Aproximación á incorporación de perspectiva de xénero nunha materia de Grao en Enfermaría

[Resumo] Entre os determinantes que condicionan o nivel de saúde da comunidade atópase o medioambiente psicosocial e sociocultural que engloba unha ampla gama de determinantes sociais da saúde como o sexo, a igualdade de xénero, a pobreza e a equidade (OPS/OMS, 2010). A finalidade principal da acción enfermeira é potenciar ao máximo o grao de saúde das persoas, capacitándoas para a independencia e a vivencia plena de cada unha das etapas do seu ciclo vital a través da educación. Os alumnos de Grao en Enfermaría deben estar en condicións de detectar os factores que poñen a mulleres e homes en risco para a saúde e abordar as súas necesidades con intervencións eficaces. O xénero é un deses factores, e cremos que é imprescindible adoptar unha perspectiva de xénero na saúde comunitaria para lograr a equidade en saúde (Ponferrada Arteaga, 2017). Na materia “Enfermaría Comunitaria I” se desenvolveron tres talleres de docencia interactiva en grupos de 20 alumnos, de hora e media de duración. Realizáronse lecturas e dinámicas de debate ou elaboración de materiais dixitais que se compartiron co grupo completo na aula virtual Moodle (Alcántara, 2008; Gavidia y Talavera 2012; OMS 2016). Os nosos estudantes constataron a necesidade de reflexionar en como inflúen de distinta maneira nos problemas de saúde de mulleres e homes, non só os factores biolóxicos senón tamén os relacionados co estilo de vida e mesmo coas diferenzas no acceso e uso dos servizos do sistema sanitario. Todo iso bastante relacionado á vez con outros determinantes sociais como idade, grupo étnico, situación socioeconómica, etc

Barreras y facilitadores para el afrontamiento de las mujeres con virus del Papiloma Humano

Programa Oficial de Doutoramento en Ciencias da Saúde. 5007V01[Resumo] Obxectivo: explorar as experiencias das mulleres diagnosticadas de neoplasia intraepitelial cervical (NIC) relativas ao proceso de asistencia sanitaria. Metodoloxía: realizouse un estudo cualitativo xenérico utilizando unha perspectiva post-estructuralista do manexo clínico do risco nunha Unidade de Xinecoloxía dun hospital público do Servizo Galego de Saúde (España). A mostra, seleccionada mediante mostraxe intencionada, consistiu en 21 mulleres con idades entre 21 e 52 anos e confirmación diagnóstica de NIC. As entrevistas semiestructuradas graváronse e transcribíronse e se levou a cabo unha análise cualitativa inductiva-deductiva de datos. Resultados: identificáronse dous temas: (a) experiencias das mulleres con NIC con relación ao proceso de atención realizado polos profesionais sanitarios de Atención Primaria y Especializada, e (b) consecuencias da vixilancia médica de NIC na vida persoal e social das mulleres. Conclusións: a información proporcionada ás mulleres era limitada, o que dificultaba que comprenderan e participasen na toma de decisións relativa á vixilancia médica e ao tratamento de NIC. Os/as xinecólogos/as trivializaban os cambios que as mulleres debían levar a cabo e subestimaban os efectos que as recomendacións médicas tiñan sobre o seu benestar persoal e as súas relacións sociais.[Resumen] Objetivo: explorar las experiencias de las mujeres diagnosticadas de neoplasia intraepitelial cervical (NIC) relativas al proceso de asistencia sanitaria. Metodología: se ha realizado un estudio cualitativo genérico utilizando una perspectiva post-estructuralista del manejo clínico del riesgo en una Unidad de Ginecología de un hospital público del Servizo Galego de Saúde (España). La muestra, seleccionada mediante muestreo intencional, consistió en 21 mujeres con edades entre 21 e 52 años y confirmación diagnóstica de NIC. Las entrevistas semiestructuradas se grabaron y transcribieron. Se llevó a cabo un análisis cualitativo inductivo-deductivo de datos. Resultados: se identificaron dos temas: (a) experiencias de las mujeres con NIC con relación al proceso de atención realizado por los profesionales sanitarios de Atención Primaria y Especializada, y (b) consecuencias de la vigilancia médica de NIC en la vida personal y social de las mujeres. Conclusiones: la información proporcionada a las mujeres era limitada, lo que dificultaba que comprendieran y participasen en la toma de decisiones con respecto a la vigilancia médica y el tratamiento de NIC. Los/as ginecólogos/as trivializaban los cambios que las pacientes debían llevar a cabo y subestimaban los efectos que las recomendaciones médicas tenían sobre el bienestar personal y las relaciones sociales de estas mujeres.[Abstract] Objective: To explore the experiences of women diagnosed with cervical intraepithelial neoplasia (CIN) related to their health care process. Methodology: A generic qualitative study using a poststructuralist perspective of risk management was carried out in a gynecology clinic in a public hospital of the Galician Health Care System (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women, aged 21 to 52 years old, with a confirmed diagnosis of CIN. Semi-structured interviews were recorded and transcribed. An inductive-deductive qualitative data analysis was carried out. Results: Two themes were identified: (a) experiences of women diagnosed with CIN in relation to the health care process carried out by the health professionals of primary care and specialized care, and (b) effects of medical surveillance on the personal and social lives of women undergoing CIN follow-up and treatment. Conclusions: The information given to women diagnosed with CIN is limited, which makes it difficult for them to understand and participate in the decision making regarding the prevention and treatment of CIN. CIN medical surveillance performed by gynecologists simultaneously trivializes the changes expected of patients and underestimates the effects of medical recommendations on patients’ personal wellbeing and social relations

Mujeres con displasia de cérvix: significado y experiencias

[Resumen] La presencia de cambios anormales en las células de la superficie del cuello uterino se denomina displasia, es producida por la infección del Virus del Papiloma Humano y es considerada una de las enfermedades de transmisión sexual más comunes. Con frecuencia (>90%), estos cambios regresan a la normalidad espontáneamente, pero, en ocasiones, evolucionan a cáncer de cérvix. Tras la revisión bibliográfica, se aprecia la alta morbilidad a nivel fisiológico que este problema produce, con muy pocos datos acerca de la adaptación psicológica de estas mujeres y de cómo experimentan su proceso desde su propia perspectiva, lo que resulta de abordaje indispensable para el trabajo de los profesionales sanitarios y la atención de Enfermería[Abstract] The presence of abnormal changes in the cells of the surface of the cervix are called dysplasia, is caused by infection of the Human Papilloma Virus and is considered one of the most common sexual disease transmission. Often (> 90%), these changes return to normal spontaneously, but sometimes progress to cervical cancer. Following the literature review, the high morbidity seen at the physiological level that this problem occurs with very few data on the psychological adjustment of these women and how they experience the process from their own perspective, which is indispensable approach to work of health professionals and nursing care.Traballo fin de grao (UDC.FEP). Enfermaría. Curso 2013/201

When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance

[Abstract] Background, After the early detection of cervical intraepithelial neoplasia (CIN), medical surveillance of the precancerous lesions is carried out to control risk factors to avoid the development of cervical cancer. Objective. To explore the effects of medical surveillance on the personal and social lives of women undergoing CIN follow-up and treatment. Methodology. A generic qualitative study using a poststructuralist perspective of risk management was carried out in a gynecology clinic in a public hospital of the Galician Health Care System (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women with a confirmed diagnosis of CIN. Semistructured interviews were recorded and transcribed, and a thematic analysis was carried out, including researcher triangulation to verify the results of the analysis. Findings. Two main themes emerged from the participants’ experiences: CIN medical surveillance encounters and risk management strategies are shaped by the biomedical discourse, and the effects of “risk treatment” for patients include (a) profound changes expected of patients, (b) increased patient risk management, and (c) resistance to risk management. While doctors’ surveillance aimed to prevent the development of cervical cancer, women felt they were sick because they had to follow strict recommendations over an unspecified period of time and live with the possibility of a life-threatening disease. Clinical risk management resulted in the medicalization of women’s personal and social lives and produced great uncertainty. Conclusions. This study is the first to conceptualize CIN medical surveillance as an illness experience for patients. It also problematizes the effects of preventative practices in women’s lives. Patients deal with great uncertainty, as CIN medical surveillance performed by gynecologists simultaneously trivializes the changes expected of patients and underestimates the effects of medical recommendations on patients’ personal wellbeing and social relations

Health care informational challenges for women diagnosed with cervical intraepithelial neoplasia : a qualitative study

[Abstract] Background: Internationally, women with cervical intraepithelial neoplasia (CIN) lack knowledge about their disease, which limits their ability to take responsibility for self-care and creates negative psychosocial effects, including marital problems. Normally, screening is performed in primary care, and in case of abnormal results, the patient is referred to specialized care for follow-up and treatment. Given the lack of international literature regarding patients’ experiences in primary and specialized healthcare, our study aims to: (a) investigate how women with CIN perceive the communication and management of information by healthcare providers at different moments of their healthcare and (b) identify these women’s informational needs. Methods: A qualitative exploratory study was carried out in a gynecology unit of a public hospital of the Galician Health Care Service (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women aged 21 to 52 years old with a confirmed diagnosis of CIN. Semistructured interviews were recorded and transcribed. A thematic analysis was carried out, including triangulation of researchers for analysis verification. Results: Two analytical themes were identified. The first was communication gaps in the diagnosis and management of information in primary and specialized healthcare. These gaps occurred in the following moments of the healthcare process: (a) cervical cancer screening in primary care, (b) waiting time until referral to specialized care, (c) first consultation in specialized care, and (d) after consultation in specialized care. The second theme was participants’ unmatched informational needs. The doubts and informational needs of women during their healthcare process related to the following subthemes: (a) HPV transmission, (b) HPV infection symptoms and consequences, and (c) CIN treatment and follow-up. Conclusions: This study shows that women who have a diagnosis of CIN experience important healthcare informational challenges when accessing primary and specialized care that have several implications for their wellbeing. The information given is limited, which makes it difficult for women to understand and participate in the decision making regarding the prevention and treatment of CIN. Service coordination among different levels of care and the availability of educational materials at any given time would improve the patients’ healthcare experience.Xunta de Galicia; ED481A-2016/34

Asymmetric power relations in gynaecological consultations for cervical cancer prevention: biomedical and gender issues

[Abstract] A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters

Aprendizaje cooperativo para la sensibilización en violencia de género

[Resumen] La violencia de género (VG) es un importante problema de salud pública que afecta a millones de mujeres en el mundo. Las enfermeras frecuentemente son los primeros profesionales de salud que evalúan a las víctimas de abuso. Una de las principales barreras identificadas por las enfermeras en el screening de la VG es el tipo de formación que han recibido. Como consecuencia, las enfermeras puede que no reconozcan los signos de VG o no se sientan seguras en el manejo de estas situaciones. Con el fin de asegurar que los estudiantes de grado de enfermería tengan experiencia en la detección de la VG así como en la implementación de adecuadas estrategias de intervención, un grupo de profesores de enfermería han desarrollado una actividad de aprendizaje activo y cooperativo. Esta experiencia muestra la importancia de proveer a los estudiantes de enfermería de conocimientos y habilidades en VG para poder trabajar con mujeres como profesionales de enfermería competentes.[Abstract] Intimate partner violence (IPV) is a significant public health problem affecting millions of women in the world. Nurses are often the first health care professionals to assess victims of abuse. One of the most common identified barriers to nurses not screening for IPV is the lack of training. As a result, nurses may not recognize signs of IPV or feel confident in handling the situation. In order to ensure nursing degree students gain experience in assessing for IPV and implementing appropiate intervention strategies, nursing faculty developed an active and cooperative learning activity. This experience demonstrates the importance of equipping nurse students with the knowledge and skills in IPV to work with women as a competent nursing graduates

Gender-based violence attitudes and dating violence experiences of students in nursing and other health sciences: a multicentre cross-sectional study

[Abstract] Background: Gender-based violence is a major public health problem. Healthcare providers' ability to identify this type of violence and support victims may be influenced by their knowledge, attitudes, and beliefs, which requires solid education. Objectives: To identify the gender-based violence attitudes and dating violence experiences of students in nursing and other health sciences. Design: A multicentre cross-sectional study was performed. Settings: This study was conducted in three faculties of the University of A Coruña, Spain. Participants: Participants were undergraduate students of nursing, podiatry, occupational therapy, and physiotherapy. Methods: The Attitudes towards Gender and Violence Questionnaire and the Dating Violence Questionnaire were used from October 2019 to March 2020. Descriptive and inferential statistics were calculated to determine associated factors and identify differences in gender-based violence attitudes and dating violence experiences between sexes and degrees. Results: Data from 459 students were analysed, of whom 180 (39.2 %) studied nursing. The mean age was 20.9 (SD = 3.6) and 76.0 % were women. Statistically significant differences were obtained in attitudes towards gender-based violence according to sex where men displayed more sexist attitudes and violence justification. Results showed a significant difference in attitudes regarding the biological usefulness of sexism and violence between students of nursing and other health sciences. 61.9 % of students had experienced one or more abusive behaviours in relationships; no significant differences were detected according to the degree. However, male students experienced dating violence more often than females. It was observed that students who had suffered dating violence showed greater agreement with sexist attitudes that justify violence. Conclusion: Students of health sciences, particularly males and nursing students, show sexist attitudes that justify gender-based violence. They also frequently experience dating violence, especially psychological violence. It is necessary to intensify or include education on these types of violence in the curricula of degrees in health sciences

Using photovoice to explore the impact on a student community after including cross-sectional content on environmental sustainability in a university subject: a case study

[Abstract] Purpose. Higher education institutions have a significant impact in preparing future generations for the creation of a sustainable society. By formulating appropriate curricula, the university can shape student personality with sustainability concerns. This study aims to present the results of a teaching approach on environmental sustainability using the photovoice methodology. A guided visit to the sewage treatment plant of A Coruña was included as a teaching activity in the “Microbiology and Parasitology” classes of the podiatry degree at University of A Coruña. The teaching objectives were to reinforce contents through observation and to introduce citizen awareness on sustainability and responsible water use in a cross-sectional manner. Design/methodology/approach. In this case study, different steps of photovoice as a qualitative participatory action methodology were developed. A total of 43 university students willingly participated with their photographs. Qualitative data were collected from the students’ photovoice visit reports and a subsequent discussion group. Thematic content analysis was performed manually. Findings. This study explored the impact of an environmental sustainability teaching activity on the university student community. Six main categories emerged from the qualitative analysis: savings/waste of water, misuse of the water closet, disposing of used oil, solid waste/trash, reuse of clean water and reuse/reduction of the use of plastics. The cross-sectional findings on the needs of education and awareness of sustainability in the community and companies are presented. Originality/value. The findings provide evidence of the ability of photovoice method as a pedagogical tool to promote reflection and change in the university community and to introduce sustainability cross-sectional content in green campus curricula. This photovoice experiment is simple and feasible to implement and has a very low economic cost, as long as there are qualified educators

Fotovoz, una metodología de investigación acción participativa, aplicada para evaluar una actividad académica en una materia de Grado en Podología

[Resumen] Entre las actividades académicas de la asignatura "Microbiología y Parasitología" de Grado en Podología se incluyó una visita guiada a la depuradora de aguas residuales de A Coruña. El objetivo de este trabajo es presentar una metodología de investigación acción participativa para evaluar la pertinencia de la actividad docente. Se ha implementado el uso de diferentes pasos de fotovoz que fomenta la participación de la comunidad estudiantil a través de la fotografía y facilita la reflexión crítica sobre una realidad concreta, con el objetivo final de ser colectivamente conscientes. Cuarenta y tres estudiantes universitarios de edad comprendida entre los 18 y 45 años (edad media 22,9) presentaron foto en color y reflexiones sobre ella en su informe individual. Los resultados se obtuvieron del análisis cualitativo de las fotografías, las narraciones del informe, y la transcripción del grupo de discusión posterior realizado en clase. Se identificaron ocho categorías principales que emergieron de los datos. Consideramos muy positiva la aplicación de esta metodología cualitativa para complementar actividades formativas que se realizan en entorno real y que implican acciones con consecuencias para la comunidad. Fotovoz se puede considerar eficaz para introducir contenido transversal de sostenibilidad en los currículos de campus verdes.[Abstract] Among the academic activities of the subject "Microbiology and Parasitology" of Degree in Podiatry, a guided visit to the wastewater treatment plant of A Coruña was included. The objective of this work is to present a participatory action research methodology to evaluate the relevance of the above teaching activity. The use of different photovoice steps was implemented. Photovoice encourages the participation of the student community through photography and facilitates critical reflection on a specific reality, with the ultimate goal of being collectively aware. Forty-three university students aged between 18 and 45 years (average age 22.9) presented a color photo and reflections on it in their individual report. The results were obtained from the qualitative analysis of the photographs, the narratives of the report, and the transcription of the subsequent discussion group conducted in class. Eight main categories that emerged from the data were identified. We consider the application of this qualitative methodology to complement teaching assignments very positive. Especially, for those activities that are carried out in a real environment and that involve actions with consequences for the community. Photovoice can be considered effective in introducing transversal sustainability content in green campus curricula.https://doi.org/10.17979/spudc.978849749775