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The paper comments briefly the nature of grounded theory, its origins and characteristics, and later gives way to the presentation of two research studies. One is about a context of interaction (adolescent pregnancy) and the other about a subjective experience (being a chronic patient). Context and experience are key issues for a cultural competent and congruent nursing care. Grounded Theory studies enable us to contextualize nursing care, and reveal the different interactions and the constructions that caregivers have about a given activity and its cultural elements. [ABSTRACT FROM AUTHOR]

Abstract Background Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts.

Abstract: This article deals with the particularities of the quality of qualitative research, under the double lens of valuing it and ensuring it. While achieving the quality of qualitative research concerns only those who have opted for this methodology, assessing it is everyone's business because researchers in training will encounter, in the literature reviews, qualitative studies on which they must reflect and estimate their quality. Appreciating the quality of a research work is a complex activity as it is situated within a context and conducted by individuals who use any of the means available to do so. The means they use are criteria as evaluation guides and criteria checklists. For researchers in training, I suggest some guiding criteria to evaluate qualitative publications and ensure quality during the research process, key issues that they must address., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Objective: To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals., Methods: We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016-2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category., Results: A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+=0.87). Multifactorial (RR+=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively., Conclusions: Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses., (Copyright © 2024. Published by Elsevier España, S.L.U.)

The aim of the study was to describe and analyze the experience of people with advanced chronic kidney disease. Chronic kidney disease is a growing public health problem that is on the increase worldwideThe experience of living with this illness is paradoxical, as it can include feelings of dependent autonomy, distant connection, abnormal normalcy, and uncertain hope. Every chronic disease involves a biographical alteration from the onset. For those who suffer it, it implies a breaking down and reconstruction of their everyday life. Despite the prevalence of the disease and the increase in the number of qualitative research studies in recent decades, there has not been much research on the experience of people with Chronic kidney disease. This is a qualitative study that began in 2018 and concluded in 2021.Twenty-one people with advanced chronic kidney disease were interviewed. They participated voluntarily with informed consent Participants were selected by purposive sampling. Data analysis was guided by grounded theory procedures using the Nvivo 12 software. This study reveals that people with advanced chronic kidney disease do not feel the same as they used to because their control over their lives is limited; because they feel their health is in a continuous state of deterioration; and because of the changes in themselves and in their relationships with others. With chronic kidney disease, their identity is continually called into question. The normal lives of these people-their biographical constructions-are precarious and are continuously being remodelled by the effects of treatment and the inexorable course of this disease. This study contributes to an understanding of the experience of people with advanced chronic kidney disease. It can contribute to helping health care professionals effectively support these patients in their efforts to lead a normal life and in making decisions about their treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 de la Cuesta-Benjumea et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To analyse and synthesize the evidence on fall prevention of people older than 65 years and their family care providers METHOD: Qualitative synthesis, which is a part of a convergent systematic integrative review. Forty-one qualitative studies were retained for full text scrutiny. Nine studies on family care providers were selected for this synthesis., Results: Care providing, and kinship relationships mediated family care providers' interventions to prevent falls in older people. The fall of the dependent relative constitutes a turning point in these relationships. Family care providers are vulnerable to having a fall themselves and therefore receivers of preventive interventions., Conclusions: Taking into account the context of care and family relations will improve the effectiveness of preventive interventions and will facilitate adherence. Fall prevention policy and programmes must pay better attention to the health and wellbeing of family care providers., (Copyright © 2019 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Aim: To know and understand the strategies carried out by the relatives of people with mental health problems in the care of their sick relatives., Design: Qualitative study SETTING: Mental Health Service (SESCAM) and Social Health Centres of Castilla-La Mancha region (Spain)., Participants: Twenty-four adult family members who live and care for a family member who suffers a mental health crisis. The participants were contacted both through the health directorate of the area and a social health foundation. They were selected with purpose and by snowball sampling., Method: Twenty-two semi-structured were conducted and analysed according to the constructivist grounded theory procedures between January 2014 and February 2016. The theoretical sampling guided the obtaining of the data that ended with the saturation of the emerging categories., Results: A person with a mental problem during a crisis becomes a stranger and is inaccessible to family members. In this situation the efforts are aimed at the recovery of the relative, to take them out of the unreason and to keep them in a day-to-day normality constructed for them. Thanks to this, the ill relative is integrated into family life., Conclusions: Family caregivers of people with mental problems struggle not to lose them in a crisis and to maintain family ties. Primary care professionals must give importance to these links, because it determines their care strategies during a crisis and the strategies to conserve the family member., (Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Aim: To understand the experience of family members of an older relative who has had a fall which required medical attention., Background: There is abundant bibliography in caregiving, but little is known about the problems faced by caregivers and how family members cope when their older relative has a fall., Design: Qualitative study that used a symbolic interactionism perspective., Methods: Twenty-two people with older relatives, who had had a fall and contacted health services in Spain, participated in the study. Data were obtained via written accounts, focus groups, and semi-structured interviews between February 2014 - December 2015. Analysis was guided by grounded theory procedures., Results: With the fall, dependency becomes a complex issue for the family. To manage a complex dependency is the core issue that emerges from the data analysis. It depicts family efforts to assist their relative in gaining autonomy after a fall, in the best conditions they can provide. They do this with little guidance and support from healthcare professionals., Conclusions: Guides and protocols for the care of a fragile older person, particularly after a fall, should not only include care but also support to caregivers. Health professionals and especially nurses need to be aware and respond to the family caregivers needs after a fall. To the fall prevention initiatives already in place, it must be added that those who support family members to cope with the care of an older person who has had a fall., (© 2018 John Wiley & Sons Ltd.)

Aim: To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions., Background: Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes this role and care providers' views on fall's prevention initiatives., Design: A convergent synthesis of qualitative, quantitative, and mixed methods studies. The eligibility criteria will be based on participants, interventions/exposure, comparisons, and outcomes for quantitative studies and on population, the phenomena of interest and the context, for qualitative studies. To extract data and assess study qualities members of the research team will work in pairs according to their expertise. The review will follow the guidelines for integrative reviews and the proposed methods will adhere to the PRISMA statement checklist complemented by the ENTREQ framework. As qualitative synthesis are emergent, all procedures and changes in procedure will be documented., Discussion: The review has a constructivist drive as studies that combine methods ought to be paradigmatic driven. Review questions are broad to allow issues emerge and have purposefully left the design flexible to allow for adjustments as the review progresses. The review seeks to highlight the roles that care providers play in fall prevention and their views on fall's prevention initiatives., (© 2016 John Wiley & Sons Ltd.)

Objective: To describe the experience of women caregivers with chronic conditions who care for a dependent relative., Design: Qualitative study based on constructivist grounded theory., Location: Study conducted on two Health Areas urban of the Community of Madrid., Participants: Thirty nine women with a chronic condition who take care of dependent relatives were selected by means of purposive sampling., Method: Data were collected through 23 semi-structured interviews and 2 focus groups between April 2010 and December 2011. Grounded theory procedures were used in the data analysis., Results: To feel their life hampered describes the subjective experience of family caregivers with chronic conditions who take care of a dependent relative. When comparing their past life with the current life they become aware of the losses they have suffered over time. They feel less strong, sadder and less free; they worry about how to meet the demands of family care. The life they are leading makes them question the meaning of their own lives., Conclusions: This study shows the losses realized day by day by women caregivers with a chronic illness, which lead them to lose the meaning of their own lives. To know the experience of these women caregivers will help develop interventions and specific services that compensate for the losses they feel and help improve their quality of living., (Copyright © 2014 Elsevier España, S.L.U. All rights reserved.)

Aims and Objectives: Uncover how women self-manage their own chronic illness while taking care of a dependent relative., Background: International policies place special emphasis in promoting interventions addressed to control, prevent and care for people with chronic health conditions. Self-management is a crucial part of this care. Caregivers are more prone to have chronic illness than non-caregivers. They are confronted with dilemmas about taking care of themselves while taking care of their dependent relative and the rest of their families. Caregivers articulate strategies to enable them to focus their energy on caring., Design: Qualitative study using constructivist grounded theory., Methods: Thirty-nine women caregivers with a chronic illness participated in the study. Twenty-three semi-structured interviews and two focus groups were carried out between April 2010-December 2011. Data were analysed using grounded theory procedures., Findings: Self-management helps women caregivers with a chronic illness to balance the demands of their own illness and those of the dependent relative. They self-manage their illness by self-regulating the treatment, by regulating their strength and by controlling their emotions., Conclusions: Women caregivers integrate effectively and creatively the management of their chronic illnesses within the complexities of family care. This renders their health needs invisible and reaffirms them as capable caregivers., Relevance to Clinical Practice: Identifying self-management strategies of women caregivers allow health professionals to acknowledge and reinforce effective self-care measures and to deter those that are ineffective and lessen their quality of life., (© 2014 John Wiley & Sons Ltd.)

Objective: This study sought to recognize the active and symbolic role played by the objects from the material world for nursing care in Spain between 1855 and 1955., Methodology: This was a historical study using procedures from founded theory. The information sources were eight handbooks for the formation of healthcare professionals published in Spain, during the period of interest. The information was gathered from March 2012 to June 2013. During this period, the sources were revised comprehensively and bibliographic information, description of instruments, and analysis files were made; methodological and analytic memoranda were written. Forty-five procedures and 360 material objects were registered., Results: The categories ''principal and secondary objects'' and ''guarded objects'' reveal the influence exerted by the objects from the material world for care., Conclusion: In Spain, between 1855 and 1955, nursing care was carried out within a scenario comprised of objects with secondary status and situated within the periphery of care, as well as by guarded objects that professionals could not use. This material world influenced the social recognition of healthcare professionals at the time and the visibility of their work.

Aim: To explore the strategies used by women caregivers to deal with their own chronic health conditions., Background: Providing care has a negative impact on the physical and mental health of caregivers. When caregivers suffer chronic health problems, it increases the burden of caring, making them more vulnerable and less likely to look after their own health., Design: Qualitative study carried out between April 2010-December 2011., Method: Thirty-nine women with long-term illness who care for dependent family members took part in the study, 23 in semi-structured interviews and 16 in two focus groups. The data were analysed using the grounded theory method., Findings: Women caregivers feel that they cannot let their own chronic health problems prevent them from caring for others. Dealing with their health problems enables them to provide the time and effort their family member requires. They do this by: (1) normalizing their chronic conditions; (2) neutralizing the effects of their long-term illness; and (3) forgetting that they are chronic sufferers., Conclusions: This study analyses the strategies that family caregivers use to deal with their own chronic health problems, so that they can continue to provide family care. It shows that, to forget about their own illnesses, these women must take charge of them. Nurses need to recognize and value the strategies that caregivers use to deal with their own health problems. They also need to encourage them to use the most effective strategies, to improve their quality of life., (© 2013 John Wiley & Sons Ltd.)

In this article attention is focused on access to data; a process that tends to be taken for granted and which in practice takes time and energy from the person who investigates. Access implies a process of contacting key people in institutions; negotiating with them, being invited to obtain data, achieving formal permission, and--finally--constructing relationships with the participants. Access to data is negotiated, trust is constructed in relationships with study participants, and data is obtained. All this constitutes an interactive process in which the person who investigates is revealed as an instrument in obtaining the data. Thus, the appearance, manners, and the way of being of the person who investigates will facilitate access to broad and detailed information.

Aims and Objectives: To understand the process of adaptation to dependency in older adults and their families., Background: Dependency and family care giving are attracting the attention of policymakers, service providers and researchers., Design: An interpretative synthesis of qualitative studies has been conducted., Methods: An extensive search without time and idiom limitations was conducted using the main databases (MEDLINE, CINAHL, EMBASE, PsycINFO, SSCI, LILACS, CUIDEN, Cochrane Library and JBI): personal communication from expert panel was used to detect filters strategies to find qualitative studies; these strategies were combined with search terms for dependence in older adults. The studies (2164 potentially relevant papers) were judged by two reviewers based on reading title, abstract, keywords and/or full text (English, Spanish, French and Portuguese) to determine their inclusion. After, 203 papers were critically appraised by two reviewers (disagreements were resolved by discussions). Finally, the synthesis of the 20 studies with best interpretative character was carried out based on the principles and procedures of Grounded Theory., Results: The findings were related to the process of adaptation to dependency, the factors and the strategies used, the emotions, perceptions and feelings of care givers and older adults. The central category that emerged was 'Caring to achieve the maximum independence possible', and this could be seen as a transition period in which older adults and their families progressed in a mutually determined adaptation process. This category is made up of several redefinitions of concepts, phases, adaptation strategies and final responses to the process., Conclusions: The findings show the interconnected nature of physical, material, social and emotional aspects of care; and the profound social impact of providing and receiving care. Relevance to clinical practice.  The nurses can assist families and older adults to enhance adaptation to dependency, anticipating and helping to redefine the concepts of care., (© 2012 Blackwell Publishing Ltd.)

Purpose: Although past research has focused on the coping strategies of family caregivers, how immigrant caregivers cope with the demands of caregiving remains unknown. This study examines the strategies immigrant caregivers use to relieve the burden of care., Method: A qualitative study based on 17 immigrant women caregivers using purposive and snowball sampling was done. Semistructured interviews and testimonies were obtained and analyzed using grounded theory procedures., Findings: Turning to one's world describes how caregivers seek relief from the burden of care. They escape virtually, go to a private place, make those they care for their own, and decide to go home. These mechanisms enable them to escape from the world of caregiving in which they find themselves., Discussion: Findings reveal the significance of family connections and networks for immigrants to achieve burden relief., Implications: The importance of promoting positive working environments and raising awareness about immigrant caregivers' need for rest.

Aim: This paper is a report of a study conducted to uncover the strategies that women caregivers of relatives with advanced dementia use to rest from care-giving., Background: Respite consists of activities and situations that briefly take caregivers away from their care-giving responsibilities. Qualitative studies are focusing on respite as an outcome and are deepening our knowledge about the experience of caregivers' rest. The strategies that caregivers use to relieve the burden, however, are not fully known., Method: A qualitative approach was used influenced by the work of Charmaz's constructivist grounded theory. Twenty-three female primary caregivers of relatives with advanced dementia participated in semi-structured interviews between November 2006 and March 2009 in Spain. Data collection was guided by the emergent analysis and ceased when no more relevant variations in the categories were found., Findings: Taking leave from the life of care-giving is the general strategy that caregivers use to rest from their caregivers selves. The key issue is to be able to connect with a different world from that of care-giving. Three strategies that participants use to leave the life of care-giving follow: (1) Connecting with one's own life, (2) building moments of life in common with the sick relative and (3) keeping in touch with care-giving., Conclusion: To have respite from care-giving implies distancing oneself from the care-giving identity and reveals the caregiver's need for alternative selves to have true breaks from caring. Nurses are in a unique situation to foster respite as an inner experience., (© 2011 The Author. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.)

Reflexivity is an English term that Spanish speaking people have to assign a technical meaning. Reflexivity expresses the conscience of researchers conscience and refers to their connection with the study's situation. It is a process by which researchers step back to critically exam the effect they have on the study and the impact of their interactions with participants. The reflexive process is embedded in all research levels and is present in all the research phases, from the research question to fieldwork, from data analysis to writing the final report. Nevertheless, the question is not so much to engage in reflective activities but to be a reflexive researcher. Reflexivity is a human ability that is present during social interactions. For this reason it is present in qualitative research. A self inquirer can be addressed as it is constructed by the relationships and interactions that are established with study participants. Reflexivity has an educational character that continues after the study is completed., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Aim: This paper is a report of a study conducted to identify the conditions that favour the relief of the burden of female caregivers of relatives with advanced dementia., Background: Respite services are a response to caregivers' needs for rest. Although they are wanted and needed services, caregivers do not always have access to or use them. The need for a caregiver-centred approach to relieving the burden of care is a conclusion which respite researchers are increasingly reaching., Method: Grounded theory was chosen as the research strategy. Twenty-two female primary caregivers of relatives with advanced dementia participated in semi-structured interviews between November 2006 and May 2008 in Spain. Data collection was guided by the emergent analysis and ceased when no more relevant variations in the categories were found., Findings: While having a rest is legislated as a right in civil and religious laws in family care in Spain, it should meet certain conditions that in the caregiver's eyes legitimate it. In the present study these were: (i) when there is no abandonment, (ii) when others are not harmed, (iii) when having a rest is obligatory and (iv) when having a rest is acknowledged., Conclusion: Many caregivers experience ambivalence over accepting respite. Nurses should assess caregivers' situations and promote context-specific interventions and a relief of burden free from guilt. Exploration of the conditions that favour the relief of burden within other cultural and caregiver groups is recommended.

Objective: To understand caregivers' experience of rest., Method: We performed a qualitative study guided by grounded theory procedures. This study forms part of a wider study about burden relief in vulnerable situations. Seventeen women family caregivers of patients with advanced dementia were purposely sampled. Data were collected with 17 semi-structured interviews and were analyzed following grounded theory procedures., Results: Caregivers did not rest as previously, with rest being incomplete and depending on the well-being of the sick relative. In this study, tranquillity emerged as the central element of this new experience of rest. Rest was perceived as an interpreted experience involving organizational and emotional effort. Caregivers created and negotiated conditions that would provide the tranquillity to be able to rest., Conclusions: The present study provides greater insight into the experience of relief from the burden of care and highlights the moral connotation present in family care. Identifying how caregivers rest and what subjectively enables them to do so will not only help healthcare professionals to support and promote rest, but will also help to avoid blaming caregivers for not being able or wanting to rest. Support services should bear in mind the change that has taken place in the experience of relief in caregivers' lives.

In Spain, care in dependency has traditionally fallen to family members but this situation is changing. The existence of a model based on the family's contribution used to enable dependent elders to remain at home; however, social changes such as the crisis of the informal caregiving system, which has been extensively discussed in the literature is leading to the collapse of this situation. In an attempt to respond to this crisis, society has resorted to contracting immigrant women to carry out family care. Responsibility and caregiving is thus transferred to these women and is financially remunerated. Thus, family caregiving of the elderly provided by immigrants is presented as an important resource for care. The care of dependent elderly individuals is often the only opportunity for immigrant women who arrive in Spain in search of better conditions to become incorporated into the labor market. The dispersion of studies on immigrant care highlights the invisibility of this phenomenon. Based on a literature review, the present study highlights the situation of the family care provided by immigrant women and outlines the characteristics of this type of care. The relationship between caregiving and the conditions in which this care takes place is described. Given their situation, immigrant caregivers have a heavy burden of care and limited respite from caregiving responsibilities.

A qualitative research question reflects the researcher's paradigm and should be consistent with the proposed research method. A research question implies engaging in a process that defines the research area, subject, question, and place of the study. Because this process is interactive and changes during the course of the investigation, the beginnings are necessarily provisional. The qualitative research question is constructed, is central to the research process, and differs from what is commonly expected of a research question. Once formulated, the pertinence of the research question must be argued. Justifying a study does not imply an exhaustive literature review, but rather a selective one, by selecting the data that support the need for the study and the relevance of the research question. In practice, constructing a research question involves two phases: a first phase of intuitive reasoning and a second phase of theoretical and practical reasoning. A qualitative study can be prompted by distinct factors, common ones being personal experience, conversations with colleagues, lines of research, and the library.

To care for someone who suffers a chronic disease is a very complex activity which implies more than a strict medical aspect. The families affected, especially those from the lower income brackets, must confront difficult situations; for the majority of these families, enrolling the ill patient in a residential treatment center is not an option and as time passes, these families will depend on their own aid mechanisms more and more; this makes this family care situation a public health affair and one for nurses in particular. This article shows how these caretakers are active creators of a world which provides them with the resources to deal with the daily care of these patients.

The authors reveal the findings of an qualitative investigation on teenage pregnancy. Their data came from 21 semi-structured interviews with pregnant teenagers. The analysis of this data followed the procedures set forth in tested theories. This study reveals that the nature of the interplay a teenager who gets pregnant is that of a serious love affair in which the ideas of romantic love and the rules of that genre guide their behavior. This is the social milieu in which youths live and where they construct their identifies. Sexual relations are part of the natural course of a love affair since they link sex with love. This is not an easy love affair; it develops under unstable conditions. The aspects revealed by this study show the difficulties which surround conventional anti-conceptive practices. The authors hope this study serves as a guide, as orientation, in order that promotional and preventative compaigns become relevant, meaningful and acceptable to youths.

Objective: To describe, from the patients' point of view, the process they follow from the moment they face a symptom until they seek medical help., Material and Methods: Findings reported here are part of a qualitative study on the health of women from Colombia. Data were collected by semistructured interviews. The analysis was guided by grounded theory., Results: When facing a symptom, women first evaluate it, then weigh their own capacities and assess their options, and last, they chose who might help them. These three stages form part of the process followed to seek medical help., Conclusion: Health professionals should be sensitive to patients' subjective experience and acknowledge their role in the diagnostic process and in health care.