Scale for the Environment Evaluation of Professional Nursing Practice: Construct validation.

AIM: Testing the validity and reliability of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). BACKGROUND: The environment of professional nursing practice is key to achieve better results for clients, nurses and institutions. Therefore, instruments enabling the assessment of all its attributes are required. METHOD: Cross-sectional methodological study. The SEE-Nursing Practice, based on a previous qualitative study and literature review, was applied as a questionnaire. Exploratory and confirmatory factor analyses were used to assess construct validity. RESULTS: A total of 752 nurses participated in the study. Exploratory factor analysis of the SEE-Nursing Practice led to a factor solution with 93 items and three subscales. The Structure, Process and Outcome subscales, respectively, have 43, 37 and 13 items, loaded in 6 factors, 6 factors and 2 factors and explaining 62.6%, 59.2% and 67.4% of the total variance. Cronbach's alpha of the overall scale and of the 3 subscales was greater than 0.90. Confirmatory factor analysis showed a good fit. CONCLUSION: SEE-Nursing Practice is a good valid and reliable instrument. IMPLICATIONS FOR NURSING MANAGEMENT: The SEE-Nursing Practice enables assessing practice environments and is a tool for nursing managers in the definition of strategies ensuring favourable environments for nursing care quality.

Death and dying: contributions to a practice based on nursing theoretical frameworks. / A morte e o morrer: contributos para uma prática sustentada em referenciais teóricos de enfermagem.

OBJECTIVE: To identify nurses' agreement on nursing conceptions with the potential to support their practice in the death and dying process context. METHOD: An exploratory and descriptive study with a quantitative approach was carried out with 3,451 nurses from 36 hospitals in Portugal, from July 2015 to March 2016. Data collection was carried out with the use of questionnaires and data analysis was carried out by means of descriptive and inferential statistics. RESULTS: Among conceptions with the potential to support practice, nurses highlighted those from Virginia Henderson, Afaf Meleis, and Madeleine Leininger. The following variables influenced the degree of agreement: region, service, gender, professional training, and length of professional practice. CONCLUSION: Considering current challenges of a practice that is mostly based on meeting needs, the relevance of nursing practices' purposes emerges in order to facilitate experiencing death and the dying process in culturally significant ways.

Behavior of nursing managers and leaders when errors are disclosed in the media. / Posicionamento de gestores e lideranças de enfermagem diante dos erros divulgados na mídia.

OBJECTIVE: To analyze the behavior of nursing managers and leaders when nursing errors are disclosed in the media. METHODOLOGY: A qualitative, retrospective, documental study of the collection carried out in newspapers in Brazil and Portugal, between 2012 and 2016. Analysis performed at Atlas.ti, using a Ricoeur technique based on Habermas Theory of Communicative Action. RESULTS: Managers and caretakers focused on the workforce, continuing with the opening of internal syndication, removal of position and dismissal. How to lead the discipline process, carrying out inspections, requesting documents and questioning about the facts, as well as repudiating some disclosed notes. CONCLUSION: Leaderships in nursing played a crucial role in developing a complex problem strategy. However, this was not done efficiently.

The influence of capitalism on the production of knowledge in nursing. / Influências capitalistas na produção do conhecimento em enfermagem.

OBJECTIVE: To understand the capitalist influence over the production of nursing knowledge according to Brazilian and Portuguese researchers. METHOD: Descriptive, exploratory, and qualitative research, with 17 research nurses selected using the snowball technique. Data were collected from October 2011 to November 2012 in Brazil and Portugal, by means of semi-structured interviews. We analysed the content of the interviews and produced inferences based in the theoretical assumptions of Gaston Bachelard and the notion of an epistemological obstacle. RESULTS: The results were organised into three categories: Blocks to creativity/innovation and the practice of repetition; Overestimation of the quantitative; and Resistance to rupture. CONCLUSION: It is necessary to create new ways of assessing scientific literature from a qualitative perspective that allows room for creativity, professional development, and critical and reflective thinking. Solidarity is perceived as an alternative to overcoming the problems caused by the capitalist way of producing knowledge.

Evaluation of the online management course from the perspective of former students. / Avaliação do curso de gerenciamento online na perspectiva dos egressos.

Objective To evaluate the online course from the perspective of e-learners as well as the relation between variables. Method A quantitative, descriptive and exploratory study. Results After three years, the satisfaction rates in the three listed categories presented an average rate higher than 75%. The coefficients indicated a high consistency of the questionnaire. Considering the overall rates in the three years period, the Instructor Performance category presented the highest rate. Strong associations between Self-Assessment and Instructor Performance, Self-Evaluation and Program of the Course and Instructor performance and Program of the course were identified. There was no association between the three categories mentioned with any other variables existing in the study. Conclusion E-learners expressed satisfaction with the course that means favored the interaction and the promotion of collective knowledge in nursing management. Also aspects need to be improved, especially the training of the instructor to mediate discussions and encourage student involvement throughout the course.

Nurses' attitudes regarding the importance of families in pediatric nursing care.

Affective, cognitive and behavioral components affect nurses´ attitudes to include families in the care processes. The purpose of this study was to investigate the attitudes of nurses about the importance of including families in nursing care. Data collection was performed in pediatric and maternal-child unit of a Brazilian university hospital. A sample of 50 nurses completed the Portuguese version of the instrument Families'Importance in Nursing Care-Nurses' Attitudes (FINC-NA). The results indicated that nurses have supportive attitudes regarding families participation in nursing care. Attitudes of lower support for involving families in nursing care were found among nurses with older age, more time in the profession and who had no previous contact with contents related to Family Nursing. The application of the instrument in other contexts of assistance may help to illuminate important aspects of the challenges to implementing a family-centered approach in clinical practice.

Nurses' perspectives on nurses' work methods.

OBJECTIVES: To analyze nurses' perspectives on nurses' work methods in the hospital context. METHODS: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. RESULTS: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." FINAL CONSIDERATIONS: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.

Moral sensitivity as a personal and work attribute of emergency care nurses: a cross-sectional study.

OBJECTIVE: to analyze the moral sensitivity of Brazilian emergency care nurses according to their personal and work characteristics. METHOD: this is a quantitative, descriptive, cross-sectional study with a convenience sample. A total of 422 nurses from emergency care services in the five regions of Brazil took part. Sociodemographic and work-related information was collected, as well as the Brazilian version of the Moral Sensitivity Questionnaire. After approval by the Research Ethics Committee, the data was collected using a self-administered form on the Google Forms Platform, organized using Excel software and analyzed using the R language. RESULTS: nurses with longer experience in emergency care services showed higher levels in the interpersonal orientation, moral conflict and moral significance dimensions, while in the professional knowledge dimension, men showed higher levels, as evidenced by items that include confidence in nursing knowledge, intuition, experience and opinion. CONCLUSION: the differences in the nurses' moral sensitivity were due to their professional experience. It should be emphasized that valuing the sharing of intergenerational experiences in service could be a possible strategy for fostering moral competencies in the field of practice.

Interdisciplinary health consultations for older people in Portugal: primary care and hospitals.

OBJECTIVE: To analyze the perspective of doctors, nurses, and social workers about practices for older people health in primary care and in hospitals; to create guidelines for the practice of interdisciplinary consultations. METHOD: Cross-sectional study involving 291 professionals from public institutions in the northern region of Portugal. Data were collected between May/2018 and March/2019, using a questionnaire which was then subjected to descriptive and analytical statistical analysis. RESULTS: The usefulness of scales for elderly people showed no differences between hospital and primary care. Hospital professionals collected the following data: eyesight/hearing; medication; direct contact or contact by writing between professionals; daily team meetings; need to share information among colleagues. Primary care professionals, in turn, valued: weight/height, swallowing; the need for home visits; direct contact or via e-mail between professionals; weekly team meetings. CONCLUSION: The practices of the professionals suggested an intervention model with common aspects in both groups, but with specificities for both primary and hospital care.

Construction and validation of a rehabilitation nursing program for fragile elderly.

OBJECTIVE: To build a rehabilitation nursing program to be implemented in the homes of frail elderly people and validate it by rehabilitation nurses. METHODS: This is a qualitative, exploratory study, divided into two stages. The first corresponded to an integrative literature review that supported the construction of the program. The second consisted of the program content validity stage, through a focus group, in May 2021. RESULTS: Nine experts participated in the construction and content validation of the rehabilitation nursing program for frail elderly. Two focus groups were carried out, and the final version of the program included training in life activities and particularly self-care, strength, balance, coordination and joint mobility. FINAL CONSIDERATIONS: The program reached content validity, with a minimum set of characteristics that it must integrate, now requiring application in Primary Health Care for clinical validation.

Dying in the emergency service: nurses' attitudes before and after the first critical period of COVID-19.

BACKGROUND: Death is an increasingly frequent event in hospitals, and nurses are the health professionals who live with this reality the most. The pandemic caused by COVID-19 made this event more present, showing that nurses' attitudes toward death may influence the care provided to people at the end of life. The objective of this study was to analyze the attitudes of nurses in the emergency service toward death, before and after the first critical period of the pandemic by COVID-19 in Portugal. METHODS: A quantitative, comparative, and cross-sectional study was conducted in a hospital in Northern Portugal at 2 different moments: the first in February 2018 and the second in May 2020, after the first critical period of the pandemic by COVID-19. In both moments, data were collected using a self-completion questionnaire, which included the Death Attitude Profile Assessment Scale. RESULTS: The attitudes fear, avoidance, closeness, and escape did not show significant differences. In neutral/neutral acceptance, differences were found between the first and second moments of data collection (P = .01), with a lower mean after the critical period of the pandemic. CONCLUSIONS: The results obtained in 2018 and 2020 showed slight changes in attitudes toward death. The need to invest in the training and preparation of nurses who deal directly with death and the dying process was evident. Nurse managers should promote spaces for reflection and team training on death, aiming to reduce the professionals' suffering and anxiety.

Evaluation of the health level of the elderly: patient care team considerations.

OBJECTIVE: To understand the differences of physicians, nurses, and social workers in the evaluation of the health status of the elderly. METHODS: A cross-sectional quantitative study, using descriptive statistics. Non-probabilistic sample, consisting of 291 participants from three professional categories: 71 (24.4%) physicians, 192 (66%) nurses, and 28 (9.6%) social workers. We used a questionnaire including the variables: sociodemographic characteristics and instruments used for evaluation. RESULTS: Instruments with greater utility for the evaluation of the elderly: for physicians, Mini Mental State Examination; for nurses, Braden scale; and for social workers, genogram. In the physical examination, the data most collected by physicians and nurses are the vital signs; and by social workers, the condition for performing the Activities of Daily Living. CONCLUSIONS: The evaluation of the elderly is based on a diversity of instruments and is an area in which health and social professionals need to share information.

Validation of the content of a children's game to promote the nursing profession.

OBJECTIVE: To validate content for an experimental game named Quantos Queres, using an origami, about the Nursing profession, for children from 7 to 12 years old. METHOD: Methodological study that included two groups of experts: A (n=7), B (n=40). Non-probabilistic sampling approach was used. We used a self-completion form, available by email and social networks, in Portugal, between February and April 2020. Acceptance decision established for 75% agreement. RESULTS: The groups were mostly composed by nurses. Group A identified the themes: professional profile, training, ethical principles, historical and symbolic elements and conceived the content of the statements in the form of questions and answers. In group B, agreement was higher than 75% in the areas and contents of the statements. CONCLUSION: The selection of content to integrate the game is essential. The agreement obtained shows the importance of the chosen themes and the adequacy to the purpose that will be tested later.

Nursing practices in the family health strategy in Brazil: interfaces with illness.

OBJECTIVE: To identify Nursing practices in the Family Health Strategy in Brazil and interfaces in the illness of these professionals. METHOD: Qualitative research, carried out in the five Regions of Brazil, with 79 nursing professionals from 20 health units. Data were collected from 2015 to 2017, using interviews, observation and documentary study. The analysis with the aid of the software ATLAS.ti 8.0, guided by the theorization of the Work Process and Workloads. RESULTS: The practices of the care dimension prevailed, followed by the administrative-managerial and educational dimensions. The illness resulting from workloads, predominantly psychic, was related to care practices, potentiated by overload and poor working conditions. CONCLUSION: The centrality of nursing practices in the dimension of care and administrative management characterized the professional work in Primary Care. The findings indicate that improved working conditions may minimize the wear and tear of these professionals in this scenario.

The COVID-19 pandemic and nurses' attitudes toward death.

OBJECTIVE: to analyze nurses' attitudes toward death in a hospital context after the critical period of the COVID-19 pandemic in Portugal. METHOD: this quantitative, descriptive, exploratory study was conducted in a university hospital and addressed 995 nurses. Revised Death Attitude Profile (DAP-R) was used to collect data, which were analyzed using analytical and inferential statistics. RESULTS: the nurses most frequently agreed with the statements concerning the Neutral/Neutrality Acceptance and Fear. Age, marital status, profession, and unit of work influenced the nurses' attitudes toward death. During the critical pandemic period, the nurses providing care to patients with COVID-19 presented the following means: Fear (28.89/±8.521) and Avoidance Acceptance (18.35/±7.116), which were higher than the mean obtained in the Escape Acceptance dimension, with significant differences (p=0.004). CONCLUSION: the nurses held Fear and Avoidance attitudes, revealing the need to qualify and support Nursing workers to cope with the death of those they provide care and manage pandemics and catastrophes.

200 years of Florence Nightingale: contributions to the professional practice of nurses in hospitals.

OBJECTIVE: Analyze the agreement of nurses, who work in hospital institutions, about Florence Nightingale's conceptions about nursing, people, health and the environment. METHOD: Quantitative, observational and cross-sectional study, with the participation of 3,451 nurses from 36 Portuguese hospitals. Data collection took place from July 2015 to March 2016, using a questionnaire. For analysis, descriptive and analytical statistics were used. RESULTS: It was evident that 60% to 70% of participating nurses considered that Florence Nightingale's conceptions of nursing, person, health and environment were partly in agreement or totally in agreement with their practice. The variables that influenced agreement were: service, condition in which they practice the profession, length of professional practice, academic degree and region of the country. CONCLUSION: Florence Nightingale's conceptions continue to contribute to professional nursing practice, with the region and the service significantly influencing this continuity.

Technologies used by nursing managers in Portuguese hospitals.

OBJECTIVE: To analyze the association between the characteristics of nurse managers and the use of information technologies in Portuguese hospitals. METHOD: A cross-sectional quantitative study involving 138 nurse managers. The managers answered a questionnaire about the use of key information and communication technologies in management. The findings were submitted to descriptive and analytical statistical analysis. RESULTS: Women predominated, with more than 25 years in the profession and more than ten in management. It showed that the managers identify the utility and easiness of a singular way for each technology, the use of which is influenced by the nurses' socio-occupational characteristics, their gender, specialization (having it or not), and the time of experience in services and management being significant. CONCLUSION: The study contributes to explain and predict the intention to use, as well as the mastery of technologies in hospital management, providing support of choice in the management of services and need for qualification for use.

Workloads in the Family Health Strategy: interfaces with the exhaustion of nursing professionals. / Cargas de trabalho na Estratégia Saúde da Família: interfaces com o desgaste dos profissionais de enfermagem.

OBJECTIVE: To identify the workloads of nursing teams working in the Family Health Strategy in the five regions of Brazil and their interfaces with their feelings of exhaustion. METHOD: Qualitative study with nursing professionals from 20 Family Health Units, from eight cities in the five regions of the country. Data were collected through interviews, observation and analyzed according to the precepts of thematic analysis and the theoretical framework of workloads. RESULTS: A total of 79 professionals participated in the study. Workloads were related to structural and managerial problems. Workloads that stood out were psychological workload, due to excessive demands and staff shortages; physiological workload, due to the overload of activities that generate physical pain and exhaustion; physical and mechanical workload, due to inadequacies in the work environment and equipment; biological workload, due to the presence of microorganisms; and chemical workload, due to exposure to dust and smoke. CONCLUSION: The sources that increase workloads are similar in the five regions, indicating that there is a strong influence of psychological and physiological loads on exhaustion among workers. However, workloads are reduced by dividing and planning team actions and by the affinity with the assistance model.

Elderly residents in the community: gaining knowledge to support a rehabilitation nursing program.

OBJECTIVE: To analyze the socio-demographic and health conditions of the elderly living in the community and describe the pillars for the design of a rehabilitation nursing program in the community. METHODS: Descriptive, cross-sectional study, with participation of 48 elderly selected by convenience sampling. Data collection took place between September 2018 and July 2019, in a health unit in northern Portugal, using a form. RESULTS: All the elderly have pathological processes and overweight. Most of them are sedentary, have feelings of loneliness and inappropriate relational behaviors. In the last six months, 25% have fallen at least once, with notable changes in balance, lifestyles and perceived health status. CONCLUSION: The need for rehabilitation nurses to design and implement active aging programs that ensure individual accompaniment of the elderly by valuing lifestyles, balance training and promotion of social participation was highlighted.

Instruments for assessing professional nursing practice environments: An integrative review.

OBJECTIVE: To identify the instruments used to evaluate the professional nursing practice environments in the hospital context. METHOD: An integrative review, whose research process was conducted independently by two researchers in the period from July to August 2019 in the CINHAL, PubMed and SciELO databases. RESULTS: Based on the inclusion and exclusion criteria, 53 studies published between 2009 and 2019 were considered for analysis. Ten instruments and three thematic areas were identified: instruments for the assessment of the nursing professional practice environments; implications of the use of instruments for the assessment of nursing professional practice environments; limitations of the instruments for the assessment of nursing professional practice environments. CONCLUSION: Despite the relevance of the instruments identified, this integrative review provides contributions that support the need to use specific tools to assess the nursing practice environments that include the structure, process and outcome components.