RESUMO

OBJECTIVES: To identify the current state of understanding about end-of-life experiences (ELEs) and examine evidence concerning prevalence, the impact on the process of dying and the perceptions/explanations of patients, relatives and healthcare professionals (HCPs) with regard to ELEs. METHODS: Scoping review and mixed-methods systematic review (ScR and MMSR). Nine academic databases were searched for a screening of the available scientific literature (ScR). Articles reporting qualitative, quantitative or mixed-methods studies were selected (MMSR), the quality of which was assessed using the Joanna Briggs Institute (JBI) standardised critical appraisal tools. The quantitative data were synthesised in narrative form while a meta-aggregation approach was adopted for the qualitative results. RESULTS: The ScR identified 115 reports, with 70.4% published after 2010, 55.6% from the USA and the most common terminology for ELE was deathbed visions (29%). The MMSR included 36 papers, describing 35 studies in various settings. The combination of quantitative and qualitative evidence indicated a greater prevalence of ELEs in samples of patients and HCPs compared with relatives. The most common ELEs were visions and dreams of the presence of deceased relatives/friends with references to making ready for a journey. The impact of ELEs was mainly positive, and there was a tendency to interpret them as spiritual experiences inherent to the process of dying. CONCLUSIONS: ELEs are often reported by patients, relatives and HCPs and have a significant, generally positive impact on the process of dying. Guidelines for the furtherance of studies and clinical applications are discussed.

Assuntos

RESUMO

Introducción: Los adultos mayores son la población más propensa a presentar desórdenes gastrointestinales, específicamente y en mayor proporción el estreñimiento idiopático. La alimentación es un factor clave, pero poco estudiado a la hora de tratar el estreñimiento. Objetivo: Comprender las diferentes percepciones por parte de los profesionales de la salud, los cuidadores y el adulto mayor acerca del manejo del estreñimiento idiopático, desde un enfoque alimentario, teniendo en cuenta las preferencias y gustos en el adulto mayor institucionalizado de Medellín. Métodos: La técnica de generación de la información se realizó a través de grupos focales, efectuando seis grupos: uno conformado por los profesionales del área de la salud, tres por los adultos mayores y dos por los cuidadores. Resultados: Se identificó que una de las recomendaciones que más se repite es el incremento del aporte de fibra y líquidos. En general, los adultos mayores tienen poca adherencia a las estrategias nutricionales para el manejo del estreñimiento, ya que los alimentos que se les ofrecen no se adecuan a sus preferencias. Conclusiones: No existe una percepción unánime en el personal de salud y los cuidadores con respecto a la efectividad del tratamiento nutricional para el manejo del estreñimiento en el adulto mayor; sin embargo, se identificaron testimonios exitosos sobre el uso de algunas frutas, la inclusión de fibra en la dieta y el aumento en el consumo de líquidos(AU)

Introduction: Older adults are the population most likely to present with gastrointestinal disorders specifically and idiopathic constipation to a greater extent. Diet is a key factor, but it has been little studied when it comes to treating constipation. Objective: To understand the different perceptions by health professionals, caregivers and older adults about the management of idiopathic constipation, from a dietary approach, taking into account the preferences and tastes of institutionalized older adults in Medellín. Methods: The information generation technique was carried out through focus groups, establishing six groups: one made up of health professionals, three for older adults and two for caregivers. Results: It was identified that one of the most repeated recommendations is to increase the intake of fiber and fluids. In general, older adults have poor adherence to nutritional strategies for managing constipation, since food offered to them do not suit their preferences. Conclusions: There is no unanimous perception among health personnel and caregivers regarding the effectiveness of nutritional treatment for the management of constipation in older adults; however, successful testimonies were identified regarding the use of some fruits, the inclusion of fiber in the diet and the increase in fluid consumption(AU)

Assuntos

RESUMO

Learning processes in rats during early development are importantly mediated by the mother, which represents the primary source of environmental information. This study aimed to determine whether aversive early experiences can induce the expression of pups' fear responses toward a non-aversive stimulus as a consequence of a memory process. First, we determined pups' fear responses toward an anesthetized female after being exposed to this stimulus or an empty cage together with their mothers from Postnatal Day (PNDs) 1 to 4. Second, we evaluated if the administration of the protein synthesis inhibitor cycloheximide (CHX; 0.2 mg/kg, subcutaneously (sc).) disrupted the reconsolidation processes and abolished the fear response on PND 9. Only female pups previously exposed to the female intruder expressed fear responses toward an anesthetized female on PND 8. CHX administration to female pups immediately after exposure to an anesthetized female on PND 8 suppressed fear responses on PND 9, indicating that the fear expression was the result of a memory process, probably mediated by the mother. These findings demonstrated that early experiences can shape responses to social stimuli in a sex-dependent manner and emphasize the critical role of the mother in influencing fear learning in a social context.

Assuntos

RESUMO

Introduction: Nursing professionals who contracted Covid-19 went from being caregivers to victims of the infection, and they knew first-hand how dangerous it could be. The impact on these health care professionals stayed with them even after their physical health recovered. Objective: To understand the experiences of nursing professionals hospitalized with COVID-19, regarding their illness, hospitalization and care received. Methods: Qualitative phenomenological study, with two in-depth interviews each with six nursing professionals who had representative cases from public hospitals in Lima, Peru, was chosen until theoretical saturation was achieved. Results: Four main themes emerged from the transcripts of the 12 interviews conducted: self-assessment about the form of infection, identification and complications of the disease, feelings about the disease-hospitalization, and perception of the care received as a patient. Conclusion: Being hospitalized as COVID-19 patients has been a difficult experience for nursing professionals, characterized by fear of dying; where the emotional support of their family and colleagues, as well as their spiritual strength, have allowed them to achieve their recovery, so they feel satisfied with the care received.

RESUMO

(analítico) Frente a la existencia de diferentes formas familiares y para comprender el significado que el ser humano desde su diversidad le da a la familia, se realizó un estudio narrativo con enfoque cualitativo, usando como técnica la entrevista semiestructurada. Participaron integrantes de tres formas familiares: homoparental, con hijos producto de inseminación y adoptiva. Emergieron cinco categorías: definición de familia, aceptación, crianza, actitudes del medio familiar y social. El análisis concluye que el ser humano, desde su diversidad, le da un significado a la familia a partir de sus vivencias, sin diferenciar género, roles o funciones; por tanto, exigen derechos igualitarios frente a la conformación y dinámica familiar de los diferentes modelos y formas familiares, evidenciado la necesidad de ampliar la mirada sobre los significados atribuidos a la familia.

(analytical) Given the existence of different types of families, and with the aim of understanding the meaning that human beings give to the diverse expressions of family that currently exist, a qualitative narrative study using semi-structured interviews was carried out. Members of 3 different types of families participated: homoparental, families with children who are the result of artificial insemination and families that adopted their children. Five categories emerged from the interviews: the meaning of family, acceptance, parenting, social life and attitudes to the family environment. The study finds that human give meaning to their families based on their experiences without differentiating gender, functions or roles. They demand equal rights for the conformation of the different family types and models, demonstrating the need to broaden perspectives on meanings attributed to family.

(analítico) Diante da existência existência de diferentes formas familiares e com o objetivo de compreender o significado que o ser humano dá à família a partir de sua diversidade, foi realizado um estudo narrativo com abordagem qualitativa, utilizando como técnica a entrevista semiestruturada. Participaram membros de 3 formas familiares: homoparental, com filhos produto de inseminação e adotiva. Emergiram cinco categorias: definição de família, aceitação, criação, atitudes da família e ambiente social. Concluise que, a partir de sua diversidade, o ser humano dá sentido à família a partir de suas vivências, sem diferenciar gênero, papéis ou funções, portanto, demandam direitos iguais frente à conformação e dinâmica familiar dos diferentes modelos e formas de família, destacando a necessidade de ampliar o olhar sobre os significados atribuídos à familia.

RESUMO

Resumo Compreender a história da terapia ocupacional no Brasil por meio das trajetórias individuais e coletivas é fundamental, tanto para o avanço da produção de conhecimentos quanto para a formação e desenvolvimento profissional no campo. Este artigo baseia-se na história de vida de Milton Carlos Mariotti, terapeuta ocupacional, Professor Sênior da Universidade Federal do Paraná (UFPR). Objetiva-se documentar sua narrativa profissional, o legado de sua liderança e seu compromisso ético com o desenvolvimento da profissão terapia ocupacional no Brasil. Para tanto, quatro docentes terapeutas ocupacionais reuniram-se para formular um roteiro de entrevista semiestruturada composto por 34 questões. A partir das respostas, organizou-se o texto em quatro eixos temáticos: 1) Formação acadêmica, 2) Atuação como terapeuta ocupacional, 3) Trajetória acadêmica e 4) Militância política. Apresenta-se como resultado uma narrativa histórica que documenta a história de vida profissional do professor e sua contribuição para a institucionalização da terapia ocupacional no Estado do Paraná, Sul do Brasil.

Abstract Understanding the history of occupational therapy in Brazil through individual and collective trajectories is fundamental, both for the advancement of knowledge production and for professional training and development in the field. This article is based on the life story of Milton Carlos Mariotti, occupational therapist, Senior Professor at the Federal University of Paraná (UFPR). The objective is to document his professional narrative, the legacy of his leadership and his ethical commitment to the development of occupational therapy in Brazil. For that, four occupational therapist professors got together to formulate a semi-structured interview script composed of 34 questions. Based on the responses, the text was organized into four thematic axes: 1) Educational background, 2) Work as an occupational therapist, 3) Academic trajectory and 4) Political militancy. As a result, a historical narrative is presented that documents the history of the teacher's professional life and his contribution to the institutionalization of occupational therapy in the State of Paraná, southern Brazil.

RESUMO

A transição da adolescência para a vida adulta é caracterizada por transformações, às quais o jovem precisa se adaptar. A entrada na universidade requer mais uma adaptação, já que a rotina acadêmica no Ensino Superior é diferente daquela do Ensino Médio. Este processo é ainda mais complexo no caso do estudante de Medicina, um curso reconhecidamente exigente com seus discentes. Quando estes últimos deixam suas cidades de origem para estudar, passando a viver sem suas famílias, a adaptação à nova realidade é um desafio ainda maior. Muitos têm dificuldades neste processo e apresentam ansiedade, depressão e perturbações do sono. O presente estudo qualitativo pretendeu conhecer ­ por meio de entrevistas com 14 estudantes ­ as experiências subjetivas de alunos que se mudaram sozinhos para o Rio de Janeiro para estudar Medicina na Universidade Estácio de Sá. A análise das entrevistas revelou que os participantes apresentaram sentimento de insegurança e ansiedade na fase inicial da mudança e ao começarem os estudos na Universidade, mas, à época da pesquisa, percebiam mais aspectos positivos do que negativos na mudança. Essa alteração de percepção se deu porque descobriram, em si, novas habilidades, adquiriram maior liberdade, maturidade e autonomia. Sua experiência bem-sucedida se deve em parte ao fato de estes estudantes contarem com uma rede de apoio efetiva.

The transition from adolescence to adulthood is marked by transformations to which the youngster needs to adapt. University admission requires further adaptation, as the academic reality in higher education is different from that of high school. This process is even more complex for medical students, as their school is known to be demanding with its undergraduates. When the latter leave their hometowns to go to university in other cities, without their families, the adaptation to the new reality is an even greater challenge. Many of them have difficulties in this process and develop anxiety and depression. This qualitative study aimed to understand ­ through interviews with 14 undergraduates ­ the subjective experiences of students who moved alone to Rio de Janeiro to study Medicine at Universidade Estácio de Sá. The analysis of these interviews revealed that participants used to have feelings of emotional insecurity and anxiety when they moved to Rio and started their studies at the University. This change in perception occurred because they discovered new skills in themselves acquired greater freedom, maturity, and autonomy. Their successful experience is partly since these students have an effective support network.

RESUMO

Esta pesquisa teve como objetivo apreender a vivência de mães jovens sobre o processo da amamentação. Trata-se de um estudo descritivo, de abordagem qualitativa cujos dados foram obtidos de narrativas maternas em oficinas educativas no período de maio a junho de 2017. As narrativas foram submetidas a técnicas de análise de conteúdo temática. As vivências foram sintetizadas nas temáticas: "amamentação: uma experiência desafiadora"; "amamentação: uma experiência apoiada pela família"; e "amamentação: uma experiência condicionada social e culturalmente". Sugere-se a realização de novos estudos com mulheres jovens, de diferentes níveis sociais, culturais e de escolaridade, com emprego de outros delineamentos de pesquisa, que possam traçar o perfil de nutrizes jovens e suas necessidades ante o processo de amamentação, a fim de que haja subsídios para propor intervenções na prática clínica de enfermagem que venham a dar o suporte necessário a essas mulheres no ato de amamentar.

This study aimed to understand young mothers' experience on the breastfeeding process. It is a descriptive research, with a qualitative approach whose data were obtained from maternal narratives in educational workshops, from May to June 2017. The narratives were submitted to thematic content analysis techniques. The experiences about the breastfeeding process were summarized in the themes: breastfeeding: a challenging experience; breastfeeding: an experience supported by the family; and breastfeeding: a socially and culturally conditioned experience. It is suggested that new studies with young women, from different social, cultural and educational levels, using other research designs are carried out, outlining the profile of young nursing mothers and their needs in the breastfeeding process, so that there are subsidies to propose interventions in clinical nursing practice that will provide the necessary support to these women in the act of breastfeeding.

RESUMO

This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.

Assuntos

RESUMO

BACKGROUND: The pain associated with childbirth is a cause of severe pain, and the literature suggests that it can be influenced by psychosocial influences, the environment, and cognitive processes, creating the overall experience of childbirth. Therefore, the investigation of women's childbirth pain experience is essential. AIM: The purpose of this study is to understand women's childbirth pain and determine which influences can contribute to building different experiences. METHOD: A qualitative descriptive approach was adopted to explore the women's childbirth pain experiences, by understanding the influences on their experiences. Data were collected through in-depth interviews with 21 women in a hospital setting in São Paulo, Brazil, and analysed by thematic analysis. RESULTS: Three major themes emerged from the analysis: (1) experiencing childbirth pain, (2) face-to-face with pain, and (3) empowerment needs. DISCUSSION: Many factors influence how Brazilian women manage pain and shape their experience during childbirth. The findings suggest that when women had a positive experience, they asked for minimal support, demonstrated balance, and expressed that the pain was manageable; when they had unfavourable experiences, they regarded pain as a threat and a punishment and associated it with unpleasant emotions. CONCLUSION: The results outlined concerns that should be addressed in the provision of specific, appropriate care for women, to support them in improving their experience during childbirth.

Assuntos

RESUMO

Objective: To understand the experiences of patients who have graduated from the intensive care unit of a tertiary care clinical institution in the City of Cartagena using Rosemarie Rizzo Parse's theory of human development as an approach. Materials and Methods: Phenomenological-interpretive study with a hermeneutic perspective, 11 adults graduated from the intensive care unit participated, the in-depth interview technique was used with a duration of 30 and 40 minutes, the data were analyzed through the technique of intentionality, reduction and constitution. Results: The study participants were eight adult men and three women, their experience was described with feelings of fear and anguish that included the subtopics: Good treatment; Imagination of death: My life, work and family; Feelings of loneliness; Spiritual strength and life changes. Conclusion: Being hospitalized in the intensive care unit managed to trigger an experience described as "fear and anguish", for the participants the family nucleus, spiritual strength, transformation and life changes are essential.

Objetivo: Comprender las experiencias de pacientes egresados de la unidad de cuidado intensivo de una institución clínica de tercer nivel de atención de la Ciudad de Cartagena utilizando como enfoque la teoría del desarrollo humano de Rosemarie Rizzo Parse. Materiales y Métodos: Estudio fenomenológico - interpretativo con perspectiva Hermenéutica, participaron 11 adultos egresados de la unidad de cuidados intensivos, se utilizó la técnica de entrevista a profundidad con una duración de 30 y 40 minutos, los datos se analizaron a través de la técnica de intencionalidad, reducción y constitución. Resultados: Los participantes del estudio fueron ocho hombres y tres mujeres adultos, su experiencia la describieron con sentimientos de temor y angustia que incluyen los subtemas: Buen trato; imaginación de muerte: Mi vida, el trabajo y la familia; Sentimientos de soledad; Fortaleza espiritual y Cambios de vida. Conclusión: Estar hospitalizado en la unidad de cuidados intensivos logró desencadenar una experiencia descrita como "temor y angustia", para los participantes es primordial el núcleo familiar, la fortaleza espiritual, la transformación y cambios de vida.

Objetivo: Entender as experiências de pacientes formados na unidade de terapia intensiva de uma instituição clínica de terceiro nível na cidade de Cartagena utilizando como foco a teoria do desenvolvimento humano de Rosemarie Rizzo Parse. Materiais e métodos: Estudo fenomenológico - interpretativo com uma perspectiva hermenêutica, participaram 11 adultos formados na unidade de terapia intensiva, foi utilizada a técnica de entrevista em profundidade com duração de 30 e 40 minutos, os dados foram analisados através da técnica de intencionalidade, redução e constituição. Resultados: Os participantes do estudo foram oito homens adultos e três mulheres adultas. Eles descreveram suas experiências com sentimentos de medo e angústia que incluíram os subtópicos: Bom Tratamento; Imaginação da Morte: Minha Vida, Trabalho e Família; Sentimentos de Solidão; Força Espiritual e Mudanças de Vida. Conclusão: Ser hospitalizado na unidade de terapia intensiva conseguiu desencadear uma experiência descrita como "medo e angústia". Para os participantes, a unidade familiar, a força espiritual, a transformação e as mudanças de vida são primordiais.

Assuntos

RESUMO

RESUMEN Objetivo: Identificar evidencia científica relacionada con la experiencia de pacientes oncológicos que practican terapias complementarias. Material y Método: Revisión integrativa que siguió los 5 pasos metodológicos de Crossetti, cuya búsqueda bibliográfica, considerando los términos "Terapias Complementarias", "Neoplasia", "Enfermería", "Experiencia e Investigación Cualitativa", en portugués e inglés y utilizando los operadores booleanos "AND" y "OR", se realizó en las bases de datos BVS, SCIELO, SCOPUS y WOS, publicada entre los años 2000 y 2019. Resultados: 16 artículos primarios de tipo cualitativo cumplieron criterios de inclusión. Se identificaron 6 categorías: creencias sobre las terapias complementarias, terapia complementaria v/s terapia convencional, cuidado holístico del ser, tiempo para el amor personal, dar sentido a la experiencia del cáncer y aumento del control personal. Conclusiones: Las personas con cáncer que utilizan terapias complementarias experimentan vivencias positivas, de buena calidad de vida, con beneficios sobre los síntomas propios del cáncer o de la quimioterapia y mejoras en la salud mental, espiritual y social. Los estudios cualitativos sobre las terapias complementarias se centran en las razones que llevan a los pacientes a utilizarlas, sus creencias y la satisfacción de necesidades como un todo. Es necesario indagar dichas experiencias en terapias específicas y reconocer cuál es más beneficiosa para una persona con cáncer. Más evidencia podría justificar su incorporación a los cuidados formales de la práctica de Enfermería.

ABSTRACT Objective: To identify the scientific evidence related to the experience of cancer patients undergoing complementary therapies. Materials and Methods: Integrative review that followed Crossetti's 5 methodological steps. The search strategy considered the terms "Complementary Therapies", "Neoplasia", "Nursing", "Experience and Qualitative Research", using the Boolean operators "AND" and "OR" in Spanish, Portuguese and English. It was carried out in the BVS, SCIELO, SCOPUS, WOS data bases, in the period between 2000 and 2019. Results: 16 qualitative primary articles met the inclusion criteria. Six categories were identified: beliefs about complementary therapies, complementary therapy vs. conventional therapy, holistic wellbeing, time for personal love, making sense of the cancer experience and increasing personal control. Conclusions: People with cancer who use complementary therapies report positive experiences and good quality of life, with benefits over cancer or chemotherapy symptoms, and improvements in mental, spiritual and social health. Qualitative studies on complementary therapies focus on the reasons leading patients to use them, their beliefs and overall satisfaction as a whole. It is necessary to investigate these experiences focusing on specific therapies, and to recognize which is more beneficial to a person with cancer. More evidence could support its inclusion into nursing care practice.

RESUMO Objetivo: Identificar a evidência científica relacionada à experiência de pacientes oncológicos que utilizam terapias complementares. Material e Método: Revisão integrativa que segue as 5 etapas metodológicas de Crosseti, cuja estratégia de busca considera os termos "Terapias Complementares", "Neoplasia", "Enfermagem", "Experiência e pesquisa qualitativa", com os operadores booleanos "AND" e "OR" em espanhol, português e inglês. A busca foi realizada nas bases de dados BVS, SCIELO, SCOPUS e WOS, no período compreendido entre os anos 2000 e 2019. Resultados: 16 artigos primários do tipo qualitativo cumpriram critérios de inclusão. Foram identificadas 6 categorias: crenças sobre as terapias complementares, terapia complementar versus terapia convencional, cuidado holístico do ser, tempo para o amor pessoal, dar sentido à experiencia do câncer e aumento do controle pessoal. Conclusões: As pessoas com câncer que utilizam terapias complementares têm experiências positivas, boa qualidade de vida, com benefícios sobre os sintomas do câncer ou da quimioterapia e melhorias na saúde mental, espiritual e social. Os estudos qualitativos sobre as terapias complementares estão enfocados nas razões que levam aos pacientes a utilizá-las, suas crenças e a satisfação de necessidades como um todo. É necessário investigar essas experiências em terapias específicas e reconhecer qual entrega mais benefícios a uma pessoa com câncer. Mais evidências poderiam justificar a incorporação aos cuidados formais da prática de Enfermagem.

Assuntos

RESUMO

OBJECTIVE: To get an insight into the structure and dynamics of the original families of five teenage mothers through their life stories and their own experiences. METHODS: Qualitative study with a narrative approach based on the life stories of five teenage mothers delivered at Engativá Hospital. Semistructured interviews were used to gain insight into the organization and structure of their original families. Emerging categories were identified by means of text hermeneutics, and results were validated using triangulation across researchers. RESULTS: The nuclear families of the pregnant women interviewed were characterized by the inability to deal with conflict appropriately, separations, structuring of new homes, confusion regarding roles, and matriarchal authority; reconstituted homes where the girls lived their own lives on the edge, where little value was attached to education, and where sexual and affective education were ambiguous and contradictory; families with expulsive dynamics where the teenage mother found herself having to survive on her own. CONCLUSIONS: Our pregnant adolescents live in the midst of families with unfavorable structure and dynamics that prevent the nuclear family from responding appropriately to teenage pregnancy. Consequently, pregnancy is an unplanned and rarely desired outcome, and a situation in which the family just normalizes the pregnancy when it occurs. In this context, pregnant adolescents are the result of a chain of inequities, where schooling is not valued and competencies for coping with life cannot grow fully to become an input for development. The noticeable resilience of one of the participants points to the need to undertake new studies focusing on identifying those traits of the individual, the family and the couple that increase their ability to adapt to the new situation.

TITULO: HISTORIAS DE VIDA FAMILIAR EN MADRES ADOLESCENTES: ESTUDIO CUALITATIVO REALIZADO EN EL HOSPITAL ENGATIVÁ ESE EN BOGOTÁ, COLOMBIA. OBJETIVO: Indagar en los relatos personales de cinco madres adolescentes inmersas en sus historias de vida y la vivencia de estas. METODOS: Estudio de tipo cualitativo con enfoque narrativo, mediante historias de vida de cinco mujeres adolescentes a quienes se les atendió su parto en el Hospital Engativá; mediante entrevistas semiestructuradas se indagó sobre la organización y la dinámica familiar de sus familias de origen. Mediante la hermenéutica del texto se identificaron categorías emergentes y se validaron los resultados por medio de triangulación de investigadores. RESULTADOS: Los núcleos familiares de las mujeres gestantes entrevistadas se caracterizaron por el mal manejo del conflicto, por las separaciones, por la estructuración de nuevos hogares y por la confusión en el ejercicio de roles, con una autoridad de tipo matriarcal; hogares reconstituidos donde las adolescentes orbitaban para hacer sus vidas; donde se daba un menor valor a la escolarización y en los que la educación de la sexualidad y la afectividad fueron ambiguas y contradictorias; familias con dinámicas expulsivas donde la madre adolescente debió enfrentarse al mundo de la supervivencia. CONCLUSIONES: Las adolescentes embarazadas del estudio desarrollan su vida en familias con una estructura y una dinámica poco propicia, que no les permite reaccionar adecuadamente a la adolescencia. De esta manera, el embarazo es una resultante no planeada y pocas veces deseada, situación en la que la familia se limita a normalizarlo cuando este se presenta. En este contexto, las adolescentes gestantes son el resultado de una serie de inequidades, donde la escolaridad tiene un menor valor y el desarrollo de competencias para la vida no alcanza a completarse como insumo para el desarrollo. Se destaca la capacidad resiliente de una de las participantes, lo que invita a nuevos estudios que permitan identificar aquellos elementos personales, de la familia y de la pareja que incrementen la capacidad de adaptación a esta nueva situación.

Assuntos

RESUMO

ABSTRACT Objective: To get an insight into the structure and dynamics of the original families of five teenage mothers through their life stories and their own experiences. Materials and methods: Qualitative study with a narrative approach based on the life stories of five teenage mothers delivered at Engativá Hospital. Semistructured interviews were used to gain insight into the organization and structure of their original families. Emerging categories were identified by means of text hermeneutics, and results were validated using triangulation across researchers. Results: The nuclear families of the pregnant women interviewed were characterized by the inability to deal with conflict appropriately, separations, structuring of new homes, confusion regarding roles, and matriarchal authority; reconstituted homes where the girls lived their own lives on the edge, where little value was attached to education, and where sexual and affective education were ambiguous and contradictory; families with expulsive dynamics where the teenage mother found herself having to survive on her own. Conclusions: Our pregnant adolescents live in the midst of families with unfavorable structure and dynamics that prevent the nuclear family from responding appropriately to teenage pregnancy. Consequently, pregnancy is an unplanned and rarely desired outcome, and a situation in which the family just normalizes the pregnancy when it occurs. In this context, pregnant adolescents are the result of a chain of inequities, where schooling is not valued and competencies for coping with life cannot grow fully to become an input for development. The noticeable resilience of one of the participants points to the need to undertake new studies focusing on identifying those traits of the individual, the family and the couple that increase their ability to adapt to the new situation.

RESUMEN Objetivo: indagar en los relatos personales de cinco madres adolescentes inmersas en sus historias de vida y la vivencia de estas. Materiales y métodos: estudio de tipo cualitativo con enfoque narrativo, mediante historias de vida de cinco mujeres adolescentes a quienes se les atendió su parto en el Hospital Engativá; mediante entrevistas semiestructuradas se indagó sobre la organización y la dinámica familiar de sus familias de origen. Mediante la hermenéutica del texto se identificaron categorías emergentes y se validaron los resultados por medio de triangulación de investigadores. Resultados: los núcleos familiares de las mujeres gestantes entrevistadas se caracterizaron por el mal manejo del conflicto, por las separaciones, por la estructuración de nuevos hogares y por la confusión en el ejercicio de roles, con una autoridad de tipo matriarcal; hogares reconstituidos donde las adolescentes orbitaban para hacer sus vidas; donde se daba un menor valor a la escolarización y en los que la educación de la sexualidad y la afectividad fueron ambiguas y contradictorias; familias con dinámicas expulsivas donde la madre adolescente debió enfrentarse al mundo de la supervivencia. Conclusiones: las adolescentes embarazadas del estudio desarrollan su vida en familias con una estructura y una dinámica poco propicia, que no les permite reaccionar adecuadamente a la adolescencia. De esta manera, el embarazo es una resultante no planeada y pocas veces deseada, situación en la que la familia se limita a normalizarlo cuando este se presenta. En este contexto, las adolescentes gestantes son el resultado de una serie de inequidades, donde la escolaridad tiene un menor valor y el desarrollo de competencias para la vida no alcanza a completarse como insumo para el desarrollo. Se destaca la capacidad resiliente de una de las participantes, lo que invita a nuevos estudios que permitan identificar aquellos elementos personales, de la familia y de la pareja que incrementen la capacidad de adaptación a esta nueva situación

Assuntos

RESUMO

El médico de familia está capacitado para resolver la mayoría de los problemas de salud de sus pacientes. Dentro del consultorio, el cansancio constituye un motivo de consulta muy frecuente. Su abordaje debe incluir la evaluación del contexto del paciente y un enfoque sistémico que incluya otros niveles diagnósticos y terapéuticos. Se presenta el caso de una paciente que, a partir de este motivo de consulta tan frecuente y junto a intervenciones de su médico de cabecera, logró modificar el foco del problema y comenzar un tratamiento acorde. (AU)

Family physicians are able to solve the majority of their patients' health issues. In the office, fatigue is a common complaint. Its approach should include the evaluation of the context of the patient and a systemic approach that includes other diagnostic and therapeutic levels. We present the case of a patient who went to his doctor with a common complaint and was able to change the focus of the problem and begin a consistent treatment. (AU)

Assuntos

RESUMO

Life scripts are shared cultural expectations about a selected group of events that occur during the life of a common individual in a certain culture. Life scripts are, therefore, normative expectations within a given culture regarding individual life patterns. We conducted a thematic analysis on 2,688 life script events indicated by 384 adults, mostly from the south and southeast regions of Brazil (70.3 women %). Following previous studies, we identified 74 events, or groups of events, common to other cultures; 30 events not mentioned by our participants; and 40 events specifically yielded by our analysis. Results show that first-time events play a special role on life scripts of Brazilians, as well as contents such as attending political events and post-graduate education. Methodological considerations on the qualitative analyses required to identify life events are discussed. Future studies may investigate prevalence, importance, valence, and gender and age differences with Brazilian participants.

Roteiros de vida são expectativas culturais acerca de um determinado grupo de eventos que ocorrem durante a vida de um indivíduo comum. Roteiros de vida são, portanto, expectativas normatizadas em uma determinada cultura com relação aos padrões de vida individuais. Foi conduzida uma análise temática em 2688 eventos de roteiros de vida relatados por 384 adultos, majoritariamente das regiões sul e sudeste do Brasil (70,3% mulheres). A partir de estudos prévios, foram identificadas 74 categorias de eventos comuns a diversas culturas; 30 não mencionadas pela amostra, e 40 emergentes da análise. Os resultados mostram que eventos relacionados à "primeira vez" tem papel especial nos roteiros de vida dos brasileiros, assim como conteúdos tais quais "comparecer a eventos políticos" e "pós-graduação". Considerações metodológicas acerca da análise qualitativa são necessárias para identificar os eventos de vida discutidos. Estudos futuros podem investigar prevalência, importância, valência, e diferenças etárias e de gênero em brasileiros.

Guiones de vida son expectativas culturales compartidas sobre un grupo seleccionado de eventos que ocurren durante la vida de un individuo común. Guiones de vida son, por lo tanto, expectativas normativas dentro de una cultura dada con respecto a patrones de vida individuales. Llevamos a cabo un análisis temático de 2.688 eventos de guiones de vida indicados por 384 adultos, mayoritariamente de las regiones sur y sudeste de Brasil (70,3% mujeres). Siguiendo estudios previos, identificamos 74 eventos, o grupos de eventos, comunes a otras culturas; 30 eventos no mencionados por nuestros participantes; y 40 eventos específicamente producidos por medio del análisis. Los resultados muestran que los eventos de primera vez desempeñan un papel especial en los guiones de vida de brasileños, tales como la participación en eventos políticos y la educación de postgrado. Se discuten consideraciones metodológicas sobre los análisis cualitativos requeridos para identificar guiones de vida. Estudios futuros pueden investigar prevalencia, importancia, valencia, y diferencias de edad y de género en brasileños.

Assuntos

RESUMO

OBJECTIVE: The objectives of the present study were to describe and compare the characteristics and reports of end-of-life experiences (ELEs) by healthcare professionals at different institutions and to investigate the influence of religious beliefs on these reports. METHOD: A multicenter study was carried out in Brazil that included six nursing homes (NHs), a cancer hospital (ONC), and a palliative care (PC) unit. Sociodemographic data, ELE reports (Fenwick's questionnaire), religiosity (the Duke Religion Index), spirituality (the Spirituality Self-Rating Scale), and mental health (the DASS-21 questionnaire) were assessed. The analysis was performed using ANOVA and chi-square tests in order to compare ELE perceptions in these different settings. RESULTS: A total of 133 healthcare professionals (46 ONC, 36 PC, and 51 NH) were interviewed, 70% of whom recounted at least one ELE report in the previous five years. The most common ELEs were "visions of dead relatives collecting the dying person" (88.2%), "a desire to mend family rifts" (84.9%), and "visions of dead relatives near the bed providing emotional comfort" (80.6%). Most healthcare professionals (70-80%) believed that these experiences had a spiritual significance and were not due to biological effects. Comparison among settings revealed that those working in the PC unit had more reports, a greater openness about the issue, and more interest in training. Individual religious beliefs had no influence on perception of ELEs. SIGNIFICANCE OF RESULTS: Our study revealed that ELE reports are not uncommon in clinical practice and seem to be little influenced by religious or spiritual beliefs. Although strongly reported in all settings, palliative care professionals tend to be more open to this issue and have a stronger perception of ELEs.

Assuntos

RESUMO

Introduction: The experience of living with people who present a Severe Mental Disorder (SMD) is hard for the families, especially for children who have been less studied. This research was aimed to know how the experience of having lived with a parent with severe mental disorder influenced on childhood, adolescence and young adulthood of their children. Method: The experience of coexistence with a parent with SMD in 10 children (6 men and 4 women) aged between 18 and 29 years was analyzed through individual semi-structured interviews and a group interview. The sample was obtained by convenience and all participants lived at least two continuous years during their childhood with a parent who presented SMD. Regarding the diagnoses, four parents suffered schizophrenia and six, bipolar disorder. The study is qualitative, exploratory and of descriptive type. An analysis of content and thematic of the corpuses was performed. Results: Show that by coexisting with a parent with SMD have negative as well as positive consequences. Among the negative consequences the following can be mentioned: distressing feelings, family burden and the delay of stages in the vital cycle. On the other hand, the positive consequences are related to the development of strengths in the offspring. Conclusions: These findings may provide inputs to be focused on the work with children of people affected by SMD.

Introducción. La experiencia de vivir con personas que presentan un Trastorno Mental Severo (TMS) es difícil para las familias, en especial para los hijos quienes han sido poco estudiados. El objetivo de la investigación fue conocer cómo la experiencia de haber vivido con un padre o madre con un trastorno mental severo influyó en la infancia, adolescencia y adultez joven de sus hijos e hijas. Método. Se analizan las experiencias de convivencia con un padre/madre con TMS en 10 hijos (6 hombres y 4 mujeres) de entre 18 y 29 años, a través de entrevistas semiestructuradas individuales y una entrevista grupal. La muestra se obtuvo por conveniencia y todos los participantes vivieron al menos dos años seguidos durante su niñez con un padre o madre que presentaba un TMS. Respecto a los diagnósticos, cuatro progenitores tenían esquizofrenia y seis trastornos bipolares. El estudio es cualitativo, exploratorio, de tipo descriptivo. Se realizó un análisis de contenido y temático de los corpus. Resultados. Muestran que convivir con padre/madre con TMS tiene consecuencias negativas y positivas, entre las primeras están: sentimientos aflictivos, carga familiar y el retraso de etapas del ciclo vital, en tanto las segundas se refieren al desarrollo de fortalezas en los descendientes. Conclusiones. Estos hallazgos pueden entregar insumos para focalizar el trabajo con los hijos e hijas de personas con TMS.

Assuntos

RESUMO

Resumen Una mayor comprensión sobre las experiencias de jóvenes antes, durante y después de pertenecer a un grupo armado ilegal (GAI), busca aportar elementos sobre la reintegración en contextos urbanos en Colombia, que orienten la prevención de la violencia. Se hizo un estudio cualitativo desde un enfoque histórico hermenéutico para entender estas experiencias desde la perspectiva de los participantes, como actores directos o indirectos del conflicto armado. Se entrevistaron 50 jóvenes de 14 a 24 años, de estrato socioeconómico bajo de Medellín, 7 mujeres y 43 hombres, 26 de ellos con experiencias directas en GAI. Sobresalen en sus relatos los obstáculos de progreso en la vida, marcados por estigma, pobreza, violencia e inequidad; la diferencia de opiniones entre los jóvenes para decidir la pertenencia o no a estos grupos; ser miembro activo de un GAI, una oportunidad en el presente y un obstáculo más en el futuro que complejiza las conductas de riesgo y el proceso de reintegración como una nueva expectativa de acceder a oportunidades educativas, laborales y reconocimiento social. Todo ello confluye en la necesidad no solo de un proceso de reintegración integral sino de políticas sociales más incluyentes y equitativas, en este caso, para niños, niñas y jóvenes.

Abstract A better understanding of the experiences of young people before, during and after belonging to an illegal armed group (IAG) can provide information to promote their reintegration into urban settings in Colombia and to help prevent violence. A qualitative study with a hermeneutic historical approach was performed to examine these experiences from the perspective of direct or indirect participants in the armed conflict. Fifty individuals aged 14-24 years (7 women and 43 men) with low socioeconomic status from Medellín were interviewed; 26 of them had a history of direct experience with IAGs. What stands out in their stories are descriptions of obstacles to progress in their lives; lives marked by stigma, poverty, violence and inequality; the differences of opinion among these young people regarding whether to belong to these illegal groups; how becoming an active member of an IAG creates both an opportunity for the present and an additional obstacle for the future, which adds complexity to the risk behaviors they assume; and how the reintegration process offers new expectations regarding access to educational and employment opportunities and social recognition. All of these factors point to the need for not only a comprehensive reintegration process but for more inclusive and equitable social policies, in this case for children and young people.

Assuntos

RESUMO

Este estudo teve por objetivo conhecer a percepção de adolescentes de uma escola pública municipal da região metropolitana do Rio Grande do Sul sobre as relações entre violência doméstica e bullying. Trata-se de um estudo qualitativo que teve por base metodológica a Entrevista Reflexiva. Por meio de duas etapas anteriores, foram selecionados como participantes oito estudantes que declararam sofrer violência doméstica e serem autores e/ou alvos de bullying. Resultados indicaram que os adolescentes percebem a associação entre os microssistemas escola e família diante das vivências de violências. Sendo vítimas de violência doméstica, alguns tornam-se alvos de bullying, pois demonstram fragilidade; outros, autores, por seguirem os exemplos negativos ou direcionarem a raiva a colegas. Estes achados destacam a necessidade de se implementarem projetos de intervenção e políticas públicas de combate a essas violências, que associem escolas e famílias.

This study aimed to know the perception of adolescents from a public school in the metropolitan region of Rio Grande do Sul about the relationships between domestic violence and bullying. It is a qualitative study that was based on Reflexive Interview as the methodological approach. By means of two previous stages, eight students were selected as participants, who declared that they suffered domestic violence and were authors and /or targets of bullying. Results indicated that adolescents perceive the association between school and family microsystems from the experiences of violence. Being victims of domestic violence, some become targets of bullying because they show fragility; others, authors, by following the negative examples or directing anger to their peers. These findings highlight the need to implement intervention projects and public policies to combat this violence, which associate schools and families.

Este estudio tuvo como objetivo conocer las percepciones de los adolescentes de una escuela pública en la región metropolitana de Rio Grande do Sul, sobre las relaciones entre la violencia doméstica y bullying. Se trata de un estudio cualitativo que tuvo por base metodológica la Entrevista Reflexiva. Por medio de dos etapas anteriores, se seleccionaron como participantes ocho estudiantes que declararon sufrir violencia doméstica y ser autores o víctimas de bullying. Los resultados indicaron que los adolescentes perciben la asociación entre los microsistemas escuela y familia ante las vivencias de violencias. Siendo víctimas de violencia doméstica, algunos se convierten en víctimas de bullying, pues demuestran fragilidade; otros, autores, por seguir los ejemplos negativos o dirigir la rabia a colegas. Estos resultados destacan la necesidad de implementar proyectos de intervención y políticas públicas de combate a esas violencias, que asocien escuelas y familias.

Ce texte vise à compreendre la perception des étudiants adolescents d'une école publique sur les relations entre violence familiale et l'intimidation. Ceci est une recherche qualitative qui avait comme base méthodologique l'entretein réflexif. Huit étudiants qui se sont déclarés victimes de violence familiale et étaient auteurs et /ou cibles d'intimidation ont été sélectionnés comme participants à la recherche. Les résultats de cette recherche indiquent que les adolescents perçoivent l'association entre les microsystèmes scolaires et familiaux face à des expériences violentes. Ceux qui sont victimes de violence familiale deviennent des cibles d'intimidation principalement parce qu'ils sont fragiles. D'autres élèves deviennent des intimidateurs simplesment en suivant des tendances négatives ou en dirigeant leur colère vers des collègues. Ces résultats soulignent la nécessité de mettre en oevre des projets d'intervention et des politiques publiques de lutte contre l'intimidation impliquant les écoles et les familles.