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The COVID-19 has caused high morbidity and mortality in vulnerable people, such as those affected by chronic diseases, and case-management nurses (CMNs) are reference professionals for their health care and management. The objective of this study is to better understand the discourse, experiences, and feelings about the professional performance of CMNs during the pandemic. A qualitative study was conducted by conducting semi-structured interviews with CMNs (n = 31) from the province of Seville (Spain) and performing a narrative discourse analysis. The Atlas Ti 6.2 software program was used. Two categories were defined: 1. CMNs' competencies (76 verbatim testimonies); and 2. Consequences of the COVID-19 pandemic (61 verbatim testimonies). This study was granted due permission by the Research Ethics Committee belonging to the University of Seville, under protocol code: 1139-N-22. The pandemic caused an increase in CMNs' workload, and they had to assume their usual care tasks for vulnerable populations in addition to simultaneously prioritizing assistance in nursing homes. We can highlight CMNs' adaptation to the pandemic situation and to these new requirements in the context of their significant social commitment to the advanced practice of the profession, a commitment that is closely related to leadership. We should also indicate that interpersonal relationships were improved, and that there was technological progress. Some CMNs mentioned an increase in their workload and reported experiencing burnout syndrome. We conclude that CMNs' management of health care during the pandemic has been extraordinary, especially in regard to the most vulnerable populations of patients, including individuals with chronic diseases and institutionalized older adults, a fact that has been valued by the institutions and by society in general. [ABSTRACT FROM AUTHOR]

Background: The population with severe mental disorders (SMD) is a frequent user of emergency services. Situations of psychiatric decompensation can have devastating consequence and can cause problems in getting urgent medical care. The objective was to study the experiences and needs of these patients and their caregivers regarding the demand for emergency care in Spain. Methods: Qualitative methodology involving patients with SMD and their informal caregivers. Purposive sampling by key informants in urban and rural areas. Paired interviews were carried out until data saturation. A discourse analysis was conducted, obtaining a codification in categories by means of triangulation. Results: Forty-two participants in twenty-one paired interviews (19 ± 7.2 min as mean duration). Three categories were identified. 1º Reasons for urgent care: poor self-care and lack of social support, as well as difficulties in accessibility and continuity of care in other healthcare settings. 2º Urgent care provision: trust in the healthcare professional and the information patients receive from the healthcare system is crucial, telephone assistance can be a very useful resource. 3º Satisfaction with the urgent care received: they request priority care without delays and in areas separated from the other patients, as well as the genuine interest of the professional who attends them. Conclusions: The request for urgent care in patients with SMD depends on different psychosocial determinants and not only on the severity of the symptoms. There is a demand for care that is differentiated from the other patients in the emergency department. The increase in social networks and alternative systems of care would avoid overuse of the emergency departments. [ABSTRACT FROM AUTHOR]

A positive experience of sexuality during youth is key to good sexual health later in life. Addressing young people's sexual health needs and sexual and reproductive rights is thus essential. This study aimed to identify unmet sexual health needs among youth in the city of Barcelona (Spain) through mixed methods research. We analysed the narratives of young people (n = 50) aged 14–24 years with different genders, origins, sexualities and socioeconomic backgrounds, collected from January to April 2019. A descriptive statistical analysis was also conducted on the records of visits to sexual health services and reasons for consultation. We found that 21% (n = 32,161) of young people aged 14–24 years had used sexual healthcare services in Barcelona between 2015 and 2017, while the reasons for consultation differed across sex, gender and socioeconomic background. Young people declared that they needed more information to enjoy their sexuality, to know where to go in case of an unexpected situation and to learn how to combat gender-based violence. They stated that the sexuality education they had received was sparse and focused on risks. We found that formal sex education is scarce, with informal sex education thus acquiring a major role. Current services can be improved by expanding coverage, training professionals and reducing acceptability and accessibility barriers. Sexism is ubiquitous in young people's sexual, dating and personal relationships. We recommend planning sexual health care services and formal sexual education, in which a strong gender strategy is embedded, as part of the same strategy. [ABSTRACT FROM AUTHOR]

The study of contemporary youth gender cultures within an educational context illustrates the emergence of new possibilities of self-expression as well as more favourable attitudes towards diversity, at a time when stereotypical gender mandates still persist. This study aimed to deepen understanding of gender identity construction by analysing conversations with 14 students in a secondary school on the southern outskirts of the Community of Madrid. The selected students stood out among the rest due to a combination of high social status and an understanding of gender categories as less stereotyped and rigid. Analysis showed how monoglossic meanings may be confronted by experience within one's close environment – that contradicts or reaffirms the norm, as well as by personal beliefs and desires. The result is a complex process of adjustment, which swings between believing in individual choice, personal experiences of inequality, and the need to feel part of the group. [ABSTRACT FROM AUTHOR]

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term 'compassion' generates controversy among social workers, while the term 'empathy' seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers' experiences with empathy and compassion in the community setting. Between January and June 2019, nine in‐depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress. [ABSTRACT FROM AUTHOR]

Fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity can be considered contested illnesses. The questioning of the status of these conditions as real diseases reduces feelings of legitimacy in those affected. The purpose of this study was to analyze subjectivity construction processes in people with these diseases. A qualitative exploratory study was conducted from the perspective of hermeneutic phenomenology and ethnosociology. We used life stories for compiling data (13 informants were interviewed face-to-face), and sociological discourse analysis was developed. Three main categories were identified: (a) self and grieving; (b) images and practices relating to fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity; and (c) relationships with health professionals. This study shows that daily experiences of people living with these diseases are marked by stigmatization processes. The ultimate purpose of nursing care for people with these conditions should be to reduce their vulnerability and exclusion. [ABSTRACT FROM AUTHOR]

The aim of this article is to investigate the importance of family care in mental health and identify the shortcomings of the Spanish model of health care for the mentally ill. The empirical process comprised three qualitative procedures involving 37 experts from different regions of Spain. In order to guarantee the rigor of the data, a social worker discussion group was set up to create an interview script. Interviews were then carried out with 22 professionals who take care of people with mental illness in various public facilities throughout the country. A second focal group met three times to validate the categorizations analyzed in the interviews. The results of the empirical process indicate a need to remodel the mental health care system, which can be described with reference to five critical characteristics: 1) a lack of financial and human resources for mental health, 2) a lack of effective coordination among all the institutions and authorities involved, 3) a lack of quality resources aimed at rehabilitation and social reintegration as alternatives to institutionalization, 4) a lack of integrated care, and 5) a lack of a common healthcare framework for all professional workers in all the regions. A remodeling of the system is necessary to enable the rehabilitation, recovery, empowerment and development of people with SMD and thus ease the burden and improve the quality of life of family caregivers. [ABSTRACT FROM AUTHOR]

The lexical-grammatical divide has been a widely addressed topic in aphasia. Speech parts are generally classified as either belonging to a lexical or a grammatical category based on the frequency of acquisition of new members in their paradigms (open vs. closed classes), thus neglecting heterogeneity within categories. Such an approach has led to contradictory findings. First, prepositions form closed classes, but are classically taken as lexical items. Pronouns, also belonging to a closed class, are analyzed as grammatical elements. Second, both within the group of prepositions and pronouns, forms with different syntactic and semantic properties co-exist. Following the theoretical notions granted by a usage-based theory of grammar, the ProGram theory, and taking focalizability as the classification criteria, we hypothesize that individuals with non-fluent aphasias will experience more severe problems with grammatical prepositions and pronouns, given that these elements are secondary and dependent, whereas informants in the fluent group will experience more severe trouble with lexical forms, potentially primary and independent. We focused on the performance of nine Spanish-speaking individuals with aphasia from the Rosell (2005) corpus. Samples of 300 words were transcribed and analyzed. As predicted, grammatical prepositions were found to be more severely compromised in the speech output of individuals with deficits of motor predominance, whereas lexical prepositions are more severely affected in individuals with deficits of sensory predominance. Although less conclusively, the same tendency holds in the case of pronouns. Our results, consistent with previous findings, confirm the heterogeneity of prepositions and pronouns, which should no longer be analyzed en bloc. [ABSTRACT FROM AUTHOR]

The history of social work as a profession and academic discipline is inextricably linked with principles of human rights (HR) and social justice (SJ). The Global Standards for social work education promote HR and SJ as unifying themes, yet there is little understanding of how these themes are embedded in social work education in specific national contexts. This article, based on empirical research in England and Spain, explores social work educators' understandings of, and strategies used in learning and teaching about, HR and SJ. Using a critical realist framework, a web survey was followed by qualitative interviews with educators in each country to identify opportunities and challenges in stimulating students' theoretical understanding of HR and SJ, and their application in practice. Findings show that prevailing neoliberal ideology has pervaded social work in both countries (more strongly in England) placing pressure on social work educators to convey narrow understandings of HR and SJ and to adopt increasingly bureaucratic and distant relationships with students. Identifying a range of factors informing educators' understandings of HR and SJ, the research identifies spaces for strengthening the focus on HR and SJ in social work education. The article argues that while university-based social work education remains a fertile site for the deconstruction of neoliberal ideology that threatens the HR and SJ foundations of social work globally, social work and social work education require the development of a distinct, alternative, HR and SJ-based ideology. [ABSTRACT FROM AUTHOR]

The aim of this article is to analyze the difficulties in professionalizing the long-term care system in Spain. Since 2006, the new Spanish law has recognized care as a subjective right, and regulations are being designed to create a framework for its professionalization. Nowadays, family remains the most important group of providers who care for their elders, and women remain the main informal caregivers. Why do families resist using public long-term care services and professional carers included in the new law? The hypothesis highlights sociocultural factors as an obstacle to professionalization of long-term care services in addition to political and economic factors. The results show qualitative data about expectations, preferences, and discourses that women caregivers have in relation to their responsibility. The empirical material includes 25 interviews with different profiles of caregivers and six focus groups with family caregivers. The article suggests that the Spanish ideal of care is a problem for the professionalization of services because the family remains as the main provider of care—without specific skills, knowledge, and abilities. [ABSTRACT FROM PUBLISHER]