Photovoice: An active learning tool with community nursing students

OBJECTIVE

To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community.

METHODS

A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data.

RESULTS

Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action".

CONCLUSIONS

Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.

Factors that affect the health of immigrants: Qualitative meta synthesis

BACKGROUND

Migration has challenged society. Most people who move do so for economic reasons, but others move for more tragic reasons. The proportion of female migrants was slightly higher than that of male migrants, partly due to the longer life expectancy of women and the higher demand for female migrants in care-related Jobs. The process may affect migrants' health, particularly in countries where healthcare is associated with high economic costs or insurance availability. A global systematic review of qualitative studies with meta-synthesis was conducted. The results can be used to support health policy and clinical practice.

OBJECTIVE

To describe how migrants perceive and experience the process of migrating and how it affects their health.

SEARCH STRATEGY

Databases consulted were Medline, PsychInfo, Cuiden, Cinahl, WOS, Scopus, Social Science Database, and Epistemonikos. Thirty-four articles were selected for final meta-synthesis.

INCLUSION CRITERIA

All qualitative primary studies were included that describe the experiences or perceptions of migrants and refugees over 18 years that talk about their migration process and the impact on their health; written in English or Spanish between 2016 and 2021. Articles referring to second generations and those dealing with pathologies that pre-date the migration process were excluded.

DATA EXTRACTION AND SYNTHESIS

The COREQ and JBI templates were used as quality criteria. Studies mostly used a phenomenological methodology and in-depth interviews, both individual and group, were used for data collection and narrative synthesis.

MAIN RESULTS

Uncertainty emerges as a main category. Three other interrelated themes have a direct impact on migrants' health: Language, Social Networks and Work. There are several conditions in each of these that have a positive or negative impact on health. The gender condition appears in both work and social networks, positively and negatively.

DISCUSSION AND CONCLUSIONS

Health would be improved by having a stable job, which would facilitate access to health resources. Social networks and language are facilitators of access to a better job, but not the only condition. From a gender perspective, social networks can become a source of health problems, especially for women. The process of migration places women in a position of vulnerability due to the difficulties of reconciling family and work life. Job insecurity, workload, loss of family life or social isolation increase hopelessness and anxiety, leading to health problems.

PUBLIC OR PATIENT CONTRIBUTION

As an academic review study, no patient contribution was required, and this study serves as a theoretical framework for more in-depth research that will work with migrant populations. As a public contribution, this work provides evidence of the need to improve access to health for some populations, in line with the Sustainable Development Goals (SDGs) set for 2030.

Perception of care from the perspective of nursing students: A study using photovoice, storytelling and poetry

BACKGROUND

The Higher Education in Nursing requires providing students with skills such as critical and reflective thinking about the actions to be carried out so that they are capable of providing humanised and quality care in an increasingly complex and technified society. Participatory teaching methodologies promote the development of these skills.

OBJECTIVES

to explore the potential of photovoice, storytelling and poetry as instruments capable of encouraging reflection. To identify through images (photovoice) and poetic narratives (storytelling and poetry) the perception that students of the nursing degree express about nursing care.

DESIGN

qualitative study in the framework of the socio-critical paradigm, using photovoice, storytelling and poetry in the field of care.

PARTICIPANTS

first-year undergraduate nursing students at two Spanish universities in the academic year 2021-2022.

METHODOLOGY

48 images were shown and students were asked to select one, write a narrative and generate a short poem connected to the image. Subsequently, a content analysis was conducted of those poems evoked by the five photographs most chosen by the students. The analysis was supported by qualitative data analysis software. A total of 67 contributions from 67 students were analysed.

RESULTS

the concepts addressed in the poems and the compositions generated reveal how critical humanist thinking and reflection on the subject of care developed. The topics identified were care, accompaniment throughout the life cycle, working on the basis of values and caring for small details as subcategories of nursing care.

CONCLUSION

The combination of different tools in university education has encouraged reflection and enabled students to identify for themselves the importance of humanised care. Working on the theoretical foundation in an active way can reduce the gap between theory and practice and foster the empowerment of the nursing identity.

[Reacciones de las mujeres ante el folleto del Programa de Detección Precoz del Cáncer de Mama.]

OBJECTIVE

Breast cancer screening (BCS) leaflets are important for outreach and dissemination of BCS programs. Knowing how women perceive these leaflets is relevant to better understand their attitude towards BCS. The objective of this paper was to explore women's reactions regarding BCS leaflet.

METHODS

A simple descriptive qualitative design was performed involving women aged between forty and sixty years of age in Asturias (Spain). Twenty-six semi-structured interviews were conducted with women of different socioeconomic profiles in 2018. Thematic analysis was carried out.

RESULTS

Reading the leaflet elicited positive emotions such as peace of mind, well-being or gratitude, in addition to fear or anxiety. The women expressed various beliefs about breast cancer (highly prevalent and high survival rates), about BCS (a program aimed at prevention, a normative activity among their peers) and about the relevant role of health services and the media. Ambivalent attitudes towards BCS were detected, related to emotions.

CONCLUSIONS

The emotional response after reading the brochure is ambivalent, although most of the women express positive emotions. Women compare the information with previous beliefs, especially regarding breast cancer (BC) and BCS. It is important to understand how certain emotions (especially negative ones) are closely related to the attitude towards BCS.

Nursing Students' Perception about Gender Inequalities Presented on Social Networks: A Qualitative Study

During the COVID-19 pandemic, gender inequalities in nurses have been exacerbated through the images shown on social networks. This study aimed to explore and describe nursing students' experiences and perceptions about gender inequalities in nurses during the COVID-19 pandemic. A descriptive qualitative study was carried out in two universities in 264 undergraduate nursing students. The photovoice method was used to guide the study. Results: Two main categories and four subcategories were described from the data: "gender-related stereotypes", with "male leadership in a female profession" and "sexualization of female nurses" and "women's vulnerability in the pandemic" with "the gender gap in the face of increased risk of contagion " and "women's emotional fragility". Over the years, care has been considered a female task, and nursing continues to be thought of in this way. The nurse has been discriminated against, poorly considered as a professional, and, as a woman, subjected to gender roles.

The Feelings of Nursing Students during the COVID-19 Confinement: Narrative-Based Nursing and Poetry-of-Care Perspectives

(1) Background: Experiences involve feelings, which, in turn, produce meaning that can become a subjectively lived experience. Therefore, the study of experiences and feelings is essential.

INTRODUCTION

We examined the role of narrative-based nursing (NBN) and the poetry of care (PC).

OBJECTIVE

To reflect upon the emotions and feelings experienced by nursing students during confinement induced by COVID-19. (2) Methods: This is a qualitative study with a focus on reflexive anthropology, NBN, and PC.

SETTING AND PARTICIPANTS

The non-probabilistic sample of incidental, casual, or accessibility type. It consists of 198 students completing their first degree in nursing (the academic year of 2019-2020) of the University of Alicante. (3) Results: Three main categories were considered in the research: For the 'first day', 21 subcategories were identified, and uncertainty was the most frequently noted feeling. For the 'most significant day', 22 subcategories were found, with the explosion of feelings being the most frequent. For the 'last day', 15 subcategories were recorded, with the feeling of relief being the most common.

CONCLUSIONS

The NBN and PC are relevant therapeutic tools that facilitate reflection and promote awareness of feelings.

The Impact of COVID-19 Pandemic on Health Inequities: A Photovoice Study With Nursing Students

INTRODUCTION

The COVID-19 pandemic has an amplified impact on vulnerable populations. Also, aspects related to health inequalities are insufficiently taught in higher education. This study aims to promote reflection in nursing students on the impact of the COVID-19 pandemic on vulnerable populations affected by health inequities.

METHODOLOGY

A photovoice method was used. Undergraduate nursing students (Spain and United Kingdom) took and explained photographs using SHOWED models.

RESULTS

108 students participated. Two-domain summary themes were created: The COVID-19 pandemic has impacted ethnic minorities and socioeconomically vulnerable groups, and Proposals to respond to the negative impact on ethnic minorities and socioeconomically vulnerable groups.

DISCUSSION

The students identified negative health scenarios by linking COVID-19 with aspects of work, salary, and housing of these two specific populations. Holistic actions were also proposed to protect their health. As future health professionals, they must recognize these communities and work to eliminate inequalities.

Violence in Dating Relationships: Validation of the CADRI Questionnaire in a Young Adult Population

Dating violence in the young adult population is reaching alarming levels. However, the instruments used to measure it and their results are still heterogeneous. The main aim of this study was to validate the Conflict in Adolescent Dating Relationships Inventory questionnaire for a young adult Spanish university population aged between 19 and 25 years old, and to describe the types of violence perpetrated and suffered.

MATERIAL AND METHODS

Observational, descriptive, cross-sectional study. A validity analysis was carried out through a confirmatory factor analysis. The relative frequencies for each type of violence and the Chi2 test for two dichotomous variables were used to describe the different types of violence perpetrated and suffered.

RESULTS

The sample consisted of 976 young adults aged 19-25 years old (M = 21.7 years. SD = 1.8). The confirmatory factor analysis had an adequate structure and a good fit to the model. The types of violence perpetrated and suffered were described according to the sex of the participants, with significant differences found for verbal-emotional violence and physical violence exerted.

CONCLUSIONS

The confirmatory factor analysis allowed us to consider the application of the questionnaire to be correct for the study population.

Baby-led weaning: Health professionals 'knowledge and attitudes and parents' experiences from Spain. A mixed methods approach

Baby-led weaning or self-regulated small chunk feeding by the baby has emerged as an alternative to the traditional method of complementary feeding. Parents and healthcare professionals often differ in the benefits and drawbacks about it. The research aims were to describe the knowledge of health professionals about complementary feeding and baby-led weaning (BLW) method and the attitudes towards its recommendation, and to explore the knowledge, experiences and attitudes of parents who have used this method to feed their children. A mixed methods research was carried out. A questionnaire was completed by 38 health professionals and 10 interviews were conducted with participating mothers. A total of 52.6% of health professionals recommended initiating complementary feeding at 6 months of age, a guideline followed by the mothers who used BLW. Some 86.8% of the professionals knew the BLW method and 76.3% knew its benefits, but the mothers consulted mainly informal sources of information sources to learn about and implement it. The health professionals stated that it facilitated family transition, enabled the infant to adapt better to flavours and textures, promoted chewing and the development of fine motor skills, improved growth and might also be a protective factor against obesity. The mothers noted that the method was natural, encouraged infant autonomy and promoted healthy eating habits. The health professionals expressed varied opinions concerning the risks entailed in the method. The main conclusions are that the majority of health professionals participating in the study know the BLW method, its benefits; however, they do not recommend it in all cases. Mothers listen to the advice of professionals but continue to rely on other informal sources of information.

Photovoice and dramatisation in the classroom with nursing students: An exploratory study to raise awareness of the cultural and social dimensions of violence against women

BACKGROUND

Active teaching methodologies that incorporate students' feelings and beliefs and encourage them to reflect upon and critically think about certain variables, are extremely useful to teachers.

OBJECTIVE

To explore the potential of dramatisation and photovoice technologies as instruments to stimulate nursing students to reflect upon violence against women in society, thereby encouraging critical thinking and debate in a participatory way.

DESIGN

This was a qualitative, descriptive-exploratory study which used the participatory action research approach.

PARTICIPANTS

Forty fourth-year students enrolled in the Nursing undergraduate degree at the University of Alicante in Spain.

METHODS

The photovoice technique was used to record images from a dramatisation which served as the basis to represent scenes from the everyday life of people who are subjected to physical and psychological violence. These photographs were then debated and analysed by the students. We used MAXQDA® software and the guidelines published by Giorgi to aid our data analysis.

RESULTS

Four main categories emerged; the 'violence against women'. The 'victim' and 'abuser' categories considered 'emotions', 'feelings', 'attitudes', and 'behaviours'. The fourth category that emerged was 'social viewpoints'.

CONCLUSIONS

Photovoice-dramatisation raised awareness among the students and allowed them to reflect upon these behaviours and to critically think about the cultural and social dimensions of violence against women. The use of both of these techniques in practical and theoretical contexts to train students can help to nurture social commitment when faced with this problem.

Contribution of students to nursing practice settings during clinical training: Design and validation of a questionnaire

BACKGROUND

A validated questionnaire to measure the contributions of nursing students to clinical settings could potentially assist in the improved management of students in healthcare institutions.

AIM

To develop and test the psychometric properties of the questionnaire 'Nursing Student Contributions to Clinical Settings' (CEEEC, Spanish acronym for 'Contribuciones de los Estudiantes de Enfermería a los Entornos Clínicos').

DESIGN

Instrument design and psychometric testing.

PARTICIPANTS/SETTINGS

A multicentre study involving 1,098 nursing professionals from three universities and five hospitals of Spain, between January 2019 and March 2020.

METHODS

The study was carried out in two phases. Phase 1 involved the questionnaire design by experts (n = 28), which required a review of the available literature, cognitive interviews and Delphi rounds, and a preliminary validity study, which included a pilot test with responses from a sample of nurses (n = 143). Phase 2 involved a formal validation with a wider sample of nurses (n = 927), including factor analysis and a study of convergent validity with the Practice Environment Scale-Nursing Work Index and Health Sciences-Evidence Based Practice.

RESULTS

Experts selected 42 items on student contributions. After cognitive interviews, three items were eliminated and seven failed to reach the minimum content validity index (78%). Based on the remaining 32 items, the discrimination index of each item was calculated, and those with <0.3, eight items were sequentially eliminated. The resulting questionnaire contained 24 items grouped into a single factor, which explained 41% of the variance. The internal consistency was excellent (Cronbach's alpha: 0.94), and the convergent validity was confirmed.

CONCLUSIONS

A 24-item questionnaire was designed and validated to measure the contributions of nursing students to clinical practice settings.

IMPACT

Most hospitals are also teaching centres where nursing students undergo clinical practice. The application of this test will provide insight into the nursing professionals' perception of the students' role.

Emotions, Feelings, and Experiences of Social Workers While Attending to Vulnerable Groups: A Qualitative Approach

Social workers in the community setting are in constant contact with the suffering experienced by the most vulnerable individual. Social interventions are complex and affect social workers’ emotional well-being. The aim of this study was to identify the emotions, feelings, and experiences social workers have while attending to individuals in situations of vulnerability and hardship. A qualitative methodology based on hermeneutic phenomenology was used. Six interviews and two focus group sessions were conducted with social workers from the community social services and health services of the Andalusian Public Health System in the province of Almería (Spain). Atlas.ti 8.0 software was used for discourse analysis. The professionals highlighted the vulnerability of certain groups, such as the elderly and minors, people with serious mental problems, and people with scarce or no economic resources. Daily contact with situations of suffering generates a variety of feelings and emotions (anger, sadness, fear, concern). Therefore, more attention should be paid to working with the emotions of social workers who are exposed to tense and threatening situations. Peer support, talking, and discussions of experiences are pointed out as relevant by all social workers. Receiving training and support (in formal settings) in order to learn how to deal with vulnerable groups could be positive for their work and their professional and personal quality of life.

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model

BACKGROUND AND PURPOSE

The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice.

PURPOSE

To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger's Sunrise Model.

METHODS

Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care.

RESULTS

Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company).

IMPLICATIONS FOR PRACTICE

The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.

Using Photovoice to stimulate critical thinking: An exploratory study with Nursing students

Objective:

to explore the potentialities of the Photovoice methodology to stimulate critical thinking on Social Determinants of Health.

Method:

an exploratory and descriptive study with a qualitative approach, using different steps of the Photovoice methodology. Nursing students obtained photographs in their community, showing Social Determinants of Health, analyzed and classified the photographs, and exposed the results in the Nursing school. The students answered a questionnaire writing their perceptions. The data collected from the questionnaires were qualitatively analyzed.

Results:

91 students participated in the study. Two main categories emerged from the data: Photovoice is a good methodology to stimulate critical thinking on Social Determinants of Health, and Photovoice is a good methodology to stimulate other skills (expressing beliefs and perceptions, stimulating creativity, developing research skills, strengthening ties with colleagues, and attracting attention).

Conclusion:

we explore the potentialities of the Photovoice methodology. It can be an original, simple and economical tool to stimulate critical thinking on Social Determinants of Health, and to stimulate other skills. Photovoice can be considered in teaching about aspects related to health/care in Nursing students, in order to promote critical thinking of future agents for a change in health.

Perceptions and wishes about delivery of full-term pregnant women in Zamora

OBJECTIVE

To describe perceptions and wishes regarding childbirth in a group of full-term pregnant women in Zamora.

METHOD

Qualitative study of phenomenological character. Participants and scope of study: pregnant women (37-38 weeks), Zamora Sur and Santa Elena health centres (Zamora, Spain).

DATA COLLECTION

semi-structured interviews, until data saturation (16 interviews).

DATA ANALYSIS

analysis of thematic content.

RESULTS

The maternal feelings varied from joy to fear or stress. The interviewees said they did not feel capable of enduring the pain of childbirth. The needs that they felt most important were having support and accompaniment during delivery (especially of their partner) and receiving good treatment from the healthcare workers.

CONCLUSIONS

The importance and repercussion of childbirth for women are not only biological, but also largely mental, emotional and social. It is conditioned by multiple factors: maternal feelings, their ability to deal with the pain of childbirth, their needs, the changes they have made, the support they have and the health professionals who care for them.

Social Network Analysis and Resilience in University Students: An Approach from Cohesiveness

The Social Network Analysis offers a view of social phenomena based on interactions. The aim of this study is to compare social reality through the cohesion variable and analyse its relationship with the resilience of university students. This information is useful to work with the students academically and to optimise the properties of the network that have an influence in academic performance. This is a descriptive transversal study with 90 students from the first and third year of the Nursing Degree. Cohesion variables from the support and friendship networks and the level of resilience were gathered. The UCINET programme was used for network analysis and the SPSS programme for statistical analysis. The students' friendship and support networks show high intra-classroom cohesion although there are no differences between the support networks and friendship or minimal contact networks in both of the courses used for the study. The network cohesion indicators show less cohesion in the third year. No correlations were found between cohesion and resilience. Resilience does not appear to be an attribute related to cohesion or vice versa.