Psychosocial impact of malocclusion in the school performance. A Hierarchical Analysis

OBJECTIVE

To identify any association between the psychosocial impact of malocclusion and academic performance in adolescents.

METHODS

Cross-sectional study in a sample of 297 adolescents aged 10 to 14 years old enrolled in public schools. A self-complete questionnaire enquiring about socioeconomic, demographic, and psychological characteristics and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered in classrooms. The school provided documents related to School Performance (average grade in the Portuguese subject and absences). A conceptual structure was built, and independent variables were inserted hierarchically into logistic models for school performance (outcome). Independent variables were: Gender, age, caries status (DMFT), orthodontic treatment need (IOTN-DHC), psychological impact (PIDAQ) and school commitment (class absences and missed classes).

RESULTS

Boys (OR = 3.56; 95% CI: 1.54-8.21) with caries experience (OR = 2.77; 95% CI: 1.23-6.23), need for orthodontic treatment (OR = 0.40; 95% CI; 0.18-0.91) and adolescents who reported a psychological impact (OR = 2.70; 95% CI: 1.16-6.30) had worse school performance.

CONCLUSION

Boys with caries and malocclusion experience who reported the psychological impact of the need for orthodontic treatment are more likely to have worse school performance.

A Corbin and Strauss Grounded Theory on the Experiences of Patients, Relatives, and Health Professionals About the Family Presence During Emergency Care

This study aimed to explore the experiences of patients, relatives, and health professionals about family presence during emergency care. In this grounded theory, 42 participants were interviewed from October 2016 to February 2017 in 2 Brazilian emergency rooms. Data collection and analysis were based on the constant comparative method. Findings identified that there is a social meaning about family presence during emergency care, which is conditioned, sporadic, and variable, and health professionals are responsible for the decision. The implementation of family systems care in emergency rooms is required to meet the needs of both patients and families. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A30.

Information and communication technologies: interfaces the nursing work process

OBJECTIVES

to unveil the meanings that nurses attribute Information and Communication Technologies for the nursing work process.

METHODS

qualitative research, theoretically and methodologically based on the Complexity Theory and on the Grounded Theory, respectively. Research with 19 participants, being 12 clinical nurses, and 7 resident nurses. Semi-structured interviews were used for data collection.

RESULTS

the results revealed the meanings that clinical nurses attribute to Information and Communication Technologies and, thus, the motivations and limitations for the use of these technologies, pointing out possibilities and strategies that impact the nursing work process, based on the interactions promoted by the official and non-official use of these resources.

FINAL CONSIDERATIONS

the meanings that nurses attribute to Information and Communication Technologies are dependent on their ability to successfully employ those technologies and their importance to the work process developed by the professionals.

Methodological path to reach the degree of saturation in qualitative research: grounded theory

OBJECTIVES

to achieve the degree of saturation in study that applied the grounded theory.

METHODS

qualitative research, carried out in four Family Health Units, between June 2018 and May 2019. The data from the interviews with 30 health professionals and non-participant observation were coded in the stages: open, axial and integration.

RESULTS

the degree of saturation was achieved by two conceptual models - theoretical saturation and inductive thematic. Theoretical saturation was considered: the development of conceptual codes and observation, in the collection and analysis of data, when they generated new categories/subcategories or only indicated increasing instances. For thematic inductive saturation, the use of new codes based on each interview stood out.

FINAL CONSIDERATIONS

the visual layout for the number of codes, the theoretical scope of the concepts and the delimitation of the sample groups guided the identification of the degree of saturation for the development of the conceptual body that supported the substantive theory.

Knowledge management: connections for teaching research in undergraduate nursing

OBJECTIVES

to understand the meanings that nursing students and professors attribute to research and research teaching in the context of undergraduate studies.

METHODS

this is a qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Sixteen students and 14 undergraduate nursing professors from a public university in Rio de Janeiro were interviewed. Semi-structured interviews were used for data collection.

RESULTS

causes, actions, and interactions related to research and teaching research in undergraduate nursing are connected with learning science for nursing praxis, which ranges from students' ability to question to their and their professors' understanding of social demands guided by science.

FINAL CONSIDERATIONS

nursing professors and students signify research and teaching of this as a structure for the training of nurses for the critical professional capacity needed to meet social demands.

Nurse researchers and nursing assistants: construction and projection of polymorphous identities

OBJECTIVE

To understand the meanings that nurse researchers and nursing assistants attribute to one another, and to the development of research produced by Nursing.

METHOD

Qualitative research. The Grounded Theory and the Complexity Theory were used as theoretical and methodological frameworks, respectively. Ten nursing assistants and six research nurses participated in the research. The semi-structured interview was used as a data collection technique. The results were categorized by comparative analysis and validated by ten judges.

RESULTS

The valuation of nursing care research as well as interactions between research development and nursing care may be related to the way nursing assistants and nurse researchers perceive themselves. These perceptions are multifaceted.

CONCLUSION

The meanings nurse researchers and nursing assistants attribute to each other reveal mechanisms of closeness and distance between these actors, as well as between research and nursing care.

Care management for the hospitalized child with chronic cancer pain: intervening conditions

ABSTRACT Objective: To understand the intervening conditions of care management for the hospitalized child with chronic cancer pain. Method: Qualitative research, anchored in the methodological and theoretical frameworks, respectively, Grounded Theory and Complex Thinking. The semi-structured interview and non-participant observation were used to collect the data. Twenty-one health professionals, organized in three sample groups: nurses; nursing technicians; and professionals of the multiprofessional health staff. Results: They emerged as intervening conditions of care management: human resources and materials, teamwork, absenteeism, professional relocation, professional qualification, family, playful, dialogue, empathy and caring relationship. Conclusion: It was understood as limiting conditions for care management: deficits of human resources and materials, absenteeism, ineffective teamwork, professional relocation, and insufficient professional qualification. On the other hand, they were presented as facilitating conditions: adequate professional knowledge, effective teamwork, dialogue, empathy, playful and affective relationship with the child.

Management challenges for best practices of the Kangaroo Method in the Neonatal ICU

OBJECTIVE

To understand the conditions that influence the adherence and application of best practices by nurses in the context of the Nursing care management in the Kangaroo Mother Care in the Neonatal ICU.

METHOD

Study of qualitative approach, whose theoretical and methodological frameworks were Symbolic Interactionism and Grounded Theory, respectively. We used the in-depth interview with 8 nurses from the Neonatal ICU of a public maternity hospital in the city of Rio de Janeiro.

RESULTS

The conditions involved in adhering to the best practices of humanization in the Neonatal ICU are related mainly to human resources, interaction among professionals, work processes and leadership strategies; and care management.

CONCLUSION

Professional and institutional challenges have been identified that need to be addressed to improve adherence and implementation of the Kangaroo Mother Care best practices.

ESTRATÉGIAS DE AÇÃO E INTERAÇÃO PARA O CUIDADO À CRIANÇA HOSPITALIZADA COM DOR ONCOLÓGICA CRÔNICA

RESUMO Objetivo: discutir, a partir do referencial da complexidade, as estratégias de ação e interação adotadas pelos profissionais de saúde para o cuidado à criança hospitalizada com dor oncológica crônica. Método: pesquisa de abordagem qualitativa, realizada com base no referencial metodológico da Teoria Fundamentada nos Dados e no referencial teórico do Pensamento Complexo, na perspectiva de Edgar Morin. A entrevista semiestruturada e a observação não participante foram utilizadas para a coleta de dados. Participaram da pesquisa 21 profissionais de saúde, os quais foram organizados em três grupos amostrais: enfermeiros; técnicos de enfermagem; e profissionais da equipe multiprofissional de saúde. Os resultados da pesquisa foram validados por cinco examinadores, dos quais três apresentam expertise no método de pesquisa. Resultados: a categoria “Lidando com a complexidade do contexto gerencial de cuidado à criança com dor oncológica crônica”, por meio de suas subcategorias, revelou que os profissionais de saúde utilizam o lúdico, o diálogo, a empatia, a relação afetiva e o trabalho em equipe como estratégias de interação para cuidar da criança e do familiar. Ademais, os resultados apresentam a busca da espiritualidade e do equilíbrio emocional como estratégias de ação necessárias para lidar com o sofrimento infantil e familiar. Conclusão: os resultados revelam a necessidade de os profissionais de saúde estabelecerem estratégias de ação que melhorem a sua interação com a criança e com o familiar, posto que uma efetiva interação facilita o processo de avaliação e manejo da dor, bem como viabiliza a continuidade e a qualidade do cuidado prestado.

ASPECTOS CONTEXTUAIS SOBRE O GERENCIAMENTO DO CUIDADO DE ENFERMAGEM À CRIANÇA COM DOR ONCOLÓGICA CRÔNICA

RESUMO Objetivo: discutir os aspectos contextuais relacionados ao gerenciamento do cuidado de enfermagem à criança hospitalizada com dor oncológica crônica. Método: pesquisa de abordagem qualitativa, desenvolvida com base no referencial metodológico da Teoria Fundamentada em Dados e no referencial teórico do Pensamento Complexo, a partir de Edgar Morin. A coleta de dados ocorreu por meio da entrevista semiestruturada e da observação não participante. Os 21 participantes da pesquisa foram organizados em três grupos amostrais: o primeiro foi composto por sete enfermeiros; o segundo foi constituído por sete técnicos de enfermagem e o terceiro foi formado por sete profissionais da equipe multiprofissional de saúde. Os resultados da pesquisa foram validados por cinco examinadores, dos quais três apresentavam expertise no método de pesquisa. Resultados: a categoria intitulada “Desvelando aspectos contextuais sobre o gerenciamento do cuidado de enfermagem à criança com dor oncológica crônica” revelou por meio de suas subcategorias que a hospitalização dessa criança é longa, marcada por mudanças na dinâmica familiar, perdas e limitações impostas pela doença e/ou tratamento. O gerenciamento do cuidado de enfermagem é complexo, realizado por meio do trabalho em equipe e da demanda um planejamento que valorize as múltiplas necessidades da criança e do familiar. Conclusão: os resultados apontam para a necessidade do profissional de enfermagem contextualizar suas relações de cuidado, a partir da valorização de aspectos que transcendem a dimensão biológica da criança hospitalizada com dor oncológica crônica.

O CONTEXTO DE TRABALHO E OS FATORES INTERVENIENTES AO CONSUMO DE PESQUISA POR ENFERMEIROS ASSISTENCIAIS*

Objetivo: compreender, na perspectiva de enfermeiros assistenciais e pesquisadores, as influências que o contexto de trabalho exerce sobre o consumo de pesquisa por enfermeiros assistenciais. Metodologia: pesquisa qualitativa cujos referenciais teórico e metodológico foram a Teoria da Complexidade e a Teoria Fundamentada nos Dados. Participaram 10 enfermeiros assistenciais e seis enfermeiros pesquisadores, vinculados a instituições públicas da cidade do Rio de Janeiro. Os dados foram captados mediante entrevista semiestruturada, entre outubro de 2014 e março de 2015. Resultados: dimensões da cultura organizacional e do gerenciamento de enfermagem surgiram como aspectos influenciadores do consumo de pesquisa pelo enfermeiro assistencial. Nestes, estão: liderança, recursos humanos, físicos, flexibilidade e incentivo para a busca de competências a partir da pesquisa. Conclusão: na dimensão assistencial, o consumo de pesquisa é influenciado por fatores multifacetados, relacionados com a valorização do capital humano que sofre e exerce influência na dinâmica organizacional a partir do conhecimento científico atualizado.

CONEXÕES ENTRE PESQUISA E ASSISTÊNCIA: DESAFIOS EMERGENTES PARA A CIÊNCIA, A INOVAÇÃO E A TECNOLOGIA NA ENFERMAGEM

RESUMO Objetivo: compreender os significados que permeiam as conexões entre a produção/resultados de pesquisa e o processo de trabalho da enfermagem no âmbito assistencial. Método: pesquisa do tipo explicativa, de abordagem qualitativa, que teve como referenciais teórico e metodológico, respectivamente, a Teoria da Complexidade e a Teoria Fundamentada nos Dados. Os dados foram coletados com 25 sujeitos, distribuídos em três grupos amostrais: dez enfermeiros assistenciais, vinculados a um hospital universitário; seis enfermeiros pesquisadores e nove estudantes de graduação em enfermagem. A entrevista semiestruturada foi utilizada como técnica de coleta de dados. A pesquisa foi validada por dez juízes de diferentes regiões do Brasil. Resultados: apresenta-se a categoria: Enfrentando desafios emergentes da enfermagem na era da ciência, inovação e tecnologia, alicerçada pelas subcategorias: Pontos de partida para uma enfermagem contextualizada: da produção científica ao consumo de resultados de pesquisa; e Conexões fragilizadas entre produção científica e prática assistencial da enfermagem. Conclusão: os sistemas de significados que influenciam as conexões entre pesquisa científica e prática assistencial da enfermagem são estruturados e fortalecidos por fenômenos plurais, dentre os quais estão as inflexões negativas do processo de comunicação, presença e pertencimento dos pares, entre quem produz pesquisa e quem poderá consumi-la.

Learning through research: from teaching science to the sphere of nursing care

Abstract Objective: To understand the connections established between the teaching of research in undergraduate school and reflections on the context of nursing care based on the meanings assigned by nurses and undergraduate nursing students. Method: Qualitative research, the theoretical and methodological frameworks of which were Complexity Theory and Grounded Theory. Sixteen nurses and nine undergraduate nursing students participated. Data were collected through semi-structured interviews. Results: The study revealed that aspects that structure and maintain the scientific practice of nurses are connected with the teaching of nursing in undergraduate school. The transversality of teaching of research and strategies adopted by professors influence this process. Conclusion: In the nursing field, learning through research requires strategies that contextualize research within the context of care delivery, so that students perceive science as an element that structures their profession. For that, research should be a non-linear, transversal procedure that takes place over the course of the undergraduate program.

[Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence]

OBJECTIVE

to understand the perception of nurses on the vulnerabilities to STD/AIDS in light of the process of adolescence.

METHOD

qualitative research conducted with 15 nurses in a centre for the studies of adolescent healthcare of a university hospital in Rio de Janeiro/Brazil. The adopted theoretical and methodological frameworks were the Complexity Theory and the Grounded Theory, respectively. The semi-structured interview was used to collect data from January to August 2012.

RESULTS

this research presents the category: Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence, and the subcategories: Risks and uncertainties of the process of adolescence: paths to STD/AIDS; Age-adolescence complex: expanding knowledge from the perception of nurses.

CONCLUSION

once the nurses understand the complexity of adolescence, they create strategies to reduce the vulnerability of adolescents to STD/AIDS. This signals the need to invest in education, assistance and the management of nursing care for adolescents.

COMPLEX THINKING suPPOrTING CArE sTrATEGIEs FOr THE PrEVENTION OF sTDs/AIDs IN ADOLEsCENCE

ABsTrACTThis was qualitative research performed with 15 nursing professionals of a study cohort on adolescent health, in the capital of Rio de Janeiro/Brazil. The objective of the study was to discuss nursing care strategies for the prevention of STDs/AIDS in adolescence, from the perspective of complexity. A semi-structured interview was used for data collection from January to August of 2012. Grounded Theory was used as the methodological framework. The category "Starting points for the nursing care of adolescents in the context of STDs/AIDS" is presented, which discusses aspects related to interdisciplinarity; multidimensionality and specificities of the adolescence-related process, in the midst of vulnerabilities to STDs/AIDS, thereby revealing the importance of contemplating the phenomenon as delimited by its complexity.

Gerenciamento do cuidado de enfermagem à criança em condição crônica hospitalizada

RESUMO Objetivo: compreender as interações do enfermeiro na prática do gerenciamento do cuidado de enfermagem à criança em condição crônica hospitalizada. Método: foram utilizados como referenciais teórico e metodológico, respectivamente, o Pensamento Complexo e a Grounded Theory. Participaram do estudo 18 sujeitos organizados em três grupos: enfermeiros, técnicos de enfermagem e familiares. A técnica empregada para a coleta de dados foi a entrevista semiestruturada. A análise dos dados seguiu as três etapas de codificação: aberta, axial e seletiva. Resultados: a categoria "Necessitando gerenciar o cuidado de enfermagem à criança em condição crônica na Unidade de Internação Pediátrica" e suas respectivas subcategorias apresentam as complexas vinculações intersubjetivas estabelecidas pelo enfermeiro que sustentam a prática do gerenciamento do cuidado de enfermagem. Conclusão: nota-se dificuldade dos profissionais de enfermagem em interagir com o familiar da criança e na implementação do processo gerencial de cuidado, a dialógica ordem/desordem/interação/organização.

Nurses' adherence to the Kangaroo Care Method: support for nursing care management

OBJECTIVE:

construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management.

METHOD:

qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed.

RESULTS:

four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (de)motivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method.

CONCLUSIONS:

the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (dis)continuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model.