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Introducción: La complejidad de la época actual exige tener en cuenta enfoques cuantitativos y cualitativos, datos de diferentes fuentes, métodos múltiples y un crisol de enfoques. Para dar respuesta a esta complejidad se presenta el análisis situacional como método posible. Metodología: Se presenta una revisión integrativa en relación con la variante de análisis situacional, que sigue los siguientes pasos: 1) identificación del problema (pregunta y objetivo de la investigación claramente definidos); 2) búsqueda bibliográfica (estrategia de búsqueda exhaustiva); 3) evaluación de datos; 4) análisis de datos (reducción de datos, visualización, comparación y conclusiones); y 5) presentación de los resultados así como las implicaciones para la práctica, la política públicas y las futuras investigaciones. Resultados: Emerge literatura que da cuenta del análisis situacional como una metodología utilizada en educación en salud, gestión en salud, políticas públicas y atención en salud, que incorpora elementos del análisis de discurso y teorías poshumanistas. Conclusiones: El análisis situacional es una metodología de comprensión de los fenómenos sociales, culturales, sanitarios y de educación, que está disponible y es acorde con la mirada multidimensional requerida para comprender la complejidad del entorno y fluidez de la era que estamos viviendo.

Introdução: A complexidade da realidade atual exige que se levem em conta enfoques quantitativos e qualitativos, dados de diferentes fontes, múltiplos métodos e uma porção de abordagens. Para responder a essa complexidade, a análise situacional é apresentada como um método possível. Metodologia: É apresentada uma revisão integrativa em relação à variante da análise situacional, que segue as seguintes etapas: 1) identificação do problema (questão e objetivo de pesquisa claramente definidos); 2) pesquisa bibliográfica (estratégia de pesquisa abrangente); 3) avaliação dos dados; 4) análise dos dados (redução, visualização, comparação e conclusões dos dados); e 5) apresentação dos resultados, bem como implicações para a prática, políticas públicas e pesquisas futuras. Resultados: Surge uma literatura que ampara a análise situacional como uma metodologia usada na educação em saúde, na gestão da saúde, nas políticas públicas e na assistência à saúde, incorporando elementos da análise do discurso e das teorias pós-humanistas. Conclusões: A análise situacional é uma metodologia de compreensão de fenômenos sociais, culturais, de saúde e de educação, que está disponível e alinhada com a visão multidimensional necessária para entender a complexidade do ambiente e a fluidez da era em que vivemos.

Introduction: The complexity of the current era requires considering quantitative and qualitative perspectives, data from different sources, multiple methods, and a melting pot of approaches. To respond to this complexity, situational analysis is presented as a possible method. Methodology: An integrative review is presented in relation to the variant of situational analysis, which follows the following steps: 1) problem identification (clearly defined research question and objective); 2) literature search (comprehensive search strategy); 3) data assessment; 4) data analysis (data reduction, visualization, comparison, and conclusions); and 5) presentation of results as well as implications for practice, public policy, and future research. Results: Literature emerges that accounts for situational analysis as a methodology used in health education, health management, public policy, and health care, which incorporates elements of discourse analysis and posthumanist theories. Conclusions: Situational analysis is a methodology for understanding social, cultural, health and educational phenomena, which is available and in accordance with the multidimensional view required to understand the complexity of the environment and fluidity of the era we are living in.

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Ground N°3 of Law 21,030 allows for the termination of a pregnancy due to rape, with the woman's consent, establishing a gestational age limit of 14 weeks for adolescents under 14 years of age and 12 weeks for those over 14 years of age. OBJECTIVE: To describe, between the period 2018-2020, the main sociodemographic and other variables linked to ground N°3 in minors under 14 years, adolescents aged 14 years or older and under 18 years, and women aged 18 years or older. PATIENTS AND METHOD: Cross-sectional, descriptive, and population-based design. National data was obtained from the official registry of the Ministry of Health and through the Transparency Law. Measures of central tendency (median), dispersion (interquartile range), absolute frequencies, and percentages were used. RESULTS: 31.6% of the women with rape-related pregnancies were under 18 years of age. Women under 14 lived mainly in the regions of the country, had a higher gestational age at the time of the ground factor, and 31.2% decided to continue the pregnancy. Adolescents aged 14 or older and under 18, had a higher multidimensional poverty index. Women aged 18 or older were most frequently foreigners, lived mainly in the Metropolitan Region, and decided to terminate the pregnancy. 57.4% of those who reported the rape and 11.1% who failed to establish the ground were under 18. CONCLUSIONS: Sexual violence is a public health problem. Pregnancy due to rape in adolescents is a social reality. There should be permanent evaluation and monitoring of the implementation of Law 21,030, guaranteeing timely, efficient, and nondiscriminatory access to benefits.

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Introduction: After decades of absolute criminalization, on September 14, 2017, Chile decriminalized voluntary termination of pregnancy (VTP) when there is a life risk to the pregnant woman, lethal incompatibility of the embryo or fetus of genetic or chromosomal nature, and pregnancy due to rape. The implementation of the law reveals multiple barriers hindering access to the services provided by the law. Objectives: To identify and analyze, using the Tanahashi Model, the main barriers to the implementation of law 21,030 in public health institutions. This article contributes to the follow-up of this public policy, making visible the obstacles that violate women's rights of women to have dignified access to abortion and that affect the quality of health care in Chile. Material and method: Qualitative design, following the postpositivist paradigm. The sample consisted of relevant actors directly related to pregnancy termination. Snowball sampling and semi-structured interviews were used. Grounded theory was used through inductive coding, originating categories regrouped into meta-categories following Tanahashi's model. The rigor criteria of transferability, dependability, credibility, authenticity, and epistemological theoretical adequacy were used. The identity of the participants and the confidentiality of the information were protected. Results: From January 2021 to October 2022, 62 interviews were conducted with 20 members of the psychosocial support team; 18 managers; 17 members of the biomedical health team; 4 participants from of civil society, and three women users. The main obstacles correspond to availability barriers, accessibility barriers, acceptability barriers, contact barriers, and effectiveness barriers. Conclusions: Barriers to access abortion under three grounds violate the exercise of women's sexual and reproductive rights. It is urgent to carry out actions of control and follow-up of this public policy to the corresponding entities.

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Introduction: After three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital or genetic lethal pathology, and in pregnancy due to rape. The law incorporates conscientious objection as a broad right at the individual and institutional levels. Objectives: The aim of the study was to explore the exercise of conscientious objection in public health institutions, describing and analyzing its consequences and proposals to prevent it from operating as structural violence. Materials and methods: This study uses a qualitative, post-positivist design. At the national level, according to the chain technique, people who were identified as key actors due to their direct participation in implementing the law were included. Grounded theory was used to analyze the information obtained through a semi-structured interview. The methodological rigor criteria of transferability or applicability, dependability, credibility, auditability, and theoretical-methodological adequacy were met. Results: Data from 17 physicians, 5 midwives, 6 psychologists, 8 social workers, 2 nursing technicians, and 1 lawyer are included. From an inductive process through open coding, conscientious objection as structural violence and strategies to minimize the impact of objection emerge as meta-categories. The first meta-category emerges from the barriers linked to the implementation of the law, the infringement of the rights of the pregnant person, and pseudo conscientious objection, affecting timely and effective access to pregnancy termination. The second meta-category emerges as a response from the participants, proposing strategies to prevent conscientious objection from operating as structural violence. Conclusion: Conscientious objection acts as structural violence by infringing the exercise of sexual and reproductive rights. The State must fulfill its role as guarantor in implementing public policies, preventing conscientious objection from becoming hegemonic and institutionalized violence.

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BACKGROUND: End-stage chronic kidney disease is a severe public health problem due to the poor quality of life of patients on dialysis and the costs associated with renal replacement treatment. AIM: To understand the social representations of kidney disease of people on dialysis. MATERIAL AND METHODS: In a qualitative study under the post-positivist paradigm, eighteen patients in peritoneal or hemodialysis participated in an in-depth interview. The analysis was performed using content analysis. RESULTS: Eight categories were identified: Friends, Health Care Team, Spirituality and Disease, Family, Health Support System, Physical Consequences, Psychosocial Consequences, Self-Care of Continuous Health-Disease. CONCLUSIONS: Health care of people on dialysis should take into consideration the experience of kidney disease from the perspective of the patient, including his beliefs and feelings and involving the family, community, and the state.

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The death of a child in the intrauterine stage has legal, psychological, spiritual, and health-related connotations that condition the woman's experience. To understand better the processes set in motion around early pregnancy loss, this ethnographic study explores the experiences of miscarriage in a group of 15 women. The following themes are analyzed: Experience of losing the child, spirituality, health care, and the need to physically recognize the child. The study shows that the need women have to honor the child who did not live may be conditioned by the perception of an uncertain loss and by the absence of a place to honor him/her. Attitudes among professionals are revealed that could be perceived as gender-related abuse. The care of women places emphasis on physical aspects, underlining the lack of comprehensive care during the grieving process.

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BACKGROUND: End-stage chronic kidney disease is a severe public health problem due to the poor quality of life of patients on dialysis and the costs associated with renal replacement treatment. Aim: To understand the social representations of kidney disease of people on dialysis. MATERIAL AND METHODS: In a qualitative study under the post-positivist paradigm, eighteen patients in peritoneal or hemodialysis participated in an in-depth interview. The analysis was performed using content analysis. Results: Eight categories were identified: Friends, Health Care Team, Spirituality and Disease, Family, Health Support System, Physical Consequences, Psychosocial Consequences, Self-Care of Continuous Health-Disease. CONCLUSIONS: Health care of people on dialysis should take into consideration the experience of kidney disease from the perspective of the patient, including his beliefs and feelings and involving the family, community, and the state.

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