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Mirror therapy and self-care autonomy after stroke: an intervention program

Background: In patients with middle cerebral artery (MCA) stroke, changes in upper limb function lead to dependence on others for self-care. In the process of recovering autonomy/independence, there is evidence on the effectiveness of sensory stimulation techniques in the motor recovery after stroke. Objective: To assess the effect of mirror therapy on the self-care autonomy of patients with hemiplegia/hemiparesis due to MCA stroke. Methodology: Cross-sectional and quasi-experimental study with a quantitative approach, a before-and-after design, and a non-equivalent control group. A nonprobability sample of 30 participants was selected. Results: Gains in grip strength, joint range of motion, and manual dexterity of the upper limb were more significant in the experimental group but without statistically significant differences between groups. Conclusion: Despite the more significant evolution of the experimental group, mirror therapy was not effective in the motor recovery of the upper limb. Further studies are needed in this area using randomized designs, larger samples, and focused on self-care

Comparación entre la gravedad del paciente y la carga de trabajo de la enfermería antes y después de la ocurrencia de eventos adversos en ancianos con cuidados críticos

Indexación: Scopus.Objective: to compare the patient severity and the nursing workload before and after the occurrence of moderate and severe adverse events in elderly hospitalized at intensive care units. Method: comparative study developed at nine intensive therapy units of a University Hospital in São Paulo. The events were collected from the patient histories and classified as moderate and severe according to the World Health Organization. For the severity analysis, the Simplified Acute Physiologic Score II was used and, for the workload analysis, the Nursing Activities Score was applied 24 hours before and after the moderate and severe event. The t-test with 5% significance was used to compare the mean clinical severity and workload scores before and after the event. Results: the sample consisted of 315 elderly, 94 (29.8%) of whom were victims of moderate and severe events at the units. Among the 94 events, the clinical process and procedure type was predominant (40.0%). The installation and maintenance of therapeutic artifacts and catheters were the prevalent interventions that resulted in moderate (76.5%) physiopathological damage (66.0%). The mean workload score (75.19%) dropped 24 hours after the occurrence of the event (71.97%, p=0.008), and the severity, represented by the probability of death, increased from 22.0% to 29.0% after the event (p=0.045). Conclusion: in the patient safety context, the identification of the changes in clinical conditions and the nursing workload in elderly victims of events supports the prevention of these occurrences. © 2018, Universidade Federal de Santa Catarina. All rights reserved.Objetivo: comparar a gravidade do paciente e a carga de trabalho de enfermagem antes e após a ocorrência de evento adverso moderado e grave em idosos internados em unidades de terapia intensiva. Método: estudo comparativo, realizado em nove unidades de terapia intensiva de um Hospital Universitário de São Paulo. Os eventos foram coletados dos prontuários dos pacientes e classificados em moderados e graves segundo a Organização Mundial de Saúde. A análise da gravidade foi realizada segundo o Symplified Acute Phsiologic Score II e a carga de trabalho segundo o Nursing Activities Score, 24 horas antes e depois do evento moderado e grave. O teste t, com significância de 5%, foi utilizado para a comparação das médias da gravidade clínica e da carga de trabalho, antes e após o evento. Resultados: a amostra foi composta por 315 idosos, sendo que 94 (29,8%) sofreram eventos moderados e graves nas unidades. Dos 94 eventos, predominou o tipo processo clínico e procedimento (40,0%). A instalação e manutenção de artefatos terapêuticos e cateteres foram as intervenções prevalentes que resultaram em danos fisiopatológicos (66,0%), de grau moderado (76,5%). A média de pontuação da carga de trabalho (75,19%) diminuiu 24 horas após a ocorrência do evento (71,97%, p=0,008) e, a gravidade, representada pela probabilidade de morte, aumentou de 22,0% para 29,0% depois do evento (p=0,045). Conclusão: no contexto da segurança do paciente, a identificação das alterações nas condições clínicas e na carga de trabalho de enfermagem em idosos que sofrem eventos subsidiam a prevenção dessas ocorrências.Objetivo: comparar la gravedad del paciente y la carga de trabajo en enfermería antes y después de ocurrir un evento adverso moderado y grave en ancianos internados en unidades de terapia intensiva. Método: estudio comparativo realizado en nueve unidades de terapia intensiva de un Hospital Universitario de São Paulo. Los eventos fueron obtenidos a través de los prontuarios de los pacientes y clasificados en moderados y graves según la Organización Mundial de la Salud. El análisis sobre la gravedad fue realizado de acuerdo al Symplified Acute Physiologic Score II y la carga de trabajo se hizo conforme al Nursing Activities Score, 24 horas antes y después del evento moderado y grave. El test t, con una significancia del 5%, fue utilizado para la comparación de los promedios de la gravedad clínica y de la carga de trabajo antes y después del evento. Resultados: la muestra incluyó 315 ancianos, siendo que 94 (29,8%) sufrieron eventos moderados y graves en las unidades. De los 94 eventos, predominó el tipo de proceso clínico y el procedimiento (40,0%). La instalación y mantenimiento de artefactos terapéuticos y catéteres fueron las intervenciones prevalentes que resultaron en daños fisiopatológicos (66,0%) y de grado moderado (76,5%). El promedio de puntuación de la carga de trabajo (75,19%) disminuyó 24 horas después de ocurrido el evento (71,97%, p=0,008) y la gravedad, representada por la probabilidad de muerte, aumentó de 22,0% para 29,0% después del evento (p=0,045). Conclusion: en el contexto de seguridad del paciente, la identificación de las alteraciones en las condiciones clínicas y en la carga de trabajo de enfermería en los ancianos que sufren eventos subsidia la prevención de tales ocurrencias.http://ref.scielo.org/wcg6x

A construção imaginativa de cuidados: a experiência de profissionais de enfermagem em um serviço de assistência remota

Indexación: Web of Science; ScieloThe direction of care delivery goes from the action to the being; a process built from professional experience, which gains special characteristics when the service is delivered by telephone. The goal of this research was to understand the interaction between professionals and users in a remote care service; to do so, a research is presented, using Grounded Theory and Symbolic Interactionism as theoretical references. Data were collected through eight interviews with professionals who deliver care by telephone. The theoretical understanding permitted the creation of the theoretical model of the Imaginative Construction of Care, which shows the interaction processes the professional experiences when delivering care by telephone. In this model, individual and social facts are added, showing the link between the concepts, with special emphasis on uncertainty, sensitivity and professional responsibility, as essential components of this experience.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692012000400009&nrm=isohttp://ref.scielo.org/44chq

La importancia de la calificación de las revistas científicas para el avance de la producción y la visibilidad de la investigación en enfermería

Universidade de São Paulo Escola de Enfermagem de Ribeirão Preto Departamento de Enfermagem Materno-Infantil e Saúde PúblicaUniversidade Federal de Goiás Faculdade de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem Departamento de Enfermagem PediátricaUniversidade Federal de Santa Catarina Departamento de Enfermagem Programa de Pós-Graduação em EnfermagemUniversidade de São Paulo Escola de Enfermagem de Ribeirão PretoUNIFESP, EPE Depto. de Enfermagem PediátricaSciEL

Cuidar de Imigrantes: das interações em contexto à construção de competências culturais nos enfermeiros

Background: Immigrant care provides nurses with a new way to look at themselves and those they care for. According to Leininger and Meleis, the interaction between them underlies the development of cultural competencies in nurses and a balanced experience of transition processes in immigrants. Objectives: To study the process of building cultural competencies in nurses based on the identification of the meanings assigned in dyads in health care settings (family health units and immigrants’ households). Methodology: This qualitative and ethnographic study mobilised the researcher to be present in loco with the participants. Data were collected using narratives, participant observation, ethno-biographical interviews and focus groups with a group of volunteers selected from health care units: 23 nurses, 27 immigrants and 2 privileged informants (a cultural mediator and a physician). Results: In health care contexts, nurses’ cultural competencies are built in a procedural way. This process begins with their interaction with immigrants; nurses then identify deficit areas in their cultural knowledge and skills; and recognise the bilateral cultural heritage during those meetings. Conclusion: In nurses’ clinical practice, cultural awareness, combined with the motivation to take care of immigrants, is based on an evolutionary basis, from ethnocentrism to ethnic relativism. Enquadramento: Cuidar de imigrantes proporciona aos enfermeiros uma nova forma de olhar sobre si mesmos e sobre aqueles de quem cuidam. As interações entre estes atores estão na base do desenvolvimento das competências culturais nos enfermeiros e da vivência equilibrada de processos de transição nos imigrantes, de acordo com Leininger e Meleis. Objetivos: Estudar o processo de construção das competências culturais nos enfermeiros, partindo da identificação dos significados atribuídos nas díades em contexto de cuidados (unidades de saúde familiar e domicílios dos imigrantes). Metodologia: Este estudo qualitativo e etnográfico mobilizou a presença do investigador com os atores no contexto. Utilizámos na recolha de dados: narrativas, observação participante, entrevistas etnobiográficas e grupos de discussão. Participantes selecionados: integrantes de unidades de saúde e voluntários para o estudo – 23 enfermeiros, 27 imigrantes e 2 informantes privilegiados (mediadora cultural e médico). Resultados: As competências culturais nos enfermeiros constroem-se de forma processual no contexto de cuidados. O processo inicia-se nas interações com os imigrantes; os enfermeiros identificam as áreas deficitárias nos conhecimentos e habilidades culturais; e tomam consciência do património cultural bilateral nos encontros. Conclusão: A consciência cultural, associada à motivação para cuidar de imigrantes, assenta numa base evolutiva do etnocentrismo para o relativismo étnico na prática clínica dos enfermeiros.info:eu-repo/semantics/publishedVersio

Cultural adaptation to Brazil of the questionnaire Costs of caring for children with cancer.

Objectiveto present the cultural adaptation of the questionnaire Costs of caring for children with cancer, offering a valid and reliable tool to assess the economic repercussions of childhood cancer for Brazilian families.Methodit is a methodological research with a cross-sectional design. The methodological framework to validate the questionnaire was a combined process that included seven steps: translation to Portuguese; first translated consensus version; evaluation by Expert Committee; consensus on the Expert Committee version; back-translation; consensus of back-translated versions; semantic validation. The study was conducted in two phases: phase one was the translation and back-translations process, with five expert committee members. Phase two was the semantic validation, with 24 participants, who answered an instrument about their impressions of the questionnaire and suggested modifications.Resultsin phase one, items were included, excluded, and replaced to make the content equivalent and valid for use with Brazilian context. In phase two, the majority of the participants were mothers, who made suggestions about the relevance and clarity of the items in the questionnaire.Conclusionsthe authors discussed these recommendations and made adaptations, turning the questionnaire into a valid and reliable tool for application

Sintomatología musculoesquelética en estudiantes de enfermería: un análisis de concepto

Objective: to analyze the musculoskeletal symptomatology concept in undergraduate nursing students through Rodgers' evolutionary method. Method: An integrative review of the literature was performed for the identification and selection of ten articles. A concept analysis was performed according to Rodgers' evolutionary method. Article search was performed using the EBOSCO Host platform, Virtual Health Library and Google scholar for the years from 2004 to 2018. Results: Based on the 3 elements of Rodgers model we found: 1) substitute terms and related concepts, where musculoskeletal disorders and musculoskeletal symptoms were highlighted; 2) as essential attributes of the concept we highlight pain and discomfort, as well as, measurement using the Nordic Musculoskeletal Questionnaire; and 3) risk factors were identified as antecedents, and the consequences were the impact on students' lives. Conclusions: This study contributes to the knowledge and clarification of the concept of musculoskeletal symptomatology in nursing students