Percepciones y deseos sobre el parto en gestantes a término en Zamora / Perceptions and wishes about delivery of full-term pregnant women in Zamora

OBJETIVO: Describir las percepciones y deseos sobre el parto en un grupo de gestantes a término de Zamora. MÉTODO: Estudio cualitativo de carácter fenomenológico. Participantes y ámbito de estudio: embarazadas de 37-38 semanas, centros de salud Zamora Sur y Santa Elena (Zamora). Recogida de datos: entrevistas semiestructuradas, hasta llegar a saturación de datos (16 entrevistas). Análisis de datos: análisis de contenido temático. RESULTADOS: Los sentimientos maternos variaron desde la alegría hasta el miedo o el estrés. Las entrevistadas manifestaron no sentirse capaces de soportar el dolor del parto. Las necesidades que sintieron como más importantes fueron contar con apoyo y acompañamiento en el parto (sobre todo de su pareja) y recibir buen trato de los sanitarios. CONCLUSIONES: La importancia y la repercusión del parto para la mujer no solo atiende al ámbito biológico, sino en gran medida también al mental, al emocional y al social. En él intervienen múltiples factores que lo condicionan: los sentimientos maternos, su capacidad de afrontar el dolor del parto, sus necesidades, sus cambios realizados, el apoyo con el que cuentan y los profesionales sanitarios que atienden a la mujer

OBJECTIVE: To describe perceptions and wishes regarding childbirth in a group of full-term pregnant women in Zamora. METHOD: Qualitative study of phenomenological character. Participants and scope of study: pregnant women (37-38 weeks), Zamora Sur and Santa Elena health centres (Zamora, Spain). Data collection: semi-structured interviews, until data saturation (16 interviews). Data analysis: analysis of thematic content. RESULTS: The maternal feelings varied from joy to fear or stress. The interviewees said they did not feel capable of enduring the pain of childbirth. The needs that they felt most important were having support and accompaniment during delivery (especially of their partner) and receiving good treatment from the healthcare workers. CONCLUSIONS: The importance and repercussion of childbirth for women are not only biological, but also largely mental, emotional and social. It is conditioned by multiple factors: maternal feelings, their ability to deal with the pain of childbirth, their needs, the changes they have made, the support they have and the health professionals who care for them

Acompañamiento a la familia del paciente crítico / Support to families of critically ill patients

Introducción. La hospitalización de la persona enferma genera en la familia ansiedad, estrés, etc. Los familiares, en esta situación, no tienen herramientas para afrontar la realidad y desatienden sus necesidades. Objetivo. Identificar la correlación entre las necesidades de la familia y las intervenciones enfermeras. Metodología. Se realizó una revisión bibliográfica en las bases de datos Pubmed, CINAHL, Cuidatge, Cuiden y ScienceDirect. Después de incluir los artículos que cumplían los criterios de selección, se seleccionaron 18 artículos. Resultados y discusión. En los artículos escogidos se analizaron las necesidades que genera la hospitalización de un familiar en la UCI, las actuaciones, intervenciones y propuestas de mejora que se proponen para satisfacer las necesidades y las limitaciones y reticencias que se producen en la práctica. Conclusiones. A pesar de que en la literatura se identifican las necesidades de la familia, los problemas que se plantean y las soluciones que se proponen, las enfermeras no integran estas necesidades en sus intervenciones (AU)

Introduction. The hospitalization of the sick person in the family creates anxiety, stress, etc... The families in this situation have no tools to face reality and ignore their needs. Objective. To identify the relationship between family needs and nursing interventions. Methods. We conducted a literature review in the databases Pub- Med, CINAHL, Cuidatge, Cuiden and ScienceDirect. After including items that meet the selection criteria were selected 18 items Results and discussion. In selected items were analyzed the necessities generated by the hospitalization of a family member in the ICU, performances, interventions and proposals for improvement that are proposed to meet the needs and constraints and reluctance that occur in practice. Conclusions. Although the literature identifies the needs of the family, the problems encountered and solutions proposed, the nurses do not integrate these needs into their operations (AU)

Plan integral de orientación en infección por VIH y SIDA / Comprehensive plan for HIV counseling and AIDS

El artículo presenta los pasos de orientación que debe dársele al usuario en el momento de realizar una prueba para la detección del VIH y SIDA, ya sea ésta positiva o negativa. Las personas que realizan las orientaciones deben prepararse emocionalmente antes de iniciar cualquier proceso de orientación para responder a las necesidades de información que el ususario necesite.

Hermann, Maurício Castejón / Hermann, Maurício Castejón

O livro que Maurício Hermann nos brinda é fruto de sua tese de doutorado em Psicologia Clínica, defendida na USP em 2008. Trata-se da formalização da experiência clínica como Acompanhante Terapêutico (AT) nos últimos 15 anos em suas andanças por São Paulo. Parte-se de um ponto importante, na medida em que não é um acompanhante qualquer: trata-se de um AT atravessado pela formação em psicanálise de orientação lacaniana e é em torno das considerações de Lacan a respeito da clínica das psicoses que edifica suas perguntas e suas hipóteses de trabalho

Hermann, Maurício Castejón

O livro que Maurício Hermann nos brinda é fruto de sua tese de doutorado em Psicologia Clínica, defendida na USP em 2008. Trata-se da formalização da experiência clínica como Acompanhante Terapêutico (AT) nos últimos 15 anos em suas andanças por São Paulo. Parte-se de um ponto importante, na medida em que não é um acompanhante qualquer: trata-se de um AT atravessado pela formação em psicanálise de orientação lacaniana e é em torno das considerações de Lacan a respeito da clínica das psicoses que edifica suas perguntas e suas hipóteses de trabalho

The use of a chaperone in obstetrical and gynaecological practice.

The aim of this study was to assess the use of a chaperone in obstetrical and gynaecological practice in Ireland and to explore patients' opinions. Two questionnaires were designed; one for patients and the other one was sent to 145 gynaecologists in Ireland. One hundred and fifty two women took part in this survey of whom 74 were gynaecological and 78 were obstetric patients. Ninety five (65%) patients felt no need for a chaperone during a vaginal examination (VE) by a male doctor. On the other hand 34 (23%) participating women would request a chaperone if being examined by a female doctor. Among clinicians 116 (80%) responded by returning the questionnaire. Overall 60 (52%) always used a chaperone in public practice, in contrast to 24 (27%) in private practice. The study demonstrated that most patients do not wish to have a chaperone during a VE but a small proportion would still request one regardless of the examiner's gender. Patients should be offered the choice of having a chaperone and their opinion should be respected and documented.

Medical chaperoning at a tertiary care hospital in Saudi Arabia: survey of physicians.

BACKGROUND: Medical chaperones (MC) are underutilised. The influence of Islamic culture on the use of MC is not known. AIM: To examine physicians' use and perception of MC in Islamic culture. SETTING: A major tertiary care hospital in Saudi Arabia. METHODS: 315 self-administered questionnaires were distributed to attendees of grand rounds of 13 departments. RESULTS: 186 (59%) questionnaires were completed. 64.5% of the respondents were 30-49 years old, 75.8% were men and 31.2% were in training; 79% had a clinic load of under 50 patients per week and 47.8% had postgraduate training (PGT) in an Islamic country. MC were reported to be infrequently (< or =25% of the time) used by 44.1% (69.2% female vs 39% male physicians, p = 0.001; 58.6% in training vs 36.8% attending, p = 0.007; 52.1% PGT in Islamic vs 35.6% in western countries, p = 0.027), offered by 52.7% (78.9% female vs 46.8% male physicians, p<0.001) and requested by 79% of patients. MC were reported to be commonly (>75% of the time) used, offered by physicians and requested by patients by 38.2%, 29% and 7.5% of respondents, respectively. The most frequently cited reasons for not using MC were privacy/confidentiality (36.6%) and understaffing (30.5%). Equal numbers of respondents perceived MC use as a protection for physicians or patients (67.7% and 65.6%, respectively). CONCLUSIONS: MC are underutilised even in Islamic culture, especially among female physicians. Training in western countries is favourably associated with MC use. Underutilisation appears to be related to privacy/confidentiality, understaffing and failure of patients to request a MC.

Patients' attitude towards the use of a chaperone in breast examination.

INTRODUCTION: The aim of this study was to assess the attitude and the preferences of patients towards the use of a chaperone during breast examination. PATIENTS AND METHODS: A two-part questionnaire was circulated among 204 consecutive new patients, attending both symptomatic breast and screened assessment clinics. RESULTS: A total of 200 questionnaires were fully completed and returned. Although 104 (52%) patients felt that they did not need a chaperone during breast examination, 65 (33%) preferred to have one. Amongst these 65 patients, the majority (52%) wanted a chaperone in the presence of both a male and female doctor whereas 19 (29%) wanted a chaperone in the presence of a male doctor. When patients were asked which person would be the best chaperone for them, 63 patients (32%) preferred their spouse to act as a chaperone, whereas 57 (29%) preferred a clinic nurse. However, the majority of teenagers and young adults (10-30 years) preferred their parents to act as a chaperone. On asking the reason for preferring a chaperone during breast examination, 69% felt a chaperone helped them to feel more at ease, 28% felt they get more support, 23% get less embarrassed and 10% felt safer. The majority (54%) preferred the nurse to offer a chaperone instead of the doctor (22%). Patients generally said they were comfortable in asking for a chaperone (68%). Overall, 68% of patients considered the offer of a chaperone as a sign of respect and the majority felt the attitude (32%) and gender (20%) of the clinician are the two most important factors influencing the chaperone use. Most patients were of the opinion that the presence of a chaperone does not have a negative effect on the doctor-patient relationship (75%), patient confidentiality (74%) and do not cause embarrassment (68%). Following their assessment in clinic, the patients' views on the use of a chaperone were not significantly changed. CONCLUSIONS: There is a wide variety of opinion among patients about the desirability of a chaperone during breast examination. However, the majority consider the offer of a chaperone as a sign of respect and many patients commented that the presence of a chaperone is important for medicolegal protection of both patient and clinician. In recent years, there has been an increasing call from medicolegal societies and medical insurance companies for greater use of chaperones during intimate examinations. We feel that recommendations regarding the use of a chaperone should now be incorporated into the British Association of Surgical Oncology guidelines.

Postmenopausal women undergoing transvaginal ultrasound screening prefer not to have chaperones.

The Royal College of Radiologists has recommended chaperones of the appropriate gender for those undergoing intimate scans. This has significant implications for clinical and research programmes. Two hundred and fifty women undergoing scanning in a screening trial were sent postal questionnaires to determine their views as to the presence of chaperones and the gender of ultrasonographers. Ninety-five percent of 198 women stated that they would not like another person to be present during transvaginal scanning. Of greater consequence to women was the gender of the ultrasonographer, with 83.3% expressing a preference for a female ultrasonographer. This needs to be considered in making decisions about allocation of scarce resources.

Presence of family member during upper endoscopy. What do patients and escorts think?

We evaluated what effect an escort present during upper endoscopy had on the attitude and anxiety level of patients and on the escorts. The study consisted of 206 patients (ages 15-85, 47% male) and their escorts. Both patients and escorts were interviewed before the procedure. Escorts were then randomly divided into two groups-on-the-spot escorts, who present throughout the procedure, as opposed to waiting-room escorts. Both groups were reinterviewed following the procedure. Before the procedure, 80% of the patients understood the nature of endoscopy. Thirteen percent believed the procedure to be dangerous, and only 33% were totally worry-free. Fifty percent preferred to be escorted during the procedure, while 17% refused. Following the procedure, 89% of the patients who were escorted in the endoscopy room expressed satisfaction. Fifty-two percent of the patients found the procedure to be mild, with a higher proportion among escorted patients. Among the escorts, 63% felt that their close presence had lessened their own fears and anxiety regarding the procedure, and 72% believed their presence to have been supportive to the patient. Having an escort present throughout endoscopy appears to be a promising approach.