EXPERIÊNCIA TRANSICIONAL DE ENFERMEIROS EM UM PROGRAMA DE RESIDÊNCIA

Objetivo: analisar as condições vivenciadas por enfermeiros durante a experiência transicional em um programa de residência. Método: estudo exploratório, qualitativo, que utilizou a história oral de vida temática, fundamentada na teoria de transição de Afaf Meleis. Participaram do estudo 40 enfermeiros egressos de um curso de residência, cujas narrativas foram submetidas à análise de conteúdo temática. Resultados: foram experienciadas condições favoráveis e desfavoráveis que expressaram a coesão entre a instituição de ensino e os cenários de prática, a integração das equipes gestora e executora, a coerência do conteúdo teórico e prático, o apoio da rede social, o conhecimento de pessoas e o estabelecimento de laços de amizade, a queda do padrão de vida, o acúmulo de atividades e o afastamento de vínculos sociais. Conclusão: o significado e o valor atribuídos pelos egressos às condições favoráveis e desfavoráveis vivenciadas durante a experiência transicional em um programa de residência interferiram na adaptação, no desenvolvimento da transição e nos resultados da experiência transicional.Descritores: Educação de Pós-Graduação em Enfermagem. Internato não Médico. Especialização. Enfermagem

A COMUNICAÇÃO NA PROMOÇÃO DA DIGNIDADE EM CUIDADOS PALIATIVOS: DESAFIOS PARA A ENFERMAGEM

Objetivo: compreender a influência da comunicação enquanto instrumento básico de Enfermagem na promoção da dignidade em Cuidados Paliativos. Método: reflexão teórica mediante revisão da literatura e com recurso ao Modelo da Dignidade de Chochinov. A pesquisa de artigos científicos foi realizada na biblioteca do conhecimento online, na base de dados das publicações Elsevier e na plataforma agregadora de bases de dados EBSCO Host Web, publicados durante o período 2010-2016. Resultados: identificou-se intervenções associadas às competências comunicacionais dos enfermeiros que promovem a dignidade dos clientes em cuidados paliativos. As intervenções comunicacionais que mais promovem a dignidade são as que transmitem ao cliente paliativo o respeito pela sua individualidade e valorização da sua história pessoal. Conclusão: o enfermeiro deve adotar uma postura de compreensão empática, escuta ativa, disponibilidade, atenção às necessidades emocionais, aos componentes não verbais (como a presença física e o contacto visual), à gestão de expectativas e o incentivo do autocuidado.Descritores: Enfermagem. Cuidados Paliativos. Comunicação. Dignidade Humana

The relationship between individualized care and the practice environment: an international study

Ethical approval: University of Turku Ethics Committee, 1/2009, 14.1.2009.Abstract BACKGROUND: Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies. OBJECTIVES: The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries. DESIGN: This study had an international, multisite, prospective, cross-sectional, exploratory survey design. SETTINGS: The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey. PARTICIPANTS: Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study. METHODS: Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model. RESULTS: Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care. CONCLUSIONS: The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes

Nurses' Sociodemographic Background and Assessments of Individualized Care

Aim: The aim of this study was to explore the association between nurses’ characteristics (educational level, country, work title, gender, type of work, age, and length of working experience) and their assessments of individualized care. Design: A cross-sectional comparative survey using questionnaires was employed to sample nurses from seven countries. Methods: Data were collected from orthopedic and trauma nurses from Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the United States (N = 1,163, response rate 70%) using the Individualized Care Scale-Nurse (ICS-Nurse) and a sociodemographic questionnaire in 2008. Data were analyzed using descriptive statistics and general linear models. Results: When compared with practical nurses, registered nurses, length of working experience, and the country of the nurses were associated with assessments of the support of patient individuality in specific nursing activities (ICS-A-Nurse) and country assessments of individuality in the care provided (ICS-B-Nurse). The background and experience within nursing teams together with the country affect the delivery of individualized care. Conclusions: Overall, our findings suggest that nurses’ personal attributes have important effects on their assessments of individualized nursing care that will be useful when making context-dependent recruitment decisions. Clinical Relevance: The characteristics of nurses contribute to the care delivered in healthcare organizations. Recognition of these nurse-related factors may help nurse leaders in the development and management of clinical practice

A seven country comparison of nurses’ perceptions of their professional practice environment

Aims To describe and compare nurses perceptions of their professional practice environment in seven countries. Background There is evidence of variation in the nursing professional practice environments internationally. These different work environments affect nurses ability to perform and are linked to differing nurse and patient outcomes. Methods A descriptive, comparative survey was used to collect data from orthopaedic and trauma nurses (n = 1156) in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and Kansas, USA using the 39-item Revised Professional Practice Environment instrument. Results Differences were found between participants from the northern countries of Europe, Kansas, USA, and the Mediterranean countries regarding perceptions about control over practice. No between-country differences were reported in the internal work motivation among the nurses from any of the participating countries. Conclusions Although between-country differences in nurses professional practice environment were found, difficulties related to demographic, cultural and health system differences and the way in which nursing is defined in each country need to be considered in the interpretation of the results