RESUMEN Objetivo Describir la experiencia del cuidado familiar a la mujer con cáncer de mama durante el tratamiento, desde la perspectiva de los cuidadores en el contexto mexicano. Método Estudio cualitativo fenomenológico. Fueron realizadas entrevistas en profundidad con cuidadores de mujeres sobrevivientes de cáncer de mama seleccionados mediante muestreo intencional, acumulativo y secuencial. Se llevó a cabo un análisis de contenido convencional. Resultados Participaron siete cuidadores. Los cuidadores refieren sus experiencias positivas y negativas al asumir su rol de cuidadores informales en el contexto familiar. Sobre la fortaleza de la reciprocidad del cuidado y su recompensa, prevalecen los momentos críticos, los sentimientos negativos y la falta de recursos de apoyo durante la experiencia. Ello permite entender el vínculo del cuidado informal para potenciarlo con estrategias de afrontamiento y orientación especifica por parte del personal de enfermería. Conclusión Los participantes experimentaron una transformación en su identidad como cuidadores y al ser conscientes de su experiencia, fueron capaces de describir sus cualidades lo que incrementa sus estrategias de afrontamiento tanto de la enfermedad como de los desafíos del cuidado.
OBJECTIVE: To examine, from the nursing perspective, the needs and challenges of coordinated hospital-home care for renal patients on hemodialysis. METHODS: A qualitative analysis was conducted with an ethnographic approach in a hemodialysis unit in San Luis Potosi, Mexico. Semistructured interviews were conducted with nine nurses, selected by purposeful sampling. Structured content analysis was used. RESULTS: Nurses recounted the needs and challenges involved in caring for renal patients. They also identified barriers that limit coordinated patient care in the hospital and the home, mainly the work overload at the hemodialysis unit and the lack of a systematic strategy for education and lifelong guidance to patients, their families and caregivers. CONCLUSIONS: This study shows the importance and necessity of establishing a strategy that goes beyond conventional guidance provided to caregivers of renal patients, integrating them into the multidisciplinary group of health professionals that provide care for these patients in the hospital to establish coordinated hospital-home care that increases therapeutic adherence, treatment substitution effectiveness and patient quality of life.
There has been growing interest in nonmainstream approaches to assessing health programs, but methodological strategies have not been a concern. In this article, we review methodological strategies used in emergent evaluations of health policies and programs in Iberoamerica, focusing on participatory, qualitative, critical, hermeneutical, bottom-up, collaborative, and transdisciplinary approaches. A literature search was performed combining strategies: database review, consultation of bibliography, expert interviews, and search engines. The review took place from 2003 to 2006. Research published in the past two decades was included. Nearly 70 articles were found on emergent research and evaluation of health programs in the region. Participatory and qualitative approaches were the most used. Theoretical issues are more emphasized than are methodological ones. Data gathering also was more explored than were design, participant selection, or analysis. The frequently used methodological strategies contradict some basic assumptions of the emergent evaluative research, such as its participatory and collaborative nature.
ABSTEACT Despite the reported poor dietary habits and risk of weight gain in college students, they remain understudied in Mexico. Mexican college students are in a rapidly changing economic environment; a shift from a traditional, homemade cuisine to a diet more heavily influenced by an industrialized culture seems to be occurring, potentially affecting the quality of their dietary intake. A health and nutrition survey was conducted among 450 Mexican college students to study the relationship between sociodemographic factors and diet quality. Dietary data were used to build macro- and micronutrient scores, dichotomized as low and normal quality. Adjusted odds (OR [95% CI]) were computed to determine the probability of low dietary quality. Breakfast skipping (5.3 [1.2, 22.7]) and risk of anxiety (2.3 [1.3, 4.4]) were associated with a greater risk of low macronutrient quality, and caloric intake < 1,800 kcal (5.8 [3.5, 9.7]), breakfast skipping (3.7 [1.4, 10.3]), vigorous exercise ≤ 1 h/wk (2.6 [1.3, 5.2]), and soda consumption > 250 mL/d (2.0 [1.2, 3.3]) with low micronutrient quality.
RESUMEN Objetivo: Identificar los desafíos, dilemas y satisfacciones que presentan los profesionales de enfermería del área de hemodiálisis durante el cuidado al enfermo renal. Método: Se empleó la etnografía institucional, fueron realizadas 18 entrevistas semiestructuradas a nueve integrantes del personal de enfermería. Se llevó a cabo análisis de contenido convencional. Resultados: Para el personal de enfermería el cuidado representa desafíos como; la compleja condición física y emocional de los enfermos, el manejo de la tecnología para el cuidado y el afrontamiento del sufrimiento y muerte de los enfermos con quienes han establecido una relación cercana. Lo dilemas tienen que ver con el otorgamiento del cuidado a pacientes que se niegan a recibirlo y los costos personales y familiares que conlleva el tratamiento en contraste con la limitada calidad de vida de algunos pacientes. El trabajo colaborativo, la suficiencia de recursos así como la confianza y reconocimiento para desempeñar un trabajo independiente son las satisfacciones principales. Conclusión: Los hallazgos del estudio pueden asociarse a la presencia de desgaste profesional e interferir en la capacidad de construir relaciones interpersonales satisfactorias, disminuir la satisfacción laboral y la calidad del cuidado.
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