Pastor Bravo, María del Mar

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Pastor Bravo, María del Mar

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Pastor Bravo, María del Mar

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Universidad de Murcia. Departamento de Enfermería

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Open Access
Factors contributing to the perpetuation and eradication of female genital mutilation/cutting in sub-Saharan women living in Spain
(Elsevier, 2021-11-21) Pastor Bravo, María del Mar; Almansa-Martínez, Pilar; Jiménez Ruiz, Ismael; Enfermería; Facultad de Enfermería
Objective: Female Genital Mutilation/Cutting (FGM/C) is one of the most widespread traditional practices harmful to the health of women and girls in the world. Its spread to the West highlights the need to establish preventive actions in European countries taking into account the affected population. That is why this study is aimed at finding out the elements that support the continuation of FGM/C and those that promote the change of attitudes and fight against FGM / C from the perspective of the sub-Saharan women themselves who reside in Spain. Design: Qualitative exploratory research that uses the method of life stories through an open interview. Participants and Setting: The participants were 24 women living in the Region of Murcia (Spain) who come from sub-Saharan countries where FGM/C is commonly practised. Findings: Arguments supporting FGM/C, the lack of knowledge and family pressure are identified as factors that perpetuate the practice, whereas the motivating factors for the change in attitudes that make most of the interviewees oppose FGM/C are the awareness of the consequences on health and close negative experiences, growing awareness of their rights, supportive legislation and breaking the taboo related to this practice to question justifications for FGM / C and share experiences. Key conclusion and implications for practice: Being aware of the arguments of both sides, women who defend FGM/C and those who oppose it, is a valuable source of information that obstetrics, midwifery and nursing professionals can use. The study provides the core elements that any healthcare education program should incorporate to prevent female genital mutilation/circumcision.
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School victimization in transgender people: a systematic review
(Elsevier, 2020-09-18) Martín Castillo, David; Jiménez Barbero, José Antonio; Pastor Bravo, María del Mar; Sánchez Muñoz, María; Fernández Espín, María Elvira; García Arenas, José Joaquín; Enfermería
Background The term transgender refers to people whose gender identity does not conform to that associated with the sex assigned to them at birth. Scientific evidence has shown that transgender adolescents have an increased risk of being victims of violence during the school stage. This study aims to synthesize and analyze the findings of the individual studies carried out so far in order to report on the circumstances that influence the process of victimization of this collective. Methods A systematic search was carried out following the recommendations of the PRISMA statement in the following databases: Pubmed/Medline, PsycINFO, Cochrane, Lilacs, and Web of Science, where relevant qualitative and quantitative design studies were identified, which met previously established eligibility criteria. Quality was assessed through bias-risk analysis, and data were extracted from a previously elaborated template. Results The systematic review finally included 19 quantitative studies (N = 23,749). The results of this review indicate the existence of a number of sociodemographic, family, school and individual factors that influence the victimization of transgender people. The high heterogeneity found among the outcome measures of the quantitative studies prevented performing a meta-analysis, as recommended in the PRISMA declaration. Conclusions The results of this review suggest the importance of identifying the different factors that influence victimization and intervening in them as a relevant measure for the prevention of bullying.
Open Access
Social determinants of health influence on trans and gender-diverse people: a qualitative photovoice study
(MDPI, 2026-02-11) Marín-Rodríguez, María; Jiménez Ruiz, Ismael; Jiménez Barbero, José Antonio; Sánchez-Muñoz, María; Pastor Bravo, María del Mar; García Hernández, Miguel; Enfermería; Facultad de Enfermería
Despite the introduction of inclusive and gender-affirming approaches in healthcare, transgender and non-binary people continue to show poorer physical, psychological, and social outcomes, shaped by social determinants within historically pathologizing and stigmatizing contexts. This study used qualitative participatory action research with photovoice among seven transgender individuals residing in Murcia, Spain; data were generated through semi-structured interviews and focus group dialogue, applying the SHOWED technique to the visual and discursive narratives of the participants, and analyzed with Atlas.ti v8. Educational, employment, and healthcare contexts significantly condition well-being. Well-being was determined by the circumstances and support in which gender identity is constructed, within sociocultural environments marked by gender stereotypes, exclusion from social spaces, and fears regarding the irreversibility of certain transition steps. Reported lifetime negative events, social barriers, exclusion, and persistent questioning of identity were associated with increased anxiety, depressive symptoms, and insomnia. At the same time, the relevance of resilience and support networks also emerged during the sessions. Replicating photovoice in diverse settings may help identify social and territorial inequities and inform improvements in clinical practice, healthcare education, public policies, and legislation for transgender and gender-nonconforming people.
Open Access
Lessons learned from cross-sectoral collaboration to protect migrant farmworkers during COVID-19 in Spain
(Public Library of Science, 2025-01-03) Úbeda, Miquel; Villa-Cordero, Vanesa; González-Rodríguez, Agustín; Andrés-Cabello, Sergio; Pérez-Urdiales, Iratxe; Jiménez Lasserrotte, María del Mar; Pastor Bravo, María del Mar; Briones-Vozmediano, Erica; Enfermería; Facultad de Enfermería
In Spain, the agricultural sector relies heavily on migrant workers, especially during seasonal seasons. However, these workers face significant challenges related to precarious working conditions and structural vulnerability, which have become more acute since the outbreak of the COVID-19 pandemic. This descriptive qualitative study was based on 87 personal interviews with health and social professionals from sectors such as NGOs, social services, trade unions, local institutions, and health services to promote compliance with these measures in four Spanish regions. It explored the difficulties faced by migrant agricultural workers in complying with prevention measures during the COVID-19 pandemic, the measures taken by organizations and public institutions and the health consequences of the pandemic on this group. After a reflexive thematic analysis, the results show how to mitigate the pandemic’s impact, both local authorities and NGOs implemented extraordinary measures to care for migrant farm workers. Responses to the pandemic included temporary housing, mass testing, and stricter labor regulations. Working conditions, constant mobility, precarious housing, and language barriers contributed to the difficulty of implementing preventive measures. Covid-19 intensified inequalities and highlighted the lack of preparedness of institutions to deal with this group. The conclusions suggest that intercultural competence in health professional training and the creation of inclusive approaches to health and social care are critical to addressing health disparities and ensuring the well-being of all migrant farm workers, regardless of their migration status or mobility.
Open Access
Burnout and job satisfaction among nurses in three Spanish regions
(Wiley, 2021-05-17) Acea-López, Lorena; Pastor Bravo, María del Mar; Rubinat-Arnaldo, Esther; Bellon, Filip; Blanco-Blanco, Joan; Gea-Sánchez, Montserrat; Briones-Vozmediano, Erica; Enfermería; Facultad de Enfermería
Aims: To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions. Background: The nursing profession involves high work stress due to emotional involvement, workload and available resources. Methods: Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS. Results: The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so. Conclusion: Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment. Implications for Nursing Management: Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.
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Fighting for inclusion across borders: Latin American Trans women’s health in Canada
(Taylor and Francis Group, 2022) Pastor Bravo, María del Mar; Gailits, Nicola; Gastaldo, D.; Bajwa, U.; Bilbao Joseph, C.; Castro, C.; Godoy, S.; Enfermería
Background Worldwide, Trans women from Latin America experience some of the highest rates of violence, which has led many to emigrate. There is limited research exploring the experiences of Trans migrants, and most LGBTQI2S + migrant research focuses on immigrant gay men. This study uses the frameworks of Intersectionality and the Social Determinants of Health (SDoH) to examine the impact of migration on the health and wellbeing of Latin American Trans women living in Toronto, Canada. Methodology This qualitative arts-based study included nine participants and used hand mapping, a sociodemographic questionnaire, and focus groups to generate data. Data analysis encompassed inductive and deductive approaches and rigor was maintained through reflexivity and several verification strategies. Results While migration was used as a safety strategy, participants’ multiple identities as immigrants, Trans women, and Latinas, produced compounded experiences of oppression post-migration. Facing transphobia and xenophobia simultaneously, participants were forced to navigate precarious housing and employment, minimal social capital, and low social position. This limited their ability to exercise power and ultimately caused poor health and wellbeing post-migration; however, participants used sophisticated strategies to resist asymmetrical power relations, actively searching for safety and community participation, and caring for themselves and each other. Conclusion The participants fought for inclusion across borders of economic exclusion and gender identity, borders of power and social position, as well as geopolitical borders. Their intersectional experiences across these “borders” should be understood in the context of migration without liberation, consumption without income, compounding oppressions, as well as positive intersectionality. While the women’s resistance and strength are positive by-products of fighting oppression, they cannot be the solution. Access to health and wellbeing should not be a privilege for some; it must be a right for all.
Open Access
Access to healthcare among transgender and non-binary youth in Sweden and Spain: a qualitative analysis and comparison
(Public Library of Science, 2024-05-14) Pastor Bravo, María del Mar; Linander, Ida; Enfermería; Facultad de Enfermería
Background: Transgender and non-binary (TGNB) people tend to report worse health than cis people, however, despite an increased need for care, they face several barriers when trying to access healthcare. These barriers might be exacerbated when young age intersects with a trans identity, and so there is a need for studies highlighting the experiences of TGNB youth. Aims: To explore and compare how TGNB youth (15–26 years old) in Sweden and Spain experienced their access to healthcare, in order to shed light on the strengths and limitations of different kinds of healthcare systems and improve healthcare provision and policy development. Methods: This study was based on a qualitative analysis of semi-structured interviews with TGNB youth living in Sweden (n = 16) and Spain (n = 18). Of these, 22 identified as male or transmasculine, six as non-binary, and six as women or transfeminine; 25 had undergone some type of gender-affirming care, and the rest were on the waiting list or undergoing preparatory visits and had not started hormonal treatment. The interviews were analyzed using reflexive thematic analysis. An abductive approach was applied, and the Levesque conceptual framework was used to compare the analyses of each set of materials. Results: We present our findings using the structure of the accessibility framework, focusing on approachability, acceptability, availability, affordability, and appropriateness. The conceptualization of accessibility in combination with the concept of cisnormativity illustrates how specific ideals and normative expectations affect access to healthcare for TGNB people across contexts, with most barriers arising from the appropriateness of the services. Discussion: Young TGNB people experience barriers to accessing healthcare both in the Spanish and the Swedish contexts. Strategies to reduce these barriers should be framed within the critique of and resistance to cisnormativity and should focus on users with intersecting marginalized identities to promote health equity.
Open Access
The vulnerability of migrant women working in agriculture in Spain: a qualitative study from the perspective of social and health professionals
(Elsevier, 2025-02-11) Loezar-Hernández, Mariana; González-Rodríguez, Agustin; Urrego-Parra, Heidy Natalia; Jiménez-Lasserrotte, María del Mar; Pastor Bravo, María del Mar; Briones-Vozmediano, Erica; Enfermería; Facultad de Enfermería
Workers from developing countries migrate to Spain to meet the need for low-skilled labour in the agricultural sector. This study aims to explore health and social professionals' discourses on the agricultural work of migrant women in Spain from a gender perspective. A qualitative descriptive study was conducted using 87 semi-structured interviews with 92 professionals from non-governmental organizations, health, and social services between January and October 2021. Thematic analysis was used with Atlas.ti web software. Two main themes emerged: 1) Feminised tasks in agriculture and 2) Harassment towards women. Participants highlighted specific work types and conditions, harassment, sexual harassment, partner influence, and the health consequences of these inequalities on women. Seasonal migrant women face challenges due to their migration status, precarious working conditions, and gender vulnerability. Labour and sexual harassment, and lack of support networks and resources perpetuate their exclusion, affecting their physical and mental health. Public policies are needed to guarantee these women's labour rights and comprehensive care from health and social professionals with an intersectional perspective.