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Mendive. Revista de Educación

 ISSN 1815-7696

        30--2023

 

Original articl

Inclusive practices: their social representation in students of the Nursing Career of the Autonomous University of Guerrero

0000-0002-4428-5998Alicia Morales Iturio1  *  , 0009-0000-0024-8629Anselmo Vázquez Vázquez1  , 0009-0007-7939-0193Blanca Estela Sánchez Jaimes1  , 0009-0006-5374-4451Martha Rodríguez Lugo1 

1Universidad Autónoma del Estado de Guerrero. México

ABSTRACT

The article focuses on the problem of educational inclusion, seen from the perspective of a group of students of the Nursing Career of the Autonomous University of Guerrero, who from their teaching practices offered a very interesting overview of their representation of a fundamental aspect of this phenomenon: inclusive practices. The objective was to characterize the social representation of inclusive practices in Nursing students. The study followed a methodological strategy with a mixed quantitative-quantitative design, using empirical methods for data collection such as the questionnaire, the Likert-type scale and the focus group. The most relevant result obtained was that the social representation of inclusive practices in the community of nursing students studied is still insufficient and deserves more attention, as well as the design of innovative strategies and proposals that allow the educational transformation that is currently needed. In conclusion, the research provides knowledge about the social representations held by students, favoring the understanding of the different groups of the study, in order to influence, from their representations in the transformation of inclusive practices in the faculty.

Key words: social representation; inclusive practices; nursing

Introduction

The task of guaranteeing quality education for all constitutes a true professional challenge. Teaching those who learn more easily is not such a difficult task for the specialized professional, but looking for the ways, methods, procedures and means that guarantee the maximum development of each student according to their particularities, is a much more complex task that requires preparation, study, reflection and search for methodological alternatives to give the most appropriate educational response to each student (Nazarova & Bell, 2019).

In order to achieve this purpose, it is necessary to carry out an educational inclusion adapted to the specific needs of the students, if we start from conceiving educational inclusion as a consolidation of proposals and agreements that have a social function, seeking access to knowledge, science, arts, technology, and other goods and values of culture (Gayle, 2021).

One of the key works in this area is the so-called "Index for Inclusion" carried out by Tony Booth and Mel Ainscow in 2002. One of the dimensions that this index contemplates is the so-called inclusive practices, which seeks to guarantee that the actions of the educational center reflect the culture and inclusive school policies. This dimension aims to ensure that activities in the classroom and extracurricular activities encourage the participation of all students and take into account the knowledge and experiences of students inside and outside of school (Cedillo, Barrera, Contreras & Maceda, 2023).

In another order of interest is what is related to social representations, as a social construct of learning within a specific workplace that influences the actions of people and, consequently, the rational process that sustains these actions.

Various authors conceive social representations as a subjective dimension that integrates cognitive and symbolic content and processes, mediated by affective/emotional processes, which updates the object in a particular situation conditioned by the specific socio-historical-cultural context (Lynch, 2020; Alba, 2016).

Social representations thus become an explanation of everyday events and allow us to build a position against them.

Among the approximations of the last decades around the subject under study, it can be highlighted that, in Latin America, experiences in inclusive education developed in Chile, El Salvador, Peru, Colombia, Paraguay, Brazil, Uruguay and Guatemala are appreciated.

These experiences are fundamentally based on studies on the preparation of teachers for educational inclusion, as well as attitudes, knowledge and inclusive practices, in isolation in different localities and schools (Marchesi, Blanco & Hernández, 2014; Marchesi & Hernández, 2019).

The studies on social representation around inclusion in educational environments, consulted up to now, come from countries such as Spain, Mexico and Chile, between 2008 and 2012, where in the case of Chile in 2008, a study on the perceptions and attitudes of pedagogy students towards educational inclusion was found, arriving at interesting results that show that inclusive education favors the socialization of students with special educational needs, that the academic performance of these students is is favored in the inclusive modality, as well as the fact that regular education teachers do not have the necessary training to serve students with these characteristics (Sánchez, 2008).

Also in Chile in 2013, the social representations on the inclusion of people with disabilities in higher education were studied, taking a sample of students from different universities, in this case its objective was focused on determining and describing the social representations of university students on disability, inclusion and the admission of students with disabilities to Higher Education, using for their study the technique of semantic networks, in this case the results were fundamentally related to the main relationship they make regarding the concept of inclusion with the concept of insertion, followed by acceptance and integration ; likewise with the concept of disability, where its semantic core is configured by the word limitation and it is followed by the words deficiency, diversity and disability (Isaacs & Mansilla, 2013; Gutiérrez & Martínez, 2020).

In the case of Venezuela, a study related to the approach to the social representations of university professors on visual disability was found. For this study, a sample of university professors who had had experiences with students with these characteristics in their class was taken, and through an in-depth interview, the most significant results were denoted, the professors have a vision of the person with visual disability from their limitations and not from their potentialities; they have feelings of fear at the time of teaching classes, they demand to expand their knowledge in the area and strengthen their personal and teaching strategies to raise the quality of their educational practice with these students, in this way, initiate contributions to the process of transformation towards an inclusive education within the framework of educational policies at the university level.

In Spain, specifically in the province of Alicante, a study on the perceptions and attitudes of teachers towards inclusion is reported, as an indicator of inclusive educational practices in the classroom, carried out in 2011, with a sample of infant, primary and secondary teachers. Some of the results of this study show that the attitude they assume towards inclusion will directly influence their practice, teachers who said they had the necessary time controlled and followed the mastery of concepts with higher quality and lower-level teachers adapted plus teaching (Gómez-Puerta et al., 2023).

In the case of Mexico in 2012, a study was carried out on the social representations in basic education teachers regarding school inclusion, observation, questionnaire and interview techniques were applied to 17 educational actors, called educational managers, inclusive teachers and collaborating teachers, the results that are manifested in descending order are, as the most outstanding, lack of training, followed by the expressions material, student, guide, capabilities and commit (Garnique, 2012). In 2016, also in Mexico, a study was carried out that addresses disability and higher education: A matter of rights or goodwill? For this purpose, 137 surveys were applied to teaching and administrative staff and students with and without disabilities in the regions of Xalapa and Veracruz.

In this study it was found that students without disabilities are in great agreement regarding the right of people with disabilities to a university education, while university professors agree in a medium-low percentage. Regarding the respect for the rights of students with disabilities by the university, it was found that the professors were in great agreement and the students with disabilities were in agreement.

Regarding accessibility at the university, students without disabilities disagree and teachers agree with a very low percentage. In the aspect, participation in equal opportunities and equity, the students without disabilities agreed, and the teachers also, only in a very low percentage.

Regarding the aspect of seeing the university as a space where diversity is admitted, we have that students without disabilities strongly agree, professors strongly agree to a lesser extent, and in the case of the progress of people with disabilities, we have that students without disabilities strongly agree with a high percentage that they can make progress, followed by administrative staff and teachers to a lesser extent, and students with disabilities perceive themselves as even more limited in this aspect (Cruz, 2016).

In studies carried out specifically in the Faculty of Human Communication of the UAEM, several investigations related to the subject in question were found, a first study that bears the title, "The educational inclusion of students with disabilities: The social representations of the teacher in Primary Education", carried out in 2013, this study proposed as a general objective, to know the social representations of the teacher in the face of the challenge of educational inclusion of students with disabilities who attend primary education.

It was carried out in a primary school in Tetela del Volcán in the State of Morelos, the sample consisted of 18 teachers, 2 support teachers (USAER) and the director of the center in question, the techniques of information collection, participant observation and semi-structured interview were applied, the main regularities found in the study were shortcomings in the academic training of the teacher, lack of interest and commitment of teachers on the subject, beliefs and ways of perceiving people with disabilities and that the representations they have are correspond to the model of educational integration.

As the second reviewed study we find the one entitled "The social representations of the community instructor around Educational Inclusion" carried out in 2016, as a general objective, to identify the social representations of community instructors around educational inclusion to propose alternatives for improvement to community teaching work.

For this, 26 community instructors from suburban and multi-grade schools from 14 municipalities were taken as a population, as well as 3 tutor trainers and 1 primary coordinator, questionnaires, interviews and observations were applied as information collection instruments. The fundamental conclusions reached by the study were related to the gradual modification of the concept of integration by that of inclusion during the course of the study itself, ignorance and lack of training of teachers and a favorable institutional climate. In addition, related to the subject, there is another study entitled, "The USAER teacher in inclusive education: Social representations about their role", also carried out in 2016. The general objective of this study was to know the social representation of the special education teacher who works at USAER regarding their role in the inclusive education process.

To this end, a questionnaire was applied to the USAER teaching staff and an in-depth interview with the USAER staff, this research showed that teachers have the representation that they should play the role of counselor as the main regularities, several of the meanings elaborated that give meaning to inclusion are located in the field of administration, teachers perceive excessive administrative work, lack of time, lack of support from parents, lack of preparation on the subject by teachers as difficulties to work for inclusion.

In summary, at this time we can identify that in a general sense in the reviewed studies, especially in Latin America, referring to the issue of social representations in the field of disability and inclusion, they tell us a panorama where even teachers of different teachings and specifically university teachers, have not had in their initial training, nor in their professional practice, adequate preparation for the care of students with special educational needs, nor for educational inclusion, the term disability continues to be perceived by both teachers and students of the higher level as a term related to limitation. On the other hand, in relation to the term inclusion, the perception that people have continues to be very restricted, framing it in aspects such as companionship, acceptance, right, equality, necessary.

In the case of Mexico, specifically, it was found that basic education teachers do not feel prepared to take on the challenge of inclusion, that they have a lack of interest and commitment on the subject, beliefs and ways of perceiving people with disabilities and that the representations they have correspond to the educational integration model.

It is also found that the representations of the community instructor are related to the ignorance and lack of training of the teachers, as well as the gradual modification of the concept of integration by that of inclusion during the course of the study itself. It can also be seen that the social representation of the special education teacher who works in USAER regarding their role in the inclusive education process considers that they should play the role of counselors, in addition they perceive excessive administrative work, lack of time, lack of support from parents and lack of preparation on the subject by teachers as difficulties to work in favor of inclusion.

In the case of university teachers (Cruz, 2016) they state that they are at a very low level according to the entry of students with disabilities to this level of education, they also state that university institutions are not sufficiently accessible, and regarding the progress of people with disabilities at this level, it can be seen that students without disabilities are in great agreement with this progress, thus not being the representation that teachers have and even lower expectations have the students with disabilities themselves.

Where inclusive practices are weak, hardly critical or naive, it could be the opening for the analysis of the exclusion process in the educational system. Based above all on implications that are hidden behind some educational practices qualified as inclusive that, however, do nothing more than open new doors to marginalization and exclusion.

Exclusion is a generated social fact, either because an individual is incapable of integrating into a society, or because society is incapable of integrating certain categories of individuals considered economically and socially useless.

Perhaps the politically correct discourse, but so far not very effective in the practices of inclusion, should also consider the discourse of exclusion as an indicator of these practices as well.

A foray into the etymology of both terms leads to the Latin verbs included, which means "to enclose, insert" and excluded, whose meaning is "to enclose outside." The term alludes, then, to a spatial relationship in which, demarcated an inside and an outside, the two verbs complement and oppose each other. Center-periphery relations constitute the basis of the meaning of the two concepts.

Referring to the existence of excluded people implies at the same time thinking that there are included people. The point in question is that we are not dealing with two orders of reality, but with the same process.

In relation to this controversial matter, we can state that, within the Mexican university framework, steps are being taken to achieve greater inclusion of students with a disability, such is the case of the three autonomous universities that have academically regulated their services for students with disabilities; These are the National Autonomous University of Mexico (UNAM), the Autonomous University of the State of Morelos (UAEM) and the Autonomous University of Tlaxcala (UATx). Inclusive education in Higher Education (Guajardo-Ramos, 2017; 2021)

However, there are several autonomous universities in Mexico that in one way or another carry out actions to confront the entry into their classrooms and socio-cultural spaces of students with disabilities.

This topic acquires greater relevance when it comes to future professionals who will have the task of living together, educating and guiding people from the communities in an inclusive way, from the human and sensitive role that the Nursing Career assigns to its students.

This study therefore delves into the social representation that these students have about inclusive practices.

Therefore, the objective is aimed at characterizing the social representation of inclusive practices in students of the Nursing Career belonging to the Autonomous University of Guerrero.

Materials and methods

We worked with a group of participants made up of 17 Nursing students who attended their practices in the community and health areas, of which 34% were from the first semesters of the degree and 66% were already in the final semesters of said Degree. Therefore, we worked with a non-probabilistic sampling, for convenience, appropriate to the attendance of nursing students in the different health areas in which the study researchers worked.

The instruments used for data collection and analysis were: Likert-type scale (using the items: totally agree, agree, indifferent, disagree, totally disagree, as well as an open question) aimed to collect information on the indicators on inclusive practices derived from the index for inclusion.

Before the application, the study subjects were informed that the data collected in the instruments would be used only for research purposes, so they would be treated confidentially and anonymously.

In the case of the focus group, guiding questions were asked that allowed delving into aspects that had not been completely clear in the questionnaire and aspects of interest that were or were not reflected in the questionnaires were delved into. At the time of the invitation to participate in the focus group, the students were given the opportunity to decide whether or not to participate in it.

For the analysis of the instruments presented we can see that areas are established, finding for this the area called "inclusive practices developed by the faculty" in the case of the questionnaire for students, we find the statements, from 1 to 6 and from 11 to 14; Regarding the inclusive practices developed by teachers according to the opinion of the students, we have statements from 7 to 10 and from 15 to 19, and regarding the opinion that students have about their own involvement in the development of inclusive practices in the faculty, we find statements from 20 to 23.

In the open question of the questionnaire where the student was suggested to express other aspects that they have not found in the questionnaire, that are related to the topic or that they consider important to add, they are grouped according to the areas described above, in case of not having a direct relationship with any of them they are treated individually as the case may be.

Regarding the focus group, we found that from question number 1 to 5, the opinions of the students regarding the concepts of disability, inclusion, exclusion and the relationship between these concepts were explored, questions 6, 8, 9 and 11 related to inclusive practices in the faculty, questions 7 and 10 related to the preparation of teachers to develop inclusive practices and questions 12, 13 and 14 related to the involvement of students in the development of inclusive practices. .

Regarding the inclusive actions carried out by the teachers, dimension C included 1.1, 1.2, 1.3, 1.6, 1.7, 1.8, 1.10, 2.1 and 2.3.

Regarding the inclusive actions developed by the students, we find in dimension C we find 1.4, 1.5 and 1.11.

To organize the analysis of the results of the study, the areas, indicators and the respective instruments were conceived. (See table 1)

Table 1 - Organization for the analysis of the study results. 

Areas Indicators Instruments
Inclusive practices developed by the faculty Statements from 1 - 6 and 11 - 14. Question 6, 8, 9 and 11Dimension C the 2.2, 2.4 and 2.5. Questions 3 to 8. Likert Scale Students Focus Group Students.
Inclusive practices developed by teachers Statements from 7 - 10 and from 15 - 19 Question 7 and 10Dimension C the 1.1, 1.2, 1.3, 1.6, 1.7, 1.8, 1.10, 2.1 and 2.3. Question 9
Inclusive practices developed by students Affirmations of the 20 -23 Questions 12, 13, 14. Dimension C the 1.4, 1.5 and 1.11. Question 10

After applying the data collection instruments, we proceeded to the analysis of the results obtained in the process.

Results

In the Likert scale applied to the students (graph 1), we can assess in relation to sociodemographic data, that there is a high number of female students more than male, the ages of these students’ range between 18 and 24 years.

Graph 1 - Age-sex relationship in the studied group. 

Table 2 shows the percentage of students who self-perceive with disabilities within the selected sample.

Table 2 - Percentage of students who perceive themselves as having a disability within the selected sample. 

Students %
students with disabilities 6.3%
Students who do not indicate this item 93.7%

In the area of inclusive practices developed by the faculty, according to the indicators taken into account and applied, the Likert scale was obtained: (table 3 and 4)

Table 3 - Representation of the inclusive practices developed in the faculty, in terms of educational policy. 

The Nursing career understands inclusion as a process of change The Nursing career offers welcome activities for students with disabilities There is a strategy of educational attention to students with disabilities during their years of study. There is an area or department responsible for the care of students with disabilities There is some kind of tutoring for students with disabilities at the faculty. There is a legal framework in the Nursing career that covers care strategies for students with disabilities.
Strongly Disagree 18.8 10.0 16.3 13.8 6.3
In disagreement 11.3 25.0 23.8 17.5 21.3 18.8
Indifferent 21.3 32.5 30.0 27.5 26.3 43.8
OK 46.3 18.8 17.5 23.8 26.3 23.8
Totally agree 21.3 5.0 18.8 15.0 12.5 7.5

Table 4 - Representation of the inclusive practices developed in the faculty, in terms of resource logistics. 

The premises of the Nursing Career maintain an adequate distribution for the access of students with disabilities The premises of the Nursing Career have materials adapted for students with disabilities (materials in Braille, sign language interpreter, among others). The resources of the Nursing Career are distributed taking into account the real needs of the students, for their inclusion
Strongly Disagree 22.5 32.5 11.3
In disagreement 23.8 30.0 31.3
Indifferent 17.5 23.8 27.5
OK 28.8 8.8 26.3
Totally agree 7.5 5.0 3.8

In the area of inclusive practices developed by teachers, it was obtained (Table 5)

Table 5 - Criterion of the students on the inclusive practices developed by the teachers in the faculty. 

During the formative process, the family is incorporated as part of the educational inclusion process. Teachers plan their classes taking into account the diversity of their students. The classes that are taught respond to the diversity of the students. The classes taught are accessible to all students. The contents of the classes contribute to a greater understanding of the differences. Students are oriented towards collaborative work in the classroom.
Total. in disagreement 8.8 8.8 7.5 5.0 2.5 3.8
In disagreement 22.5 28.8 25.0 23.8 28.8 15.0
Indifferent 42.5 30.0 31.3 33.8 18.8 15.0
OK 22.5 27.5 25.0 28.8 38.8 50.0
Total. OK 3.8 5.0 11.3 8.8 11.3 16.3

Regarding the inclusive practices developed by the students, the results are shown below in Table 6.

Table 6 - Criterion of the students on inclusive practices developed by the students themselves in the faculty. 

  Students participate in extracurricular activities and pre-professional practices in centers where people with disabilities are cared for, organized by the faculty. All students accept the differences between their own peers and collaborate consciously, facilitating the process of educational inclusion in the faculty. Most of the students consider themselves prepared and motivated to work with people with disabilities in their future professional life. Students with disabilities at the faculty feel welcomed, respected, and included in all spaces and activities at the faculty.
strongly disagree 6.3 2.5 7.5 7.6
In disagreement 12.5 21.3 12.5 16.5
Indifferent 20.0 13.8 22.5 30.4
OK 45.0 41.3 40.0 34.2
Totally agree 16.3 21.3 17.5 11.4

Discussion

The disabilities reported by the nursing students studied are: dyslexia and slow learning, especially in the case of students in the first semesters of the degree. However, in higher grade students, three of them self-indicate with visual impairment, chronic anxiety and myopia; and, there is a student who did not argue the disability that he has.

In this case, in the general results, it is striking that most of the students manifest themselves between indifferent and in agreement, in the statements corresponding to the inclusive practices carried out at the Career level.

It is important to pay attention to the fact that the role of history, culture, the social context and the traversal of a set of personal factors in the ways in which the social representations of certain phenomena are configured and interpreted have indeed been demonstrated (Lynch, 2020; Alba, 2016).

It is interesting to highlight how in the statement that the faculty understands inclusion as a process of change, a considerable majority of students have a positive representation, while similar or necessary aspects for this to be fulfilled are found with a more negative representation, finding themselves indifferent or in disagreement.

Secondly, in aspects such as welcoming activities for students with disabilities and in relation to the fact that there is a care strategy for students with disabilities during the years of the degree, they are in disagreement, expressing an even greater degree of unfavorable assessments regarding these aspects.

In the cases in which a relatively higher degree of favorable evaluation has been found, it is in aspects such as that there is an area or department responsible for the care of students with disabilities; there is some type of tutoring for students with disabilities and that there is a legal framework that protects the strategies of attention to students with disabilities.

Very close to this result, it is worth noting that in relation to the concept of inclusion in higher education, it has been appreciated that the semantic nucleus is configured by the words support, guide, companionship, followed by acceptance, right, equality and necessary (Isaacs & Mansilla, 2013; Gutiérrez & Martínez, 2020), categories in which the role of the figure of the tutor, advisor, or teacher is of vital importance throughout the training process.

It was possible to appreciate in the statements that are represented in the analyzed tables that in a general sense the nursing students studied have a not sufficiently favorable representation regarding the characteristics of access for people with disabilities, which invites reflection and an important challenge of teaching and training work, as well as administrative. It is a fact that the attitude assumed towards inclusion will directly influence the practices that are established and shared (Gómez-Puerta et al., 2023).

It is striking in the statement regarding the incorporation of the family as part of the inclusion process, that a high number of students are indifferent.

As well as the affirmation, regarding whether students are oriented towards collaborative work in the classroom, where everyone has possibilities of participation according to their individual characteristics, where the majority agree and totally agree.

In this case, it is denoted that the majority of students perceive themselves to have inclusive values towards their classmates with disabilities, understanding inclusion not necessarily as a limitation or barrier. This aspect is favorable for the development of inclusive practices in the career, in the communities where they carry out their practices and, of course, in the future exercise of the profession.

However, in previous studies it has been found that the main relationship that students make with respect to the concept of inclusion is linked to the concept of disability, but with a semantic nucleus configured by the word limitation and followed by the words deficiency, diversity and disability (Isaacs & Mansilla, 2013; Gutiérrez & Martínez, 2020).

Also in the case of students with disabilities, we find relevant data that students with disabilities in the statement that all students accept the differences between their own classmates and collaborate consciously, facilitating the process of educational inclusion in the faculty, one student disagrees and the other did not mark that answer, so it seems that students with disabilities do not have a positive representation of this statement, as their fellow students do.

Next, the analysis of the aspects of the focus group is carried out, which were not previously reflected in the analysis of the student questionnaire, in this case they are those related to the conceptualizations that students have about the term’s disability, inclusion, exclusion and the relationship that exists between them, according to their representations.

Regarding the students of the first semesters, it is found that the concept of disability is represented as different abilities, different abilities, authentic, and also as physical or mental capacity, respectively.

Finding in this case an adequate representation of the term, valuing the person for their qualities, despite not making associations with the social aspect of disability in their interaction with the environment.

In this case, it does not correspond to the results of other studies found, where the semantic nucleus of the word disability is configured by the word limitation and it is followed by the words deficiency, diversity and disability (Isaacs & Mansilla, 2013).

In the case of students in upper semesters, this term is represented as a state of the organism, closely associated with the social aspect, they state that the importance of the perception that society has, also represents it as someone who cannot move or has no ability for daily life and they consider it as limitations that people have.

As we can see, the students in semesters closer to the end of the degree have a different representation than those in the first semesters, since, despite offering important elements on the social aspect of disability, this concept is represented as a limitation, finding shortcomings in the representation that these students have, despite being at a more advanced level of their university studies.

Regarding the concept of inclusion, the students of the first semesters represent it as teamwork, which is due to the development of skills, which are different ways of thinking, they also consider that we are all equal and there should be no difference, that there should be no different treatment for anyone and they also link it to the term integration.

In this case, we consider the representation that these students have quite adequate, pointing out only the characteristic that the concept of inclusion is linked to that of integration, apparently not existing an adequate representation of the differences between both practices.

These characteristics appear in studies carried out previously, in this case we find a study carried out in a primary school in Tetela del Volcán in the State of Morelos, where one of the main regularities found suggests that the representations that teachers have correspond to the model of educational integration.

In relation to this controversial issue, it is revealed in the context of the study that, within the Mexican university framework, steps are being taken to achieve greater inclusion of students with a disability, such is the case of autonomous universities that have academically regulated their services for students with disabilities (Guajardo-Ramos, 2017; 2021).

As a conclusion, it can be stated that the students of upper semesters represent the concept of inclusion as the need to include people with disabilities, design facilities and activities appropriate for all.

For their part, the first-semester students have a representation about the relationship between these terms and disability, considering that people who have a disability must be included, due to their different abilities.

Final semester students relate these terms stating that inclusion is related to disability because there are limitations, exclusion is a social label. Society encompasses these characteristics. There are people who do not respect those with disabilities, they are made invisible, they are not cared for, others if they are cared for, include them.

Although there are differences between those who are beginning and those who have almost completed their Nursing studies, it is worth noting that there is still an important gap to work on in this important educational dimension, which is not only designing policies, or supporting and promoting a culture of inclusion, but it is in practices where it is necessary to objectify everything learned and made aware by the university communities, in this case of careers such as Nursing.

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Received: May 27, 2023; Accepted: July 02, 2023

*Autor para correspondencia. E-Mail: alicia@morales.hotmail.com

Los autores declaran no tener conflictos de intereses.

Los autores participaron en el diseño, análisis de los documentos y redacción del trabajo.

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