Moral distress and professors of nursing: A cluster analysis.

BACKGROUND: Professors of nursing sometimes experience specific situations in their daily practice that conflict with their values and ethical principles and may culminate in moral distress. Moral distress occurs when one is prevented from acting according to his or her knowledge or values, or what one considers to be ethically sound. OBJECTIVES: To identify the profile of professors of nursing through grouping sociodemographic characteristics and intensity of moral distress. METHOD: Cross-sectional and exploratory study addressing 373 nurses teaching in Brazilian federal public higher education institutions. Data were collected from June to December 2018 through email, using the Google Docs tool. A moral distress scale directed to nurse educators was used. Data were analyzed using descriptive statistics, variance analysis, and cluster analysis. ETHICAL CONSIDERATIONS: The Institutional Review Board at the Federal University of Rio Grande approved this study. FINDINGS: Initially, four clusters emerged for each variable predicting the profile of Brazilian professors of nursing: sex; whether the individual worked in a graduate program; age; experience in years in their respective higher education institution; and intensity of moral distress. The profile of Brazilian professors of nursing was represented by the largest cluster, 36.5% (n = 136), composed of women working in graduate programs, aged 37 years old on average, having worked in their respective institutions for approximately 5 years, and presenting a moderate intensity of moral distress. CONCLUSION: Assigning individuals into groups facilitates seeing similarities among the predictors that compose the profile of Brazilian professors of nursing, thus recognizing those workers experiencing moral distress in their daily work routine. In addition, this study's results are expected to encourage reflection on the planning of efficacious interventions directed to the context of education and health.

Moral distress in undergraduate nursing students.

BACKGROUND: Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints. OBJECTIVES: To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil. METHOD: Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models. ETHICAL CONSIDERATIONS: Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande. FINDINGS: The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60-3.14, p = 0.000). CONCLUSION: The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician.

[Nursing beliefs and actions in exercising patient advocacy in a hospital context]. / Crenças e ações de enfermeiros no exercício da advocacia do paciente no contexto hospitalar.

OBJECTIVE: Analyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context. METHOD: A quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance. RESULTS: Nurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy. CONCLUSION: Nurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.

Analysis of moral courage and related factors among undergraduate nursing students: a scoping review.

OBJECTIVE: to analyze scientific evidence on moral courage and related factors among nursing undergraduate students. METHOD: the protocol of this scoping review was registered on Open Science Framework. A search was performed in five databases, according to the method provided by Joanna Briggs Institute Reviewers, the mnemonic strategy Population, Concept and Context, and a specific checklist. RESULTS: a total of 2,812 results were identified, but only nine studies were eligible and presented three thematic approaches: Moral courage from the perspective of nursing students; Moral courage and related factors; and The teaching of moral courage in the training of nursing students. The factors related to moral courage include moral distress, moral sensitivity, age, and having a previous degree in the health field. FINAL CONSIDERATIONS: few studies were found with a low evidence level. Most were performed in developed countries, indicating some gaps that need to be addressed in the future.

[Option and evasion of a bachelor's degree programme in nursing evaded students' perception]. / Opção e evasão de um curso de graduação em enfermagem: percepção de estudantes evadidos.

Qualitative study, developed in a Federal University in southern Brazil aiming to know the motives for choosing and evading a Bachelor's degree programme in Nursing, in the evaded students 'perception. The data were collected through a questionnaire sent by e-mail to 19 evaded students. The 9 questionnaires that returned were submitted to Qualitative Textual Analysis, and two categories emerged motives to opt for the nursing programme and motives to evade from the nursing programme. The results showed that the option for the programme is associated to personal vocation, perception of Nursing as a profession of care, and its closeness to the health area. Evasion seems to be related to passing the first option of undergraduate programme, ignorance about the profession, financial difficulties, and professional depreciation. We demonstrated that greater emphasis should be put on promoting knowledge about the nursing work, areas of activity and attributions.

Postgraduate nursing students' conceptions on scientific integrity and research ethics.

OBJECTIVES: to understand the conceptions of postgraduate Nursing students regarding integrity in scientific research. METHODS: a qualitative, descriptive and exploratory study conducted in October 2020, with 40 students from a postgraduate program in Nursing from a public university in Southern Brazil. The interviews had an emphasis on scientific integrity and its importance for scientific research; they were conducted using synchronous communication tool and analyzed by textual discourse analysis. RESULTS: two categories emerged: "Scientific integrity: the ethical dimension of research" and "Implications of academic productivism for scientific integrity". Such integrity is intrinsically related to the supporting ethical elements, as well as to the nuances of productivism and its impacts on integrity. FINAL CONSIDERATIONS: the cross-sectionalism of ethical practices is necessary in the production spheres of science, so that knowledge is perpetuated in harmony with integrity and its representations to the community.

Support provided to nursing students in the face of patient safety incidents: a qualitative study.

OBJECTIVES: to identify the support provided to nursing students after a patient safety incident. METHODS: qualitative study developed with 23 students attending an undergraduate nursing program in southern Brazil. Data were collected between September and November 2021 and submitted to textual discursive analysis using the Iramuteq software. RESULTS: the students reported that mainly classmates and professors of the practical courses provided support. The students showed no knowledge of organizational support or protocols available to students who become second victims of such incidents. FINAL CONSIDERATIONS: the primary support sources available to nursing students involved in patient safety incidents were identified. Note that support provided to nursing students is still incipient both in Brazil and internationally. Hence, further studies are needed to address potential victims and support resources to mitigate this phenomenon.

Authentic leadership in nurses' professional practice: an integrative review.

OBJECTIVES: to identify the primary constructs concerning authentic leadership and its relevance for nurses' professional practice. METHODS: integrative literature review conducted between 2015 and 2020 in LILACS, SciELO, and PubMed databases. RESULTS: the United States published most of the 31 studies analyzed, with eight studies (25.8%), followed by Canada with seven studies (22.6%), and Brasil with five (16.1%). Most studies adopted a quantitative approach (77.41%), and 96.8% presented weak evidence. Three categories emerged: Work Engagement/Job Satisfaction and Organizational Commitment; Healthy Work Environment; and Intention to Quit the Job and Mental Exhaustion. FINAL CONSIDERATIONS: authentic leadership positively contributes to management and nursing care practice, promoting healthy work environments, structural empowerment, greater work engagement, and organizational commitment, decreasing absenteeism and mental exhaustion.

Patient Safety Incidents and the second victim phenomenon among nursing students.

OBJECTIVE: To map the factors involved in incidents that harm patient safety and contribute to the second victim phenomenon among nursing students. METHOD: Qualitative, exploratory-descriptive study addressing 23 nursing students attending a Federal University in the South of Brazil. The interviews were analyzed using text and discoursive analysis. The Iramuteq software supported the processing of texts. RESULTS: Communication failures within the health staff, a lack of protocols and equipment that prioritize patient safety, and factors related to the teaching-learning process favor the occurrence of patient safety incidents and the second victim phenomenon among nursing students. CONCLUSION: Addressing the topic concerning patient safety in nursing programs can promote the patient safety culture by encouraging reporting and admitting the possibility of errors and learning from them, strategies that can mitigate second victim effects.

The ethical dimension of problems faced in general medicine: relationship with moral sensitivity.

OBJECTIVE: to identify the main ethical problems and how these relate to the moral sensitivity of nurses working in a general medicine ward. METHOD: this qualitative, exploratory, and descriptive study was conducted in a university hospital located in the south of Brazil. A total of 18 nurses working in a general medicine ward were interviewed. A semi-structured interview script was used, and data were analyzed using discursive textual analysis. RESULTS: nurses considered the main ethical problems to include conflicts at the institutional level, situations involving conflicts with patients and/or family members, and conflicts within the staff. The perception of nurses and how they deal with these problems relate to moral sensitivity. Two categories emerged: experiencing ethical problems, and relationship with moral sensitivity. CONCLUSION: because of the multidimensional nature of moral sensitivity, it trains and enables nurses to recognize and deal with ethical problems faced in clinical practice so that nurses become able to make fair and prudent decisions, improving the quality of nursing care.

Nursing students facing moral distress: strategies of resistance.

OBJECTIVE: To understand the resistance strategies adopted by undergraduate students in nursing, faced with situations of moral distress (MD). METHOD: Qualitative research, developed in three universities in the south of Brazil, two federal and one private, with 21 undergraduate students in nursing from December 2015 to February 2016; the data was submitted to the discursive textual analysis and Foucauldian theoretical reference. RESULTS: Students resisting demonstrate a sense of self-preservation and moral empowerment. Moreover, non-resistance initiatives are related to the fear of possible sanctions. Thus, by resisting or not, students may experience both positive and negative repercussions. FINAL CONSIDERATIONS: By resisting, students aim to defend what they believe to be right, demonstrating their moral empowerment in the face of their moral distress. However, the exercise of disciplinary power seems to contribute to their moral fragilization, making it difficult to implement resistance strategies.

Analysis of moral courage and related factors among undergraduate nursing students: a scoping review / Análisis del coraje moral y factores relacionados entre estudiantes de graduación en enfermería: scoping review / Análise da coragem moral e fatores relacionados entre estudantes de graduação em enfermagem: scoping review

ABSTRACT Objective: to analyze scientific evidence on moral courage and related factors among nursing undergraduate students. Method: the protocol of this scoping review was registered on Open Science Framework. A search was performed in five databases, according to the method provided by Joanna Briggs Institute Reviewers, the mnemonic strategy Population, Concept and Context, and a specific checklist. Results: a total of 2,812 results were identified, but only nine studies were eligible and presented three thematic approaches: Moral courage from the perspective of nursing students; Moral courage and related factors; and The teaching of moral courage in the training of nursing students. The factors related to moral courage include moral distress, moral sensitivity, age, and having a previous degree in the health field. Final Considerations: few studies were found with a low evidence level. Most were performed in developed countries, indicating some gaps that need to be addressed in the future.

RESUMEN Objetivo: analizar las evidencias científicas sobre el coraje moral y factores relacionados entre estudiantes de graduación en enfermería. Métodos: se trata de un scoping review con protocolo registrado en el Open Science Framework, realizado en cinco bases de datos, conforme método de Joanna Briggs Institute Reviewers, estrategia mnemónica Población, Concepto y Contexto, y checklist específico. Resultados: se identificaron 2.812 resultados, siendo que nueve estudios fueron seleccionados. Tres enfoques temáticos fueron identificados: Percepción del coraje moral por los estudiantes de enfermería; Coraje moral y factores relacionados; y, la Enseñanza del coraje moral en el ámbito de la formación de estudiantes de enfermería. Entre los factores relacionados con el coraje moral, se destacaron el sufrimiento moral, la sensibilidad moral, la edad y la presencia de un título anterior en el área de la salud. Consideraciones Finales: se evidenciaron pocas publicaciones y con bajo nivel de evidencias provenientes, mayoritariamente, de países desarrollados, indicando que existen vacíos que necesitan ser llenados.

RESUMO Objetivo: analisar as evidências científicas sobre a coragem moral e fatores relacionados entre estudantes de graduação em enfermagem. Métodos: trata-se de uma scoping review com protocolo registrado no Open Science Framework, realizada em cinco bases de dados, conforme método do Joanna Briggs Institute Reviewers, estratégia mnemônica População, Conceito e Contexto, e checklist específico. Resultados: identificou-se 2.812 resultados, sendo que nove estudos foram elegidos. Três enfoques temáticos foram identificados: Percepção da coragem moral pelos estudantes de enfermagem; Coragem moral e fatores relacionados; e Ensino da coragem moral no âmbito da formação de estudantes de enfermagem. Dentre os fatores relacionados com a coragem moral, destacou-se o sofrimento moral, a sensibilidade moral, a idade e a presença de um diploma anterior na área da saúde. Considerações Finais: evidenciou-se poucas publicações e com baixo nível de evidência, sendo oriundas majoritariamente de países desenvolvidos, indicando que lacunas ainda precisam ser preenchidas.

Cross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses.

OBJECTIVE:: Cross-culturally adapt and validate the Moral Distress Scale-Revised for nurses. METHOD:: Quantitative, analytical cross-sectional study conducted with 157 nurses of two hospital institutions of Southern Brazil, one public and one philanthropic. Procedures conducted: cultural adaptation of the instrument according to international recommendations; validation for the Brazilian context. RESULTS:: Face and content validation was considered satisfactory as assessed by a specialist committee and a pretest. The instrument demonstrated satisfactory internal consistency through frequency and intensity analysis per question in the 157 items and per subgroups of the various hospital units. Cronbach's alpha was 0.88 for the instrument and between 0.76 and 0.94 for hospital units. Pearson's correlation found a moderate association for moral distress among nurses. CONCLUSION:: The Moral Distress Scale-Revised - Brazilian version is a valid instrument for the assessment of moral distress in nurses. OBJETIVO:: Adaptar culturalmente e validar a Moral Distress Scale Revised para enfermeiros. MÉTODO:: Estudo quantitativo, transversal analítico, realizado com 157 enfermeiros de duas instituições hospitalares do Sul do Brasil, uma pública e uma filantrópica. Realizou-se: a adaptação cultural do instrumento segundo recomendações internacionais; e a sua validação para o contexto brasileiro. RESULTADOS:: A validade de face e conteúdo foi considerada satisfatória mediante avaliação de comitê de especialistas e realização de pré-teste. Mediante análise de frequência e intensidade por questão nos 157 questionários e por subconjuntos das diferentes unidades hospitalares, o instrumento demonstrou consistência interna satisfatória, com alfa de Cronbach 0,88 para o instrumento e entre 0,76 e 0,94 para as unidades hospitalares. A correlação de Pearson identificou moderada associação de sofrimento moral nos enfermeiros. CONCLUSÃO:: o Moral Distress Scale Revised - versão brasileira é um instrumento válido para ser utilizado na avaliação de sofrimento moral de enfermeiros.

Perfil de usuários de um serviço de estomaterapia: análise de cluster / Perfil de usuarios de un servicio de estomaterapia: análisis de cluster / Profile of users of a stomatherapy service: cluster analysis

Resumo Objetivo Analisar o perfil das pessoas com estomias intestinais e/ou urinárias acompanhadas em serviço de estomaterapia, conforme variáveis sociodemográficas e clínicas. Método Trata-se de um estudo transversal, realizado com 90 usuários do serviço de estomaterapia. A coleta foi realizada de janeiro a fevereiro de 2020, por meio de dois instrumentos: COH-QOL-Ostomy, adaptado e traduzido para o contexto brasileiro; e City of Hope Quality of Life - Ostomy Questionnaire, instrumento original com questionário elaborado pelas próprias pesquisadoras, contemplando os aspectos sociodemográfico e clínico. Esses dados foram transferidos e organizados no Software Statistical Package for the Social Science, versão 22. Resultados Foram identificados quatro grupos distintos. No cluster 1, o grupo possui de duas a três complicações associadas ao estoma e 52,9% possuem colostomia. No cluster 2, 45% não apresentam nenhuma complicação e 70% têm urostomia. Já no cluster 3, a totalidade do grupo apresenta uma complicação e colostomia. E no cluster 4, nenhum participante do grupo apresenta complicação e todos têm colostomia. Conclusão e implicações para a prática O estudo proporcionou a geração de dados que podem auxiliar no planejamento do trabalho desenvolvido pelas equipes de saúde junto aos pacientes estomizados.

Resumen Objetivo Analizar el perfil de las personas con ostomías intestinales y/o urinarias seguidas en un servicio de estomaterapia, según variables sociodemográficas y clínicas. Método Se trata de un estudio transversal, realizado con 90 usuarios del servicio de Estomaterapia. La recolección de datos se realizó de enero a febrero de 2020, utilizando dos instrumentos: COH-QOL-Ostomy, adaptado y traducido al contexto brasileño; y City of Hope Quality of Life - Ostomy Questionnaire, instrumento original con cuestionario elaborado por las propias investigadoras, considerando aspectos sociodemográficos y clínicos. Estos datos se transfirieron y organizaron en Software Statistical Package for the Social Science, versión 22. Resultados Se identificaron cuatro clústeres distintos. En el clúster 1, el grupo tiene de dos a tres complicaciones asociadas con estoma y el 52,9% tiene una colostomía. En el grupo 2, el 45% no presenta complicaciones y el 70% tiene urostomía. En el clúster 3, todo el grupo presenta complicación y colostomía. Y en el clúster 4, ninguno de los participantes del grupo tiene complicaciones y todos tienen una colostomía. Conclusión e implicaciones para la práctica El estudio generó datos que pueden ayudar a planificar el trabajo que desarrollan los equipos de salud con pacientes ostomizados.

Abstract Objective To analyze the profile of people with intestinal and/or urinary ostomies followed up in a stomatherapy service, according to sociodemographic and clinical variables. Method This is a cross-sectional study, carried out with 90 users of the stomatherapy service. Data collection was carried out from January to February 2020, using two instruments: COH-QOL-Ostomy, adapted and translated to the Brazilian context; and City of Hope Quality of Life - Ostomy Questionnaire, an original instrument with a questionnaire prepared by the researchers themselves, considering the sociodemographic and clinical aspects. These data were transferred and organized in the Statistical Package for Social Science Software, version 22. Results Four distinct clusters were identified. In cluster 1, the group has two to three complications associated with the stoma and 52.9% have a colostomy. In cluster 2, 45% have no complications and 70% have urostomy. In cluster 3, the entire group presents a complication and colostomy. And in cluster 4, none of the participants in the group have complications and all have a colostomy. Conclusion and implications for practice The study provided the generation of data that can help in planning the work developed by the health teams with ostomy patients.

Postgraduate nursing students' conceptions on scientific integrity and research ethics / Concepciones de los estudiantes de postgrado en enfermería sobre integridad científica y ética en la investigación / Concepções dos estudantes de pós-graduação em Enfermagem sobre integridade científica e ética na pesquisa

ABSTRACT Objectives: to understand the conceptions of postgraduate Nursing students regarding integrity in scientific research. Methods: a qualitative, descriptive and exploratory study conducted in October 2020, with 40 students from a postgraduate program in Nursing from a public university in Southern Brazil. The interviews had an emphasis on scientific integrity and its importance for scientific research; they were conducted using synchronous communication tool and analyzed by textual discourse analysis. Results: two categories emerged: "Scientific integrity: the ethical dimension of research" and "Implications of academic productivism for scientific integrity". Such integrity is intrinsically related to the supporting ethical elements, as well as to the nuances of productivism and its impacts on integrity. Final Considerations: the cross-sectionalism of ethical practices is necessary in the production spheres of science, so that knowledge is perpetuated in harmony with integrity and its representations to the community.

RESUMEN Objetivos: conocer las concepciones de estudiantes de postgrado en Enfermería sobre integridad en investigación científica. Métodos: estudio cualitativo, descriptivo y exploratorio realizado en octubre de 2020, con 40 estudiantes de un programa de postgrado en Enfermería de una universidad pública del Sur brasileño. Las entrevistas tuvieron énfasis en la integridad científica y su importancia para las investigaciones científicas; fueron realizadas usando herramienta síncrona de comunicación y analizadas por el análisis textual discursivo. Resultados: emergieron dos categorías: "Integridad científica: la dimensión ética de la investigación" e "Implicaciones del productivismo académico para la integridad científica". Tal integridad se muestra intrínsecamente relacionada a los elementos éticos de base, así como a los matices del productivismo y sus impactos para la integridad. Consideraciones Finales: es necesaria la transversalidad en ética en los ámbitos de producción de la ciencia, para que el conocimiento perpetúe en armonía con la integridad y sus representaciones para la comunidad.

RESUMO Objetivos: conhecer as concepções dos estudantes de pós-graduação em Enfermagem sobre integridade em pesquisa científica. Métodos: estudo qualitativo, descritivo e exploratório realizado em outubro de 2020, com 40 estudantes de um programa de pós-graduação em Enfermagem de uma universidade pública do Sul do Brasil. As entrevistas tiveram ênfase na integridade científica e sua importância para as pesquisas científicas; foram realizadas usando ferramenta síncrona de comunicação e analisadas pela análise textual discursiva. Resultados: emergiram duas categorias: "Integridade científica: a dimensão ética da pesquisa" e "Implicações do produtivismo acadêmico para a integridade científica". Tal integridade mostra-se intrinsecamente relacionada aos elementos éticos de suporte, bem como às nuances do produtivismo e seus impactos para a integridade. Considerações Finais: é necessária a transversalização de práticas éticas nos âmbitos de produção da ciência, para que o conhecimento seja perpetuado em harmonia com a integridade e suas representações para a comunidade.

Patient Safety Incidents and the second victim phenomenon among nursing students / Los incidentes de seguridad del paciente y el fenómeno de la segunda víctima entre estudiantes de enfermeira / Incidentes de segurança do paciente e o fenômeno da segunda vítima entre estudantes de enfermagem

ABSTRACT Objective: To map the factors involved in incidents that harm patient safety and contribute to the second victim phenomenon among nursing students. Method: Qualitative, exploratory-descriptive study addressing 23 nursing students attending a Federal University in the South of Brazil. The interviews were analyzed using text and discoursive analysis. The Iramuteq software supported the processing of texts. Results: Communication failures within the health staff, a lack of protocols and equipment that prioritize patient safety, and factors related to the teaching-learning process favor the occurrence of patient safety incidents and the second victim phenomenon among nursing students. Conclusion: Addressing the topic concerning patient safety in nursing programs can promote the patient safety culture by encouraging reporting and admitting the possibility of errors and learning from them, strategies that can mitigate second victim effects.

RESUMEN Objetivo: mapear los factores que participan en incidentes que fragilizan la seguridad de los pacientes y que colaboran para el fenómeno de la segunda víctima entre los estudiantes de enfermería. Método: estudio de abordaje cualitativo, de carácter exploratorio y descriptivo, realizado en 23 estudiantes de enfermería de una Universidad Federal del sur de Brasil. Las entrevistas fueron analizadas a través del análisis textual discursivo. El software Iramuteq auxilió en el procesamiento de los textos. Resultado: las fallas en la comunicación entre el equipo de la salud; la ausencia de protocolos y de equipamientos que den prioridad a la seguridad del paciente; y, los factores relacionados al proceso de enseñanza y aprendizaje, favorecen la ocurrencia de incidentes de seguridad del paciente y corroboran el fenómeno de la segunda víctima entre estudiantes de enfermería. Conclusión: la incorporación de la temática sobre seguridad del paciente, en el curso de enfermería, puede auxiliar a desarrollar una cultura de seguridad del paciente al incentivar la cultura del relato, admitir la posibilidad del error e incentivar el aprendizaje; y, partiendo de este, crear estrategias que puedan auxiliar a mitigar los efectos de la segunda víctima.

RESUMO Objetivo: mapear os fatores envolvidos em incidentes que fragilizam a segurança dos pacientes e que colaboram para o fenômeno da segunda vítima entre os estudantes de enfermagem. Método: estudo de abordagem qualitativa, de caráter exploratório-descritivo, realizado com 23 estudantes de enfermagem de uma Universidade Federal do Sul do Brasil. As entrevistas foram analisadas através da análise textual discursiva. O software Iramuteq auxiliou no processamento dos textos. Resultado: falhas na comunicação entre a equipe de saúde, ausência de protocolos e de equipamentos que priorizem a segurança do paciente e os fatores relacionados ao processo de ensino-aprendizagem favorecem a ocorrência de incidentes de segurança do paciente e corroboram para o fenômeno da segunda vítima entre estudantes de enfermagem. Conclusão a incorporação da temática sobre segurança do paciente no curso de enfermagem pode auxiliar o desenvolvimento de uma cultura de segurança do paciente, ao incentivar a cultura do relato, admitir a possibilidade do erro e o aprendizado a partir dele, estratégias que podem propiciar na mitigação dos efeitos da segunda vítima.

Isolamento social e solidão em estudantes de enfermagem no contexto da pandemia Covid-19 / Social isolation and loneliness in nursing students in the context of the COVID-19 pandemic / Aislamiento social y soledad entre estudiantes de enfermería en el contexto de la pandemia COVID-19

Objetivo: identificar a ocorrência de isolamento social e solidão e sua relação com fatores sociodemográficos e de saúde em graduandos de enfermagem no contexto da pandemia de COVID-19. Método: estudo transversal, descritivo e correlacional, desenvolvido com 147 estudantes de enfermagem que responderam um formulário eletrônico, contendo Questionário de caracterização, Escala de Solidão da Universidade de Califórnia e Escala de Depressão, Ansiedade e Estresse. Resultados: evidenciou-se a ocorrência de isolamento social percebido em 42,2% dos estudantes, e que, 8,8% dos estudantes apresentaram isolamento social conforme indicador rede de discussão, e 6,8% de acordo com o indicador de apoio social. Observou-se a solidão em 49,7% dos estudantes. Ambos foram associados com depressão, ansiedade e estresse, além de outras variáveis. Conclusão: identificou-se isolamento social e solidão e a relação destes com outras variáveis durante a pandemia de COVID-19, demandando intervenções por parte das instituições de ensino e dos formuladores de políticas de saúde.

Objective: to identify the occurrence of social isolation and loneliness and their relationship with sociodemographic and health factors in nursing undergraduates in the context of the COVID-19 pandemic. Method: in this cross-sectional, descriptive, correlational study, 147 nursing students answered an electronic form comprising a characterization questionnaire, the University of California Loneliness Scale and the Depression, Anxiety and Stress Scale. Results: perceived social isolation was found to occur in 42.2% of the students, and 8.8% experienced social isolation according to the discussion network indicator, and 6.8%, according to the social support indicator. Loneliness was observed in 49.7% of students. Both were associated with depression, anxiety and stress, and other variables. Conclusion: this study found isolation and loneliness and their relationship with other variables during the COVID-19 pandemic, requiring interventions by educational institutions and health policymakers.

Objetivo: identificar cómo ocurre el aislamiento social y la soledad y su relación con factores sociodemográficos y de salud en estudiantes de enfermería en el contexto de la pandemia de COVID-19. Método: estudio transversal, descriptivo y correlacional, desarrollado junto a 147 estudiantes de enfermería que respondieron un formulario electrónico, que contenía un cuestionario de caracterización, la Escala de Soledad de la Universidad de California y la Escala de Depresión, Ansiedad y Estrés. Resultados: resaltó la incidencia de aislamiento social percibido en el 42,2% de los estudiantes, y que el 8,8% de los estudiantes presentó aislamiento social según el indicador de red de discusión, y el 6,8% según el indicador de apoyo social. La soledad se verificó en el 49,7% de los estudiantes. Ambos fueron asociados con depresión, ansiedad y estrés, además de otras variables. Conclusión: se identificaron el aislamiento social y la soledad y su relación con otras variables durante la pandemia de COVID-19, requiriendo intervenciones por parte de las instituciones de enseñanza y de los formuladores de políticas de salud.

Instrumentos de medida para avaliação do conhecimento de estudantes de Enfermagem sobre segurança do paciente / Measurement instruments to evaluate Nursing students' knowledge about patient safety / Instrumentos de medición para evaluar los conocimientos de los estudiantes de Enfermería sobre la seguridad del paciente

Objetivo: Analisar as evidências científicas relacionadas aos instrumentos utilizados para avaliar o conhecimento de estudantes de enfermagem sobre Segurança do Paciente. Métodos: Revisão integrativa realizada nas bases de dados MEDLINE, CINAHL, WOS, LILACS e BDENF. A amostra foi composta por 11 estudos primários, publicados entre os anos de 2008 a 2017, nos idiomas português, espanhol ou inglês e que responderam à questão de pesquisa. Resultados: Houve predomínio de estudos transversais, no idioma inglês. O instrumento mais utilizado para avaliação do conhecimento em segurança do paciente foi o Health Professional Education in Patient Safety Survey (H-PEPSS). Dentre os fatores que limitaram o processo de aprendizagem destacou-se a inexperiência dos alunos. Simulações clínicas e aproximação precoce com o tema representaram as intervenções que favorecem o desenvolvimento do conhecimento e de competências. Conclusão: A avaliação do conhecimento em segurança do paciente pode auxiliar no desenvolvimento de programas e ensino, bem como refletir diretamente na qualidade da assistência, surgindo, assim, a necessidade da criação, adaptação e validação de instrumentos de medida. (AU)

Objective: To analyze the scientific evidence related to the instruments used to evaluate nursing students' knowledge about patient safety. Methods: Integrative review performed in the electronic databases MEDLINE, CINAHL, WOS, LILACS and BDENF. The sample consisted of 11 primary studies, published between the years 2008 and 2017, in Portuguese, Spanish or English, and which answered the research question. Results: There studies were predominant cross-sectional, and in English. The synthesis of knowledge was divided into three categories: The use of measurement instruments to assess knowledge in patient safety; Interventions that contribute to learning about patient safety; Factors that limit learning about patient safety. Conclusion: The assessment of patient safety knowledge can assist in the development of programs and teaching, as well as directly reflect on the quality of care, thus arising the need for the creation, adaptation and validation of instruments measure. (AU)

Objetivo: Analizar las evidencias científicas relacionadas con los instrumentos utilizados para evaluar el conocimiento de estudiantes de enfermería sobre seguridad del paciente. Métodos: Revisión integrativa realizada en las bases electrónicas de datos MEDLINE, CINAHL, WOS, LILACS y BDENF. La muestra consistió en 11 estudios primarios publicados entre los años 2008 a 2017, en portugués, español o Inglés y que respondieron a la pregunta de investigación. Resultados: Hubo predominios de estudios transversales, en el idioma inglés. La síntesis del conocimiento se dividió en tres categorías: el uso de instrumentos de medida para la evaluación del conocimiento en seguridad del paciente; Intervenciones que contribuyen al aprendizaje sobre Seguridad del paciente; Factores que limitan el aprendizaje sobre seguridad del paciente. Conclusión: La evaluación de los conocimientos sobre seguridad del paciente puede ayudar en el desarrollo de programas y docencia, así como reflejar directamente la calidad de la atención, surgiendo así la necesidad de la creación, adaptación y validación de instrumentos la medida. (AU)

Authentic leadership in nurses' professional practice: an integrative review / El liderazgo auténtico en el ejercicio profesional del enfermero: una revisión integradora / A liderança autêntica no exercício profissional do enfermeiro: uma revisão integrativa

ABSTRACT Objectives: to identify the primary constructs concerning authentic leadership and its relevance for nurses' professional practice. Methods: integrative literature review conducted between 2015 and 2020 in LILACS, SciELO, and PubMed databases. Results: the United States published most of the 31 studies analyzed, with eight studies (25.8%), followed by Canada with seven studies (22.6%), and Brasil with five (16.1%). Most studies adopted a quantitative approach (77.41%), and 96.8% presented weak evidence. Three categories emerged: Work Engagement/Job Satisfaction and Organizational Commitment; Healthy Work Environment; and Intention to Quit the Job and Mental Exhaustion. Final Considerations: authentic leadership positively contributes to management and nursing care practice, promoting healthy work environments, structural empowerment, greater work engagement, and organizational commitment, decreasing absenteeism and mental exhaustion.

RESUMEN Objetivos: identificar los principales constructos adoptados sobre el liderazgo auténtico y su relevancia para la práctica profesional del enfermero. Métodos: revisión integradora de la literatura en el período de 2015 a 2020, en las bases de datos: LILACS, SciELO y PubMed. Resultados: de los 31 estudios analizados, los países que más publicaron fueron Estados Unidos, con 08 estudios (25,8%), Canadá con 07 (22,6 %) y Brasil con 05 (16,1%); hubo predominio de estudios de abordaje cuantitativo (77,41%) y 96,8% presentaron nivel de evidencia débil. Surgieron tres categorías para discusión: Compromiso/Satisfacción en el Trabajo y Comprometimiento organizacional; Ambiente de Trabajo Saludable; Intención de Salir del Empleo y Desgaste Mental. Consideraciones Finales: el liderazgo auténtico contribuye positivamente en la gestión y práctica del cuidado del enfermero, proporcionando ambientes de trabajo más saludables, empoderamiento estructural, mayor compromiso con el trabajo y comprometimiento organizacional, además de contribuir para la disminución de las tasas de ausentismo y desgaste mental.

RESUMO Objetivos: identificar os principais construtos adotados sobre a liderança autêntica e sua relevância para a prática profissional do enfermeiro. Métodos: revisão integrativa da literatura no período de 2015 a 2020, nas bases de dados: LILACS, SciELO e PubMed. Resultados: dos 31 estudos analisados, os países que mais publicaram foram Estados Unidos, com 8 estudos (25,8%), Canadá com 7 (22,6 %) e Brasil com 5 (16,1%); houve predomínio de estudos de abordagem quantitativa (77,41%), e 96,8% apresentaram nível de evidência fraca. Emergiram três categorias para discussão: Engajamento/Satisfação no trabalho e comprometimento organizacional; Ambiente de trabalho saudável; Intenção de sair do emprego e desgaste mental. Considerações Finais: a liderança autêntica contribui positivamente na gestão e na prática do cuidado do enfermeiro, proporcionando ambientes de trabalho mais saudáveis, empoderamento estrutural, maior engajamento no trabalho e comprometimento organizacional, além de contribuir para diminuição das taxas de absenteísmo e desgaste mental.

Support provided to nursing students in the face of patient safety incidents: a qualitative study / Soporte a los estudiantes de enfermería delante de incidentes de seguridad del paciente: investigación cualitativa / Suporte aos estudantes de enfermagem diante de incidentes de segurança do paciente: pesquisa qualitativa

ABSTRACT Objectives: to identify the support provided to nursing students after a patient safety incident. Methods: qualitative study developed with 23 students attending an undergraduate nursing program in southern Brazil. Data were collected between September and November 2021 and submitted to textual discursive analysis using the Iramuteq software. Results: the students reported that mainly classmates and professors of the practical courses provided support. The students showed no knowledge of organizational support or protocols available to students who become second victims of such incidents. Final Considerations: the primary support sources available to nursing students involved in patient safety incidents were identified. Note that support provided to nursing students is still incipient both in Brazil and internationally. Hence, further studies are needed to address potential victims and support resources to mitigate this phenomenon.

RESUMEN Objetivos: conocer el soporte ofrecido al estudiante de enfermería después de un incidente de seguridad del paciente. Métodos: investigación cualitativa, desarrollada en el curso de licenciatura de enfermería en el Sur de Brasil, con 23 estudiantes. Los datos fueron recolectados entre septiembre y noviembre de 2021 y sometidos al análisis textual discursivo, con la utilización del software Iramuteq. Resultados: los estudiantes relataron que recibieron apoyo principalmente de los compañeros y profesores de las materias del campo de práctica; también, ellos demostraron no conocer ningún tipo de soporte organizacional, protocolo o apoyo cuando son por segunda vez víctimas de esos incidentes. Consideraciones Finales: se identificaron las principales fuentes de apoyo, cuando el estudiante de enfermería se envuelve en incidentes de seguridad del paciente. Se destaca la insipiencia de los recursos de soporte ofrecidos al estudiante de enfermería, tanto en el ámbito nacional como internacional; así, es necesario realizar más investigaciones dirigidas a esas potenciales víctimas e proporcionar recursos de soporte para mitigar ese fenómeno.

RESUMO Objetivos: conhecer o suporte ofertado ao estudante de enfermagem após um incidente de segurança do paciente. Métodos: pesquisa qualitativa, desenvolvida com 23 estudantes de um curso de bacharelado de enfermagem do Sul do Brasil. Os dados foram coletados entre setembro e novembro de 2021 e submetidos à análise textual discursiva, com a utilização do software Iramuteq. Resultados: os estudantes relataram que receberam apoio principalmente dos colegas e professores das disciplinas do campo de prática, mas demonstraram desconhecer qualquer tipo de suporte organizacional, protocolo ou apoio quando se encontram na condição de segunda vítima desses incidentes. Considerações Finais: foram identificadas as principais fontes de apoio quando o estudante de enfermagem se envolve em incidentes de segurança do paciente. Destaca-se a incipiência dos recursos de suporte oferecidos a esse estudante, tanto nacional como internacionalmente, sendo prementes mais pesquisas direcionadas a essas potenciais vítimas, bem como recursos de suporte para mitigar esse fenômeno.