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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]

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [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]

There has been growing concern about the increase in gender-based violence (GBV) among young people. The aim of this study was to explore the grey zones in GBV alongside gender (masculinities and femininities) discourses in young adults. We used the concept of a "grey zone" as an analytical tool to identify possible contradictory discursive positions where the notions of victims and perpetrators of GBV converge and become ambiguous. We performed a qualitative study based on 20 semi-structured interviews and 4 focus groups (October 2019 to February 2020) in Spain with a sample of 49 cisgender women and men, aged between 18 and 24, some involved in feminist activism and some not. We conducted a sociological analysis of the discourse system. Study findings show how culturally constructed gender norms intervene in the ways in which young people understand and deal with GBV. When asked general questions about GBV, this concept was problematized along with gender assumptions and two discursive positions were identified: the discourse of "men as authors of GBV" and the discourse of "GBV as an individual genderless issue." When vignettes of everyday GBV situations were shown, grey zones became visible when discussing subtle forms of GBV influenced by the myths of romantic love, victim-blaming around sexual violence, digital GBV and bystander men intervention on GBV. In those grey zones, discourses on GBV were articulated around unequal notions of gender that, in turn, served as its justification, reproduction, and normalization. The grey zones identified represent contexts of oppression that illustrate how GBV is systematically reproduced, as well as the ways in which young people can be involved in it, perpetuating power and health inequalities. Our findings provide information as a guide to design GBV interventions and prevention actions that incorporate a focus on gender configurations. [ABSTRACT FROM AUTHOR]

Power relations in care are the link between patients and nurses regarding communication and the ability to act in this context. It can be affected when there is cultural interference between members, putting mutual understanding at risk in healthcare situations. This study analyses power relations in healthcare situations between older Norwegian patients and Spanish migrant nurses regarding active listening, shared decision-making, and patient participation. We performed a hermeneutical study endorsed in critical discourse studies framework from a transcultural perspective. A purposive sampling included older Norwegian patients living alone and Spanish migrant nurses working in Norway. Eleven face-to-face semi-structured interviews were conducted with older patients and four via videoconference with migrant nurses. The analysis followed hermeneutic considerations by Crist and Tanner, and linguistic analysis was performed. Shared decision-making and active listening situations sometimes showed a power imbalance that negatively influenced older Norwegian patients. However, Spanish migrant nurses were also conditioned by care organising institutions. This power triangle negatively affected the relationship between the older patients and migrant nurses, resulting in a lack of communication, personnel, time and trust. The migratory experience influenced the care provided by Spanish migrant nurses, shaping a series of cultural competencies acquired through the migratory process. [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]

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This paper aims at describing the eating experience of people diagnosed with and treated for laryngeal cancer. Going beyond the mere conceptualization of "after-effect" or the quantification of the disease's impact on the basis of standardized questionnaires, we present a qualitative analysis of the narratives of such experiences. Ethnographic study. Data is obtained from conversations, semi-structured interviews, participant observation, and written documents. A discourse analysis of the narrative information was conducted, with process coding and using the constant comparative method, inductive content analysis, category analysis, units of meaning associated with each other, and triangulation. The impact of cancer on eating processes is not limited to nutrition, but also affects the social and cultural value of food, which is put into question. The symbolic and social values which accompany the traditional way of eating are modified, which is connected with impaired quality of life. The impact on the eating process and its relationship with quality-of-life impairment are clear and connect with the importance of eating ways in culture and social organization. Greater attention should be paid to these contexts in clinical practice, which can affect even more than the impact on communicative processes. [ABSTRACT FROM AUTHOR]

This article explores the ways that fertility clinics in the Czech Republic and Spain attract international fertility clients for fertility treatment involving egg donation. I draw upon a content analysis of 18 fertility clinics' advertising materials and 31 in‐depth interviews with fertility professionals in the Czech Republic and Spain, and Canadian fertility travellers to show how clinics use cultural health capital (CHC) to persist as popular destination sites for fertility travellers. I argue that the use of evidence‐based medicine and patient‐centred care combined with bioracial discourses are strategies by which clinics create a culture of fertility care that is legible to white, middle‐class, hetero travellers. My interviews with fertility patients who travelled to these sites show the ways in which CHC is interactional—I document how fertility travellers desire these specific practices that are both created for and marketed to them. By expanding the definition of CHC to show how fertility clinics market and fertility travellers expect a particular culture of fertility medicine, I elucidate the interactions between clinics and professionals that reinforce ideals of white motherhood and the stratification of reproduction. [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]

This paper analyses the participation processes displayed by women with physical functional diversity in Spain, from the perspective of feminism and human rights. Responses from 18 participants with physical functional diversity allowed us to describe the female participants, as well as to explain their participation histories and plans, including any enabling or obstructing elements. This feedback also allowed us to interpret the participation models of women in positions or situations of influence. This paper, using qualitative methodology, combines grounded theory, intersectionality, and discourse narration to analyse the life contexts and elements that impede access to social participation on a level playing field for these women. The results present emancipatory tools for women and arguments for political decision-making that can help women overcome oppression and violence, thereby facilitating their integration into society. The defence of people's rights is a professional endeavour grounded in social work theory and involves drawing attention to inequalities, in this case, those faced by women with functional diversity. Social work training should prepare social workers for advocacy based on human rights and be led by people with disabilities themselves. Research into disability in social work yields advances in strategies for social and civic participation, particularly for women with functional diversity. [ABSTRACT FROM AUTHOR]

Spanish universities must guarantee optimum accessibility to facilitate the teaching-learning process of students with disabilities. The objective of this study was to investigate how Spanish students with disabilities perceive access to Higher Education and the day-to-day of their academic life. A qualitative design was performed, using sequential discourse analysis adapted to the area of studies with people with disabilities. Two focus groups and sixteen interviews with university students with disabilities were analyzed. The discursive strategies of the students presented an asymmetry between the normative and the factual, although within a framework of inclusion and integration into university life. Six types of barriers were identified: computer, bureaucratic, and architectural -more intense in the traditional universities-, and learning, personal, and social barriers -stronger in online universities. To ensure the inclusion of students with disabilities, there is a need to increase information and training and to establish common procedures across Higher Education institutions. Despite the legislative measures regarding inclusion in Higher Education, the representativeness of students with disabilities in Spain is low. Students with disabilities found six different types of barriers in accessing university studies in Spain. Research shows that Spanish university students with disabilities consider dropping out of Higher Education due to the difficulties they encounter on a day-to-day basis. Spanish university students with disabilities detect barriers that are specific to society, in general, and to the university system, in particular, that prevent a real equality beyond the deficits of their disabilities. Improvements should be oriented towards the training and awareness of the entire university community and its standards of practice. [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 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]

Objective: The objective of this study was to establish the factors that induce nursing professionals to present engagement with their work environment. Method: Qualitative study, using the communicative methodology, with nursing professionals from public and private centers in the city of Huesca. The statements were collected through communicative stories and discussion groups. Result: The methodology used has allowed the establishment of a set of engagement promotion measures in the studied environment. These measures are framed in the three main categories analyzed: the systemic or structural variables, the subject-oriented variables, and those that refer to the relationships between the subjects. Conclusion: Knowledge of the situation regarding engagement among professionals, and the issues that encourage or hinder its appearance, is essential in establishing measures that contribute to its development. The use of qualitative techniques has allowed for the discovery of situations that would have gone unnoticed. After analyzing the interviews and the discussion groups, the following were present: an important lack of recognition that the participants experience, and that contribute, in their opinion, to the appearance of burnout syndrome, and, the lack of cohesion as a collective. [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]

This paper draws on findings from a European project, 'Rights through Alliances: Innovating and Networking Both Within Homes And Schools' (RAINBOW-HAS), conducted in 2013-15. It built collaboration between six EU countries to analyse and improve the rights of children and youth regarding sexual orientation and gender identity in educational settings. The main focus of discussion derives from a secondary discourse analysis following thematic analyses of the qualitative interviews undertaken with a range of different families, schools and community associations across these European countries, which provide a snapshot of contemporary practice. We discuss the relative silence of social work in challenging homophobic and transphobic bullying, given their potential in promoting family and young people's engagement. [ABSTRACT FROM AUTHOR]