The problem of nurses' professional identity continues to be seen in the disjunction between theoretical training and clinical placements. Moreover, it is not known how nursing students perceive these contradictions or how this discrepancy influences the construction of professional identity. To gain insight into nursing students' perception of their theoretical and practical training and how this training influences the process of constructing their professional identity. Qualitative, ethnographic study. Third-year nursing students at the l'Escola Universitària d'Infermeria Vall d'Hebron de Barcelona. Participant observation was conducted in the hospital setting and primary care. Discussion groups were held. The constant comparative method was used for the analysis. The study adhered to the criteria of credibility, transferability, dependability and confirmability. Students believed that both theoretical and practical trainings were indispensable. Nevertheless, clinical placements were considered essential to confer sense to the theory and to shape their identity, as they helped student nurses to experience their future professional reality and to compare it with what they had been taught in theoretical and academic classes. The role of the clinical placement mentor was essential. With regard to theory, the skills developed in problem-based learning gave novice nurses' confidence to approach the problems of daily practice and new situations. Equally, this approach taught them to reflect on what they did and what they were taught and this ability was transferred to the clinical setting. For students, both strategies (theory and practice) are vital to nursing education and the construction of a professional identity, although pride of place is given to clinical placements and mentors. The skills developed with problem-based learning favor active and reflective learning and are transferred to learning in the clinical setting.
The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42–3.30) and asthma (IRR: 2.05, 95% CI: 1.76–2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03–1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme.
Aims and Objectives: To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated.Background: Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient.Design: We conducted a qualitative descriptive study, using semi‐structured interviews. This research adheres to the COREQ guidelines and checklist.Methods: We carried out 18 semi‐structured face‐to‐face interviews with pregnant women, using intentional sampling and thematic analysis.Results: We identified an overarching theme, ‘factors that influenced participants’ decision to be vaccinated or not’, which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants’ decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse‐midwives were the most important factors encouraging vaccination. Participants trusted their nurse‐midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests.Conclusions: The convictions and actions of the nurse‐midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women.Relevance to clinical practice: Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse‐midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns.
The process of international migration causes a situation of vulnerability in people’s health and greater difficulty in coping with disease. Furthermore, the adversities suffered during migration can trigger reactive signs of stress and cause anxious, depressive, confusional and somatic symptoms. This article studies the relationships between psychosocial risk, psychological distress and somatization in immigrants from four communities: Maghrebis, Sub-Saharans, South Americans and South Asian. A cross-sectional study was carried out with questionnaires on 602 immigrants who were surveyed in the primary care centers of an urban area of Catalonia. The instruments used were the Demographic Psychosocial Inventory (DPSI), the Brief Symptom Inventory (BSI) and the Somatic Symptom Inventory (SSI). The average psychosocial risk obtained was 0.35, with the highest values in the Sub-Saharan community. Psychological distress showed a mean value of 0.66, with the Sub-Saharan community scoring the lowest in all dimensions except depression. The average somatization values were 1.65, with the Sub-Saharan community scoring the least. The female gender is a risk factor for somatization and psychological distress. Perceived psychosocial risk is a predictor of psychological distress, but not somatization, suggesting that the use of more adaptive coping strategies could minimize the effect of the migration process on somatizations.