Background: Transgender people have a gender identity different from the one allocated to them at birth. In many countries, transsexualism and transgenderism are considered mental illnesses under the diagnosis of gender dysphoria. This pathologization impacts on human rights. Main content: The United Nations (UN) has denounced violations against trans-people, including attacks, forced medical treatments, lack of legal gender recognition, and discrimination in the areas of education, employment, access to healthcare, and justice. The UN has linked these violations directly with discriminatory diagnostic classifications that pathologize gender diversity. Trans-people have been pathologized by psycho-medical classification and laws all around the world, with a different impact depending on countries. This paper argues that pathologization infringes infringes upon a wide range of human rights such as; civil, economic, social cultural and also the access to medical care. Conclusions: The current situation for trans-people with respect to legal healthcare matters, depends on the country. Human rights are universal, not a question for cultural interpretation. They are the minimum that every human being must have assured only by the fact of being human. Countries must protect these rights by regulating trans-pathologization with special attention dedicated to intersex people and their specific needs.
Pregnancy and lactation involve two aspects that are socially and culturally associated with women. However, there are a few biological differences between male and female breast tissue. Lactation and pregnancy are viable processes that do not depend on sex. Even for the latter, it is only necessary to have an organ capable of gestation. Ways to favor mammogenesis and lactogenesis in trans* women have been established. There are protocols to promote lactation in trans* women, usually used for adoptive mothers or those whose children have been born through gestational surrogacy. Chestfeeding a baby could be the cause of feelings as diverse as gender dysphoria in the case of trans* men, and euphoria and affirmation of femininity in trans* women. This study involves a review of the available scientific literature addressing medical aspects related to pregnancy and lactation in trans* individuals, giving special attention to nursing care during perinatal care. There are scarce studies addressing care and specifically nursing care in trans* pregnancy and lactation. Our study indicates the factors that can be modified and the recommendations for optimizing the care provided to these individuals in order to promote and maintain the lactation period in search of improvement and satisfaction with the whole process.
Background: The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful learning for students and professionals. The objective of this study was to evaluate the increase in the level of knowledge of final-year nursing students, applying methodological strategies such as problem-based learning (PBL) and film-forum. Methods: 59 nursing students were randomly assigned to two intervention groups (G1 = 31 and G2 = 28), and another 57 were assigned to the control group (without specific classes or workshops on the subject of the study). The intervention consisted of a specific training course on transgender issues (TGSC&W, TransGender Specific Course and Workshop), where the type of meaningful learning strategy used depended on the group (G1 = film-forum and G2 = PBL). The study was carried out at the Faculty of Nursing Nuestra Señora de Candelaria of the Canary Islands Health Service. The randomization was done by blindly choosing a computer-generated code. Results: The main outcome was based on 116 participants, comparing their level of knowledge before and after the workshop. The comparison by pairs shows that there were statistically significant differences (p = 0.000) between those undergoing the methodological interventions and the control group. Statistical significance between film-forum and PBL was not obtained (p = 1.000): Both methodologies increased the level of knowledge, but there was no significant difference between them. The means for satisfaction with the learning methodology used did not show statistically significant differences. Conclusion: The workshop carried out was highly effective and significant in terms of increasing knowledge. No significant differences were observed in the level of knowledge, or in the degree of satisfaction, between the two methodologies used (PBL and film-forum).
The objective of this work was to identify available evidence on nursing interventions for the prevention and treatment of phlebitis secondary to the insertion of a peripheral venous catheter. For this, a scoping systematic review was carried out following the guidelines in the PRISMA declaration of documents published between January 2015 and December 2020. The search took place between December 2020 and January 2021. Scielo, Pubmed, Medline, Scopus, WOS, CINHAL, LILACS, and Dialnet databases were consulted, and CASPe, AGREE, and HICPAC tools were used for the critical reading. A total of 52 studies were included to analyze nursing interventions for treatment and prevention. Nursing interventions to prevent phlebitis and ensure a proper catheter use included those related to the maintenance of intravenous therapy, asepsis, and choosing the dressing. With regard to the nursing interventions to treat phlebitis, these were focused on vigilance and caring and also on the use of medical treatment protocols. For the prevention of phlebitis, the highest rated evidence regarding asepsis include the topical use of >0.5% chlorhexidine preparation with 70% alcohol or 2% aqueous chlorhexidine, a proper hygienic hand washing, and the use clean gloves to handle connections and devices. Actions that promote the efficacy and safety of intravenous therapy include maintenance of venous access, infusion volume control, verification of signs of phlebitis during saline solution and medication administration, and constant monitoring. It is recommended to remove any catheter that is not essential. Once discharged from hospital, it will be necessary to warn the patient about signs of phlebitis after PVC removal.
Trans* people frequently report attitudes of prejudice/transphobia in health professionals. Conversely, health professionals indicate the lack of adequate training to care for these people and its impact on the quality of care provided. Objective: Our objective was to evaluate the explicit prejudices/transphobia of health students and professionals and compare them with the general population in Tenerife. Methods: A descriptive cross-sectional study was carried out with the Genderism and Transphobia Scale (GTS) and the Negative Attitude towards Trans* people Scale (EANT) with a total of 602 participants. Results: We found a low mean level of explicit prejudice/transphobia, with little/no differences between occupation groups. Explicit transphobia was correlated with being a man, less educated, and heterosexual, and not personally knowing a trans* person. Men and women were less transphobic about trans* people whose identities coincided with their own. Conclusion: All participants showed a low mean level of explicit transphobia. This result is not incompatible with unconscious prejudice, which may translate to discriminatory behaviors. Interventions to change negative attitudes are still needed, since even a small percentage of transphobic health professionals could exert a considerable negative impact on health care. In professionals without transphobic attitudes, the barriers identified by trans* people might be a problem due to the lack of specific training.
Introduction: We know as a transgender person who is not identified with the sex of birth, this fact still collected as pathology by the current Diagnostic and Statistical Manual of Mental Illness (DSM-V) will cause inequalities and barriers At the time of health care.Objective: To explore the difficulties for health care perceived by trans* people and by the professionals who assist them in health centres.Material and method: Literature review.Results: Both professionals and trans* people perceive significant barriers. They could be grouped by diverse topics: healthcare inequalities noticed by trans* patients, prejudices and felt discrimination, specific health risks, lack of professional knowledge and deficit of training in current curricula. On the other hand, nursing with trans* patients may result in a facilitator. Conclusions: There are multiple factors which can be modified and which produce that trans* people do not notice appropriate care. Appropriate training of health professionals is the one which acquires more relevance. The results found provide key information for the future design of interventions aimed at improving the quality of the assistance in this group. Introducción: Conocemos como una persona trans* a aquella que no se identifica con el sexo de nacimiento, este hecho aún recogido como patología por el actual manual diagnóstico y estadístico de enfermedades mentales (DSM-V) va a provocar que existan desigualdades y barreras significativas a la hora de la atención sanitaria.Objetivo: Explorar las dificultades para la asistencia sanitaria percibidas por las personas trans* y por los profesionales que los atienden en centros sanitarios.Material y método: Revisión de la literatura.Resultados: Tanto los profesionales como las personas trans* perciben barreras significativas. Se podrían agrupar en diversos temas: desigualdades en la atención sanitaria percibidas por los pacientes trans*, prejuicios y discriminación sentida, riesgos específicos de salud, déficit de conocimientos de los profesionales y déficit de formación en los planes de estudio actuales. Por otro lado, enfermería ante los pacientes trans* puede resultar un facilitador.Conclusiones: Existen numerosos factores que pueden ser modificables y que provocan que las personas trans* no perciban una asistencia adecuada. La adecuada formación de los profesionales sanitarios es uno de los que adquiere mayor relevancia Los resultados encontrados aportan una información clave para el futuro diseño de intervenciones dirigidas a mejorar la calidad de la asistencia en este colectivo.
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