Modelos de exercício profissional usados pelos enfermeiros em hospitais portugueses

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Gestão de enfermagem: estratégias para a segurança de clientes e profissionais

Introdução: A segurança em saúde tem ganho especial destaque devido aos dados preocupantes que têm sido revelados. Altos padrões de segurança não se alcançam sem o envolvimento de Enfermeiros gestores. Objetivos: Conhecer as estratégias dos enfermeiros gestores para garantir a segurança dos clientes e enfermeiros num serviço hospitalar. Métodos: Estudo qualitativo interpretativo com recurso a entrevista semiestruturada a 14 enfermeiros gestores de um hospital da região centro de Portugal, com amostragem por conveniência. Realizada análise de conteúdo com recurso à metodologia de Bardin e ao software Atlas.ti. Resultados: Foram identificadas vinte categorias, das quais se destacam Discussão em Equipa, Reforço da Equipa, Distribuição do Plano de Trabalho, Formação, Sensibilização, Supervisão. De referir que, do total de categorias, dez dizem respeito à segurança do cliente e enfermeiro, nove em exclusivo com a segurança do cliente e uma à segurança do enfermeiro. Conclusões: Verifica-se que as estratégias de gestão da segurança são predominantemente globais, evidente na coincidência de categorias entre estratégias para segurança de utentes e profissionais. As estratégias para a segurança do cliente superam em número as estratégias para os enfermeiros. Os participantes demonstraram conhecimento de algumas das principais recomendações estratégias da Organização Mundial de SaúdeIntroduction: Health safety has gained special prominence due to the worrying data that has been revealed. High safety standards are not achieved without the involvement of nurse managers. Objetives: Know the strategies of nurse managers to ensure the safety of clients and nurses in a hospital service. Methods: Qualitative interpretative study using semi-structured interviews with 14 nurse managers of a hospital in central Portugal, with convenience sampling. Performed content analysis using Bardin methodology and Atlas.ti software. Results: Twenty categories were identified, such as Team Discussion, Team Reinforcement, Work Plan Distribution, Training, Awareness Raising, Supervision. Of the total of categories, ten relate to client and nurse safety, nine exclusively to client safety and one to nurse safety. Conclusions: Safety management strategies are predominantly global, evident in the coincidence of categories between user and professional safety strategies. The strategies for client safety outnumber the strategies for nurses. Participants demonstrated knowledge of some of the World Health Organization's key strategic recommendationsinfo:eu-repo/semantics/publishedVersio

Procesos desarrollados por los gestores de enfermería frente al error

Enquadramento: No contexto atual de promoção da segurança do doente, os enfermeiros gestores assumem um papel preponderante nos cuidados de saúde. Objetivos: Conhecer as perceções dos enfermeiros gestores e identificar estratégias de gestão face ao erro, analisar as medidas corretivas e preventivas implementadas pelos mesmos. Metodologia: Estudo qualitativo fundamentado na teoria de James Reason, realizado através de entrevista semiestruturada a 14 enfermeiros gestores de um centro hospitalar da região centro de Portugal, escolhidos por conveniência. Realizada análise de conteúdo com recurso ao software ATLAS.ti. Resultados: Foram identificadas 8 categorias agrupadas em duas áreas temáticas. Na abordagem individual identificaram-se as categorias: Análise com o enfermeiro, e Comunicar ao médico na abordagem sistémica; Análise com a equipa, Notificação de eventos adversos, Grupo de trabalho, Sensibilização, Análise de reclamações e Reforço positivo. Conclusão: As categorias do âmbito sistémico superam em número as do âmbito individual, os entrevistados salientaram a necessidade de melhoria na adesão à notificação, e não foram explícitas estratégias para prevenção de erros.Background: In the current context of patient safety promotion, nurse managers play a key role in health care. Objectives: To identify nurse managers’ perceptions and their management strategies regarding the error, and to analyze the corrective and preventive measures implemented by them. Methodology: Qualitative study, based on James Reason’s theory, with semi-structured interviews to a convenience sample of 14 nurse managers of a hospital center in the central region of Portugal. Content analysis was performed using the ATLAS.ti software. Results: Eight categories were identified and grouped into two thematic areas. The following categories were identified: Analysis with the nurse, and Report to the physician in the Person approach; and Analysis with the team, Adverse event reporting, Working Group, Awareness, Analysis of complaints, and Positive reinforcement in the System approach. Conclusion: Systemic categories outnumbered individual categories. Participants emphasized the need to improve adherence to reporting. No strategies for error prevention were identified.Marco contextual: En el contexto actual de promoción de la seguridad del paciente, los enfermeros gestores asumen un papel preponderante en los cuidados de salud. Objetivos: Conocer las percepciones de los enfermeros gestores e identificar las estrategias de gestión frente al error, analizar las medidas correctivas y preventivas implementadas por los mismos. Metodología: Estudio cualitativo fundamentado en la teoría de James Reason, realizado a través de una entrevista semiestructurada a 14 enfermeros gestores de un centro hospitalario de la región centro de Portugal, escogidos por conveniencia. El análisis de contenido se realizó con el software ATLAS.ti. Resultados: Se identificaron 8 categorías agrupadas en 2 áreas temáticas. En el enfoque individual se identificaron las categorías: Análisis con el enfermero, y Comunicar al médico en el enfoque sistémico; Análisis con el equipo, Notificación de eventos adversos, Grupo de trabajo, Sensibilización, Análisis de reclamaciones y Refuerzo positivo. Conclusión: Las categorías: del ámbito sistémico superan en número a las del ámbito individual. Los entrevistados resaltaron la necesidad de mejorar la adhesión a la notificación, y no se explicitaron estrategias para prevenir errores.info:eu-repo/semantics/publishedVersio

Nursing management: priority areas regarding safety of professionals and clients

Background: Due to the disturbing data that have been published, health security has gained special notoriety. The involvement of manager nurses is a fundamental condition to ensure high hospital safety standards. These are responsible for promoting a safety culture in teams and for promoting safe environments. Objective: To know what areas manager nurses consider as priority in the safety of clients and nurses in a hospital service. Methodology: A phenomenological qualitative study carried out through a semi- -structured interview to 14 manager nurses of a hospital in the central region of Portugal, chosen by convenience. Content analysis was carried out using Atlas.ti software and Bardin methodology. Results and Discussion: We identified 11 priority areas in client safety that reflect concern about adverse events with higher incidence rates and their causes described as more significant. The 12 priority areas in occupational safety are in line with the known occupational hazards and the most frequent workplace accidents. There are 5 categories that show a relationship between nurses ‘and clients’ safety. Conclusion: For those interviewed, customer and professional safety are equally important and interrelated. It is understood that health security is complex and multidimensional and does not only imply client safety, this may be dependent on the safety of the nurse and vice versa. They also demonstrated knowledge of the main safety problems described in the literature.info:eu-repo/semantics/publishedVersio

The IGF1 small dog haplotype is derived from Middle Eastern gray wolves

Abstract Background A selective sweep containing the insulin-like growth factor 1 (IGF1) gene is associated with size variation in domestic dogs. Intron 2 of IGF1 contains a SINE element and single nucleotide polymorphism (SNP) found in all small dog breeds that is almost entirely absent from large breeds. In this study, we surveyed a large sample of grey wolf populations to better understand the ancestral pattern of variation at IGF1 with a particular focus on the distribution of the small dog haplotype and its relationship to the origin of the dog. Results We present DNA sequence data that confirms the absence of the derived small SNP allele in the intron 2 region of IGF1 in a large sample of grey wolves and further establishes the absence of a small dog associated SINE element in all wild canids and most large dog breeds. Grey wolf haplotypes from the Middle East have higher nucleotide diversity suggesting an origin there. Additionally, PCA and phylogenetic analyses suggests a closer kinship of the small domestic dog IGF1 haplotype with those from Middle Eastern grey wolves. Conclusions The absence of both the SINE element and SNP allele in grey wolves suggests that the mutation for small body size post-dates the domestication of dogs. However, because all small dogs possess these diagnostic mutations, the mutations likely arose early in the history of domestic dogs. Our results show that the small dog haplotype is closely related to those in Middle Eastern wolves and is consistent with an ancient origin of the small dog haplotype there. Thus, in concordance with past archeological studies, our molecular analysis is consistent with the early evolution of small size in dogs from the Middle East. See associated opinion by Driscoll and Macdonald: http://jbiol.com/content/9/2/1

Tamoxifen Suppresses the Growth of Malignant Pleural Mesothelioma Cells.

INTRODUCTION: Malignant pleural mesothelioma (MPM) is a rare but highly aggressive malignancy most often associated with exposure to asbestos. Recent evidence points to oestrogen receptor (ER)-β having a tumour-suppressor role in MPM progression, and this raises the question of whether selective modulators of ERs could play a role in augmenting MPM therapy. MATERIALS AND METHODS: We investigated the action of tamoxifen in inhibiting the growth and modulating the cisplatin sensitivity of four MPM cell lines. RESULTS: Tamoxifen inhibited the growth of MPM cells and also modulated their sensitivity to cisplatin. The MPM cell lines expressed ERβ, but the actions of tamoxifen were not blocked by antagonism of nuclear ERs. Tamoxifen treatment repressed the expression of cyclins by MPM cells, resulting in cell-cycle arrest and caspase-3-coupled apoptosis signaling. CONCLUSION: The ER-independent actions of tamoxifen on MPM cell proliferation and cell-cycle progression may have clinical benefits for a subset of patients with MPM

La hermenéutica como método en la investigación sobre errores de enfermería en los medios de comunicacion

O objetivo deste artigo é relatar como as concepções da hermenêutica de Paul Ricoeur utilizadas como referencial metodológico em uma tese de doutorado, contribuíram para a compreensão do fenômeno - erro de enfermagem na comunicação social. O referencial adotado se revelou coerente, com a proposta da pesquisa de abordagem qualitativa, documental, por proporcionar a interpretação de textos escritos pela mídia e suas interfaces diante do fenômeno “erro”. Destaca-se a importância do referencial para pesquisas na enfermagem, pelo diálogo que proporciona com o destinatário do trabalho da profissão - os seres humanos - e pelas possibilidades de interpretação do que é dito e escrito sobre a profissão, quando não há um desfecho favorável de sua práxis.The aim of this article is to report how the conceptions of Paul Ricoeur's hermeneutics, used as a methodological reference of the doctoral thesis contributed to the understanding of the phenomenon - social. The adopted framework proved to be coherent with the proposal of a qualitative and documentary approach, since it provides the interpretation of texts written by the media and their interfaces to the "error" phenomenon. Emphasis is placed on the importance of the referential for nursing research, for the dialogue it provides with the recipient of the profession's work - human beings - and for the possibilities of interpretation of what is said and written about the profession, when there is no favorable outcome of his praxis.El propósito de este artículo es describir cómo los conceptos de la hermenéutica de Paul Ricoeur, que se utiliza como un marco metodológico de una tesis doctoral contribuyeron a la comprensión del fenómeno error de enfermería en la comunicación social. El marco adoptado resultó coherente con la propuesta de la investigación cualitativa, en documentos, proporcionando la interpretación de los textos escritos por los medios de comunicación y sus interfaces del fenómeno de "error". Se destaca la importancia de referencia para la investigación en enfermería, el diálogo que proporciona el destinatario de la profesión - los seres humanos - y las posibilidades de interpretación de lo que se ha dicho y escrito acerca de la profesión cuando no hay un resultado favorable en su praxis. Descriptores: Hermenéutica; Investigación cualitativa; Enfermería; Seguridad del paciente.info:eu-repo/semantics/publishedVersio

Violence Against the Elderly: Social Representations of Portuguese and Brazilian Caregivers

The increase in life expectancy and elderly people in society, coupled with changes in family structure, have highlighted the importance of formal and informal caregivers of elderly people. Objective: To analyse the social representations of violence against the elderly, of two groups of formal and informal caregivers. Methods: Exploratory, quantitative and qualitative research, supported by the theoretical-methodological reference of the Social Representations Theory and in the context of this, the Central Core Theory. The sample was participated in by 81 formal caregivers from the project “Aging in Safety in the Alentejo - Understanding to Act, of the University of Évora” and 20 informal caregivers from the project “Qualification of caregivers and aspects related to the quality of life of the elderly people dependent on primary and tertiary care: Implementation and protocol evaluation, of the State University of Southwest of Bahia”. We used the Free Word Association Technique. The data was analysed by prototypical analysis based on two matrices by the software IRAMUTEQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) 0.7 alpha 2. Results: In Portugal, the elements “bad, mistreatment, I will be, sad, anger, patience, physical, injustice, irritation and meanness” stood out in the central core. In Brazil the mention of “hitting” was emphasized. Conclusions: In both Portugal and Brazil, physical violence takes on particular significance in the social representations of caregivers, rather than verbal and psychological violence, which is not present in the central core of social representations of violence against the elderly in either of the countries

International Physical Activity Questionnaire (IPAQ) and New Zealand Physical Activity Questionnaire (NZPAQ): A doubly labelled water validation

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Aplicación del proceso de enfermería en los hospitales portugueses

RESUMO Objetivo: Descrever a aplicação do processo de enfermagem pelos enfermeiros, que exercem funções em instituições hospitalares. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa, realizado em 19 Centros Hospitalares de Portugal continental, no qual participaram 56 enfermeiros. Os dados foram coletados através de entrevista semiestruturada. Resultados: Da análise de conteúdo realizada emergiram como categorias: processo de enfermagem; avaliação inicial; diagnóstico; planejamento; implementação e avaliação final. Apesar de nos últimos anos se ter assistido a uma progressiva apropriação do processo de enfermagem, a descrição das práticas dos enfermeiros tornam evidentes algumas fragilidades. Conclusão: Os resultados do estudo evidenciam que a aplicaçãoObjective: To obtain a description of the implementation of the nursing process by nurses who work in hospitals. Methods: Qualitative, descriptive study that was carried out in 19 hospitals in Continental Portugal with 56 nurses. Data were collected through a semi-structured interview. Results: Content analysis originated the categories nursing process, initial evaluation, diagnosis, planning, implementation, and final evaluation. Although there has been a progressive appropriation of the nursing process in the past years, the description of nurses’ practices evinces some weaknesses. Conclusion: The results of this study show that the application of the nursing process requires more clarification and comprehensiveness of the contents included in its stages. Keywords: Nursing. Nursing process. Hospitals.Objetivo: Obtener una descripción de la aplicación del proceso de enfermería echa por los enfermeros que ejercen funciones en instituciones hospitalarias. Métodos: Se trata de un estudio descriptivo con enfoque cualitativo, que se realizó en 19 centros hospitalarios en Portugal Continental, y en el que participaron 56 enfermeros. Los datos se recolectaron a través de entrevista semiestructurada. Resultados: Del análisis de contenido surgieron las siguientes categorías: proceso de enfermería, evaluación inicial, diagnóstico, planificación, implementación y evaluación final. Aunque en los últimos años se haya producido una apropiación progresiva del proceso de enfermería, la descripción de las prácticas de los enfermeros hace evidente algunas debilidades. Conclusión: Los resultados del estudio sugieren que la aplicación del proceso de enfermería requiere una mayor clarificación y la integridad de los contenidos incluidos en los pasos que lo constituyen.info:eu-repo/semantics/publishedVersio