Experiências de mulheres migrantes cuidadoras em cuidados formais no final da vida

Objective: To describe and understand the experience of Latin American migrant women as caregivers of elderly people in situations of advanced illness and end of life. Method: Qualitative study using Gadamer’s hermeneutic phenomenology. Data were collected in 2019 through 9 semi-structured interviews with Latin American women caregivers, who had cared for people at the end of life, in the Province of Granada (Spain). Results: Two themes emerged: “Migrant caregiver at the end of life” and “And now, what should I do?”: the impact of the loss at the economic, emotional and labor level Conclusion: Care during the end of life of the cared person generates an additional overload to the situation of migrant women. The experience of this stage is related to the bond with the persons cared and their families, which may affect the development of complicated grief and personal problems related to the loss of employment and the absence of economic support.Objetivo: Describir y comprender la experiencia de las mujeres migrantes latinoamericanas como cuidadoras de personas mayores en situación de enfermedad avanzada y final de la vida. Método: Estudio cualitativo desde la fenomenología hermenéutica de Gadamer. Los datos fueron recogidos en 2019 mediante 9 entrevistas semiestructuradas a cuidadoras latinoamericanas, que hubieran atendido a personas al final de la vida en Granada (España). Resultados: Surgieron 2 temas: “Cuidadora migrante al final de la vida” e “Y ahora ¿qué hago?”: El impacto de la pérdida a nivel económico, emocional y laboral Conclusión: La atención durante el final de la vida de la persona cuidada genera una sobrecarga adicional a la situación de las mujeres migrantes. La vivencia de esta etapa se relaciona con el vínculo con la persona cuidada y su familia, que puede incidir en la elaboración de un duelo complicado y problemas personales relacionados con la pérdida de empleo y la ausencia de apoyo económico.Objetivo: Descrever e compreender a experiência de mulheres migrantes latino-americanas, cuidadoras de idosos em situações de doença avançada e de fim da vida. Método: Estudo qualitativo baseado na fenomenologia hermenêutica de Gadamer. Os dados foram coletados em 2019 por meio de 9 entrevistas semiestruturadas com mulheres cuidadoras latino-americanas que cuidaram de pessoas no final da vida em Granada (Espanha). Resultados: Surgiram dois temas: “Cuidador migrante no fim da vida” e “E agora, o que eu faço?”: o impacto da perda nos níveis econômico, emocional e de trabalho. Conclusão: O cuidado durante o fim da vida da pessoa cuidada gera uma sobrecarga adicional à situação das mulheres migrantes. A experiência dessa fase está relacionada ao vínculo com a pessoa cuidada e sua família, o que pode ter um impacto na elaboração de luto complicado e problemas pessoais relacionados à perda do emprego e à ausência de apoio econômico

The post-endodontic periapical lesion : histologic and etiopathogenic aspects

Apical periodontitis is produced in the majority of cases by intraradicular infection. Treatment consists in the elimination of the infectious agents by endodontia. Even when carrying out a correct cleansing and filling of canals, it is possible that periapical periodontitis will persist in the form of an asymptomatic radiolucency, giving rise to the post-endodontic periapical lesion. The chronic inflammatory periapical lesion is the most common pathology found in relation to alveolar bone of the jaw. From the histological point of view, it can be classified as chronic periapical periodontitis (periapical granuloma), radicular cyst, and as scar tissue. The most frequent is the periapical granuloma, constituted by a mass of chronic inflammatory tissue, in which isolated nests of epithelium can be found. The radicular cyst is characterized by the presence of a cavity, partially or wholly lined by epithelium. Scar tissue is a reparative response by the body, producing fibrous connective tissue. The aim of this study is to review and update the etiopathogenic and histological aspects of chronic post-endodontic periapical lesions

Content analysis of the effects of palliative care learning on the perception by nursing students of dying and dignified death

Background: Providing care for dying people and the death of patients are stressing situations faced by nursing students during their clinical practice. Learning about palliative care improves the management of emotions and the ability to cope when caring for patients in end-of-life processes. However, there is little knowledge on the effect of this learning on the students' perceptions of their own death. Objectives: To determine the effect of a palliative care course on the thoughts of nursing students about their own death. Design: A qualitative, descriptive, and comparative study was conducted based on content analysis, administering an open-ended questionnaire on dying and death at the start and end of a palliative care course. Participants: The study included 85 volunteers studying Palliative Care in the second year of their Nursing Degree at the University of Granada (Spain). Results: Students described their perceptions in more detail after the course, with more numerous code citations, and their post-course responses evidenced a reduction in anxiety about their own death and an increased recognition of the need to respect the decisions of patients for a dignified death. Conclusions: Palliative care learning modifies the perception by nursing students of their own death and their understanding of a dignified death, which may enhance the care they deliver to patients at the end of life

Cultural Adaptation, Validation, and Analysis of the Self-Efficacy in Palliative Care Scale for Use with Spanish Nurses

The aim of the present study is to validate the Self-Efficacy in Palliative Care Scale (SEPC) in Spanish nursing professionals and students, to describe their levels of self-e cacy, and to determine the influencing factors. A validation study and a cross-sectional descriptive study were carried out, with the data analysed using contrast tests and multiple linear regression; 552 nurses and 440 nursing students participated. The Spanish version consists of 23 items and has a high degree of reliability (alpha = 0.944). Confirmatory factor analysis revealed one additional factor (i.e., management of psychosocial and spiritual aspects) in comparison to the original scale. Contrast tests revealed that the mean SEPC score was higher in professionals than in students (p < 0.001) and that the professionals who had higher levels of self-efficacy were older (p < 0.001), had more previous training (p < 0.001), and had more experience in end-of-life care (p = 0.001). The linear analysis results confirm a significant association between age and previous training in end-of-life care. The Spanish version of the SEPC is a reliable tool for both nursing professionals and students. The level of self-efficacy of both groups is moderate and is influenced by age, experience, and training in end-of-life care.The present study has been supported by the Spanish Ministry of Education through a University Faculty Training contract granted to RHH (FPU15/02487)

The concept of death in children aged from 9 to 11 years: Evidences through inductive and deductive analysis of drawings

The objective of the research was to analyze children’s conceptualization of death through drawings, using a mixed approach, which combines deductive and inductive qualitative analysis. The sample consisted of 99 children aged 9–11 years, who were asked to elaborate a drawing about their idea of death and to explain it to the researchers. Drawings were coded basing on Tamm and Granqvist’s model (deductive analysis) and codes and categories were created and modified (inductive analysis). Three main categories were identified in the analysis and four sub-categories were modified and/or created: causes of death, good death, anxiety-fear and symbolization

Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)

Discrepant results have been published by studies comparing deaths by suicide with attempted suicides. This study aimed to determine factors associated with suicides and attempted suicides in Andalusia (Spain) between 2007 and 2013, comparing sex, age, year, and suicide method between these populations. A retrospective study was conducted of data on deaths by suicide and attempted suicides over a seven-year period, calculating the sex and age rates for each behavior. Adjusted Poisson regression was used to analyze the association with study variables, and incidence rate ratios were estimated. During the seven-year study period, 20,254 attempted suicides and 5202 deaths by suicide were recorded. The prevalence of attempted suicide did not differ between the sexes, whereas the prevalence of deaths by suicide was three-fold higher among males than among females and increased with higher age. The most frequently used method was the same in males and females for suicide attempts, but differed between the sexes for suicides. The combined influence of sex and age was greater in the model for death by suicide than in the model for attempted suicide. The key differentiating factor was the method used, while the finding of greatest concern was the suicide behavior among the elderly. Preventive strategies should take these differences into account

Suicide attempts in Spain according to prehospital healthcare emergency records

Objective To analyze the number and characteristics of suicide attempts by reviewing records of the public emergency healthcare service information system. Method A retrospective observational study was conducted of emergency telephone calls received between January 1 2007 and December 31 2013 throughout the Andalusia region (Southern Spain). Cases were selected based on phone operator or healthcare team labeling. Data were analyzed on the characteristics of the individuals, the timing and severity of attempts, their prioritization, and their outcome. Results Between January 1 2007 and December 31 2013, 20.942 calls related to suicide attempts were recorded, a rate of 34.7 attempts per 100,000 inhabitants. Most cases were classified by the public emergency healthcare service (Empresa Pública de Emergencias Sanitarias, EPES) as code X84 (The International Statistical Classification of Diseases, tenth revision, ICD-10) or 305(The International Statistical Classification of Diseases, ninth revision, ICD- 9). Attempts were more frequent in the 35-49-year age group and there were similar proportions of males and females. The lowest number of calls for suicide attempts were in 2007 and the highest in 2013. Calls were more frequent during the summer months, at weekends, and between 16:00 and 23:00 h. The likelihood of evacuation to the hospital emergency department was almost two-fold lower in over 65-yr-olds than in younger individuals. Significant (ƿ = 0.001) gender differences were found in call outcome and prioritization. The most influential factor for evacuation to a hospital emergency department was the code assigned by the attending healthcare team. Conclusions Information obtained from extra-hospital emergency services provides valuable data on the characteristics and timing of calls related to suicide attempts, complementing information from hospital emergency departments or population surveys. There is a need to standardize the definition and recording of a suicide attempt.The authors are grateful to the Public Enterprise of Healthcare Emergencies of Andalusia (Empresa Pública de Emergencias Sanitarias de Andalucía) for providing the data used in this study

Understanding the Occupational Adaptation Process and Well-Being of Older Adults in Magallanes (Chile): A Qualitative Study

Background: Aging and longevity are important topics nowadays. Purpose: To describe how older adults perform the occupational adaptation process in the extreme region of Magallanes (Chile), and to identify the factors that might contribute to successful occupational adaptation and well-being. Method: Qualitative study, with a phenomenological interpretative approach. In-depth interviews were carried out with 16 older adults, with high or low levels of well-being, assessed with the Ryff Scale. An inductive content analysis according to Elo and Kyngäs was performed. Findings: Resilience, self-esteem and interdependence with significant others are key elements that promote well-being. Participants develop strategies to minimize the effects of environmental factors. The occupation’s function in terms of socialization, use of time, and social participation is revealed as a conditioning factor of occupational adaptation. Implications: Interventions with older people to achieve a successful occupational adaptation process must take into consideration the commitment to meaningful activities

El uso de las TICs en Atención Primaria de Salud por parte de enfermería

Objetivos Determinar el papel de las TICs como herramienta para el personal de enfermería de Atención Primaria (AP) Se realizó una revisión de la literatura de Julio a Septiembre de 2018 en las bases de datos Medline, Scielo, Cuiden, Dilanet, Elsevier, Ovid y Cochrane. Los criterios de inclusión fueron idioma español o inglés y fecha de publicaición últimos 5 años. Se utilizaron los términos incluidos en el DeSH ICT, Nurs* y Primary Care. Los operadores booleanos utilizados en la estrategia de búsqueda fueron AND y OR. Se realizó una evaluación crítica mediante la herramienta CASPe. Resultados Los estudios revisados incluyeron este tipo de recursos en programas para dejar de fumar, tratamiento de la obesidad, seguimiento y prevención de osteoporosis, TCA, diabetes, HTA y dislipemia. Las dimensiones en las que se suele implementar son, la evaluación de pacientes, planificación y evaluación de la atención prestada, gestión del tiempo, calidad de la atención y seguridad del paciente, además de barreras lingüísticas. Como principales ventajas, los pacientes que están bien informados, serán más propensos a adoptar hábitos de vida saludables y manejar su condición. Podría ser una herramienta útil para cuidadores informales. Una de las principales limitaciones para enfermería, es la población en la que implementar esta estrategia, la cual debe ser normalmente, gente joven con un nivel socio cultural alto. y algunas cuestiones polémicas como el riesgo y beneficio que supone su uso en determinados colectivos. Conclusiones Las TICs tienen una amplia aplicación en AP. El personal debe estar formado en su uso para poder capacitar al usuario. La realización de talleres específicos con poblaciones diana, especialmente crónicos, puede facilitar el registro de información y la comunicación, ventajas que pueden convertirse en las principales limitaciones relacionadas con su usoUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Alfabetización en Salud y Enfermedades Crónicas

Objetivo:Determinar el papel de la alfabetización en salud en el manejo de las enfermedades crónicas. Metodología:Se realizó una revisión de la literatura llevando a cabo una búsqueda bibliográfica durante julio-septiembre de 2018, en las bases de datos Medline, Scielo, Cuiden, Dialnet, Elservier, Ovid y Cochrane. Los criterios de inclusión fueron: idioma español/inglés; fecha de publicación en los últimos 5 años. Se utilizaron los términos incluidos en los Descriptores en Ciencias de la Salud.Los operadores booleanos utilizados en las distintas fórmulas de búsqueda que dieron lugar tras la conjunción de dichos términos fueron AND y OR. Se realizó una evaluación crítica mediante la herramienta CASPe. Resultados:La alfabetización en salud se asocia con la adherencia al tto y el autocontrol de la enfermedad. A pesar de ello, el nivel en pacientes con enfermedades crónicas es generalmente bajo. Así mismo, las creencias que el paciente tiene sobre su salud, pueden determinar las conductas que lleve a cabo en la autogestión de su proceso. El nivel de alfabetización en salud no depende sólo del paciente sino también del personal que le atiende y sus habilidades comunicativas.En general, al mejorar la alfabetización en salud de pacientes y cuidadores, se reducen los comportamientos de riesgo y las tasas de hospitalización. Conclusiones:Comprender la naturaleza y el impacto de la alfabetización en salud debería ser una prioridad en la gestión de nuestro sistema sanitario. Los resultados muestran la necesidad de invertir recursos en la promoción de salud, prevención y tratamiento de enfermedades a través de esta estrategia. Aunque no existe consenso en su definición, la alfabetización en salud comprende una serie de habilidades que permiten al individuo acceder, comprender y evaluar, la información de salud para actuar en aras de mejorar su salud y bienestar. La alfabetización en salud es todavía una herramienta poco estudiada.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech