RESUMO
BACKGROUND: The Mapuche are a minority group living in small communities in southern Chile. Due to many variables, such as poverty and cultural factors, they are susceptible to inequalities in education and healthcare. PURPOSE: To describe nurse educators' experiences of caring for Mapuche people in primary care centers in Chile. METHODS: A descriptive qualitative study was performed with nine female nurse educators who supervised nursing students in clinical placement. Data were obtained through semi-structured interviews. Triangulation was achieved through consensus among the researchers. RESULTS: The analysis yielded two themes: Cultural sensitivity and Humanisation of care. Nurse educators respect Mapuche beliefs and practices about health and treatment and adapt clinical interventions accordingly. Nurse educators are committed to integrate Mapuche spiritual and cultural needs into the biomedical model, aiming to build a genuine person-centered relationship with patients and to promote transcultural nursing models with students. CONCLUSIONS: Culturally competent professionals are needed to train nurses about the demands of a globalized and culturally diverse world. Training is required in both humanized care competencies and cross-cultural nursing. Improving cultural competence among nurses and nurse educators would improve patients' health outcomes and would allow preventative intervention, therefore reducing treatment failures and further complications.
Assuntos
Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Enfermagem Transcultural , Chile , Docentes de Enfermagem , Feminino , HumanosRESUMO
BACKGROUND: To achieve an optimal quality of life through chronic disease management, people living with HIV (PLHIV) must adhere to antiretroviral therapy (ART). ART has been available throughout Peru since 2004 without cost in all regions; yet only 60% (43 200) of PLHIV receive ART and 32% are virally suppressed. Despite the low adherence, little is known about the experience of PLHIV with ART adherence in the context of Latin America. METHODS: A constructivist grounded theory design was used to understand the ART adherence experiences of PLHIV in Northern Peru. Unstructured interviews were conducted with 18 participants resulting in theoretical saturation. All interviews were recorded, immediately transcribed and analysed concurrently with data collection using constant comparative analysis with Atlas.ti (V.8) software. Rigour was maintained through openness, reflexivity, audit trail, memo writing, debriefings, member checks and positionality. RESULTS: The core category 'staying alive' emerged through the interaction of four categories, including: (1) overcoming barriers; (2) working with the healthcare team; (3) tailoring self-care strategies; and (4) appreciating antiretrovirals. Adherence is not a spontaneous outcome, instead, the surprise of HIV diagnosis transitions to living with HIV as a chronic disease. The healthcare team helps PLHIV realise ART is their life source by enhancing, supporting and facilitating self-care and overcoming barriers. CONCLUSION: Adherence emerges from experiential learning as PLHIV recognised ART as their life source in balance with their desire to continue living a normal life. Social support and healthcare team interventions help PLHIV implement tailored self-care strategies to overcome personal, social, and structural barriers to adherence. Healthcare professionals need to recognise the challenges confronted by PLHIV as they learn how to continue living while trying to stay alive.
Assuntos
Infecções por HIV , Qualidade de Vida , Teoria Fundamentada , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , Peru/epidemiologiaRESUMO
Talking about sex with people living with HIV receives insufficient attention in health care. A cross-sectional and exploratory study describes the preferences of people living with HIV to talk about sex with specialized HIV physicians and nurses in a clinic in Barcelona (Spain). A 27-item self-administered questionnaire was used between June 2017 and May 2018. One hundred fourteen people agreed to participate. Data were analyzed using multivariate logistic regression. Most of the participants reported "never or almost never" having been asked about sex practices in visits with the HIV specialist physician (n = 65 [57.0%]) or nurse (n = 74 [64.9%]). Older participants stated that neither physicians nor nurses talked about sex during visits. Women felt that physicians hardly ever asked about their sexual practices. Men who had sex with other men indicated that their physicians always asked about their sex practices compared with heterosexuals living with HIV. Health professionals should reformulate how to talk about sex with people living with HIV to facilitate communication and provide adequate care.
Assuntos
Infecções por HIV/complicações , Pacientes/psicologia , Comportamento Sexual/psicologia , Adulto , Estudos Transversais , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Estigma Social , Espanha , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: a qualitative study that followed the principles of the grounded theory in order to analyze the professional identity of nursing academics through the analysis of the most disturbing critical incidents. METHOD: semi-structured interviews were conducted with seven nurses who worked as professors and researchers in a private university in Barcelona. RESULTS: the resulting empirical material was organized into two categories: characterization of critical incidents and responsiveness to the incident. CONCLUSION: the professional identity of nurses regarding the academic area is still under construction and inexperience is the major obstacle in the management of critical incidents in the teaching career.
Assuntos
Docentes de Enfermagem , Crise de Identidade , Pesquisa em Enfermagem , Estudos Transversais , Docentes de Enfermagem/psicologiaRESUMO
RESUMEN Objetivo: estudio cualitativo que siguió los principios de la teoría fundamentada con el fin de analizar la identidad profesional de docentes de enfermería por medio del análisis de incidentes críticos que más las desestabilizaban. Método: entrevistas semi-estructuradas fueron realizadas a siete enfermeras que actúan como docentes e investigadoras en una universidad privada de Barcelona. Resultados: el material empírico resultante fue organizado en dos categorías: caracterización de los incidentes críticos y reacción de las enfermeras frente a ellos. Conclusión: se concluye que la identidad profesional de estas enfermeras en el campo académico está aún en construcción y que la inexperiencia es el mayor obstáculo que enfrentan para gestionar los incidentes críticos en el trabajo docente. .
RESUMO Objetivo: estudo qualitativo que seguiu os princípios da teoria fundamentada em dados com o objetivo de analisar a identidade profissional de docentes de enfermagem por meio da análise de incidentes críticos que mais as desestabilizaram. Método: entrevistas semiestruturadas foram realizadas com sete enfermeiras que atuam como docentes e pesquisadoras em uma universidade privada de Barcelona. Resultados: o material empírico resultante foi organizado em duas categorias: caracterização dos incidentes críticos e reação das enfermeiras frente a eles. Conclusão: concluiu-se que identidade profissional dessas enfermeiras no campo acadêmico está ainda em construção e a que inexperiência é o maior obstáculo que enfrentam para gerenciar incidentes críticos no trabalho docente. .
ABSTRACT Objective: a qualitative study that followed the principles of the grounded theory in order to analyze the professional identity of nursing academics through the analysis of the most disturbing critical incidents. Method: semi-structured interviews were conducted with seven nurses who worked as professors and researchers in a private university in Barcelona. Results: the resulting empirical material was organized into two categories: characterization of critical incidents and responsiveness to the incident. Conclusion: the professional identity of nurses regarding the academic area is still under construction and inexperience is the major obstacle in the management of critical incidents in the teaching career. .
Assuntos
Humanos , DNA , Receptores de Glucocorticoides/química , Receptores de Mineralocorticoides/química , Sequência de Aminoácidos , Cristalografia por Raios X , DNA , Escherichia coli/genética , Escherichia coli/metabolismo , Expressão Gênica , Dados de Sequência Molecular , Mutação , Neoplasias/genética , Neoplasias/metabolismo , Neoplasias/patologia , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Pseudo-Hipoaldosteronismo/genética , Pseudo-Hipoaldosteronismo/metabolismo , Pseudo-Hipoaldosteronismo/patologia , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo , Receptores de Mineralocorticoides/genética , Receptores de Mineralocorticoides/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , Homologia Estrutural de ProteínaRESUMO
Objective. To represent how a new identity is being constructed by nurses initiating their activities as teachers. Methodology. In 2010, a descriptive-interpretative qualitative research was conducted of four cases of nurse teachers from Nursing Schools. Aspects of teacher identity and management of critical incidents in the classroom were reviewed. The information was obtained through a structured survey and the data underwent analysis of contents. Results. The nurses surveyed state that the teaching exercise is a culmination stage of clinical nursing. Teaching confers them stability in their professional life; however, they report that the complexity of the educational practice poses a big challenge. They feel responsible for the formation of future nursing professionals. In spite of defining themselves as constructivists in the way of teaching, they are governed by a technical conception on the way of approaching the educational practice. They attribute the critical incidents to which they are exposed to the types of students entering the universities; these turn out uncomfortable and do not feel responsible for their development. These incidents are lessons to better face similar situations in the future. Conclusion. The nurses participating in this study are facing their new role as teachers of human resource, seeking to construct a new identity different from what they had when working in direct care of individuals.
Objetivo. Representar cómo se construye una nueva identidad la enfermera que inicia su actividad como formadora. Metodología. En 2010 se realizó una investigación cualitativa de corte descriptivo-interpretativo de cuatro casos de enfermeras profesoras de Escuelas de Enfermería. Se revisaron aspectos de la identidad docente y del manejo de incidentes críticos en el aula. La información fue obtenida mediante entrevista estructurada y a los datos se les hizo análisis de contenido. Resultados. Las enfermeras entrevistadas afirman que el ejercicio docente es una etapa de culminación de la enfermería clínica. La labor de la docencia les confiere estabilidad en su vida profesional, sin embargo aseguran que la complejidad de la práctica educativa les plantea un gran desafío puesto que se sienten responsables de la formación de los futuros enfermeros. A pesar de definirse como constructivistas en la manera de enseñar, se rigen por una concepción técnica en la forma de abordar la práctica educativa. Los incidentes críticos a los que se exponen los atribuyen al tipo de estudiante que ingresa, les resultan incómodos y no se sienten responsables del desarrollo de los mismos. Estos incidentes son un aprendizaje que les permitirá enfrentarse mucho mejor a situaciones similares en el futuro. Conclusión. Las enfermeras participantes en este estudio enfrentan un nuevo rol como formadoras de recurso humano, para lo cual intentan construir una identidad nueva diferente a la que tenían cuando trabajaban en el cuidado directo de las personas.
Objetivo. Representar como está construindo uma nova identidade a enfermeira que inicia sua atividade como formadora. Metodologia. Em 2010 se realizou uma investigação qualitativa de corte descritivo-interpretativo de quatro casos de enfermeiras professoras de Escolas de Enfermaria. Revisaram-se aspectos da identidade docente e do manejo de incidentes críticos no sala de aula. A informação foi obtida mediante entrevista estruturada e aos dados se lhes fez análises de conteúdo. Resultados. As enfermeiras entrevistadas afirmam que o exercício docente é uma etapa de culminação da enfermaria clínica. O labor da docência lhes confere estabilidade em sua vida profissional, no entanto asseguram que a complexidade da prática educativa lhes propõe um grande desafio. Sentem-se responsáveis da formação dos futuros enfermeiros. Apesar de definir-se como construtivistas na maneira de ensinar, regem-se por uma concepção técnica na forma de abordar a prática educativa. Os incidentes críticos aos que se veem expostas os atribuem ao tipo de estudante que ingressa nas universidades, resultam-lhes incômodos e não se sentem responsáveis do desenvolvimento dos mesmos. Estes incidentes são uma aprendizagem para enfrentar-se melhor a situações similares no futuro. Conclusão. As enfermeiras participantes neste estudo estão enfrentando seu novo papel como formadoras de recurso humano, tentando construir uma identidade nova diferente à que tinham quando trabalhavam em cuidado direto às pessoas.