Lorena Saletti-Cuesta

Diferencias de género en la percepción del logro profesional en especialistas de medicina familiar y comunitaria

BACKGROUND The concept of achievement is important to study the professional development. In medicine there are gender inequalities in career. The purpose was to know and compare the professional achievements perceptions and attributions of female and male primary care physicians in Andalusia. METHOD Qualitative study with 12 focus groups (October 2009 to November 2010). POPULATION primary care physicians. SAMPLE intentionally segmented by age, sex and health care management. Were conducted by sex: two groups with young physicians, two groups with middle aged and two with health care management. TOTAL: 32 female physician and 33 male physicians. Qualitative content analysis with Nuddist Vivo. RESULTS Female and male physicians agree to perceive internal achievements and to consider aspects inherent to the profession as external achievements. The most important difference is that female physician related professional achievement with affective bond and male physician with institutional merit. Internal attributions are more important for female physician who also highlight the importance of family, the organization of working time and work-family balance. Patients, continuing education, institutional resources and computer system are the most important attributions for male physician. CONCLUSIONS There are similarities and differences between female and male physicians both in the understanding and the attributions of achievement. The differences are explained by the gender system. The perception of achievement of the female physicians questions the dominant professional culture and incorporates new values in defining achievement. The attributions reflect the unequal impact of family and organizational variables and suggest that the female physicians would be changing gender socialization.

Validación de escala para evaluar la relación familia-trabajo en médicas y médicos de familia

Background: Studying the work-family relationships is important because it affects the personal and professional life. Women increases in medicine without redistribute domestic tasks and responsibilities. The purpose of this study was to create and validate a scale of work-family relations in women and men family physician (FP) in Andalusia. Methods: Cross sectional and multicenter study. The study population were FP of urban primary care centres, sample=500FP (50% by sex). We studied: sex, age, postgraduate family medicine specialty, care burden (2 variables), and family burden (7 variables). We design, and included in self-administered questionnaires, a scale of 13 questions on work-family relations. Bivariate analysis, exploratory factor and multiple regressions to test the convergent validity was performed. Results: The response rate was 73.6%. We identified two dimensions, Overloading and Family Support Deficit (OFSD) (5 questions), and Work-Family Conflict (WFC) (6 questions), in both, female FP score higher than their peers. There are more family variables associated with both dimensions in female FP, it expresses differences in the complexity of the causes of OFSD and WFC by sex. Conclusion: The scale obtained is valid, reliable and gives two empirical dimensions of family-work relationships.BACKGROUND Studying the work-family relationships is important because it affects the personal and professional life. Women increases in medicine without redistribute domestic tasks and responsibilities. The purpose of this study was to create and validate a scale of work-family relations in women and men family physician (FP) in Andalusia. METHODS Cross sectional and multicenter study. The study population were FP of urban primary care centres, sample=500FP (50% by sex). We studied: sex, age, postgraduate family medicine specialty, care burden (2 variables), and family burden (7 variables). We design, and included in self-administered questionnaires, a scale of 13 questions on work-family relations. Bivariate analysis, exploratory factor and multiple regressions to test the convergent validity was performed. RESULTS The response rate was 73.6%. We identified two dimensions, Overloading and Family Support Deficit (OFSD) (5 questions), and Work-Family Conflict (WFC) (6 questions), in both, female FP score higher than their peers. There are more family variables associated with both dimensions in female FP, it expresses differences in the complexity of the causes of OFSD and WFC by sex. CONCLUSION The scale obtained is valid, reliable and gives two empirical dimensions of family-work relationships.

Identifying patient‐centred recommendations for improving patient safety in General Practices in England: a qualitative content analysis of free‐text responses using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS‐PC) questionnaire

There is a growing interest in identifying strategies to achieve safer primary health‐care provision. However, most of the research conducted so far in this area relies on information supplied by health‐care providers, and limited attention has been paid to patients’ perspectives.

Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes: un análisis de género

Fundamentos: En atencion primaria se han identificado diferencias de practica segun sexo del profesional y, simultaneamente, existen desigualdades de genero en la asignacion de recursos sanitarios, aspectos ambos que suscitan un interes creciente en la gestion y provision de servicios de salud. El objetivo del estudio es conocer si existen diferencias de practica en las derivaciones sanitarias realizadas por medicas y medicos de familia (MF) de centros de salud de Andalucia, si existen desigualdades en las derivaciones recibidas por hombres y mujeres, y si existe interaccion sexo de profesional sexo de paciente. Metodos: Estudio transversal y multicentrico. Poblacion: MF de 4 distritos sanitarios (DDSS). Muestra: 382 MF. Variables: tasa de derivaciones por visita (TDxV), tasa de derivaciones por cupo (TDxC), sexo de paciente; sexo, edad, y formacion postgraduada en medicina familiar de MF, tamano del cupo por sexo, media de visitas/paciente por sexo, edad media del cupo por sexo, y proporcion de hombres en el cupo; centro de salud urbano/rural, tamano del equipo, poblacion adscrita y acreditacion docente. Fuentes: bases de datos de los DDSS. Analisis estadistico: descriptivo. Bivariante y multivariante mediante analisis multinivel de la TDxV con modelo mixto de Poisson. Resultados: En 2010 los/as 382 MF realizaron 129.161 derivaciones a especialistas. La TDxC fue 23,47 y la TDxV es 4,92. Las TDxC de las medicas fue 27,23 en mujeres y 19,78 en hombres y las de los medicos 27,37 en mujeres y 19,51 en hombres. La TDxV de las medicas fueron 4,92 en mujeres y 5,48 en hombres y para los medicos 4,54 y 4,93 respectivamente. Conclusiones: No existen diferencias en las derivaciones segun sexo de MF, sin embargo, existen indicios de que las mujeres son menos derivadas. No existe interaccion sexo profesional-sexo paciente.

Understanding informal carers' experiences of caring for older people with a hip fracture: a systematic review of qualitative studies.

Abstract Purpose: This systematic review aimed to reconceptualize experiences from a variety of papers to provide direction for research, policy and practice. Method: Meta-ethnography was used to inform the review, and 21 studies were included. Findings: The analysis identified a core theme of “engaging in care: struggling through”, as carers, who wanted to be involved in caring, learnt to live with the intense and stressful impact of caring and changes to their life. The core theme is represented through three themes (1) Helping another to live, (2) Adapting ways of living and (3) Negotiating the unknown. Conclusions: The discussion identified a focus on carers of people suffering from a hip fracture, the willingness of informal carers to engage in caring and the intense experience of adapting to changes in relationships and dependency alongside a steep experiential learning curve. Tensions exist in negotiations with complex health care systems as carers do not feel their expertise is valued and struggle to find and understand information. Implications for Rehabilitation Including relatives/carers in the umbrella of care within a family-centred approach. Involving relatives/carers within shared decision-making about care requirements and rehabilitation goals. Utilizing forms of experiential learning to help the development of relatives/carers skills in relation to their role as carer. Providing opportunities for carers to explore ways of sustaining their own health through self-compassion.