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To seek consensus among global experts on concepts, measures and approaches to guide national and global action to address HIV-related stigma and formulate a call to action. This outlines priorities to unite actors in more effectively responding to and resourcing efforts to address HIV-related stigma.
An adapted Delphi consensus-building process using two rounds of online questionnaires.
Online questionnaires sent to a global expert panel.
50 global experts on HIV-related stigma and discrimination representing sectors including civil society, people living with HIV and key populations, research and academia, clinical practice, law, non-profit organisations, the United Nations, and policy and donor organisations.
The panel reached consensus on 55 points relating to the 12 broad themes extracted from the evidence base. These comprised the importance of addressing HIV-related stigma at scale; HIV-related stigma terms and definitions; Frameworks; Programming and approaches; Community leadership in HIV-related stigma-reduction implementation; Intersectional stigma and discrimination; Stigma and discrimination measures and assessment scales; Monitoring and evaluation; Stakeholder and community participation in monitoring and evaluation; Knowledge gaps and research needs; Funding and Commitment calls. From these, a consensus statement and call to action were formulated on priorities for strong political and financial commitments by all countries to reduce and mitigate HIV-related stigma and achieve global HIV targets adopted in 2021.
This study illustrated that global experts across sectors consider that action is needed to support the three critical enablers of the HIV response—society, systems and services—to ensure that HIV services are non-discriminatory and person-centred. The importance of attention and action to reduce stigma is critical in the current geopolitical and funding crisis affecting HIV and global health.
Objetivo. Analizar la prevalencia de la automedicación y su relación con la capacidad de autocuidado en estudiantes del Centro de Ciencias de la Salud de una universidad pública. Metodología. Se llevó a cabo un estudio cuantitativo, relacional y observacional con una muestra de 330 estudiantes seleccionados aleatoriamente. Se utilizaron dos instrumentos validados para medir la automedicación y la capacidad de autocuidado, además de un formulario para variables sociodemográficas. Los datos se analizaron con SPSS versión 25, utilizando pruebas de normalidad, independencia y Chi-cuadrado de Pearson. Resultados. El 81,5% de los estudiantes presentó una capacidad media de autocuidado, mientras que el 18,5% tuvo una capacidad alta. No se encontraron estudiantes con baja capacidad de autocuidado. La prevalencia de la automedicación fue del 73,9%, siendo los fármacos más comunes antidiarreicos (10,6%), anfetaminas (10%), anticonceptivos orales y acetaminofén (7,6% cada uno). Los síntomas principales para automedicarse fueron dolor estomacal (9,7%), desgano/agotamiento (9,4%) y dolor de cabeza (9,1%). La carrera de Enfermería mostró la mayor prevalencia de automedicación (80,6%), seguida de Terapia Física (78,6%) y Medicina (76,4%). Se identificó dependencia estadísticamente significativa entre automedicación y capacidad de autocuidado. Discusión. Existe alta prevalencia de automedicación entre los estudiantes del área de salud. Es crucial reevaluar la independencia de ambas variables y abordar los factores que llevan a los estudiantes a automedicarse, ya que este comportamiento podría afectar su capacidad para proporcionar cuidados seguros y adecuados a los pacientes. Aun cuando no hay independencia entre variables.
ABSTRACT
Objective. To analyze the prevalence of self-medication and its relationship with the capacity of self-care among students of the Health Sciences Center in a public university. Methodology. A quantitative, relational and observational study was performed to a sample group of 330 students randomly selected. Two validated instruments were used to measure self-medication and self-care capacity, as well as a form for sociodemographic variables. All data were analyzed utilizing SPSS version 25, and using tests of normality, independence, and Pearson's Chi-square. Results. 81.5% of the students showed having a medium capacity of self-care, while 18.5% showed having a high capacity. Students with low self-care capacity were not found. The prevalence of self-medication was 73.9%, with the most common drugs being antidiarrheals (10.6%), amphetamines (10%), oral contraceptives, and acetaminophen (7.6% each). The main symptoms for self-medication resulted being stomach pain (9.7%), apathy / exhaustion (9.4%), and headache (9.1%). The Nursing career resulted with the highest prevalence of self-medication (80.6%), followed by Physical Therapy (78.6%) and Medicine (76.4%). A statistically significant dependency was identified between self-medication and self-care capacity. Discussion. There is a high prevalence of self-medication among health students. It is crucial to reevaluate the independence of both variables and address the factors that lead students to self-medication, as this behavior could affect their ability to provide safe and appropriate care to patients. Even when there is no independence between variables.
Introducción. El fenómeno de la muerte resulta importante para las enfermeras identifiquen fortalezas y oportunidades para el cuidado como práctica esencial en la disciplina. Objetivo. Interpretar la experiencia vivida de enfermeras al cuidado de su familiar en proceso de cronicidad y muerte. Método. Estudio cualitativo con enfoque fenomenológico hermenéutico. Criterios de estudio: profesionales de enfermería con cualquier grado académico, ambos sexos, que hayan cuidado a familiar en casa u hospital por 6 meses o más. Se realizó la ntrevista fenomenológica en el lugar seleccionado por participante evitando la intrusión a sus modos de ser. La selección se desarrolló en cadena de referencia y alcanzó la saturación de la información teórica. Cumplió criterios de Ley General de Salud en materia de investigación. Análisis a través del círculo hermenéutico heideggeriano. Resultados. Se exploró vivencias de 6 enfermeras, edades entre 42 y 55 años. Todas profesan religión católica, y en común las siguientes unidades de significado; Ontológicamente: angustia en la impropiedad de la clínica, delegación del compromiso, sentimientos autosuficientes sin reciprocidad, responsabilidad auto asignada. Ónticamente: angustia proyectada y cansancio por la enfermedad. Discusión. Se destaca la muerte como etapa vital, fase que es inevitable. Vivir el proceso de morir es un fenómeno complejo, debe ser abordado bajo esquemas contemporáneos propiamente disciplinares. Conclusión: Ser que cuida de su familiar en este proceso crea lazo afectivo, involucrándose inconscientemente. Se coincide el alivio para evitar el sufrimiento es la muerte del familiar, y generando satisfacción de hacer menos su agonía.
ABSTRACT
Introduction. The phenomenon of death is important for nurses to identify strengths and opportunities for care as an essential practice in the discipline. Objective. To interpret the lived experience of nurses caring for their relative in the process of chronicity and death. Methodology. Qualitative study with a hermeneutical phenomenological approach. Study criteria: nursing professionals with any academic degree, both genders, who have cared for a family member at home or in a hospital for 6 months or more. Phenomenological interview in the place selected by the participant, avoiding intrusion into their ways of being. The selection was developed in a reference chain and reached the saturation of the theoretical information. It met the criteria of the General Health Law regarding research. Analysis through the Heideggerian hermeneutic circle. Results. The experiences of 6 nurses, ages between 42 and 55 years, were explored. They all profess the Catholic religion, and in common the following units of meaning; Ontologically: anguish in the impropriety of the clinic, delegation of commitment, self-sufficient feelings without reciprocity, self-assigned responsibility. Ontic mind: projected anguish and fatigue due to illness. Discussion. Death is highlighted as a vital stage, a phase that is inevitable. Living the process of dying is a complex phenomenon, it must be approached under properly disciplinary contemporary schemes. Conclusion. Being that you take care of your relative in this process creates an affective bond, getting involved unconsciously. The relief to avoid suffering is the death of the family member and generating satisfaction of making their agony less.
Post-stroke depression is the most common neuropsychiatric consequence and reduces rehabilitation effectiveness. However, the efficacy of virtual reality (VR) on mental health treatment for patients after a stroke is uncertain.
The aim of this study was to evaluate the efficacy of VR as a co-adjuvant form of treatment to reduce depression in stroke patients admitted to neurorehabilitation units.
We systematically searched medical databases including PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception to November 16, 2023. Clinical trials comparing the use of VR as an adjuvant form of treatment in stroke patients' rehabilitation with the usual treatment were included. Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses were performed according to type of stroke, VR characteristics, and the scale used to measure depression. Meta-regression analysis was performed for intervention duration and to determine the mean age of the participants.
Eight studies and 388 stroke patients were included. The VR interventions were associated with a lower risk of depression in patients (ES = −0.69; 95% CI [−1.05, −0.33]; I 2 = 57.6%; p ≤ .02). The estimates were not affected by the type of stroke, the type of VR used, the blinding process, the type of scale used to detect depression, the duration of the intervention (weeks and minutes), and the total number of sessions. Meta-regression shows that younger samples (p = .00; 95% CI [0.01, 0.08) and longer interventions (p = < .05; 95% CI [−0.00, −0.00) lead to a greater reduction in depression.
This review provides an important basis for treating depression in patients after a stroke. Professionals working in stroke neurorehabilitation units should consider VR as a form of co-adjuvant treatment for depression in patients.
CRD42022303968.
Objetivo principal: Explorar las barreras percibidas para el autocuidado de la salud sexual de una mujer cisgénero de 57 años en situación de trabajadora sexual. Metodología: Se abordó un relato biográfico de naturaleza cualitativa, constructivista y fenomenológica. Resultados principales: Del análisis sistemático y de contenido, emergieron los temas: el trabajo sexual como una alternativa de vida; el estigma y la discriminación por la identidad ocupacional; la falta de una atención en salud preventiva, humanizada e incluyente; la necesaria autoestima para autocuidarse; la psicología informal como método de cribaje del cliente; el saber profesional en prácticas protectoras y de cuidado; las brechas y dificultades para el uso del condón masculino; y la necesidad de una política pública con mirada de género e inclusiva. Conclusión: La narrativa refleja la necesidad de afrontar las barreras para el autocuidado de la salud sexual, mediante metodologías participativas e inclusivas que promuevan la cooperación de políticas, estrategias e intervenciones en salud preventiva congruentes con las necesidades de las mujeres trabajadoras sexuales.
Objetivo principal: Elaboración y validación de un cuestionario sobre detección precoz de lesiones oculares en el paciente crítico pediátrico. Metodología: Estudio descriptivo de validación de contenido de un cuestionario. Se seleccionó bibliografía científica, se redactaron los ítems y se validó el contenido mediante un panel de 8 expertos con experiencia en unidades de cuidados intensivos pediátricos. Resultados principales: 53 artículos relacionados con la aparición de daño ocular en unidades de cuidados intensivos fueron seleccionados. Se agruparon los factores de riesgo y se incluyeron aquellos que superaron la valoración de un panel de expertos. Conclusión principal: el contenido de este cuestionario para detectar lesiones oculares en unidades de cuidados intensivos pediátricos es un instrumento repre-sentativo, por lo que puede usarse en estudios posteriores para establecer su fiabilidad, validez, viabilidad y sensibilidad al cambio.
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