Enfermeras y conocimiento de enfermería: Como fuerzas para lograr las Metas de Desarrollo Sostenible / Nurses and nursing knowledge: As forces for achieving Sustainable Development Goals / Enfermeiras e conhecimento de enfermagem: Como forças para atingir as Metas de Desenvolvimento Sustentável

Las Metas de Desarrollo del milenio 2000-2015 fueron el impulso para lograr mejoras significativas en el mundo, desde la disminución de la pobreza y las tasas de mortalidad maternoinfantil, hasta el incremento de tratamientos para infecciones como el VIH/sida y la malaria; desde la expansión del acceso a la educación y el empoderamiento de las mujeres, hasta el aseguramiento de la sustentabilidad ambiental. El profesional de enfermería tiene un contrato de facto con la sociedad. Ese contrato se refiere a proteger a las personas de las enfermedades, a colaborar para disminuir la degradación ambiental y la violencia; a mantener a la población saludable e incrementar su bienestar.

Women's work and symptoms during midlife: Korean immigrant women.

PURPOSE: To describe how Korean immigrant women tend to describe their work experiences within their daily lives and how they relate their work to the symptoms experienced during midlife. DESIGN: Cross-sectional study using methodological triangulation. Using a convenience sampling method, 119 Korean immigrant women were recruited for the quantitative phase, and 21 among the 119 women were recruited for the qualitative phase. Data were collected using both questionnaires and in-depth interviews. The data were analyzed using descriptive and inferential statistics and thematic analysis. FINDINGS AND DISCUSSIONS: The symptoms that the women experienced during midlife were influenced by their work experience, which was complicated by their cultural heritage, gender issues embedded in their daily lives, and immigration transition. IMPLICATIONS: Complexities and diversities in women's work need to be incorporated in menopausal studies.

Role integration and perceived health in Asian American women caregivers.

In this study, role involvement, role integration (including role stress and role satisfaction), and perceived health were examined in 50 Asian American women who were caregivers of aging parents in addition to being wives, mothers, and employees. Their mean age was 47.8 years. Twenty-nine of the participants were Chinese and 21 Filipino, with an average length of caregiving for each group of 11 years. All participants were born outside the United States. Instruments used in the study were translated and back-translated into Chinese and Tagalog and tested for validity and reliability. The association of role involvement, role integration, role stress, and role satisfaction with perceived physical and psychological health in the combined and separate groups was examined. Role involvement was not associated with health in the combined group of caregivers but was associated with overall health in the sample of Chinese women. Role integration was positively associated with all three perceived health measures in the Filipino group but not in the Chinese group. Role satisfaction was consistently high in both groups. Role satisfaction and psychological well-being were significantly correlated for the combined group and for the Filipino caregivers. Total role stress was significantly correlated with overall health and current health only in the combined group. Thus, support that helps to decrease role stress and to increase role satisfaction may be more effective than efforts to decrease the extent of role involvement.

An international imperative for gender-sensitive theories in women's health.

PURPOSE: To propose gender-sensitive theories as a future direction for theoretical development of women's health. Few theories pertain to women's health and illness experiences, with gender issues embedded in social, cultural, and historical contexts. ORGANIZING CONSTRUCT: Significance, definition, and philosophical bases of gender-sensitive theories. FINDINGS: Six major components should be incorporated in the development of gender-sensitive theories: (a) gender as a major feature, (b) women's own words and experiences, (c) nature of women's experiences, (d) theorists' perspectives, (e) contexts, and (f) guidelines for actions. CONCLUSIONS: We believe that the development of gender-sensitive theories in nursing could enable researchers to transcend androcentric and ethnocentric views on women's health, decrease gender inequity in health care, enhance women's well being, and ultimately contribute to knowledge development in nursing.

Experiencing transitions: an emerging middle-range theory.

Changes in health and illness of individuals create a process of transition, and clients in transition tend to be more vulnerable to risks that may in turn affect their health. Uncovering these risks may be enhanced by understanding the transition process. As a central concept of nursing, transition has been analyzed, its components identified, and a framework to articulate and to reflect the relationship between these components has been defined. In this article, the previous conceptual analysis of transitions is extended and refined by drawing on the results of five different research studies that have examined transitions using an integrative approach to theory development. The emerging middle-range theory of transitions consists of types and patterns of transitions, properties of transition experiences, facilitating and inhibiting conditions, process indicators, outcome indicators, and nursing therapeutics. The diversity, complexity, and multiple dimensionality of transition experiences need to be further explored and incorporated in future research and nursing practice related to transitions.

A study of the spousal role of Egyptian women in clerical jobs.

More women are seeking outside employment worldwide. However, the spousal role with all that it entails remains a significant core for women, particularly in developing countries. How women experience this role when they are also employed in low-income jobs has not been uncovered adequately. One hundred and ninety Egyptian women who are employed in clerical jobs were asked about the satisfaction and the stress they experience in their spousal role. The study's participants described the centrality of their spousal role in their life and discussed how fulfilling the needs and the expectations of their husbands were most significant for them. Their role in creating harmony in the family and the extent to which they were able to succeed in achieving this goal also were cited as the most significant aspects of their spousal relationship. Another satisfying part of their marital life was having children. On the other hand, their husbands' demanding behavior, the way the husbands express their demands, the husbands' abuse, and the participants' constant feeling of el masooliah, or their "sense of overload from responsibilities," were some of the stresses described by the participants. They also perceived a gap in the values that they and their husbands hold. This gap was most constraining to some of the participants. The participants coped by enduring the stress. This begs the question of what societal values keep women in less than satisfying relationships. The findings are discussed within a framework of societal norms and values expectations that reinforce women's commitment and endurance of spousal stress.

Cultural competence of measurement scales of menopausal symptoms: use in research among Korean women.

Even though there are advancements in research related to culturally competent care, there is an increasing realization that coherent theories and a research base to guide health care that is culturally competent is yet to be fully developed. In this paper, cultural competence of the scales measuring menopausal symptoms are critically analyzed in light of their limitations for Korean women--a population other than for whom it was developed. The analyses indicate that there are issues of contextuality, relevance, communication style, authenticity, power relationships and time constraints.

A feminist critique of research on menopausal experience of Korean women.

Despite the increasing number of studies on the menopausal experience of Asian women, the focus of the studies has been on simple comparisons of their symptoms with Western women's and other disease-oriented research topics. To propose directions for future research on menopause, we analyzed and critiqued 158 studies on the menopausal experience of a group of Asian women-Korean women. The studies were retrieved through a search of computerized databases in the United States and South Korea, and they were reviewed, analyzed, and critiqued with a feminist perspective. Many of the studies have problems with (a) conceptualization, including ethnocentric and androcentric views of menopause, biomedical perspectives, and language difficulties; (b) research methods, such as inadequate instruments, passive relationships between researchers and research participants, culturally inappropriate communication styles, inadequate study designs, and homogeneous research participants; and (c) interpretation and communication of study findings. These issues undermine the conclusions drawn about the nature of the menopausal experience of Korean women.

Symptom experience during menopausal transition: low income Korean immigrant women.

The symptoms experienced during menopausal transition of a vulnerable group of women, low income Korean immigrants, are described in this paper. The findings demonstrated that (a) the types of the symptoms that the women reported were different from those reported by Western women; (b) the women tended to normalize their symptoms; and (c) their symptom experience was influenced by immigration transition and its contextual variables. We suggest that symptom experience of immigrant women during menopausal transition be understood within the contexts of their immigration transition, and that their own views of normality of the menopausal transition be respected.

A situation-specific theory of Korean immigrant women's menopausal transition.

PURPOSE: To extend the previous model of transitions by including the experiences of low-income Korean immigrant women in the United States during their menopausal transition. The extension results in a situation-specific theory of Korean immigrant women's menopausal transition. DESIGN: Findings from a study of menopausal transition among Korean immigrant women were used as a main source for modification of the conceptual properties of transitions, conditions shaping the transitions, and indicators of healthy transitions. The study was cross-sectional with methodologic triangulation. Quantitative analysis was based on data from 119 first-generation Korean immigrant women who engaged in low-status or low-income work outside their homes; qualitative study using theoretical sampling method included 21 women. METHODS: Analyses included descriptive and inferential statistics and thematic analysis. Integrative conceptual analysis using deductive and inductive reasoning was conducted to determine modifications in theory based on the descriptions of menopausal transition of Korean immigrant women. FINDINGS: Three main themes were identified: (a) the women gave their menopausal transition far less attention than they did to their immigrant and work transition; (b) menopause was a hidden experience in cultural background; and (c) the women "normalized," ignored, and endured symptoms. The findings indicated additions of the following concepts: (a) number, seriousness, and priority of transitions; (b) socioeconomic status; (c) gender; (d) context; (e) attitudes toward health and illness; (f) interrelationships among all conditions shaping transitions; and (g) symptom management. CONCLUSIONS: The proposed situation-specific model is limited in scope. However, it provides understanding of the menopausal transition of Korean immigrant women in context, and is a guide for nursing interventions for immigrant women experiencing transition.

Situation-specific theories: philosophical roots, properties, and approach.

It is imperative to further develop theoretical bases in nursing, which incorporate diversities and complexities in nursing phenomena, and which consider sociopolitical, cultural, and historic contexts of nursing encounters. Situation-specific theories are proposed in this work as a future direction of such theoretical bases in nursing. Philosophical roots and properties of situation-specific theories are discussed, and an integrative approach to developing this type of theories is suggested. Situation-specific theories could be based on the assumptions of post-empiricism, critical social theory and feminism, and or hermeneutics. Six properties of situation-specific theories are presented: (1) low level of abstraction, (2) reflection of specific nursing phenomena, (3) context, (4) connection to research and/or practice, (5) incorporation of diversities, and (6) limits in generalization. The proposed integrative approach to developing situation-specific theories includes (1) a nursing perspective, (2) a linkage among theory, research, and practice, and (3) a conceptual scheme based on internal and external dialogues.

Transcending marginalization in knowledge development.

Quality care requires a body of knowledge that reflects the experiences and the responses of the marginalized populations to health and illness, and requires demarginalization of nursing knowledge. We argue the significance of developing an understanding of people who are marginalized, and organize our arguments and discussions into four sections: (i) developing knowledge that is not marginalizing; (ii) developing knowledge about marginalized populations; (iii) integrating nursing knowledge and making it visible; and (iv) the future of research enterprise. We propose that nurses critically consider strategies and processes to deal with and transcend marginalization of populations and of nursing knowledge.

ReVisions in knowledge development: a passion for substance.

Members of the nursing community have been engaged in numerous debates, some of which are related to the roles of holism and particularism in the care of clients and in the development of nursing knowledge. Others center on most and least congruent methodologies for nursing research, These healthy debates have played a significant role in invigorating the discipline of nursing. If they continue without special attention to nursing's substance, however, they may detract from its knowledge development. By refocusing the debates on substance, that is, on the major phenomena and theoretical propositions considered central to nursing, progress in the development of nursing knowledge will be enhanced. Other reVisions include co-opting some existing methods in knowledge development that are congruent with feminist approaches and not limited to certain strata of populations or certain nations, thus highlighting international nursing as an arena for the generation of gender-sensitive and culture-sensitive theories. Finally, the commitment to reVisions in knowledge development means a personal commitment of nursing scholars to health care in general and to the discipline of nursing in particular.

Taiwanese patients' concerns and coping strategies: transition to cardiac surgery.

OBJECTIVE: To explore patients' concerns during the admission transition to cardiac surgery. DESIGN: A descriptive qualitative design. SETTING: Four hospitals in northern Taiwan, Republic of China. PATIENTS: A purposive sample consisting of 40 adult patients (20 men and 20 women) who planned to have cardiac surgery. Age range was 20 to 70 years (mean 50.1 years). OUTCOME MEASURES: The types, levels, components, coping strategies, context, and conceptual framework of patients' concerns. INTERVENTION: Data were collected through semistructured interviews, and then analyzed using qualitative content analysis. RESULTS: Ninety percent of subjects (N = 36) reported two types of concerns: certain (80%) and uncertain (10%). Their certain concerns reflected three levels of concerns: "Caring about" or "Thinking about" (52%); "Worrying about" or "Being afraid of" (43%); and "Experiencing a mortal fear of" (30%), ordered from the weakest to the strongest. The components of patients' concerns were the process of recovery; hospital experiences, including maintaining daily activities, pain at admission, and expectant discomforts and disabilities in the intensive care unit; death; unfinished responsibilities and life goals, significant persons, and places; financial needs; and poor quality of care. Strategies developed to manage their concerns included (1) The use of person-focused effort (both cognitive and psychomotor), (2) Seeking help from others, including family members, friends, other patients, and health professionals, and (3) Turning to metaphysical power. The context for the phenomenon of Taiwanese subjects' concerns concerning cardiac surgery during the admission transition were "Being a person," resuming normality, and empowerment of self. CONCLUSION: The types, levels, components, and coping strategies of patients' concerns during the admission transition to cardiac surgery were discovered and delineated. The background context and conceptual framework for the phenomenon also were developed from the data analysis to describe and depict this phenomenon.

Helpseeking for self-discovered breast symptoms. Implications for early detection.

PURPOSE: Most breast cancer symptoms are discovered by women themselves, and at least one third of these women will be aware of their symptoms for 3 months or more before seeking an initial provider evaluation. The authors identify personal, social, and environmental influences on women's intention to seek an immediate provider evaluation (helpseek) versus to delay evaluation of a breast symptom that worried them. DESCRIPTION OF STUDY: Black women (N = 352) from the San Francisco Bay are women's organizations, community settings, and churches formed this convenience sample. Participants ranged across age, income, and educational levels. The survey contained 10 scales that measured health behavior variables, including new and existing scales augmented by items derived from prior interview and focus group investigations. RESULTS: Women of younger age and lower income were significantly less likely to intend to seek an evaluation for self-discovered breast symptoms. Single and partnered women were less likely to seek a provider evaluation than married or widowed women. Perceiving negative consequences of delaying, having previous habits of healthcare utilization, perceiving access to services, and feeling fearful were positively related to the intention to seek evaluation of breast symptoms. Holding fatalistic beliefs about getting breast cancer or dying and perceiving constraints to seeing a provider negatively influenced helpseeking intention. Racism in the healthcare delivery system was perceived, but was not a significant influence on helpseeking intention. A multiple linear regression model containing these variables explained 46% of the variance in helpseeking intention. CLINICAL IMPLICATIONS: This study shows that the intent to helpseek is not merely a matter of education and economics, but is dependent on a complex picture of personal, social, and economic factors. Gynecologic and primary care providers should consider this and the potential influences on helpseeking in the women for whom they provide cancer screening and early detection services. History taking should be expanded to assess women's ideas about the consequences of delaying evaluation of self-discovered breast symptoms, their sense of vulnerability to breast cancer, the constraints on cancer early detection they may be feeling related to role obligations, their economic or strategic limitations to accessing services, the pressures they may feel to hide a breast cancer symptom, or their own tendency to interpret the breast symptom as not threatening. Healthcare providers should not assume that helpseeking for breast symptoms is an automatic behavior for all women. Rather, providers should assess whether a women is the one in three who will delay the evaluation of a breast cancer symptom she discovers herself for months or years.

Auxiliary nurses in Mexico: impact of multiple roles on their health.

As more women worldwide enter the labor force, debate has been generated over how this additional work role influences women's health. In this study, we explored the work, maternal, and spousal roles of 59 auxiliary nurses in two university-affiliated Mexican hospitals. Participants completed questionnaires that included demographics, a women's roles interview protocol, a self-rating of health status, and the Cornell Medical Index (CMI). No significant correlation was found between the perception of their health status and the number of roles, amount of role involvement, or their perceived levels of stress and satisfaction in any of their three roles. Work stress was significantly correlated with the number of physical symptoms (r = .30, p < .05), longer periods of standing (r = .31, p < .05), more muscle strain (r = .53, p < .01), eye problems (r = .43, p < .01), frequent changes in environmental temperature (r = .30, p < .05), and perceptions of economic inadequacy (r = .37, p < .01). Years of education was not related to any health measure or degree of stress or satisfaction in any of the roles. The greater the degree of role integration, that is, the greater the sum of satisfactions minus stresses of each role, the fewer the physical symptoms (r = .48, p < .05) and the fewer total symptoms (r = .43, p < .05) reported on the CMI. Those with more spousal stress reported more work-related muscle strain (r = .35, p < .05), and working mothers with three or more children tended to perceive themselves as less healthy (r = .75, p < .01). Thus, analyzing the interrelationship of women's multiple roles is a better predictor of health than examining specific role stresses in isolation.