It was interviewed until a saturation of meanings was reached. The analysis was performed through the method proposed by Streubert. Results: the phenomenon was revealed in the comprehensive multiplicity of roles category composed of the subcategories distress/burden and guilt. Conclusions: it is urgent to make visible the consequences of the multiplicity of roles and develop public policies for their reconciliation (AU)

Understanding the Relationship between Depression and Chronic Diseases Such as Diabetes and Hypertension: A Grounded Theory Study.

There is a bi-directional relationship between depression and chronic illnesses such as diabetes and hypertension. This comorbidity is associated with higher mortality risk and diminishes the efficacy of interventions. The specific mechanisms of this mutual influence are still not fully understood, and most intervention protocols address these conditions separately. This study aims to improve our understanding of this relationship. We interviewed 18 patients and 24 health care professionals, focusing on understanding the different ways in which depression and chronic illness could influence each other. Our results show a common cyclical pattern and specific situations where the reported bi-directional relationship does not occur. We discuss the importance of opening a space for the patient's grief process after the chronic illness diagnosis, managing the demands and stress of the patient's treatment, and how to adjust the treatment to the different needs and possibilities of each person.

Profundización en la experiencia de profesionales de salud al incorporar terapias complementarias en su práctica clínica / Aprofundando a experiência dos profissionais de saúde, incorporando terapias complementares na sua prática clínica / Analysis into the experience of health professionals at incorporating complementary therapies in their clinical practice

Resumen: Introducción: Las terapias complementarias se han ido incorporando cada vez más en la atención de salud, especialmente en áreas como la oncología, cuidados paliativos, rehabilitación y obstetricia. En varios países, son los propios profesionales de la salud los que las han incorporado en forma integrada a su práctica clínica, llevándolos a cambiar el paradigma del sistema biomédico actual, permitiendo brindar un cuidado más integral y autónomo. Objetivo: Comprender la experiencia de los profesionales de salud de Chile al incorporar las terapias complementarias en su práctica clínica. Método: Estudio cualitativo fenomenológico. Se invitó a participar a profesionales de la salud, con certificación en una terapia no convencional, la cual integran a su práctica clínica. Tras la firma del consentimiento, se realizaron las entrevistas en profundidad hasta lograr la saturación de los datos. El proceso de investigación se realizó siguiendo las 10 etapas de Streubert. Resultados: Participaron 11 profesionales de salud, quienes desarrollan terapias como el reiki, terapia floral y acupuntura integrada a su práctica clínica. Se develó que la incorporación de Terapias Complementarias le dio mayor sentido a la propia labor como profesional de la salud, sin embargo, hubo facilitadores y obstaculizadores del proceso, lo cual les generó nuevos desafíos para la integración con la medicina alópata. Conclusión: La integración de las Terapias Complementarias ampliaron las herramientas terapéuticas, lo que generó en ellos mayor satisfacción profesional al brindar una atención más humana y centrada en la persona, reconociendo la necesidad de incorporar estos saberes en los currículos de las carreras de la salud.

Resumo: Introdução: As terapias complementares têm sido cada vez mais incorporadas à assistência à saúde, principalmente em áreas como oncologia, cuidados paliativos, reabilitação e obstetrícia. Em vários países, os próprios profissionais de saúde os incorporaram à prática clínica de forma integrada, levando-os a mudar o paradigma do sistema biomédico vigente, permitindo-lhes uma atenção mais integral e autônoma. Objetivo: compreender a experiência dos profissionais de saúde no Chile ao incorporar as terapias complementares em sua prática clínica. Método: estudo fenomenológico qualitativo. Foram convidados a participar profissionais de saúde com certificação em terapia não convencional, que integram à sua prática clínica. Após a assinatura do Termo de Consentimento Livre e Esclarecido, foram realizadas entrevistas em profundidade até a saturação dos dados. O processo de pesquisa foi realizado seguindo as 10 etapas de Streubert. Resultados: participaram 11 profissionais de saúde, que desenvolvem terapias como reiki, floroterapia e acupuntura integradas à sua prática clínica. Revelou-se que a incorporação das Terapias Complementares deu maior sentido ao próprio trabalho como profissional de saúde, porém, surgiram facilitadores e obstáculos ao processo, o que gerou novos desafios para a integração com a medicina alopática. Conclusão: A integração das Terapias Complementares ampliou os instrumentos terapêuticos, o que gerou nelas maior satisfação profissional por proporcionar um cuidado mais humano e centrado na pessoa, reconhecendo a necessidade de incorporação desse conhecimento nos currículos das carreiras em saúde.

Abstract: Introduction: Complementary therapies have been increasingly incorporated into health care, especially in areas such as oncology, palliative care, rehabilitation and obstetrics. In several countries, it´s the health professionals themselves who have incorporated them into their clinical practice in an integrated way, leading them to change the paradigm of the current biomedical system, allowing them to provide a more comprehensive and autonomous care. Objective: To comprehend the experience of health professionals in Chile when incorporating complementary therapies in their clinical practice. Method: Qualitative phenomenological study. Health professionals certified in unconventional therapy were invited to participate, which they integrate into their clinical practice. After signing the consent, in-depth interviews were carried out until the data was saturated. The research process was carried out following the 10 steps of Streubert. Results: 11 health professionals participated, who develop therapies such as reiki, flower therapy and acupuncture integrated into their clinical practice. It was revealed that the incorporation of Complementary Therapies gave greater meaning to the work itself as a health professional, however, there were facilitators and obstacles to the process, which generated new challenges for integration with allopathic medicine. Conclusion: The integration of Complementary Therapies expanded the therapeutic tools, which generated in them greater professional satisfaction by providing a more human and person-centered care, recognizing the need to incorporate this knowledge into the curricula of health careers.

La confianza en la relación profesional de la salud y paciente / Confidence in the health professional and patient relation

Introducción: Las condiciones crónicas de salud demandan un cuidado continuo con enfoque en el método clínico centrado en la persona, que incluye la relación médico-paciente como un elemento transversal, siendo la confianza el eje principal. Esta confianza podría mediar entre el manejo de las condiciones crónicas de los pacientes y sus efectos. Objetivo: Identificar el efecto de la confianza en la relación paciente-proveedor de salud en los diversos contextos de salud. Métodos: Se efectuó una revisión crítica de la literatura durante los meses de junio a agosto del 2017, para comprender el rol de la confianza en la relación entre el paciente-proveedor de salud y su relación con los resultados en salud. La búsqueda inicial fue con las palabras clave: confianza, médico, proveedor de salud, paciente y sus variantes en inglés y francés, en las bases de datos electrónicas JSTOR (Filosofía), Race Relations Abstracts, SocIndex with Full Text, Social Science Database, PubMed Central, CINAHL, Nursing & Allied Health Database, Web of Science, Academic Search Complete y ProQuest Central. Se aplicaron diferentes estrategias de búsqueda con las palabras claves y el operador boleano AND. Conclusiones: La confianza es una variable de la relación paciente-proveedor de salud que tiene un rol estratégico en los procesos terapéuticos. De ahí que sea fundamental considerarla como parte de la atención en salud, en especial como una instancia de colaboración y compromiso del paciente con su salud. Por lo que se hace necesario crear instrumentos que midan esta variable de acuerdo a las características culturales de los países latinoamericanos y que se extienda a todos los que tienen un rol asistencial en el contacto directo con el paciente(AU)

ABSTRACT Introduction: Health's chronic conditions demand continuous care with an approach to the clinical method focused in the person, which includes physician-patient relation as a cross-sectional element where confidence is the core. This confidence would mediate between the management of the patient's chronic conditions and their effects. Objective: To identify the effect of confidence in health provider/professional-patient relation in different health contexts. Methods: It was carried out a critical review of related literature from June to August, 2017 in order to understand the role of confidence in health provider- patient relation, and its relation with the results in health. The initial search was with the keywords: ´confidence, physician, health provider, patient and their equivalents in English and French, in the electronic databases JSTOR (Philosophy), Race Relations Abstracts, SocIndex with Full Text, Social Science Database, PubMed Central, CINAHHL, Nursing & Allied Health Database, Web of Science, Academic Search Complete and ProQuest Central. There were carried out different search strategies with the keywords and the boolean operator AND. Conclusions: Confidence is a variable of the atient-health provider relation that has a strategic role in therapeutic processes. Then, it is important to consider it as a part of health care, specially as a point of collaboration and commitment of the patient with his/her health. Thus, it is necessary to create instruments that measure this variable in accordance with the cultural characteristics of Latin American countries and this can be extended to all having a care role in the direct contact with patients(AU)

Perceptions on Connecting Respite Care Volunteers and Caregivers.

The most common requirement for informal caregivers is to experience a respite or temporary break from their caregiving routine. Some initiatives have been undertaken to provide respite care through volunteer providers. We report on a qualitative study carried out in Santiago, Chile, to learn about the willingness of potential volunteers to provide respite care for bedridden older persons, as well as their willingness to use information and communication technologies (ICT) to connect to caregivers in a low-income neighbourhood within their own geographic district. A trustworthy institution that mediates the volunteer-caregiver relationship is considered to be important by potential volunteers. Potential volunteers were found to be willing to use ICT to provide respite care, sharing basic information about themselves. However, they were also aware of the digital skill gap that may exist between them and the caregivers and were distrustful of unknown websites that could connect them to care recipients.

Care during Breastfeeding: Perceptions of Mothers and Health Professionals.

OBJECTIVES: To know the perceptions of mothers and health professionals in relation to the care provided and received during breastfeeding at primary health care level. METHODS: A qualitative exploratory study was conducted with breastfeeding mothers (10) and primary health care professionals (24). Data was gathered through in-depth interviews and focus groups. Data analysis was performed through thematic content analysis. The rigor of the study was ensured by the Guba and Lincoln criteria for qualitative research. Ethical aspects were addressed through the informed consent process, confidentiality, and methodological rigor. RESULTS: The experience of providing/receiving breastfeeding support was revealed as a dynamic, multidimensional care and support process, through three central themes: 1. Influence of previous care and support experiences during the breastfeeding process; 2. Importance of the context within which care is framed; and 3. Addressing emotions to establish trust between professionals and mothers. CONCLUSIONS: The study findings contribute to further understanding a complex phenomenon, such as breastfeeding support and care for mothers/families, from the experience of the actors involved, deepening the experiences of both in integrated manner. In addition, the relational, organizational, and contextual dimensions that influence support, and that should guide care, are also highlighted.

Care during Breastfeeding: Perceptions of Mothers and Health Professionals

Abstract Purpose. To know the perceptions of mothers and health professionals in relation to the care provided and received during breastfeeding at primary health care level. Methods. A qualitative exploratory study was conducted with breastfeeding mothers (10) and primary health care professionals (24). Data was gathered through indepth interviews and focus groups. Data analysis was performed through thematic content analysis. The rigor of the study was ensured by the Guba and Lincoln criteria for qualitative research. Ethical aspects were addressed through the informed consent process, confidentiality, and methodological rigor. Results. The experience of providing/receiving breastfeeding support was revealed as a dynamic, multidimensional care and support process, through three central themes: 1. Influence of previous care and support experiences during the breastfeeding process; 2. Importance of the context within which care is framed; and 3. Addressing emotions to establish trust between professionals and mothers. Conclusion. The study findings contribute to further understanding a complex phenomenon, such as breastfeeding support and care for mothers/families, from the experience of the actors involved, deepening the experiences of both in integrated manner. In addition, the relational, organizational, and contextual dimensions that influence support, and that should guide care, are also highlighted.

Resumen Objetivo. Conocer las percepciones de madres y profesionales de salud en relación con los cuidados que se brindan y que reciben durante el proceso de amamantamiento en el nivel primario de atención. Métodos. Estudio cualitativo exploratorio realizado en Santiago (Chile) con la participación de 10 madres en proceso de lactancia y 24 profesionales de la salud. La recolección de datos se realizó a partir de entrevistas en profundidad y grupos focales. El análisis de la información se obtuvo mediante el análisis de contenido temático. El rigor de la investigación se guardó con los criterios de Guba y Lincoln. Los aspectos éticos se abordaron mediante el proceso de consentimiento informado, confidencialidad y rigor metodológico. Resultados. La experiencia de brindar y recibir apoyo durante el proceso de amamantamiento se develó como un proceso de cuidado y apoyo dinámico, multidimensional, a partir de tres temas centrales: Influencia de las experiencias previas de cuidado y apoyo durante el proceso de amamantamiento; Importancia del contexto en el que se enmarca el cuidado; y Abordaje de las emociones para el establecimiento de la confianza entre profesionales y madres. Conclusión. Las percepciones de madres y profesionales de salud en relación a los cuidados que se brindan y que reciben durante el proceso de amamantamiento son un fenómeno con dimensiones contextuales, organizacionales y relacionales que influyen en el apoyo, por lo que deberían orientar el cuidado.

Resumo Objetivo. Conhecer as percepções de mães e profissionais de saúde em relação aos cuidados que se brindam e recebem durante o processo de amamentação no nível primário de atenção. Métodos. Estudo qualitativo exploratório realizado em Santiago (Chile) com a participação de 10 mães em processo de amamentação e 24 profissionais da saúde. O recolhimento de dados se realizou através de entrevistas em profundidade e grupos focais. A análise da informação se obteve através da análise de conteúdo temático. O rigor da investigação se cautelou por meio dos critérios de Guba e Lincoln. Os aspectos éticos se abordaram mediante o processo de consentimento informado, confidencialidade e rigor metodológico. Resultados. A experiência de brindar e receber apoio durante o processo de amamentação se revelou como um processo de cuidado e apoio dinâmico, multidimensional, através de três temas centrais: Influência das experiências prévias de cuidado e apoio durante o processo de amamentação; Importância do contexto no qual se enquadra o cuidado; e Abordagem das emoções para o estabelecimento da confiança entre profissionais e mães. Conclusão. As percepções de mães e profissionais de saúde em relação aos cuidados que se brindam e recebem durante o processo de amamentação são um fenômeno com dimensões contextuais, organizacionais e relacionais que influem no apoio e que deveriam orientar o cuidado.

Experiencia de participar en un programa de apoyo al trabajador/cuidador familiar de adultos mayores dependientes / Experience of participating in support program for working/family caregivers of a disabled elder

Introducción: El envejecimiento poblacional aumenta el riesgo de tener dependencia y con ello demandar cuidados. Las familias son quienes principalmente cuidan a sus mayores, teniendo también que asumir responsabilidades laborales. El doble rol como trabajador y cuidador se convierte en un factor de riesgo para su propia salud. Objetivo: Generar conocimiento comprensivo acerca de la experiencia vivida de participar en un programa de apoyo al trabajador/cuidador familiar de un adulto mayor dependiente, ofrecido en el espacio laboral. Metodología: estudio cualitativo fenomenológico. Se realizaron 14 entrevistas semiestructuradas a personas que participaron en al menos un 70% de los talleres del "Programa de apoyo al trabajador/ cuidador familiar", y que eran cuidadores primarios o secundarios de un adulto mayor dependiente. Se entrevistó hasta cumplir con el criterio de saturación de resultados. El análisis se realizó a través del método propuesto por Streubert y cols. Resultados: se develaron tres categorías comprensivas: apoyo institucional para el fortalecimiento del trabajador/ cuidador, necesidades de cuidado del cuidador y multiplicidad de roles. Conclusiones: Los participantes reconocen el programa de apoyo a cuidadores familiares como un gesto de preocupación, solidaridad y empatía a través del cual la institución demuestra el valor que tienen sus empleados y una forma de validarlos como seres humanos trascendentes y multidimensionales

Background: The aging population process increases the risk of dependency and thus, it demands special care. Family members have primarily taken care of the elderly, also attending to their working responsibilities. This double-role, as worker and caregiver becomes a risk factor for their own health. Aim: To generate comprehensive knowledge about the lived experience of worker/ caregivers of dependent elderly relatives, who participate of a support program offered by the employer in the workplace. Methodology: Phenomenological qualitative study. semi-structured interviews were carried out with individuals who participated in at least 70% of the support program's workshops. To take part on the study, these individuals had to be the primary or secondary caregiver of a dependent elderly relative. Fourteen interviews were conducted and analyzed until data saturation was reached. Then, data was analyzed through a method suggested by Streubert et al. Results: Three comprehensive categories were found: Institutional support for worker/caregiver strengthening, the Worker/caregiver needs, and the Multiplicity of roles. Conclusions: Participants recognize the support program delivered by their employer as a sign of concern, solidary and empathy towards them. Through it, the institution shows appreciation for its employees, and recognizes them as transcendental and multidimensional human beings

Adaptando mi vida: vivencias de cuidadores familiares de personas con enfermedad de Alzheimer / Adapting my life: experiences of caregivers of people with Alzheimer's disease

La enfermedad de Alzheimer (EA) es una de las demencias más comunes y afecta al 8% de la población mayor de 65 años y al 30% de la población mayor de 80 años en los países con una alta expectativa de vida. Esta enfermedad es devastadora tanto por el deterioro progresivo de la persona que la presenta como por el impacto que produce en la familia, en la que habitualmente la responsabilidad de ser el "cuidador principal" recae sobre uno de sus integrantes. Objetivo: conocer la experiencia de ser cuidador principal de un familiar con EA y sus necesidades de cuidado. Metodología: se utilizó un diseño cualitativo fenomenológico. Resultados: se entrevistaron 8 cuidadores familiares de personas con EA. La vivencia de los cuidadores se develó en seis categorías comprensivas interrelacionadas entre sí: Inicio de los síntomas y búsqueda de un diagnóstico; Impacto de la enfermedad; Adaptación; Perfil del cuidador; Necesidad de no perder la esencia de la persona y Devolviendo la esperanza. Conclusión: Las categorías comprensivas dan cuenta de un proceso que viven los cuidadores desde el inicio de los síntomas hasta la adopción de su rol como cuidador. Este conocimiento podría aportar información para generar programas de atención innovadores que permitan acompañar a los cuidadores y su familia en el proceso de cuidados que requieren las personas con EA, para de esa manera contribuir a mejorar su calidad de vida, la de su familia y la del familiar a su cuidado

Alzheimer's disease (AD) is one of the most common dementias and affects 8% of the population over 65 years and 30% of the population over 80 years, in countries with a high life expectancy. This disease is devastating because of the progressive deterioration of the person who presents it and the impact it has on the family, in which the responsibility of being the "primary caregiver" usually falls to one of its members. Objective: To know the experience of being a primary caregiver of a family member with AD and their care needs. Methodology: A phenomenological qualitative design was used. Results: 8 family caregivers of people with AD were interviewed. The caregivers' experience was revealed in six interrelated comprehensive categories: Start of symptoms and search for a diagnosis; Impact of disease; Adaptation; Caregiver profile; Need to not lose the essence of the person and giving back hope. Conclusion: Comprehensive categories account for a process that carers live from the onset of symptoms to the adoption of their role as caregiver. This knowledge could provide information to generate innovative care programs to accompany caregivers and their families in the care process required by people with AD, in order to contribute to improve their quality of life, their family's and to the person to his/her care

Del autocuidado al automanejo: La escuela de enfermería UC en la vanguardia del cuidado crónico / From self-care to self-management: UC nursing school in the forefront of chronic care

Se propone una reflexión sobre el desafío que representa el cuidado de personas con condiciones crónicas de salud (CC) en la atención de salud y la incorporación del constructo "Apoyo al Automanejo " como parte de la formación profesional y a su vez, cómo este desafío ha sido asumido por la Escuela de Enfermería UC. Se apoya esta propuesta, en el escenario epidemiológico actual de las condiciones crónicas de salud, especialmente de las enfermedades no transmisibles y los limitados resultados alcanzados con el modelo actual de atención, con los consecuentes efectos en las personas y familias. Se discute sobre el déficit de preparación en el equipo de salud para afrontar la complejidad de la situación. Se revisa la trayectoria de la Escuela de Enfermería en el ámbito de formación e investigación en autocuidado de la salud y su relación y evolución hacia el apoyo al automanejo como parte integral del Modelo de Cuidados Crónicos que es la estrategia definida por el Ministerio de Salud para enfrentar esta situación y se releva el rol de la Escuela al ser reconocida como Centro Colaborador OMS-OPS para el Desarrollo de Servicios de Salud y Enfermería para el Cuidado en Enfermedades No Transmisibles.

We propose a reflection on the challenge of caring for people with chronic health conditions (CC) and the incorporation of "Supporting Self-Management" concept in the undergraduate program. Also there is a comment on how this challenge has been assumed by the UC School of Nursing. This approach is based on the current epidemiological scenario of chronic health conditions, particularly non-communicable diseases and the limited results achieved with the current model of care, with consequent effects on individuals and families diseases. It discusses the deficit of preparation for health teams to deal with the complexity of the situation. The trajectory of the School of Nursing is reviewed in the field of training and research in self- care and their relationship and evolution towards self-management support as an integral part of the Chronic Care Model which is the strategy defined by the Ministry of Health to deal with this situation and the role of the School is relieved to be recognized as WHO-PAHO Collaborating Center for the Development of Health Services and Nursing in non communicable diseases.

Programa de apoyo al trabajador-cuidador familiar: fenómeno social emergente / A Program to Support Family Worker-Caregivers: An Emerging Social Phenomenon / Programa de apoio ao trabalhador-cuidador familiar: fenômeno social emergente

En el contexto demográfico actual de envejecimiento poblacional surge un nuevo rol: el funcionario-cuidador. La persona que trabaja y, además, cuida a un familiar con discapacidad, presenta problemas personales, laborales y menor compromiso con su autocuidado. Entre las intervenciones eficaces se encuentra el mejorar la percepción del apoyo social. Se presenta un programa interdisciplinario, iniciado en el año 2009, de apoyo a trabajadores-cuidadores familiares. Su propósito es promover la salud y prevenir factores de riesgo de enfermedad a través del fortalecimiento de sus habilidades de autocuidado y el desarrollo de políticas institucionales que faciliten el cumplimiento de ambos roles en forma eficiente y saludable. Como estrategias de promoción en salud se han utilizado: la educación para el autocuidado, el fortalecimiento de redes de apoyo familiar y social, la asesoría profesional y la comunidad de pares. En las últimas tres cohortes anuales han participado sesenta funcionarios, de los cuales el 83,4% son mujeres, con un promedio de edad de cincuenta años. El programa ha cumplido con éxito los objetivos propuestos, aumentando la percepción de apoyo social manifestado por los propios participantes.

A new role has emerged within the current demographic context of an aging population; namely, that of the worker-caregiver. The person who works and also cares for a disabled family member has personal and work-related problems and is less committed to their own self-care. Improving the perception of social support can be an effective intervention in this respect. The article describes an interdisciplinary program initiated in 2009 to support family workers-caregivers. Its purpose is to promote health and prevent disease risk factors by strengthening self-care skills and the development of institutional policies that facilitate efficient and healthy compliance with both roles. Some of the health promotion strategies that have been used include education for self-care, strengthening family and social support networks, professional counseling and a community of peers. Sixty workers took part in the last three annual cohorts: 83.4% were women, with an average age of fifty. The program has successfully met its proposed objectives by increasing the perception of social support expressed by the participants themselves.

No contexto demográfico atual de envelhecimento populacional, surge um novo papel: o funcionario-cuidador. A pessoa que trabalha e, além disso, cuida de um familiar com necessidades especiais apresenta problemas pessoais, laborais e menor compromisso com seu auto-cuidado. Entre as intervenções eficazes, encontra-se o melhorar a percepção do apoio social. Apresenta-se um programa interdisciplinar, iniciado em 2009, de apoio a trabalhadores-cuidadores familiares. Seu propósito é promover a saúde e prevenir fatores de risco de doenças por meio do fortalecimento de suas habilidades de autocuidado e o desenvolvimento de políticas institucionais que facilitem o cumprimento de ambos os papéis de forma eficiente e saudável. Como estratégias de promoção da saúde têm sido utilizados: a educação para o auto-cuidado, o fortalecimento de redes de apoio familiar e social, a assessoria profissional e a comunidade de pares. Nas últimas três coortes anuais, participaram 60 funcionários, dos quais 83,4% são mulheres, com uma média de idade de 50 anos. O programa tem cumprido com sucesso os objetivos propostos e, assim, tem aumentado a percepção de apoio social manifestado pelos próprios participantes.