Open Access
Combining participatory action research and emerging ways of collective action to promote institutional change toward social commitment: groundings, strategies, and implications of an experience
(Wiley, 2021) López Martínez, Jorge S.; Soria Oliver, María; Aramayona, Begoña; García Sánchez, Rubén; Martín, María J.; Martínez, José M.; Ciencias de la Salud; Osasun Zientziak
Aims: this study reports the foundations, strategies, and results of an institutional change experience based on the combination of participatory-action-research and new currents of collective mobilization and political participation. It aimed to achieve the institution's greater social commitment and a more participatory and transparent management. Methods: the process took place in a Spanish public university and was promoted and coordinated by a Work Group that emerged from grassroots university community. Collective diagnosis was performed through face-to-face strategies (global, sectorial, and faculty meetings) and virtual tools (web-blog, on-line surveys, shared documents). Collective action combined nonformal with formal institutional participation and applied hybrid activism, self-organization in horizontal structures and integrative conflict management. Results: a sequential process of diagnosis, collective action, and negotiation was implemented. As a result, the university Governing Team, representatives from different sectors and members of the Work Group worked jointly to define several institutional actions that were thereafter launched. Those actions aimed to improve institutional participation and transparency, and greater institutional social commitment. Conclusion: the combination of participatory-action-research and new ways of collective action can be an excellent tool to draw institutions towards greater social engagement, thus contributing to sustainable social change. A model to guide institutional change is drafted.
Open Access
Grief reactions of potential organ donors' bereaved relatives: an observational study
(American Association of Critical-Care Nurses, 2020-09-01) Soria Oliver, María; Aramayona, Begoña; López Martínez, Jorge S.; Martín, María J.; Martínez, José M.; Sáenz Mendía, Raquel; García Sánchez, Rubén; Ciencias de la Salud; Osasun Zientziak
Background: most family members of potential organ donors experience the death of their relative in an intensive care unit. While under an emotional burden, bereaved relatives must make a decision that will affect the life of other patients. A better understanding of grief within the context of organ donation will help intensive care unit staff better support families during this process. Objectives: to empirically describe the emotional reactions of potential organ donors' family members facing a loved one's death and analyze the relationship of these reactions to factors that occur in the process of illness and death. Methods: a prospective observational study was conducted in 16 Spanish hospitals for 36 months. Data of 421 relatives of potential organ donors, collected through a previously validated instrument, included relatives' emotional responses, deceased's and relatives' characteristics, circumstances of death, and behavior of health care staff. Results: unexpected deaths were linked to more intense emotional reactions and less acceptance of death than were anticipated deaths. Additional stressors, such as perception of poor treatment by hospital staff, perception of deficient medical care, and poor relationships among family members, were associated with stronger reactions. Conclusions: observation and analysis of the factors studied may help hospital staff members anticipate bereaved relatives' emotional reactions and provide better support during the grieving process, increasing family members¿ well-being and facilitating a better-informed organ donation decision.
Open Access
Do psychosocial factors mediate the appearance of musculoskeletal symptoms? Evidence of an empirical study about the role of mental workload in computer workers
(Public Library of Science, 2021) Soria Oliver, María; López Martínez, Jorge S.; Torrano, Fermín; García González, Guillermo; Ciencias de la Salud; Osasun Zientziak
The emergence of musculoskeletal symptoms (MSSs) in computer workers is a relevant occupational health problem. This study tests a multilevel model of analysis of risk factors in the appearance of musculoskeletal pain and discomfort in computer workers that integrates indicators from different areas: temporal usage patterns, ergonomic factors, psychosocial factors, and individual variables, specifically testing the possible mediating role of the mental workload. A cross-sectional study was performed through online registration with a nonprobabilistic sample of 1198 workers from Spanish organizations. The results show that mental workload has a higher association than the rest of the factors with the onset of pain and discomfort in various body areas: neck in men, neck, shoulders and upper back in women. They also support the mediation role of mental workload in the relationship between usage patterns and the appearance of musculoskeletal symptoms. The use of multilevel theoretical models that adequately consider the complexity of the relationships between the different risk factors is necessary for a better understanding and intervention on MSSs in computer workers.
Embargo
Requesting relatives' consent for intensive care for organ donation: an empirical analysis of Spanish transplant coordinators' practices
(Lippincott, Williams & Wilkins, 2024-10-08) García Sánchez, Rubén; Soria Oliver, María; López Martínez, Jorge S.; Martínez, José M.; Martín, María J.; Barceló-Soler, Alberto; Coll, Elisabeth; Roldán, José; Uruñuela, David; Fernández-Carmona, Alberto; Ciencias de la Salud; Osasun Zientziak
Background. Intensive care to facilitate organ donation (ICOD) involves the initiation or continuation of intensive care for patients with devastating brain injury for donation purposes. In the Spanish system, relatives undergo an early interview to request consent for this procedure. If they consent, a waiting time is agreed upon in the expectation that death by neurological criteria occurs and donation after brain death takes place. Otherwise, relatives can decide on donation after circulatory determination of death or withdrawal of life support. This study analyzes how Spanish transplant coordinators interact with relatives in early interviews and follow-ups on potential donation pathways. Methods. Semistructured interviews were conducted with a random stratified sample of 23 Spanish transplant coordination teams to explore strategies, practices, and perceptions of ICOD consent requests. The interviews were recorded, transcribed, and analyzed using content analysis. Results. Previous coordination with other units and information retrieval regarding patient and relatives' situations is crucial. The development of early interviews includes an introduction to the family, identification of decision makers, empathizing with relatives and offering condolences, reaffirming the fatal prognosis, explaining the possibility of donating based on the patient's will, confirming the family's understanding and resolving doubts, and ensuring comfort and assessing family needs. Conclusions. Approaching families to obtain ICOD consent is a regular practice for Spanish coordination teams. It involves a highly professional and diversified set of strategies based on establishing a support relationship for relatives. Our study provides strategies that serve as a reference for obtaining ICOD consent from families in other settings.

López Martínez, Jorge S.

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