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      Rol de cuidadores migrantes de mayores dependientes y opinión de la asistencia sanitaria en atención primaria Translated title: Role of migrant caregivers of dependent elderly and opinion of health care in Primary Care

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          Abstract

          RESUMEN Objetivo: Describir el proceso de experiencias de vida de las personas migrantes que se convierten en cuidadores de mayores en situación de dependencia y conocer su opinión de la asistencia sanitaria. Diseño: Investigación cualitativa fenomenológica basada en la metodología de la teoría fundamentada. Realizado en el distrito sanitario Málaga-Guadalhorce durante 2017 y 2018. La captación se realizó mediante las enfermeras de familia de los centros de salud y a través de la base de datos de programas de atención domiciliaria de siete centros de salud. Se realizaron 17 entrevistas en profundidad a cuidadores migrantes que llevan cuidando un año o más a personas dependientes, hasta la saturación de la información. Resultados: En este estudio se han descrito tres fases: fase inicial, la persona siente la necesidad de cambio y motivación para venir; segunda fase, búsqueda de trabajo en nuestro país y asunción de nuevas actividades; tercera fase, estrategia de afrontamiento e incertidumbre por expectativas de futuro. Manifiestan mejoras en salud en relación con: tiempos reducidos de consulta, dificultad para ver especialistas, falta de regularidad en las visitas médicas en domicilio y discriminación sufrida por ser migrante. Conclusión: Los migrantes traen experiencia en el cuidado de sus diferentes culturas que deben ser exploradas. El refuerzo positivo de los empleadores, salarios y tiempo libre han sido condicionantes de mejora de satisfacción laboral y apoyo social. Lo mejor valorado del servicio sanitario son las visitas domiciliarias por el refuerzo positivo. Al mismo tiempo se quejan de que no reciben todas las que necesitan. Los profesionales deben realizar intervenciones en cada fase para facilitar la adopción de este rol, tratar de solucionar los problemas que surjan e informar a los organismos de salud de nuestra comunidad autónoma sobre dónde están los puntos débiles que deben mejorarse y de qué puntos fuertes partimos.

          Translated abstract

          ABSTRACT Objective: To describe the process of life experiences of migrants who become caregivers of elderly people in situations of dependency and to know their opinion about health care. Design: Phenomenological qualitative research based on the methodology of grounded theory. Carried out in the Málaga-Guadalhorce health district, during 2017 and 2018. Recruitment was carried out by nurses from families in the Health Centers and through a database of home care programs, from seven health centers. 17 in-depth interviews were carried out with migrant caregivers, who have been caring for a year or more, dependent people, until the saturation of the information. Results: Three phases have been described in this study. In the initial stage the person feels the need for change and motivation to come; second stage of job search in our country and assume new activities; third stage of coping strategy and uncertainty for future expectations. They show improvements in health in relation to: reduced medical consultation time, it is difficult to consult with specialists, lack of regularity in home doctor visits and discrimination suffered by being a migrant. Conclusion: Migrants bring experience in caring for their different cultures that must be explored. The positive reinforcement of employers, salaries and free time have been conditions for improving job satisfaction and social support. What they value most in the health service are home visits for positive reinforcement, at the same time they complain that they do not receive all they need. Professionals should make interventions at each stage to facilitate the adoption of this role.

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          Developing and implementing a triangulation protocol for qualitative health research.

          In this article, the authors present an empirical example of triangulation in qualitative health research. The Canadian Heart Health Dissemination Project (CHHDP) involves a national examination of capacity building and dissemination undertaken within a series of provincial dissemination projects. The Project's focus is on the context, processes, and impacts of health promotion capacity building and dissemination. The authors collected qualitative data within a parallel-case study design using key informant interviews as well as document analysis. Given the range of qualitative data sets used, it is essential to triangulate the data to address completeness, convergence, and dissonance of key themes. Although one finds no shortage of admonitions in the literature that it must be done, there is little guidance with respect to operationalizing a triangulation process. Consequently, the authors are feeling their way through the process, using this opportunity to develop, implement, and reflect on a triangulation protocol.
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            Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race

            Introduction This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). Methods The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005–2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. Results Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. Conclusions SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.
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              The discovery of grounded theory: strategies for qualitative research

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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2021
                : 32
                : 2
                : 76-83
                Affiliations
                [5] Málaga orgnameC.S. La Luz España
                [1] Andalucía orgnameUniversidad de Málaga orgdiv1Facultad Ciencias de la Salud Spain
                [10] Málaga orgnameC.S. Delicias España
                [6] Virgen de la Victoria, Málaga orgnameHospital Clínico Universitario Málaga España
                [8] Málaga orgnameDistrito Sanitario Málaga-Guadalhorce orgdiv1C.S. Victoria España
                [9] Málaga orgnameC.S. Portada alta España
                [12] Málaga orgnameUnidad de Residencia Málaga-Guadalhorce España
                [4] Alhaurín de la Torre Málaga orgnameC.S. Alhaurín de la Torre España
                [3] Málaga orgnameC.S. Torcal-San Andrés España
                [11] Andalucía orgnameUniversidad de Málaga Spain
                [2] Andalucía orgnameUniversidad de Málaga Spain
                [7] Andalucía orgnameUniversidad de Málaga orgdiv1Facultad Ciencias de la Salud Spain
                Article
                S1134-928X2021000200076 S1134-928X(21)03200200076
                ad70a819-b4b4-4ee5-891f-6b98119eede5

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 18 June 2019
                : 07 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 8
                Product

                SciELO Spain

                Categories
                Originales

                human migration,qualitative research,delivery of health care,Caregivers,prestación de atención de salud,migración humana,Cuidadores

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