Using Photovoice to stimulate critical thinking: An exploratory study with Nursing students

[EN] Objective: to explore the potentialities of the Photovoice methodologytostimulatecritical thinkingonSocialDeterminants of Health. Method: an exploratory and descriptive study with a qualitative approach, using different steps of the Photovoice methodology. Nursing students obtained photographs in their community, showing Social Determinants of Health, analyzed and classified the photographs, and exposed the results in the Nursing school. The students answered a questionnaire writing their perceptions. The data collected from the questionnaires were qualitatively analyzed. Results: 91 students participated in the study. Two main categories emerged from the data: Photovoice is a good methodology to stimulate critical thinking on Social Determinants of Health, and Photovoice is a good methodology to stimulate other skills (expressing beliefs and perceptions, stimulating creativity, developing research skills, strengthening ties with colleagues, and attracting attention). Conclusion: we explore the potentialities of the Photovoice methodology. It can be an original, simple and economical tool to stimulate critical thinking on Social Determinants of Health, and to stimulate other skills. Photovoice can be considered in teaching about aspects related to health/care in Nursing students, in order to promote critical thinking of future agents for a change in health.S

The story of a midwife in rural Spain in the mid-twentieth Century

La historia que sigue es la de Petrina, una mujer que compaginó sus labores en el campo, costura y hogar con la de partera en su localidad, Alvares de la Ribera, un pequeño pueblo situado en la comarca leonesa del Bierzo. Desarrolló esta actividad durante las décadas de 1960 y 1970, hasta que las embarazadas comenzaron a ir a dar a luz a la Residencia pública de Ponferrada, en la capital de la comarca. Adoptando los enfoques y técnicas metodológicas propios de la historia oral y la historia social, a través de su testimonio hemos alcanzado el objetivo de conocer y reflexionar sobre la atención en el momento del parto en una zona rural en esos años de transición, hasta que se generalizó la asistencia a través de la Seguridad Social. Así mismo, hacer público el trascendental papel que mujeres como ella desempeñaron en ese primer tramo de la vida de muchas personas, y que por razones varias ha permanecido invisible.The story that follows is that of Petrina, a woman who combined her work in the farm, sewing and the housework with that of a midwife in her village, Alvares de la Ribera, a small town located in El Bierzo, in the province of Leon. She worked as a midwife during the 1960s and 1970s, until women started going to give birth to the public hospital in Ponferrada, the capital of the county. With the methodological techniques proper to oral and social history, her testimony has allowed us to understand the attention that expecting women of rural areas received in the period before the National Health Service generalized. Additionally, her story helps us also to raise aware of the important role that those women like her played in the first days of life of many people, a social concerned that has in many cases remained unknown

A participação doméstica na assistência ao parto em meados do século XX

Objective: to describe how the progressive creation of the Social Security (providing widespread health care) affected the birth assistance in Spain from the 1940s to the 1970s in a rural area. Method: historical ethnography. Twenty-seven people who lived at that time were selected and interviewed guided by a semistructured script. Based on their testimonies, a chart was built with the functional elements involved in birth assistance in this region. Results: three agents performed such care: traditional midwives, women of the family/neighbors and health workers. Conclusion: although birth assistance had been transferred to the hands of the health workers from the forties in this region, women in labor continued to count on the domestic resources until the early seventies, when births were compulsorily transferred to hospitals. This research brings to light the names and recognizes the work performed by these female characters of the popular sphere, who helped women in labor of that community to give birth, for at least three decades.Objetivo: describir cómo incidió la creación progresiva de la Seguridad Social (ofreciendo asistencia sanitaria generalizada) en la atención al parto en España durante las décadas de 1940 a 1970, en una zona rural. Método: etnografía histórica. Se seleccionaron 27 personas que habían vivido en esos años, y se las entrevistó apoyadas por un guión semiestructurado. A través de sus testimonios se construyó un mapa con los elementos funcionales implicados en los cuidados en el nacimiento en ese territorio. Resultado: tres actores desempeñaban dicha atención: parteras tradicionales, mujeres familiares/vecinas y personal sanitario. Conclusión: a pesar de que la asistencia en el momento del parto pasó a estar en manos de los sanitarios a partir de los años cuarenta, en esta zona las parturientas siguieron haciendo uso de los recursos domésticos hasta bien entradas los setenta, cuando los partos obligatoriamente fueron desplazados a los hospitales. Esta investigación saca a la luz el nombre y reconoce la labor de personajes femeninos que, desde la esfera popular, ayudaron a dar a luz a parturientas de esa comunidad durante, al menos, tres décadas.Objetivo: descrever como a criação progressiva da Seguridade Social (oferecendo assistência médica ampla) afetou a assistência ao parto na Espanha durante as décadas de 1940 a 1970, em uma região rural. Método: etnografia histórica. Foram selecionadas 27 pessoas que viveram nessa época, as quais foram entrevistadas com o auxílio de um roteiro semiestruturado. Através dos seus depoimentos, construiu-se um quadro com os elementos funcionais envolvidos na assistência ao nascimento nessa região. Resultado: três agentes desempenhavam tal assistência: parteiras tradicionais, mulheres da família/vizinhas e profissionais da saúde. Conclusão: apesar da assistência durante o parto ter sido transferida para a responsabilidade dos profissionais da saúde a partir dos anos quarenta, nesta região as parturientes continuaram utilizando os recursos domésticos até o início dos anos setenta, quando os partos foram obrigatoriamente transferidos para os hospitais. Esta pesquisa traz à tona os nomes e reconhece o trabalho de personagens femininas da classe popular, que ajudaram mulheres em trabalho de parto dessa comunidade a dar à luz, durante pelo menos três décadas

The domestic participation in birth assistance in the mid-twentieth century

[EN] Objective: to describe how the progressive creation of the Social Security (providing widespread health care) affected the birth assistance in Spain from the 1940s to the 1970s in a rural area. Method: historical ethnography. Twenty-seven people who lived at that time were selected and interviewed guided by a semistructured script. Based on their testimonies, a chart was built with the functional elements involved in birth assistance in this region. Results: three agents performed such care: traditional midwives, women of the family/neighbors and health workers. Conclusion: although birth assistance had been transferred to the hands of the health workers from the forties in this region, women in labor continued to count on the domestic resources until the early seventies, when births were compulsorily transferred to hospitals. This research brings to light the names and recognizes the work performed by these female characters of the popular sphere, who helped women in labor of that community to give birth, for at least three decades.S

Uso do Photovoice para estimular o pensamento crítico: um estudo exploratório com estudantes de Enfermagem

Objetivo: explorar las potencialidades de la metodología del Photovoice para estimular el pensamiento crítico sobre los Determinantes Sociales de la Salud. Método: estudio exploratorio y descriptivo con enfoque cualitativo, en el que se utilizaron diferentes pasos de la metodología del Photovoice. Los estudiantes de enfermería tomaron fotografías en su comunidad, en las que se mostraban los Determinantes Sociales de la Salud, las analizaron y clasificaron y expusieron los resultados en la facultad. A continuación, completaron un cuestionario escribiendo sus percepciones sobre las mismas. Los datos recopilados de los cuestionarios se analizaron cualitativamente. Resultados: en el estudio participaron 91 estudiantes. Surgieron dos categorías principales de los datos: Photovoice es una buena metodología para estimular el pensamiento crítico sobre los Determinantes Sociales de la Salud, y Photovoice es una buena metodología para estimular otras habilidades (expresar creencias y percepciones, estimular la creatividad, desarrollar habilidades de investigación, fortalecer los lazos con los compañeros y atraer la atención). Conclusión: exploramos las potencialidades de la metodología Photovoice. Puede ser una herramienta original, simple y económica para estimular el pensamiento crítico sobre los Determinantes Sociales de la Salud, y también para estimular otras habilidades. Photovoice se puede considerar para la enseñanza de aspectos relacionados con la salud y/o el cuidado con estudiantes de enfermería, para promover el pensamiento crítico de futuros agentes de cambio en la salud.Objective: to explore the potentialities of the Photovoice methodology to stimulate critical thinking on Social Determinants of Health. Method: an exploratory and descriptive study with a qualitative approach, using different steps of the Photovoice methodology. Nursing students obtained photographs in their community, showing Social Determinants of Health, analyzed and classified the photographs, and exposed the results in the Nursing school. The students answered a questionnaire writing their perceptions. The data collected from the questionnaires were qualitatively analyzed. Results: 91 students participated in the study. Two main categories emerged from the data: Photovoice is a good methodology to stimulate critical thinking on Social Determinants of Health, and Photovoice is a good methodology to stimulate other skills (expressing beliefs and perceptions, stimulating creativity, developing research skills, strengthening ties with colleagues, and attracting attention). Conclusion: we explore the potentialities of the Photovoice methodology. It can be an original, simple and economical tool to stimulate critical thinking on Social Determinants of Health, and to stimulate other skills. Photovoice can be considered in teaching about aspects related to health/care in Nursing students, in order to promote critical thinking of future agents for a change in health.Objetivo: explorar as potencialidades da metodologia Photovoice para estimular o pensamento crítico sobre os Determinantes Sociais da Saúde. Método: estudo exploratório e descritivo, com abordagem qualitativa, utilizando diferentes etapas da metodologia Photovoice. Os estudantes de enfermagem obtiveram fotografias em sua comunidade, mostrando Determinantes Sociais da Saúde, analisaram e classificaram as fotografias e expuseram os resultados na faculdade. Os alunos preencheram um questionário escrevendo suas percepções. Os dados coletados dos questionários foram analisados qualitativamente. Resultados: 91 estudantes participaram do estudo. Duas categorias principais emergiram dos dados: A Photovoice é uma boa metodologia para estimular o pensamento crítico sobre os determinantes sociais da saúde e estimular outras habilidades (expressar crenças e percepções, estimular a criatividade, desenvolver habilidades de pesquisa, fortalecer laços com colegas e atrair atenção). Conclusão: exploramos as potencialidades da metodologia Photovoice. Esta pode ser uma ferramenta original, simples e barata para estimular o pensamento crítico sobre os Determinantes Sociais da Saúde e estimular outras habilidades. A Photovoice pode considerar o ensino de aspectos relacionados à saúde/assistência em estudantes de enfermagem, a fim de promover o pensamento crítico de futuros agentes de mudança na saúde

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model

Background and Purpose: The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. Purpose: To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger’s Sunrise Model. Methods: Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. Results: Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). Implications for Practice: The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model

[EN] Background and Purpose: The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. Purpose: To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger’s Sunrise Model. Methods: Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. Results: Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). Implications for Practice: The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. An interesting fact to consider to provide cultural care. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.S

Care given by midwives in Bierzo Alto (León, Spain): a hundred years evolution

[ES] El papel que las matronas han desempeñado a lo largo de la historia ha estado íntimamente condicionado por la cultura de la sociedad en la que vivían: las costumbres, las creencias y los ritos. El objeto del presente trabajo fue acercarse al conocimiento y evolución de los cuidados brindados por las matronas a lo largo del siglo XX en una zona concreta de la geografía española, la subcomarca del Bierzo Alto, ubicada en la provincia de León. Nos basamos para ello en el análisis de datos extraídos de diferentes fuentes bibliográficas en los que aparece información sobre el tema, principalmente en la obra "El Ciclo Vital en España. Encuesta del Ateneo de Madrid, 1901-1902", y en el "Anuario General de España Bailly-Bailliére-Riera", años 1930 y 1944. Como complemento de esta información escrita, se realizó un "trabajo de campo", en el que gracias a los datos facilitados por "personas conocedoras" pudimos comparar y seguir la función realizada por el colectivo de matronas y parteras en tres momentos diferentes: 1901, 1950 y 2002. Finalmente añadir que con este pequeño estudio se pretende hacer una nueva aportación al campo de la "Antropología de la Enfermería", lo cual contribuirá, aunque sea de forma modesta, a profundizar un poco más en la cultura de los cuidados referida a la primera etapa del ciclo vital.[EN] The role played by midwives throughout history has been intimately conditioned by the culture of the society in which they lived: habits, beliefs and rites. The aim of the present work is approaching to knowledge and evolution of care given by midwives during the XX century in this Spanish area, Bierzo Alto, located in Leon. Data from various literature sources were analysed, specially from "El Ciclo Vital en España. Encuesta del Ateneo de Madrid, 1901-1902" and "Anuario General de España Bailly-Bailliere- Riera, 1930 and 1944". As complementary information, a field work was carried out in which -thanks to the data provided by "people who knew"- the role played by midwives could be followed and compared in three different moments: 1901, 1950 and 2002. Finally, this article is aimed to contribute if only modestly to "Anthropology of Nursing", deepening into culture of care during the first stage of the vital cycle.S

The Feelings of Nursing Students during the COVID-19 Confinement: Narrative-Based Nursing and Poetry-of-Care Perspectives

[EN] Background: Experiences involve feelings, which, in turn, produce meaning that can become a subjectively lived experience. Therefore, the study of experiences and feelings is essential. Introduction: We examined the role of narrative-based nursing (NBN) and the poetry of care (PC). Objective: To reflect upon the emotions and feelings experienced by nursing students during confinement induced by COVID-19. (2) Methods: This is a qualitative study with a focus on reflexive anthropology, NBN, and PC. Setting and participants: The non-probabilistic sample of incidental, casual, or accessibility type. It consists of 198 students completing their first degree in nursing (the academic year of 2019-2020) of the University of Alicante. (3) Results: Three main categories were considered in the research: For the ‘first day’, 21 subcategories were identified, and uncertainty was the most frequently noted feeling. For the ‘most significant day’, 22 subcategories were found, with the explosion of feelings being the most frequent. For the ‘last day’, 15 subcategories were recorded, with the feeling of relief being the most common. Conclusions: The NBN and PC are relevant therapeutic tools that facilitate reflection and promote awareness of feelings.S

The Feelings of Nursing Students during the COVID-19 Confinement: Narrative-Based Nursing and Poetry-of-Care Perspectives

(1) Background: Experiences involve feelings, which, in turn, produce meaning that can become a subjectively lived experience. Therefore, the study of experiences and feelings is essential. Introduction: We examined the role of narrative-based nursing (NBN) and the poetry of care (PC). Objective: To reflect upon the emotions and feelings experienced by nursing students during confinement induced by COVID-19. (2) Methods: This is a qualitative study with a focus on reflexive anthropology, NBN, and PC. Setting and participants: The non-probabilistic sample of incidental, casual, or accessibility type. It consists of 198 students completing their first degree in nursing (the academic year of 2019-2020) of the University of Alicante. (3) Results: Three main categories were considered in the research: For the ‘first day’, 21 subcategories were identified, and uncertainty was the most frequently noted feeling. For the ‘most significant day’, 22 subcategories were found, with the explosion of feelings being the most frequent. For the ‘last day’, 15 subcategories were recorded, with the feeling of relief being the most common. Conclusions: The NBN and PC are relevant therapeutic tools that facilitate reflection and promote awareness of feelings.This research was financed by “Redes ICE de Investigación en Docencia Universitaria”// Instituto de Ciencias de la Educación. Universidad de Alicante