EMPOWERMENT OF NURSES FROM A HOSPITAL IN THE SOUTH OF CHILE

ABSTRACT Objective: to identify the level of empowerment among the nurses from a hospital located in the south of Chile and verify its potential association with personal and professional characterization variables. Method: cross-sectional and descriptive study conducted with 117 nurses from a hospital in the south of Chile. Data were collected in 2018 using a personal and professional characterization form and the Spanish version of the Conditions of Work Effectiveness Questionnaire II. Data were analyzed using descriptive and inferential statistics. Results: the means of the factors of the empowerment scale were: Opportunity (4.11±0.82); Information (3.81±0.90); Support (3.81±0.86), and Resources (3.13±0.97). Statistically significant differences were found between empowerment and having greater professional experience, working in the medical-surgical unit, having from 3 to 10 patients under responsibility, job satisfaction, and intention to quit their jobs. Conclusion: the nurses reported a positive perception of empowerment in their roles, especially concerning having opportunities to perform tasks that contribute to acquiring new knowledge and skills at work.

CORRELAÇÃO ENTRE MARCADORES DE VULNERABILIDADE SOCIAL FRENTE AO USO DO PRESERVATIVO POR TRABALHADORAS SEXUAIS

Objetivou-se analisar a correlação entre os marcadores de vulnerabilidade social com o uso do preservativo entre trabalhadoras sexuais. Estudo quantitativo, inferencial e de corte transversal realizado com 138 mulheres no sertão produtivo da Bahia, em abril de 2017. Foi utilizado o software SPSS, versão 22.0, para a realização dos testes estatísticos r de correlação, p de Pearson e Teste-t student; adotou-se o nível de significância de 5%. O teste r apontou correlação do uso de preservativo entre as mulheres com idade, cor autodeclarada e o tempo de serviço. No teste p de Pearson, a idade relacionada ao uso do preservativo, o resultado foi negativo, o Teste-t resultou em duas amostras r e p com variâncias equivalentes. As três correlações estabelecidas entre os marcadores de vulnerabilidade social e o uso de preservativo pelas trabalhadoras sexuais são significantes; ressalta-se que o nível de escolaridade não influenciou na adesão ao uso do preservativo.

Learning experiences in community health of nursing students

OBJECTIVE

Understand the learning experiences on health promotion and prevention of nursing interns during their community practice.

METHOD

This is a descriptive-interpretative study, with a qualitative approach, obtaining data from 19 nursing interns from a public university in Lima-Perú, using 3 focus groups.

RESULTS

Three categories were structured: considering the importance of the nursing teacher in their training; experiencing complexity in training for the prevention and promotion of health in the community; and considering the preventive-promotional area as a future professional practice.

FINAL CONSIDERATIONS

The students perceived the complexity of community practice in the prevention and promotion of health. They stated that teachers and students should know the context where they develop their practices and that teacher's exercise leadership in the community. The inclination of some nursing interns for their future professional practice in this area was also evident.

Resources and competencies for management of educational practices by nurses: integrative review

OBJECTIVE

To know the resources used and the necessary skills to the nurse for the management of educational practices in health services.

METHOD

This is an integrative literature review, carried out in the Latin American and Caribbean databases on Health Sciences Information (BIREME), PubMed Central (PMC), Scopus and Web of Science (WoS). After analysis resulted in 18 studies, published between the period 2011 to 2017, which were presented in three categories.

RESULTS

The results were presented in the categories: instrumental resources used in health education, technological resources applied to educational practices and competencies for management of educational practices.

CONCLUSION

This study brings as a contribution to the practice of nurses subsidies for the development of management of educational practices in health services through technological and instrumental resources and professional skills that aim at team development, user autonomy and institutional growth.

Contributions of the nurse's clinical practice to Primary Care

OBJECTIVE

To understand the repercussions of the nurse's clinical practice on Primary Health Care.

METHOD

Qualitative research with the theoretical and methodological contribution of Grounded Theory. Data collection took place between May and October 2016 in Florianópolis' Primary Care service. The theoretical sample was comprised of 18 nurses divided into two groups.

RESULTS

nurses' clinical practice has repercussions on the consolidation of the trust bond between individuals, families and communities, by amplifying the problem-solving efficacy of the Primary Health Care professional's clinical practice. This is due to the implementation of clinical nursing protocols, and also the use of the International Classification for Nursing Practice.

FINAL CONSIDERATIONS

Nurses' clinical practice has positive repercussions on the health of Primary Health Care users.

Management of prenatal nursing care at a Health Center in Angola

OBJECTIVE

To understand how care management in prenatal care in a Care Center in Angola happens.

METHOD

A qualitative study, which used the Constructivist Grounded Theory (GT) as a methodological framework. The theoretical sample consisted of 22 participants, including nursing professionals, pregnant women and nursing students from Huambo, Angola. The data were collected by interviews and analyzed according to initial and focused coding.

RESULTS

Five categories arose: Embracing the pregnant woman for prenatal care; Performing the prenatal consultation; Creating a bond and dialogical relationship with pregnant women; Establishing collaborative working relationships; and Inserting the pregnant woman's family into prenatal care.

CONCLUSION

The management of nursing care in the study setting is effective through complementary and interdependent steps, based on collaborative relationships among professionals and in the effort to establish bonds with pregnant women and their families.

CONTEXTO DA VIOLÊNCIA CONJUGAL EM TEMPOS DE MARIA DA PENHA: UM ESTUDO EM GROUNDED THEORY

Objetivo: desvelar o contexto da violência conjugal experienciados por mulheres em processo judicial. Método: pesquisa qualitativa baseada na Grounded Theory, realizado com 29 mulheres em processo judicial por violência conjugal e os nove profissionais que atuam junto a duas Varas de Justiça pela Paz em Casa, na Bahia, Brasil. A coleta dos dados foi realizada no período de janeiro a maio de 2015. Resultados: em que pese a Lei Maria da Penha, o estudo revela que as relações conjugais das mulheres são permeadas por abusos físicos, sexuais, psicológicos, morais e patrimoniais, inclusive expulsão do lar. Conclusão: o contexto de violência experienciado na conjugalidade feminina se manifesta de diferentes formas, passíveis de identificação por profissionais de saúde, o que possibilita ação de cuidado à mulher e enfrentamento da problemática.

Entrepreneurship in Nursing: an integrative literature review

ABSTRACT Objective: To demonstrate in the national and international literature the concept and typologies of entrepreneurship in Nursing. Method: Integrative review in six databases, with the descriptors entrepreneurship, entrepreneurs, entrepreneurial, entrepreneurialism, intrapreneurial, iniciativa empresarial, contrato de risco, nursing, nurse, nurses, enfermagem and enfermeira, making a final sample of 31 articles. Results: The concept of entrepreneurship in Nursing is related to personal and professional characteristics, such as autonomy, independence, flexibility, innovation, proactivity, self-confidence and responsibility. The typologies found were: social and business entrepreneurship, and intrapreneurship. Social entrepreneurship is a mechanism of social mobilization and transformation, entrepreneurship is one in which nurses are autonomous professionally and intrapreneurship relates to corporate entrepreneurs. Conclusion: Entrepreneurship can increase the visibility of the profession and foster the creation of new spaces for nurses.

BEST PRACTICES IN NEONATAL NURSING CARE MANAGEMENT

ABSTRACT Objective: to build a theoretical matrix of care system/organization of Nursing in a Neonatal Intensive Care Unit based on the meanings attributed by the Nursing Team professionals and other involved actors in the relationships and interactions of care in dealing with the fragility of living/surviving newborn. Method: a qualitative study adopting the theoretical framework the Complexity Paradigm and the Grounded Theory as research design. The participants were 22 subjects divided into four sample groups. Data was obtained from interviews and analyzed through comparative analysis, performed from May to August 2012. Results: nursing care practices management is based on the experience of the relationships/interactions with the family members and other health team actors, aiming to incorporate best practices. Thus, nursing care practices management seeks to address the fragility that surrounds prematurity, minimizing the sequelae when seeking newborn’s survival. Conclusion: the organization of nursing care system in a Neonatal Intensive Care Unit is complex, dynamic, interactive and interdependent with other health systems, mobilized by a management process of care and/or good care management practices that enables pre-term and his family a care focused on the fragility and uncertainties of living/surviving in singular conditions of life. The nurse stands out with the fundamental role of articulation in the light of the relationships/interactions in the care and organizational daily routine.

THE BREAST RECONSTRUCTION PROCESS OF WOMEN WITH BREAST CANCER: A THEORETICAL MODEL

ABSTRACT Objective: to build a theoretical model on the experience and meaning of the breast reconstruction process in women with breast cancer. Method: a qualitative research using Grounded Theory and Symbolic Interactionism as theoretical-methodological frameworks. Data collection and analysis occurred simultaneously, from April to October 2015, through theoretical sampling and theoretical saturation of the categories. Theoretical sample with 31 participants, 21 women and 10 health professionals, interviewed at home or at work, comprising four sample groups. Results: the theoretical model “Women face challenges and overcome difficulties: fear of death, breast mutilation and breast reconstruction, changing the way of being a woman” offers an explanation of the phenomenon and emerged from the systematic interrelation of the 11 study categories, with three causal categories, one category representing the context, five categories of intervening conditions, the strategies and the consequences represented by one category each. Conclusion: this study demonstrates the experience of the breast reconstruction process for women with breast cancer, the meaning of overcoming difficulties, value life and oneself, putting themselves first, taking care of themselves and learning to change, to be more tolerant, to value material things less and to face life with courage and faith. It also indicates that research on theoretical models on issues that plague our professional practices can enhance teaching and science and, consequently, improve care in women's health.

BREAST RECONSTRUCTION FROM THE PERSPECTIVE OF WOMEN SUBMITTED TO MASTECTOMY: A META-ETNOGRAPHY

ABSTRACT Objective: to analyze qualitative studies published in the national and international scientific literature on breast reconstruction after mastectomy for breast cancer, from the perspective of women. Method: systematic literature review using meta-ethnography, where the synthesis of knowledge is based on the induction and interpretation of the data found. Searches in the electronic databases identified 65 studies. 27 studides meet the inclusion and exclusion criteria. 13 studies compressed the analytical corpus of the review, according to the Critical Appraisal Skills Programme checklist. The data were synthesized by means of the meta-ethnographic approach. Results: the analyzed studies showed similarities regarding the women´s decision to perform breast reconstruction, the difficulty of choosing the type of surgery and to deal with the experience of the reconstruction, and that the women had difficulties in establishing relationships with certain health professionals, especially with doctors. They refer to the ambivalence of feelings regarding the expectations and results of breast reconstruction and complex process of "carrying on". Conclusion: this review synthesizes the scientific knowledge regarding women's perspective regarding the breast reconstruction process and highlights that health professionals must understand the perceptions of women undergoing mastectomy and breast reconstruction in order to improve the care provided.

Good practices for patient safety in the operating room: nurses' recommendations

OBJECTIVE

To describe nurses' recommendations for good patient safety practices in the operating room.

METHOD

Quantitative, descriptive and exploratory research developed from an online survey of 220 operating room nurses from different regions of Brazil. The data processing for textual analysis was performed by the software IRAMUTEQ.

RESULTS

There were eight recommendations: (1) Involvement of the multiprofessional team and the managers of the institution; (2) Establishment of a patient safety culture; (3) Use of the safe surgery checklist; (4) Improvement of interpersonal communication; (5) Expansion of nurses' performance; (6) Adequate availability of physical, material and human resources; (7) Individual search for professional updating; and (8) Development of continuing education actions.

CONCLUSION

These recommendations can be used as care management strategies by nurses for patient safety in the operating room.

REVASCULARIZAÇÃO MIOCÁRDICA: REFERÊNCIA E CONTRARREFERÊNCIA DO PACIENTE EM UMA INSTITUIÇÃO HOSPITALAR

RESUMO Objetivo: compreender o processo de referência e contrarreferência vivenciado pelo paciente com coronariopatia submetido à cirurgia de revascularização do miocárdio. Métodos: pesquisa qualitativa, ancorada na Teoria Fundamentada nos Dados. O cenário da pesquisa foi uma instituição hospitalar pública, referência em atendimento cardiovascular no Estado de Santa Catarina (Brasil). A coleta de dados ocorreu entre março de 2013 a junho de 2014, por meio de entrevista semiestruturada envolvendo 21 participantes, distribuídos em três grupos amostrais (pacientes, profissionais de saúde e profissionais gestores). Resultados: o processo de referência e contrarreferência aponta o fenômeno “Emergindo a alta complexidade como referência para a pessoa submetida à revascularização miocárdica diante da fragilidade da Atenção Primária à Saúde no acompanhamento e articulação com os demais níveis de atenção no Sistema Único de Saúde”, sustentado por cinco categorias. Conclusão: para que a referência aconteça há necessidade de consolidar o vínculo do paciente com coronariopatia com a atenção primária à saúde, uma vez que este encontra dificuldades no acompanhamento da sua condição na rede pública. Na contrarreferência evidenciou-se a desarticulação entre os serviços de atenção à saúde, a qual afeta o cuidado à pessoa submetida à revascularização miocárdica na manutenção da sua qualidade de vida.

Referral and counter-referral: repercussions of coronary artery bypass graft in the perspective of Primary Care

OBJECTIVE

to understand how repercussions of the referral and counter-referral of patients with indication/submitted to Coronary Artery Bypass Graft Surgery in the context of Primary Health Care.

METHOD

qualitative research with a theoretical-methodological contribution anchored in the Grounded Theory. Theoretical sampling was performed with 41 participants, divided into three sample groups (patients, health professionals and managers) in the Metropolitan Region and Western Region of Santa Catarina State.

RESULTS

the need for improvement in the process of recording clinical data in the regulation system emerged to strengthen patient referral; and the absence of a formal process of counter-referral and adaptation of lifestyle with repercussion in the counter-referral.

FINAL CONSIDERATIONS

the repercussions of the referral and counter-referral of patients with indication/submitted to the CABGS in the context of Primary Care are experienced through professional guidance and, in particular, by family support.

Myocardial revascularization: factors intervening in the reference and counter-reference in the hospital setting

OBJECTIVE

To understand the intervening factors in the process of reference and counter-reference of the individual with heart disease in the scenario of high complexity in the health care network.

METHOD

Research anchored in the Grounded Theory (Teoria Fundamentada nos Dados). It totaled 21 participants. The data collection scenario was a cardiovascular reference hospital in the south of Brazil and occurred between March and June 2014.

RESULTS

The intervening factors in the reference process were the difficulty to access the points of the network and telemedicine and the central to manage the flow of patients in the network. In the counter-reference, there was a link with the hospital and the lack of communication among network professionals.

CONCLUSION

It reveals the need to reorganize the service flow in HCN, enhancing PHC, expanding the performance of medium complexity and increasing the capacity of high complexity in order to carry out the process of reference and counter-reference.

Care management of a patient with Devic's Disease in Primary Health Care

OBJECTIVE

Describing the care management of a patient affected by Devic's Disease in the Primary Health Care setting.

METHOD

A clinical-qualitative case study based on the health status of a Devic's Disease patient in a Health Center of the municipality of Florianópolis, accompanied by the Family Health Team. Data collection was carried out by electronic medical records, documents of the patient's domain, as well as a semi-structured interview with the participant. Ethical aspects of research involving human beings were respected.

RESULTS

The categories were defined according to relevance criteria with the purpose of reporting the case study, presenting a unique implemented therapeutic project and describing the patient's perception of her situation.

CONCLUSION

Acupuncture and auriculotherapy were successfully performed, evidencing an improvement in the patient's pain, which may contribute to new possibilities of care. Despite this, not all the available care tools were implemented, considering the range of complementary care therapies that go beyond the medicinal approach.

Meaning of nursing care to brain dead potential organ donors

OBJECTIVE

To understand the meanings of care to brain dead potential organ donors for nurses, and construct a theoretical model.

METHOD

Qualitative study based on the Grounded Theory approach. Data were collected through open interviews with 12 nurses, distributed in three sample groups in a university hospital in northeastern Brazil, from December 2010 to June 2011.

RESULTS

The phenomenon Unveiling multiple relationships and interactions of nurses in the complexity of patient care in brain dead potential donors is supported by the interrelationship of five categories and results from the need to organize care practices in the context of the intensive care unit, considering the factors involved in the relationship between nurses, staff and family and reveals challenges for nurses imposed by the complexity of the care process.

CONCLUSIONS

The meaning of care to brain dead potential donors involves understanding the complexity of this patient who can save somebody's life through organ donation.

SEPSISCARE: AVALIAÇÃO DE APLICATIVO MÓVEL NO CUIDADO DE ENFERMAGEM AO PACIENTE COM SEPSE*

Objetivo: Avaliar um aplicativo móvel para a prevenção, identificação e cuidados de enfermagem ao paciente séptico. Método: Estudo descritivo que utilizou o Processo de Desenvolvimento de Produtos como método para desenvolvimento do aplicativo. Participaram do estudo seis enfermeiras da Unidade de Terapia Intensiva de um hospital público de Santa Catarina. A coleta dos dados ocorreu por meio de entrevistas nos meses de setembro de 2016 a janeiro de 2017, e utilizou-se a análise de conteúdo para análise dos dados. Resultado: O aplicativo SepsisCare foi desenvolvido na plataforma Mobincube®, com 28 telas, que na concepção dos enfermeiros é um recurso importante para a prática do enfermeiro no cuidado ao paciente com sepse. Conclusão: Acredita-se que o desenvolvimento deste aplicativo móvel facilitará a identificação, prevenção e gerência dos cuidados em torno da sepse, e contribuirá para a atualização desses profissionais, possibilitando, assim, um atendimento mais seguro e de qualidade.

University management nurse: a grounded theory

OBJECTIVE

to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university.

METHOD

this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups.

RESULTS

there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a) conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b) actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c) consequences, such as Improving teaching work and taking responsibility for university education.

CONCLUSION

the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

DESVELANDO O SIGNIFICADO DA EXPERIÊNCIA VIVIDA PARA O SER-MULHER NA AMAMENTAÇÃO COM COMPLICAÇÕES PUERPERAIS

RESUMO Objetivo: compreender o significado da experiência vivida para o ser-mulher na amamentação com complicações puerperais. Método: estudo qualitativo, de natureza fenomenológica, sustentado na fenomenologia da percepção e na hermenêutica. A coleta de dados ocorreu em duas maternidades da Região Nordeste do Brasil, por meio de entrevistas em profundidade com 28 puérperas, de fevereiro a outubro de 2014. A análise dos dados compreendeu: leitura das descrições, identificação das unidades temáticas e dos temas essenciais. Resultados: da análise das descrições emergiu como significado central: amamentar é mais importante do que a situação vivenciada na complicação puerperal, e como temas essenciais: percebendo o apoio da família e sentimentos percebidos ao vivenciar a amamentação com complicação. Conclusão: o estudo oportunizou compreender que a amamentação vivenciada pelo ser-mulher com complicação puerperal é composta por um conjunto de significados, e o conhecimento destes pelos profissionais de saúde, poderá contribuir para um cuidado mais integral.