Men's experience of caring for a family member with cancer: a theory based on data

OBJECTIVE

to understand the meaning attributed by men to the experience of caring for their family member with cancer and to develop a substantive theory that represents the experience of men caring for their family member with cancer.

METHOD

this is qualitative research guided by the methodological framework of Grounded Theory and the precepts of Symbolic Interactionism. A form with identification and interview data was used. The analysis followed the substantive and theoretical coding stages.

RESULTS

12 male caregivers of their family member with cancer participated. The constant comparative analysis of the data allowed the creation of a substantive theory "Experiencing the care of a family member with cancer: men as a caregivers" explaining the experience that has as its central category "The love that drives care", representing the symbolic actions and attitudes of men living in the context of illness due to cancer and care.

CONCLUSION

the theory allowed us to understand feelings, perceptions, ways of acting and facing the diagnosis, providing care, recognizing difficulties and learning from the situations that arise, making explicit the interactional processes and symbolic elements present and how these influence male caregivers in their actions and attitudes.

BACKGROUND

(1) For men, caring is a choice (2) Taking care symbolizes a way of expressing love and reciprocation. (3) Love in caring is strengthened by reciprocity, commitment, gratitude and zeal. (4) To provide care, man reorganizes himself and adjusts to the conditions that present themselves (5) Male caregivers need to be heard and included in the actions of health teams.

Focus group in the development of concepts for a Nursing model: experience report

OBJECTIVE

To communicate the experience of developing concepts for the construction of a care model through focus groups.

METHODS

An experience report on the development of concepts through remote focus groups with members of a research group from a public university in southern Brazil.

RESULTS

Focus groups were developed in which homogeneity and heterogeneity criteria were observed among participants. In addition to the concepts of the nursing metaparadigm, the concepts of care and family-centered care were developed, relevant to the nursing care model in question.

FINAL CONSIDERATIONS

Despite the challenges of conducting remote focus groups, they were suitable for the collective construction of concepts for a nursing care model, allowing the interaction of participants from different locations.

Palliative care management by caregivers in home care: theoretical validation in a conversation circle

OBJECTIVES

to present the validation process of a Grounded Theory on the management of palliative care at home by a caregiver of a family member who experiences a death/dying process.

METHODS

a qualitative, explanatory research, which validated a theoretical matrix through a conversation circle containing 15 family caregivers and nine healthcare professionals, in December 2018.

RESULTS

forty-six propositions were validated regarding family caregivers' contextual, causal, intervening conditions, consequences and action strategies to deal with the dying and death process of a family member. Conversation circles encouraged dialogue and (re)signification of the senses and knowledge of those involved, proving to be a way of educating and promoting the exercise of citizenship by participants.

FINAL CONSIDERATIONS

the conversation circle made it possible for participants to interact and share information and experiences regarding home care for palliative patients and their families.

Construction of a nursing care protocol for children in post-hematopoietic stem cell transplantation

OBJECTIVE

To construct a nursing care protocol for children in post-hematopoietic stem cell transplantation.

METHOD

Methodological research carried out from January to September 2019, in three steps: (a) integrative review (nursing care was identified); (b) theoretical structuring and organization of healthcare based on the Theory of Basic Human Needs and on the International Classification for Nursing Practice (supplementing the review data); and (c) development of a protocol in the three previously mentioned stages. Analysis of the understanding of the protocol's items/care was performed by three specialist nurses.

RESULTS

The care protocol consists of 40 nursing problems and is organized in accordance with the psychobiological, psychosocial, and psycho-spiritual needs of children undergoing transplantation, integrating practical and guidance care.

CONCLUSION

The care protocol is an important technology for nursing care to transplanted children, aimed to prevent and manage transplantation complications.

Use of the International Classification for Nursing Practice in the construction of a care protocol

OBJECTIVES

to describe the use of the International Classification for Nursing Practice (ICNP®) in the construction of a nursing care protocol for children undergoing hematopoietic stem cell transplantation.

METHODS

experience report.

RESULTS

nursing problems were defined based on complications identified in a previous study; later, the ICNP® enabled the organization and systematization of childcare. The care protocol consists of 40 nursing problems, with their human needs affected, diagnoses and nursing interventions. The axes Focus, Judgment, Location, Action, Means, Time, and Client were used in the elaboration of diagnoses and interventions proposed in the protocol. Final Considerations: the use of the classification allowed the establishment of nursing interventions compatible with the needs of the child undergoing transplantation, providing support for the care protocol. It made it possible to encourage the use of classification in this context, contribute to patient safety and strengthen professional practice.

Cuidados de transição: análise do conceito na gestão da alta hospitalar

RESUMO Objetivo analisar o conceito Cuidados de Transição no contexto da gestão da alta hospitalar. Método reflexão analítica utilizando-se a análise conceitual de Walker e Avant: seleção do conceito; definição do objetivo, identificação do uso do conceito (busca na literatura e dicionários entre setembro-dezembro/2019 nas bases de dados: PubMed, Biblioteca Virtual em Saúde e SCOPUS. Consideraram-se 77 artigos que contemplaram conceito e outros termos que corroboraram o estudo; para fins metodológicos, 12 estudos possibilitaram a análise); definição dos atributos; descrição de caso modelo; descrição de casos adicionais; definição de antecedentes e consequentes; definição de indicadores empíricos. Resultados os antecedentes cuidados fragmentados e reinternação são comuns ao conceito. Identificaram-se atributos cuidado integrado, colaboração profissional, coordenação, planejamento da alta, comunicação, integração profissional e gerenciamento de casos. Conclusão e implicações para a prática foi oportuno analisar o conceito em conjunto com termos relacionados ao contexto da alta hospitalar. Cuidados de Transição são práticas coordenadas e eficazes para a Continuidade dos Cuidados na transferência do usuário na alta hospitalar; nesse contexto, as Enfermeiras de Ligação são potenciais protagonistas para estar à frente nesse processo de Integração. As especificidades do conceito poderão favorecer a sua compreensão e a construção de conhecimentos que repercutam no cuidado coordenado e contínuo.

Construção de protocolo de cuidados de enfermagem à criança no pós-transplante de células-tronco hematopoiéticas

RESUMO Objetivo: Construir protocolo de cuidados de enfermagem à criança no pós-transplante de células-tronco hematopoiéticas. Método: Pesquisa metodológica conduzida entre janeiro e setembro de 2019 e, em três etapas: a) realização de revisão integrativa (cuidados de enfermagem foram identificados); b) estruturação e organização teórica de cuidados a partir da Teoria das Necessidades Humanas Básicas e da Classificação Internacional para a Prática de Enfermagem, complementando os dados da revisão; c) desenvolvimento do protocolo, cuja elaboração integrou as etapas anteriores. A análise de compreensão de itens/cuidados do protocolo foi realizada por três enfermeiros especialistas. Resultados: O protocolo de cuidados é composto por 40 problemas de enfermagem e está organizado de acordo com as necessidades psicobiológicas, psicossociais e psicoespirituais de crianças submetidas ao transplante, integrando cuidados práticos e de orientação. Conclusão: O protocolo é opção tecnológica para a assistência de enfermagem à criança transplantada, com vistas à prevenção e manejo das complicações.

Gestão de cuidados paliativos por cuidadores na atenção domiciliar: validação teórica em roda de conversa

RESUMO Objetivos: apresentar o processo de validação de uma Teoria Fundamenta nos Dados sobre a gestão do cuidado paliativo domiciliar pelo cuidador de um familiar que vivencia processo de morte/morrer. Métodos: pesquisa do tipo explicativa, qualitativa, que validou uma matriz teórica por meio de uma roda de conversa contendo 15 cuidadores familiares e nove profissionais de saúde, em dezembro de 2018. Resultados: foram validadas 46 proposições relativas a condições contextuais, causais, intervenientes, consequências e estratégias de ação de cuidadores familiares para lidar com o processo de morrer e morte do familiar. A roda de conversa impulsionou o diálogo e a (re)significação dos sentidos e dos saberes dos envolvidos, demonstrando ser uma forma de educar e propiciar o exercício da cidadania dos participantes. Considerações Finais: a roda de conversa possibilitou a interação dos participantes e o compartilhamento de informações e experiências diante do cuidado domiciliar de pacientes paliativos e seus familiares.

Decision making by health professionals during COVID-19: an integrative review

OBJECTIVE

To analyze the scientific production on the decision making of health workers during the COVID-19 pandemic.

METHODS

Integrative review in the databases CINAHL, MEDLINE, Scopus, ScienceDirect, WoS, and BVS. Inclusion criteria: original articles available in full, in any language, related to the object investigated.

RESULTS

During this pandemic, health workers have been making decisions based on ethical/bioethical principles (utility, beneficence, non-maleficence, autonomy, justice, proportionality, flexibility, clinical prognosis, duration of the need, and fair health attention), values (solidarity, equality, equity, utilitarianism, relational autonomy, reliability, reciprocity, maximization of the benefits and resources, and prioritization of those in worse conditions), beliefs and personal motivation, protocols, directives, tools, algorithms, recommendations, and criteria.

FINAL CONSIDERATIONS

Decision making has never been so necessary as in this pandemic. This article is not a recipe for the professionals, since decision making is based on numerous factors. However, it provides them with a foundation that can be helpful in this difficult process.

The role of nurses in the integration of care for people with chronic noncommunicable diseases

OBJECTIVE

To describe the role of nurses in the integration of care for people with chronic noncommunicable diseases.

METHOD

This was an integrated single-case study conducted with care coordinators and nurses, purposefully selected, with interviews, documentary analysis and computerized files as sources of evidence. Categorical analysis was used based on data organization using MAXQDA® software, version 2018.

RESULTS

Thirty-four professionals participated. Most of the professionals who held coordination positions were nurses. The categories clinical team integration and care integration and their subcategories increased understanding of the roles of nurses.

CONCLUSION

The role of nurses in integrating care for people with chronic noncommunicable diseases was mainly focused on coordination of care, which occurred because of the different roles that they play and that give them autonomy to make decisions and place them in the front line to contribute to situations that required assertive attitudes, such as directing users within the care network.

Strengthening nurses in prenatal care through reflection-action

OBJECTIVE

To describe the reflection-action process for the development of nurses' competence in prenatal care.

METHOD

Action research with 30 nurses from primary health care in a municipality in the south of the country, through workshops held between June and August 2019, analyzed according to Creswell.

RESULTS

Nurses identify nursing consultation as a differential in prenatal care; point out the ignorance of work processes as an obstacle to the protagonism in prenatal care; and they highlight the registration of activities and the dissemination of the nurse's role with the team and the population as aspects that strengthen and value the profession.

CONCLUSION

The workshops enabled reflection to identify and overcome obstacles to the development of a competent practice, by strengthening nurses regarding the work process itself to discuss and implement changes in order to improve and enhance the care provided.

Nursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review

OBJECTIVES

to analyze the available evidence on the nursing care provided to patients after hematopoietic stem cell transplantation.

METHODS

integrative review with the search for primary studies in four databases and a virtual health library. A broad search strategy was used, including research published in English, Brazilian Portuguese, or Spanish, between 2008 and 2018, totaling a sample of 42 studies.

RESULTS

the studies were grouped into three categories: multiple nursing care (n=19), first-line care (n=18), and self-management of care (n=5).

CONCLUSIONS

nursing care is critical, comprising patients' physical, psychological and social aspects. It occurs in hospital and home contexts, mainly involving technical actions and health guidance. The evidence identified provide subsidies for decision-making; however, most studies are of the non-experimental type, indicating the need for conducting intervention research.

Conceptions on care and education technologies in the practices of the hospital nurse / Concepções sobre tecnologias do cuidar e educar na práxis do enfermeiro hospitalar

Objetivos: analisar a(s) concepção(ões) de enfermeiras que atuam no cenário hospitalar sobre tecnologias do cuidar e educar. Método: pesquisa qualitativa, descritiva-exploratória, fundamentada pelo referencial filosófico da práxis humana. Desenvolvida com 21 enfermeiras de um Hospital público do Sul do Brasil. A coleta dos dados ocorreu por meio de entrevista semiestruturada e observação. Para análise, utilizou-se a técnica de análise de conteúdo temática. Resultados: emergiram duas categorias: tecnologias do cuidar: da utilização em si às maneiras de se utilizar e gerenciar; e tecnologias do educar: aproximações com a práxis do educar-cuidando e cuidar-educando. Conclusão: analisar e refletir sobre conceitos de tecnologias do cuidado e educação demonstrou que os enfermeiros necessitam evoluir seus conhecimentos sobre essas definições, no intuito de aplicá-las na/para tomada de decisões, elevando assim, a qualidade dos resultados assistenciais.

Care for the critical patient undergoing point-of-care testing: integrative review

OBJECTIVE

to identify, based on the evidence, point-of-care testing in bedbound in critically ill patients.

METHOD

integrative review, carried out through search in Pubmed, Virtual Health Library, Joanna Briggs Institute, The British Institute of Radiology, Brazilian Radiology, and Google Scholar databases. We used the PICO research strategy and selected articles published from 2013 onwards, which presented information about point-of-care testing.

RESULTS

the different interventions found in the analysis of the 23 selected articles allowed the thematic grouping of care related to safety in communication, patient identification, care with devices, and the prevention and control of infection, which can be used in point-of-care testing. Final considerations: The care described in the evidence provided support for validating a safe care protocol for critically ill patients undergoing imaging studies in bed.

Covid-19 containment measures adopted in bone marrow transplantation service

OBJECTIVE

To describe the experience of nursing, in adopting containment measures, in the care of patients undergoing hematopoietic stem cell transplantation to avoid COVID-19.

METHODS

Experience report.

RESULTS

Containment measures involve those recommended by major health organizations, such as hand hygiene, social isolation, identification and monitoring of suspected or confirmed cases; and also the local measures implemented in the health service, such as the reduction in the number of hospitalizations for transplantation, clinical screening of outpatients entering the service, monitoring of respiratory signs and symptoms, the allocation of specific isolation rooms for those suspected of the disease and testing of symptomatic patients. Final considerations: The nurse is responsible for the challenge of planning nursing care to prevent the spread of coronavirus in a high-risk population and to implement measures based on available evidence, periodically updated.

Strengthening and weakening factors for breastfeeding from the perspective of the nursing mother and her family

OBJECTIVE

To describe the strengthening and weakening factors for breastfeeding.

METHOD

This is a descriptive multiple case qualitative study, conducted in Curitiba, Parana, with members of 17 families with children between 6 and 12 months old, through semi-structured interview and construction of genograms, analyzed by the strategy of cross case synthesis.

RESULTS

28 people participated in the study. Strengthening factors for breastfeeding were: the desire to breastfeed; child with facility for breastfeeding; mother with time available to the child; previous breastfeeding experience and family history of breastfeeding; the support and encouragement to breastfeed. Weakening factors were: negative expectations; the myth of weak milk; child's disease; maternal illness; negative experiences of the mother; the absence of family history of breastfeeding; lack of a support network.

CONCLUSION

Breastfeeding is a family and social phenomenon. Therefore, practices that go beyond the mother-baby dyad are necessary. The care process should include the social and subjective dimension, strengthening the support network of nursing mothers, in order to obtain more satisfactory professional practices that promote breastfeeding.

STANDARDS OF KNOWLEDGE THAT FOUND NURSING PERFORMANCE IN HOME CARE

ABSTRACT Objective: to analyze the knowledge standards that found nursing practices in the home care setting. Method: qualitative study using a single case study strategy, supported by the dialectical methodological framework. Thirteen nurses who work in home care services from two municipalities in Minas Gerais, Brazil, participated. The data were obtained in 266.5 hours of participant observation and 8 hours and 58 minutes of interview and submitted to Critical Discourse Analysis. Results: empirical knowledge was revealed to be fundamental for clinical, managerial and educational care at home. The adaptations specific to this environment require aesthetic knowledge. The relational and educational actions, the decisions responsible for benefiting the individual and his family, the doubt and willingness to learn when dealing with unpredictable cases and the assessment of the socioeconomic conditions of the family, represent, respectively, personal, ethical, lack of knowledge and sociopolitical aspects present in the practice of nurses in home care. Conclusion: the particularities of home care trigger different patterns of knowledge to ensure creative, sensitive, human and responsible care. Innovation and availability to learn are part of nurses' performance in home care. The need for differentiated training is reinforced in order to respond to the increasing complexity in this field.

GROUNDED THEORY: USE IN SCIENTIFIC ARTICLES PUBLISHED IN BRAZILIAN NURSING JOURNALS WITH QUALIS A CLASSIFICATION

ABSTRACT Objective: to analyze the use of Grounded Theory as a methodological framework in scientific articles published in Brazilian Nursing journals with Qualis Capes A1 and A2. Method: descriptive, documentary study with a quantitative approach. Five Brazilian nursing journals with Qualis A1 and A2 in the 2016 assessment were used as sources. Data were collected on the website of each journal through the Scientific Electronic Library Online (SciELO), by consulting the numbers published in the 2013-2016 quadrennium. Data were analyzed using descriptive statistics. Results: 49 articles were selected, most of them published by the Texto & Contexto Enfermagem journal (34.6%). Regarding the methodological aspect, the use of the Straussian perspective predominated (79,6). Regarding the methodological characteristics, most articles used theoretical sampling (63.3%), theoretical saturation (53.1%), comparative analysis (69.4%), and presented the development of a theoretical model or central category in the results (75.6%). However, only seven (14.3%) studies specified the use of memos, 22 (44.9%) mentioned the use of diagrams and 16 (32.7%) described the theory validation step. Conclusion: the need for consensus among Brazilian nursing researchers on the methodological characteristics to be described in studies using the Grounded Theory is highlighted.

ACCESS VERSUS CARE CONTINUITY IN HEALTH NETWORK SERVICES: EXPERIENCING POSSIBILITIES AND CONTRADICTIONS

ABSTRACT Objective: to understand the meaning of access to health services with a view to care continuity in the care network for users and professionals. Method: qualitative research, which used the methodological steps of Grounded Theory, carried out from November 2015 to April 2017. The theoretical sampling was obtained with 33 participants from a hospital institution and a Family Health Strategy unit. The participants were organized into three sample groups according to circular and continuous orientation of data collection and Grounded Theory analysis. The analysis was conducted according to the guidelines of the methodological framework which was composed of the open, axial and integrative coding phases. Results: four central concepts emerged from the data that demonstrate how participants experience access with a view to care continuity. These range from the first contact with the health network, through limitations and alternatives found to achieve perspectives to the care continuity in health actions and services. Conclusion: possibilities and contradictions were identified in the experience of care, with regard to access to health services and actions for the continuity of care, understanding them as feasible in health services, but divergent from the ideal advocated by the literature on the theme, as well as by the norms and prerogatives in force in the Unified Health System.

Recommendations in covid-19 times: a view for home care

ABSTRACT Objective: To suggest recommendations for the practice of Home Nursing in the context of COVID-19. Method: Reflective study, originated from readings associated with the theme, available in current guidelines from the Pan American Health Organization, World Health Organization and the Ministry of Health. Results: Recommendations were developed from current scientific evidence for prevention of infections, control of epidemics and pandemics in the Brazilian home scenario. Final considerations: the reflections achieved contribute to guiding actions for better assistance to the patient, family caregivers and the community in the perspective of safe home care with COVID-19, and it is characterized as an introductory discussion on the theme, encouraging new studies to be carried out from the unfolding of the current scenario.

Grounded Theory methodological aspects in Brazilian nursing thesis

ABSTRACT Objective: to analyze the application of methodological aspects of Grounded Theory in Brazilian nursing thesis. Methods: qualitative, descriptive study elaborated based on theses available in the CAPES Thesis and Dissertations Catalog, located with the search for the terms “Teoria Fundamentada nos Dados” OR “Grounded Theory”, from 2013 to 2017. The data obtained were analyzed, considering the Grounded Theory methodological assumptions. Results: observance of Grounded Theory basic concepts and articulation with several theoretical frameworks in the conduct of the investigations are strengthening aspects of the method. However, dissent in the description of the operationalization of the stages and naming of the elaborated construct weaken the methodological quality. Final considerations: the methodological consistency provided by Grounded Theory has the potential to demonstrate the studies’ rigor and reliability conducted and theories generated. It is necessary to deepen theoretical-conceptual studies to elucidate discrepancies in the applicability in nursing research.

PERFIL CLÍNICO DE CRIANÇAS SUBMETIDAS A TRANSPLANTE DE CÉLULAS-TRONCO HEMATOPOIÉTICAS

Objetivo: identificar o perfil clínico de crianças em pós-transplante de células-tronco hematopoiéticas.Método: pesquisa quantitativa, transversal, retrospectiva, em serviço transplantador do Sul/Brasil, com dados de prontuários de crianças com 12 anos incompletos, submetidas a transplante. Para análise utilizaram-se medidas de tendência central, dispersão, frequências e testes do qui-quadrado e Fisher para associar variáveis.Resultados: a média de idade foi de 6,2 anos, predomínio do sexo masculino 92 (66,7%), diagnóstico Anemia de Fanconi 42 (30,4%) e transplante alogênico não aparentado 71 (51,4%). A alta hospitalar aconteceu em até 30 dias pós-transplante para 85 (61,6%) e 48 (34,8%) foram reinternadas. As perdas do cateter acometeram 11 crianças (8%) e as principais intercorrências clínicas ambulatoriais foram dor, tosse, coriza e febre. Infecção viral esteve relacionada ao transplante não aparentado e doença do enxerto contra hospedeiro.Conclusão: o perfil identificado corrobora o planejamento de cuidados a esta população, contribuindo com a prática de enfermagem.

Care performed by family caregivers of children submitted to hematopoietic stem cell transplantation

OBJECTIVE

to know the care provided by family caregivers of children submitted to hematopoietic stem cell transplantation.

METHOD

the Grounded Theory was used as methodology. The study comprised four sample groups, comprising 36 caregivers. Data were collected by semi-structured interviews and analyzed according to the coding proposed by Strauss and Corbin in three phases: open, axial and selective.

RESULTS

eight propositions were identified for the care provided to the child in the researched context, namely administering medications; attention to cleaning issues; care with water and food intake; care with the body; experiencing protective isolation; addressing the child's need for emotional support; addressing the child's self-care; and facing complications.

CONCLUSION

the different aspects in which the caregiver acts in the care of the child were understood. Such care equips the health team to elaborate measures for guidance and preparation of home care that are effective and directed to the needs of the patient and their family. The understanding of the care that they accomplish enables the caregiver a greater understanding of their role, as well as of the decisions they will make by their being under treatment.

EVALUATION OF CARE FOR CHILDREN AND ADOLESCENTS USERS OF PSYCHOACTIVE SUBSTANCES: POTENTIALITY AND FRAGILITIES

ABSTRACT Objective: to evaluate the care to the child and the adolescent in treatment in the general hospital for mental and behavioral disorders due to the use of psychoactive substances, from the perspective of the Nursing. Method: evaluative study, of the case study type, with the use of the theoretical-methodological reference of the Fourth Generation Evaluation. The group of interest was composed of 19 professionals of the Nursing team of a Unit allocated in a general and teaching hospital of the West of Paraná. Data were collected from June 2015 to February 2016 through 410 hours of non-participant observation, individual interviews, following the hermeneutic-dialectical circle and a negotiation meeting. Data analysis was performed using the Constant Comparative Method. Results: three categories emerged from the analysis: nursing care for children and adolescents, Potential care and Fragility in care. the interest group reported a differentiated care of the other units of the institution, expressing the concern to care in a global and humanized way. They pointed out the development of meetings of agreement between the scenario of the study and the municipalities as one of the facilities for the care and, as greater fragility, the lack of physical space. Conclusion: It is hoped that the results of this study may instigate and provide critical reflection of professionals who develop their practice with children and adolescents who use or abuse psychoactive substance in the various health treatment services.

Developing a nursing healthcare protocol: a case report

OBJECTIVE

to report the use experience of convergent healthcare research for developing a nursing care protocol.

METHOD

convergent care research developed in university hospital, from July to December 2016, with 27 participants.

RESULTS

the stages of the research and its results are described in the steps: conception, instrumentation, screening and analysis. The end result was the nursing care protocol in day zero of hematopoietic stem cell transplantation.

CONCLUSION

convergent care research was an appropriate method for developing the care protocol, and an important contribution to the approximation between theory and practice. The nursing care protocol was the result of this study and confirmed both the purpose of the research as a professional Master's in acquiring knowledge aimed at improving professional practice.

Psychosocial aspects of work and minor psychic disorders in nursing: use of combined models

OBJECTIVE

to analyze the combined use of models for the evaluation of work-related psychosocial aspects and their association with the prevalence of Minor Psychics Disorders among nursing workers.

METHOD

cross-sectional study with a sample of 285 nursing workers. Data collection was performed through the application of a structured sociodemographic and occupational questionnaire and the Demand-Control-Support, Effort-Reward Imbalance and Self-Reporting Questionnaire. Descriptive analysis and a multiple logistic regression were performed.

RESULTS

the prevalence of suspicion of minor psychics disorders was 32.6%. The dimensions of both models were associated with mental health. The full Effort-Reward Imbalance and Demand-Control and Social Support models predict Minor Psychics Disorders to a greater extent than the combined use of partial models.

CONCLUSION

it was found that the Effort-Reward Imbalance model captured better the magnitude of the Minor Psychics Disorders in this sample of workers compared to the Demand-Control and Social Support model. However, the concomitant use of the theoretical models revealed unique contributions in the evaluation of Minor Psychics Disorders. Considering the complexity of mental illnesses, it is important that different factors be evaluated.

Research contributions for the Nursing care in pediatric transplantation of hematopoietic stem cells / Contribuições da pesquisa para os cuidados de Enfermagem em transplante pediátrico de células-tronco hematopoiéticas

Objetivo: Propor cuidados de enfermagem ambulatoriais que subsidiem o tratamento de crianças em pós transplante de células-tronco hematopoiéticas a partir dos dados advindos de pesquisa sobre perfil sociodemográfico e clínico. Método: Ensaio repercussivo sobre proposição de cuidados de enfermagem baseados em resultados de pesquisa e por diagnósticos de enfermagem segundo a taxonomia da North American Nursing Diagnosis Association. Resultados: Os principais diagnósticos foram risco de infecção, risco de função hepática prejudicada e risco de função cardiovascular prejudicada. Os cuidados de enfermagem incluíram controle de sinais vitais, avaliação da ingesta alimentar, cuidados com cateteres, controle de exames laboratoriais, avaliação do funcionamento dos sistemas corporais, administração de medicamentos e transfusões, medidas de controle de transmissão de microrganismos, educação em saúde/serviço e comunicação integrada com a equipe interdisciplinar. Considerações finais: Os cuidados de enfermagem foram sustentados por evidências e buscou-se o atendimento da criança em todas as suas necessidades.Descritores: Prática profissional, Cuidados de enfermagem, Transplante de células-tronco hematopoéticas, Pesquisa em enfermagem.

GESTÃO DE ALTA PARA A CONTINUIDADE DO CUIDADO: EXPERIÊNCIA DAS ENFERMEIRAS DE LIGAÇÃO DE PORTUGAL

Objetivo: descrever as atividades de continuidade do cuidado desenvolvidas pelas enfermeiras de ligação nos serviçoshospitalar. Método: estudo descritivo, exploratório, realizado de setembro/2016 a março/2017, em 15 hospitais dePortugal, com 107 enfermeiras. Os dados foram coletados com um questionário semiestruturado e analisados pormeio das frequências absolutas. Resultados:51 (47,7%) dos pacientes que necessitam de cuidados continuados sãoidentificados por médicos e enfermeiras assistenciais, 69 (64,5%) utilizam critérios para a identificação dos riscospara a alta do paciente. Os elementos considerados no planejamento de alta são: reabilitação motora e funcional,54 (30,86%); e preparo do cuidador, 41 (23,43%). As transferências das informações para continuidade do cuidadoocorrem majoritariamente por correio eletrônico, 58 (25,55%). Conclusão: as atividades para a continuidade do cuidadonão são homogêneas entre os profissionais que realizam atividades de ligação, mas contribuem para estratégias maisconsolidadas para o enfrentamento da descontinuidade do cuidado.

A vivência do contexto domiciliar por familiares e profissionais de saúde

Objetivo: compreender a vivência do contexto domiciliar na perspectiva dos familiares cuidadores e profissionais de saúde. Método: Teoria Fundamentada em Dados desenvolvida em Serviço de Atendimento Domiciliar, coleta realizada de fevereiro a dezembro de 2016, por meio de entrevista semiestruturada, com 22 participantes divididos em dois grupos amostrais. Para a análise dos dados realizou-se codificação substantiva e teórica. Resultados: a compreensão do fenômeno se deu por meio das categorias: ingressando no cuidado domiciliar (causa); inter-relacionando-se com a rede social de apoio (estratégia); expressando percepções acerca da vivência do cuidado (condição interveniente) e experienciando aspectos do contexto domiciliar (consequência). Considerações finais: o fenômeno esclarece que a vivência do contexto domiciliar decorre das condições ambientais e físicas da casa que incluem as condições de higiene e segurança, dos aspectos socioeconômicos, relacionais e culturais das famílias e dos recursos disponíveis para o cuidado provenientes das redes sociais de apoio.

VALORIZAÇÃO E VISIBILIDADE DA ENFERMAGEM

Editorial

Elderly people with mental disorders: experiencing the use of psychotropic medicines

OBJECTIVE

To interpret the experience of the elderly with mental disorder in the use of psychotropic medicines.

METHOD

Qualitative study in the interpretative modality, supported by the Grounded Theory. It was carried out from interviews with 16 elderly people with mental disorder and six relatives, totaling 22 participants.

RESULTS

In the experience of the use of psychotropic medicines, the elderly with mental disorders become aware of their condition, attribute meaning and establish strategies for the correct use. On the other hand, they express their dissatisfaction with being dependent on psychotropic medicines to live without symptoms, face their side effects and do not always use them correctly.

CONCLUSION

The use of psychotropic medicines is a priority in the life of the elderly and, in view of the fragilities found, it is necessary a continuous monitoring of health professionals.

CONTINUIDADE DO CUIDADO E O INTERACIONISMO SIMBÓLICO: UM ENTENDIMENTO POSSÍVEL

RESUMO Objetivo: buscar um entendimento pela consubstanciação entre o conceito de continuidade do cuidado ao referencial teórico do interacionismo simbólico, no sentido de agregar uma possibilidade de fortalecê-lo como conceito indispensável ao cuidado prestado aos usuários do sistema de saúde e provocar uma necessária reflexão sobre este. Método: estudo teórico-reflexivo, organizado em quatro seções, sobre a continuidade do Cuidado analisado sob a luz do referencial do interacionismo simbólico. Resultados: o interacionismo simbólico busca compreender a ação humana em grupo e acredita que os indivíduos ajam tendo como base os significados que as coisas têm para eles. Esta é uma construção social que se desenvolve na medida em que as pessoas agem e interagem consigo mesmas e com os outros. A continuidade do cuidado, trabalhada a partir das dimensões relacional, informacional e de gestão, coaduna com o proposto, por representar um produto social resultante das interações entre os envolvidos no cuidado, que se expressa segundo sua ação e reação, como uma constante para um conjunto de práticas de diferentes profissionais que buscam garantir o cuidado integral e coerente ao usuário. Conclusão: este trabalho possibilitou apresentar a continuidade do cuidado, dentro do contexto das interações sociais, não como algo concreto, mas como um objeto social decorrente do agir de cada um dos envolvidos com o cuidado, embora, ainda assim, se perceba a necessidade de sensibilizar profissionais e usuários a respeito de seu significado e intencionalidade no agir da cada um.

Disability retirement among university public servants: epidemiological profile and causes

OBJECTIVE

To identify the epidemiological profile and causes of disability pensions for university public servants.

METHOD

A cross-sectional and descriptive study, carried out with 40 retired employees due to disability of a public university. Sociodemographic, occupational and clinical data were obtained. The analyses were stratified according to gender, considering a significance level of 5%.

RESULTS

Disability pensions were more frequent among women (72.5%), aged up to 60 years (77.5%). Mental and behavioral disorders were mainly responsible for pensions (35%). There was a significant difference between the sexes (p ≤ 0.05) for the variables: educational level, function performed by the worker and presence of dependents.

CONCLUSION

The epidemiological profile showed a higher frequency of female, married/stable marital status, aged between 51 and 60 years and up to 12 years of schooling. Chronic degenerative diseases were predominant among the causes for disability pensions.

Enhancing the process of teaching and learning homecare

ABSTRACT Objective: to identify possibilities for improvement in the process of teaching and learning homecare in nursing, pharmacy, medicine, nutrition, dentistry and occupational therapy courses. Method: qualitative research using the Grounded Theory approach. Sixty-three semi-structured interviews were conducted with students, teachers and graduates of the six mentioned courses at a public university in the south of Brazil. Data analysis was performed through open, axial and selective coding. Results: the possibilities for improving the process of teaching and learning homecare included: scientific production in the area; use of different teaching techniques; development of extracurricular activities; extension projects; curricular reformulation; and laboratory simulation. Final considerations: the strategies cited in this study enable undergraduate courses in health to envisage the possibility of enhance the process of teaching and learning homecare.

Minor psychiatric disorders in nursing: prevalence and associated factors

ABSTRACT Objective: to investigate the prevalence of Minor Psychiatric Disorders and associated factors in nursing workers. Method: observational and analytical sectional study. Data were collected from 285 nursing workers. A questionnaire containing sociodemographic, occupational, psychosocial aspects of work and mental health was used. Bivariate and multivariate analysis were performed by binary logistic regression. Results: the global prevalence of suspected Minor Psychiatric Disorders among nursing workers was 32.6%. Higher prevalence rates were found among female, young, married/common-law married individuals, in the nursing assistant/technician categories, with income up to four minimum wages, developing high-demand work with low social support, high effort-reward imbalance, and over-commitment. Conclusion: the variables that remained associated with the mental health outcome in the final model were: female gender, married/common-law married, high-demand work, high effort-reward imbalance, and over-commitment.

SUGESTÕES DE ORIENTAÇÕES PARA ALTA DE CRIANÇAS NO PÓS-TRANSPLANTE DE CÉLULAS-TRONCO HEMATOPOIÉTICAS

Estudo qualitativo descritivo com sugestões de aprimoramento de orientações para a alta hospitalar de crianças no pós-transplante de células-tronco hematopoiéticas. Realizado em serviço público de transplante de medula óssea do sul do Brasil com 58 participantes, entre eles profissionais da equipe multiprofissional e familiares cuidadores, entrevistados de janeiro de 2014 a março de 2016. Utilizou-se a análise de conteúdo temático categorial. As possibilidades de aprimoramento são capacitação dos profissionais envolvidos no cuidado, construção e aplicação de planejamento de alta pela equipe multiprofissional, inclusão da criança na orientação, utilização de formas variadas para orientar, e elaboração de material didático apropriado. O processo de alta hospitalar é complexo e a equipe envolvida na assistência ao paciente e cuidador é responsável por tornar esse momento de transição um período de aprendizagem, para auxiliá-los nos cuidados em casa.

The experience of family care in transitional support houses

OBJECTIVE

to present the theoretical model that represents the experience of care in transitional homes of support to families of children in a period of post-transplantation of hematopoietic stem cells.

METHOD

grounded theory, performed with 18 participants from three different samples. For analysis, we used the QSR Nvivo10 software.

RESULTS

we elaborated four categories: living in the transitional support home; experiencing care of children in post-transplantation of hematopoietic stem cells; taking care of the family caregiver; and returning to a new life at home, which interrelate according to the theoretical code of the interactive family.

CONCLUSION

this research contributes to understanding the experience of care in transitional support homes of families with children in post-transplantation of hematopoietic stem cells and subsidizes nursing and health actions provided to this population; it also contributes to the development of a hospital discharge guidance and care directed to this clientele.

Clinical competences of nursing assistants: a strategy for people management

OBJECTIVE

to identify the clinical competences of nursing assistants in a hospital organization and to understand how professional acquired these competences.

METHOD

an exploratory study of a qualitative approach, performed at a private hospital in southern Brazil, through a semi-structured interview, in May and June 2013 with 20 nursing assistants.

RESULTS

the nursing assistantswho worked longer in the same work unit had a higher list of clinical competences. The acquisition of clinical competences occurred through interaction with other professionals; in daily nursing practice; in previous experiences and in formal learning.

FINAL CONSIDERATIONS

the identification of clinical competences and the way nursing assistants acquire these competences can be important resources for managing people, which can be used by nurse managers to better allocate these professionals and provide th e opportunity for their professional development.

Guide to deliver the elements of the Clinical Caritas Process

Abstract Objective: To introduce a guide to apply the elements of the Clinical Caritas Process. Methods: It is a study introducing a guide developed to identify the necessary caring actions, aiming to provide transpersonal care. It was designed from a bibliographic review and discussion with peers, who apply the theory underpinning the present study. Results: The instrument features a layout with ten lines and two columns, decoding each structural component in its enunciation with its respective care manifestations. Additionally, it showed to be a facilitator for the use of the Human Caring Theory. Conclusion: It is believed that the guide can be reproduced in order to direct the practice of transpersonal care in different settings of Brazilian nursing. Moreover, it can also be used to teach this theory.

The home care teaching and learning process in undergraduate health care degree courses

Home care, one of the services provided by the health system, requires health practitioners who are capable of understanding its specificities. This study aimed to build a substantive theory that describes experiences of home care teaching and learning during undergraduate degree courses in nursing, pharmacy, medicine, nutrition, dentistry and occupational therapy. A qualitative analysis was performed using the grounded theory approach based on the results of 63 semistructured interviews conducted with final year students, professors who taught subjects related to home care, and recent graduates working with home care, all participants in the above courses. The data was analyzed in three stages - open coding, axial coding and selective coding - resulting in the phenomenon Experiences of home care teaching and learning during the undergraduate health care degree courses. Its causes were described in the category Articulating knowledge of home care, strategies in the category Experiencing the unique nature of home care, intervening conditions in the category Understanding the multidimensional characteristics of home care, consequences in the category Changing thinking about home care training, and context in the category Understanding home care in the health system. Home care contributes towards the decentralization of hospital care.

Integrality of care: challenges for the nurse practice

ABSTRACT Objective: to understand the role of the nurse in the collegiate management model of a teaching hospital, in the integrality of care perspective. Method: a single case study with multiple units of analysis, with the theoretical proposition "integrality of care is a result of the care offered to the user by multiple professionals, including the nurse". Data were obtained in a functional unit of a teaching hospital through interviews with 13 nurses in a non-participant observation and document analysis. Results: from the analytical categories emerged subcategories that allowed understanding that the nurse promotes integrality of care through nursing management, team work and integration of services. Final considerations: the theoretical proposition was confirmed and it was verified that the nursing management focus on attending to health care needs and is a strategy to provide integrality of care.

Model of transpersonal caring in nursing home care according to Favero and Lacerda: case report

Objective

The aim of this paper is to report the experiences of applying a model of transpersonal caring in nursing home care according to Favero and Lacerda to adult patients after hematopoietic stem cell transplantation.

Method

This is a case report on the application of this model to an outpatient monitored by a bone marrow transplant service. In addition to the initial outpatient contact, the patient received home care visits in October 2014. Data were recorded in the field diary and analysed according to the Care Model and Clinical Caritas Process.

Results

The provided care served as support to meet basic human needs, and strengthen the belief system. It also promoted the necessary emotional care to cope with the treatment and professional maturity in the caring relationship.

Conclusion

The experience description revealed that the model can support the application of the Theory of Human Caring in home care and the use of care models in practice, professional training, and research development.

Grau de sobrecarga dos cuidadores de idosos atendidos em domicílio pela Estratégia Saúde da Família

RESUMO Objetivou-se conhecer as características sociodemográficas, de saúde e o grau de sobrecarga dos cuidadores de idosos atendidos em domicílio pela Estratégia Saúde da Família de Sobral (CE). Pesquisa de abordagem quantitativa do tipo descritiva, foram entrevistados 60 cuidadores de idosos e utilizou-se a escala de Zarit. Os cuidadores são de todas as idades, inclusive tendo mais de 60 anos (26,7%); do sexo feminino (90%); portadores de hipertensão (33,3%) e diabetes (16,7%); e apresentam sobrecarga leve (81,7%). Identificou-se a existência de idosos cuidando de idosos e fragilidade nas ações de apoio às famílias, necessitando de novas estratégias de cuidado e do direcionamento de políticas.

Experience of hypertensive patients with self-management of health care

AIMS

The aim of this study was to interpret how hypertensive patients experience health care self-management.

BACKGROUND

Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care.

DESIGN

Qualitative study.

METHODS

Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory.

FINDINGS

The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care.

CONCLUSION

This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities.

ANÁLISE DE SITUAÇÕES DE PACIENTES AGRESSIVOS EM UNIDADE DE TERAPIA INTENSIVA

esquisa exploratória em Unidade de Terapia Intensiva adulto de um hospital de ensino de Curitiba/Paraná, com coleta de dados de agosto a setembro de 2010. Participaram oito profissionais de enfermagem, cujos objetivos foram apreender a percepção da equipe de enfermagem sobre a violência ocorrida na unidade e reações desta equipe mediante o evento. Os dados obtidos, por entrevista em grupo e pela Análise de Conteúdo, permitiram as seguintes categorias: a violência advinda do paciente contra a equipe enfermagem; motivos de violência durante o cuidado de enfermagem e reação da equipe de enfermagem à violência provocada pelo paciente. Encontrou-se que a violência ocorre pela não resolutividade do problema do paciente, podendo vir de familiares ou de pacientes e pela falta de comunicação como antecipação do cuidado. Conclui-se que a comunicação é instrumento para o cuidado de enfermagem e pode contribuir para a não violência aos indivíduos que trabalham para promover o cuidado em saúde.

[Conceptual self-management analysis of hypertensive individuals]

This research aimed to analyze the concept of self-management of hypertensive individuals. Theoretical and documentary study based on Walker and Avant's conceptual analysis by means of the Scientific Electronic Library Brazil and the Medical Literature Analysis and Retrieval System Online in the Coordination for Higher Education Personnel Development (CAPES, in Portuguese) and the National Library of Medicine websites. Fourteen (14) articles and one (1) thesis were selected and reviewed in Portuguese and English, in the period January 2007 to September 2012.

BACKGROUND

missing doctor's appointments, non-compliance to blood pressure control treatment to recommendations to proper diet standards and stress. Attributer blood pressure control and disease management Consequences home monitoring of blood pressure with control improvement, accomplishment of disease management, compliance and sharing of the creation process of self-management goals and caring activities by the interdiscplinary team through individualized actions. It was concluded that the self-management concept is a dynamic, active process which requires knowledge, attitude, discipline, determination, commitment self-regulation, empowerment and self-efficiency in order to manage the disease and achieve healthy living.

The teaching and learning experience of home care in undergraduate nursing programs

The objectives of this research were interpreted as the teaching and learning home care is experienced by students and teachers at the Nursing Undergraduate Course, at the Federal University of Paraná and build a theoretical model that explain this experience. It is a qualitative research that used the Grounded Theory method. Semi-structured interviews were performed with eight of the last academic year of nursing undergraduate course and five professors of content related to the topic. The experience in home care occurs and grows out in contact with reality through interaction between practical and theoretical issues and stage with specific working hours. The student comes across various nuances of this type of assistance, which allows understanding the health system and knowledge expansion related to home care. This fact shows that this area of expertise should be part of nursing undergraduate course because it is in expanding process and requires trained professionals to perform it.