Lorenzo Mariano Juárez, David Conde Caballero, Carmen Cipriano Crespo

This chapter is a literary review based on the experience of patients with ambulatory oxygen therapy treatment that analysed the way in which this treatment influences patients from an occupational point of view. The relationship of these pathologies and treatments with mental health, especially with depression, anxiety, and stress, is also addressed, with an interest in the treatment of possible functional limitations from the intervention of the discipline of occupational therapy. Oxygen therapy allows patients to continue in their performance contexts, although it can generate new limitations and deficiencies derived from episodes of anxiety and mood disorders, causing greater occupational disfunction. A function-dysfunction process that can be approached from occupational therapy with the aim of minimizing the impact both physical and psychological, enhancing the autonomy and independence of these patients.

Oxygen therapy consists on administering oxygen at a higher concentration than that found in the air in order to treat problems due to respiratory failure. When the oxygen therapy treatment is not necessary to administer in the hospital, within a hospital admission, it can be prescribed for the patient to receive at home, referred to as continuous home oxygen therapy. This type of therapy has great advantages for patients and their families because it allows them to stay together longer. But there are also important difficulties to be taken into account that have to do with the handling of the devices that are used for the administration of oxygen, as well as the compliance or not of the time prescribed by the health professional.

Enfermería Basada en Narrativas. Redefiniendo los modelos de atención

Population aging constitutes one of the central issues on the political agenda of the \(21^\mathrm{st}\) century. The social implications of these population dynamics are subject to discussion due to their evident impact on aspects such as labour relations, health and care systems, pension policy but also on family models or the social construction of feelings. In this context, the understanding of food ideologies and practices in rural populations is a crucial issue in health policies and interventions. With the traditional tools and assumptions of ethnographic fieldwork, our research is aimed at a series of objectives in order to complete the limited knowledge on these issues: (1) to know the nutritional situation of the elderly population in rural areas; (2) to describe cultural food practices and their association with ideologies, representations, supply and availability systems; and (3) to relate technological innovation with our empirical research findings. We can describe two categories of analysis on which we are working. First, the problems of access to food. The circulation of food -“the field of the eatable”- is conditioned from a structural framework. Then, is also crucial in the diagnostic phase. We work too on the mapping of study areas with a variable representation of distances and difficulties depending on factors such as functionality, but also social position or gender. The intersections between socio-cultural approaches and technology occur in the field of interventions. Technological proposals can prove successful and attractive in labs, but they need to “work” in real life.

Population aging constitutes one of the central issues on the political agenda of the 21st century. The social implications of these population dynamics are subject to discussion due to their evident impact on aspects such as labour relations, health and care systems, pension policy but also on family models or the social construction of feelings. In this context, the understanding of food ideologies and practices in rural populations is a crucial issue in health policies and interventions. With the traditional tools and assumptions of ethnographic fieldwork, our research is aimed at a series of objectives in order to complete the limited knowledge on these issues: (1) to know the nutritional situation of the elderly population in rural areas; (2) to describe cultural food practices and their association with ideologies, representations, supply and availability systems; and (3) to relate technological innovation with our empirical research findings. We can describe two categories of analysis on which we are working. First, the problems of access to food. The circulation of food -“the field of the eatable”- is conditioned from a structural framework. Then, is also crucial in the diagnostic phase. We work too on the mapping of study areas with a variable representation of distances and difficulties depending on factors such as functionality, but also social position or gender. The intersections between socio-cultural approaches and technology occur in the field of interventions. Technological proposals can prove successful and attractive in labs, but they need to “work” in real life.

Es posible que el lector haya mostrado cierto recelo nada más leer el título de este capítulo. Otro trabajo más de historia enfermera, de identidad profesional, o de empatía. Temas, debemos admitir, nada novedosos. La empatía es un asunto bien abordado en la literatura científica (Fernández-Pinto, 2008; Jeffrey, 2016; Albano, 2015). Mi intención es referirme aquí más concretamente al mundo emocional y su gestión en la práctica enfermera, relacionándolo con las diversas etapas históricas que han definido la ethos y la identidad de la profesión. Adelanto ya la tesis: si las modernas corrientes de la Narrative Based Medicine reclaman la vuelta a una práctica humanística, centrada en la persona y articulada en torno al trasiego emocional entre profesionales y pacientes, la enfermería parece caminar aún por la senda de los protocolos, la evidencia empírica y la cientificidad. Nada que objetar, por supuesto. Siempre que ese proceso de " profesionalización " no implique renunciar a los valores tradicionales. Y sí, el lector ya lo habrá adivinado: los reclamos contemporáneos de una práctica comprometida-" engaged concern " (Halpern, 1991; Charón, 1993; Hurwitz, 2000; Mariano, 2012) o la relación íntima del profesional con el padecimiento, su historia y la persona no es otra cosa que esa ethos tradicional enfermera. Este texto aborda el proceso histórico y social por el que la enfermería corre el riesgo de entender su praxis como técnica, aséptica, encapsulada en protocolos, negando la validez de la empatía y la gestión emocional del padecimiento. En esencia, definir cómo lo moderno, en ocasiones, no es otra cosa que vintage en términos de aflicciones. Cuestiones que no solo atañen a la epistemología enfermera, ni son asunto exclusivo de académicos. Si no que se trata de una cuestión central para la práctica cotidiana. Así, se pretende

Los trabajos de Enfermería Basados en Narrativas no sólo tienen una apliación teórica, sino que nos permiten el acercamiento al mundo de significaciones y aflicciones del paciente. En este caso, nuestra etnografía nos ha llevado a trabajar con pacientes infectados de VIH, explorando un de los grandes problemas transversales de la enfermedad: el estigma social.

BORDERLINE. -BPD- DSM-IV (DSM-IV 301.831). Also known as borderline disorder or border, defined as a personality disorder, primarily characterized by extremely polarized and dichotomous thinking, emotional instability and chaotic interpersonal relations. It has been said that probably there are no mental disorder that have produced so much literature, although not much of it supported by empirical research, (Koenigsberg et al., 2002). Contemporary literature and various working groups have called into question the relevance of the denomination and the secondment of the diagnosis. It Affects around 2 of the population (Torgersen et al. 2000), by far the most frequent disorders of personality (Gunderson and Zanarini, 1987). The DSM-IV-TR proposes the use of 9 specific diagnostic criteria, divided into emotional, impulsive, interpersonal symptoms and cognitive symptoms. A Evidence Based Medicine cannot remain oblivious to the most important issue: the suffering when illness bursts into life, collapsing it. On current debates about the disease, we understand that illness experiences must be put into game not as epiphenomena, but a first order evidence. Based on the classic idea that there is no disease without a body, but disease is not something that occurs in the body, but in life, we intend to biomedical evidence scale.