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Resumen Objetivo principal: Conocer la experiencia, el impacto percibido y el manejo de la experiencia de la reconstrucción de la vida cotidiana de los postcuidadores familiares después del proceso de duelo. Metodología: Se realizaron entrevistas en profundidad a 14 informantes que cuidaron a sus familiares durante más de 2 años y que dejaron de atenderlos más de 2 años antes. Los datos fueron recolectados durante un período de 13 meses en 2014-2015. El estudio se enmarca en la teoría fundamentada. Resultados principales: Se obtuvieron tres categorías a partir del análisis de los relatos: el vacío en el postcuidar, el fin del tiempo como cuidador y la transición hacia una nueva vida. Todos los informantes mencionan un vacío, marcado por el aumento del tiempo libre y la pérdida de sentido de su vida. Conclusión principal: Los postcuidadores experimentan una transición en la reconstrucción de su vida cotidiana, en la que el apoyo de los profesionales es esencial. Los postcuidadores pueden ser una fuente de apoyo para otros cuidadores. Abstract Objective: To know the experience, the perceived impact and the management of the experience of the reconstruction of the daily life of the family post-caregivers after the grieving process. Methods: In-depth interviews of 14 former caregivers who had cared for their relative for more than 2 years and who had stopped caring for them more than 2 years previously. Data were collected over 13 months in 2014-2015. The data analysis was performed using Grounded Theory. Results: Three categories were obtained from the data analysis: The emptiness in post-caring, the end of the time as a caregiver and the transition towards a new life. All the informants mention an emptiness but a new determining factor, the increase in free time, also emerges in the study. Within this increase in their free time, caregivers feel the need to occupy their time by becoming involved in caring for others. Conclusions: Former caregivers experience a transition in the reconstruction of their everyday life, in which support from professionals is essential. Former caregivers may be a source of support for other caregivers.

Introduction: Integrated care models aim to provide solutions to fragmentation of care by improving coordination. This study will evaluate the effectiveness of a new integrated care model (Salut + Social), which will promote the coordination and communication between social and healthcare services in southern Catalonia (Spain) to improve quality of life, adherence to treatment and access to medical services for patients with chronic conditions, and also to reduce caregiver burden. Additionally, we will evaluate the experience of caregivers, health professionals and social workers with the new model implemented. Methods and analysis: A clinical trial using mixed methodology will be carried out. The intervention consists of improving the coordination between the social and healthcare sectors during a 6-month period, by means of information and communication technology (ICT) tools that operate as an interface for the integrated care model. The study subjects are primary care patients with chronic health and social conditions that can benefit from a collaborative and coordinated approach. A sample size of 141 patients was estimated. Questionnaires that assess quality of life, treatment adherence, medical service and caregiver burden will be used at baseline and at 6, 9, and 12 months after the beginning of the study. The principal variable is quality of life. For statistical analysis, comparisons of means and proportions at different time points will be performed. A discussion group and semi-structured interviews will be conducted with the aim of improving the care model taking into account the opinions of professionals and caregivers. A thematic content analysis will be carried out. Ethics and dissemination: This study protocol has been approved by the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (code P17/100). Articles will be published in international, peer-reviewed scientific journals. Trial registration: Clinical-Trials.gov: NCT04164160.

CONTEXTO: Los cuidadores familiares construyen su vida en base su familiar. Una vez este que este se muere deben reconstruir su vida. OBJETIVO: Comprender la experiencia vivida de los postcuidadores familiares en la reconstrucción de su vida cotidiana desde la teoría de Afaf Meleis. MÉTODO: un estudio cualitativo basado en la Teoría fundamentada. El método de recogida de datos fue mediante entrevistas en profundidad a 14 postcuidadores familiares, durante el periodo entre junio de 2014 y diciembre de 2015 en la región de Cataluña (España). RESULTADOS: En el análisis de las entrevistas surgieron las categorías: rememorando la vida de cuidador, la transición del postcuidar y la nueva vida como postcuidador. Al profundizar en el análisis de los discursos se observó que los elementos que estructuraban la transición de los postcuidadores familiares coincidían con las bases teóricas de la Teoría de las Transiciones de Meleis. Se presenta un análisis de todos los elementos que componen la transición del postcuidar desde la Teoria de las Transiciones. CONCLUSIÓN: La teoría de las Transiciones posee un cuerpo de conocimientos que nos hacen comprensibles las situaciones que viven los postcuidadores y nos permiten comprender la diversidad de sus experiencias. CONTEXTO: Os cuidadores familiares constroem as suas vidas com base no seu familiar. Uma vez que este morre, estes devem reconstruir as suas vidas. OBJETIVO: Compreender a experiência vivida pelos pós-cuidadores familiares na reconstrução da sua vida quotidiana a partir da teoria de Afaf Meleis. MÉTODOS: Estudo qualitativo assente na teoria fundamentada. A colheita de dados foi realizada através de entrevistas em profundidade com 14 pós-cuidadores familiares, durante o período entre junho de 2014 e dezembro de 2015, na região da Catalunha (Espanha). RESULTADOS: A partir da análise das entrevistas emergiram as seguintes categorias: relembrando a vida de cuidador, a transição do pós-cuidar e a nova vida como pós-cuidador. Ao aprofundar a análise dos discursos verificou-se que os elementos que estruturavam a transição dos pós-cuidadores familiares coincidiam com as bases teóricas da Teoria das Transições de Meleis. Assim, apresenta-se uma análise de todos os elementos que compõem a transição do pós-cuidar a partir da Teoria das Transições. CONCLUSÃO: A Teoria das Transições apresenta um corpo de conhecimento que torna compreensíveis as situações vivenciadas pelos pós-cuidadores e permite compreender a diversidade das suas experiências. BACKGROUND: Family caregivers build their lives based on their relative. When he dies, they must rebuild their lives. AIM: To understand the experience of post-caregivers family in the reconstruction of their daily lives from the theory of Afaf Meleis. METHODS: A qualitative study based on grounded theory. The method of data collection was through in-depth interviews with 14 family post-caregivers during the period between June 2014 and December 2015, the region of Catalonia (Spain). RESULTS: When analyzing interview 3 categories emerged: remembering the life of the caregiver, the transition from post-care and new life as a post-caregiver. To deepen the analysis of discourses it was observed that the elements that structured the transition of post-caregivers family coincided with the theoretical basis of the Theory of Transitions Meleis. An analysis of all the elements that make the transition from post-care to the Transitions theory is presented. CONCLUSION: Transitions theory has a body of knowledge that makes us understandable situations experienced by post-caregivers and allows us to understand the diversity of their experiences.

Aims and objectives To identify which are the needs arised from feelings, perceptions and experiences of the family members during any time within the death process in an emergency service of an acute care hospital, with regard to the assistance received. Background The publications refer to the needs expressed by bereaved families, who explain the support they received right after the death of a relative in an emergency service, and during the months after the tragedy. Design Qualitative study drawing on grounded theory based on Charmaz (2006). Methods Ten interviews were conducted to a member of each family, who had been in an emergency service with a relative during any of the stages of the dying process. Data were collected from September 2015-June 2016. The analysis was made while data were being collected. Three types of codification were carried out: open, axial and selective. Theoretical saturation was achieved after data collection and analysis. Results Three thematic categories emerged: the power of information/communication (a), decisions taken by professionals within the dimension of caring (b) and the humanisation of death in emergency services (c). Conclusions The quality of the information given to families in the process of death in an emergency service affects to their satisfaction. Family support must be essential in a situation of death. Institutions must guarantee standards of practice, which include orientation on the care of people in bereavement, and the commitment to provide specialised attention those families. Relevance to clinical practice Research findings reveal the need to create changes within clinical practice, regarding how to take care of the family involved in a death process in an emergency service. From the needs detected by the participants, it could be possible to implement an interventional programme, which offers the relatives the emotional support they may need.

To identify associations between sociodemographic characteristics variables and competence levels of triage nurses in hospital emergency departments.Descriptive, cross-sectional, multicenter study of triage nurses in hospital emergency departments in the southwestern area of Catalonia (Ebre River territory). We used an instrument for evaluating competencies (the COM_VA questionnaire) and recording sociodemographic variables (age, sex, total work experience, emergency department experience, training in critical patient care and triage) and perceived confidence when performing triage. We then analyzed the association between these variables and competency scores.Competency scores on the COM_VA questionnaire were significantly higher in nurses with training in critical patient care (P=.001) and triage (P=0.002) and in those with longer emergency department experience (P.0001). Perceived confidence when performing triage increased with competency score (P.0001) and training in critical patient care (P.0001) and triage (P=.045).The competence of triage nurses and their perception of confidence when performing triage increases with emergency department experience and training.Identificar la relación entre las variables sociodemográficas estudiadas y el nivel competencial de los enfermeros que realizan triaje en los servicios de urgencias hospitalarios (SUH).Estudio descriptivo, transversal, multicéntrico realizado a enfermeros que realizan triaje en los SUH de Terres de l’Ebre. Se analiza la relación entre variables del cuestionario evaluativo de competencias COM_VA©, sociodemográficas (edad, sexo, experiencia laboral total y en SUH, formación en paciente crítico y en triaje, seguridad percibida en la realización del triaje) y habilidades profesionales.El nivel competencial (COM_VA©) es mayor en enfermeros con formación en paciente crítico (p = 0,001) y triaje (p = 0,002) y con experiencia en el SUH (p0,0001). La seguridad percibida al realizar triaje aumenta con el nivel competencial (p0,0001) y con la formación en paciente crítico (p0,0001) y triaje (p = 0,045).La formación y experiencia en el SUH aumentan las competencias del enfermero de triaje y la seguridad percibida al realizarlo.

Purpose: The aim of this study is to explore and understand the experience of the adaptation process among family caregivers in hospitals, who have an active presence in hospital and are essential in ensuring proper patient care. Methods: A qualitative phenomenological approach was used to gain a deeper understanding of caregivers' lived experiences. Data were collected using in-depth interviews to explore six caregivers' experiences of hospitalization. Results: The caregivers' accounts highlight the different determining factors in the transition process of a chronically ill patient's family caregiver during the patient's time in hospital. The most important themes emerging from the analysis were the importance of cultural beliefs and attitudes, meaning of the situation, caregiver's training and knowledge, socio-economic status and the hospital as a community. These categories can be analyzed using transitions theory. Conclusions: The most important conclusion is that the hospital in this study was not designed to accommodate caregivers, and the mechanisms used to meet caregivers' needs endanger their privacy, health, and coexistence in the hospital's rooms. Transitions theory provides a holistic understanding of the experience of the family caregiver.