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01-01-2015
Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
Abstract
Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
DOI 10.1590/0034-7167.2015680414i
Views0See moreABSTRACT
Objective:
to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories.
Method:
qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis.
Results:
data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model.
Conclusion:
the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that infl uence and determine right decisions.
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01-01-2015
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
Abstract
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
DOI 10.1590/0034-7167.2015680413i
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Objective:
to know the social representations of sexuality for the elderly, based on the Social Representation Theory.
Method:
study performed in a Basic Family Health Unit in Maracanau-CE, Brazil, with 30 elderly adults. Data were collected from March through April of 2013, using the free word evocation technique. Data were organized and processed using the EVOC 2000.software
Results:
the subjects evoked 150 words associated with the evocator word “sexuality”. Out of these, 43 were different. At the possible core of the representation of sexuality for the elderly, the following words were found: love, affection and respect. Sex, companionship, understanding and coexistence composed the intermediate elements of representation.
Conclusion:
the performed analyses pointed to love, respect and affection as central elements that structured and organized the social representation of sexuality in the elder years for the group studied.
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01-01-2015
Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
Abstract
Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
DOI 10.1590/0034-7167.2015680412i
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Objective:
To identify post-accident conduct in the workplace by health professionals in caring for people with HIV/Aids.
Method:
A qualitative and descriptive research study with a socio-historical perspective (1986-2006), performed in a reference hospital for infectious diseases in the State of Santa Catarina. To collect data, interviews were conducted with oral history among 23 health workers and, for the treatment of data, Bardin’s content analysis was used.
Results:
Post-accident behaviors emerged that included assessment, accident records, chemoprophylaxis when necessary, support, monitoring of the injured worker, and mainly psychological support.
Conclusion:
In situations in which the accident could not be avoided, post-exposure behaviors were important biosecurity strategies mentioned by health workers caring for patients with HIV/Aids, in the sense of minimizing the possible transmission of the HIV virus.
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01-01-2015
Social support towards the necessity of caring after myocardial infarction
Revista Brasileira de Enfermagem. 2015;68(4):649-655
Abstract
Social support towards the necessity of caring after myocardial infarction
Revista Brasileira de Enfermagem. 2015;68(4):649-655
DOI 10.1590/0034-7167.2015680411i
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Objective:
to know the received or assisted social support by the family towards the necessity of care after acute myocardial infarction.
Method:
qualitative and exploratory research. Data collection was carried out through observation and interviews with six families, from February to May, 2012. Data were also analyzed based on the thematic analysis.
Results:
three categories emerged: Immediate social support; Mediate social support; Late social support.
Conclusion:
social support follows the infarction trajectory, which attains the family members and favors the support according to the needs of care in each lived moments by the patient.
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01-01-2015
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
Abstract
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
DOI 10.1590/0034-7167.2015680410i
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Objective:
to understand the interactions of nurses managing nursing care for the hospitalized child with a chronic condition.
Method:
Theoretical and methodological references were used, Complex Thought and grounded theory, respectively. In the study 18 subjects have participated arranged in three groups: nurses, nursing technicians and family members. A semi-structured interview was used as technique for data collection. The data analysis followed three stages of coding: open, axial and selective.
Results:
the category “Needing to manage nursing care to the hospitalized child with chronic condition in Pediatric Inpatient Unit” and their subcategories show the complex inter subjective bindings established by nurses that support the practice of nursing care management.
Conclusion:
There are difficulties for nursing professionals to interact with the child’s family and the dialogical order/disorder/interaction/organization in the implementation of the management process of care is.
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01-01-2015
Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
Abstract
Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
DOI 10.1590/0034-7167.2015680409i
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Objective:
to verify the prevalence of functional disability and associated socioeconomic and demographic factors in elderly patients of Campina Grande/PB.
Method:
cross-sectional study with elderly patients of both genders. The variables associated with functional disability were assessed using Poisson regression.
Results:
A total of 420 elderly patients were included (68.1% women). The highest prevalence of functional disability were found among females aged 80 or older, white, widowed, of economic classes D/E , who lived alone, with frequency of contacts of up to 224 people and diversity of contacts of up to 14 people. After multivariate analysis, statistically significant association was observed between functional disability, gender and age group.
Conclusion:
the association between functional disability gender and age group is shown to be an important guidance for health interventions since it will allow health services to plan actions aiming to improve, maintain or restore the functional capacity of the elderly population.
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01-01-2015
Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
Abstract
Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
DOI 10.1590/0034-7167.2015680408i
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Objectives:
to evaluate the program proposed by the Reorganization Care Plan for Hypertension and Diabetes Mellitus on user’s view, and describe aspects of the trajectory of the participants correlating with the program’s evaluation.
Method:
evaluative study with a qualitative approach conducted in health units with the Family Health Strategy, in a city of the metropolitan region of Curitiba, in the period from September to March, 2012. A total of 30 adults with hypertension and/or Diabetes mellitus were interviewed. Data were analyzed through content analysis.
Results:
Four categories were identified: Disease diagnosis; Reasons for the program need; Knowledge of the program, and program evaluation.
Conclusion:
there was the recognition of the orientations, and the monitoring of activities developed, with emphasis in cost reduction for users.
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01-01-2015
Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
Abstract
Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
DOI 10.1590/0034-7167.2015680407i
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Objective:
to apply the methodology of Culture Circles on adolescents as a strategy for health education of nurses in the construction of the collective knowledge of the thematic violence.
Method:
action research type and qualitative study. Participants were 11 adolescents from a public school in Recife, PE, Brazil. Data production in Culture Circles included the participant observation with field diary, photographic recording and filming, as well as the photovoice technique. The analysis was performed by triangulating data in dialogue with the literature.
Results:
it was shown that the problematizing action provided by the Culture Circle made possible to create situations in which adolescents felt invited to critically refl ect on the phenomenon of violence in all its complexity.
Conclusion:
the health education intervention, performed by Culture Circles, added learning and mutual growth subsidizing nursing care actions that excel at leadership and autonomy of adolescents.
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01-01-2016
Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
Abstract
Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
DOI 10.1590/0034-7167.2016690409i
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Objective:
to analyze nurses’ managerial skills in the hospital setting, their perception of their own education and the relevance of training for their professional practice.
Method:
qualitative study based on the dialectical hermeneutics framework. Thirty-two nurses from three hospitals in the Brazilian state of Minas Gerais contributed to the study by taking part in six focus groups. Records were transcribed and three categories emerged from content analysis.
Results:
results evidenced the following managerial skills: supervision, leadership, decision making, planning and organization, as well as the relevance of education centers for their improvement and the continuing development of the nurses’ managerial skills.
Conclusion:
the authors believe this investigation will contribute for the improvement of nurses’ necessary managerial skills and also to identify gaps in this area of their education.
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01-01-2016
Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
Abstract
Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
DOI 10.1590/0034-7167.2016690408i
Views1See moreABSTRACT
Objective:
analyze the pertinence of calls made by obstetric users of the Mobile Emergency Care Service (SAMU 192) of Botucatu-SP.
Method:
retrospective and analytical research. All records of prehospital obstetric care delivered by the SAMU 192 in 2012 were analyzed. To be considered responsive, calls should lead to referral to a reference obstetric hospital or be classified with the colors red, orange and yellow, according to risk criteria defined by the Ministry of Health.
Results:
considering the two outcomes evaluated: referral to a reference hospital and risk criteria defined by the Ministry of Health, 6.7% and 75.6% of the calls were not pertinent, respectively. There was no matching between outcomes, neither variation between primiparas and multiparas as regards the call pertinence.
Conclusion:
this study ratifies the need for implementing a risk classification protocol in obstetrics, and support managers in the organization, qualification and effective implementation of the Rede Cegonha.
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01-01-2016
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
Abstract
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
DOI 10.1590/0034-7167.2016690407i
Views0See moreABSTRACT
Objective:
to know and analyze the experiences of women who developed an episode of Severe Maternal Morbidity.
Method:
this is a qualitative study, in which we interviewed 16 women admitted to a tertiary level hospital, as a result of this morbid state. We used content analysis in data processing.
Results:
two categories were identified: “Understanding maternal morbidity as a negative presence” and “Moving ahead: on constant alert”. The interviewees mentioned negative aspects, such as treatment difficulties and hospitalization, feelings of fear, concern for the fetus, frustration with the idealized pregnancy, trauma; and positive aspects, such as learning and the expression of the divine will in the experience of illness.
Conclusion:
effective care during the prenatal period, delivery and postpartum period should provide adequate support for the prevention and assistance in Severe Maternal Morbidity.
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01-01-2016
Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
Abstract
Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
DOI 10.1590/0034-7167.2016690406i
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Objective:
to understand how dialogue occurs in the pedagogical relation in the practical reflective teaching in an undergraduate program in nursing.
Method:
qualitative research, case study. Data collection was conducted from May 2013 to September 2014 with eight professors of Nursing, by means of observation and interviews. Data analysis followed the operational proposal constituted by the exploratory stage and the interpretive stage.
Results:
point the dialogue established within the pedagogical relation as a challenge to be faced in practical-reflective teaching, so professor and student build a relationship that foster thought and action in the theoretical context and in the field of practice.
Conclusion:
in establishing a dialogic-reflective tone in the pedagogical relationship, the professor opens paths to new discoveries, enabling the creation of teaching-learning spaces that stimulate autonomy, abilities, and critical and reflective attitudes of students along their education.
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01-01-2016
Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
Abstract
Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
DOI 10.1590/0034-7167.2016690405i
Views0See moreABSTRACT
Objective:
to describe the perception of hospitalized children of school age, on nursing care and understand what are, from their perspective, the best ways to address it to when performing such care.
Method:
qualitative, descriptive, exploratory research, with concepts of Vygotsky used as theoretical framework. The data collection occurred through interviews mediated by drawings and was performed with ten school children, with the interview later transcribed and submitted to a thematic analysis.
Results:
showed the importance of playing during hospitalization, of a friendly and caring approach and providing explanations regarding the performed procedures.
Conclusion:
nursing professionals need to consider how the children would like to receive the care being provided, so that their singularities are respected, characterizing nursing actions according to a perspective of the whole human being.
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01-01-2016
Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
Abstract
Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
DOI 10.1590/0034-7167.2016690404i
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Objective:
to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil.
Methods:
secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00).
Results:
the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment.
Conclusion:
the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.
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01-01-2016
Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
Abstract
Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
DOI 10.1590/0034-7167.2016690403i
Views1See moreABSTRACT
Objective:
to understand health practices of black, elderly people in a terreiro community (community of followers of traditional African-Brazilian religions).
Method:
qualitative descriptive study under the Black-African paradigm of civilization constituted by the Black-African cultural complex and the structuring elements of the African cosmovision. Semi-structured interviews were carried out from July to September 2013, with six black older people from a terreiro community in Porto Alegre, RS.
Results:
thematic content analysis resulted in the following categories: Ancestry; Belonging: the way to know and practice health; Health knowledge and practices in terreiro communities; and Complementarity: promoting health in the terreiro and traditional medicine and its respective subcategories.
Conclusion:
the study understood the importance of having a knowledge of the practices of African traditions in both the lifestyle and health of the older black population to help with nursing planning and interventions in response to their needs.
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01-01-2016
Social representations of citizenship by inpatients: implications for hospital care
Revista Brasileira de Enfermagem. 2016;69(4):625-632
Abstract
Social representations of citizenship by inpatients: implications for hospital care
Revista Brasileira de Enfermagem. 2016;69(4):625-632
DOI 10.1590/0034-7167.2016690402i
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Objective:
examine the social representations of citizenship by inpatients receiving hospital care.
Method:
qualitative approach, using the Theory of Social Representations as a framework, with 31 inpatients in the internal medicine sector of a public university hospital. Semi-structured interviews were conducted, whose data were submitted to the Alceste program, with application of lexical analysis.
Results:
patients understand their rights, and citizenship in the care process is understood based on the right to health, to receive good care from a technical and human standpoint.
Conclusion:
being well treated as a person and the provision of technical-procedural care are rights of patients; the absence of one or the other implies, therefore, lack of respect for their citizenship.
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01-01-2016
Association between self-care and hospital readmissions of patients with heart failure
Revista Brasileira de Enfermagem. 2016;69(3):500-506
Abstract
Association between self-care and hospital readmissions of patients with heart failure
Revista Brasileira de Enfermagem. 2016;69(3):500-506
DOI 10.1590/0034-7167.2016690312i
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Objective:
to assess the association between self-care and the number of hospital readmissions of patients with heart failure (ADHF) and test the applicability of two self-care assessment tools. longitudinal study, performed in a cardiology reference hospital in southern Brazil.
Method:
it included 82 patients with a mean age of 61.85±12.33 years, 57.3% male. The mean score of self-care assessment found the scales European Heart Failure Self-care Behavior Scale and Self-care Scale for Patients with Heart Failure was unsatisfactory.
Results:
it was observed an average of 2.57±1.66 rehospitalization last year for decompensated heart failure. There was a correlation between self-care scores with the number of hospital readmissions for decompensated HF. Education and age were associated to self-care of HF patients.
Conclusion:
both scales assess self-care in a relevant way, and correlated their indexes.
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01-01-2016
Knowledge management in Portuguese healthcare institutions
Revista Brasileira de Enfermagem. 2016;69(3):492-499
Abstract
Knowledge management in Portuguese healthcare institutions
Revista Brasileira de Enfermagem. 2016;69(3):492-499
DOI 10.1590/0034-7167.2016690311i
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Objective:
to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution’s management model.
Method:
a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature.
Results:
the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model.
Conclusion:
management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.
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01-01-2016
Social impairment of patients undergoing hematopoietic stem cell transplant
Revista Brasileira de Enfermagem. 2016;69(3):484-491
Abstract
Social impairment of patients undergoing hematopoietic stem cell transplant
Revista Brasileira de Enfermagem. 2016;69(3):484-491
DOI 10.1590/0034-7167.2016690310i
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Objective:
to evaluate the impairment of social and emotional domains of hospitalized patients undergoing hematopoietic stem cells transplantation.
Method:
an observational, longitudinal study with 25 participants evaluated in the period of pre-transplant, pancytopenia and pre-hospital discharge between September 2013 and September 2014, in a reference hospital for this treatment modality in Brazil. Two international instruments were used, both of which translated and adapted to Portuguese (Brazil): Quality of Life Questionnaire-Core 30 and Functional Assessment Cancer Therapy – Bone Marrow Transplantation.
Results:
patients have shown a statistically significant decrease in the social domain, and stability of the emotional function along the course of treatment.
Conclusion:
hematopoietic stem cell transplantation changes the social function of patients with hematologic cancer during hospitalization stage. Thus, patients should receive guidance addressing the social domain in order that it can be less affected.
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01-01-2016
Frailty and quality of life in elderly primary health care users
Revista Brasileira de Enfermagem. 2016;69(3):478-483
Abstract
Frailty and quality of life in elderly primary health care users
Revista Brasileira de Enfermagem. 2016;69(3):478-483
DOI 10.1590/0034-7167.2016690309i
Views1See moreABSTRACT
Objective:
to investigate the association between physical frailty and quality of life in elderly users of primary health care in the capital of the state of Paraná.
Method:
a cross-sectional, quantitative study with 203 elders. Data collected included: physical activity questionnaires, weight loss, fatigue/exhaustion, quality of life, performance of gait speed tests, and handgrip strength.
Results:
of the 203 older adults, 115 were pre-frail, 49 were non-frail, and 39 were frail, with a significant association with functional capacity and quality of life in all groups. The dimensions resulting from physical aspects, pain, and vitality were associated with those that were non-frail.
Conclusion:
in this study, frailty syndrome was inversely proportional to the quality of life, and significantly associated with functional capacity of older adults. Physical frailty is a manageable condition which can be targeted through geriatric nursing interventions.
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01-01-2016
Impact of home visits on the functional capacity of patients with venous ulcers
Revista Brasileira de Enfermagem. 2016;69(3):468-477
Abstract
Impact of home visits on the functional capacity of patients with venous ulcers
Revista Brasileira de Enfermagem. 2016;69(3):468-477
DOI 10.1590/0034-7167.2016690308i
Views0See moreABSTRACT
Objective:
to assess the impact of protocol home visits on the functional capacity of adult and elderly patients with venous ulcers, before and after guidance received at home.
Method:
clinical experimental, randomized, nonblinded and controlled study, developed with 32 patients (case and control groups). Fields of research were the Wound Outpatient Care Unit of the Antônio Pedro University Hospital and households of patients treated in the outpatient unit. Data collection occurred from February to June 2014, by means of an assessment tool of the health care unit, the TINETTI index and a script for directions to be provided to study participants who received home visits.
Results:
participants in the case group showed significant and differentiated improvement post-intervention when compared to the control group, which remained stable.
Conclusion:
directions provided in the home context were beneficial to the members of the case group.
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01-01-2016
Pressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
Abstract
Pressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
DOI 10.1590/0034-7167.2016690307i
Views0See moreABSTRACT
Objective:
to identify the incidence and describe the associated factors for pressure ulcers in critically ill patients.
Method:
this was a prospective cohort study with 77 patients, using a clinical, metabolic assessment and the associated factors for pressure ulcer, applying the risk scales (Braden and Waterlow) and assigning ulcers to categories.
Results:
an incidence of 22% (95% CI 12.6 – 31.5), with 17 patients with 32 pressure ulcers in the sacral region (47%), and of Class I (72%). The length of stay was greater than ten days (71%), most admissions were surgical (53%) or for congestive heart failure (24%), and were high risk on the Braden Scale (59%).
Conclusion:
the study highlights the high incidence of pressure ulcers, clinical and metabolic characteristics and associated factors, as well as the outcome of death, requiring, therefore, preventive measures.
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01-01-2016
Accreditation in a public hospital: perceptions of a multidisciplinary team
Revista Brasileira de Enfermagem. 2016;69(3):451-459
Abstract
Accreditation in a public hospital: perceptions of a multidisciplinary team
Revista Brasileira de Enfermagem. 2016;69(3):451-459
DOI 10.1590/0034-7167.2016690306i
Views1See moreABSTRACT
Objective:
to analyze the perceptions of the multidisciplinary team on Accreditation in a public hospital.
Method:
descriptive, exploratory, qualitative research, performed in May 2014, using recorded individual interviews. In total, 28 employees of a public hospital, Accredited with Excellence, answered the guiding question: “Tell me about the Accreditation system used in this hospital”. The interviews were transcribed and subjected to content analysis.
Results:
of the speeches, three categories emerged: Advantages offered by the Accreditation; Accredited public hospital resembling a private hospital; Pride/satisfaction for acting in an accredited public hospital.
Conclusion:
participants perceived Accreditation as a favorable system for a quality management in the public service because it promotes the development of professional skills and improves cost management, organizational structure, management of assistance and perception of job pride/satisfaction.
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01-01-2016
Health status and the return to work after traffic accidents
Revista Brasileira de Enfermagem. 2016;69(3):443-450
Abstract
Health status and the return to work after traffic accidents
Revista Brasileira de Enfermagem. 2016;69(3):443-450
DOI 10.1590/0034-7167.2016690305i
Views0See moreABSTRACT
Objective:
to compare the health status of traffic accident victims, at hospital discharge and after six months, and to analyze the predictive variables of their health status and return to work.
Method:
observational, longitudinal study. Data were collected through interviews and medical records of 102 patients with a mean age of 33 years; with the majority being men and victims of motorcycle accidents. The variables were analyzed by means of validated tools, student’s t-test, multiple linear regression, and logistic regression.
Results:
there was an improvement of perception in the patients’ health status six months after hospital discharge and functional capacity. The individuals who returned to work showed better health-related quality of life evaluation.
Conclusion:
improvement of the perceived health status six months after hospital discharge was found. Factors that influenced the patients’ return to work were not identified.
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