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INTRODUCTION: Dyspareunia refers to painful sexual intercourse that negatively affects a person's psychological well-being and quality of life and can also have an impact on their partner, family, and social circle. The objective of this study was to understand the experiences of women with dyspareunia and a history of sexual abuse in the Dominican Republic. METHODS: This was a qualitative study based on Merleau-Ponty's hermeneutic phenomenology. Fifteen women with a diagnosis of dyspareunia and a history of sexual abuse participated. The study was carried out in Santo Domingo, Dominican Republic. RESULTS: In-depth interviews were conducted for data collection. Through inductive analysis using ATLAS.ti, 3 main themes were developed that represent women's experiences of dyspareunia and sexual abuse: (1) a history of sexual abuse as a background to dyspareunia, (2) living in fear in a society that revictimizes the survivor, and (3) the sexual consequences of dyspareunia. DISCUSSION: In some Dominican women, dyspareunia stems from their history of sexual abuse, which was unknown to their families and partners. The participants experienced dyspareunia in silence and found it difficult to seek help from health care professionals. In addition, their sexual health was marked by fear and physical pain. There are individual, cultural, and social factors that influence the occurrence of dyspareunia; a better understanding of these factors is vital for planning innovative preventive strategies that reduce the progression of sexual dysfunction and its impact on the quality of life of people with dyspareunia.

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End-stage kidney disease has a negative impact on patients' quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer's hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) "The impact of a kidney transplant on sexuality", with the subthemes "sexuality is relegated to the background", "physical decline acts as a sexual inhibitor", and "changes in sexual activity following a kidney transplant"; (2) "Sexual education in kidney transplant recipients" with the subthemes "sexuality: a hidden concern amongst kidney transplant recipients" and "talking about sexuality with healthcare professionals". Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.

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Resumo Objetivo O objetivo deste estudo foi explorar as experiências e expectativas de pacientes submetidos a prostatectomia radical não poupadora de nervos. Métodos Estudo qualitativo, descritivo-exploratório, baseado na fenomenologia hermenêutica. Foram realizadas dezesseis entrevistas em profundidade entre fevereiro e dezembro de 2017 e análise indutiva dos dados. Resultados Dois temas que refletem as experiências dos pacientes emergiram da análise: (1) As mudanças sexuais como fator-chave da resposta adaptativa, com os subtemas "Dificuldades sexuais após a cirurgia" e "Questões com relacionamentos íntimos e bem-estar psicossocial"; (2) Prostatectomia: a necessidade de adaptação a uma sexualidade holística, com os subtemas "Questionamento das experiências a partir do comportamento sexual atual" e "Adaptação da sexualidade e a intimidade após a cirurgia". Conclusão Pacientes submetidos à prostatectomia enfrentam dificuldades sexuais como disfunção erétil. Essas mudanças causam problemas nos relacionamentos sexuais e íntimos que afetam seu bem-estar. Diante dessa situação, alguns participantes questionam suas práticas sexuais habituais e tentam se adaptar a uma sexualidade holística não centrada no coito, incorporando formas inovadoras de sexualidade. Conhecer as experiências de homens submetidos a prostatectomia radical pode ajudar os profissionais de saúde a oferecer novas estratégias para lidar com as mudanças ambientais envolvidas na cirurgia da próstata.

Resumen Objetivo El objetivo de este estudio fue analizar las experiencias y expectativas de pacientes sometidos a prostatectomía radical sin conservación de bandeletas neurovasculares. Métodos Estudio cualitativo, descriptivo-exploratorio, basado en la fenomenología hermenéutica. Se realizaron 16 entrevistas en profundidad entre febrero y diciembre de 2017 y un análisis inductivo de los datos. Resultados A partir del análisis, surgieron dos temas que reflejan las experiencias de los pacientes: (1) Los cambios sexuales como factor clave de la respuesta adaptativa, con dos subtemas "Dificultades sexuales después de la cirugía" y "Cuestiones sobre relaciones íntimas y bienestar psicosocial" y (2) Prostatectomía: necesidad de adaptación a una sexualidad holística, con los subtemas "Cuestionamiento de las experiencias a partir del comportamiento sexual actual" y "Adaptación de la sexualidad e intimidad después de la cirugía". Conclusión Los pacientes sometidos a prostatectomía enfrentan dificultades sexuales como disfunción eréctil. Estos cambios causan problemas en las relaciones sexuales e íntimas que afectan su bienestar. Ante esta situación, algunos participantes cuestionan sus prácticas sexuales habituales e intentan adaptarse a una sexualidad holística no centrada en el coito, incorporando formas innovadoras de sexualidad. Conocer las experiencias de hombres sometidos a prostatectomía radical puede ayudar a los profesionales de la salud a ofrecer nuevas estrategias para lidiar con los cambios ambientales relacionados con la cirugía de próstata.

Abstract Objective The aim of this study was to explore the experiences and expectations of patients who underwent non-nerve sparing radical prostatectomy. Methods A qualitative descriptive, exploratory, study, based on hermeneutic phenomenology. Sixteen in-depth interviews were carried out between February and December 2017. An inductive analysis of data was performed. Results Two themes reflecting the patients' experiences emerged from the analysis: (1) Sexual changes as a key factor of the adaptive response, with the subthemes "Sexual difficulties after surgery" and "Issues with intimate relationships and psychosocial wellbeing". (2) Prostatectomy: the need of adaptation to a holistic sexuality, with the subthemes "Questioning the experiences from the current sexual behavior" and "Adapting sexuality and intimacy after surgery". Conclusion Patients undergoing prostatectomy face sexual difficulties such as erectile dysfunction. These changes cause problems in sexual and intimate relationships that affect their wellbeing. Given this situation, some participants question their usual sexual practices and try to adapt to a holistic sexuality not centered on coitus by incorporating innovative forms of sexuality. Knowing the experiences of men who underwent radical prostatectomy might help healthcare workers to provide new strategies for coping with the environmental changes involved in prostate surgery.

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Resumo Objetivo Explorar e compreender as experiências sexuais de gestantes durante a gravidez. Métodos O estudo foi realizado em dois centros de saúde no Distrito Sanitário de Almería, sul da Espanha. Os participantes incluíram gestantes que receberam atendimento pré-natal e/ou educação para maternidade. Os critérios de inclusão foram estar grávida, manter atividade sexual e concordar em participar do estudo. Os critérios de exclusão foram ter limitações na atividade sexual por prescrição médica. A amostra foi composta por 15 gestantes selecionadas por meio de amostra de conveniência, das quais cinco participaram de grupo focal (GF) e 10 de entrevistas em profundidade (EP). Os dados foram coletados entre os meses de junho e dezembro de 2016. Os participantes foram contatados pelo pesquisador principal e foi realizada uma consulta para conduzir o GF ou EP. Resultados Três categorias principais emergiram: Falsas crenças e uma abordagem holística da sexualidade durante a gravidez, que está relacionada ao conceito de sexualidade, falsas crenças e aconselhamento sexual limitado durante a gravidez. Limitações: Do medo no início à dificuldade física no final, referindo-se às flutuações no desejo sexual, bem como às mudanças físicas que limitam a atividade sexual. Adaptação às mudanças: práticas seguras e satisfação com a imagem corporal, que engloba preocupações com os riscos e a relação entre imagem corporal e autoestima. Conclusão A falta de aconselhamento sexual durante a gravidez leva à criação de falsas crenças, que, juntamente com mudanças físicas, preocupações com o risco e flutuações no desejo e interesse sexual, provocam uma diminuição na atividade sexual. Mas a sexualidade permanece um aspecto importante da gravidez, em relação ao qual os participantes devem adotar uma abordagem mais ampla e não limitada ao ato sexual, além de adotar práticas adaptadas às mudanças físicas e emocionais que ocorrem durante esse período.

Resumen Objetivo Explorar y comprender las experiencias sexuales de gestantes durante el embarazo. Métodos Estudio realizado en dos centros de salud del Distrito Sanitario de Almería, Sur de España. Dentro de los participantes se incluyó a gestantes que recibieron atención prenatal y/o educación para la maternidad. Los criterios de inclusión fueron: estar embarazada, mantener actividad sexual y aceptar participar del estudio. Los criterios de exclusión fueron tener limitaciones de actividad sexual por prescripción médica. Muestra compuesta por 15 embarazadas seleccionadas mediante muestra de conveniencia, cinco de las cuales participaron del grupo focal (GF) y 10 de entrevistas en profundidad (EP). Datos recolectados entre junio y diciembre de 2016. Las participantes fueron contactadas por el investigador principal, realizando una consulta para incluirlas en el GF o en el EP. Resultados Surgieron tres categorías principales: Falsas creencias y un abordaje holístico de la sexualidad durante el embarazo, relacionada al concepto de sexualidad; falsas creencias y asesoramiento sexual limitado durante el embarazo. Limitaciones: Del miedo inicial a la dificultad física al final, refiriéndose a las fluctuaciones en el deseo sexual, así como a los cambios físicos limitantes de la actividad sexual. Adaptación a los cambios: prácticas seguras y satisfacción con la imagen corporal, que incluye preocupaciones con los riesgos y la relación entre imagen corporal y autoestima. Conclusión La falta de asesoramiento sexual durante el embarazo lleva a crear falsas creencias, que, conjuntamente con los cambios físicos, preocupaciones por riesgos y fluctuaciones del deseo e interés sexual, provocan una disminución de la actividad sexual. Pero la sexualidad continúa siendo un aspecto importante del embarazo, respecto del cual los participantes deben adoptar un abordaje más amplio y no limitado al acto sexual, además de adoptar prácticas adecuadas a los cambios físicos y emocionales típicos del período.

Abstract Objective To explore and understand the sexual experiences of expectant mothers during their pregnancy. Methods The study was carried out in two healthcare centers in the Almería Health District, in southern Spain. The participants included pregnant women who received prenatal care and/or maternity education. The inclusion criteria were being pregnant, maintaining sexual activity and agreeing to participate in the study. The exclusion criteria were having limitations on sexual activity by medical prescription. The sample consisted of 15 expectant women selected using a convenience sample, of which 5 took part in a focus group (FG) and 10 in in-depth interviews (IDI). Data was collected between the months of June and December 2016. Participants were contacted by the main researcher and an appointment was made to carry out the FGs or the IDIs. Results Three main categories emerged: False beliefs and a holistic approach to sexuality during pregnancy, which is related to the concept of sexuality, false beliefs, and limited sexual counseling during pregnancy. Limitations: From fear at the beginning to physical difficulty at the end, referring to the fluctuations in sexual desire as well as the physical changes that limit sexual activity. Adapting to changes: safe practices and satisfaction with one's body image, which encompasses concerns about the risks and the relationship between body image and self-esteem. Conclusion A lack of sexual counseling during pregnancy leads to the creation of false beliefs, which, together with physical changes, concerns about the risk, and fluctuations in sexual desire and interest, bring about a decrease in sexual activity. But sexuality remains an important aspect of pregnancy, toward which the participants must adopt a broader approach, not limited to intercourse, and adopt sexual practices that are adapted to the physical and emotional changes that happen during this time.

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BACKGROUND: Respecting dignity is having a profound effect on the clinical relationship and the care framework for terminally ill patients in palliative care units, hospices and their own homes, with particular consequences for the emergency department. However, dignity is a vague and multifaceted concept that is difficult to measure. OBJECTIVE: The aim of this study is to define the attributes of dignity in end-of-life care in the emergency department, based on the opinions of physicians and nurses. RESEARCH DESIGN: A hermeneutic phenomenological approach utilising Gadamer's philosophical underpinnings guided the study. Participants and research context: This research was conducted in Spain in 2013-2014. Participants included 10 physicians and 16 nurses with experience working in the emergency department. Two focus groups and 12 in-depth interviews were carried out. Ethical considerations: The study was approved by the Research Centre Ethical Committee (Andalusian Health Service, Spain). FINDINGS: The results point to the person's inherent value, socio-environmental conditions and conscious actions/attitudes as attributes of dignity when caring for a dying patient in the emergency department. DISCUSSION: Dying with dignity is a basic objective in end-of-life care and is an ambiguous but relevant concept for physicians and nurses. In line with our theoretical framework, our results highlight care environment, professional actions and socio-family context as attributes of dignity. CONCLUSION: Quality care in the emergency department includes paying attention to the dignity of people in the process of death. The dignity in the care of a dying person in the emergency department is defined by acknowledging the inherent value in each person, socio-environmental conditions and social and individual acceptance of death. Addressing these questions has significant repercussions for health professionals, especially nurses.

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Resumo Objetivo Avaliar se um workshop de simulação e curta duração sobre punção da artéria radial melhoraria a competência de alunos de enfermagem em um nível em que pudessem praticar o procedimento em um paciente vivo sem comprometer sua segurança. Métodos Estudo quase-experimental do tipo pré-teste e pós-teste com um grupo de 111 estudantes do terceiro ano de enfermagem. Foi implementado um workshop de simulação e 1,5 horas de duração. Isso incluiu uma vídeo-palestra, demonstrações ao vivo, prática simulada autodirigida em díades e feedback intermitente individual. As habilidades, conhecimentos e autoeficácia dos participantes em punção arterial foram medidos antes e depois da participação no workshop. Resultados Após a intervenção, 61,1% dos participantes demonstraram o nível de competência necessário para a prática segura da punção da artéria radial em um paciente vivo sob supervisão. Conclusão O treinamento efetivo em punção arterial baseado em simulação para estudantes de enfermagem não necessariamente precisa ser intensivo em recursos. Sessões de treinamento bem planejadas e baseadas em evidências, com uso de simuladores de baixa tecnologia podem ajudar os educadores a alcançarem bons resultados educacionais e promover a segurança do paciente.

Abstract Objective To evaluate whether a short simulation-based workshop in radial artery puncture would improve nursing students’ competence to a level in which they could practise the procedure on a live patient without compromising his safety. Methods Quasi-experimental one-group pretest-posttest study with 111 third-year nursing students. A 1.5-hour simulation-based workshop was implemented. This included a video-lecture, live demonstrations, self-directed simulated practice in dyads and individual intermittent feedback. Participants’ skills, knowledge and self-efficacy in arterial puncture were measured before and after attending the workshop. Results After the intervention, a total of 61.1% of the participants showed the level of competence required to safely practice radial artery puncture on a live patient under supervision. Conclusion Effective simulation-based training in arterial puncture for nursing students does not necessarily need to be resource-intensive. Well-planned, evidence-based training sessions using low-tech simulators could help educators to achieve good educational outcomes and promote patient safety.

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OBJECTIVE: To identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students. METHOD: A descriptive and correlational design with a one-group pretest-posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree. RESULTS: No significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning. CONCLUSION: The use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students.

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The Bolivian indigenous Ayoreo ethnic people are vulnerable to sexually transmitted infections and HIV. Ayoreo women who also work in sex trades belong to an extremely high-risk group, and prevention programs are not delivering effective outcomes for them. The aim of our study was to explore, describe, and understand behavioral and cultural patterns related to sexual and reproductive health in Ayoreo sex workers. A qualitative-ethnographic study was designed; data were collected through participant observation and in-depth interviews with sex workers and key informants. Two fundamental themes contributing to HIV risk for female Ayoreo sex workers in Bolivia emerged: reproductive/sexual freedom and sociocultural risk determinants. We concluded that the in-depth examination of the sexual-reproductive culture amongst the Ayoreo has provided useful information, which might contribute to the cultural adaptation and design of future policies and prevention programs for sexually transmitted infections and HIV in this group.

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OBJECTIVETo identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students.METHODA descriptive and correlational design with a one-group pretest-posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree.RESULTSNo significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning.CONCLUSIONThe use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students.

OBJETIVOIdentificar associações entre o uso da simulação eletrocardiográfica na internet e os estilos e estratégias de aprendizagem dos estudantes de graduação em enfermagem.MÉTODODesenho descritivo-correlacional com avaliação pré e pós-teste num único grupo. A amostra do estudo incluiu 246 estudantes que frequentavam a disciplina de Suporte Básico e Avançado de Vida.RESULTADOSNão foram encontradas diferenças significativas entre gêneros em qualquer das dimensões dos estilos e estratégias de aprendizagem. Após introdução da simulação eletrocardiográfica recorrendo à internet, encontraram-se diferenças estatisticamente significativas em algumas das pontuações dos itens dos estilos de aprendizagem teórico (p <0,040), pragmático (p <0,010) e das estratégias de aprendizagem.CONCLUSÃOO uso da simulação eletrocardiográfica em ambiente web está associado ao desenvolvimento de estilos de aprendizagem ativos e reflexivos, à melhoria da motivação e da abordagem profunda em estudantes de enfermagem.

OBJETIVOIdentificar asociaciones entre el uso de la simulación electrocardiográfica en la internet y los estilos y estrategias de aprendizaje de los estudiantes de graduación en enfermería.MÉTODODiseño descriptivo-correlacional con evaluación pré y post prueba en un solo grupo. La muestra del estudio incluyó a 246 estudiantes que acudían a la asignatura de Soporte Básico y Avanzado de Vida.RESULTADOSNo fueron encontradas diferencias significativas entre géneros en cualquiera de las dimensiones de los estilos y estrategias de aprendizaje. Después de la introducción de la simulación electrocardiográfica recurriendo a la web, fueron encontradas diferencias estadísticamente significativas en algunas de las puntuaciones de los ítems de los estilos de aprendizaje teórico (p <0,040), pragmático (p <0,010) y las estrategias de aprendizaje.CONCLUSIÓNEl uso de la simulación electrocardiográfica en ambiente web está asociado con el desarrollo de estilos de aprendizaje activos y reflexivos, la mejoría de la motivación y el abordaje profundo en estudiantes de enfermería.

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The Habermasian concept of 'interest' has had a profound effect on the characterization of scientific disciplines. Going beyond issues unrelated to the theory itself, intra-theoretical interest characterizes the specific ways of approaching any science-related discipline, defining research topics and methodologies. This approach was developed by Jürgen Habermas in relation to empirical-analytical sciences, historical-hermeneutics sciences, and critical sciences; however, he did not make any specific references to health sciences. This article aims to contribute to shaping a general epistemological framework for health sciences, as well as its specific implications for the medical and nursing areas, via an analysis of the basic knowledge interests developed by Habermas.

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The Ayoreo population constitutes one of Bolivia's most vulnerable ethnic groups in terms of HIV/AIDS. Being a woman, indigenous, and a sex worker signifies belonging to a high-risk group. The aim of this study is to explore the Ayoreo sex workers' and health agents' perceptions of HIV/AIDS prevention programs in order to identify variables that could influence their success or failure. This study used an ethnographic methodology that included participant observation and semistructured interviews. In the data collection, participant observation and semistructured interviews with sex workers and key informants were conducted. Three themes emerged from the inductive data analysis: health prevention efforts, cultural inadequacy of prevention programs, and the eventuality of interventions. We conclude that nursing can develop culturally-adequate HIV/AIDS prevention interventions and programs as well as promote health within these populations.

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The aim of this study is to carry out a socio-linguistic analysis of the dissemination of the Charter of Citizens' Rights and Obligations in Public Health Services. We designed a qualitative investigation using observation and content analysis. A deductive analysis technique was followed, based on the "SPEAKING" model categories. The data analysis suggests a clear framework of rights and obligations has been established, but is not very familiar to patients and relatives. We can conclude that despite the widespread dissemination and publicity of the Citizens' Charter of Rights and Obligations, we still need the involvement of professionals. Nurses can develop a fundamental role in this process.

O objetivo deste estudo foi desenvolver uma análise sociolinguística da difusão da Carta dos Direitos e Deveres dos Cidadãos nos Serviços de Saúde Pública. Desenhamos uma investigação qualitativa seguida de uma estratégia analítico-dedutiva, com base nas categorias do modelo "SPEAKING". A análise dos dados sugere que um quadro claro de direitos e obrigações tenha sido estabelecida, mas não é muito familiar para pacientes e familiares. Concluímos que, apesar da ampla difusão e publicidade da Carta dos Direitos e Deveres dos Cidadãos, ainda precisamos do envolvimento dos profissionais. Os enfermeiros podem desenvolver um papel fundamental neste processo.

El objetivo de este estudio es desarrollar un análisis socio-lingüístico de la difusión de la Carta de derechos y Obligaciones de los Ciudadanos en los Servicios Públicos de Salud. Diseñamos una investigación cualitativa mediante análisis de contenido y observación. Se sigue una estrategia analítica deductiva con base en las categorías del modelo "SPEAKING". El análisis de los datos sugiere el establecimiento de un claro marco de derechos y obligaciones, pero que no se ejerce habitualmente por los pacientes y familiares. Concluimos que, pese a la amplia difusión de la Carta de Derechos y Obligaciones de los ciudadanos, sigue siendo necesaria la implicación de los profesionales. Las enfermeras pueden desempeñar un papel fundamental en este proceso.

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AIMS AND OBJECTIVES: To describe and understand Ayoreo sex workers' perceptions of HIV/AIDS and to identify factors that may affect the prevention of risk behaviours. BACKGROUND: According to recent HIV/AIDS incidence reports, being female, indigenous and a sex worker means belonging to a maximum-risk group, left in the background in terms of strategies for the fight against HIV. Although there has been research into intervention models in these populations, it is important to detail the perceptions of the problem from the perspective of sex workers from the affected ethnic groups. DESIGN: This study used an ethnographic methodology that included participant observation and semi-structured interviews. METHODS: The research was conducted in two phases. First, participant observation was chosen to access and observe the behaviour of Ayoreo sex workers. The second phase was a semi-structured interview with sex workers and key informants. The interviews, together with the field notes, were transcribed and analysed, following inductive strategies to find emerging themes. RESULTS: Here, we present the results related to four emerging themes: the cultural acceptance of sex work as a useful economic activity; the lack of concern for sexually transmitted illnesses and the stigmatisation of people who are HIV seropositive; external factors that increase vulnerability such as difficulties in using a condom; and conflictive and unbalanced relationships between the Ayoreo people and the health system and health professionals. CONCLUSIONS: The health- and sexual reproduction-related culture, the knowledge and attitudes of sex workers, external factors, and relationships with the health system and health professionals continue to place Ayoreo sex workers in high-risk conditions in relation to sexually transmitted diseases and HIV/AIDS. RELEVANCE TO CLINICAL PRACTICE: Employing cultural care as its base, nursing could develop programmes and interventions culturally adapted for the prevention of disease and the promotion of health in these populations.

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Este estudio, desarrollado de abril a julio de 2008, objetiva desarrollar y validar un instrumento para orientar la evaluación de enfermería en parámetros asistenciales y docentes en Santa Cruz, Bolivia. Participaron doce enfermeras bolivianas y se utilizaron el análisis de documentos y técnicas de consenso para definir las categorías y criterios a ser incluidas en el instrumento. Estas categorías son: la evaluación física y los 11 Patrones Funcionales de Salud de Gordon. El instrumento se caracteriza por ser breve, de sencilla comprensión y por centrarse en el enfermero. No incluye elementos de evaluación física avanzada, pero sí criterios de estilos de vida y autonomía del paciente. El desarrollo de estos instrumentos contribuye a la calidad de los registros, favorece el juicio clínico y la aplicación del proceso a la enfermería, refuerza el papel del enfermero, favoreciendo la sistematización de su práctica.

Este estudo, realizado entre abril e julho de 2008, teve como objetivo desenvolver e validar um instrumento para orientar a avaliação de enfermagem em parâmetros assistenciais e docentes, em Santa Cruz, na Bolívia. Participaram do estudo doze enfermeiras bolivianas, e utilizaram-se a análise de documentos e técnicas de consenso para definir as categorias e critérios a incluir no instrumento. As categorias definidas foram a avaliação física e os onze Padrões Funcionais da Saúde de Gordon. O instrumento caracteriza-se por ser breve, de fácil compreensão e por centrar-se no enfermeiro. Não foram incluídos elementos de avaliação física avançada, mas sim critérios de estilos de vida e autonomia do paciente. O desenvolvimento do instrumento contribuiu para a qualidade dos registros, favorecendo o juízo clínico e a aplicação do processo à enfermagem, reforçando o papel do enfermeiro e contribuindo para a sistematização da sua prática.

The objective of this study, conducted in Bolivia from April toJuly of 2008, is the design and validation of an initial nursing assessment instrument to be used in clinical and educational environments in Santa Cruz (Bolivia). Twelve Bolivian nurses participated; both document analysis as well as consensus techniques were used to determine the categories and criteria to be assessed. Categories included in the nursing assessment instrument are a physical assessment and the eleven Gordon's Functional Health Patterns. The nursing assessment instrument stands out as being concise, easy to complete and utilizing a nursing approach. It does not include items for advanced nursing assessment. However, it incorporates items regarding lifestyle and the patient's autonomy. The nursing assessment instrument contributes to improving the quality of clinical records, supports the nursing diagnosis and implementation of the nursing process, promotes the nurse's role and helps to standardize practice.

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Bolivian nurses have not yet incorporated the scientific method and taxonomies into nursing care. This qualitative study aims at understanding the meaning that faculty and nursing professionals from the Department of Santa Cruz de la Sierra (Bolivia) attribute to the nursing process. Data collection was performed through interviews and participant observation. The analysis was performed using the theoretical and methodological framework of Symbolic Interactionism and Grounded Theory, utilizing ATLAS.ti.6.0. The following topics emerged from the data: difficulties in implementing the nursing process due to a lack of preparation and training in leadership, dominance by physicians, lack of records, and poor support from the institution. Advantages were that it combines criteria and language and facilitates the autonomous role of nursing. In conclusion, nurses should establish their professional expectations regarding the implementation of the nursing process and care plans, which is a cultural change that involves faculty, management and clinical nurses.

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Las enfermeras bolivianas no han incorporado definitivamente el método científico y las taxonomías a los cuidados. Este estudio cualitativo pretende comprender el significado atribuido al proceso de enfermería por docentes y profesionales del Departamento de Santa Cruz de la Sierra (Bolivia). Recolección de datos mediante entrevistas semiestructuradas y observación participante. Análisis bajo el marco teórico y metodológico del Interaccionismo Simbólico y la Teoría Fundamentada, usando el software ATLAS.ti.6.0. De los datos emergieron los siguientes temas: dificultades de implantación del proceso de enfermería; déficit de formación e iniciativa profesional; posición de dominio del médico; carencia de registros; escaso apoyo institucional. Ventajas de implementación: unificar criterios, lenguaje y facilitar el rol propio de enfermería. Se concluye en que las enfermeras depositan sus expectativas profesionales y de mejora de los cuidados en la implementación del Proceso de Enfermería y los Planes de Cuidados, un giro cultural que involucra a docentes, auxiliares y gestores.

As enfermeiras bolivianas ainda não incorporaram o método científico e as taxonomias para o cuidado. Este estudo qualitativo busca compreender o significado atribuído ao processo de enfermagem para professores e profissionais do Departamento de Santa Cruz de la Sierra (Bolívia). Para isso, realizou-se coleta de dados por meio de entrevistas semiestruturadas e observação participante. A Análise foi realizada à luz da abordagem teórico-metodológica -do Interacionismo Simbólico e a Grounded Theory, utilizando o software ATLAS.ti 6,0. Dos dados, emergiram os seguintes temas: dificuldades de implementação do processo de enfermagem pela falta de formação e treinamento de liderança, domínio médico, falta de registros e apoio institucional fraco e vantagens por unificar critérios e linguagem e facilitar o papel autônomo da enfermagem. Conclui-se que as enfermeiras devem estabelecer as suas expectativas profissionais na aplicação do processo de enfermagem e plano de cuidados, uma mudança cultural que envolve professores, gestores e clínicos.

Bolivian nurses have not yet incorporated the scientific method and taxonomies into nursing care. This qualitative study aims at understanding the meaning that faculty and nursing professionals from the Department of Santa Cruz de la Sierra (Bolivia) attribute to the nursing process. Data collection was performed through interviews and participant observation. The analysis was performed using the theoretical and methodological framework of Symbolic Interactionism and Grounded Theory, utilizing ATLAS.ti.6.0. The following topics emerged from the data: difficulties in implementing the nursing process due to a lack of preparation and training in leadership, dominance by physicians, lack of records, and poor support from the institution. Advantages were that it combines criteria and language and facilitates the autonomous role of nursing. In conclusion, nurses should establish their professional expectations regarding the implementation of the nursing process and care plans, which is a cultural change that involves faculty, management and clinical nurses.

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The objective of this study, conducted in Bolivia from April to July of 2008, is the design and validation of an initial nursing assessment instrument to be used in clinical and educational environments in Santa Cruz (Bolivia). Twelve Bolivian nurses participated; both document analysis as well as consensus techniques were used to determine the categories and criteria to be assessed. Categories included in the nursing assessment instrument are a physical assessment and the eleven Gordon's Functional Health Patterns. The nursing assessment instrument stands out as being concise, easy to complete and utilizing a nursing approach. It does not include items for advanced nursing assessment. However, it incorporates items regarding lifestyle and the patient's autonomy. The nursing assessment instrument contributes to improving the quality of clinical records, supports the nursing diagnosis and implementation of the nursing process, promotes the nurse's role and helps to standardize practice.

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OBJECTIVE: To explore students' assessments of the clinical seminar as a complementary teaching method to the clinical practicum experience. METHODS: This was a qualitative study based on the hermeneutic phenomenology of Gadamer. Twenty-three open-ended interviews were conducted from among the 132 first-year students who attended an initial clinical practicum. We performed a qualitative analysis of the data using ATLAS.ti software. RESULTS: The students agreed that the clinical seminar gave them the opportunity to learn about procedures, nursing care and interpersonal relationships. They also found it very helpful when they encountered challenging stressful situations as they performed their practice, and believed it allowed them to make a connection between the theory in the classroom and the clinical practice. CONCLUSIONS: These seminars can contribute to reducing levels of stress during clinical practice. They can also help students obtain significant learning from their fellows and reduce the theory-practice gap.

OBJETIVO: Avaliar a importância que os alunos atribuem ao seminário clínico como método de ensino complementar às práticas clínicas em estágio. MÉTODO: Estudo qualitativo baseado na fenomenologia hermenêutica de Gadamer. Foram realizadas 23 entrevistas abertas entre um universo de 132 alunos do primeiro ano da licenciatura de enfermagem, que assistiram a um seminário clínico, durante o seu primeiro ensino clínico/estágio. Foi realizada uma análise qualitativa dos dados através do software ATLAS.ti. RESULTADOS: Os entrevistados coincidiram na opinião de que o seminário lhes deu oportunidades de aprendizagem sobre procedimentos, cuidados de enfermagem e relações interpessoais. Referiram também que o mesmo foi útil para lidar com situações estressantes e relacionar os conteúdos teóricos com a prática. CONCLUSÕES: Este tipo de seminários pode contribuir para a redução dos níveis de estresse durante a prática clínica, para a aquisição e partilha de aprendizagens significativas em grupo e para colmatar lacunas teórico-práticas.

OBJETIVO: Evaluar la importancia atribuida por los alumnos al seminario clínico como método de enseñanza complementaria a las prácticas clínicas. MÉTODO: Estudio cualitativo basado en la fenomenología hermenéutica de Gadamer. Se realizaron 23 entrevistas abiertas entre un universo de 132 alumnos del primer año del pregrado en enfermería, que asistieron a un seminario clínico, durante su primera enseñanza clínica/práctica. Se llevó a cabo un análisis cualitativo de los datos a través del software ATLAS.ti. RESULTADOS: Los entrevistados coincidieron en la opinión de que el seminario les dio oportunidades de aprendizaje sobre procedimientos, cuidados de enfermería y relaciones interpersonlaes. Refirieron también que el mismo fue útil para lidiar con situaciones estresantes y relacionar los contenidos teóricos con la práctica. Conclusiones: Este tipo de seminarios puede contribuir en la reducción de los niveles de estrés durante la práctica clínica, para adquirir y compartir aprendizajes significativos en grupo y para corregir lagunas teórico-prácticas.

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The objective of this study was to determine the association between the professional activity and the perceived quality of life in climacteric women who work in Health and Education. A descriptive and cross-sectional study was developed in a sample of 203 climacteric women, together with a correlation analysis of labor factors’ influence on health-related quality of life. Significant differences were found between working women’s quality of life and some labor conditions. The perceived quality of life in perimenopausal women who work in Education is higher than that of those working in Health (p=0.004). Nursing professionals can develop health programs that deal with the work conditions that negatively influence the perceived quality of life in climacteric women.

O objetivo deste estudo foi determinar a associação entre a atividade profissional e a qualidade de vida percebida em mulheres climatéricas que trabalham nas áreas da saúde e educação. Realizou-se estudo descritivo e transversal, numa amostra de 203 mulheres climatéricas, juntamente com análise correlacional da influência dos fatores de trabalho na qualidade de vida, relacionada à saúde. Encontraram-se diferenças significativas entre a qualidade de vida das trabalhadoras e algumas variáveis laborais. A qualidade de vida percebida pelas mulheres perimenopáusicas que trabalham na área da educação é superior à daquelas que trabalham na área da saúde (p=0,004). Os profissionais de enfermagem podem elaborar programas de saúde que abordem as condições de trabalho que influenciam negativamente a qualidade de vida percebida pelas mulheres climatéricas.

El objetivo de este estudio fue determinar la asociación entre la actividad profesional y la calidad de vida percibida en mujeres climatéricas que trabajan en las áreas sanitaria y educativa. Se realizó un estudio descriptivo y transversal, en una muestra de 203 mujeres climatéricas, junto al análisis correlacional de la influencia de los factores laborales en la calidad de vida relacionada con la salud. Se encontraron diferencias significativas entre la calidad de vida de las trabajadoras y algunas condiciones laborales. La calidad de vida percibida por las mujeres perimenopáusicas que trabajan en educación es superior a la de las que trabajan en salud (p=0,004). Los profesionales de Enfermería pueden elaborar programas de salud, que aborden las condiciones de trabajo que influyen negativamente en la calidad de vida percibida por las mujeres climatéricas.

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Este artículo contiene un resumen de las críticas a la utilización del factor de impacto (FI) como indicador de calidad de las publicaciones y de producción de investigadores. Tales críticas alcanzan a los autores que intentan publicar en revistas con FI, argumentando que así renuncian a la propia identidad, primando su currículum sobre la utilidad de su investigación. En oposición a esas críticas se afirma que unos criterios de evaluación exigentes sirven de estímulo para la internacionalización del sistema científico. Existe consenso en la comunidad académica sobre las imperfecciones del FI y su aceptación como recurso válido y necesario para la evaluación científica, como también en que el debate identitario contribuye poco a resolver la invisibilidad internacional de la investigación de enfermería en español. Se esbozan propuestas que apuestan por aprovechar las fortalezas para incrementar y visibilizar dicha investigación, desarrollar estrategias para incluir y mantener a las revistas en español en el Journal Citation Reports (JCR), fomentar la formación y cooperación interdisciplinar, promover la publicación de investigaciones desarrolladas en los programas de posgrado, y reclamar la apuesta editorial por la indexación de sus revistas en el JCR. Se concluye que, aunque difícil, es posible aumentar la visibilidad de la producción científica de enfermería en español.

This paper contains a summary of criticism on use of the impact factor (IF) as an indicator of the quality of work published by researchers. The criticism is directed to authors who are trying to publish in journals with IF. The claim is they are renouncing their own identity and prioritizing their curriculum over the usefulness of their research. The authors challenge this criticism by arguing that stringent assessment criteria stimulate the internationalisation of science, that there is a consensus in the scientific community about the imperfections of FI and its acceptance as a valid and necessary tool for scientific evaluation, and that the debate over identity does little to resolve the international invisibility of nursing research written up in Spanish. Proposals are outlined on how to benefit from the strengths of this system to increase the visibility of nursing research, to develop strategies for including journals written in Spanish in the Journal Citation Reports (JCR), to encourage professional training and interdisciplinary cooperation, to promote the publication of research conducted in postgraduate programs, and to claim an editorial commitment for indexing their journals in the JCR. It can be concluded that, although difficult, it would be possible to increase the visibility of nursing scientific research in Spanish.

Este artigo contém um resumo das críticas ao uso do Fator de Impacto (FI) como um indicador da qualidade de publicações e produção dos pesquisadores. As críticas são direcionadas para os autores que publicam em revistas com FI, argumentando que renunciar à sua própria identidade, priorizando seus currículos sobre a utilidade de suas pesquisas. Confrontado com as críticas, argumenta-se que os critérios rigorosos de avaliação constituem um estímulo à internacionalização da ciência, há consenso na comunidade científica nas imperfeições do FI e na sua aceitação como recurso válido e necessário para a avaliação científica de modo que o debate de identidade faz pouco para resolver a invisibilidade internacional da pesquisa em enfermagem em espanhol. A proposta é o aproveitamento de fortalezas para incrementar e visibilizar dita pesquisa, assim como desenvolver estratégias para incluir e manter as revistas em espanhol no Journal Citation Reports (JCR), fomentar a formação e cooperação interdisciplinar, promover a publicação de pesquisas desenvolvidas nos programas de pós-graduação, e reivindicar a proposta editorial pela indexação de suas revistas no JCR. Conclusão: É possível aumentar a visibilidade da produção científica de enfermagem em espanhol.

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