A experiência de enfermeiras cuidando de famílias culturalmente diversas: uma meta-síntese qualitativa

Objective: to understand the experience of nurses in care delivery to culturally diverse families. Method: qualitative meta-synthesis. Exhaustive search in seven databases, three repositories and a manual search in references without time limit, in English, Spanish and Portuguese, resulting in 1609 potentially relevant studies. These were assessed based on the title, summary and full text, determining the final inclusion of 14 studies. Two independent reviewers used the Critical Appraisal Skills Programme (CASP) to assess the quality. The interpretative synthesis implied permanent contrast and consensus among the authors, revealing four categories and one meta-theme. Results: "taking care of a culturally diverse family, the experience of crossing a tightrope". Conclusion: the experience of nurses in care delivery to culturally diverse families is demanding and challenging because it imprints a constant tension among barriers, cultural manifestations and the ethical responsibility of care, incipiently revealing elements of cultural competency. The omission of information in the participants' reports in the studies represents a limitation. The findings offer a baseline for professionals and organizations to focus their intervention efforts on the continuing barriers in care delivery to culturally diverse families and strengthens the need for cultural competency training for nurses.Objetivo: comprender la experiencia de enfermeras cuidando a familias culturalmente diversas. Método: metasíntesis cualitativa. Búsqueda exhaustiva en siete bases de datos, tres repositorios y búsqueda manual en referencias sin límite de tiempo en idioma inglés, español y portugués. 1609 estudios resultaron potencialmente relevantes. Éstos fueron evaluados en base a título, resumen y texto completo determinando la inclusión final de 14 estudios. Dos revisores independientes emplearon el Critical Appraisal Skills Programme (CASP) para valorar la calidad. La síntesis interpretativa implicó contraste permanente y consenso entre autores, arrojando cuatro categorías y un meta-tema. Resultados: "cuidar a la familia culturalmente diversa, la experiencia de cruzar una cuerda floja". Conclusión: la experiencia de enfermeras cuidando a familias culturalmente diversas es exigente y desafiante porque imprime una tensión constante entre barreras, manifestaciones culturales y la responsabilidad ética de cuidado, donde emergen elementos de la competencia cultural de manera incipiente. La omisión de información en el reporte de participantes en los estudios constituyó una limitación. Los hallazgos proporcionan una línea de base para que los profesionales y organizaciones concentren sus esfuerzos de intervención sobre las barreras persistentes en el cuidado a las familias culturalmente diversas y reafirman la necesidad de formación de enfermeros en competencia cultural.Objetivo: compreender a experiência de enfermeiras no cuidado a famílias culturalmente diversas. Método: meta-síntese qualitativa. Uma busca exaustiva foi realizada em sete bases de dados e três repositórios, além de uma busca manual em referências sem delimitação de tempo em inglês, espanhol e português. As buscas revelaram 1609 estudos potencialmente relevantes. Estes foram avaliados considerando-se o título, o resumo e o texto completo, o que levou à inclusão final de 14 estudos. Dois revisores independentes usaram o Critical Appraisal Skills Programme (CASP) para avaliar a qualidade. A síntese interpretativa implicou um contraste permanente e consenso entre os autores, mostrando quatro categorias e um meta-tema. Resultados: "cuidar da família culturalmente diversa, a experiência de atravessar uma corda bamba". Conclusão: a experiência de enfermeiras cuidando de famílias culturalmente diversas é exigente e desafiante porque traz uma tensão constante entre barreiras, manifestações culturais e a responsabilidade ética do cuidado, de onde emergem elementos da competência cultural de maneira incipiente. A omissão de informações nos relatos dos participantes nos estudos representa uma limitação. Os resultados proporcionam uma linha de base para que os profissionais e as organizações concentrem seus esforços de intervenção nas barreiras persistentes no cuidado às famílias culturalmente diversas e reafirmam a necessidade de formação de enfermeiros em competência cultural

Folk care of chronic diseases among Pijao indigenous people during the Co-vid-19 pandemic

Justificación: La pandemia del Covid-19 provocó una interrupción en los servicios destinados a la atención de enfermedades crónicas, resultando en reajustes en la atención a los pacientes. Objetivo: Describir la atención popular utilizada por el pueblo indígena Pijao para el tratamiento y control de enfermedades crónicas en el contexto de la pandemia en Bogotá (Colombia). Metodología: Estudio cualitativo microetnográfico. Participaron 16 indígenas Pijao. Los datos recogidos mediante entrevistas y observación fueron analizados temáticamente. Resultados: emergieron tres categorías: (1) del territorio de origen a la ciudad: atención popular para el tratamiento de enfermedades, (2) vivir con la enfermedad: signos y síntomas de las enfermedades, y (3) búsqueda de otros recursos para el cuidado: autoatención y apoyo familiar. Conclusión: la trayectoria de cuidado de los Pijao con enfermedades crónicas fue permeada por la pandemia, convirtiendo el cuidado popular, caracterizado por un sincretismo de saberes, en parte fundamental de su rutina de cuidado. © 2023, Fundación Index. Todos los derechos reservados.Justification: The Covid-19 pandemic caused an interruption in the services aimed at attending to chronic diseases, resulting in readjustments in the care of patients. Objective: To describe the popular care used by the Pijao indigenous people for treating and controlling chronic diseases in the context of the pandemic in Bogotá (Colombia). Methodology: Qualitative micro-ethnographic study. Sixteen Pijao indigenous people participated. The data collected through interviews and observation were analyzed thematically. Results, three categories emerged: (1) from the territory of origin to the city: popular care for the treatment of illnesses, (2) living with the illness: signs and symptoms of illnesses, and (3) seeking other re-sources for care: self-attention and family support. Conclusion: the care trajectory of the Pijao with chronic diseases was permeated by the pandemic, turning popular care, characterized by a syncretism of knowledge, into a fundamental part of their care routine. © 2023, Fundacion Index. All rights reserved

Análise em chave decolonial da interculturalidade no modelo integral de atenção em saúde em Guainía, Colômbia

Objective: to analyze interculturality in the daily implementation of the integral health care model in Guainía, Colombia, under the critical lens of decolonial thinking. Methodology: Holistic single case study with the voluntary participation of 22 indigenous users, 26 health professionals and 3 key participants (a traditional doctor, an administrative official and an indigenous leader). The study settings were the hospital, health posts and health centers belonging to the public health care network. Data were collected through semi-structured interviews and direct observation. The analysis was guided by Bardin's thematic content analysis technique. Results: interculturality has been configured in the daily implementation of the health care model in Guainía, according to three different perspectives: relational, functional and critical. Conclusions: it is evident that interculturality can acquire different meanings in the field of health care in culturally diverse territories, being fundamental to promote a critical perspective based on the daily actions and the agency of the people, as well as working together with the communities to identify needs, limitations and potentialities, which allow the scope and concretization of a true dialogue of knowledge.Objetivo: analizar bajo el lente crítico del pensamiento decolonial la interculturalidad en el cotidiano de implementación del modelo integral de atención en salud en Guainía, Colombia. Metodología: Estudio de caso único holístico que contó con la participación voluntaria de 22 usuarios indígenas, 26 profesionales de salud y 3 participantes clave (un médico tradicional, un funcionario administrativo y un líder indígena). Los escenarios de estudio fueron el hospital, los puestos y centros de salud pertenecientes a la red pública de atención. Los datos fueron recolectados mediante entrevistas semiestructuradas y observación directa. El análisis se orientó siguiendo la técnica de análisis de contenido temático de Bardin. Resultados: la interculturalidad se ha configurado en el cotidiano de implementación del modelo de atención en salud, en Guainía, conforme tres perspectivas distintas: relacional, funcional y crítica. Conclusiones: se evidencia que la interculturalidad puede adquirir diferentes sentidos en el ámbito de la atención en salud en territorios culturalmente diversos, siendo fundamental promover una perspectiva crítica que parta de las acciones cotidianas y la agencia de las personas, así como del trabajo junto con las comunidades para la identificación de necesidades, limitaciones y potencialidades, que permitan el alcance y concretización de un verdadero diálogo de saberes.Objetivo: analisar a interculturalidade na implementação diária do modelo integrado de saúde em Guainía, Colômbia, através da lente crítica do pensamento descolonial. Metodologia: Um único estudo de caso holístico com a participação voluntária de 22 usuários indígenas, 26 profissionais de saúde e 3 participantes-chave (um médico tradicional, um funcionário administrativo e um líder indígena). Os ambientes de estudo foram o hospital, postos de saúde e centros de saúde pertencentes à rede pública de saúde. Os dados foram coletados através de entrevistas semi-estruturadas e observação direta. A análise foi guiada pela técnica de análise de conteúdo temático de Bardin. Resultados: a interculturalidade foi configurada na implementação diária do modelo de saúde em Guainía, de acordo com três perspectivas diferentes: relacional, funcional e crítica. Conclusões: é evidente que a interculturalidade pode adquirir diferentes significados no campo da saúde em territórios culturalmente diversos, sendo fundamental para promover uma perspectiva crítica baseada nas ações cotidianas e no agenciamento do povo, bem como trabalhar em conjunto com as comunidades para identificar necessidades, limitações e potencialidades, que permitam o alcance e a concretização de um verdadeiro diálogo de conhecimento

Experiencia de enfermeras cuidando a familias multiculturales: una metasíntesis cualitativa

Antecedentes: Los estudios sobre el fenómeno de la experiencia de las enfermeras cuidando a familias multiculturales han generado hallazgos significativos que aún no habían sido sintetizados para servir como soporte a la práctica basada en la evidencia. Objetivo: Interpretar y sintetizar los hallazgos de las investigaciones cualitativas acerca de la experiencia de enfermeras cuidando a familias multiculturales. Método: Revisión sistemática de estudios cualitativos tipo metasíntesis, siguiendo la propuesta de Sandelowski y Barroso (2007). La búsqueda exhaustiva se implementó en siete bases de datos, tres repositorios y adicionalmente búsqueda manual en referencias, incluyendo estudios de diversos diseños cualitativos sin límite inicial de años, publicados antes de abril de 2014. La evaluación de estudios se llevó a cabo a través de evaluación individual aplicando los criterios propuestos por el Critical Appraisal Skills Programme (CASP) y evaluación comparativa caracterizando los estudios según datos publicación, diseño, escenarios y participantes. La síntesis implicó análisis comparativo constante. Resultados: Un total de catorce estudios fueron incluidos. Los hallazgos se sintetizaron en cuatro categorías y un meta-tema denominado: “Cuidar a la familia culturalmente diversa, la experiencia de cruzar una cuerda floja”. Conclusión: Los resultados de la síntesis indican que la experiencia de las enfermeras es gratificante y admirable, pero a la vez exigente y desafiante porque imprime una constante tensión entre barreras internas, externas, manifestaciones culturales y la responsabilidad ética de cuidado. Los hallazgos derivados de esta metasíntesis generan evidencia a nivel de la práctica para la formulación de directrices en el cuidado a las familias culturalmente diversas y recomendaciones en el ámbito de la investigación para el reporte de informes de investigación y el planteamiento de estudios futuros.Abstract: Background: The studies about the phenomenon of the experience of nurses caring for multicultural families have generated significant findings that had not yet been synthesized to serve as a support for evidence-based practice. Aim: To Interpret and synthesize the findings of qualitative research on the experiences of nurses caring for multicultural families. Method: A systematic review of qualitative research studies type meta-synthesis, following the procedures outlined by Sandelowski and Barroso (2007). The exhaustive search was implemented in seven databases, three repositories and hand search of references, including qualitative studies of different designs without limit initial years, published before April 2014. The appraising reports were conducted through individual appraisal using the criteria proposed by the Critical Appraisal Skills Programme (CASP) and comparative appraisal characterizing the studies according publication, design, scenarios and participants. The synthesis implicated the constant comparative analysis. Findings: A total of fourteen studies were included. The findings were synthesized in four categories and one meta-theme called: “Caring for the multicultural family, the experience of crossing a tightrope". Conclusion: The synthesis of results indicate that nurses’ experience is rewarding and admirable, yet demanding and challenging because it prints a constant tension between internal barriers, external barriers, cultural behaviors and an ethical responsibility to care. The findings from this meta-synthesis generate evidence to practice level for the formulation of guidelines on the care of culturally diverse families and recommendations in the field of research for the research reports and the approach of future studies.Maestrí

The experience of nurses in care for culturally diverse families: A qualitative meta-synthesis

Abstract Objective: to understand the experience of nurses in care delivery to culturally diverse families. Method: qualitative meta-synthesis. Exhaustive search in seven databases, three repositories and a manual search in references without time limit, in English, Spanish and Portuguese, resulting in 1609 potentially relevant studies. These were assessed based on the title, summary and full text, determining the final inclusion of 14 studies. Two independent reviewers used the Critical Appraisal Skills Programme (CASP) to assess the quality. The interpretative synthesis implied permanent contrast and consensus among the authors, revealing four categories and one meta-theme. Results: "taking care of a culturally diverse family, the experience of crossing a tightrope". Conclusion: the experience of nurses in care delivery to culturally diverse families is demanding and challenging because it imprints a constant tension among barriers, cultural manifestations and the ethical responsibility of care, incipiently revealing elements of cultural competency. The omission of information in the participants' reports in the studies represents a limitation. The findings offer a baseline for professionals and organizations to focus their intervention efforts on the continuing barriers in care delivery to culturally diverse families and strengthens the need for cultural competency training for nurses

Competência cultural dos enfermeiros na área da saúde pública: uma meta-síntese

Objective: To explore the experiences and life events regarding the cultural competence in the public health practice. Methods: A qualitative meta-synthesis covering the databases Medline, OvidNursing, OvidJournal, Embase and BVS-LILACS, including papers in English, Spanish and Portuguese between 2009 and 2014. Ten studies were included and assessed by using the Critical Appraisal Skills Programme in Spanish (CASPe). The three stages of the meta-aggregation programme were applied to do the obtaining and synthesis of findings. Results: the findings were aggregated in six categories and two types of results: 1) paradoxeswhen providing public health care to people from different culture and 2) going beyond the barriers – the daring by the public health nurses. Conclusion: the nurses experienced and expressed their cultural competence from the paradoxical situation produced when encountering another culturally different people. They showed a stance open to both understand and make sense of the other’s culture, even though it was hard to produce culturally competent interventions.Objetivo: explorar las experiencias y vivencias sobre la competencia cultural de enfermeras en salud pública. Metodología: metasíntesis cualitativa. Las bases utilizadas fueron: Medline, OvidNursing, OvidJournal, Embase y BVS-LILACS, publicados en inglés, español o portugués, entre 2009 y 2014. Se incluyeron diez estudios y fueron valorados usando el Critical Appraisal Skills Programme en español (CASPe). Se implementaron las tres fases del proceso de metaagregación en la extracción y síntesis de hallazgos. Resultados: los hallazgos fueron agregados en seis categorías y dos resultados: 1) paradojas en la atención de salud pública a personas de diversas culturas; 2) sobrepasando barreras: la osadía de las enfermeras de salud pública. Conclusión: las enfermeras vivenciaron y expresaron la competencia cultural desde lo paradójico que resulta el encuentro con el otro culturalmente diferente, manifestaron apertura a comprender y dar sentido a la cultura, aunque fue difícil generar intervenciones culturalmente competentes.Objetivo: explorar as experiências e vivências sobre competência cultural de enfermeiras em saúde pública. Metodologia: metasíntese qualitativa. As bases utilizadas foram: Medline, OvidNursing, OvidJournal, Embase e BVS-LILACS, publicados em inglês, espanhol ou português, entre 2009 e 2014. Dez estudos foram incluídos e valorados usando o Critical Appraisal Skills Programme em espanhol (CASPe). As três fases do processo de meta-agregação na extração e síntese de achados foram implementados. Resultados: os achados foram agregados em seis categorias e dois resultados: 1) paradoxos no atendimento de saúde pública a pessoas de diversas culturas; 2) ultrapassando barreiras: a ousadia das enfermeiras de saúde pública. Conclusões: as enfermeiras vivenciaram e expressaram a competência cultural desde o paradoxal que resulta o encontro com um outro culturalmente diferente, manifestaram apertura para compreender e dar sentido à cultura, embora fosse difícil gerar intervenções culturalmente competentes

Competência cultural dos enfermeiros na área da saúde pública: uma meta-síntese

Objective: To explore the experiences and life events regarding the cultural competence in the public health practice. Methods: A qualitative meta-synthesis covering the databases Medline, OvidNursing, OvidJournal, Embase and BVS-LILACS, including papers in English, Spanish and Portuguese between 2009 and 2014. Ten studies were included and assessed by using the Critical Appraisal Skills Programme in Spanish (CASPe). The three stages of the meta-aggregation programme were applied to do the obtaining and synthesis of findings. Results: the findings were aggregated in six categories and two types of results: 1) paradoxeswhen providing public health care to people from different culture and 2) going beyond the barriers – the daring by the public health nurses. Conclusion: the nurses experienced and expressed their cultural competence from the paradoxical situation produced when encountering another culturally different people. They showed a stance open to both understand and make sense of the other’s culture, even though it was hard to produce culturally competent interventions.Objetivo: explorar las experiencias y vivencias sobre la competencia cultural de enfermeras en salud pública. Metodología: metasíntesis cualitativa. Las bases utilizadas fueron: Medline, OvidNursing, OvidJournal, Embase y BVS-LILACS, publicados en inglés, español o portugués, entre 2009 y 2014. Se incluyeron diez estudios y fueron valorados usando el Critical Appraisal Skills Programme en español (CASPe). Se implementaron las tres fases del proceso de metaagregación en la extracción y síntesis de hallazgos. Resultados: los hallazgos fueron agregados en seis categorías y dos resultados: 1) paradojas en la atención de salud pública a personas de diversas culturas; 2) sobrepasando barreras: la osadía de las enfermeras de salud pública. Conclusión: las enfermeras vivenciaron y expresaron la competencia cultural desde lo paradójico que resulta el encuentro con el otro culturalmente diferente, manifestaron apertura a comprender y dar sentido a la cultura, aunque fue difícil generar intervenciones culturalmente competentes.Objetivo: explorar as experiências e vivências sobre competência cultural de enfermeiras em saúde pública. Metodologia: metasíntese qualitativa. As bases utilizadas foram: Medline, OvidNursing, OvidJournal, Embase e BVS-LILACS, publicados em inglês, espanhol ou português, entre 2009 e 2014. Dez estudos foram incluídos e valorados usando o Critical Appraisal Skills Programme em espanhol (CASPe). As três fases do processo de meta-agregação na extração e síntese de achados foram implementados. Resultados: os achados foram agregados em seis categorias e dois resultados: 1) paradoxos no atendimento de saúde pública a pessoas de diversas culturas; 2) ultrapassando barreiras: a ousadia das enfermeiras de saúde pública. Conclusões: as enfermeiras vivenciaram e expressaram a competência cultural desde o paradoxal que resulta o encontro com um outro culturalmente diferente, manifestaram apertura para compreender e dar sentido à cultura, embora fosse difícil gerar intervenções culturalmente competentes

Data_Sheet_1_Mental health among adolescents exposed to social inequality in Latin America and the Caribbean: a scoping review.docx

Background and objectiveAdolescents from Latin America and the Caribbean grow up in a context of social inequality, which diminishes their well-being and leads to impaired emotional-cognitive development. To understand the problem, it is important to synthesize the available research about it. This study aims to explore the knowledge about adolescents’ mental health in Latin America and the Caribbean exposed to social inequality.MethodsA systematic scoping review was conducted encompassing a search in five databases (Medline, CINAHL, PsycINFO, Scopus, and LILACS) in June 2022. Articles of various typologies were included without time limit. After two rounds of screening, relevant data were manually extracted and synthesized into self-constructed themes using thematic analysis.ResultsOut of 8,825 retrieved records, 42 papers were included in the final review, with a predominance of quantitative approaches. The synthesis revealed two main analytical themes: (a) defining social inequality, wherein intersecting inequalities produce discrimination and determine conditions for social vulnerability; (b) social inequality and mental health, which highlights the association between socio-structural difficulties and emotional problems, amplifying vulnerability to mental ill health and poor mental health care.ConclusionThe scientific evidence reveals that social inequality is related to impaired well-being and mental ill health on the one hand and a lack of access to mental health care on the other hand.</p

Table_1_Mental health among adolescents exposed to social inequality in Latin America and the Caribbean: a scoping review.docx

Background and objectiveAdolescents from Latin America and the Caribbean grow up in a context of social inequality, which diminishes their well-being and leads to impaired emotional-cognitive development. To understand the problem, it is important to synthesize the available research about it. This study aims to explore the knowledge about adolescents’ mental health in Latin America and the Caribbean exposed to social inequality.MethodsA systematic scoping review was conducted encompassing a search in five databases (Medline, CINAHL, PsycINFO, Scopus, and LILACS) in June 2022. Articles of various typologies were included without time limit. After two rounds of screening, relevant data were manually extracted and synthesized into self-constructed themes using thematic analysis.ResultsOut of 8,825 retrieved records, 42 papers were included in the final review, with a predominance of quantitative approaches. The synthesis revealed two main analytical themes: (a) defining social inequality, wherein intersecting inequalities produce discrimination and determine conditions for social vulnerability; (b) social inequality and mental health, which highlights the association between socio-structural difficulties and emotional problems, amplifying vulnerability to mental ill health and poor mental health care.ConclusionThe scientific evidence reveals that social inequality is related to impaired well-being and mental ill health on the one hand and a lack of access to mental health care on the other hand.</p

The experience of nurses in care for culturally diverse families: A qualitative meta-synthesis

OBJECTIVE: to understand the experience of nurses in care delivery to culturally diverse families. METHOD: qualitative meta-synthesis. Exhaustive search in seven databases, three repositories and a manual search in references without time limit, in English, Spanish and Portuguese, resulting in 1609 potentially relevant studies. These were assessed based on the title, summary and full text, determining the final inclusion of 14 studies. Two independent reviewers used the Critical Appraisal Skills Programme (CASP) to assess the quality. The interpretative synthesis implied permanent contrast and consensus among the authors, revealing four categories and one meta-theme. RESULTS: "taking care of a culturally diverse family, the experience of crossing a tightrope". CONCLUSION: the experience of nurses in care delivery to culturally diverse families is demanding and challenging because it imprints a constant tension among barriers, cultural manifestations and the ethical responsibility of care, incipiently revealing elements of cultural competency. The omission of information in the participants' reports in the studies represents a limitation. The findings offer a baseline for professionals and organizations to focus their intervention efforts on the continuing barriers in care delivery to culturally diverse families and strengthens the need for cultural competency training for nurses