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Cultivating Compassion in Students for End‐Of‐Life Processes: A Mixed‐Methods Participatory Research Protocol

ABSTRACT

Aims

To analyse the impact of a participatory process of awareness and reflection on compassion, in the face of end-of-life processes, in students aged 12–23 years in six Spanish regions, and to understand how the participatory process can transform their compassion.

Design

Mixed sequential transformative methodology with different phases. In the first phase, a prospective quasi-experimental design with evaluation pre-post in a single group will be adopted. The second phase is the intervention under study, which will consist of a Participatory Action Research with concurrent evaluations.

Methods

In the quantitative phase, 1390 students aged 12–23 from a Public University and a Public Secondary Education Institute across six different Spanish regions will be included. A single questionnaire will be administered before and after the Participatory Action Research to contribute to the process evaluation, incorporating four scales (compassion for others' lives, Death Anxiety Scale, basic empathy modified for adolescents and self-compassion). Responses will be recorded in the Research Electronic Data Capture system. For data analysis, comparison groups, change evolution and associations between variables will be examined, along with multivariate logistic regression models. In the qualitative phase of participatory action research, a promoter group will be established in each university and secondary school in every region. Qualitative data will be analysed following the authenticity, transferability, auditability and neutrality criteria. Discourse analysis triangulation will be conducted to achieve data saturation.

Conclusions

Implementing participative action research in the educational environment to improve students' compassion makes them capable of founding compassion communities to help those who have a terminal illness.

Reporting Method

This study will adhere to the relevant EQUATOR guidelines, such as the Good Reporting of a Mixed Methods Study guideline, to efficiently report its results through the different steps of this mixed-methods study.

Patient or Public Contribution

Participatory action research is a method that enables participants to act as researchers of the phenomenon under study, facilitating the immediate application of results within the context. Although students did not participate in the writing of the proposal grant or the research design.

Trial and Registration

This study registered on Clinical Trials (NCT06310434), was initiated in January 2024, and it will continue up to December 2026.

Nursing Implications

This multicentre study will contribute to the nursing community with an overview of compassion for those at the end of their lives among young people and provide the knowledge needed to cultivate compassion at universities and schools.

Impact

Implementing compassion programmes and death education in the educational environment will empower students to create a compassionate community. The double evaluation of the process will contribute to the qualitative databases.

Consensus on addressing HIV-related stigma and achieving the societal enabler targets using an adapted Delphi process

Por: Molesworth · K. · Nkosi · S. · Camacho · S. · Caswell · G. · Salem · S. · Baral · S. · Kamarulzaman · A. · Sprague · L. · Stackpool-Moore · L.
Objectives

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.

Design

An adapted Delphi consensus-building process using two rounds of online questionnaires.

Setting

Online questionnaires sent to a global expert panel.

Participants

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.

Results

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.

Conclusions

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.

Relación entre autocuidado y automedicación en estudiantes de ciencias de salud de una universidad pública

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.

Experiencia vivida de enfermeras al cuidado de su familiar en proceso de cronicidad y muerte

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.

Mujer cisgénero en situación de trabajo sexual: “nos ven como el foco infeccioso o como el virus andante”

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.

Detección precoz de lesiones oculares en una unidad de cuidados intensivos pediátricos: Elaboración y validación de un cuestionario

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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