Impacto de um modelo de supervisão clínica nas capacidades da inteligência emocional em enfermeiros / Impact of a model of clinical supervision over the emotional intelligence capacities of nurses

RESUMO Objetivo analisar o impacto da implementação de um modelo de supervisão clínica em enfermagem nas capacidades da inteligência emocional dos enfermeiros. Métodos estudo de métodos mistos. Colheu-se os dados quantitativos antes e após a implementação do Modelo, pela escala Capacidades da Inteligência Emocional em Enfermeiros; analisou-se por estatística descritiva e pelo teste-t para amostras emparelhadas. Participaram 47 enfermeiros de um hospital. Obteve-se os dados qualitativos pela análise dos discursos dos enfermeiros numa apresentação pública, através de técnicas de análise de conteúdo tipo temática/categorial. Os achados foram integrados no final para gerar os resultados. Resultados não se verificou diferenças estatisticamente significativas com a implementação do Modelo. Contudo, os enfermeiros envolvidos reconheceram o impacto positivo do Modelo SafeCare no desenvolvimento das competências emocionais. Conclusão o estudo apresentou contributos para a supervisão clínica e para o desenvolvimento das competências emocionais.

ABSTRACT Objective to analyze the impact of the implementation of a model of clinical supervision over the emotional intelligence capacities of nurses. Methods mixed methods study. Quantitative data were collected before and after the implementation of the Model, using the scale of Emotional Intelligence Capacities of Nurses; analyses were carried out using descriptive statistics and paired samples were analyzed using the t-test. 47 nurses from one hospital participated. Qualitative data were obtained from the analysis of the discourses of the nurses in a public presentation, using thematic/categorizing content analysis. The findings were integrated at the end to generate the results. Results no statistically significant differences were found with the implementation of the Model. However, the nurses involved recognized the positive impact of the SafeCare Model in the development of emotional competences. Conclusion the study contributed for clinical supervision and for the development of emotional competences.

Perdão e satisfação conjugal: uma revisão sistemática / Forgiveness and marital satisfaction: a systematic review / Perdón y satisfacción conyugal: una revisión sistemática

O objetivo deste estudo foi realizar uma revisão sistemática da literatura sobre o perdão, quando estudado, com a satisfação conjugal, possibilitando uma melhor integração empírica da investigação sobre os dois construtos. Apesar da interdisciplinaridade emergente, a investigação face a esses dois construtos têm permanecido inconsistente, existindo várias dúvidas quanto à relação entre ambos. Foi realizada uma pesquisa em diferentes bases de dados internacionais (Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology and Behavioral Sciences Collection), consultadas até 1990, retrospectivamente, permitindo uma identificação inicial de 516 estudos. Com base em critérios de inclusão e exclusão rigorosa e previamente definidos, 25 estudos, publicados entre 2002 e 2016, foram selecionados para uma análise crítica. Os resultados indicam que a maioria dos estudos aposta numa conceptualização multidimensional do perdão, emergindo a presença de uma dimensão motivacional positiva (benevolência) e a renúncia a um estado motivacional negativo (vingança, evitamento, retaliação). Os dados sugerem relações positivas entre perdão e satisfação conjugal: o perdão promove níveis superiores de satisfação conjugal; níveis superiores de satisfação conjugal promovem um maior perdão; a relação entre os construtos pode ser bidirecional. Contudo, a maioria dos estudos incluídos revela um design metodológico transversal, limitando a exploração e a retirada de conclusões acerca da direção das relações causais entre os dois construtos. Revela-se fundamental o desenvolvimento de estudos futuros com designs metodológicos mais complexos, permitindo uma compreensão mais rigorosa e o alargamento do campo de estudos.(AU)

This study aimed to conduct a systematic review on forgiveness associated with marital satisfaction, enabling a better empirical integration of the literature on them. Despite the emergent interdisciplinarity, the true association between these constructs still raise many doubts, indicating the inconsistency in studies on this topic. Thus, this study conducted a retrospective search for articles published up from 1900 in the Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology, and Behavioral Sciences Collection databases, identifying 516 studies. After applying strict predefined inclusion and exclusion criteria, 25 studies published between 2002 and 2016 were selected for a critical analysis. The results indicate that most studies rely on a multidimensional conceptualization of forgiveness, resulting in a positive motivational dimension (benevolence) and the renouncement to a negative motivational state (revenge, avoidance or retaliation). Forgiveness and marital satisfaction were also positively and bidirectionally associated, with forgiveness promoting higher levels of marital satisfaction and higher levels of marital satisfaction promoting greater forgiveness. However, most of the studies adopted a cross-sectional design, limiting exploration and conclusions regarding the direction of causal relationships between the two constructs. Further studies on the theme, with more complex methodological designs, are essential for a more rigorous understanding and the broadening of the field of studies.(AU)

El objetivo de este estudio fue realizar una revisión sistemática de la literatura acerca del perdón asociado con la satisfacción conyugal, posibilitando una mejor integración empírica de la investigación sobre los dos constructos. A pesar de la emergente interdisciplinaridad, es inconsistente la investigación con estos dos constructos, lo que plantea dudas sobre la relación entre ambos. Se realizó una búsqueda en diferentes bases de datos internacionales (Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology and Behavioral Sciences Collection), consultadas hasta 1990 (retrospectivamente), y se obtuvo inicialmente 516 estudios. Con base en criterios de inclusión y exclusión rigurosos y previamente definidos, se seleccionaron 25 estudios, publicados entre 2002 y 2016, para el análisis crítico. Los resultados indican que la mayoría de los estudios presentan una conceptualización multidimensional del perdón, emergiendo la presencia de una dimensión motivacional positiva (benevolencia) y la renuncia a un estado motivacional negativo (venganza, evitación, represalia). Los datos evidencian relaciones positivas entre perdón y satisfacción conyugal: el perdón promueve niveles superiores de satisfacción conyugal; los altos niveles de satisfacción conyugal favorecen más el perdón; la relación entre los constructos puede ser bidireccional. Sin embargo, la mayoría de los estudios incluidos revelan un diseño metodológico transversal, limitando la exploración y la retirada de conclusiones acerca de la dirección de las relaciones causales entre los dos constructos. Es fundamental desarrollar estudios futuros con diseños metodológicos más complejos para obtener una comprensión más rigurosa y la ampliación del campo de estudios.(AU)

Desenvolvimento de competências de prática baseada em evidência dos enfermeiros: contributos da supervisão clínica / Development of nurses' evidence-based practice skills: contributions of clinical supervision

RESUMO Objetivo avaliar o impacto da implementação do Modelo SafeCare nas competências de prática baseada em evidência dos enfermeiros. Métodos método misto caracterizado pela triangulação concomitante. Os dados quantitativos foram coletados antes e após a implementação do Modelo, por meio do Questionário de Eficácia Clínica e Prática Baseada em Evidências, com análise estatística descritiva. Os valores de prova foram obtidos com recurso ao teste de Wilcoxon. Participaram 13 enfermeiros. Os dados qualitativos foram obtidos de entrevistas com 11 enfermeiros de um hospital público e analisados pela técnica de Análise de Conteúdo. Resultados não houve diferenças estatisticamente significativas com a implementação do modelo. Contudo, os enfermeiros identificaram o aumento de competências em prática baseada em evidência com o reconhecimento de vantagens no seu desenvolvimento profissional, na organização e na assistência ao paciente. Conclusão a implementação do modelo mostrou ter contribuído para o desenvolvimento das competências em prática baseada em evidência.

ABSTRACT Objective to evaluate the impact of the implementation of the SafeCare Model on the evidence-based practice competencies of nurses. Methods mixed method characterized by concomitant triangulation. Quantitative data were collected before and after the implementation of the Model, by means of the Clinical Effectiveness and Evidence-Based Practice Questionnaire, with descriptive statistical analysis. Evidence values were obtained using the Wilcoxon test. Thirteen nurses participated. Qualitative data were obtained from interviews with 11 nurses from a public hospital and analyzed using the Content Analysis technique. Results there were no statistically significant differences with the implementation of the model. However, nurses identified increased competencies in evidence-based practice with the recognition of advantages in their professional development, organization, and patient care. Conclusion the implementation of the model has been shown to have contributed to the development of competencies in evidence-based practice.

Relatório de Estágio de Natureza Profissional: Transição para a paternidade: contributos da intervenção do Enfermeiro Especialista / Internship Report of Professional Nature: Transition to parenthood: contributions of the intervention of the Nurse Specialist

O estágio de natureza profissional visa a aquisição e desenvolvimento de competências para a obtenção do título de mestre e especialista em enfermagem de saúde materna, obstétrica e ginecológica. Desenvolveram-se ainda conhecimentos e competências no âmbito da transição para a paternidade, através da realização de uma intervenção. OBJETIVOS: Desenvolver competências na prestação de cuidados de enfermagem especializados em saúde materna, obstétrica à mulher na gravidez e durante o trabalho de parto e promover a transição para a paternidade. METODOLOGIA: Realizada prestação de cuidados de enfermagem especializados, baseados nos pressupostos teóricos de Meleis e Mercer à mulher inserida na família e na comunidade durante os períodos pré-natal, trabalho de parto e pós-natal, promovendo o bem-estar materno-fetal e a adaptação do recém-nascido à vida extrauterina, bem como a transição para a parentalidade. Foi implementada uma intervenção dirigida aos pais participantes no curso de preparação para o parto e para a parentalidade. RESULTADOS: O desenvolvimento de competências técnico científicas em cuidados especializados em enfermagem de saúde materna e obstetrícia. Da intervenção os pais identificaram as principais alterações fisiológicas do homem durante a gravidez da companheira, o seu papel no trabalho de parto e parto da companheira e consideraram pertinente a existência de uma intervenção dirigida aos pais. CONCLUSÕES: No estágio atingiu-se os objetivos delineados, no que concerne à prestação de cuidados especializados à mulher inserida na família e comunidade. O enfermeiro especialista assume um papel determinante na transição para a paternidade, a adaptação do pai à gravidez da companheira e no momento do parto.

The internship of professional nature, in order to meet development of competences and the personal goals and guidelines established by the Council of Nurses and the European community to obtain a master's degree and the midwifery specialization. Knowledge and skills were also developed in the context of promoting through the application of an intervention. OBJECTIVES: To develop competences in specialized care in maternal, obstetric and gynecological nursing and promote the transition to paternity. METHODOLOGY: Specialized nursing care, based on the theoretical assumptions of Meleis and Mercer, was provided to women inserted in the family and community during the prenatal period, labor and postnatal, optimizing the health of the woman in labor and the newborn in adapting to the extra-uterine life, supporting the transition to parenthood. An intervention was implemented directed to the parents who participated in the preparation for childbirth and for parenthood. RESULTS: The development of expertise in maternal, obstetric and gynecological nursing was met by assistance practiced in different contexts such as hospital or community . The parents identified the main physiological changes of the male during their woman's pregnancyn and their role in the labor.They further stated the relevance of the existence of an intervention addressed to parents. CONCLUSIONS: At the internship of professional nature, it was possible to reach the objectives outlined, related to the provision of specialized care to women in the family and community. The midwife represents a determinant role in the transition to parenting, namely in the transition from man to father and the adaptation of this to the their wife's pregnancy and at the time of labor.

Agminated Clear Cell Tumor: An Impostor of PEComa and Distinctive Dermal Clear Cell Mesenchymal Neoplasm.

Cutaneous clear cell tumors are a heterogeneous group of cutaneous neoplasms, which may show a wide range of histogenesis. We report the clinicopathological features of an agminated clear cell tumor, arising in a 67-year-old man, otherwise asymptomatic, with distinct histopathological and immunohistochemical features, which did not fit into any existing diagnostic categories. The patient presented with several skin-colored papules at the lateral and posterior aspects of the neck, which on histopathological examination showed circumscribed lobular aggregates of clear cells within the dermis. The immunohistochemical marker panel performed showed diffuse expression of vimentin, NKI-C3, and CD64 while revealing marked negativity for factor XIIIa, CD10, CD13, CD14, CD34, CD68, CD163, lysozyme, HMB45, Renal Cell Carcinoma antigen, calponin, h-caldesmon, Anti-alpha smooth muscle actin antibody [1 A4], S100, and pancytokeratin, leading the authors to postulate a monocytic origin.

Kaposi Sarcoma of the eyelid as an initial manifestation of AIDS.

Kaposi sarcoma (KS) is a multifocal systemic disease that originates in the vascular endothelium related to Human Herpes Virus 8 (HHV-8). In the early 1980s the first series of cases of disseminated Kaposi Sarcoma in HIV infected patients were reported. However, with the advent of highly active antiretroviral therapy (HAART) since 1997, these cases are less frequently observed by clinicians. We report the case of a 40-year-old woman, presenting with two asymptomatic purpuric nodules localized in the superior and inferior left eyelids, occluding the palpebral fissure, which were present for 4 months prior to presentation. The eyelid nodules were determined to represent KS, but there were no additional cutaneous lesions. Pulmonary and gastric KS involvement was documented. Antiretroviral therapy was initiated along with pegylated liposomal doxorubicin. The nodules gradually disappeared and her immune status eventually improved. Ocular and periorbital involvement of KS associated with HIV-1 infection as the initial clinical manifestations is a rare advent. This case is important as it illustrates that disseminated KS was not to be predicted by the number or the extension of cutaneous lesions.

Terapêutica Fotodinâmica com metil-aminolevulinato no tratamento de lesões refractárias de Micose Fungóide: resposta clínica e histológica mantida em dois doentes.

According to the guidelines proposed by the National Comprehensive Cancer Network, early-stage Mycosis Fungoides (MF) should be treated with skin-directed therapies such as topical steroids or retinoids, topical chemotherapy (carmustin and nitrogen mustard), photochemotherapy, and superficial radiotherapy. Patients with refractory lesions to these therapeutic options are particularly challenging. Photodynamic Therapy (PDT) has been approved to treat cutaneous neoplastic and pre-neoplastic lesions such as superficial basal cell carcinoma, Bowen disease and actinic keratosis. Recently, several small studies have demonstrated the efficacy of PDT with methyl-aminolaevulinate (MAL) in the treatment of early-stage MF. We report two patients diagnosed with IA and IB MF, previously treated with conventional treatments (topical steroids and photochemotherapy) with short-term recurrence that were treated with PDT with MAL with complete and maintained response for one year. Our findings confirm that PDT with MAL can be one more palliative option in the treatment of early-stage MF, especially in pauci-lesional disease or in lesions resistant or inaccessible to conventional therapies.

Viability and proliferation of rat MSCs on adhesion protein-modified PET and PU scaffolds.

In 2011, the first in-man successful transplantation of a tissue engineered trachea-bronchial graft, using a synthetic POSS-PCU nanocomposite construct seeded with autologous stem cells, was performed. To further improve this technology, we investigated the feasibility of using polymers with a three dimensional structure more closely mimicking the morphology and size scale of native extracellular matrix (ECM) fibers. We therefore investigated the in vitro biocompatibility of electrospun polyethylene terephthalate (PET) and polyurethane (PU) scaffolds, and determined the effects on cell attachment by conditioning the fibers with adhesion proteins. Rat mesenchymal stromal cells (MSCs) were seeded on either PET or PU fiber-layered culture plates coated with laminin, collagen I, fibronectin, poly-D-lysine or gelatin. Cell density, proliferation, viability, morphology and mRNA expression were evaluated. MSC cultures on PET and PU resulted in similar cell densities and amounts of proliferating cells, with retained MSC phenotype compared to data obtained from tissue culture plate cultures. Coating the scaffolds with adhesion proteins did not increase cell density or cell proliferation. Our data suggest that both PET and PU mats, matching the dimensions of ECM fibers, are biomimetic scaffolds and, because of their high surface area-to-volume provided by the electrospinning procedure, makes them per se suitable for cell attachment and proliferation without any additional coating.