El cuidador familiar. Una revisión sobre la necesidad del cuidado doméstico y sus repercusiones en la familia

En los últimos 50 años se han producido importantes cambios en el patrón epidemiológico. El aumento de la esperanza de vida y el descenso de la natalidad han originado un envejecimiento de la población y una mayor prevalencia de enfermedades crónicas. Aunque el envejecimiento es un fenómeno universal, en España, se está produciendo a una velocidad mayor que en otros países. Se espera que la población mayor de 80 años aumente su tamaño en un 66% entre 1986 y 2010. La mayor parte de los cuidados que necesitan las personas con enfermedades crónicas o invalidez, se dispensan en el núcleo familiar y aunque desde la década de los 80 se observa una mayor preocupación por los cuidadores informales no existe un sistema de apoyo institucional eficaz. A través de una revisión bibliográfica de los últimos 5 años, se analiza la situación actual en nuestro país y se reflexiona sobre el futuro de estos cuidados, debido a los cambios profundos que se están produciendo en las formas de vida de la familia. También se hace hincapié en las repercusiones físicas, psicológicas y sociales que tiene el hecho de cuidar para el cuidador principal y sobre el proceso de atención a la familia que deberían desarrollar los profesionales, especialmente la enfermera.In the last 50 years important changes have taken place in the epidemiological pattern. The life expectancy increase and the birth rate decrease have caused an ageing in the population and a higher prevalence of chronical diseases. Although this ageing is a universal phenomenon, in Spain it is faster than in other countries. It is expected that population over 80 will increase by 66% between 1986 and 2010. Most of the care required by people with chronical diseases or disabilities are provided within the core family and, although since the 80's a higher concern for caregivers has emerged, there is no effective institutional support system yet. Through a bibliographic revision of the last 5 years, the current situation in our country is analized and the future of this caretaking is thought over, due to the deep family lifestyle changes that are taking place. The physical, psychological and social implications of caretaking on the main caregiver are emphasized, as well as the process of family assistance that should be developed by medical professionals, and above all, by the nurse

Living with diabetes: quality of care and quality of life

Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials

Impact of diagnosis of type 1 diabetes in children and adolescents

OBJETIVO: Conocer el impacto personal y familiar del diagnóstico de diabetes tipo 1 (DM1) en niños y adolescentes

Contradictory views of nursing care among students at the end of their nursing education

Aim: to understand how nursing students at the end of their nursing education view nursing care. Background: although care is understood as the essence of nursing, it is often difficult for nurses to provide care, which demonstrates a contradiction between theory and practice. Moreover, it is unknown to what extent this contradiction is transmitted to future nursing professionals or how they view nursing care and its practice. Design: qualitative ethnographic research. Methods: the fieldwork was conducted between December 2010 - May 2012 in a university nursing school in Barcelona and two centres where students carry out most of their practical education. The data collection techniques were participant observation and focus groups. A thematic analysis was used. Results: the students demonstrated contradictory views of nursing care. On one hand, they voiced a more theoretical, official definition where care is considered the core of the profession. On the other hand, they also expressed a view where the provision of care is not nurses' principal daily activity, a fact that did not surprise them. Students interpreted caring as an activity that has low value and that can be transferred unproblematically to other professionals. Conclusion: the contradictory views of care reveal a problem in the transmission of the definition of nursing to new generations of professionals and reflect a problematic professional reality where there is dissonance between how nursing is defined and how it is carried out in practice

Theory and practice in the construction of professional identity in nursing students: a qualitative study

Background: The problem of nurses' professional identity continues to be seen in the disjunction between theoretical training and clinical placements. Moreover, it is not known how nursing students perceive these contradictions or how this discrepancy influences the construction of professional identity. Objective: To gain insight into nursing students' perception of their theoretical and practical training and howthis training influences the process of constructing their professional identity. Design: Qualitative, ethnographic study. Participants/Settings: Third-year nursing students at the l'Escola Universitària d'Infermeria Vall d'Hebron de Barcelona. Methods: Participant observation was conducted in the hospital setting and primary care.Discussion groupswere held. The constant comparativemethodwas used for the analysis. The study adhered to the criteria of credibility, transferability, dependability and confirmability. Results: Students believed that both theoretical and practical trainings were indispensable. Nevertheless, clinical placements were considered essential to confer sense to the theory and to shape their identity, as they helped student nurses to experience their future professional reality and to compare it with what they had been taught in theoretical and academic classes. The role of the clinical placement mentor was essential. With regard to theory, the skills developed in problem-based learning gave novice nurses' confidence to approach the problems of daily practice and newsituations. Equally, this approach taught themto reflect onwhat they did andwhat they were taught and this ability was transferred to the clinical setting. Conclusions: For students, both strategies (theory and practice) are vital to nursing education and the construction of a professional identity, although pride of place is given to clinical placements and mentors. The skills developed with problem-based learning favor active and reflective learning and are transferred to learning in the clinical setting

Diabetes Mellitus en el anciano

A una persona obesa de 55 años se le descubre, por azar, una glucemia de 150 mg% con glucosurias negativas, sin acetona y sin complicaciones. Podríamos afirmar que se trata de..

Investigación cuantitativa e investigación cualitativa ¿complementarias o contrapuestas?

Se presentan algunos artículos (que irán apareciendo en números sucesivos) que recogen las aportaciones más interesantes de las 1as Jornadas Internacionales de Investigación Cualitativa en Salud: "Acercándonos a las personas", que tuvieron lugar en Barcelona en el año 2004. Los temas principales se centran en tres ejes: la complementariedad o no de las metodologías cuantitativas y cualitativas; el enfoque interdisciplinario en el estudio de los problemas de salud y enfermedad..

Repercusiones de la diabetes en el niño y el adolescente

La DM1 se puede presentar a cualquier edad, pero su mayor incidencia se observa en menores de 15 años, con mayor frecuencia en edad preescolar y especialmente prepuberal. Representa alrededor del 1O% del total de formas de DM y constituye una de las alteraciones crónicas más frecuentes en la infancia y la adolescencia. La destrucción de las células β pancreáticas comporta un déficit absoluto de insulina en estos enfermos por lo que precisan tratamiento con insulina desde el momento del diagnóstic

Educación sanitaria en la diabetes mellitus

En el X Congreso de médicos y biólogos de lengua catalana, celebrado en Perpignan en 1976, se definió la salud, antropológica y culturalmente, como la forma de vida cada vez más autónoma, solidaria y alegre..

Complicaciones cronicas de la diabetes mellitus

La diabetes mellitus (DM) es una de las enfermedades con mayor impacto sociosanitario, no sólo por su elevada prevalencia, sino, sobre todo, por las consecuencias de las complicaciones crónicas que genera. La hiperglucemia ocasiona daño tanto en el ámbito de la microcirculación como en los grandes vasos provocando lesiones macroangiopáticas y microangiopáticas. Las complicaciones macroangiopáticas se originan a partir de alteraciones o lesiones en los grandes vasos arteriales siendo las más importantes, desde el punto de vista clínico, la cardiopatía isquémica, la enfermedad cerebrovascular y la arteriopatía periférica. Las complicaciones microangiopáticas son consecuencia de alteraciones o lesiones de pequeños vasos siendo las más importantes, desde el punto de vista clínico, la nefropatía, la retinopatía y la neuropatía diabéticas