Cuidar em casa - quais as dificuldades

El envejecimiento demográfico, los cambios en la organización de la sociedad y en el mundo son desafíos importantes en las políticas de salud. El éxito de estas políticas se basa en el vínculo entre los sistemas formales e informales y en el reconocimiento y agradecimiento de los roles de cuidadores y pacientes. Objetivos: identificar las dificultades del cuidador y el paciente dependiente en su casa; conocer cómo el paciente vive su espiritualidad como una estrategia de afrontamiento. Método: estudio descriptivo, enfoque cualitativo. 250 pacientes dependientes y 250 cuidadores fueron parte del estudio. Los datos se recogieron en los hogares de los pacientes a través de entrevistas semiestructuradas. Resultados: dificultades de los cuidadores. Esos momentos difíciles se relacionan con la falta de información (70,3%), de ayuda técnica (64.9%), desplazamientos a los servicios de salud (42,6%) y falta de apoyo de profesionales de la salud. Las dificultades de pacientes están relacionadas con la falta de un médico, una enfermera o un fisioterapeuta en casa; la falta de apoyo económico, familiar, emocional y espiritual y también con la ineficiencia en la combinación de la atención. La espiritualidad tiene un papel importante en el camino de los pacientes frente a la enfermedad, dándoles un estado de armonía interna. Discusión / conclusión: las dificultades identificadas son unas Orientaciones Estratégicas de Plano Nacional de Salud y Seguridad Social (2004-2010) que quieren conseguir: la creación de una política que integre la salud y la Seguridad Social, que permita desarrollar acciones cercanas a estos pacientes dependientes.The demographical aging, the changings in the organization of the society and the world are important challenges in the Health Politics.The success of these politics lays in the link between formal and informal systems and in the recognition and appreciation of the roles of care giver ant patient.Goals: to identify the difficulties of the care giver and the dependent patient at home; to know how the patient lives his/her spirituality as a coping strategy.Method: descriptive study, qualitative approach. 250 dependent patients and 250 care givers were part of the study. Data were collected at the patients’ homes through semi-structured interviews.Results: the majority of care givers struggles. Those hard times are related to the lack of information (70,3%), of technical help (64,9%), of commuting to Health services (42,6%) and lack of support from Health care professionals.The patients’ difficulties are related to the lack of a doctor, a nurse or a physiotherapist at home; to the lack of economical, familiar, emotional and spiritual support and also to the inefficiency in care combination. Spirituality has an important role in the way patients face the illness and in giving them a state of inner harmony.Discussion / Conclusion:The difficulties identified are the ones that Orientações Estratégicas do Plano Nacional de Saúde e de Segurança Social (2004-2010) want to fight back: the creation of integrated health politics and Social Security that allow the development of actions closer to dependent patients.peerReviewe

Construction and validation of “Diabetes Education Process (DEP)” scale

Nursing interventions in diabetes education are considered relevant in order to achieve proper outcomes. It is important to know what nurses do in this field and for this purpose we need valid and reliable instruments. Objective: To develop and determine the psychometric characteristics of Diabetes Education Process Scale (DEP). Methods: Based on the question “What interventions nurses develop in their practice in diabetes education?", we developed two studies: (a) a qualitative one in order to identify relevant variables to measure in diabetes education; and (b) a quantitative and methodological study of validation of DEP scale. Results: We identified four guidelines in qualitative study through which emerged the relevant variables for the evaluation of therapeutic education. We applied this DEP Scale to a sample of 104 nurses, with an average age of 41.3 years (SD = 8.1). DEP Scale has in its dimensions α values between 0.6720 and 0.834, revealing reasonable internal consistency. The scale revealed also validity characteristics. Conclusion: We concluded that it is important to know nurses practices in order to let emerge their contribution to patient care. For this purpose, we need valid and reliable instruments. DEP Scale proved itself to be valid and reliable, so it can be used to access nurses´ interventions in diabetes education.info:eu-repo/semantics/publishedVersio

Cuidados continuados no Domícilio

Ciências de EnfermagemDoctoral Degree in nursing scienc

Cuidar em casa - quais as dificuldades

El envejecimiento demográfico, los cambios en la organización de la sociedad y en el mundo son desafíos importantes en las políticas de salud. El éxito de estas políticas se basa en el vínculo entre los sistemas formales e informales y en el reconocimiento y agradecimiento de los roles de cuidadores y pacientes. Objetivos: identificar las dificultades del cuidador y el paciente dependiente en su casa; conocer cómo el paciente vive su espiritualidad como una estrategia de afrontamiento. Método: estudio descriptivo, enfoque cualitativo. 250 pacientes dependientes y 250 cuidadores fueron parte del estudio. Los datos se recogieron en los hogares de los pacientes a través de entrevistas semiestructuradas. Resultados: dificultades de los cuidadores. Esos momentos difíciles se relacionan con la falta de información (70,3%), de ayuda técnica (64.9%), desplazamientos a los servicios de salud (42,6%) y falta de apoyo de profesionales de la salud. Las dificultades de pacientes están relacionadas con la falta de un médico, una enfermera o un fisioterapeuta en casa; la falta de apoyo económico, familiar, emocional y espiritual y también con la ineficiencia en la combinación de la atención. La espiritualidad tiene un papel importante en el camino de los pacientes frente a la enfermedad, dándoles un estado de armonía interna. Discusión / conclusión: las dificultades identificadas son unas Orientaciones Estratégicas de Plano Nacional de Salud y Seguridad Social (2004-2010) que quieren conseguir: la creación de una política que integre la salud y la Seguridad Social, que permita desarrollar acciones cercanas a estos pacientes dependientes.The demographical aging, the changings in the organization of the society and the world are important challenges in the Health Politics.The success of these politics lays in the link between formal and informal systems and in the recognition and appreciation of the roles of care giver ant patient.Goals: to identify the difficulties of the care giver and the dependent patient at home; to know how the patient lives his/her spirituality as a coping strategy.Method: descriptive study, qualitative approach. 250 dependent patients and 250 care givers were part of the study. Data were collected at the patients’ homes through semi-structured interviews.Results: the majority of care givers struggles. Those hard times are related to the lack of information (70,3%), of technical help (64,9%), of commuting to Health services (42,6%) and lack of support from Health care professionals.The patients’ difficulties are related to the lack of a doctor, a nurse or a physiotherapist at home; to the lack of economical, familiar, emotional and spiritual support and also to the inefficiency in care combination. Spirituality has an important role in the way patients face the illness and in giving them a state of inner harmony.Discussion / Conclusion:The difficulties identified are the ones that Orientações Estratégicas do Plano Nacional de Saúde e de Segurança Social (2004-2010) want to fight back: the creation of integrated health politics and Social Security that allow the development of actions closer to dependent patients.peerReviewe

Cuidar em casa: Quais as dificuldades

The demographical aging, the changings in the organization of the society and the world are important challenges in the Health Politics.The success of these politics lays in the link between for- mal and informal systems and in the recognition and appreciation of the roles of care giver ant patient. Goals: to identify the difficulties of the care giver and the dependent patient at home; to know how the patient lives his/her spirituality as a coping strategy. Method: descriptive study, qualitative approach. 250 dependent patients and 250 care givers were part of the study. Data were collected at the patients’ homes through semi-structured interviews. Results: the majority of care givers strug- gles. Those hard times are related to the lack of information (70,3%), of technical help (64,9%), of commuting to Health services (42,6%) and lack of support from Health care professionals.The patients’ difficulties are related to the lack of a doctor, a nurse or a physiotherapist at home; to the lack of economical, familiar, emotional and spiritual support and also to the inefficiency in care com- bination.Spirituality has an important role in the way patients face the illness and in giving them a state of inner harmony. Discussion / Conclusion: The difficulties identified are the ones that Orientações Estratégicas do Plano Nacional de Saúde e de Segurança Social (2004-2010) want to fight back: the creation of integrated health politics and Social Security that allow the development of actions closer to dependent patients

CONSTRUCTION AND VALIDATION OF “DIABETES EDUCATION PROCESS (DEP)” SCALE

Nursing interventions in diabetes education are considered relevant in order to achieve proper outcomes. It is important to know what nurses do in this field and for this purpose we need valid and reliable instruments. Objective: To develop and determine the psychometric characteristics of Diabetes Education Process Scale (DEP). Methods: Based on the question “What interventions nurses develop in their practice in diabetes education?", we developed two studies: (a) a qualitative one in order to identify relevant variables to measure in diabetes education; and (b) a quantitative and methodological study of validation of DEP scale. Results: We identified four guidelines in qualitative study through which emerged the relevant variables for the evaluation of therapeutic education. We applied this DEP Scale to a sample of 104 nurses, with an average age of 41.3 years (SD = 8.1). DEP Scale has in its dimensions α values between 0.6720 and 0.834, revealing reasonable internal consistency. The scale revealed also validity characteristics. Conclusion: We concluded that it is important to know nurses practices in order to let emerge their contribution to patient care. For this purpose, we need valid and reliable instruments. DEP Scale proved itself to be valid and reliable, so it can be used to access nurses´ interventions in diabetes education.&nbsp

THE INFLUENCE OF NURSES’ WORK ENVIRONMENT AND PATIENT-CENTERED CARE PRACTICES ON GLYCATED HEMOGLOBIN

In this cross-sectional study of 292 type 2 diabetics and their 49 family nurses in Portugal, we have examined the relationship between the nursing work environment and the implementation of patientcentred care practices, and between these practices and the glycated hemoglobin (HbA1c). For this purpose, we used the Structural Equations Model (SEM) in order to test these relationships. The clinical supervision and resource adequacy as assessed by “The Practice Environment Scale of the Nursing Work Index (PES–NWI)” had a direct and positive effect on the quality of patient-centered care as measured by “Diabetes Education Process (DEP)”, which in turn had a negative and direct effect on the gold standard outcome of diabetes (HbA1c). For the sample under study, it has been shown that the care environment affects the development of clinical care practices centered on the patient and that these practices affect the results on patients with diabetes

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved