Understanding the expectations of nursing students following the first clinical internship: A qualitative study

"This study aimed to describe how nursing students' expectations are achieved in their first clinical internship, as part of a longitudinal qualitative study conducted in a public nursing school in Barcelona, Spain. Data in the current phase were collected in 2019 from students (n = 15) after completing an internship for the first time, recruited with purposive sampling until data saturation was reached in semi-structured interviews, and thematic analysis was performed on the interview content. Positive factors that had a powerful influence on students included the accessibility at the internship location and the experience with the clinical instructor, when these provided assessment and integration of the student in the health team. Practical learning is mediated by chance in terms of the center, service, teacher, and clinical instructor assigned. It is crucial to establish consensual measures among all the actors involved to facilitate the efficacy of teaching and learning.

Autonomy and isolation experienced by patients and primary caregivers during COVID-19 hospitalization in Barcelona (Spain)

SARS-CoV-2; Autonomy; IsolationSARS-CoV-2; Autonomía; AislamientoSARS-CoV-2; Autonomia; AïllamentThis study aims to describe patients' and family caregivers' hospitalization experiences during the COVID-19 pandemic. Using qualitative exploratory descriptive methods, 13 patients admitted to the largest hospital in Barcelona (Spain) due to COVID-19 were interviewed by telephone once discharged, as were eight primary caregivers. Data were analyzed using the content analysis method proposed by Krippendorff. Two main themes were identified: (i) Acceptance of mandatory isolation for patients and family caregivers, which refers to the verbalization of a feeling that justifies the imposed isolation and the need for the use of personal protective equipment by the health team for everyone's safety; and (ii) Limited autonomy during hospitalization for patients and family caregivers, which describes participants' perceptions of autonomy during hospitalization. Patients and caregivers experienced feelings of loneliness, which negatively affected their emotional health. In addition, they experienced reduced autonomy due to new habits and routines intended to control the pandemic for the benefit of public and global health

Caracterización ultraestructural y molecular de cepas de Tetraselmis (Chlorodendrophyceae, Chlorophyta) aisladas de Chile

Species of the genus Tetraselmis (Chlorodendrophyceae, Chlorophyta) have traditionally been used in aquaculture facilities as food forlarval varieties of marine organisms. Recently, some strains with high lipid content have been considered as having potential for biofuelproduction. Although many Tetraselmis species are relatively well-characterized using light and electron microscopical methods,there are still taxonomic ambiguities among the species. DNA sequence analysis, which provides a reliable and more convenient toolfor species delimitation, has been poorly used in Tetraselmis. In this study, three strains of Tetraselmis, isolated from coastal Chileanwaters, have been characterized using an integrative approach (light and electron microscopy, molecular phylogeny of ITS, includingsecondary structure analysis). According to the pyrenoid ultrastructure of the strains investigated two of them (from Dichato andColiumo) belong to the subgenus Parviselmis, while the Caldera strain corresponds to the subgenus Tetrathele. Even though it was notpossible to identify the strains at species level, it was clearly demonstrated by phylogenetic analyses of ITS-1 and ITS-2 sequencesand by ITS-2 secondary structure that the Dichato and Coliumo strains are the same species, and could belong either to T. suecica or T.chui. However, the Caldera strain might correspond to an undescribed species. As our study has shown, the genus Tetraselmis needs tobe taxonomically revised using an integrative approach, which includes the investigations of authentic strains of this genus.Especies del género Tetraselmis (Chlorodendrophyceae, Chlorophyta) han sido tradicionalmente usadas en centros acuícolas comoalimento para larvas de una variedad de organismos marinos. Adicionalmente, algunas cepas con alto contenido de lípidos hansido recientemente consideradas como fuente potencial para la producción de biodiesel. Aunque muchas especies de Tetraselmis seencuentran morfológica y ultraestructuralmente bien caracterizadas, todavía hay ambigüedades taxonómicas al interior del género. Elanálisis de secuencias de ADN, una herramienta complementaria y conveniente para delimitar especies, ha sido pobremente utilizadoen Tetraselmis. En este estudio, se caracterizaron tres cepas de Tetraselmis, aisladas de aguas costeras chilenas, utilizando un enfoqueintegrativo (morfología, ultraestructura y filogenia molecular). Basado en la ultraestructura del pirenoide de las cepas estudiadas,dos de ellas (Dichato y Coliumo) pertenecen al subgénero Parviselmis, mientras que la cepa de Caldera corresponde al subgéneroTetrathele. Aunque no fue posible identificar las cepas a nivel específico, el análisis filogenético de las secuencias ITS-1 e ITS-2y la estructura secundaria del ITS-2 demostraron claramente que las cepas de Dichato y Coliumo son la misma especie, y podríanpertenecer a T. suecica o a T. chui, mientras que la cepa de Caldera podría corresponder a una especie no descrita aún para la ciencia.Los resultados obtenidos demuestran la necesidad de llevar a cabo una revisión taxonómica del género Tetraselmis, utilizando unenfoque integrativo, el cual incluya las cepas auténticas de las especies

TRANSALUD: A qualitative study of the healthcare experiences of transgender people in Barcelona (Spain)

Transgender people; Social discrimination; Psychological attitudesPersonas transgénero; Discriminación social; Actitudes psicológicasPersones transgènere; Discriminació social; Actituds psicològiquesTransgender identities are still considered a psychiatric pathology in many countries according to the prevailing biomedical model. However, in recent years, this pathologizing vision has begun to shift towards a perspective that focuses on the diversity of transgender peoples’ experiences. However, some transgender people still face denial of services, discrimination, harassment, and even violence by healthcare professionals, causing them to avoid seeking ongoing or preventive healthcare. This article describes the health experiences of transgender people in Barcelona regarding their access and use of non-specialized health services. Semi-structured interviews were conducted using a descriptive phenomenological approach with sixteen transgender people between December 2018 and July 2019. The data were analyzed descriptively and thematically following the method proposed by Colaizzi with the help of the Atlas.ti8 software. Transgender people care experiences were divided into three categories: overcoming obstacles, training queries, and coping strategies. Participants identified negative experiences and difficulties with the health system due to healthcare providers’ lack of competence. Discriminatory, authoritarian, and paternalist behaviors are still present and hinder the therapeutic relationship, care, and access to healthcare services. There is a fundamental need for the depathologization of transgender reality and training for healthcare professionals in the field of sexual diversity. Training in sexual and gender diversity must be included in the curricula of university courses in the health sciences

Expectations of patients awaiting lung transplantation: A qualitative study

Expectations; Lung transplant; Patient experienceExpectativas; Trasplante de pulmón; Experiencia del pacienteExpectatives; Trasplantament de pulmó; Experiència del pacientAim The main aim of the present study is to examine the expectations and feelings of people awaiting lung transplantation. Background The assessment of the benefits of lung transplant should consider, among other things, the subjective perceptions of patients about the procedure, especially in relation to the context and to their values, goals and expectations. This is an issue that has not been studied in depth, especially in Spain. Design Exploratory qualitative study. Methods Data were collected through semi-structured interviews during the period of being on the waiting list for transplantation. Thematic analysis of the data was supported by the Atlas.ti software. Results The study population comprised 16 patients awaiting lung transplant, a number sufficient to reach data saturation. Four categories were identified to describe patients' feelings and expectations: (1) reasons for undergoing the transplant, (2) expectations about life post-transplant, (3) emotional state, and (4) relationship with the healthcare team. Conclusions Patients have high expectations of lung transplantation. They see it as offering them a second chance at life, although the future creates uncertainty. The healthcare professionals are identified as key actors, providing essential support and information throughout the various stages of the process. Future research should explore recipients' experiences of lung transplant at later stages. Relevance to clinical practice It is important to adapt care through all the lung transplant process, which is accompanied by intense and complex emotions since the beginning. Thus, providing social and psychological support from the beginning may contribute to their health status, helping them deal with all the emotions and feelings experienced, and find balance between expectations and reality. Patient or public contribution Sixteen patients awaiting lung transplant were interviewed. Interview transcripts were returned to participants to check for accuracy with their experiences

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence

"Introduction: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. Aim: To explain how people with a serious mental illness perceive and experience their sexuality Method: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. Results: Four categories were identified: ""Pathologized sexuality,"" which explains how the disorder and treatment affect sexuality; ""Not my sexuality anymore,” which describes feelings emerging from the perceived limitations and the role of self-acceptance; “Learning to manage intimate relationships,” which explains the desire to establish intimate personal relationships and define their meaning; and ""Reconstructing my sexuality,"" which elucidates the influence of the environment on sexuality. Discussion: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. Implications for practice: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

La identidad de los académicos de enfermería: un proceso en construcción

El procés de construcció de la identitat de la infermera s’inicia amb l’estudi de la carrera i es consolida durant la pràctica professional; no obstant, la construcció d’una identitat com a acadèmic en l’àmbit de la infermeria, suposa una trajectòria menys institucionalitzada, que comença habitualment quan s’accedeix a la docència universitària. Això requereix l’exercici en àrees per a les quals ha estat poc preparada durant la seva formació. Per altra banda, el rol d’investigador apareix en els últims anys també amb força en els estudis d’infermeria, i en el context actual constitueix una nova dimensió que s’afegeix a la de docent, i requereix a la vegada la construcció i desenvolupament d’elements identitaris específics. Tenint en compte les consideracions precedents, aquesta investigació va tenir com a propòsit investigar els processos de construcció de la identitat docent i investigadora de l’acadèmic d’infermeria, amb la finalitat de promoure el desenvolupament i l’adaptació de les infermeres als reptes que planteja la situació universitària actual. Per aconseguir aquest objectiu es van realitzar quatre estudis, tots ells realitzats a través d’un disseny descriptiu i interpretatiu, el primer amb infermeres que treballaven en docència en dues Universitats de Xile, i els altres tres amb infermeres de diferents Universitats de Catalunya. La recollida de dades es va fer a través d’entrevistes semiestructurades i el registre de diaris narratius setmanals per part de les participants. L’objectiu del primer estudi va consistir en identificar com les infermeres dedicades a la docència construeixen la seva identitat professional en aquest rol. El segon, va profunditzar en les construccions identitàries de l’acadèmic d’infermeria respecte als processos d’ensenyament i aprenentatge i la investigació en infermeria. El tercer, va tenir per finalitat incloure l’anàlisi dels incidents crítics i les seves estratègies de com afrontar en l’exercici d’aquest rol. El quart, analitzar les posicions de l’acadèmic d’infermeria i les tensions experimentades durant una situació de transició. Els resultats relatius al primer estudi indiquen que les infermeres consideren necessari un perfeccionament continu i específic per a l’exercici d’aquest nou rol. Pel que fa al segon, els acadèmics d’infermeria busquen un equilibri entre la docència i la investigació i se senten desafiades a desenvolupar teories i models en la seva pròpia disciplina. Pel que fa al tercer, la identitat professional d’aquestes infermeres en el camp acadèmic està encara en construcció i la inexperiència és el major obstacle que afronten per a gestionar els incidents crítics en el treball docent. Finalment els resultats del quart i últim estudi indiquen que, la identificació de certes contradiccions durant una situació de transició és d’una gran utilitat per evitar a posteriori el desenvolupament d’incidents crítics, o discontinuïtats en la pràctica docent. L’existència de la denominada identitat novell de l’acadèmic d’infermeria en el rol d’investigació es presenta com la principal conclusió d’aquest estudi. Es suposa que, conjuntament amb la necessitat d’accedir a continguts específics en pedagogia i didàctica, i una preparació adequada en la gestió d’incidents crítics a l’aula, es precisa d’una formació especialitzada en el desenvolupament de les habilitats i competències que posicionen a aquest professional en el terreny de la investigació. Ens referim a la implementació de programes orientats al desenvolupament de competències per investigar en ciències biomèdiques, que permetin donar resposta als problemes que afecten aquesta àrea d’exercici, i per últim que contribueixin a millorar la construcció de la identitat de l’acadèmic d’infermeria.El proceso de construcción de la identidad de la enfermera se inicia con el estudio de la carrera y se consolida durante la práctica profesional; no obstante, la construcción de una identidad como académico en el ámbito de la enfermería, supone una trayectoria menos institucionalizada, que comienza habitalmente cuando se accede a la docencia universitaria. Ello requiere el desempeño en áreas para las que fue escasamente preparada durante su formación. Por otra parte, el rol de investigador aparece en los últimos años también con fuerza en los estudios de enfermería, y en el contexto actual constituye una nueva dimensión que se añade a la docente, y requiere a su vez la construcción y desarrollo de elementos identitarios específicos. Teniendo en cuenta las consideraciones precedentes, esta investigación tuvo como propósito indagar en los procesos de construcción de la identidad docente e investigadora del académico de enfermería, con la finalidad de promover el desarrollo y la adaptación de las enfermeras a los retos que plantea la situación universitaria actual. Para el logro de este objetivo se realizaron cuatro estudios, todos ellos realizados a través de un diseño descriptivo e interpretativo, el primero con enfermeras que trabajaban en docencia en dos Universidades de Chile, y los otros tres con enfermeras de diferentes Universidades de Catalunya. La recogida de datos se hizo a través de entrevistas semi - estructuradas y el registro de diarios narrativos semanales por parte de las participantes. El objetivo del primer estudio consistió en identificar cómo las enfermeras dedicadas a la docencia construyen su identidad profesional en este rol. El segundo, profundizó en los constructos identitarios del académico de enfermería respecto a los procesos de enseñanza y aprendizaje y la investigación en enfermería. El tercero, tuvo por finalidad incluir el análisis de los incidentes críticos y sus estrategias de afrontamiento en el ejercicio de este rol. El cuarto, analizar las posiciones del académico de enfermería y las tensiones experimentadas durante una situación de transición. Los resultados relativos al primer estudio indican que las enfermeras consideran necesario un perfeccionamiento continuo y específico para el ejercicio de este nuevo rol. Con respecto al segundo, que los académicos de enfermería buscan un equilibrio entre la docencia y la investigación y se sienten desafiadas a desarrollar teorías y modelos en su propia disciplina. En cuanto al tercero, la identidad profesional de estas enfermeras en el campo académico está aún en construcción y la inexperiencia es el mayor obstáculo que enfrentan para gestionar los incidentes críticos en el trabajo docente. Finalmente los resultados del cuarto y último estudio indican que, la identificación de ciertas contradicciones durante una situación de transición profesional es de gran utilidad para evitar a posteriori el desarrollo de incidentes críticos, o discontinuidades en la práctica docente. La existencia de la denominada identidad novel del académico de enfermería en el rol de investigación se presenta como la principal conclusión de este estudio. Esto supone que, conjuntamente con la necesidad de acceder a contenidos específicos en pedagogía y didáctica, y una preparación adecuada en la gestión de los incidentes críticos en el aula, se precisa de una formación especializada en el desarrollo de habilidades y competencias que posicionen a este profesional en el terreno de la investigación. Nos referimos a la implementación de programas orientados al desarrollo de competencias para investigar en las ciencias biomédicas, que permita dar respuesta a los problemas que afectan esta área de desempeño, y en último término contribuyan a mejorar la construcción de la identidad del académico de enfermería.Nurses’ identity construction process starts in the undergraduate studies and strengthens in the professional practice. Nevertheless, the construction of an identity as a nursing teacher implies a less institutionalized trajectory. It begins after accessing university teaching and requires nurses to work in areas for which they were scarcely prepared during their training. On the other hand, in the last years the role of researcher also gained importance in nursing studies and nowadays it constitutes a new dimension of nursing teachers’ profession. In turn, it requires the construction and development of specific identity elements. Taking into account the previous considerations, this research aimed at enquiring into the processes of construction of nursing academics’ identity in order to promote nurses’ development and adaptation to the challenges of this new discipline. To fulfill this objective, we conducted four studies based on a descriptive and interpretative design, the first one with nurses teaching in two Chilean universities, and the other three with nurses of different Catalan universities. Data collection consisted in semi-structured interviews and weekly narrative diaries completed by the participants. The goal of the first paper was to identify how nurses are building their new teacher identity. The second study deepened in the analysis of how nurses represent their role as nursing academics and their conceptions, strategies and feelings involved in teaching-learning and research in nursing. In the third we analyzed the professional identity of academics in Nursing through the analysis of the most perturbing critical incidents. And the last paper aimed at analyzing academic nursing’ positions and the tensions experienced during a transition process. The results of the first study show that nurses think that they need continuous development in order to perform their new role, while the second shows that the nursing academics look for a balance between teaching and research and they also wish to promote the development of models and theories in their discipline. Regarding the third study, we found that nurses' professional identity in relation to the academic area is still under construction and that inexperience is the greatest obstacle in the management of critical incidents in the teaching task. Finally the results of the fourth study indicate that the identification of certain contradictions during a professional transition was very useful to avoid ‘a posteriori’ the appearance of critical incidents or discontinuities in the teaching practice. The existence of the so-called nursing academics’ novel identity in the role of research is highlighted as the main conclusion of this thesis. This implies that, together with the need to access to pedagogical and didactical specific contents and proper trainings for the management of critical incidents in the classroom, a specialized training for the development of abilities and competences that help professional position themselves in the field of research is required. We refer to the implementation of a program oriented towards the development of research competences in biomedical sciences, which would allow participants to solve problems related to this area and, ultimately, contribute to the improvement of the construction of nursing academics’ identity

Incidentes críticos en los docentes de enfermería: descubriendo una nueva identidad

RESUMEN Objetivo: estudio cualitativo que siguió los principios de la teoría fundamentada con el fin de analizar la identidad profesional de docentes de enfermería por medio del análisis de incidentes críticos que más las desestabilizaban. Método: entrevistas semi-estructuradas fueron realizadas a siete enfermeras que actúan como docentes e investigadoras en una universidad privada de Barcelona. Resultados: el material empírico resultante fue organizado en dos categorías: caracterización de los incidentes críticos y reacción de las enfermeras frente a ellos. Conclusión: se concluye que la identidad profesional de estas enfermeras en el campo académico está aún en construcción y que la inexperiencia es el mayor obstáculo que enfrentan para gestionar los incidentes críticos en el trabajo docente