Spirituality in the uncertainty of illness: the perspective of oncology patients.

OBJECTIVE: To analyze spirituality in the process of illness uncertainty in cancer patients. METHODS: This is a qualitative study, in which Merle Mishel's Theory of Uncertainty of Disease was used as a theoretical framework; and as a methodological reference, the stages of Bardin's Content Analysis. As a technique for obtaining information, a semi-structured interview was used. RESULTS: Spirituality in the uncertainty of the disease varies from patient to patient and acts in a unique way. They presented readaptation attitudes in their reports. The presence of spirituality in their lives acted as the main force mechanism to deal with the uncertainty of the disease, and this moment was called by Mishel "probabilistic thinking". CONCLUSION: Patients demonstrated readaptation attitudes in their reports, and spirituality acted as the main mechanism of strength to deal with uncertainty in the disease.

Improving the inhibitory control task to detect minimal hepatic encephalopathy.

BACKGROUND & AIMS: Quantification of the number of noninhibited responses (lures) in the inhibitory control task (ICT) has been proposed for the diagnosis of minimal hepatic encephalopathy (MHE). We assessed the efficacy of ICT compared with recommended diagnostic standards. METHODS: We studied patients with cirrhosis and healthy individuals (controls) who underwent the ICT at 2 centers (center A: n=51 patients and 41 controls, center B: n=24 patients and 14 controls). Subjects were evaluated for MHE by psychometric hepatic encephalopathy score (PHES). Patients from center B also were assessed for MHE by critical flicker frequency and spectral electroencephalogram analyses. RESULTS: Patients with cirrhosis had higher ICT lures (23.2+/-12.8 vs 12.9+/-5.8, respectively, P<.01) and lower ICT target accuracy (0.88+/-0.17 vs 0.96+/-0.03, respectively, P<.01) compared with controls. However, lures were comparable (25.2+/-12.5 vs 21.4+/-13.9, respectively, P=.32) among patients with/without altered PHES (center A). There was a reverse, U-shaped relationship between ICT lure and target accuracy; a variable adjusting lures was devised based on target accuracy (weighted lures at center B). This variable differed between patients with and without MHE. The variable weighted lures was then validated from data collected at center A by receiver operator characteristic curve analysis; it discriminated between patients with and without PHES alterations (area under the curve=0.71+/-0.07). However, target accuracy alone was as effective as a stand-alone variable (area under the curve=0.81+/-0.06). CONCLUSIONS: The ICT is not useful for the diagnosis of MHE, unless adjusted by target accuracy. Testing inhibition (lures) does not seem to be superior to testing attention (target accuracy) for the detection of MHE.

[Nursing as social practice: an exercise of reflection]. / Enfermagem como prática social: um exercício de reflexão.

In this work we aimed at reflecting about the nursing as a social practice. To build these ideas, we reconsidered this concept in its philosophical and social roots. With the purpose to contribute for this reflection, we looked for the characteristics that define the nursing as an historical and socially build practice, through the nursing development, since its beginning. At last we also propose a concept of social practice and, into this perspective, we built,along the text, an other concept for the nursing.

Spirituality in the uncertainty of illness: the perspective of oncology patients / Espiritualidad en la incertidumbre frente a la enfermedad: la perspectiva de pacientes oncológicos / Espiritualidade na incerteza da doença: a perspectiva de pacientes oncológicos

ABSTRACT Objective: To analyze spirituality in the process of illness uncertainty in cancer patients. Methods: This is a qualitative study, in which Merle Mishel's Theory of Uncertainty of Disease was used as a theoretical framework; and as a methodological reference, the stages of Bardin's Content Analysis. As a technique for obtaining information, a semi-structured interview was used. Results: Spirituality in the uncertainty of the disease varies from patient to patient and acts in a unique way. They presented readaptation attitudes in their reports. The presence of spirituality in their lives acted as the main force mechanism to deal with the uncertainty of the disease, and this moment was called by Mishel "probabilistic thinking". Conclusion: Patients demonstrated readaptation attitudes in their reports, and spirituality acted as the main mechanism of strength to deal with uncertainty in the disease

RESUMEN Objetivo: Analizar espiritualidad en el proceso de la incertidumbre de la enfermedad en el paciente oncológico. Métodos: Investigación cualitativa, en la cual fue utilizada como referencial teórico la Teoría de la Incertidumbre Frente a la Enfermedad, de Merle Mishel; y como referencial metodológico, las etapas del Análisis de Contenido de Bardin. Como técnica de obtención de las informaciones, fue usada la entrevista semiestructurada. Resultados: La espiritualidad en la incertidumbre de la enfermedad varia de paciente para paciente y actúa de manera singular. Ellos presentaron actitudes de readaptación en sus relatos. La presencia de la espiritualidad en sus vidas actuó como el principal mecanismo de fuerza para lidiar con la incertidumbre de la enfermedad, siendo, eso momento, llamado por Mishel de "pensamiento probabilístico". Conclusión: Los pacientes demostraron actitudes de readaptación en sus relatos, y la espiritualidad actuó como el principal mecanismo de fuerza para lidiar con la incertidumbre en la enfermedad.

RESUMO Objetivo: Analisar a espiritualidade no processo da incerteza da doença no paciente oncológico. Métodos: Trata-se de uma pesquisa qualitativa, na qual foi utilizada como referencial teórico a Teoria da Incerteza da Doença, de Merle Mishel; e como referencial metodológico, as etapas da Análise de Conteúdo de Bardin. Como técnica de obtenção das informações, foi usada a entrevista semiestruturada. Resultados: A espiritualidade na incerteza da doença varia de paciente para paciente e atua de forma singular. Eles apresentaram atitudes de readaptação nos seus relatos. A presença da espiritualidade em suas vidas agiu como o principal mecanismo de força para lidar com a incerteza da doença, sendo, esse momento, chamado por Mishel de "pensamento probabilístico". Conclusão: Os pacientes demonstraram atitudes de readaptação nos seus relatos, e a espiritualidade atuou como o principal mecanismo de força para lidar com a incerteza na doença.

[Worker's life before and after repetive cumulative trauma (RCT) and osteomuscular work-related disease (OWRD)]. / A vida do trabalhador antes e após a lesão por esforço repetitivo (LER) e Doença osteomuscular relacionada ao trabalho (DORT).

This is a qualitative work, which focused on workers routine before and after being affected by RCT/ OWRD. The study aimed at verifying and analyzing if workers' lives had changed after the disease diagnostic. The research took place at sections of the TRT-AL--a Court responsible for labor conciliations in Maceió - Alagoas. The information was collected based on semi-structured interviews and data were analyzed based on the following tematics: life before RCT/OWRD; the activity that caused it; the diagnosis; an answer to the repetitive work and a new perspective to the horizon. Results enabled researchers to suggest preventive care, as well as to contribute for reducing damages caused by repetitive activities and high pressure on workers.

[History and perspectives of nurses' organization in union movements]. / História e perspectivas da organização dos enfermeiros nos movimentos sindicais.

This article presents a reflection about the history of nurses' organization in union movements just like the Central Unica dos Trabalhadores--CUT (Workers Central Union) and its perspectives for the future. The objective is to clarify the presenting ways for the union movements at present time. Primary sources for reflections was CUT's documentation. The approach considers a retrospective of CUT movement in Brazil, discussing its constituting principles. The workers union reformation was also approached, inquiring if the ways to follow in current conjuncture are respecting these principles and assuming the defense of workers' rights. This union movement defended the independence of political party, focusing nursing union as well as the National Federation of Nurses, pointing out perspectives and suggesting discussing issues and linkages to the general fight of Brazilian workers.

[Understanding and practice of educational actions of health family program professionals in São Sebastião-AL: detecting difficulties]. / Entendimento e prática de ações educativas de do Programa Saúde a Família de São Sebastião-AL: detectando dificuldades.

Observing the activities of PSF (Health Family Program) in São Sebastião, it was detected low offer of the education actions in health, as part of the activities of this program. The aims of this work were to identify what was causing all this, according to the professionals' understanding about Education in Health and also to identify difficulties that was faced to develop those actions. It was a descriptive study whose subjects were 10 academical professionals of the local team, interviewed according to a semi-structured guide. As causes of the deficit we have: disorganization of the demand, low education, resistance of the population to the educational actions, absences of appropriate areas and shortage of material support. We concluded that it was necessary that health professionals to update, as well as a larger offer of physical resources and support material, so that the education in health is a reality in PSF.

[Circumstances of the formalization of the nursing assistant course in Brazil: studying between the lines the 775/49 law]. / Circunstâncias de oficialização do curso de auxiliar de enfermagem no Brasil: estudando as entrelinhas da lei 775/49.

The objective of this study is to discuss the circunstances that determined the incorporation of nursing assistant course at the law number 775/49. Thus we tried to understand the brasilian scene and the politics of hospital health during the period of president Dutra's government and the hospital conditions at that time. The laws and edicts about nursing between 1945 and 1949 are fundamental sources, documents from CD/EEAN/UFRJ and nurses deposition about this question. The first documents analised showed nursin staff insufficiency and the conflict between nurses wish to maintain a high level education and the responsability to supply the demand of nursing personal. The law officialized a course what informaly already existed.

[Technical production and its interface with nursing]. / A produção tecnológica e a interface com a enfermagem.

This is a descriptive study which subject concerns the interfaces of technological production with nursing. Its objectives is to analyse the interface of technological production with nursing and to discuss that production on the following dimensions: instructional, instrumental and informatic. To develop this the summaries of the papers presented during the last three editions of the Congresso Brasileiro de Enfermagem--1998, 1999 and 2000 were used as a source of information. The inherent subjectivity of a study of summaries was considered a limitation, since it is possible that a miscomprehension between our understanding and the real idea of the author occur. This study showed that Nursing, even in an incipient manner, has been producing constitutive components of the technological production, on its daily work.

[Pedagogical Project for the Graduate Nursing Program at UFAL: adaptations to curricular guidelines]. / Projeto Pedagógico do Curso de Graduação em Enfermagem/UFAL: adequações às Diretrizes Curriculares.

This is an analysis of the adaptation of the Pedagogical Political Project of the Nursing Graduate Program at Alagoas Federal University (PPP/Enf/UFAL) to new Brazilian curriculum guidelines, evidencing convergence points and some points that need to be approached, taking into account that the present project was established prior to the existence of the current curricular guidelines. Our analysis shows that the main difficulties presented by the newly implemented curriculum lie in the ones inherent to the process of changing conceptions on the educational process in Nursing and in the work conditions imposed by the current situation of the Brazilian Public University System. It calls for a review on strategies and contents related to the basis of research and expansion in Nursing Sciences, as well as the search for alternatives to integration with domain areas from Humanistic and Health Sciences.

[Project HOPE contribution to the setting up of the professional identity of the first nurses from Alagoas, 1973-1977]. / Contribuição do Projeto HOPE para a configuração da identidade profissional das primeiras enfermeiras alagoanas, 1973 a 1977.

Social-historical study conducted to examine the contribution of the American Nurses of Project HOPE to the configuration of the professional identity of the first trained nurses in Alagoas, in the period of 1973-1977. The theoretical framework was the "Civilizing Process" of Norbert Elias. Primary sources were official documents and personal files of 13 respondents by oral history; the secondary sources were authors of the History of Brazil/Alagoas. Data analysis showed that the configuration of the professional identity of the first trained nurses in Alagoas was a civilizing process, with all the nuances that make up the power relations. There was a significant contribution of American Nursing. However the movement of resistance to this domination was very strong, resulting in a Course that could take advantage of technological advancement and prestige brought by the United States, to build a unique Nursing from the social fabric embroidery at this meeting with so many different cultures.

A assistência de enfermagem obstétrica à luz da teoria dos cuidados de Kristen Swanson / Obstetric nursing care in the light of Kristen Swanson’s care theory

Objetivo: refletir acerca da assistência de Enfermagem obstétrica fundamentada na Teoria dos Cuidados, de Kristen Swanson. Método: trata-se de um estudo reflexivo que aborda a estrutura do cuidado proposta por Kristen Swanson correlacionada à prática assistencial de Enfermagem obstétrica. Resultados: a teoria dos Cuidados, relacionada aos processos que dão significado ao cuidado – manter as crenças, conhecer, estar com, fazer por e possibilitar, na prática assistencial materno infantil contribui para o fortalecimento dos fundamentos teóricos e filosóficos que amparam a assistência de Enfermagem. Conclusão: o artigo possibilitou a reflexão sobre o uso de uma teoria que abrange a estrutura do cuidado na Enfermagem obstétrica, o que contribui na significação do processo de cuidar no ciclo gravídico-puerperal.

Objective: to reflect on obstetric nursing care based on Kristen Swanson’s Theory of Care. Method: this is a reflexive study that addresses the structure of care proposed by Kristen Swanson correlated to the care practice of Obstetric Nursing. Results: Nursing care theory, related to processes that give meaning to care - to maintain beliefs, to know, to be with, to do for and to enable, in maternal and child care practice contributes to the strengthening of the theoretical and philosophical foundations that support Nursing care . Conclusion: the article made possible the reflection on the use of a theory that covers the structure of care in obstetric nursing, which contributes to the significance of the caring process in the pregnancy-puerperal cycle. Descriptors: Maternal and child nursing; Nursing Theory; Nursing Processes.

Objetivo: reflexionar sobre el cuidado de enfermería obstétrica basada en la Teoría de la atención, Kristen Swanson. Método: Se trata de un estudio reflexivo que se refiere a la estructura de la atención propuesto por Kristen Swanson correlacionada con la práctica de la atención de enfermería obstétrica. Resultados: la teoría de la atención, en relación con los procesos que dan sentido a la atención - mantener las creencias, conocimientos, estar con él, hacer al permitir que, en la práctica materna y el cuidado infantil contribuye al fortalecimiento de los fundamentos teóricos y filosóficos que sustentan los cuidados de enfermería . Conclusión: Artículo permitió a la reflexión sobre el uso de una teoría que cubre la estructura de la atención de enfermería obstétrica, lo que contribuye a la importancia del proceso de la atención durante el embarazo y el parto.

[Nakedness of the patient from the perspective of students of fundamental nursing]. / Nudez do paciente sob a óptica de estudantes da área de Enfermagem Fundamental.

The study aimed to analyze the speech of students, their view of the denudation of the body to handle. It was a descriptive qualitative research, whose subjects were 21 students from three courses of 3 to 5 semesters. The information was produced by transcribing the twenty-one semi-structured interviews and analyzed on the basis of Foucault's thought.The themes were: Care of the naked body implies observance of bioethical principle of autonomy as the school's reproductive power relationship in the act of stripping, naked Coping with the other requires care, Care of the naked body "moves" with their sexuality; Power relations with the naked body. It was possible to understand the exercise of power by students at the time of stripping, as response to insecurity arising from inadequate school preparation.

The patient and the relation between power-knowledge and care by nursing professionals / El paciente y las relaciones de poder-saber cuidar de los profissionales de enfermería / O paciente e as relações de poder-saber cuidar dos profissionais de enfermagem

This is a study whose objective was to analyze, in the discourse of hospitalized patients, how the power of knowledge is revealed in Nursing care relations. It was developed in the qualitative perspective, having as theoretical reference the concept of power issued by Michel Foucault. The data were collected between August and December 2015 and the participants were 16 patients hospitalized in the medical and surgical clinics of a university hospital, who had the speech recorded through a semi-structured interview, after approval of the ethics committee under Opinion No. 1189934. In order to analyze the data we used the system of differentiations developed by Foucault. The results showed that the professionals exert power by the highly specialized professional knowledge and that they know what they do, so they send and control the accomplishment of the care, leading the patient to submission. It concludes that the exercise of the power to care must be based on the observance of ethical and bioethical principles.

Estudio cuyo objetivo fue analizar, en el discurso de pacientes internados, como el poder del saber se revela en las relaciones de cuidado de Enfermería. Fue desarrollado desde una perspectiva cualitativa, teniendo como referencial teórico el concepto de poder emitido por Michel Foucault. El muestreo de los datos ocurrió entre agosto y diciembre de 2015 y los participantes fueron 16 pacientes internados en las clínicas médica y quirúrgica de un hospital universitario y sus discursos grabados mediante una entrevista semiestructurada, después del estudio haber sido aprobado por el comité de ética con el Parecer nº 1189934. Para analizar los datos se utilizó el sistema de diferenciaciones desarrollado por Foucault. Los resultados mostraron que los profesionales ejercen poder por el saber profesional altamente especializado y como ellos saben lo que hacen, mandan y controlan la realización de los cuidados, sometiendo al paciente. Se concluye que el ejercicio de poder del cuidar debe ser marcado por la observación de los principios éticos y bioéticos.

Estudo cujo objetivo foi analisar, no discurso de pacientes internados, como o poder do saber se revela nas relações de cuidado de Enfermagem. Foi desenvolvido na perspectiva qualitativa, tendo como referencial teórico o conceito de poder emitido por Michel Foucault. A coleta dos dados se deu entre agosto e dezembro de 2015 e os participantes foram 16 pacientes internados nas clínicas médica e cirúrgica de um hospital universitário, os quais tiveram o discurso gravado mediante entrevista semiestruturada, após aprovação do comitê de ética sob Parecer nº 1189934. Para analisar os dados se utilizou o sistema de diferenciações desenvolvido por Foucault. Os resultados mostraram que os profissionais exercem poder pelo saber profissional altamente especializado e que eles sabem o que fazem, por isso mandam e controlam a realização dos cuidados, conduzindo o paciente à submissão. Conclui que o exercício do poder de cuidar deve ser balizado pela observância dos princípios éticos e bioéticos.

O manejo alimentar durante o parto sob a percepção da mulher / Food management during childbirth under woman's perception / Manejo de alimentos durante el parto bajo la percepción de la mujer

Objetivo: analisar as vivências alimentares da mulher durante o parto. Método: estudo descritivo qualitativo realizado com 40 puérperas que se encontravam no Alojamento Conjunto de três maternidades de Maceió/AL. Os dados foram coletados, através de entrevistas semiestruturadas audiogravadas. Resultados: os dados demonstraram que o jejum durante o trabalho de parto e parto ainda surge como rotina hospitalar, em contrapartida, as mulheres que os vivenciam entendem que a efetivação alimentar neste momento proporcionará para as mesmas um bom desenvolvimento do processo. Conclusão: a valorização da opinião da mulher torna-se inerente para a condução da assistência ao parto, visto que é a mesma que vivencia todo o processo, desta maneira, proporciona-se que o parto ressurja de umaforma mais natural e fisiológica, com a mulher como protagonista.

Objective: to analyze women's dietary experiences during childbirth. Method: this descriptive and qualitative study was carried out with 40 puerperal women who were in the Rooming In of three maternity hospitals in Maceió, Brazil. Data were collected through semi-structured and audio-taped interviews. Results: the data showed that fasting during labor and delivery still appears as a hospital routine. On the other hand, women who experienced the fasting understood that gettimg feeded at this moment would provide them good condition during labor. Conclusion: to appreciate women's beliefs is inherent in midwifery care, since they are the ones that experience the whole process. Thus, it is possible that the childbirth becomes a more natural and physiological proccess, where the woman is the protagonist.

Objetivo: analizar las experiencias alimentares de mujeres durante el parto. Método: se realizó un estudio cualitativo y descriptivo con 40 puerperas que se encontraban en el Alojamiento Conjunto de tres maternidades en Maceió, Brasil. Los datos se recolectaron a través de entrevistas semiestructuradas grabadas en audio. Resultados: los datos mostraron que el ayuno durante el trabajo de parto y el parto aún aparece como una rutina hospitalaria. Por otro lado, las mujeres que experimentan el ayuno entienden que la oferta de los alimentos en este momento proporcionará un buen desarrollo del proceso. Conclusión: vlaorar las creencias de las mujeres es inherente a la prestación de cuidados durante el parto, ya que es la mujer que experimenta todo el proceso. De esta manera, es posible que el parto ocurra de forma más natural y fisiológica, con la mujer como protagonista.

As vivências de conforto e desconforto da mulher durante o trabalho de parto e parto / The experiences of comfort and discomfort of woman in labor and childbirth / Las experiencias de comodidad y incomodidad de la mujer durante el trabajo de parto y parto

Objetivo: analisar as vivências de conforto e desconforto da mulher durante o trabalho de parto e parto. Método: estudo descritivo qualitativo realizado em três maternidades de Maceió-AL com 40 puérperas de julho a setembro de 2014 através de entrevista semiestruturada, tendo como referencial teórico a Teoria do Conforto de Katharine Kolcaba. Resultados: apesar do crescimento da humanização do parto, muitas mulheres estão aquém dessa realidade, sendo pouco ouvidas sobre o que lhe traria conforto ou desconforto no momento do seu parto. O nascimento do filho, a assistência dos profissionais, o acompanhante, a dor, a episiorrafia e o aumento das dores devido ao uso do "soro" estão entre as principais vivências de conforto e desconforto relatadas. Conclusão: conforto e/ou desconforto podem influenciar a satisfação da mulher durante o seu parto, requerendo por parte da equipe de saúde um olhar humanizado para efetivação do cuidado.

Objective: to analyze the experiences of comfort and discomfort of women during labor and childbirth. Method: a qualitative descriptive study carried out in three maternity hospitals in Maceió-AL with 40 puerperal women, from July to September 2014, through semi-structured interviews, based on the theoretical framework of Katharine Kolcaba's Theory of Comfort. Results: despite the increase in the humanization of childbirth, many women cannot live this reality, being little heard about what would bring comfort or discomfort to them at the time of their childbirth. The childbirth, the assistance, the companion, the pain, the episiotomy and the increase of pain due to the use of oxytocin are among the main experiences of comfort and discomfort reported. Conclusion: comfort and / or discomfort can influence the woman's satisfaction during childbirth, requiring the health team a humanized look for effective care.

Objetivo: analizar las vivencias de comodidad y incomodidad de la mujer durante el trabajo de parto y parto. Método: estudio descriptivo cualitativo realizado en tres maternidades de Maceió-AL con 40 puérperas de julio a septiembre de 2014 a través de entrevista semiestructurada, teniendo como referencial teórico la Teoría del Confort de Katharine Kolcaba. Resultados: a pesar del crecimiento de la humanización del parto, muchas mujeres no viven esa realidad, siendo poco oídas sobre lo que le traería comodidad o incomodidad en el momento de su parto. El nacimiento del hijo, la asistencia de los profesionales, el acompañante, el dolor, la episiorrafia y el aumento de los dolores debido al uso del oxytocin, están entre las principales vivencias de copmodidad e incomodidad relatadas. Conclusión: comodidad y/o incomodidad pueden influenciar la satisfacción de la mujer durante su parto, requiriendo por parte del equipo de salud una mirada humanizada para la efectividad del cuidado.

Comportamentos relacionados à saúde sexual de pessoas vivendo com o vírus da imunodeficiência humana / Behaviors related to sexual health of people living with the human immunodeficiency virus / Conductas relacionadas con la salud sexual de personas con virus de inmunodeficiencia humana

Objetivo: Analisar os comportamentos relacionados à saúde sexual de pessoas com Vírus da Imunodeficiência Humana (HIV) segundo o modelo de promoção da saúde. Objetivos específicos: Identificar as características individuais e comportamentos da saúde sexual dos participantes, prévios à pesquisa; descrever sentimentos, autoeficácia, barreiras, benefícios e influências em relação aos comportamentos importantes de ser modificados; construir um plano de ação acordado com o indivíduo em relação aos comportamentos. Métodos: Estudo qualitativo realizado em 2014 com 14 pessoas por meio de entrevista semiestruturada em um serviço especializado de Maceió/AL. O Modelo de Pender foi utilizado como referencial teórico-metodológico. Resultados: Quatro categorias apontaram aspectos comportamentais sexuais-afetivos-relacionais - o (não) uso do preservativo nas relações sexuais e a responsabilidade voltada para si e para o outro; a suspensão/restrição da vida sexual e a ausência de relacionamentos afetivos; o gênero, as relações de poder e a saúde sexual de mulheres com HIV; o fortalecimento da vida sexual e do afeto relacional. Conclusão: A soropositividade se mostrou como uma situação em que comportamentos são repensados; contudo os desejos de mudança comportamental aparecem permeados pelo estigma e pela falta de apoio para a tomada de decisões. Este estudo sinaliza o modelo aplicado como mais uma ferramenta útil para enfermeiros e demais profissionais.

Objective: To analyze the behaviors related to sexual health of people living with the Human Immunodeficiency Virus (HIV)according to the health promotion model. Specific aims: to identify the individual characteristics and behaviors of the subjectsprevious to the time of the survey; describe the feelings, self-efficacy, barriers, benefits and personal influences in relationto important behaviors to be modified; build an agreed plan of action together with the individual in relation to their behavior.Methods: This is a qualitative study held in 2014 with 14 participants through semi-structured interview in a specialized healthservice in Maceió-Alagoas. Pender's model was used as theoretical and methodological framework. Results: Four categoriespointed to changes in the sexual-affective-relational life of the subjects: the use or non-use of condoms in sexual relations andthe responsibility related to themselves and to each other; suspension/restriction of sex life and lack of romantic relationships; thegender, the power relationships and the sexual health of women with HIV; the strengthening of sex life and relationship affection.Conclusion: Seropositivity proved to be a situation in which behaviors are rethought; however the behavioral change desiresarise pervaded by the stigma and the lack of support for decision-making. This study showed the model applied as anotheruseful tool for nurses and other professionals.

Objetivo: Analizar las conductas relacionadas con la salud sexual de personas con VIH de acuerdo con el Modelo de Promociónde la Salud. Objetivos específicos: Identificar características y comportamientos anterior de los sujetos; describir sentimientos,autoeficacia, barreras, beneficios y influencias relacionadas con comportamientos importantes para ser modificados; construirun plan de acción acordado con el individuo en estas conductas. Métodos: Estudio cualitativo realizado em 2014 con 14participantes através de entrevista semi-estructurada en una clínica especializada en Maceió/AL. El Modelo de Pender se utilizócomo marco teórico-metodológico. Resultados: Cuatro categorías se señalaron los cambios en la vida sexual-afectiva-relacionalde los sujetos: El uso (no) de preservativos durante las relaciones sexuales y la responsabilidad por sí mismos y a otros; Lasuspensión/restricción de la vida sexual y la falta de relaciones sentimentales; Géneros, relaciones de poder y la salud sexualde las mujeres con VIH; El fortalecimiento de la vida sexual y afecto relacional. Conclusión: La seropositividad parecía mostrarcómo situación en que se reconsideran comportamientos, sin embargo, los deseos de cambio de comportamiento aparecenpermeado por estigma y falta de apoyo para toma de decisiones. Este estudio indica el modelo aplicado como una herramientaútil para enfermeras y otros profesionales.

O custo da cura: vivências de conforto e desconforto de mulheres submetidas à braquiterapia / The healing cost: comfort and discomfort experiences of women undergoing brachytherapy / El costo de la curación: experiencias de comodidad e incomodidad de mujeres sometidas a la braquiterapia

Objetivo: Descrever as vivências de conforto e desconforto de mulheres que se submeteram à braquiterapia para tratamento de câncer do colo uterino. Métodos: Estudo qualitativo, desenvolvido em 2013, embasado na Teoria do Conforto de Kolcaba e realizado por meio de entrevistas semiestruturadas com oito mulheres que concluíram o tratamento há, no mínimo, seis meses. Resultados: Sobressaíram os seguintes desconfortos: dor do procedimento e dos efeitos pós-tratamento, no contexto físico; medo do desconhecido e do sofrimento, falta de acompanhante, estresse por sentir-se constrangida durante o tratamento, baixa autoestima e trauma psicológico pós-terapia, no contexto psicoespiritual. As medidas de conforto consistiram no diálogo com o profissional, administração de medicações e uso da fé e espiritualidade. Conclusão: Os resultados oferecem subsídios para a prática de profissionais de saúde em relação aos confortos e desconfortos que merecem ser alvo de intervenções na assistência à mulher com câncer.

Objective: To describe the experiences of comfort and discomfort in women who underwent brachytherapy for the treatmentof cervical cancer. Methods: Qualitative study carried out in 2013, based on Kolcaba comfort theory and conducted throughsemi-structured interviews with eight women who have completed treatment, at least, six months ago. Results: The followingdiscomforts stood out: pain in the procedure and in the post-treatment effects, in the physical context; fear of the unknown andsuffering; lack of a companion; stress due to embarrassment during treatment; low self-esteem; and post-therapy psychologicaltrauma, in the psycho-spiritual context. Comfort measures consisted in dialogue with the professional, medication managementand use of faith and spirituality. Conclusion: The results provide support for the practice of health professionals in relation tocomfort and discomfort that deserve to be the target of intervention in terms of the assistance to women with cancer.

Objetivo: Describir la experiencia de comodidad e incomodidad en mujeres que se sometieron a la braquiterapia para tratarel cáncer de cuello uterino. Métodos: Estudio cualitativo realizado en 2013, basado en la teoría de comodidade de Kolcabay realizado con ocho mujeres que completaron el tratamiento hace por lo menos seis meses. Resultados: Se destacan lasincomodidades: dolor del procedimiento y de los efectos después del tratamiento, en el contexto físico; miedo a lo desconocidoy al sufrimiento, el estrés por sentirse avergonzada durante el tratamento y baja autoestima y trauma psicológico después dela terapia, en el contexto psicoespiritual. Las medidas para sentirse confortables consistieron en el diálogo com el profesional,administración de medicamentos y el uso de la fe y la espiritualidad. Conclusiones: Los resultados proporcionan subsídiospara la práctica de los profesionales de la salud relacionada con las comodidades e incomodidades que merecen intervencionesen la atención de las mujeres con cáncer.

The experience of parents of children with cancer in treatment failure conditions / La experiencia de los padres de niños con cáncer en la condición de fracaso terapéutico / A vivência dos pais da criança com câncer na condição de impossibilidade terapêutica

ABSTRATC Study based on Heidegger's existential phenomenology. The objective was to understand the experience of parents of children with cancer in treatment failure conditions. Participants were eight parents of eight patients seen at an oncology center from January to May 2014. Interviews were conducted guided by the question: Tell me about your experience of being a family member of a child with cancer in treatment failure conditions? Three ontological themes emerged: the phenomenon unveiled in the discovery of the child's cancer; experiencing the process involving the child's cancer; unveiling the possibility of the child's death. It was evidenced that the experience of these parents was permeated by intense and devastating feelings towards the early loss, annihilating dreams of a desired future. It is essential for nursing to look more attentively at the family of terminal patients.

RESUMEN Estudio basado en la fenomenología existencial de Heidegger. Tuvo como objetivo comprender la experiencia de los padres de niños con cáncer en la condición de fracaso terapéutico. Los participantes fueron ocho padres de ocho pacientes atendidos en un centro de oncología de enero a mayo del 2014. Se realizaron entrevistas guiadas por la pregunta: ¿Dime cómo es su experiencia de ser miembro de la familia de un niño con cáncer en la condición de fracaso terapéutico? Emergieron tres temas ontológicos: el fenómeno presentado en el descubrimiento del cáncer en el niño; experimentar el proceso que implica la enfermedad oncológica en el niño; la revelación de la posibilidad de la muerte del niño. Era evidente que la experiencia de estos padres fue permeado por sentimientos intensos y devastadores antes de la pérdida temprana, aniquilando sueños de un futuro deseado. Es fundamental que la Enfermería considera con más atención la familia del paciente terminal.

RESUMO Estudo fundamentado na fenomenologia existencial heideggeriana, cujo objetivo foi compreender a vivência dos pais da criança com câncer na condição de impossibilidade terapêutica. Participaram da pesquisa oito pais de oito pacientes, atendidos em um centro de oncologia, de janeiro a maio de 2014. As entrevistas foram norteadas pela seguinte questão: conte para mim como é para você a experiência de ser familiar de uma criança oncológica na condição de impossibilidade terapêutica? Três temáticas ontológicas emergiram: o fenômeno desvelado na descoberta do câncer no filho; vivenciando o processo que envolve a doença oncológica no filho; o desvelar da possibilidade da morte do filho. Evidenciou-se que a vivência destes pais foi permeada por sentimentos intensos e devastadores diante da perda precoce, aniquilando sonhos de um futuro desejado. Torna-se imprescindível a enfermagem direcionar um olhar mais atento à família de pacientes terminais.

A Inclusão de Pessoas com Necessidades Especiais no Ensino Superior / Inclusion of People with Special Needs in Higher Education

RESUMO: trata-se de uma revisão integrativa que objetivou analisar a produção científica sobre a educação inclusiva no ensino superior. Os dados foram coletados nas bases de dados Lilacs, Scielo, Cochrane, Medline e PubMed, entre os anos 2005 e 2014, utilizando-se os descritores controlados Special Education, Education Higher, Mainstreaming Education e Disabled Personse e os descritores não controlados Educação Especial, Educação Superior, Inclusão Educacional e Pessoas com Deficiência; Educación Superior, Propensíon Educación, Personas com Discapacidad. A amostra constituiu em 16 artigos. As publicações sobre a educação inclusiva no ensino superior têm sido tênues, demonstrando que ainda há muito a avançar nesse assunto. Conclui-se que o tema educação inclusiva é mais estudado em relação às crianças; as atenções dos estudiosos em relação a pessoas adultas com necessidades especiais envolvem mais a assistência em saúde e não a educação inclusiva no ensino superior.

ABSTRACT: it is an integrative review that aimed to analyze the scientific literature on inclusive education in higher education. Data was collected in the following databases: Lilacs, SciELO, Cochrane, Medline and PubMed, between the years 2005 and 2014, using the controlled descriptors Special Education, Higher Education, Education and Mainstreaming Disabled Person and uncontrolled descriptors Special Education, Higher Education, Educational Inclusion and Persons with Disabilities; Educación Superior, Propensíon Educación, Personas com Discapacidad. The sample consisted of 16 articles. The publications on inclusive education in higher education has been tenuous, demonstrating that there is still much to advance in this issue. We conclude that the issue of inclusive education is more studied in relation to children; and that the attention of scholars regarding adults with special needs involves mostly health care and not inclusive education in higher education.