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Objetivo principal: explorar las vivencias y sentimientos sobre el cuidado que manifiestan las personas cuidadoras a través de las metáforas, profundizando en las diferencias de género. Metodología: Estudio cualitativo a través de entrevistas semi-estructuradas. Participaron 24 informantes, 7 pacientes y 17 personas cuidadoras vinculadas a una red de apoyo socio familiar. Se llevó a cabo un análisis del contenido con el software Atlas-ti versión 7®. Resultados principales: Las metáforas expresadas a través de los sentimientos muestran sentimientos comunes en hombres y mujeres: el amor y la satisfacción. Se identificaron sentimientos exclusivos de mujeres, que beben de mandatos de género. Se observó que los hombres se están incorporando al cuidado. Conclusión principal: Las metáforas encontradas desvelan los significados que se atribuyen al cuidado. Las mujeres son conscientes del valor de cuidar, pero lo normalizan. Los hombres esperan reconocimiento social.

Resumen Objetivo Analizar la composicion de las estructuras directivas de los colegios profesionales y las sociedades cientificas espanolas del ambito de la salud en 2019 y compararlas con los datos de 2014 y 2015. Metodo Estudio descriptivo transversal. Se recopilaron los datos de las sociedades cientificas del ambito sanitario con representacion estatal a fecha 30 de mayo de 2019 y de los colegios profesionales con representacion provincial, autonomica o estatal a fecha 1 de junio de 2019. Se compararon con los datos de 2014 y 2015. Resultados Se analizaron 259 colegios profesionales y 163 sociedades cientificas. Tanto los colegios profesionales como las sociedades cientificas del ambito de la salud en 2019 superan el porcentaje del 40% de composicion equilibrada. Los cargos que mas han aumentado en porcentaje de mujeres son los de vicesecretaria (20,8%) o secretaria (9,3% en sociedades), vicepresidenta (8,8% y 11%) y vocal (6,4% y 4%). Lo cargos de presidenta (2%) y decana (6%) los que menos han aumentado. Conclusiones Es necesario continuar con los esfuerzos para avanzar en una representacion equitativa por sexo.

To analyze the composition of the management structures of Spanish professional associations and scientific societies in the field of health in 2019 and compare them with the data obtained in 2014 and 2015.descriptive cross-sectional study. Scientific societies in the health field with state representation as of May 30, 2019 and data from professional associations with provincial, regional or state representation were collected as of June 1, 2019. They are compared to 2014 and 2015.259 professional associations and 163 scientific societies were analyzed. Both professional associations and scientific societies in the field of Health in 2019 exceed the percentage of 40% of balanced composition. The positions that have increased the most in percentage of women are those of vice-secretary (20,8%) or secretaries (9,3% in companies), vice-presidencies (8,8% and 11%) and members (6,4% and 4%). Presidency (2%) and dean (6%), the least.It is necessary to continue with the efforts to advance in an equitable representation by sex.

Multiple gestations have become an increasing phenomenon that has impacted public health globally, largely due to the application of assisted reproductive technologies. The objective of this work was to find out the discourse that the health professionals involved in its follow-up have in our context. For this, a qualitative methodology was chosen, with semi-structured interviews recorded in audio, prior authorisation, and transcribed verbatim. It was based on a script designed for this purpose, with the following analysis categories: the current trend of multiple gestations, impact, and follow-up. The content analysis was based on the experiences, knowledge, and perceptions of the professionals interviewed. Professionals stated that the current socioeconomic and legal context hinders a single embryo transfer policy that decreases multiple gestation rates. They emphasised the importance of the psychic impact of such gestations on the couple, on the mother in particular, as well as the economic effect on families, health, and society in general. They expressed the need to create specific protocols to assist these gestations. Midwives, in particular, demanded that the health administration recognise and support the differentiated care they perform with this type of gestation. Work on specific models is needed to adequately size the impact of multiple gestations, as well as to generate social health policies that lead to co-responsible reconciliation measures that favour women having one pregnancy at a time.

perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida.the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma.a single-blind quasi-randomized controlled trial with two groups: standard care and intervention.a tertiary, metropolitan hospital in Seville, Spain.women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth were randomised. Women in the experimental groups were asked to perform a pelvic floor training programme that included: daily perineal massage and pelvic floor exercises from 32 weeks of pregnancy until birth. They were allocated to an intervention group by clusters (antenatal education groups) randomized 1:1. The control group had standard care that did not involve a perineal/pelvic floor intervention. These women were collected in a labour ward at admission 1:3 by midwives.outcomes were analysed by intention-to-treat. Women assigned to the perineal/pelvic floor intervention showed a 31.63% reduction in episiotomy (50.56% versus 82.19%, p0.001) and a higher likelihood of having an intact perineum (17.61% versus 6.85%, p0.003). There were also fewer third (5.18% versus 13.12%, p0.001) and fourth degree-tears (0.52% versus 2.5%, p0.001). Women allocated to the intervention group also had less postpartum perineal pain (24.57% versus 36.30%, p0.001) and required less analgesia in the postnatal period (21.14% versus 30.82%, p0.001).a training programme composed of pelvic floor exercises and perineal massage may prevent episiotomies and tears in primiparous women. This programme can be recommended to primiparous women in order to prevent perineal trauma.the pelvic floor programme was associated with significantly lower rates of episiotomies and severe perineal trauma; and higher intact perineum when compared with women who received standard care only.the programme is an effective intervention that we recommend to all women at 32nd week of pregnancy to prevent perineal trauma.

Resumen Fundamentos La atencion al paciente pluripatologico en el hogar es un hecho cada vez mas frecuente. El indice de esfuerzo del cuidador es un instrumento en forma de cuestionario que esta disenado para medir la carga percibida en aquellas personas que cuidan a sus familiares. El objetivo fue la construccion de un nomograma diagnostico de sobrecarga en el cuidador informal mediante el cuestionario del indice de esfuerzo del cuidador con los datos de un modelo predictivo. Metodos El modelo se confecciono mediante regresion logistica binaria, siendo incluidos los items del cuestionario del indice de esfuerzo del cuidador como variables predictoras dicotomicas. La variable dependiente fue la puntuacion final obtenida mediante el cuestionario realizandose la categorizacion referenciada por la bibliografia: valores entre 0 y 6 fueron considerados como no existencia de estres del cuidador y los iguales o superiores a 7 como existencia de estres del cuidador. Se utilizo el programa estadistico R version 3.1.1. Para construir los intervalos de confianza de la curva ROC se utilizaron 2.000 repeticiones bootstrap. Resultados Sobre una muestra de 67 cuidadores se confecciono un nomograma diagnostico, con su grafica de calibracion (indice de Brier escalado = 0,686; R2 de Nagelkerke = 0,791) y con la correspondiente curva ROC (area bajo la curva de 0,962). Conclusiones El modelo predictivo generado mediante regresion logistica binaria y su nomograma contienen cuatro variables predictoras (los items 1, 4, 5 y 9 del cuestionario). El area bajo la curva ROC (0,96; IC al 95%: 0,994-0,941) muestra un valor alto y discriminativo. La calibracion del nomograma tambien presenta valores altos de bondad de ajuste por lo que estimamos que puede tener utilidad clinica en la consultas de enfermeria comunitaria, de gestion de casos, de medicina de familia y de geriatria.

When care, one of the most vital human functions, is naturalized and linked to women, it becomes a factor of injustice and inequality (Casado-Mejia et al., 2014). The dedication to care has been associated with age and gender (Del-Pino-Casado, Frias-Osuna, Palomino-Moral, & Martinez-Riera, 2012) and is related to the ideology and attitude of potential caregivers.This ideology associated with gender is supported by the typical familialism (Losada et al., 2010) of the countries in Southern Europe (Shurgot & Knight, 2005) that reinforce the caregiver role of women, hiding a completely inequitable structure in relationships between men and women (Serrano Pascual, Artiaga Leiras, & Davila, 2013).In our aging Western societies, there is an increase in dependency, accompanied by family and personal changes: women are entering the productive world, but men are not entering the reproductive world to the same extent. This highlights the crisis in the informal care system. And it is important to visualize the link between care and women's status as it reveals the impact on health of dependents who need care and the women who are sometimes caught between their traditional and new roles (Casado-Mejia et al., 2014).In this context of crisis in the informal care system, different family measures arise to give new answers (progressive incorporation of men into care and external contracting of mostly immigrant caregivers) and institutional support (Casado-Mejia et al., 2014; Ley de la Dependencia, 2006).Care management strategies have been described as an important factor related to the health status of both the caregivers and the person who is receiving care. The classification of these family strategies has been published before (Casado-Mejia & Ruiz-Arias, 2013), but the relationship between strategies and caregiver burden has not yet been examined. The different ways of organizing care depends on factors that cause a different impact on health, such as having or not having one's own life plan, age, gender, kinship, composition and size of the household, and socioeconomic status. Three different strategies of caring were identified and characterized by informal family caregivers with at least one dependent person at home: total assumption of care (the caregiver assumes all responsibility and the delivery of care), partial care management in coexistence (the caregiver takes responsibility for the care but keeps a personal lifeline, usually paid work), and independent management of care in separate homes (the caregiver is responsible for managing care, the direct care is shared; Casado-Mejia & Ruiz-Arias, 2013).Family care for an elderly person is a stressful experience that may impair one's health. The subjective strain is often analyzed to measure the consequences of care (Pinquart & Sorensen, 2011). It is defined as the state of caregivers characterized by fatigue, stress, and the perceived limitation of social contact and adjustment to their role, which comes from a negative assessment of the care situation, which can jeopardize caregivers' emotional, physical, psychological, and functional health (Gort et al., 2007). Different measurement scales for detecting burden in caregivers of dependent people have been described (Martin, Dominguez, Munoz, Gonzalez, & Ballesteros, 2013), such as the Zarit Burden Interview (Zarit, Reever & Bach-Peterson, 1980) or Caregiver Strain Index (CSI; Robinson, 1983). At the present time, the CSI is the most successful one: Crespo and Rivas (2015) have considered the CSI to be one of the preferential tools for assessing burden. Several investigators agree that it is an easier and simpler instrument than others in identifying excessive burden on family caregivers (Crespo & Rivas, 2015; Odriozola Gojenola, Vita Garay, Maiz Alkorta, Ziatzeta Aduriz, & Bengoestxea Gallastegi, 2008). It can also be a useful tool to detect early signs or symptoms of caregiver's syndrome. …

OBJECTIVE To explore women's experience with continuing breastfeeding when they returned to work. DESIGN AND SAMPLE A cross-sectional study was conducted. Participants were female employees at the University of Seville who gave birth in the last 10 years while working at University. MEASURES A questionnaire in Spanish was used to collect information on sociodemographic variables, employment characteristics, continued breastfeeding behavior after returning to work and the dimensions of the validated scale the Workplace Breastfeeding Support Scale (WBSS). RESULTS A total of 197 women responded, consisting of 53.8% faculty and 46.2% administrative staff. Almost all the women had breastfed their children (92.9%). The proportion of women who continued to breastfeed after they returned to work was 51.3%. The main reason given for interrupting lactation was the challenge of reconciling family and work (53.1%). Faculty members took more breaks for breastfeeding (p = 0.002) and were able to arrange their breaks more easily (p

This study analyzes guilt among family caregivers of dependent patients, from a gender perspective. A qualitative design was used, conducting in-depth interviews and focus groups. Using purposive sampling, we selected 73 family caregivers and 23 health professionals (family medicine, community nursing, and social work) from the Primary Care District of Seville. The content of the information collected was analyzed in terms of the following categories: a) guilt for abandoning family and friends; b) guilt for the relationship with the dependent person; and c) guilt for placing the relative in a nursing home. To validate the findings, data sources, methodological techniques, and researchers’ disciplines were all triangulated. Results indicated that women report more guilt than men for abandoning family and friends, and because of their relationship with the dependent person. However, with respect to nursing home placement, no difference was observed as a function of gender. The high incidence of caregiver guilt needs to be addressed by health professionals to avoid the emergence of other mental health issues.

Objective. To identify and understand factors that influence the relationships in the environment of family care provided by live-in immigrant caregivers. Methods. Interpretive qualitative study from a phenomenological perspective, using in-depth interviews, discussion groups and participant observation. The observation unit was the Sevillian families (Spain) with elderly dependents and a live-in female immigrant caregiver. Analysis units considered were health, care, dependence, gender, ethnicity and social class. Categories were analysed using QSR-NUD*ISTVivo9. After saturation, we triangulated between researchers, disciplines, sources and techniques to validate the results. Results . Factors of cultural discovery or clash were: language, religion, food, concept of space and time, caregiver's name and the attitudes held by both the hiring family, related to its social class, and by caregivers. Conclusion. Interpersonal relationships are the most important factor: an egalitarian relationship based on good treatment is beneficial to all involved. Knowing these codes will improve the quality of professional care in the family. Key words: caregivers; gender identity; emigration and immigration; aged. How to cite this article : Casado-Mejia R, Ruiz-Arias E. Factors influencing family care by immigrant women in Spain: a qualitative study. Invest. Educ. Enferm. 2016; 34(3): 551-563.

To analyze the factors that influence the strain on family caregivers of elderly dependent people, relating it to the strategy of care, with a gender perspective.Cross-sectional study.We interviewed 328 Spanish family caregivers in 2012. Main variable: Caregiver Strain Index (CSI).relationship, sex, age, marital status, education level, employment status, socioeconomic status, family and/or institutional supports, time they devote to care, and how long they have been giving care. Data were analyzed using bivariate procedures and multiple linear regression.Caregiver profile: women around 60 years old, housewives, with primary education. CSI average: 6.63 ± 3.36. Female sex, kinship being a son or daughter, housewife employment status, service of home care, and the care recipient being female were significantly associated with the subjective strain.Caregivers´ strain has a strong gender component: women are more tired, primarily those that practice a partial care strategy.Knowing the factors that predict burden, nurses may help caregivers to provide better care. A risk profile for strain and burden: women who practice a partial care strategy; they are adult women and daughters who do not want to give up their professional role and combine it with their duty of caregiving.

The gradual increase of women in the health professions does not correspond with her presence in positions of power. Given that professional colleges have an essential role in the representation and professional regulation, arises as an aim to describe the presence of women in the managerial structures of the professional colleges of health in Spain now to verify the degree of compliance with the criteria of parity.The Spanish official professionals' colleges were compiled by visiting the websites of the General Council of the Psychology of Spain, General Council of Medical Associations of Spain, General Council of Colleges of Nursing of Spain, General Council of Physiotherapists Schools of Spain, General Dental Council, Organization collegiate Pharmaceutical General and Council of Associations of Podiatrists. All their webs were visited. The sex of the presidency, the executive and the entire board was identified. Data were analyzed according to the overall percentage of women and profession. We compared this to the INE-2014 collegiate professionals.Out of 251 professionals' colleges in July-2015, 21, 91% had a female president. Women hold 34,69% of the executive positions and 42,80% of total boards. 11, 32% of Medical colleges had a female president and 43,48% of Nursing ones. The Psychology are those with more women in the presidency, 45, 83%.There is no parity, being higher in Psychology and Nursing and, much lower in Dentistry, Physiotherapy, Podiatry and Medicine. It decreases with the responsibility level. Health Inequality.

The Hospital Universitario Virgen del Rocío (HUVR) of Seville was chosen as the reference Andalusian site to treat possible cases of Ebola. After the health alert (WHO, 2014), a voluntary group of healthcare and non-healthcare professionals was set up, which, after being trained, treated a possible case. In this light, the aim is to understand the motivations and emotional experiences of this group and to identify the facilitators of and obstacles to its operation.Qualitative, interpretative and phenomenological study. Observation unit: professional team of the HUVR trained to treat Ebola cases. Analysis units: teamwork, motivations and emotions. Three interviews with key informants were conducted, as well as three discussion groups involving 23 of the 60 team members (2014-2016). A content analysis of the motivations, emotions and elements affecting the team's operation was conducted with QSRNUDISTVivo10.data sources, techniques and disciplinary perspectives were triangulated. The results were presented to the team, which duly agreed with the findings.Training, professional responsibility, professional self-esteem, risk appetite or loyalty to the leader stood out as motivations to voluntarily join the team. Emotional experiences evolved from fear and stress to self-pressure control, while essential elements for the team's operation were found to be calmness and confidence based on training and teamwork. Family, source department, resources, communication media and emotional management were facilitators of or obstacles to the team's success.An understanding of the key motivational and influential factors may be important in the management of effective and successful multidisciplinary teams during health alerts.

Resumen Objetivos Determinar el perfil de la persona cuidadora familiar de pacientes pluripatologicos, identificar factores asociados a la sobrecarga sentida y manifestaciones de cansancio. Construir modelos predictivos mediante los items del Indice de Esfuerzo del Cuidador (IEC). Metodo Estudio descriptivo transversal. Poblacion de estudio: personas cuidadoras de pacientes pluripatologicos de centro de salud urbano. Recogida de datos desde la historia clinica y mediante cuestionarios (indice de Barthel, indice de Pfeiffer, IEC). Analisis estadistico mediante medidas de centralizacion, de dispersion y mediante la construccion de modelos multivariantes con regresion logistica binaria (RLB) con los items del IEC como predictoras (programa R version 2.14.0). Resultados Muestra total de 67 personas cuidadoras, con una edad media de 64,69 anos (desviacion estandar = 12,71; mediana 62 anos); un 74,6% mujeres, un 35,8% esposas e hijas un 32,8%. El nivel de dependencia de las personas cuidadas fue total/severa del 77,6% y moderada del 12% (Barthel); un 47,8% tenian algun nivel de deterioro cognitivo (Pfeiffer). IEC > 7 en el 47,8% de cuidadoras, identificandose en > 40% inconvenientes para la vida, restriccion de vida social, esfuerzo fisico, molestias ante cambios, comportamientos molestos, cambios emocionales personales y familiares, y trastornos del sueno. El item n.° 4 del IEC que analiza la restriccion social fue el que mostro una mayor significacion en el modelo predictivo del estres del cuidador. El item n.° 12 (sobrecarga economica) fue el mas significativo en los pacientes con deterioro cognitivo. Conclusiones Las mujeres suelen adoptar el rol de cuidadora a una edad mas temprana que los hombres en el entorno urbano estudiado, y con relacion al IEC, son los items n.° 4 (restriccion social) y n.° 12 (sobrecarga economica) los que tienen mas significacion en los modelos predictivos construidos con RLB.

Patient homecare with multiple morbidities is an increasingly common occurrence. The caregiver strain index is tool in the form of questionnaire that is designed to measure the perceived burden of those who care for their families. The aim of this study is to construct a diagnostic nomogram of informal caregiver burden using data from a predictive model.The model was drawn up using binary logistic regression and the questionnaire items as dichotomous factors. The dependent variable was the final score obtained with the questionnaire but categorised in accordance with that in the literature. Scores between 0 and 6 were labelled as "no" (no caregiver stress) and at or greater than 7 as "yes". The version 3.1.1R statistical software was used. To construct confidence intervals for the ROC curve 2000 boot strap replicates were used.A sample of 67 caregivers was obtained. A diagnosing nomogram was made up with its calibration graph (Brier scaled = 0.686, Nagelkerke RThe predictive model generated using binary logistic regression and the nomogram contain four items (1, 4, 5 and 9) of the questionnaire. R plotting functions allow a very good solution for validating a model like this. The area under the ROC curve (0.96; 95% CI: 0.994-0.941) achieves a high discriminative value. Calibration also shows high goodness of fit values, suggesting that it may be clinically useful in community nursing and geriatric establishments.

The aim of this article is to analyze the fears about menstruation and health that have been passed down to us by oral transmission from a gender perspective. A qualitative study, whose design was the Grounded Theory, performed in Seville, Spain, with 24 rural and urban women from different generations, young (18-25, 26-35 years), middle aged (36-45, 46-55, 56-65 years) and elderly (> 65 years). The semi-structured interview was used as a data collection technique. The discourses were subjected to content analysis, following the steps of Grounded Theory. The results highlight the abundant fears related to use of water during menstruation, with very harmful effects to health. As a conclusion to highlight the lack of women's knowledge about reproductive health and that despite Health Education campaigns there are still ancient misconceptions present about menstruation. O objetivo do artigo foi analisar os medos sobre a menstruaçao e a saúde que chegaram até aos nossos dias através da comunicação oral, numa perspectiva do género. Um estudo qualitativo, cujo desenho se baseou na Teoria Fundamentada nos Dados, realizado em Sevilha, Espanha, tendo como base 24 mulheres de meio rural e urbano de diferentes gerações, jovens (18-25, 26-35 anos), de meia idade (36-45, 46-55, 56-65 anos) e idosos (>65 anos). Utilizou-se como técnica de obtenção de dados a entrevista semiestruturada. Os dados foram submetidos a uma análise de conteúdo, seguindo os passos da Teoria Fundamentada. Dentro dos resultados, destacamos os abundantes medos relacionados com o uso de água durante a menstruação, com efeitos muito prejudiciais para a saúde. Destacamos a falta de conhecimento por parte das mulheres na saúde reproductiva ja que, apesar das campanhas no âmbito da Educação para a Saúde, continuam presentes crenças milenares erradas sobre a menstruação. El objetivo del artículo es analizar los miedos sobre la menstruación y la salud que han llegado hasta nuestros días mediante transmisión oral desde la perspectiva de género. Estudio cualitativo, cuyo diseño fue la Teoría Fundamentada realizado en Sevilla, España, con 24 mujeres de medio rural y urbano de diferentes generaciones jóvenes (18-25, 26-35 años), mediana edad (36-45, 46-55, 56-65 años) y mayores (>65 años). Se utilizó como técnica de obtención de datos la entrevista semi-estructurada. Los discursos fueron sometidos al análisis de contenido, siguiendo los pasos de la Teoría Fundamentada. Como resultados destacar abundantes miedos relacionados con el uso del agua durante la menstruación, con efectos muy perjudiciales para la salud. Como conclusiones destacar la falta de conocimientos de las mujeres en la salud reproductiva ya que a pesar de las campañas en Educación para la Salud todavía siguen presente creencias erróneas milenarias sobre la menstruación.

Fundamentos: La progresiva incorporación de las mujeres en las profesiones sanitarias no se corresponde con su presencia en puestos de responsabilidad. Dado que los colegios profesionales tienen un papel esencial en la representación y regulación profesional, se plantea como objetivo describir la frecuencia de la presencia de las mujeres en las estructuras directivas de los colegios profesionales del ámbito de la salud en España y comprobar el grado de cumplimiento de los criterios de paridad. Métodos: Se identificó el género de la persona que ocupaba la presidencia, los cargos ejecutivos y la junta directiva visitando las webs del Consejo General de los colegios profesionales de Psicología, Consejo General de Colegios Oficiales de Médicos, Consejo General de Colegios Oficiales de Enfermería de España, Consejo General de Colegios de Fisioterapeutas, Consejo General de Dentistas, Organización Farmacéutica colegial y Consejo General de Colegios oficiales de Podólogos. Se describió el porcentaje de mujeres de forma global y según profesión y se comparó con las cifras de colegiados y colegiadas según el INE para 2014. Resultados: De 251 colegios profesionales en julio de 2015, 41 (21,91%) la presidencia estaba ocupada por mujeres. También ocupaban el 34,69% de los puestos ejecutivos y el 42,80% del total de las juntas directivas. Los colegios médicos y de enfermería tenían una mujer en la presidencia en el 11,32% y 43,48% respectivamente. Los de psicología fueron los que presentaron mayor presencia femenina en la presidencia, el 45,83%. Conclusión: No existe paridad entre hombres y mujeres en el conjunto de los colegios estudiados. La presencia femenina es mayor en colegios de psicología y enfermería y mucho menor en los de odontología, fisioterapia, podología y medicina con el nivel de responsabilidad disminuye la presencia de las mujeres.

To describe the presence of women in the governance of health-related scientific societies in Spain today.Spanish scientific societies were identified by vising the websites of the Ministry of Health, Social Services and Equality, and Fisterra. The sex of the president, executive officers and the board of directors was identified. Data were analyzed according to the overall percentage of women and by profession and setting.Of 173 scientific societies in July 2014, 41 had a female president (22.53%). Women held 35.45% of executive positions and accounted for 36.32% of the boards of directors. Only 16.07% of medical societies had a female president compared with 76.92% of nursing societies. Primary care societies had more women in executive positions (54.55%) than societies in which the professional activity of members involved both primary and secondary care (35.74%) and societies related to hospital care (27.93%).There is a lack of parity, which is greater in nursing and primary care societies than in medical and hospital-related societies. Parity decreases as the level of responsibility rises.

The aim of the study was, to determine the profile of the family caregiver of patients with multiple pathologies, identify factors associated with overload, and construct predictive models using items from the Caregiver Strain Index (CSI).A cross-sectional study of caregivers of patients with multiple comorbidities who attended an urban health centre. Data were collected from health records and questionnaires (Barthel index, Pfeiffer index, and CSI). Statistical analysis was performed using measures of central tendency and dispersion, and by building multivariate models with binary logistic regression with the CSI items as predictors (program R version 2.14.0).The sample included 67 caregivers, with a mean age of 64.69 years (standard deviation=12.71, median 62 years), of whom 74.6% were women, 35.8% were wives, and 32.8% were daughters. The level of dependence of the patients cared for was total/severe in 77.6%, and moderate in 12% (Barthel), and 47.8% had some level of cognitive impairment (Pfeiffer). A CSI equal or greater than 7 was seen in 47.8% of caregivers, identifying life problems in more than 40% of them such as, restriction of social life, physical exertion, discomfort with change, bad behaviour, personal and family emotional changes, and sleep disturbances. Item 4 of the CSI, analysing the social restriction, was the one that showed a greater significance in the predictive multivariate model. Item 12 (economic burden) was the most significant with age in patients with cognitive impairment.Women tend to take the role of caregiver at an earlier age than men in the urban environment studied, and items from CSI showed that items 4 (social restrictions) and 12 (economic burden) have more significance in the predictive models constructed with Binary Logistic Regression.

Objetivo: Conocer las características de la prestación de cuidados a las personas dependientes en el entorno domiciliario. Material y métodos: Estudio descriptivo trasversal en el año 2.009 en personas cuidadoras de pacientes inmovilizados con dependencia severa y total, en el Centro de Salud San Pablo en Sevilla. Tras entrevistas personales o telefónicas mediante cuestionarios, se realizó análisis estadístico. Resultados: Participaron 152 personas cuidadoras de edad media 62 años (S: 12,8), el 71.1% (108) mujeres. El 69% (105) tenían dedicación exclusiva al cuidado; un 72.4% (110) reciben ayuda, siendo ésta en un 78.2% (86) familiar no remunerada. El 87.5% (132) de personas cuidadoras solicitaron prestación: un 69.2% (92) escogieron la económica, un 25.6% (34) el servicio de ayuda a domicilio y 3.8 % (5) Unidad de Día. Conclusiones: El perfil de las personas cuidadoras es de 60 años, femenino, y sin estudios o estudios primarios. La dedicación exclusiva al cuidado es mayoritaria en nuestro entorno. Observamos la incorporación del hombre al cuidado, con ayuda generalmente de una mujer. La prestación más solicitada es la ayuda económica que las personas cuidadoras perciben y que, más de la mitad, no destinan a recibir ayuda en los cuidados, que de forma permanente realizan. Abstract: Objective: To know the features of care home provision to dependent people . Method: A descriptive cross- sectional study about caregivers of immobilized patients with severe or total dependence over the year 2.009 at San Pablo Health Center in Seville. The statistical analysis was performed through telephone interviews or personal questionnaires. Results: A total of 152 caregivers were included, whose mean age was 62 years (S:12,8), 71.1% (108) were women. 69% (105) were full-time carers, 72.4% (110) received aid, being this in a 78.2% (86) unpaid family help. 87.5% (132) of carers claimed help from social services: 69.2% (92) chose economy benefits, 25,6% (34) domestic help service and 3,8% (5) Day Care Units. Conclusions: The profile of caregivers is 60 years old, female, uneducated or with primary education. The full-time care is a majority in our environment. We can see the increase incorporation of men to family cares, usually carried out by women. Financial aid is the most requested one by the caregivers, but more than a half do not use this financial aid in the family care. Centro de Trabajo: (1) DUE C.S. San Pablo de Sevilla. Lcda. Antropología Social y Cultural. (2) DUE. Lcda. Antropología Social y Cultural. Doctora por la U. Sevilla. (3) DUE. Lcda. Psicología. C.S. La Campana de Sevilla (4) DUE. Profesora del Dpto de Enfermería U. Sevilla. Fecha del Trabajo: 18/06/2011 Palabra Clave: Cuidadores; Atención Domiciliaria de Salud; Política Social. Key Words: Caregivers; Home Nursing; Public Policy.

Objective: To know the features of care home provision to dependent people . Method: A descriptive cross- sectional study about caregivers of immobilized patients with severe or total dependence over the year 2.009 at San Pablo Health Center in Seville. The statistical analysis was performed through telephone interviews or personal questionnaires. Results: A total of 152 caregivers were included, whose mean age was 62 years (S:12,8), 71.1% (108) were women. 69% (105) were full-time carers, 72.4% (110) received aid, being this in a 78.2% (86) unpaid family help. 87.5% (132) of carers claimed help from social services: 69.2% (92) chose economy benefits, 25,6% (34) domestic help service and 3,8% (5) Day Care Units. Conclusions: The profile of caregivers is 60 years old, female, uneducated or with primary education. The full-time care is a majority in our environment. We can see the increase incorporation of men to family cares, usually carried out by women. Financial aid is the most requested one by the caregivers, but more than a half do not use this financial aid in the family care.

Objetivo: Comprender las repercusiones del cuidado familiar ejercido por inmigrantes contratadas en régimen interno, en la salud de ellas mismas, de las personas mayores dependientes y de sus familias, en Sevilla. Método: Se dise˜nó un estudio cualitativo, utilizando entrevistas en profundidad a informantes-clave, cuidadoras inmigrantes, personas mayores dependientes y familias, y grupos de discusión de profesionales sanitarios. El estudio se realizó en Sevilla entre los a˜nos 2006 y 2008. Unidad de observación: familias con mayores dependientes a su cargo y cuidadora inmigrante interna contratada. Unidades de análisis: salud, cuidados, dependencia, género, etnia y clase social. El análisis de categorías, predeterminadas y emergentes, se realizó con QSR NUD*ISTVivo1.3. Tras llegar a la saturación, se triangularon disciplinas, investigadoras, fuentes y técnicas, para enriquecer y validar los resultados. Resultados: En la salud de las cuidadoras inmigrantes influyen, fundamentalmente, la repercusión del trabajo de cuidar y el proceso migratorio. Las relaciones interpersonales son el factor que más influye en la salud de todas las personas implicadas. Conclusiones: El cuidado familiar encargado a mujeres inmigrantes, unido al duelo migratorio, tiene importantes repercusiones en su salud. Si las relaciones interpersonales son de buen trato e igualitarias, se constituyen como factor de protección para todas las personas en contacto. © 2011 SESPAS. Publicado por Elsevier España, S.L. Todos los derechos reservados. Objective: To understand the effects of care within the family provided by live-in female immigrants on elderly dependents and their families and the carers themselves in Seville (Spain). Methods: We designed a qualitative study using in-depth interviews of key informants, immigrant care workers, elderly dependents and their families, and discussion groups composed of health professionals. The study was carried out in Seville between 2006 and 2008. The observation unit consisted of the families of elderly dependents with a live-in female immigrant care worker. The analysis units were health, care, dependence, gender, ethnicity and social class. Category analysis was carried out using QSRNUD* ISTVivo1.3. After saturation, we triangulated among disciplines, researchers, sources and techniques to validate the results. Results: The most important factors for carers’ health were the migration process and care tasks. Interpersonal relationships constituted the principal factor affecting the health of all involved. Conclusions: The care tasks provided by immigrant women, together with the migration process, have an important impact on their health. Good and egalitarian interpersonal relationships are a protective factor for health. © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

To understand the effects of care within the family provided by live-in female immigrants on elderly dependents and their families and the carers themselves in Seville (Spain).We designed a qualitative study using in-depth interviews of key informants, immigrant care workers, elderly dependents and their families, and discussion groups composed of health professionals. The study was carried out in Seville between 2006 and 2008. The observation unit consisted of the families of elderly dependents with a live-in female immigrant care worker. The analysis units were health, care, dependence, gender, ethnicity and social class. Category analysis was carried out using QSR-NUD*ISTVivo1.3. After saturation, we triangulated among disciplines, researchers, sources and techniques to validate the results.The most important factors for carers' health were the migration process and care tasks. Interpersonal relationships constituted the principal factor affecting the health of all involved.The care tasks provided by immigrant women, together with the migration process, have an important impact on their health. Good and egalitarian interpersonal relationships are a protective factor for health.

To quantify and characterize the scientific production on the family care provided by immigrant women.A literature search was performed in April 2008 with no date limits in the main national and international databases: Web of Science, Current Contents Connect, ISI Proceedings, MedLine, CINAHL, PsycoInfo, EMBASE, IME, ISOC and CUIDEN. Summaries were reviewed by excluding those that did not relate to the subject of this study and those that were not in English, French or Spanish. The references of all included articles were also reviewed to detect other relevant publications. Several variables were identified and analyzed: type of article, main topic, country of the first author, and year of publication. A content analysis was performed, using the topics as categories.A total of 191 articles were retrieved and 178 were excluded. The 13 included articles analyzed differences in formal and informal care (2), determinant factors (4), epistemological needs (3), the benefits of this kind of care (5), the need for health education/training (4), the need for political/institutional support (2), immigration and health (6), and the carer/cared for relationship (4). There were five non-systematic reviews, six descriptive studies, one qualitative study and one experience. Two articles were published before 2002, eight between 2003-2005, and three between 2006-2008. Most of the studies were performed in Spain (9/13).The scarcity of articles confirms that recruitment of immigrants as caregivers is a new and invisible reality. Most of these studies highlight the benefits of this type of care. There is no dominant pattern of topics and the methodology varies widely. The few analytical studies may indicate that this topic is only beginning to be researched. Investigation into this form of care should be stimulated.