Terminal patient care: advantages on the applicability of anticipated will directives in the hospital context. / Assistência ao doente terminal: vantagens na aplicabilidade das diretivas antecipadas de vontade no contexto hospitalar.

OBJECTIVE: To know the advantages related to the applicability of the advance directives of will in the hospital context from the perspective of nurses, doctors and family members. METHOD: Qualitative, descriptive and exploratory study with semi structured interviews carried out from October to November 2014, with nurses, doctors and family members of patients in the final stage. Afterwards, a discursive textual analysis was carried out. RESULTS: Four categories emerged: respect for patient's autonomy; support in confrontation of conflicts with and from family members; reduction of conflicts in the team about treatments and conducts; disclosure and instrumentation for application of the Advance Directives of Will. CONCLUSION: The respect for personal autonomy permeates the advantages when relating the conduct of treatments at the end of life with the Advance Directives of Will. Thus, disagreements involving the processes at the end of life would be supported by the patient's desire, besides implying in the reduction of the fear of professionals in facing lawsuits and in the support of the family.

The experience of rural families who remain in halfway houses during cancer treatment. / A experiência de famílias rurais que permanecem em casas de apoio durante tratamento oncológico.

OBJECTIVE: to understand the experience of rural families who remain in halfway houses during the cancer treatment of an adult family member. METHODS: qualitative research based on Symbolic Interaction and narrative research. Seven rural families participated in the study, 14 people staying in halfway houses in Santa Maria, Rio Grande do Sul, Brazil. The data obtained through interviews from November 2010 to May 2011 were analyzed with emphasis on content. RESULTS: the three themes were: halfway houses as a reference for permanence during treatment, everyday life and living together in the halfway house. CONCLUSIONS: the experience was marked by the need to adapt to a context other than the rural one, with specific rules and routines, with discomforts and confrontations with urban culture characteristics and with what is experienced by other families who are also facing disease, which contributed to reframe the experience itself.

Educational video as a healthcare education resource for people with colostomy and their families. / Vídeo educativo como recurso para educação em saúde a pessoas com colostomia e familiares.

OBJECTIVE: To know the perceptions of participants in a support group for people with colostomy on the use of video as a resource for health education. METHOD: Qualitative research with 16 participants in a support group for people with colostomy in Santa Maria, Rio Grande do Sul, Brazil. Data were collected in April and May of 2016, through a focus group, and subjected to the thematic analysis proposed by Minayo. RESULTS: The results led to three categories: care and self-care are learned alone: the lived reality; health education and learning through educational video: perceived opportunities; the singularities of the educational video from the viewpoint of people with colostomy and their families. CONCLUSION: The scarcity of guidelines retards independence and hinders autonomy in care and self-care. The audio-visual technology applied in this study complements the educational guidelines, and can enable changes and the opportunity to rethink pedagogical nursing practices.

[Care as a commitment of all: a study in a rural settlement]. / Cuidado como compromisso de todos: estudo em assentamento rural.

This study aims to understand the perceptions of care of families living in a rural settlement in the northwestern area of Rio Grande do Sul. It is an ethnographical based qualitative field research, which has used the Observation-Participation-Reflection Model for data collection, performed between February and March, 2011. The data analysis went through four steps: raw data collection and documentation, describers and indexes identification, contextual and current patterns analysis, and identification of research themes and relevant findings. The study has shown that, for the settlers who participated in the study, care is bound to their vision of world, meaning a commitment of everybody, under the collective and individual premise of improvement of their lives. It is concluded that Nursing needs to understand cultural behaviors in order to enable a congruent and holistic care.

Men's experience of caring for a family member with cancer: a theory based on data.

OBJECTIVE: to understand the meaning attributed by men to the experience of caring for their family member with cancer and to develop a substantive theory that represents the experience of men caring for their family member with cancer. METHOD: this is qualitative research guided by the methodological framework of Grounded Theory and the precepts of Symbolic Interactionism. A form with identification and interview data was used. The analysis followed the substantive and theoretical coding stages. RESULTS: 12 male caregivers of their family member with cancer participated. The constant comparative analysis of the data allowed the creation of a substantive theory "Experiencing the care of a family member with cancer: men as a caregivers" explaining the experience that has as its central category "The love that drives care", representing the symbolic actions and attitudes of men living in the context of illness due to cancer and care. CONCLUSION: the theory allowed us to understand feelings, perceptions, ways of acting and facing the diagnosis, providing care, recognizing difficulties and learning from the situations that arise, making explicit the interactional processes and symbolic elements present and how these influence male caregivers in their actions and attitudes. BACKGROUND: (1) For men, caring is a choice (2) Taking care symbolizes a way of expressing love and reciprocation. (3) Love in caring is strengthened by reciprocity, commitment, gratitude and zeal. (4) To provide care, man reorganizes himself and adjusts to the conditions that present themselves (5) Male caregivers need to be heard and included in the actions of health teams.

Elaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias.

OBJECTIVE: to elaborate and validate the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias. METHODS: a methodological study, developed in three stages: instrument structuring through documentary research and researchers' expertise; instrument validity with a panel of 11 expert judge nurses; and instrument final composition. RESULTS: the instrument, after validity by experts, consisted of 30 items, divided into the content (26 items) and appearance (four items) domains. In the initial instrument validity process, 11 items were modified and seven were withdrawn, as they had a percentage of agreement below 0.80. The instrument showed excellent internal consistency, with values greater than 0.90 in its psychometric criteria. CONCLUSION: the instrument produced and validated aimed at assessing research methodological models for technological development showed good reliability, and may contribute to the methodological rigor of technological development research in nursing.

[Overload of family caregiver at home: an integrative literature review]. / A sobrecarga do familiar cuidador no âmbito domiciliar: uma revisão integrativa da literatura.

This is an integrative literature review that aims to identfy evidences on the factors causing overload and their consequences for family caregivers of adults or the elderly. The review covered 27 studies at databases, using the keywords caregivers, family, and overload in the period from 1999 to 2009. Four categories came up: the imposition of being a caregiver, taking care alone, the dependence of the person that receives care, and the bio-psychosocial weariness of the caregiver. The results showed that the imposition of the role of caregiver, lack of support from other family members, level of dependency of the patient related to the pathology, and physical and psychological weariness are the main factors causing overload in family caregivers. The need for more support and availability by health professionals to family caregivers in their home activities is evident.

[Sexuality and breastfeeding: concepts and approaches of primary health care nurses]. / Sexualidade e amamentação: concepções e abordagens de profissionais de enfermagem da atenção primária em saúde.

The objective of this study is to identify the primary health care nurses' concepts about sexuality, and how this theme is integrated within the health care practices of these professionals when working with breastfeeding women. This qualitative, exploratory and descriptive study was performed with eight nurses from three primary health care units in a city in the north region of Rio Grande do Sul state. Data collection was performed through semi-structured interviews. Thematic content analysis revealed three themes: ideation about sexuality; sexuality and breastfeeding; and sexuality and nursing practices aimed at the breastfeeding woman. The study revealed that nursing professionals understand the broad meaning that sexuality represents and the relationship it has with breastfeeding, but they do not approach this theme in the care provided to women engaged in the breastfeeding process, thus their practices are grounded in the biomedical approach.

A Corbin and Strauss Grounded Theory on the Experiences of Patients, Relatives, and Health Professionals About the Family Presence During Emergency Care.

This study aimed to explore the experiences of patients, relatives, and health professionals about family presence during emergency care. In this grounded theory, 42 participants were interviewed from October 2016 to February 2017 in 2 Brazilian emergency rooms. Data collection and analysis were based on the constant comparative method. Findings identified that there is a social meaning about family presence during emergency care, which is conditioned, sporadic, and variable, and health professionals are responsible for the decision. The implementation of family systems care in emergency rooms is required to meet the needs of both patients and families. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A30.

The family system seeking to transform its eating behavior in the face of childhood obesity.

OBJECTIVES: to understand families' behaviors and eating practices in the face of childhood obesity. METHODS: a qualitative study, which used the Grounded Theory as a methodological framework and the Complexity Theory as a theoretical framework. Twenty-six informants participated in the study, who were part of two sample groups. Data were collected through intensive interviews, using a semi-structured script. RESULTS: "The family system seeking to change eating behavior patterns in the face of childhood obesity" emerged as a central concept, relating three conceptual categories: "Recognizing its behavior patterns and eating practices"; "Reorganizing in the face of childhood obesity"; "Responding to change". FINAL CONSIDERATIONS: the family influences children's eating behavior and contributes to changes that occur in it, which highlights the relevance of the family approach in childhood obesity care, raising reflection on the current nursing practice together with families who experience the same problem.

Factors associated with the skills of informal caregivers in home care.

OBJECTIVE: To identify factors associated with cognitive, emotional, psychomotor, and relational skills of informal caregivers in home care. METHODS: A cross-sectional study carried out with a sample of 216 informal caregivers residing in a municipality in the state of Paraná. Data collection took place between February and July 2019, with an instrument developed and validated to assess the skills of informal caregivers. Descriptive and inferential analyses were used. RESULTS: The factors associated with a greater competence of informal caregivers were being female, having training in the field, and having more than five years home care experience. The lowest competence was observed in caregivers who had health problems and belonged to the lowest strata of family purchasing power. Participants had lower scores in psychomotor competence and had better results in cognitive competence. CONCLUSION: It was found that women with experience in care had higher levels of competence to provide quality care at home assistance services.

Cancer during pregnancy: from the diagnosis to the repercussions on the family experience of maternity.

OBJECTIVE: To investigate how the diagnosis of cancer during pregnancy occurred and assess its repercussions on the family experience of maternity. METHOD: Qualitative research, based on Symbolic Interactionism and conducted according to the Grounded Theory method. Twelve women diagnosed with cancer during pregnancy and 19 of their family members participated in the study. Data was collected from March 2018 to March 2019, using an identification form and an in-depth interview. The analysis followed the stages of open substantive coding. RESULTS: Data were organized into two categories of analysis: Being surprised by the discovery of cancer during pregnancy, which reveals the course of experiencing pregnancy and being diagnosed with cancer, Suffering from the repercussions of cancer on pregnancy and birth, which describes the repercussions of illness in the experience of pregnancy. CONCLUSION: Cancer during pregnancy was diagnosed in young women based on signs and symptoms that were confused with those of pregnancy and postpartum. The illness brought anxiety, impotence, fear and affected the experience of maternity, as it prevented women from having their pregnancy as planned and required routines different from those of low-risk pregnancies.

Caring ability of urban and rural family caregivers: association with overburden, stress and coping.

OBJECTIVE: To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. METHOD: Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. RESULTS: A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. CONCLUSION: Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.

Theoretical sampling process in a Straussian Grounded Theory study.

OBJETIVE: Describing the theoretical sampling process in the development of a Grounded Theory based on the Straussian strand. The objective of the field research, used as an example, was to develop a substantive theory, based on the theoretical framework of Symbolic Interactionism, about the perceptions and experiences of patients, family members, and health professionals regarding the presence of the family during emergency care. METHOD: In the theoretical sampling, 42 participants were recruited, divided into nine sample groups, constituted based on the constant comparative method. RESULTS: The description of this example allowed to identify how theoretical sampling guided data collection, which occurred through the in-depth study of concepts and the search for answers to questions arising from the data. FINAL CONSIDERATIONS: It is expected that the readers find subsidies to understand how theoretical sampling is conducted in a Grounded Theory study, based on the Straussian strand, and thus be able to apply it.

Grounded Theory methodological aspects in Brazilian nursing thesis.

OBJECTIVE: to analyze the application of methodological aspects of Grounded Theory in Brazilian nursing thesis. METHODS: qualitative, descriptive study elaborated based on theses available in the CAPES Thesis and Dissertations Catalog, located with the search for the terms "Teoria Fundamentada nos Dados" OR "Grounded Theory", from 2013 to 2017. The data obtained were analyzed, considering the Grounded Theory methodological assumptions. RESULTS: observance of Grounded Theory basic concepts and articulation with several theoretical frameworks in the conduct of the investigations are strengthening aspects of the method. However, dissent in the description of the operationalization of the stages and naming of the elaborated construct weaken the methodological quality. Final considerations: the methodological consistency provided by Grounded Theory has the potential to demonstrate the studies' rigor and reliability conducted and theories generated. It is necessary to deepen theoretical-conceptual studies to elucidate discrepancies in the applicability in nursing research.

Knowledge and practices of nursing professionals in caring for ostomates.

OBJECTIVE: to analyze the knowledge and practices of nursing professionals in caring for people with colostomy bag. METHOD: a qualitative and descriptive study conducted with 21 nursing professionals from a General Surgery Unit. Data collection used triangulation of techniques, based on non-participant observation, analysis of nursing records, and semi-structured interviews. Analysis followed the spiral technique assumptions. RESULTS: it was possible to comprehend the theoretical and scientific knowledge that subsidize practice; identify contradictions related to statement and care in the profession's daily work and the intervening factors, which can facilitate and/or make the nursing care process difficult. FINAL CONSIDERATIONS: knowledge and practices of professionals in caring for ostomates occur within work experiences, in which socialization of knowledge makes it possible to expand the perspectives of care.

Nurses and physicians' perception of the care of oncology patients in the emergency department.

OBJECTIVES: to understand nurses' and physicians' perceptions of the care of people with cancer admitted to an emergency department of a general hospital. METHODS: descriptive study with a qualitative approach. Data collection took place from September to November 2017 through semi-structured interviews in which participated 12 professionals from the emergency department, including nurses and physicians. The data were analyzed using Minayo's operative proposal. RESULTS: three categories emerged: 1) The person with cancer from nurses and physicians' perspective; 2) Comprehensive care of people with cancer or deconfiguration in the emergency department?; and 3) The context of the emergency department and the repercussions on the care of people with cancer. FINAL CONSIDERATIONS: we identified that the care provided to people with cancer in the emergency department is carried out differently regarding the overall population due to the disease's particularities, which lead us to reflect on the quality and humanization of care.

Caring ability, burden, stress and coping of family caregivers of people in cancer treatment.

OBJECTIVE: To analyze the association between the caring ability and the burden, stress and coping of family caregivers of people in cancer treatment. METHOD: A cross-sectional study with 132 family caregivers. The following instruments were applied: a characterization instrument, the Caring Ability Inventory, the Zarit Burden Interview, the Perceived Stress Scale, and the Brief COPE. The Spearman Correlation was used with significance ≤5%. RESULTS: There were significant and positive correlations between total caring ability and: burden - interpersonal relationship (p=0.03); stress (p=0.02) and maladaptive coping (p=0.00); and inversely proportional correlations with problem-focused coping (p=0.03). The courage had inversely proportional correlation with: self-efficacy (p=0.03), interpersonal relationship (p=0.00), stress (p=0.04) and maladaptive coping (p=0.00). The knowledge had significant and positive correlation with problem-focused coping (p=0.00), adaptive coping (p=0.01), and inverse correlation with stress (p=0.02). CONCLUSION: The level of caring ability correlates with levels of stress and burden, and with the type of coping strategy used by family caregivers.

Men's experience of caring for a family member with cancer: a theory based on data / Experiencia de hombres en el cuidado de un familiar con cáncer: una teoría fundamentada en los datos / Vivência de homens no cuidado ao familiar com câncer: uma teoria fundamentada nos dados

Objective: to understand the meaning attributed by men to the experience of caring for their family member with cancer and to develop a substantive theory that represents the experience of men caring for their family member with cancer. Method: this is qualitative research guided by the methodological framework of Grounded Theory and the precepts of Symbolic Interactionism. A form with identification and interview data was used. The analysis followed the substantive and theoretical coding stages. Results: 12 male caregivers of their family member with cancer participated. The constant comparative analysis of the data allowed the creation of a substantive theory "Experiencing the care of a family member with cancer: men as a caregivers" explaining the experience that has as its central category "The love that drives care", representing the symbolic actions and attitudes of men living in the context of illness due to cancer and care Conclusion: the theory allowed us to understand feelings, perceptions, ways of acting and facing the diagnosis, providing care, recognizing difficulties and learning from the situations that arise, making explicit the interactional processes and symbolic elements present and how these influence male caregivers in their actions and attitudes.

Objetivo: comprender el significado atribuido por los hombres a la experiencia de asistir a un familiar con cáncer y desarrollar una teoría sustantiva que represente la experiencia de los hombres acerca de dicho cuidado. Método: se trata de una investigación cualitativa guiada por el marco metodológico de la Teoría Fundamentada y los preceptos del Interaccionismo Simbólico. Se utilizó un formulario con datos de identificación y entrevista. El análisis siguió las etapas de codificación sustantiva y teórica. Resultados: participaron 12 hombres cuidadores de un familiar con cáncer. El constante análisis comparativo de los datos permitió elaborar una teoría sustantiva "Vivenciando el cuidado de un familiar con cáncer: el hombre como cuidador" explicando la experiencia que tiene como categoría central "El amor que impulsa el cuidado", representando la acciones y actitudes simbólicas del hombre que vive en el contexto de enfermedad por cáncer y sus cuidados. Conclusión: la teoría permitió comprender los sentimientos, percepciones, formas de actuar y afrontar el diagnóstico, brindar cuidados, reconocer dificultades y aprender de las situaciones que se presentan, explicitando los procesos de interacción y elementos simbólicos presentes y cómo influyen en los hombres cuidadores en sus acciones y actitudes.

Objetivo: apreender o significado atribuído pelos homens à vivência do cuidado ao seu familiar com câncer e elaborar uma teoria substantiva que represente a vivência de homens no cuidado ao seu familiar com câncer. Método: trata-se de uma pesquisa qualitativa norteada pelo referencial metodológico da Teoria Fundamentado nos Dados e pelos preceitos do Interacionismo Simbólico. Utilizouse formulário com dados de identificação e entrevista. A análise seguiu as etapas de codificação substantiva e teórica. Resultados: participaram 12 homens cuidadores de seu familiar com câncer. A análise comparativa constante dos dados permitiu a elaboração de uma teoria substantiva "Vivenciando o cuidado de um familiar com câncer: o homem como cuidador" explicativa da vivência que tem como categoria central "O amor que conduz o cuidar", representando as ações e atitudes simbólicas do homem ao viver no contexto do adoecimento por câncer e do cuidado. Conclusão: a teoria permitiu conhecer os sentimentos, percepções, modos de agir e enfrentar o diagnóstico, desempenhar o cuidado, reconhecer as dificuldades e aprender com as situações que se apresentam, deixando explícito os processos interacionais e os elementos simbólicos presentes e como estes influenciam os homens cuidadores em suas ações e atitudes.

Care-educational technologies: an emerging concept of the praxis of nurses in a hospital context.

OBJECTIVE: to know the praxis of nurses in the hospital context and, from this, to define a concept about Care-Educational Technologies. METHOD: qualitative, exploratory-descriptive research, developed in a university hospital in Rio Grande do Sul State, Brazil, with 21 nurses (non-probabilistic sampling), through non-participant observation and semi-structured interview, conducted from March to December 2015. Records were analyzed through content analysis. RESULTS: the results showed that in the context of nurses' work, it is possible to deduce care-educational possibilities, based on the person-person, person-tool and/or person-universe relationship. The concept was defined based on the intertwining of caring-training and training-caring for oneself and other people. FINAL CONSIDERATIONS: the reflections point to the need to develop or strengthen the autonomy of those involved in the health-disease process. This is based on the empowerment of people under their lives' conditions, in their multidimensionality, within human praxis.