Arévalo Ipanaqué, Janet Mercedes

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Arévalo Ipanaqué, Janet Mercedes
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    Psychometric evaluation of a Spanish translation of the moral injury symptom scale for healthcare professionals
    (2024-09-02)
    Cabanillas Chavez, Maria Teresa  
    ;
    White, Michael
    ;
    Medina Bacalla, Willy Jhon  
    ;
    Arévalo Ipanaqué, Janet Mercedes  
    ;
    Obando Zegarra, Roxana
    BACKGROUND: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish. METHODS: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability. RESULTS: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835. CONCLUSION: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury.
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    Eficacia de un programa de terapia nutricional domiciliaria ambulatoria
    (2025-05-07)
    Huayanay Escandon, Rosamell
    ;
    Valdez Narbasta, Angelina Del Pilar
    ;
    Arévalo Ipanaqué, Janet Mercedes  
    Introduction: Outpatient home nutritional therapy is a care model that allows improving the use of health resources and providing continuity to in-hospital interventions in malnourished patients with intestinal failure. Objective: To evaluate the effectiveness quality -quantitative in patients who are part of an outpatient home nutritional therapy program. Material and methods: Mixed study. The quantitative phase collected the impact indicators of all patients (34), at the beginning of the program and currently. In the qualitative phase, 9 participants were interviewed for theoretical saturation. The quantitative analysis applied descriptive statistics, Anova and Student's T; the qualitative developed transcription, ordering, coding-categorization, description and interpretation. Results: The average nutritional and biochemical indicators increased since the beginning of the program: BMI from 19.95 to 21.88, albumin from 3.63 mg/dl to 3.80 mg/dl, proteins from 7.16 mg/dl to 7.29 mg/dl and lymphocytes from 26.62µl to 29.89µl. Patients and family members presented difficulties that were overcome; They point out strengths of the PTNDA program and perceived satisfaction. Conclusion: BMI is the only indicator that presented significant differences between patients according to years of experience in the program (2 and 3 years). Overall, BMI and lymphocytes have significant differences from the beginning of the program to the present. Patients and family members report a positive impact and satisfaction with the PTNDA for the maintenance and/or improvement of their nutritional status.
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    Ansiedad, estrés y depresión en enfermeros de emergencia Covid-19
    (2020-11-26)
    Obando Zegarra, Roxana
    ;
    Arévalo Ipanaqué, Janet Mercedes  
    ;
    Aliaga Sánchez, Ruth América
    ;
    Obando Zegarra, Martina
    Resumen En la lucha contra la pandemia por Covid-19, la enfermería se enfrenta diariamente a situaciones que afectan su bienestar psicosocial. Las emociones y pensamientos negativos se extienden amenazando la salud mental de los enfermeros. Se han realizado varios estudios que indagan sobre la realidad emocional de los profesionales de salud de Asia y Europa principalmente. Sin embargo, hace falta fijar la mirada en los enfermeros latinoamericanos, donde Perú representa uno de los países más afectados. Objetivo: determinar el grado de ansiedad, estrés y depresión que presentan los enfermeros que atienden a los pacientes con sospecha de Covid-19. Metodología: estudio descriptivo trasversal, con muestra no probabilística por cuotas de 126 profesionales de enfermería del servicio de emergencia de dos hospitales públicos de nivel III de Lima y Callao, en Perú. Los datos fueron recopilados durante el mes del mayo del 2020, utilizando la escala DASS-21 vía virtual. El análisis descriptivo fue complementado con asociaciones de chi cuadrado. Resultados: El 39.1% de los enfermeros presentaron algún grado de ansiedad, 24.6% algún grado de depresión y 8,8% algún grado de estrés. El sexo femenino está asociado a las 3 condiciones estudiadas. Otras características asociadas a alguna condición son edad, años de servicio y ubicación del hospital. Conclusión: Los enfermeros que atienden a los pacientes sospechosos por Covid-19 en los servicios de emergencia, presentan mayor ansiedad que depresión. En pocos casos presentaron estrés.
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    IFN-γ Response Is Associated to Time Exposure Among Asymptomatic Immune Responders That Visited American Tegumentary Leishmaniasis Endemic Areas in Peru
    (2018-08-21)
    Iván Best  
    ;
    Angela Privat‐Maldonado
    ;
    María Cruz
    ;
    Mirko Zimic
    ;
    Rachel Bras‐Gonçalves
    Clinical manifestations of American Tegumentary Leishmaniasis (ATL) include cutaneous (CL) and mucous forms (ML); however, there are asymptomatic individuals who despite being infected do not present any clinical manifestations. This study characterized the cell-mediated immunity of travelers who lived in the Andean highlands of Cusco, free of leishmaniasis transmission, which eventually visited leishmaniasis endemic in the Amazonian basin and returned home without any clinical signs of the disease. Their immune response was compared with CL and ML patients who acquired the disease during their stage in the same region. Fifty-four human subjects from the highlands of Cusco (Peru), who have visited an endemic area, were enrolled: 28 of them did not show any symptoms, 12 showed CL and 14 showed ML. Ten healthy subjects from a non-endemic area (HS) were included as controls. T-cell proliferation was evaluated using peripheral blood mononuclear cells (PBMC) stimulated for 5 days with a total soluble leishmanial antigen (TSLA) of L. (V.) braziliensis. Th1/Th2/Th17 cytokines were also quantified in the supernatants by a flow cytometry multiplex assay. T-cell proliferation was expressed as stimulation index (SI) and the cut off was fixed at SI > 2.47. Fifteen out of 28 subjects did not show any signs of disease (54%); subjects with an SI above the cut off. They were defined as asymptomatic immune responders (AIR). CL and ML patients presented a higher SI than HS and AIR. Among the latter group, the exposure time to Leishmania was clearly associated with the IFN-γ response. Increased levels of this cytokine were observed in individuals who remained less than 90 days in an endemic area of leishmaniasis. Our results evidenced two sub-populations among asymptomatic individuals, one AIR who did not develop clinical disease manifestations when they were exposed to Leishmania in endemic areas. Exposure time to Leishmania in the wild was associated with the IFN-γ response.
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    Creencias de la capacidad preventiva de la Ivermectina para COVID-19 en personas de una zona rural
    (2020-12-20)
    Janet Mercedes Arévalo-Ipanaqué  
    ;
    Dora Clarisa Muñoz Garay
    ;
    Fabricio Alonso Lévano Bautista
    ;
    Flavio Paolo Dagnino Guzmán
    Objetivo: Abordar las creencias del efecto de Ivermectina veterinaria 1% vía oral como preventivo del COVID -19 en personas de una zona rural. Métodos: Se realizó un estudio cualitativo fenomenológico, con una muestra obtenidapor saturación, compuesta de diez personas adultas residentes de una comunidad rural, seleccionadas de forma accidental en el momento que acudían al lugar donde expenden ivermectina 1% de uso veterinario, a quienes se aplicó la entrevista semiestructurada.Resultados: La información en torno a las creencias fue agrupada en tres categorías: angustia e inicio de la enfermedad en la zona, conciencia - búsqueda de la prevención y creencia - confianza - no molestia.Conclusión: La creencia que tiene la población sobre el efecto preventivo de la ivermectina veterinaria para la infección por COVI-19, ocasiona que la tomen mensualmente de forma voluntaria e individual, refiriendo que con su consumo no presentan molestias y conservan la salud.
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    Cuidado interprofesional de mujeres indígenas durante el ciclo grávido-puerperal a la luz de la Teoría de la Complejidad
    (2026-01-01)
    Julieli Rosso
    ;
    Luana Pizarro Meneghello
    ;
    Silvia Naujorks
    ;
    Janet Mercedes Arévalo-Ipanaqué  
    ;
    Dirce Stein Backes
    RESUMEN Objetivo: Reflexionar sobre las dinámicas del cuidado interprofesional de la salud de mujeres indígenas durante el ciclo grávido-puerperal, a la luz de la teoría de la complejidad. Método: Es un estudio teórico-reflexivo llevado a cabo mediante tetragrama con el referencial de la complejidad de Edgar Morin, para revelar encuentros, tensiones y posibilidades de la atención interprofesional en contextos interculturales. Resultados: La atención interprofesional surge como una estrategia crucial para superar la fragmentación del modelo biomédico hegemónico. La aplicación del tetragrama demostró que: el orden reside en las prácticas tradicionales y protocolos biomédicos; el desorden asoma en las rupturas y conflictos culturales; la interacción se produce en las experiencias de articulación entre saberes; y la organización señala la construcción de una atención más inclusiva y adaptativa. Conclusión: La teoría de la complejidad ofrece una perspectiva fructífera para repensar y (re)orientar la atención a la salud de mujeres indígenas, destacando la importancia de la escucha activa, la valorización de los conocimientos tradicionales y la construcción de prácticas interprofesionales culturalmente seguras, contextualizadas y transformadoras.
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    Professional Quality of Life and Job Stress among Nurses in COVID-19 Areas
    (2024-01-01)
    López Mamani, Enoc Tito
    ;
    Arévalo Ipanaqué, Janet Mercedes  
    ;
    Meneses la Riva, Monica Elisa  
    ;
    Morales Garcia, Wilter Charming  
    ;
    Cabanillas Chavez, Maria Teresa  
    Background: the COVID-19 pandemic has posed unprecedented challenges in the healthcare field, notably affecting nursing professionals working in critical areas. These challenges have impacted their professional quality of life (PQoL) and increased job stress levels, which are crucial for both the well-being of healthcare personnel and the quality of care provided to patients. Objective: this study aims to explore the relationship between professional quality of life and job stress among nurses at a medium-complexity hospital in Lima, Peru, during the COVID-19 pandemic. Methods: a quantitative, non-experimental, cross-sectional, correlational methodology was used, with a non-probabilistic sample of 59 nurses. Data were collected through online questionnaires assessing PQoL and job stress, using validated tools such as the Nursing Stress Scale and the PQoL-35 Questionnaire. Results: the majority of participants (69,5 %) perceive their PQoL as good, highlighting high levels of intrinsic motivation and perceived quality of life. In contrast, workload was the most negatively valued aspect. Job stress was perceived as low overall, and a moderate positive correlation between PQoL and job stress (r = 0,517; p < 0,05) was found, suggesting that better working conditions could improve PQoL. Workload was identified as a significant factor of job stress. Conclusions: despite the challenges imposed by the pandemic, nurses maintain a positive perception of their PQoL, especially in terms of intrinsic motivation and perceived quality of life. However, workload is highlighted as a critical factor of job stressBackground: the COVID-19 pandemic has posed unprecedented challenges in the healthcare field, notably affecting nursing professionals working in critical areas. These challenges have impacted their professional quality of life (PQoL) and increased job stress levels, which are crucial for both the well-being of healthcare personnel and the quality of care provided to patients. Objective: this study aims to explore the relationship between professional quality of life and job stress among nurses at a medium-complexity hospital in Lima, Peru, during the COVID-19 pandemic. Methods: a quantitative, non-experimental, cross-sectional, correlational methodology was used, with a non-probabilistic sample of 59 nurses. Data were collected through online questionnaires assessing PQoL and job stress, using validated tools such as the Nursing Stress Scale and the PQoL-35 Questionnaire. Results: the majority of participants (69,5 %) perceive their PQoL as good, highlighting high levels of intrinsic motivation and perceived quality of life. In contrast, workload was the most negatively valued aspect. Job stress was perceived as low overall, and a moderate positive correlation between PQoL and job stress (r = 0,517; p < 0,05) was found, suggesting that better working conditions could improve PQoL. Workload was identified as a significant factor of job stress. Conclusions: despite the challenges imposed by the pandemic, nurses maintain a positive perception of their PQoL, especially in terms of intrinsic motivation and perceived quality of life. However, workload is highlighted as a critical factor of job stress
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