Empoderamiento y satisfacción profesional en Enfermería: una revisión integradora, según la Teoría Estructur

Context: Power is a central concept in professional development and one of the characteristics of the decision-making process, together with the use of a unique body of knowledge. Through the process of Empowerment, the professional is able to influence others, being considered a key aspect in contemporary organisations. Objectives: To study the relationship between Empowerment and Job Satisfaction, in a first analysis, from a structural perspective. Methodology: An integrative literature review was conducted of articles published in MEDLINE and CINAHL databases between 2005 and 2011, according to the PICOD methodology. Results: Twenty-two articles from different contexts were identified, of which most of them were conducted in America (64%) and Asia (32%). Conclusion: Despite this diversity, a clear and directly proportional association between Empowerment and Job Satisfaction was found. The perception of Empowerment is influenced by age, context of professional performance, and academic and professional qualifications. Our search retrieved no studies conducted in Portugal, thus it is important to further explore this issue..Contexto: Poder é um conceito central para o desenvolvimento profissional, sendo uma das características do processo de tomada de decisões, em conjunto com o recurso a um corpo único de conhecimentos. Através do processo de Empoderamento o profissional está apto a influenciar o outro sendo considerado um elemento chave nas organizações contemporâneas. Objetivos: Estudar a relação existente entre Empoderamento e Satisfação Profissional, numa primeira análise, do ponto de vista estrutural. Metodologia: Procedeu-se a uma revisão integrativa da literatura (2005-2011) de artigos das bases de dados Medline® e CINAHL, de acordo com a metodologia PICOD. Resultados: Foram identificados 22 artigos, provenientes de contextos variados, sendo a maioria efetuados no continente americano (64%) e asiático (32%). Conclusão: Apesar desta diversidade, constata-se a clara relação expressa entre Empoderamento e Satisfação Profissional, sendo diretamente proporcionais. Salienta-se ainda a influência da idade, contexto de desempenho profissional, formação académica e qualificação profissional na percepção de Empoderamento. Dado, da nossa pesquisa, não ter sido possível localizar estudos conduzidos em Portugal, importa o desenvolvimento desta temática.Contexto: El poder es un concepto central para el desarrollo profesional y una de las características del proceso de toma de decisiones, junto con el recurso a un único cuerpo de conocimiento. A través del proceso de empoderamiento, el profesional es capaz de influir en el otro y se le considera un elemento clave en las organizaciones contemporáneas. Objetivos: Estudiar la relación entre el empoderamiento y la satisfacción profesional en un primer análisis, según la teoría estructural. Metodología: Los autores realizaron una revisión integradora de la literatura (2005-2011) de artículos en las bases de datos Medline y CINAHL®, de acuerdo con la metodología PICOD. Resultados: Se identificaron 22 artículos de diversos contextos, la mayoría realizados en el continente americano (64 %) y asiático (32 %). Conclusión: A pesar de esta diversidad, se ha observado una clara relación directamente proporcional entre empoderamiento y satisfacción profesional. Asimismo, es importante destacar la influencia de la edad, el contexto de desempeño profesional, la formación académica y la cualificación profesional en la percepción del empoderamiento. Puesto que, en nuestro estudio, no se han podido localizar los estudios llevados a cabo en Portugal, es importante ir más allá de este tema.info:eu-repo/semantics/publishedVersio

Percepción de padres y enfermeros sobre la atención de enfermería en neonatología – una revisión integradora

Background: The admission of a Newborn (NB) to a Neonatal Intensive Care Unit (NICU) requires specialised skills from nurses in order to not only assess the NB’s biological features, but also focus care on the NB/parents binomial. Objectives: To analyse the scientific evidence on the Nursing care experienced at NICUs from the perspective of nurses and parents of NBs during their hospital stay at those units. Methodology: An integrative literature review was conducted. The following databases were searched in the EBSCOhost platform: CINAHL; MEDLINE and Cochrane. Scientific studies published in databases of reference from 2004 to 2013 were selected based on previously defined inclusion and exclusion criteria. Results: Nine studies which emphasised the diversity of perceptions of care were included. The analysis of these studies allowed organising the results into three themes: therapeutic relationship, humanisation of care and suffering. Conclusion: The evidence obtained in this study suggest that parents of NBs admitted to NICUs experience a great emotional overload and need to receive information and support from nurses.Contexto: A admissão de um Recém-Nascido (RN) numa Unidade de Cuidados Intensivos Neonatais (UCIN) requer dos enfermeiros competências especializadas, de modo a considerar não somente os aspetos biológicos do RN, mas centrando o cuidar no binómio RN/pais. Objetivos: Conhecer a evidência científica sobre os cuidados de Enfermagem experienciados em UCIN, na perceção dos enfermeiros e dos pais dos RN durante o período de internação nessas unidades. Metodologia: Realizou-se uma revisão integrativa da literatura. Elegeuse a plataforma EBSCOhost e selecionaram-se as bases bibliográficas eletrónicas: CINAHL, MEDLINE e Cochrane. Os estudos científicos publicados em bases de dados de referência, entre 2004-2013, foram selecionados com critérios de inclusão e exclusão previamente definidos. Resultados: Incluídos nove estudos que ressaltaram diversidade de perceções sobre os cuidados de Enfermagem. A análise destes estudos permitiu organizar os resultados em três temas: relação terapêutica; humanização dos cuidados e sofrimento. Conclusão: As evidências, neste estudo, mostram que os pais que têm um RN internado em UCIN experienciam uma grande sobrecarga emocional, necessitam de receber informações e apoio dos enfermeiros.Contexto: La admisión de un Recién Nacido (RN) en una Unidad de Cuidados Intensivos Neonatales (UCIN) requiere que los enfermeros tengan competencias especializadas con el fin de tener en cuenta no solo los aspectos biológicos del RN, sino centrando la atención en el binomio RN/padres. Objetivos: Conocer la evidencia científica sobre la atención de enfermería experimentada en las UCIN, en la percepción de los enfermeros y de los padres de los RN durante el período de internamiento hospitalario en estas unidades. Metodología: Se realizó una revisión integradora de la literatura. Para ello, se consultó la plataforma EBSCOhost y se seleccionaron las bases bibliográficas electrónicas: CINAHL; MEDLINE y Cochrane. Los estudios científicos publicados en las bases de datos de referencia, entre 2004 y 2013, fueron seleccionados con criterios de inclusión y exclusión previamente definidos. Resultados: Se incluyeron nueve estudios que resaltaron una diversidad de percepciones sobre la atención de enfermería. El análisis de estos estudios permitió organizar los resultados en tres temas: relación terapéutica, humanización de la atención y sufrimiento. Conclusión: En este estudio, las evidencias indican que los padres que tienen un RN ingresado en una UCIN experimentan una gran sobrecarga emocional y necesitan recibir información y apoyo de los enfermeros.info:eu-repo/semantics/publishedVersio

Psychometric Properties of the Portuguese Version of the Iceland-Family Perceived Support Questionnaire in Parents of Children and Adolescents with Chronic Condition

Abstract: The support from nurses perceived by family members of children with chronic conditions has been shown to be a protective factor at different levels in a family’s health. As such, nurses need to have instruments that assess this perception to increase the quality of the care provided to those families. This methodological study aimed to analyze the psychometric properties of the Portuguese translation of the Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) in parents of children/adolescents with chronic conditions. The ICE-FPSQ was administered to 237 parents recruited from the day hospital and outpatient services of four hospitals in Northern Portugal. Cronbach’s alpha reliability coefficients for the Total Scale, Cognitive Support, and Emotional Support subscales were excellent (α = 0.96, α = 0.93, α = 0.96, respectively). Reasonable fit indexes were found by confirmatory factor analysis (χ 2/df = 2.799; CFI = 0.960; PCFI = 0.791, and RMSEA = 0.087), indicating a good model fit to the original structure. The ICE-FPSQ is a valid and reliable instrument to measure perceived support.info:eu-repo/semantics/publishedVersio

Differential activation of nuclear factor kappa B subunits in a skin dendritic cell line in response to the strong sensitizer 2,4-dinitrofluorobenzene

Dendritic cell (DC) maturation is essential for the initiation of T-dependent immune responses. Nuclear factor kappa B (NF-kappaB) transcription factors are ubiquitously expressed signalling molecules, known to regulate the transcription of a large number of genes involved in immune responses, including cytokines and cell surface molecules. In this work, we studied the time-dependent activation of five members of the NF-kappaB family, p50, p52, p65, RelB and cRel, in a mouse skin DC line in response to stimulation with the strong sensitizer, 2,4-dinitrofluorobenzene (DNFB). Western blot assay revealed that exposure of fetal skin DC (FSDC) to DNFB induced the degradation of the inhibitor of NF-kappaB (IkappaB). Three out of its five members, i.e. p50, p52, and RelB, were similarly activated upon DNFB stimulation, with subsequent translocation of these subunits from the cytosol to the nucleus, but with different kinetics. In contrast, p65 expression was diminished in both the nucleus and the cytosol. The electrophoretic mobility shift assay (EMSA) showed that exposure of FSDC to DNFB induced DNA binding to NF-kappaB. Together, these results show that DNFB differentially activates the various members of the NF-kappaB family in skin DC

Granulocyte-macrophage colony-stimulating factor activates the transcription of nuclear factor kappa B and induces the expression of nitric oxide synthase in a skin dendritic cell line.

Nitric oxide (NO) produced by skin dendritic cells and keratinocytes plays an important role in skin physiology, growth and remodelling. Nitric oxide is also involved in skin inflammatory processes and in modulating antigen presentation (either enhancing or suppressing it). In this study, we found that GM-CSF stimulates the expression of the inducible isoform of nitric oxide synthase (iNOS) in a fetal-skin-derived dendritic cell line (FSDC) and, consequently, increases the nitrite production from 11.9 +/- 3.2 micromol/L (basal level) to 26.9 +/- 4.2 micromol/L. Pyrrolidinedithiocarbamate (PDTC) inhibits nitrite production, with a half maximal inhibitory concentration (IC50) of 19.3 micromol/L and the iNOS protein expression in FSDC. In addition, western blot assays revealed that exposure of FSDC to GM-CSF induces the phosphorylation and degradation of the inhibitor of NF-kappaB (IkB), with subsequent translocation of the p50, p52 and RelB subunits of the transcription nuclear factor kappa B (NF-kappaB) from the cytosol to the nucleus. Electrophoretic mobility shift assays (EMSA) showed that FSDC exposure to GM-CSF activates the transcription factor NF-kappaB. Together, these results show that GM-CSF induces iNOS expression in skin dendritic cells by a mechanism involving activation of the NF-kappaB pathway

Qualidade de vida da criança com cardiopatia congénita: que instrumentos de avaliação?

A qualidade de vida da criança com cardiopatia congénita é uma preocupação para todos os profissionais de saúde que diariamente desenvolvem actividades com estas crianças. Perceber com que qualidade de vida crescem e se desenvolvem, é essencial para uma tomada de decisão consciente e individualizada relativamente ao tratamento a instituir. Com o intuito de identificar escalas específicas para avaliação da sua qualidade de vida, foi realizada pesquisa em bases de dados, da qual emergiram dois instrumentos: o ConQOL e o PCQLI. Estas ferramentas de avaliação da qualidade de vida da criança com cardiopatia congénita apresentam duas versões adaptadas às idades das crianças/adolescentes e uma delas contempla também a opinião dos pais relativa à qualidade de vida dos filhos.The quality of life of children with congenital heart disease is a concern for all health professionals dealing, on a daily basis, with these children. It is essential for a good decision-making and individualized treatment to follow, to realize with which quality of life are they growing and developing. In order to identify speci$c scales for assessing the quality of life, a survey and search in databases was conducted. From this survey and search two instruments emerged: the ConQOL and PCQLI. These tools for assessing the quality of life of children with congenital heart disease have two versions tailored to teens and children ages, and one of them also includes the parents’ opinion on the quality of life of their children.info:eu-repo/semantics/publishedVersio

Urgent capsule endoscopy is useful in severe obscure-overt gastrointestinal bleeding

AIM: With capsule endoscopy (CE) it is possible to examine the entire small bowel. The present study assessed the diagnostic yield of CE in severe obscure-overt gastrointestinal bleeding (OOGIB). METHODS: During a 3-year period, 15 capsule examinations (4.5% of all CE in a single institution) were carried out in 15 patients (11 men; mean age 69.9 +/- 20.1 years) with severe ongoing bleeding, defined as persistent melena and/or hematochezia, with hemodynamic instability and the need for significant red blood cell transfusion. CE was carried out after non-diagnostic standard upper and lower endoscopy. The mean time from admission until CE was 4.1 +/- 4.4 days (0-15 days). RESULTS: CE revealed active bleeding in seven patients and signs of recent bleeding in four. Etiology of bleeding was correctly diagnosed in 11 patients (73.3%) (portal hypertension enteropathy, three patients; subepithelial ulcerated lesion, two patients; angiodysplasia, two patients; jejunal ulcer with visible vessel, one patient; multiple small bowel ulcers, one patient; jejunal tumor, one patient; jejunal mucosa irregularity with adherent clot, one patient). One patient (6.7%) had active bleeding but no visible lesion. As a consequence of the capsule findings, specific therapeutic measures were undertaken in 11 patients (73.3%) with five managed conservatively, four endoscopically and two surgically. Two patients experienced bleeding recurrence. One of them, with a probable small bowel tumor, refused any other interventions. CONCLUSIONS: CE is useful in patients with severe OOGIB by providing positive findings in the majority of patients, with subsequent impact on therapeutic procedures

Effect of portal hypertension in the small bowel: an endoscopic approach

BACKGROUND AND AIM: The effects of portal hypertension in the small bowel are largely unknown. The aim of the study was to prospectively assess portal hypertension manifestations in the small bowel. METHODS: We compared, by performing enteroscopy with capsule endoscopy, the endoscopic findings of 36 patients with portal hypertension, 25 cirrhotic and 11 non-cirrhotic, with 30 controls. RESULTS: Varices, defined as distended, tortuous, or saccular veins, and areas of mucosa with a reticulate pattern were significantly more frequent in patients with PTH. These two findings were detected in 26 of the 66 patients (39%), 25 from the group with PTH (69%) and one from the control group (3%) (P < 0.0001). Among the 25 patients with PTH exhibiting these patterns, 17 were cirrhotic and 8 were non-cirrhotic (P = 0.551). The presence of these endoscopic changes was not related to age, gender, presence of cirrhosis, esophageal or gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, prior esophageal endoscopic treatment, current administration of beta-blockers, or Child-Pugh Class C. More patients with these endoscopic patterns had a previous history of acute digestive bleeding (72% vs. 36%) (P = 0.05). Active bleeding was found in two patients (5.5%). CONCLUSIONS: The presence of varices or areas of mucosa with a reticulate pattern are manifestations of portal hypertension in the small bowel, found in both cirrhotic and non-cirrhotic patients. The clinical implications of these findings, as regards digestive bleeding, are uncertain, although we documented acute bleeding from the small bowel in two patients (5.5%)

Experiencias de las familias en el proceso de adaptación a la enfermedad oncológica en los niños

A adaptação familiar à doença oncológica na criança constitui um processo complexo que exige da família a aquisição de competências fundamentais e a remodelação do estilo de vida. Este estudo tem como finalidade contribuir para a melhoria da qualidade dos cuidados de enfermagem pediátricos, tendo a família como parceiros efetivos na prestação dos mesmos. Trata-se de um estudo descritivo de natureza quantitativa, com a aplicação dos seguintes instrumentos de colheita de dados: Entrevista Estruturada; Family Adaptability and Cohesion Evaluation Scale II (FACES II); Inventário de Respostas à Doença nos Filhos (IRDF); e, Inventário sobre a Perceção da Relação Enfermeiro-Pais (IPREP). No estudo participaram 130 familiares de crianças com doença oncológica. Os resultados encontrados indicam que os familiares percecionaram a sua família como ligada, muito flexível e moderadamente equilibrada. Revelaram boa organização face à doença, expressando com menor intensidade atitudes de descrença em contrapartida com estados de depressão. Os familiares valorizaram os cuidados de enfermagem, sobretudo os cuidados orientados para a criança e a comunicação. Conhecer as experiências dos familiares de crianças com doença oncológica permite que os enfermeiros identifiquem as necessidades e dificuldades da família e assim definir estratégias de intervenção no sentido da adaptação à doença oncológica na criança.Family adaptation to a child’s oncological cancer is an extremely complex process which requires the family to acquire new fundamental abilities and to rearrange their lifestyle. The goal of this study was to make a contribution towards better-quality pediatric nursing, by including family members as effective partners in care-giving. A quantitative descriptive study was carried out, involving administration of the following data collection instruments: Structured Interview; Family Adaptability and Cohesion Evaluation Scale II (FACES II); Inventário de Respostas à Doença nos Filhos (IRDF – inventory of Responses to the Illness of the Children); and the Inventário sobre a Perceção da Relação Enfermeiro-Pais (IPREP – Inventory of Responses of the Nurse-Parent Relationship). A sample of 130 relatives of children with oncological disease participated in this study. The results indicate that family members perceived their family as being united, flexible and moderately balanced. They demonstrated good organization in the face of disease, expressing less intensely attitudes of disbelief than states of depression. The family valued nursing care, especially with regard to childcentered care and communication. Knowing the experiences of family members of children with oncological illness helps nurses to identify the family’s needs and difficulties and to identify intervention strategies to help families adapt to oncological illness in the child.La adaptación de la familia a la enfermedad oncológica deen los niños es un proceso complejo que requiere que la familiaesta para la adquisicióeran de competencias y la renremodele suovación del estilo de vida. La finalidad de este estudio es contribuir a mejorar la calidad de los cuidados de enfermería pediátrica, incluyendo a la familia como colaboradoraes eficazces en la prestación de los mismos. Partimos de un estudio descriptivo de naturaleza cuantitativa y, utilizamosndo para ello los siguientes instrumentos depara recogida deer los datos; entrevista estructurada, Family Adaptability and Cohesion Evaluation Scale II (FACES II); Inventário de Respostas à Doença nos Filhos (IRDF); ey, Inventário sobre a Perceção da Relação Enfermeiro-Pais (IPREP). En el estudio participaronan 130 familiares de niños con enfermedades oncológicas. Los resultados obtenidos indicaronn que los familiares sintieron a su familia vinculada, muy flexible y moderadamente equilibrada. Del mismo modo, mostraron eEvidencias deron una buena organización frente a la enfermedad, con menos intensidad que expresando con menor intensidad actitudes de incredulidad en contraste con estados de depresión. Los familiares valoraron los cuidados de enfermería, especialmente en lo que respecta a la atención centrada en el niño y la comunicación. Conocer las experiencias de los familiares de niños con enfermedades oncológicas permite a los enfermos identificar las necesidades y dificultades de la familia, y definir así las estrategias de intervención para adaptarse a la la enfermedad oncológica de los niños.info:eu-repo/semantics/publishedVersio