Nursing students' knowledge regarding sexuality, sex, and gender diversity in a multicenter study

Introduction

Sexuality is an integral part of development and personality, and is important in healthcare. Nurses are among the most representative healthcare professionals. For holistic and inclusive nursing care practice and to improve equality, human rights, well-being, and health of individuals, the curricula of nursing courses must integrate broad knowledge about sexuality and its diversity. This study aimed to identify and analyze nursing students' knowledge of sexuality, sex, and gender diversity. The present study was part of a multicenter study conducted in Europe.

Methods

Questionnaires were administered in three nursing schools to assess nursing students' knowledge (n = 75). Data processing was performed using Excel® software version 20 and IRaMuTeQ (R Interface pour les Analysis Multidimensionnelles de Textes et de Questionnaires) 0.7 alpha 2, allowing organization by category and subsequent thematic analysis using content analysis.

Results

The textual corpus "Nursing students' knowledge about sexuality in its diversity," was divided into two sub-corpus: "Students' perception of sexuality" and "Students' perception of gender identity," originating Class 6 "Eroticism" (14.23%) and Classes 4 "Sexual Orientation" (16.07%) and 3 "Heteronormative" (16.07%), the latter with greater proximity to each other and consequently to Class 6. Similarly, Classes 1 "Gender" (20.36%) and 5 "Cisgender" (12.14%) also presented a greater interrelationship between themselves and consecutively with Class 2 "Gender Identity" (15.36%).

Discussion

The analyses revealed that though nursing students possessed knowledge about sexuality and its diversity, this knowledge was elementary and did not reveal a sustained appropriation of concepts related to sexuality, sexual orientation, and gender diversity. For some questions, the absence of students' answers were noteworthy, and may be associated with their personal reservation in expressing themselves on this sensitive and intimate theme. To ensure diversity, inclusivity, and impartiality in nursing practice, it is imperative to change the curriculum plans of nursing courses to address the theme of sexuality during the training process of nurses in Europe.

"Nurses and health professionals facing female genital mutilation: a qualitative study "

BACKGROUND

Transnational migratory movements make Spain a country with a very diverse population, including women and girls from countries where Female Genital Mutilation (FGM) is practiced. Given this reality, we set out to carry out a qualitative study to identify the knowledge, attitudes and skills of health professionals regarding FGM.

METHOD

Qualitative study with a content analysis approach. Forty-seven health professionals with the profiles of Nursing, Family Medicine, Pediatrics, Midwifery and Gynecology and Obstetrics were purposively selected. Data were collected through semi-structured in-depth interviews and focus groups. The qualitative content analysis approach was used for data analysis. The study was conducted in the years 2019 and 2022.

RESULTS

Although most professionals are aware of the current legislation on FGM in Spain, only a few of them are aware of the existence of the FGM prevention protocol in Castilla-La Mancha. This lack of knowledge together with the perception that FGM belongs to the private sphere of women, contributes to the loss of opportunities to identify and prevent FGM.

CONCLUSION

Health professionals' training, especially midwives and pediatricians, is essential to the identification and action against Female Genital Mutilation.

The Art of Childbirth of the Midwives of Al-Andalus: Social Assessment and Legal Implication of Health Assistance in the Cultural Diversity of the 10th-14th Centuries

(1) Background: The role of Al-Andalus's women were the result of Arabization and Islamization in Spain. The 10th to the 14th centuries were a time of significant cultural diversity in the region. Female physicians and midwives were important for providing care to women. Despite existing studies, there is still a lack of focused research on the professionalization of these trades, including their requirements, intervention areas, and treatments. (2) Methods: To address this gap, we conducted a scoping review using the dialectical structural model of care (DSMC). Primary medical and legislative sources were used. (3) Results: two kinds of midwife, or qābila, were discovered, along with a woman physician, or ṭabība, who also acted as a midwife. These professions underwent diverse training and fulfilled duties as obstetricians and pediatricians. Midwives were esteemed members of society and were the sole female professionals who needed qualified training. Their performance in the courts was exemplary. Tools for facilitating childbirth and interventions related to female health were discovered in the study. (4) Conclusions: The patriarchal societies suffer from significant inequality in terms of academic training, knowledge transmission, and healthcare provision. Midwives functioned in segregated domestic and legal spaces and were responsible for providing public care to communities from the 10th to 14th centuries.

Gender diversity and syphilis: something's going on?

Introduction

This study aims to analyze the influence of syphilis among people with sexual and gender diversity, different from the binary dimension.

Materials and methods

A systematic review was conducted as a method to address the objective of the study, based on the Dialectical Structural Model of Care (DSM), to obtain the phenomenon from the perspective of cultural history.

Results

In this review the analysis of 129 documents, of which 22 texts were used. The construction of sex and gender in Western civilization is based on the Judeo-Christian tradition, which permitted many people throughout history to be persecuted and mistreated for living a lifestyle different from that dictated by religious and traditional canons. Therefore, throughout history, gender-diverse people, sexual minorities, and prostitutes have suffered segregation, mockery, aggression, and health problems, including syphilis.

Conclusions

Despite having a treatment and cure, syphilis has stood the test of time and has remained a secret pathology that is obscure and difficult to detect disease, which is still very much present in people of all social classes. It is necessary to review history to understand the reasons why syphilis is still prevalent in different societies today.

Child Maltreatment: Skills and Perceptions as Competencies in Higher Nursing Education

Child maltreatment is any action, neglect or aggression towards a child caused by parents, family members or others. The objective of this study is to find out the beliefs and attitudes regarding abuse among nursing students.

METHODS

This was an exploratory study with the aim of validating the questionnaire, made up of four dimensions. This questionnaire was administered during the 2020/2021 academic year to 370 undergraduate nursing students (first and third year), in Toledo, Talavera de la Reina and Albacete of the University of Castilla-La Mancha, in addition to resident nurses, master's students and doctoral students during the first four-month period (September, October, November and December). A statistical analysis was carried out observing internal consistency for Cronbach's alpha.

RESULTS

In total, 61.6% of the students concluded that the child was not responsible for maltreatment, and 41.6% thought that it was independent of gender. Furthermore, 65.7% stated that it is human nature for parents to care for their children, 74.1% considered maltreatment to be a crime in the family, and 15.4% said that it does not exist in higher social classes. A total of 23.2% said that those in nursing professions should not intervene in child abuse. With regard to Münchausen syndrome, there was less agreement among the participants, being unknown to the great majority of the students.

CONCLUSIONS

Among the participants, a lack of knowledge about child abuse was observed, as well as the role of nursing in its detection. Subsequently, given the importance of nursing and its professionals in the detection and management of child abuse, it is necessary to implement knowledge and skills in undergraduate training.

A Multicentric Pilot Study of Student Nurse Attitudes and Beliefs toward Sexual Healthcare

Nurse educators are tasked with the education of students to become providers of holistic care, and part of that care includes sexuality. Students carry attitudes and beliefs that influence their behavior; therefore, students who carry negative attitudes about sexual healthcare are less likely to provide that care. This is an international, multicenter study of nursing students' attitudes and beliefs about the provision of sexual healthcare. The Sexuality Attitudes and Beliefs Survey, which measures attitudes toward the provision of sexual healthcare and has a range of scores from 12 to 72, was given to 129 students across Spain, Portugal, Italy and the United States and revealed negative attitudes about sexuality, with a mean SABS score of 39.95. Higher scores on the SABS reveal more negative attitudes and reduced likelihood of provision of sexual healthcare. Statistically significant differences were found when comparing queer and heterosexual students (41.69 vs. 38.06), and students in their final year of school held more negative attitudes toward the provision of sexual healthcare (41.4 vs. 39.5 and 39.2). This study shows that nurse educators continue to need to focus on the attitudes student nurses carry about sexuality. There is a critical shortage of education strategies to meet the needs of student nurses so that they will be comfortable and confident in providing sexual healthcare.

Women health providers: materials on cures, remedies and sexuality in inquisitorial processes (15th-18th century)

Background

The first inquisitorial trials were against Muslims and Jews. Later, they focused on women, especially caregivers. Progressively, they were linked to witchcraft and sorcery because of their great care, generational and empirical knowledge. The historiography of health in the 15th-18th centuries still has important bibliographical and interpretative gaps in the care provided by women.

Objective

To analyse the care provided by healers as health providers, accused by the Inquisition, justifying the importance of nursing in the diversity of community care in the 15th-18th centuries.

Method

A scoping review was conducted following the Dialectical Structural Model of Care (DSMC). A database search was conducted for the period 2013-2022. Bibliographic and legislative resources were used. Cases and convictions from Castilla la Nueva were found in the National Historical Archive and the Diocesan Archive of Cuenca.

Results

The concepts of healer, witch and sorceress envolved during the study period. They reflect and reveal the collective imaginary of the social structure. They had healing laboratories, practised psychological and sexual care. They used to accompany their therapeutic action with prayers and amulets. They shared their professional activity with their main denouncers, doctors, apothecaries and priests. They were usually women in socially vulnerable situations, who did not conform to social stereotypes.

Conclusions

They were predecessors of today's nursing, they overcame socio-cultural difficulties, although they were condemned for it. Healers did not manage to regulate their profession, but they acted as agents of health in a society that demanded them while participating in the "witch-hunt".

Sexual education for university students and the community in a european project: study protocol

BACKGROUND

The World Health Organisation (WHO) calls on stakeholders to give Higher Education a key educational importance for the future of Europe. Within the content of the training programmes at university, sexuality emerges as a relevant topic in the nursing degree, to promote integral health from a holistic perspective. However, research on the presence of sexuality at the curricular level in Higher Education suggests that it is incomplete and underdeveloped.

METHODS

This is a protocol for a long-term, multi-centre, exploratory, descriptive, and cross-sectional study with a quantitative and qualitative approach lasting two years. The research will be carried out in the educational community, including, on the one hand, students, and professors and health professionals of nursing programmes from five universities in different parts of the world (Portugal, Spain, Italy, and the United States), and on the other hand, women, young people, and immigrants from these communities. The study will have several target populations. Firstly, the target is nursing students, with whom the aim is to define their perspective on the sexuality content taught at the university, and their level of knowledge. Secondly university professors and health professionals, with whom we will check their perspective on sexuality in the classroom, as well as their level of knowledge in this field. And finally, we will work with the community (women, young people, and immigrants) to whom we will try to bring sexuality from a useful and enjoyable perspective. In order to measure these variables in the protocol, instruments such as questionnaires and semi-structured interviews will be used. During data collection, ethical principles will be guaranteed and informed consent will be requested from the participants.

DISCUSSION

The results of the research will have a high curricular impact on the educational community, and will last over time, since the tools generated in the project will be included as part of nursing training programmes. In addition, participation in the project will improve health education for health professionals and at the community level on sexuality in both urban and rural populations.

Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil-A Comparative Analysis

(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a new platform (Salus) developed by the Laboratory of Technological Innovation in Health in the scope of notification and management of disease data, including syphilis. In addition, this analysis aimed to assess whether Salus fully meets the necessary data management fields and can be indicated as a tool to improve health management in the context of syphilis in Brazil. (3) Results: In this study, the Salus functionalities were demonstrated and compared with the current Brazilian systems by discovering the existing gaps in the evaluated systems. The gaps found may explain the delay in meeting demands, the difficulty of making routine therapeutic follow-ups, in addition to interference with the vital purpose of follow-up in the epidemiological surveillance of diseases. As a result, Salus demonstrates functionalities that surpass all others and meet case management demands in a superior way to the systems currently used in the country. (4) Conclusions: The Brazilian health information systems related to the response to syphilis do not fulfill the purpose for which they were developed. Instead, they contribute to the fragmentation of health data and information, delays in diagnosis, incomplete case management, and loss of data due to inconsistencies and inadequate reporting. In addition, they are systems without interconnection, which do not articulate epidemiological surveillance actions with primary health care. All these factors may be obscuring accurate data on syphilis in Brazil, resulting in high and unnecessary public spending and late care for users of the Unified Health System (SUS).

Changes in Cardiorespiratory Fitness and Probability of Developing Abdominal Obesity at One and Two Years

Low cardiorespiratory fitness (CRF) is associated with an increased risk of developing abdominal obesity (AO), but it is not known if and/or how changes in CRF affect AO. We examined the relationship between changes in CRF and the risk of developing AO. This is a retrospective observational study of a cohort of 1883 sedentary patients, who had participated in a clinical trial of physical activity promotion carried out in Spain (2003-2007). These data were not used in the clinical trial. At baseline, they were free of cardiovascular disease, hypertension, diabetes, dyslipidemia, and/or AO; with an indirect VO2max measurement; 19-80 years old; and 62% were women. All the measures were repeated at 6, 12, and 24 months. The exposure factor was the change in CRF at 6 or 12 months, categorized in these groups: unfit-unfit, unfit-fit, fit-unfit, and fit-fit. We considered fit and unfit participants as those with VO2max values in the high tertile, and in the moderate or low tertiles, respectively. The main outcome measure was the risk of developing AO at one and two years, as defined by waist circumference >102 (men) and >88 (women) cm. At two years, 10.5% of the participants had developed AO: 13.5% in the unfit-unfit group of change at 6 months; 10.3% in the unfit-fit group (adjusted odds ratio (AOR) 0.86; 95% confidence interval (CI) 0.49-1.52); 2.6% in the fit-unfit group (AOR 0.13; 95%CI 0.03-0.61); and 6.0% in the fit-fit group (AOR 0.47; 95%CI 0.26-0.84). Those who stayed fit at 6 months decreased the probability of developing abdominal obesity at two years.

Effect of Non-Pharmacological Methods in the Reduction of Neonatal Pain: Systematic Review and Meta-Analysis

In neonatology, neonates have traditionally been considered incapable of feeling pain, due to the immaturity of their nervous system. Currently, there is sufficient information on the perception of pain in neonates; however, this treatment at this crucial stage for development requires a better approach. For this reason, the aim of this study was to analyse the efficacy of non-pharmacological analgesia interventions during heel prick, and to assess their effects on heart rate (HR), premature infant pain profile (PIPP) and O2 saturation. A systematic review and meta-analysis was performed following the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA), and the Cochrane collaboration handbook. The databases PubMed, Cochrane Library, Web of Science, Scopus, CINAHL and Science Direct were searched until the end of January 2022. The DerSimonian and Laird methods were used to estimate the effect size with a 95% confidence interval (CI95%). Effect size estimates were 0.05 (95% CI: -0.19, 0.29) for HR, -0.02 (95% CI: -0.24, 0.21) for PIPP scale, and -0.12 (95% CI: -0.29, 0.05) for O2 saturation. The non-pharmacological interventions analysed (breastfeeding, kangaroo-mother care method, oral sucrose and non-nutritive sucking) were not statistically significant in reducing neonatal pain, but did influence the decrease in pain score and a faster stabilisation of vital signs.

[Vulnerability of obesity as defined by body mass index, waist circumference, and body fat percentage]

AIM

To ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]).

DESIGN

Longitudinal observational and retrospective study. SITE: Eleven Spanish health centers.

PARTICIPANTS

Men and women with BMI≥30kg/m² (n=1246) or general obesity (GO), with WC>102cm and >88cm, respectively (n=2122) or abdominal obesity (AO) and with BFP>25% and >35%, respectively (n=2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80years.

MAIN MEASUREMENTS

Data from the PEPAF study at baseline and at 6, 12 and 24months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women).

RESULTS

Of 2054 participants with any type of obesity at baseline and valid data at 2years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95%CI: 17.6-21.4) ceased to have EBF, 12.0% (95%CI: 10.4-13.7) ceased to have AO and 10.5% (95%CI: 8.5-12.7) ceased to have GO.

CONCLUSIONS

Obesity differs from other chronic diseases in that it can be «cured» by normalizing the amount of body fat.

The public health nurse cutting-edge care model in Spain

Abstract Objective to analyze the figure of the Spanish visiting nurse from 1921 to 1953. Method This is a historical-social, qualitative study based on primary and secondary documentary sources. The Dialectical Structural Model of Care (DSSM) was used to support the data management and analysis process. Results Spanish visiting nurses had specialization in public health, acquired at Bedford College, in England, or at the Rockefeller Foundation, in the United States. They worked in rural and urban environments, performing their work in Primary and Secondary Centers of Rural Hygiene, where they educated the population about personal hygiene and public health rules. Conclusion and implications for practice Spanish nurse visitors were able to expand health education throughout the country, promote hygienic and nutritional habits for the general population, reduce the incidence of infectious-contagious diseases, and promote sanitary reforms that began at the beginning of the 20th century. Currently, the figure of the visiting nurse can be considered a forerunner of the specialist nurse in family and community care.

Enfermera visitadora modelo vanguardista de cuidados de salud en España

Resumen Objetivo analizar la figura de la enfermera visitadora española en el periodo comprendido entre 1921 y 1953. Método estudio histórico-social, cualitativo, a partir de fuentes documentales primarias y secundarias. Se utilizó el Modelo Estrutural Dialético de Atención (MEDC), como soporte al proceso de gestión y análisis de datos. Resultados las enfermeras visitadoras españolas tenían el título de especialistas en salud pública, adquirido en Bedford College, en Inglaterra, o en la Fundación Rockefeller, en Estados Unidos. Actuaban en entornos rurales y urbanos, realizando su trabajo en Centros Primarios y Secundarios de Higiene Rural, lugares donde educaban a la población en las normas de higiene personal y salud pública. Conclusión e implicaciones para la práctica la enfermera visitadora española consiguió extender la educación sanitaria por todo el país, promover los hábitos higiénicos y nutricionales de la población en general, reducir la incidencia de las enfermedades infecto-contagiosas y promover las reformas sanitarias que se iniciaron a principios del siglo XX. En la actualidad, la figura de la enfermera visitadora puede ser considerada como precursora de la enfermera especialista en atención familiar y comunitaria.

Adaptation and Validation of the Sexuality Attitudes and Beliefs Scale for the Italian Context

BACKGROUND

Nurses dealing with a patient's sexuality must start from an awareness of their own experience, specific attitudes, and possible limits. What emerges from the literature is a conservative tendency in nurses, which underlines the difficulty in this awareness, but even a difficulty in improving the necessary knowledge/skills. It is, therefore, essential to create tools that can raise awareness of these limits.

OBJECTIVE

the present study aims to explore the psychometric properties of the Attitudes and Beliefs about Sexuality Scale, adapted and validated for the Italian context.

METHOD

This is an instrumental, cross-sectional piece of research, whose SABS validation process applies the steps of Beaton and Valmi. The convenience sample collected data from 223 participants in the first approach. This was followed by a retest involving 44 students randomly selected from those who responded in the first phase. Ethical principles were respected.

RESULTS

The SABS questionnaire demonstrated good test-retest reliability, good internal consistency, and adequate construct validity.

CONCLUSIONS

The Italian version of the SABS is valid and reliable for use with nursing students. This is the fourth language in which the SABS is available for research.

Midwives in Health Sciences as a Sociocultural Phenomenon: Legislation, Training and Health (XV-XVIII Centuries)

Background and Objectives: The first inquisitorial processes were developed against Muslims and Jews. Then, they focused on women, especially those dedicated to care. Progressively, they were linked to witchcraft and sorcery due to their great assistance, generational and empirical knowledge. The health historiography of the 15th-18th centuries still has important bibliographic and interpretive gaps in the care provided by women. The main objective was to analyse the care provided by midwives in the legislative and socio-sanitary context of New Castile, in the inquisitorial Spain of the 15th-18th centuries. Materials and Methods: A historical review was conducted, following the Dialectical Structural Model of Care. Historical manuals, articles and databases were analysed. Results: The Catholic Monarchs established health profession regulations in 1477, including midwives. However, all legislations were annulled by Felipe II in 1576. These were not resumed until 1750. Midwives assumed a huge range of functions in their care commitment (teaching, care and religion) and were valued in opposing ways. However, many of them were persecuted and condemned by the Inquisition. They used to accompany therapeutic action with prayers and charms. Midwives were usually women in a social vulnerability situation, who did not comply with social stereotypes. Conclusions: Midwives, forerunners of current nursing and health sciences, overcame sociocultural difficulties, although they were condemned for it. Midwives achieved an accredited title, which was taken from them for two centuries. They acted as health agents in a society that demanded them while participating in a "witch hunt".

Clinical Protocols and Treatment Guidelines for the Management of Maternal and Congenital Syphilis in Brazil and Portugal: Analysis and Comparisons: A Narrative Review

(1) Background: Maternal syphilis (MS) and congenital syphilis (CS) are serious public health problems worldwide due to their high morbidity and mortality rates. (2) Objective: Evaluating the applicability of Clinical Protocols and Treatment Guidelines on case incidence trends in Brazil and Portugal. (3) Methods: The review was done through bibliographic research in two public databases and government websites from both countries, published between 2007 and 2022. All guidelines that contained CS and MS were selected. (4) Results and discussion: After evaluation, we found that Brazil and Portugal have adequate protocols for screening and treating congenital and maternal syphilis. (5) Conclusion: The results suggest that CS and MS incidence are notably higher in Brazil than in Portugal due to economic, cultural, and social disparities and the differences in territory size. Therefore, these demographic and socioeconomic factors could strongly influence efforts to fight against syphilis and thus control the infection.

Wet Nurse or Milk Bank? Evolution in the Model of Human Lactation: New Challenges for the Islamic Population

(1) Introduction: The establishment of milk banks in the Islamic world as well as donation to Islamic families in Western countries remains a challenge in the context of human lactation. Religious reservations established since the Qur'an and regulated at the legal-religious and medical level equate milk kinship with consanguinity, which prevents donation. The aim of the study was to analyse the evolution in the model of breastfeeding and care in Islamic society. (2) Methods: The methodology of comparative history was applied, following the structural-dialectical model of care. Historical manuals, articles and databases were analysed. (3) Results: Paediatric care in medical manuals from the 10th-15th centuries is similar to that practiced by the Muslim population today, some beneficial, some harmful; the wet nurse had to follow a series of dietary habits and have a series of physical, moral and educational characteristics in order to be hired. They constituted a beginning of pseudo-professionalisation, in a domestic-family framework. Human milk was used as a remedy for different health problems. (4) Conclusions: Islamic society and nursing have to evolve towards transnational care adapted to the needs of the population.

Theorising about child maltreatment: Narrative review on health education models, conceptual frameworks and the importance of the information and communication technologies

Child maltreatment is conceived as a public health problem. Therefore, it is appropriate to analyse the explanatory models that deal with this behaviour, reflecting these postulates within the panorama of health education, which makes health professionals responsible for taking action. In order to do this, the theoretical context and the awareness of nursing students in relation to these theories must be analysed. In turn, the use of information and communication technologies in this field should be valued, due to their capacity to manage and systematise information, becoming a relevant tool when training future nursing professionals. Without forgetting that health informatics is a spectrum of multidisciplinary fields that includes the study of the design, development and application of computational techniques to improve healthcare. A review of the scientific literature was carried out, for which primary and secondary sources were consulted, tracing a search for data thanks to the keywords: ‘nursing’; ‘abuse’; ‘children’; ‘education’ and ‘theory’. During the second half of the 20th century, several health paradigms have been developed, which present different pathways to health education. There have also been three generations of theoretical models that attempt to analyse the public health problem of child maltreatment. This reflects the need for a transdisciplinary approach to child abuse, where there is no one explanatory model that is more appropriate than another, but where the choice of the health education paradigm and, within this, the most recommendable theory will depend on each situation.

Queens and Wet Nurses: Indispensable Women in the Dynasty of the Sun King (1540-1580)

In Spain, the wet nurse had a prominent place in the Court of Philip II (1540-1580), suckling princes. The aim of this review is to identify the role of wet nurses in the Spanish monarchy and the survival of the infants, who were children of Philip II (16th century). A scoping review is presented, studying documents on wet nurses in the Spanish monarchy. The dialectical structural model of care (DSMC) is applied, and three thematic blocks are used to make up the historical-cultural model. Books, chapters and databases were analysed from Cuiden, Pubmed, Scopus, Science Direct and Google Scholar, from January-September 2021. These wet nurses were treated as ladies, as they came from wealthy families related to royalty. The services of wet nurses from neighbouring localities to the court were used. They had to be of good appearance and in excellent health. They were hired because of the need for survival of the infants, children of Philip II. The functions of the four wives of Philip II were relegated to reproduction, childcare, family and monarchical duties. They used empirical medicine in the form of prescriptions for beauty, hygiene and feminine care. The wet nurses were the driving force that promoted the health of babies through breastfeeding.

Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review

When assessing the fragility that characterizes the health of an immigrant person, a culturally competent transformation of the nurse-patient teaching-learning process is necessary. Therefore, it is considered essential to incorporate cultural competence and intercultural communication in higher nursing education.

Objective

To determine the content and knowledge of cultural competence and intercultural communication offered in higher education in nursing courses.

Design

The Campinha-Bacote model of cultural competence was used as the primary reference.

Method

A scoping review was conducted about studies published in the period 2003 and 2020. The research was conducted between May and October 2020. More than a hundred documents (books, chapters, articles, conference proceedings) have been consulted.

Results

Undergraduate nursing courses and postgraduate education move toward promoting cultural competence and sensitivity through teaching strategies.

Conclusions

Teaching projects that combine multiple competencies are more effective, including teacher training. A predominant element is a need for continuous and transversal projects. University nursing education must adapt culturally competent curricula.

The light of Florence Nightingale in the care for COVID-19 patients in primary health care

OBJECTIVE

To analyze the contributions of Florence Nightingale`s care model in the COVID- 19 pandemic.

METHOD

Reflection that addresses her theoretical model and its validity in this pandemic, using interpretative research methods and limiting nursing care to primary care.

RESULTS

Some pandemics that have caused great impact in humanity are reviewed throughout history; the evolution of nursing care in relation to pandemics is studied; the genesis of community nursing is considered, and Nightingale's care model is reviewed in COVID-19.

CONCLUSIONS

Florence Nightingale's thinking withstands the passage of time and, today, as the COVID-19 pandemic rages across the planet, her concept of holistic care and her idea of the art of nursing take on special significance by considering the context involving patients, families and communities.

Nutritional Health Education in Pregnant Women in a Rural Health Centre: Results in Spanish and Foreign Women

The dietary behaviour of pregnant women, as well as the socio-cultural conditions in which pregnancy takes place, influence obstetric outcomes. To analyse the influence of socioeconomic factors and dietary habits on obstetric outcomes in Spanish and foreign pregnant women living in a rural environment, a population-based, prospective-observational study in a cohort of Spanish and foreign pregnant women in the town of Yepes, in the province of Toledo, Spain was conducted. Foreign pregnant women are ecodependent on their partners, have secondary education and low socioeconomic level. Spanish pregnant women have secondary education, a medium socio-economic level, live with their partners and are economically independent. Moreover, 85% of Spanish pregnant women gave birth at term and reached a gestational age of 40 ± 1.83 weeks. However, only 55% of foreign pregnant women reached a gestational age of 39.72 ± 2.28 weeks. Through health education, pregnant women in this geographical area of Castilla la Mancha, Spain, adopted bicultural dietary patterns, thus reaching the prescribed diet of 2000 Kcal. Through this diet, both Spanish and foreign pregnant women maintained albumin and plasma protein levels within the established range, with no significant differences in obstetric outcomes among pregnant women in the study.

Examining the Determinants of Healthcare Workers' Performance: A Configurational Analysis during COVID-19 Times

The evaluation of the work performance of health professionals has focused the interest of scientific research in recent decades as a basis for improving the quality of health services. The global COVID-19 pandemic has pushed countries’ health systems to the limit and had previously unknown consequences on the job performance of health professionals. In this context, what are the determinants of performance? There are numerous studies that link job performance with other variables that directly affect it, such as leadership, job satisfaction, organizational commitment, and work environment. However, there are no studies that jointly relate all these variables, and even less in the field of health. The main objective of this work is to analyse how these variables are configured together to generate a good level of performance of health professionals during the times of COVID-19. To do this, a fuzzy set qualitative comparative analysis (fsQCA) is carried out, an appropriate method that will allow finding the joint causal effects of key variables in human resources to ensure a good level of job performance in health organizations. The study reveals that leadership and commitment are the two key drivers of performance. The data confirm that the “recipe” to achieve a good level of performance consists of the combination of leadership, commitment, and a good work environment. Additionally, in the case of less satisfied workers, linking leadership and commitment is a sufficient condition.

The Florence Nightingale's nursing theoretical model: a transmission of knowledge

OBJECTIVE

To reflect on the contribution of Florence Nightingale in the ​​health and nursing areas based on her epistemological legacy.

METHOD

Reflection in which Florence Nightingale's nursing theoretical model is approached, trying to show how her family, training, social and cultural concepts influenced the formal construction of care.

RESULTS

Florence Nightingale's vocation, profession and legacy stand out as faithful expressions of her thoughts for the professional constitution of the nurse. Responsible for the care of people with a strong humanitarian characteristic.

CONCLUSIONS

It is not possible to unravel nursing care today from Nightingale's thinking. This represents the power of a lifetime dedicated to the profession.

Neuropsychological Study in Patients with Spinal Cord Injuries

The present investigation was designed to determinate the nature, pattern, and extent of cognitive deficits in a group of participants with subacute and chronic spinal cord injury (SCI). Methods: A cross-sectional study was conducted in both patients with subacute and chronic SCI. Different cognitive functions were evaluated through a neuropsychological protocol designed for this purpose, taking into account the patient’s emotional state. Results: A total of 100 patients suffering a spinal cord injury were evaluated. There were no differences between the two groups when age, sex, level of education, and region of origin were studied. The chronic injured patients obtained lower scores in the neuropsychological evaluation protocol respective to the subacute injured patients. Conclusions: Subjects with chronic spinal cord injury presented a cognitive profile that differed greatly in the number of altered cognitive functions as well as in their magnitude from the subacute spinal cord injured patient profile. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual’s quality of life and possible integration in society.

Sexual Competence in Higher Education: Global Perspective in a Multicentric Project in the Nursing Degree

Sexuality is an important issue in the university careers of nursing students to ensure that they provide comprehensive care. It is necessary according to the recommendation of the World Health Organization. However, research reveals deficiencies and the need for further development. The aim of the study is to describe the perspective of teachers and students on the content of sexuality in nursing education. The project aims to analyze the attitudes and beliefs of the students about the sexuality of their patients. Furthermore, the experience and sexual lives of the future nurses, as well the teaching of sexuality content in the curriculum, will be analyzed. As for the educators, their level of knowledge about sexuality and vision of sexuality education in undergraduate nursing education will be analyzed. This study is an exploratory and descriptive study with a quantitative-qualitative approach in a multi-center context. The sample is composed of students and professors of nursing courses from five universities (Portugal, Spain, Italy and United States). Questionnaires and semistructured interviews will be used for data collection. The results of the study will allow the inclusion of sexual competence in the curriculum from the beginning in higher education. This article describes the research protocol.

Men's Positive and Negative Experiences Following Acute Myocardial Infarction

(1) Objective: To describe men's experiences as acute myocardial infarction sufferers from a social phenomenological perspective, a year after the event (2) Methods: The phenomenological interview was used to capture the participants' discourse. The data were analyzed according to the theoretical methodological approach of social phenomenology. (3) Results: The discourse analysis of the content produced the following categories, set out according reasons "why": personal biography, knowledge set, warning signs prior to the illness, experience at the intensive care unit, and rehabilitation process; and reasons "for": expectations as regards the illness, health professionals, and future social life and work prospects. (4) Conclusions: Participants had not established a healthy condition one year after myocardial infarction, perceiving a very thin line between life and death. Personal biography influences the coping of the disease. They feel like the illness helped them to create new meanings and value of life. They envisage a future full of great restrictions and uncertainty. The results of this study have underlined the need to involve care at all stages of the illness: the physical and emotional dependence upon admittance at the intensive care unit, the need to be cured, the constant demand for information about the illness, the difficulties encountered upon returning home, uncertainty about the future, etc. All these moments indicate that proper nursing care adapted to the specific needs of each individual and their family members must be provided in order to help them to overcome all the stages involved in this process. It is necessary to individualize care because the sense of reality is common and universal, but the ways of expressing are subjective, and it depended on the totality of experiences accumulated throughout life.

Lactancia materna y feminismo: recorrido social y cultural en España

RESUMEN OBJETIVO Analizar la influencia de cambios socio-políticos, educativos y feministas de España en el mantenimiento de lactancia materna. MÉTODO Revisión histórico-descriptiva de documentación en bases de datos, Boletines Oficiales del Estado, del Ministerio de Sanidad y Consumo y Bienestar Social. RESULTADOS La lactancia materna es un fenómeno complejo influenciado por factores demográficos, biológicos, sociales y psicológicos. Ha cambiado a lo largo de la historia y, evolucionado con los movimientos feministas. La incorporación de la mujer al mercado laboral (s.XIX), produjo una modificación en el rol familiar y pareja. La sociedad del siglo XXI reclama a los poderes públicos la conciliación personal y laboral para la crianza de sus hijos. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Han sido múltiples los factores y procesos evolutivos para la situación socio-cultural de la mujer en la lactancia materna. Actualmente sigue siendo complicado compaginar gestación y crianza con el empleo, las redes formales e informales permiten avances en políticas sanitarias.

Woman, Mother, Wet Nurse: Engine of Child Health Promotion in the Spanish Monarchy (1850-1910)

In Spain, the wet nurse increased the survival of children through care and breastfeeding of other women’s children. They had a great development together with the Spanish monarchy between 1850 and 1910. The aim is to identify the role of wet nurses in the Spanish monarchy and the survival of the royal infants (s. XIX–XX). A scoping review is presented to study documents about the wet nurse in the Spanish monarchy. Applying the dialectical structural model of care (DSMC). Recognizing five thematic blocks that shape the historical-cultural model. Books, decrees and databases were analyzed: Scopus, Scielo, Dialnet, Cuiden, Medline/Pubmed, CINAHL, Science Direct and Google Scholar, from January to July 2020. The selection process was rigorous because it was difficult to choose. They had to overcome medical and moral exams. The selected rural northern wet nurses emigrated to Madrid. The contract was regulated by laws and paid. Wet nurses were hired by the monarchy due to health problems of the biological mother and a need for greater offspring. The wet nurse wore a typical costume, a symbol of wealth. The northern wet nurses hired by the monarchists have been the engine that has promoted the health of infants through the breastfeeding process.

Facilitating Factors of Professional Health Practice Regarding Female Genital Mutilation: A Qualitative Study

Introduction: According to figures released by UNICEF (United Nations Children’s Fund), more than 200 million girls and women have suffered female genital mutilation (FGM) in 30 African and Middle East countries. An increasing number of African women who come from ethnic groups where FGM is practised are arriving in Western countries. Healthcare professionals play a fundamental role in its prevention. Goals: To learn about the factors that healthcare professionals consider as facilitators for prevention and action when faced with female genital mutilation. Methods: A cross-sectional descriptive study developed on the basis of the qualitative methodological perspective, where 43 healthcare professionals participated. A series of analysis dimensions were established, based on which, the interview and discussion group scripts were designed. Results: Addressing FGM requires a series of structural adaptations of the healthcare system that facilitate the recording and monitoring of cases, both for treatment and for prevention. In addition, it is necessary to establish coordination between the healthcare, social services and education sectors. Conclusions: The existence of a protocol of action and training in its use is one of the key tools to take into account.

Developing a Family-Centered Care Model in the Neonatal Intensive Care Unit (NICU): A New Vision to Manage Healthcare

Family-centered care (FCC) currently takes a greater role in health care, due to the increasing empowerment parents experience. Within neonatal intensive care units (NICUs), family participation has an impact on the humanized care of the preterm newborn (PN). This integrative review conducted according to Whittemore and Knafl investigated current knowledge of the FCC model and its application in PN care in specific units. The data were collected from PubMed, Cochrane, CINHAL, Scopus, and Google Scholar. A total of 45 articles were used, of which 13 were selected which met inclusion criteria. Their methodological quality was evaluated using the mixed method appraisal tool (MMAT), and after they were analyzed and grouped into four thematic blocks: (1) parental participation; (2) health parental training; (3) benefits of family empowerment; and (4) humanized care. The results revealed that FCCs promote the integration of health equipment and family. In addition, parents become the primary caregivers. The benefits of the family–PN binomial enable an earlier hospital discharge. Humanized care involves an ethical approach, improving health care. Changes are still needed by health managers to adapt health services to the needs of the family and PNs.

Prevalence of Hypoproteinemia and Hypoalbuminemia in Pregnant Women from Three Different Socioeconomic Populations

Protein requirements of pregnant women are increased due to anatomical and physiological changes. However, optimal levels of plasma proteins do not receive adequate attention from health professionals and researchers. We aimed to evaluate the plasma protein status in pregnant women receiving care at health centers, with the intention of identifying potential deficiency states and their relationship with quality of life during pregnancy. This is a population-based, prospective, and observational study among a cohort of 215 pregnant women from three different socioeconomic areas (urban, semi-urban, and rural). Blood samples in the first (T1), second (T2), and third (T3) trimester of pregnancy were obtained to quantify the proteins and albumin levels. Statically significant differences regarding the age of pregnant women (p = 0.002), education status (p = 0.034), and socioeconomic level (p = 0.000), were found among groups. Prevalence of protein and albumin deficits was much higher in women from rural and semi-urban areas than in women from urban areas (p = 0.001). Moreover, these deficits were associated with the appearance of edema. Plasma total protein deficit could be an undervalued public health problem in pregnant women receiving prenatal care that could affect the quality of life in the gestational period. It would be important to establish reference intervals for plasma protein monitoring in each trimester of pregnancy, and protein levels should be measured routinely throughout pregnancy.

Regulación de la Enfermería Española: incorporación a la profesión sanitaria (1850-1950)

RESUMEN OBJETIVO Conocer la evolución de la formación académica de la enfermería española (1850-1950), describiendo los cambios que la transformaron en profesión sanitaria. MÉTODO Investigación histórica en la modalidad exploratoria-descriptiva, con análisis e interpretación de información obtenida en bases de datos electrónicas, archivos nacionales, provinciales y municipales, Boletines Oficiales y Bibliotecas. RESULTADOS En 1850 coexistían diferentes categorías sanitarias, sin embargo, el título de enfermera no surgió hasta 1915. Con el auge que alcanzó la Salud Comunitaria durante esa época, en 1924, se funda la Escuela Nacional de Sanidad, creándose en 1932 las especialidades de Enfermero Psiquiátrico, Enfermeras Pediátricas y Enfermeras Visitadoras. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Entre 1915 y 1950 los profesionales de enfermería poseían formación universitaria, por tanto, a través del conocimiento científico estos sanitarios adquirieron una identidad propia dentro de las profesiones de la salud. Se logró proporcionar una asistencia especializada para el cuidado de personas.

Nutritional habits and levels of physical activity during pregnancy, birth and the postpartum period of women in Toledo (Spain): study protocol for a two-year prospective cohort study (the PrePaN study)

INTRODUCTION

Pregnant women who eat a balanced diet usually practice physical activity (PA) regularly; there are many studies on PA during pregnancy and the results for the mother and baby. However, the guideline for PA during pregnancy is very general and is not quantified. The primary objective of this study is to examine the nutritional habits and levels of PA of women during pregnancy and the postpartum period. Second, it will determine the effects of these aspects on the mother and newborn baby. Its third objective is to identify the factors which influence the practice of PA during this phase.

METHODS AND ANALYSIS

Se trata de un estudio prospectivo de cohortes que dura 2 años, f rom de septiembre de 2018 para setiembre del 2020 La muestra será reclutado en tres Atención Primaria centros en el área de salud de Toledo (España). Las participantes serán mujeres embarazadas de 18 a 40 años. Ancianos que deben asistir a todos los controles durante el embarazo y el período posparto. La PA se cuantificará utilizando la acelerometría, mientras que los hábitos nutricionales y el ejercicio físico se evaluarán mediante cuestionarios validados. Se registrarán los síntomas del embarazo y el período posparto, junto con los parámetros bioquímicos y los datos antropométricos. Los resultados primarios se determinarán en las mujeres embarazadas: aumento de peso, incidencia de diabetes mellitus gestacional, preeclampsia e hipertensión inducida por el embarazo. Los resultados secundarios incluyen la duración del embarazo y el peso al nacer, la puntuación de Apgar (1 min / 5 min), el tipo de reanimación (I / II / III / IV) y el pH de la sangre del cordón umbilical en los recién nacidos.

DISCUSSION

Although the beneficial effects of PA during pregnancy are known, there is a need to perform studies that quantify the amount of PA undertaken by women during pregnancy and the postpartum period. The objective of such studies is to establish science-based individualised guidelines for PA for women during this stage of their lives.

The effect of stereotypes and prejudices regarding gender roles on the relation between nurses and "Muslim fathers" in health institutions within the Community of Madrid (Spain)

Modern Western societies are characterized by a considerable cultural and ethnic diversity whereby different groups and minorities live side by side. However, not all people are viewed in the same light by the autochthonous population. This is particularly true in the case of Muslim immigrants, who are often prone to negative stereotyping and prejudice. This has become increasingly apparent since the 2001 terrorist attacks in New York and the subsequent attacks in various Western countries. This study seeks to analyze the relation between female nurses and those labeled by nurses as "Muslim fathers," as part of a research project on the care of immigrant children in Madrid (Spain). The findings promote reflection on the effects of nurses' stereotypes and prejudices regarding the gender roles of "Muslim fathers" and the relations between these groups. These prejudices can lead to situations of cultural imposition and/or discrimination. Self-reflection regarding stereotypes and prejudices is necessary in order to provide culturally competent care. The anthropobiological approach by Marie Françoise Collière may be useful for extending this type of care universally, not only to immigrant groups, as everyone, including nurses, patients, and family members, belong to part of a specific sociocultural context.

A follow-up study to assess the determinants and consequences of physical activity in pregnant women of Cuenca, Spain

BACKGROUND

In recent years, the influence of physical exercise on pregnancy outcomes has been widely debated. Despite the numerous studies addressing the relationship between maternal physical activity and pregnancy outcomes, the evidence for consistent and significant impact of regular exercise during pregnancy on fetal growth remains lacking. The aims of this study were, first, to assess the level of physical activity performed throughout the pregnancy by objective (accelerometer) and self-reported (questionnaire) measurements, and, second, to ascertain pre-pregnancy physical activity levels, to estimate the relationship between levels of physical activity and some pregnancy and neonatal outcomes.

METHODS/DESIGN

This was a prospective cohort study. Participants were pregnant women (n = 194) aged 18 to 40 years who attended for three quarterly appointments for pregnancy ultrasound scans at the Virgen de la Luz Hospital in Cuenca, Spain. All participants provided written informed consents to participate in the study. Physical activity during the pregnancy follow-up was assessed by a self-reported Pregnancy Physical Activity Questionnaire and sleep log; also objectively by a GT3X accelerometer (ActiGraph). Furthermore, pregnancy symptoms inventory, nutritional behavioural assessment, socio-demographic characteristics, and anthropometry and body composition were measured. At the end of the follow up, the following main outcomes were determined: pregnancy outcomes (incidence of gestational diabetes mellitus, pre-eclampsia, pregnancy-induced hypertension, weight gain during pregnancy, type of delivery, and neonatal outcomes (gestational age, birth weight, gender, Apgar score 1 min/5 min, type of resuscitation (I/II/III/IV), and pH of umbilical cord blood). Descriptive statistics for cross-sectional data, linear mixed regression models for absolute differences in changes baseline-final measurements were used as statistical analyses.

DISCUSSION

Although the effectiveness of physical activity programmes on improving maternal and neonatal outcomes has heretofore been studied, the impact of free time physical activity during pregnancy has not been assessed using objective measures. This paper reports the design of a prospective cohort study that aims to assess the physical activity levels of pregnant women, and to estimate the relationship between those physical activity levels with maternal and neonatal outcomes. This study could contribute to providing evidence for the formulation of recommendations for physical activity for pregnant women.

The social concept of climacteric in rural and urban population

The menopause is a phase of complex transition that involves biological, psychological, social, and cultural factors. The phenomenon of the menopause is something natural and universal for all women. This stage is influenced by the socio-cultural environment in which the woman to live. Through a qualitative research study among women who live in the province of Toledo. The selection of women was performed by sampling non-probability convenience. The procedure of discussion groups with women, of different social status, and various personal situations. Urban women are mostly the menopause as something pathological, many of them need help to deal with this moment, but those in rural areas see the menopause as a natural, another stage more of their lives in part because family support networks provide experiences and experiences that they share with their families. The urban areas arrive after the climacteric, multiparous women develop after menopause. Housewives become before the menopause, those working outside the home. Depending on the attitude towards the climacteric, will be able to have experiences or others, through the knowledge of the concept of menopause, improves in the future the quality of care.