Moral distress and moral resilience of nurse managers.

BACKGROUND: Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience. AIM: The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil. RESEARCH DESIGN: The research design is the qualitative study with discursive textual analysis. PARTICIPANTS AND RESEARCH CONTEXT: : 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions. ETHICAL CONSIDERATIONS: The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity. FINDINGS: Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation. CONCLUSION: From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.

Low back pain self-management mobile applications: a systematic review on digital platforms.

OBJECTIVE: To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults. METHOD: A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality. RESULTS: Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale. CONCLUSION: Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.

[Hospitalization by court order: ethical dilemmas experienced by nurses]. / Internação por ordem judicial: dilemas éticos vivenciados por enfermeiros.

A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed following the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation.

Digital self-care in the management of spine musculoskeletal disorders: A systematic review and meta-analysis. / Autocuidado digital en el manejo de los trastornos musculoesqueléticos de columna: revisión sistemática y metanálisis.

to analyze the effectiveness of digital self-care in the management of pain and functional disability among people with spine musculoskeletal disorders. a systematic literature review, developed with the PRISMA checklist, of randomized clinical trials of people with spine musculoskeletal disorders and digital interventions accessed by means of computers, smartphones or other portable devices. Databases researched: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cumulative Index to Nursing and Allied Health Literature and Physiotherapy Evidence Database. The descriptive synthesis of the results and by means of meta-analyses (fixed-effects model) was performed with the Review Manager software. The methodological quality was evaluated with the Physiotherapy Evidence Database scale. a total of 25 trials were selected (5,142 participants), which showed statistically significant improvements (p <0.05) in 54% (12/22) in the pain levels and 47% (10/21) in functional disability in the Intervention Group. The meta-analyses showed moderate effects on pain intensity and small effects on functional disability. There was a predominance of medium quality studies. the digital care interventions showed a beneficial result in pain intensity and in functional disability, mainly for chronic low back pain. Digital care emerges as promising to support self-management of the spine musculoskeletal conditions. PROSPERO registry number CRD42021282102.

analizar la efectividad del autocuidado digital en el manejo del dolor y la discapacidad funcional en personas con trastornos musculoesqueléticos espinales. revisión sistemática de la literatura, desarrollada con la checklist PRISMA, de ensayos clínicos aleatorizados sobre personas con trastornos musculoesqueléticos de columna e intervenciones digitales a las que se accede por computadora, smartphones u otro dispositivo portátil. Bases de datos consultadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature y Physiotherapy Evidence Database. Síntesis de resultados descriptiva y por metanálisis (modelo de efectos fijos) realizada con el software Review Manager. Calidad metodológica evaluada mediante la escala Physiotherapy Evidence Database. se seleccionaron 25 ensayos (5142 participantes) que mostraron mejoras estadísticamente significativas (p<0,05) del 54% (12/22) en los niveles de dolor y del 47% (10/21) en la discapacidad funcional en el grupo intervención. Los metanálisis mostraron efectos moderados sobre la intensidad del dolor y efectos pequeños sobre la discapacidad funcional. Predominaron los estudios de calidad media. las intervenciones de atención digital demostraron resultados beneficiosos para la intensidad del dolor y la discapacidad funcional, principalmente para el dolor lumbar crónico. Se ha demostrado que la atención digital es promisoria para favorecer el automanejo de las afecciones musculoesqueléticas de columna. Registro PROSPERO CRD42021282102.

(1) Las intervenciones digitales no fueron inferiores a la atención presencial. (2) La atención digital es promisoria para contribuir al automanejo. (3) Es necesario estandarizar el informe de resultados de los ensayos clínicos. (4) Faltan estudios de mayor calidad. (5) Examinar las estrategias que contribuyen a la aceptación y adherencia del usuario.

analisar a efetividade do autocuidado digital no manejo da dor e incapacidade funcional em pessoas com distúrbios musculoesqueléticos de coluna. revisão sistemática da literatura, desenvolvida com o checklist PRISMA, de ensaios clínicos randomizados de pessoas com distúrbios musculoesqueléticos de coluna e intervenções digitais acessadas por computador, smartphones ou outro dispositivo portátil. Bases pesquisadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature e Physiotherapy Evidence Database. Síntese dos resultados descritiva e por metanálises (modelo de efeitos fixos) com o software Review Manager. Qualidade metodológica avaliada pela escala Physiotherapy Evidence Database. selecionaram-se 25 ensaios (5142 participantes) que revelaram melhoras estatisticamente significativas (p<0,05) em 54% (12/22) nos níveis de dor e 47% (10/21) na incapacidade funcional no grupo intervenção. As metanálises mostraram efeitos moderados na intensidade da dor e pequenos na incapacidade funcional. Houve predominância de estudos de média qualidade. intervenções de cuidados digitais mostraram resultado benéfico na intensidade da dor e na incapacidade funcional principalmente para dor lombar crônica. Evidenciam-se os cuidados digitais como promissores para apoiar o autogerenciamento das condições musculoesqueléticas de coluna. Registro PROSPERO CRD42021282102.

Intensity and frequency of moral distress in mental health nurses in Brazil.

OBJECTIVE: To assess the intensity and frequency of moral distress in mental health nurses in Brazil. METHOD: Cross-sectional study with 173 nurses from the Psychosocial Care Network in Brazil. The Brazilian Scale of Moral Distress in Nurses, adapted for the context of mental health, was used. For data processing, descriptive and inferential statistical analysis was used. RESULTS: Mostly moderate levels of intensity and frequency of moral distress (medians between 2.25 - 3.73 and 2.00 - 3.22, respectively) were observed, with emphasis on the factors working conditions and social conflicts. CONCLUSION: The level of moral distress evidenced in mental health nurses in Brazil reflects the dimension and amplitude of the phenomenon in different points of the Psychosocial Care Network. The relevance of discussions on coping strategies for moral distress is highlighted, articulating elements such as sensitivity, resilience, and moral courage, so that ethical deliberation is applied in care and management settings.

Ethical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic.

OBJECTIVES: to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic. METHODS: qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants. RESULTS: the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice. CONCLUSIONS: nurses' work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.

Adaptation and Validation of a Moral Distress Instrument in Mental Health Nurses.

Background and Purpose: To adapt and validate the Brazilian Scale of Moral Distress in Nurses for the mental health field. Methods: A cross-sectional methodological study was carried out, adapted with the contribution of 34 specialists, and validated by 173 mental health nurses. Results: The validated scale consists of 37 items divided into seven factors, and they were responsible for 77.2% of variance-working conditions, advocacy for the values and rights, professional safety and autonomy, ethical violations, social conflicts, ethical-professional competence, and conflicts with the management, with Cronbach's alpha at .972 for the entire instrument, and ranging from .852 to .949 for the constructs. Conclusion: The results provide evidence that the adapted instrument is reliable, valid, and consistent in measuring moral distress in mental health nurses.

Development of the Patient Advocacy Scale for Intensive Care Nurses.

Background and Purpose: To describe the process of developing and validating the content of the Patient Advocacy Scale for Nurses in Intensive Care (EAPEnf-UTI). Methods: Methodological research. To achieve the elaboration objective, five stages were developed: (a) definition of the theme, (b) generation of the number of items, (c) determination of the measurement format, (d) validation of face and content, and (e) content adjustment. Results: The instrument elaborated from a survey and integrative literature review, and the measurement format chosen was the 5-point Likert scale. The validation of face and content was performed by expert judges and by pretest. The final instrument had 57 items. Conclusion: EAPEnf-UTI is a pioneering instrument built in the Brazilian context, whose future validation will allow the capturing of situations specific to intensive care units and the professional practice of intensive care nurses.

Moral deliberation and nursing ethics cases: elements of a methodological proposal.

A qualitative study with an exploratory, descriptive and documentary design that was conducted with the objective of identifying the elements to constitute a method for the analysis of accusations of and proceedings for professional ethics infringements. The method is based on underlying elements identified inductively during analysis of professional ethics hearings judged by and filed in the archives of the Regional Nursing Board of Santa Catarina, Brazil, between 1999 and 2007. The strategies developed were based on the results of an analysis of the findings of fact (occurrences/infractions, causes and outcomes) contained in the records of 128 professional ethics hearings and on the structural elements (statements, rules and practices) identified in five example professional ethics cases. The strategies suggested for evaluating accusations of ethics infringements and the procedures involved in deliberating on ethics hearings constitute a generic proposal that will require adaptation to the context of specific professional ethics accusations.

Self-reported violence by nursing students in the context of undergraduate studies.

OBJECTIVES: to identify the characteristics of violence in the context of the teaching and learning of the undergraduate Nursing course, from the perspective of students. METHODS: quantitative, cross-sectional study, developed with 208 undergraduate students in Nursing. The data was obtained through the application of a survey questionnaire and processed by descriptive and bivariate statistics. RESULTS: of the participants, 69.2% (n = 144) have experienced some kind of violence. Violent acts of a psychological nature were the most frequent, but there were also reports of physical, sexual violence and deprivation or abandonment. Violence was practiced in a theoretical and practical learning environment. Teachers and classmates were the most frequent perpetrators. Most students had no reaction, told friends, family, and colleagues, or pretended that nothing happened in the face of the violent acts. CONCLUSIONS: violence is present at various moments in the undergraduate Nursing course and can negatively impact the quality of training in the area.

Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective.

OBJECTIVE: to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of "angels and heroes" given by society during the pandemic of COVID-19. METHODS: a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault. RESULTS: they were organized into two thematic categories: "Angels and heroes? The (not) heroic reality of nursing during the pandemic" and "The search for recognition of the professional work of nursing: between what is said and what is not said". FINAL CONSIDERATIONS: the nurses' speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.

[Formation of masters in nursing at the Universidade Federal de Santa Catarina: contributions under post graduates' view]. / Formação de mestres em enfermagem na Universidade Federal de Santa Catarina: contribuições sob a ótica de egressos.

The objective of the study is to know the perceptions of graduates of the Masters Course in Nursing at the Universidade Federal de Santa Catarina with its contributions on formation as regards to professional work. That was a study of qualitative approach, using a questionnaire applied to the egresses of master degree program (last 5 years), totaling 88 informants. Analysis presented elements of the graduates lent in relation to the general evaluation of the course, as related to the same contributions for change at work and the medium evaluation of its objectives. The masters degree program shows a space and the valorization of construction and consolidation of an innovative knowledge that can faces challenges that might occur to a new configuration of making health daily.

Intensity and frequency of moral distress in Brazilian nurses.

OBJECTIVE: To evaluate the frequency and intensity of moral distress in Brazilian nurses. METHOD: Cross-sectional study performed with nurses from 27 Brazilian states through application of the Brazilian Moral Distress Scale in Nurses (Portuguese acronym: EDME-Br) and descriptive statistical analysis. RESULTS: Participation of 1,226 Brazilian nurses in the study. The intensity and frequency of overall moral distress were rated as moderate level, with averages of 3.08 (± 1.45) and 2.94 (± 1.37), respectively. Specifically, the highest intensity and frequency was related to the factors Acknowledgement, power and professional identity and Work teams, while the lowest was related to the factor Defense of values and rights. CONCLUSION: Moral distress occurs in precarious work environments, with little expressiveness of the nurses' role. One highlights the importance of the problem in terms of its amplitude and multicausality, reaching professionals acting in different work contexts.

Association between moral distress and supporting elements of moral deliberation in nurses.

OBJECTIVE: to identify the association between moral distress and the supporting elements of moral deliberation in Brazilian nurses. METHOD: a cross-sectional study conducted with Brazilian nurses working in health services at different complexity levels. The research protocol consisted of the Brazilian Scale of Moral Distress in Nurses, a sociodemographic and labor questionnaire, and a list of bases and ethical elements used for moral deliberation. For analysis, descriptive statistics, chi-square test, and Poisson regression were used. RESULTS: 1,226 nurses took part in the study. The 12 elements associated with the moral deliberation process were classified as important for nurses' actions, especially the professional experience acquired, code of ethics/law of professional practice, and ethical and bioethical principles. The relationship of moral distress showed higher prevalence in the Beliefs, culture and values of the patient, Beliefs and personal values, and Intuition and Subjectivity elements. CONCLUSION: the results showed a balance between the subjective criteria of professional experience and the objective ones of deontology for moral deliberation.

[Nursing care systematization at the intensive care unit (ICU) based on Wanda Horta's theory]. / Sistematização da assistência de enfermagem em unidade de terapia intensiva sustentada pela teoria de Wanda Horta.

The purpose of this study was to implement the Nursing Care Systematization--Sistematização da Assistência de Enfermagem (SAE)--with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA) Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.

Non-specific low back pain and its relation to the nursing work process. / Dor lombar inespecífica e sua relação com o processo de trabalho de enfermagem.

OBJECTIVE: to relate nonspecific low back pain within the nursing work context with their workloads, attrition processes and the risks of illness. METHOD: a cross-sectional study with 301 workers from a general hospital in the south of the country. The Nordic Musculoskeletal Questionnaire and the Work Context Assessment Scale composed of three dimensions were used: working conditions, work organization and socio-professional relations. The association of variables with low back pain was tested using bivariate and multivariate analyzes. The measure of association used was the Odds Ratio and its respective intervals with 95% confidence. The data collected were discussed under the theoretical framework of the work process within the marxist conception and the theory of social determination of the health-disease process. RESULTS: there was a statistically significant association between the dimensions of work organization and working conditions with low back pain and they obtained a critical classification meaning moderate risks to the professional illness. CONCLUSION: the study allowed a better understanding of the nursing work process and its relation with nonspecific low back pain and signaled that changes in the organization and working conditions should occur in order to reduce the risks of nursing workers' illness.

Profile of blood donors who presented adverse reactions to the donation.

OBJECTIVE: identify the adverse reactions presented by blood donors and outline their sociodemographic profile. METHOD: a quantitative, cross-sectional retrospective study of 780 records of blood donors from a public hemocenter in the southern region of Brazil, from December 2015 to January 2016. For the analysis the descriptive statistics was used. RESULTS: it was identified that throughout 12 months, the total blood donors corresponded to 27,300 people, in which 780 developed at least one reaction. They were characterized by female and recurrent donors, single, with a complete average level of education, ranging from 16 to 30 years, who triggered between 1 and 3 reactions. Mild reactions were more frequent, followed by moderate and severe reactions. CONCLUSION: There is a high rate of adverse reactions from donors emphasizing the need for changes in hemotherapy care practices.

Low back pain self-management mobile applications: a systematic review on digital platforms / Aplicaciones móviles para el autocontrol del dolor lumbar: revisión sistemática en plataformas digitales / Aplicativos móveis de autogerenciamento da dor lombar: revisão sistemática em plataformas digitais

ABSTRACT Objective: To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults. Method: A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality. Results: Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale. Conclusion: Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.

RESUMEN Objetivo: Identificar y analizar las características y la calidad del soporte de autogestión de aplicaciones móviles disponibles en Brasil para el dolor lumbar crónico en adultos. Método: Revisión sistemática en las plataformas digitales Apple Store® y Google Play®. Se utilizó la escala Self-Management Support Assessment Tool para evaluar el apoyo a la autogestión y la escala Institute for Healthcare Informatics Functionality Score para evaluar la funcionalidad. Resultados: Se seleccionaron 17 aplicaciones, que incluían alrededor de siete habilidades de autogestión. Las aplicaciones que cumplieron con la mayoría de las habilidades de apoyo a la autogestión fueron Pathways, Branch, Pancea, Pain Navigator y Curable. Las aplicaciones Curable, Branch y MoovButh obtuvieron las puntuaciones más altas, con diez características en la escala de funcionalidad. Conclusión: Algunas aplicaciones tienen potencial para complementar el tratamiento presencial en términos de validez, aceptabilidad y utilidad clínica en el manejo del dolor. Sin embargo, barreras como la falta de asociación entre los profesionales de la salud y los pacientes, el contenido limitado basado en evidencia, el apoyo social, la relevancia cultural, el costo, el idioma, la seguridad y la privacidad pueden limitar su uso sostenido. Registro PROSPERO: CRD42022382686.

RESUMO Objetivo: Identificar e analisar os recursos e a qualidade do suporte de autogerenciamento dos aplicativos móveis disponíveis no Brasil para dor lombar crônica em adultos. Método: Revisão sistemática nas plataformas digitais Apple Store® e Google Play®. Utilizaram-se a escala Self-Management Support Assessment Tool para avaliar o suporte ao autogerenciamento e a escala Institute for Healthcare Informatics Functionality Score para avaliar a funcionalidade. Resultados: Foram selecionados 17 aplicativos, que incluíram cerca de sete habilidades de autogerenciamento. Os aplicativos que atendiam à maioria das habilidades de suporte ao autogerenciamento foram Pathways, Branch, Pancea, Pain Navigator e Curable. Os aplicativos Curable, Branch e MoovButh apresentaram as maiores pontuações, com dez funcionalidades na escala de funcionalidade. Conclusão: Alguns aplicativos têm potencial para complementar o tratamento presencial em termos de validade, aceitabilidade e utilidade clínica no manejo da dor. No entanto, barreiras como falta de parceria entre profissionais de saúde e pacientes, conteúdo limitado baseado em evidências, apoio social, relevância cultural, custo, idioma, segurança e privacidade podem limitar o seu uso sustentado. Registro PROSPERO: CRD42022382686.

The perception of people with physical disabilities about exercising autonomy in a federal university / La percepción de personas con discapacidades físicas con respecto al ejercicio de la autonomía en una universidad federal / Percepção de pessoas com deficiência física acerca do exercício da autonomia em uma universidade federal

ABSTRACT Introduction: preconceptions towards people with disabilities are still present in our society; they arise from ancient behaviors and from the biomedical model, both rooted in human attitudes. Objective: to describe the potentialities/strengths and inabilities/weaknesses faced by people with disabilities to exercise their autonomy and to show the ways in which people with disabilities exercise their autonomy. Method: this is a single-case study with a qualitative approach. Twenty-two individuals with physical disabilities were interviewed, with students and employees from a university in southern Brazil among them. Data analysis was performed by means of the Collective Subject Discourse The comprehensive and interpretive analysis of the meanings that emerged from the participants' statements were associated with the theoretical framework of autonomy by Adela Cortina, Diego Gracia and Lawrence Kohlberg. Results: potentialities/weaknesses can be observed in the exchange spaces and in the information provided by the university. At the same time, inability/weakness is perceived in preconception, welfarism and all the ableism faced by people with disabilities. Conclusions: lack of information is one of the main elements that foster preconception and it is essential to fight against it for the inclusion of people with disabilities.

RESUMEN Introducción: en nuestra sociedad, todavía pueden encontrarse preconceptos con respecto a las personas con discapacidades que derivan de comportamientos de la antigüedad y del modelo biomédico y que están arraigados en las actitudes humanas. Objetivo: describir las potencialidades/fortalezas y las inhabilidades/debilidades afrontadas por las personas con discapacidades para ejercer su autonomía y demonstrar las formas en las que pueden hacerlo. Método: estudio de caso único y con enfoque cualitativo. Se entrevistó a un total de 22 personas con discapacidades, entre ellas, alumnos y empleados de una universidad del sur de Brasil. El análisis de los datos se realizó por medio del Discurso del Sujeto Colectivo. El análisis integral e interpretativo de los significados que emergieron de los testimonios de los participantes se asoció al referencial teórico de autonomía de Adela Cortina, Diego Gracia y Lawrence Kohlberg. Resultados: pueden observarse potencialidades/fortalezas en los espacios de intercambio y en la información que proporciona la Universidad. A la vez que la inhabilidad/debilidad se percibe en el preconcepto, el asistencialismo y en la totalidad del capacitismo al que hacen frente las personas con discapacidades. Conclusiones: la falta de información es uno de los principales elementos que fomentan el preconcepto y es esencial combatirla para la efectiva inclusión de las personas con discapacidades.

RESUMO Introdução: preconceitos com a pessoa com deficiência ainda estão presentes em nossa sociedade, esses são advindos de condutas da antiguidade e do modelo biomédico que estão arraigados nas atitudes humanas. Objetivo: descrever as potencialidades/fortalezas e inabilidades/fragilidades enfrentadas pelas pessoas com deficiência para o exercício da sua autonomia e demonstrar os modos pelos quais as pessoas com deficiência exercem a sua autonomia. Método: trata-se de um estudo de caso único e de abordagem qualitativa. Foram entrevistadas vinte e duas pessoas com deficiência física, dentre elas, alunos e servidores de uma universidade do Sul do Brasil. A análise de dados foi realizada por meio do Discurso do Sujeito Coletivo. A análise compreensiva e interpretativa dos significados emergidos das falas dos participantes foram associadas ao referencial teórico da autonomia de Adela Cortina, Diego Gracia e Lawrence Kohlberg. Resultados: as potencialidades/fortalezas podem ser observadas nos espaços de trocas e informação proporcionados pela universidade. Ao mesmo tempo que a inabilidade/fragilidade é percebida no preconceito, assistencialismo e todo o capacitismo enfrentado pelas pessoas com deficiência. Conclusão: a falta de informação é um dos principais fomentadores do preconceito e combatê-lo é essencial para a inclusão das pessoas com deficiência.

Validation of the Brazilian Moral Distress Scale in Nurses.

BACKGROUND AND PURPOSE: To determine the psychometric properties of the Brazilian Moral Distress Scale in Nurses (MDSN-BR). DESIGN: In this methodological, cross-sectional study, the criterion, content, and construct validation stages were presented. METHOD: A 57-item questionnaire was applied to 1,227 brazilian nurses through an online form. The exploratory factor analyses revealed significant conceptual relations among its items in six constructs, expressing the consistency of the scale. RESULTS: The validated version of the instrument consists of six constructs and 49 items-Cronbach's alpha .980 (instrument) and of constructs: (a) (.942) Acknowledgment, power, and professional identity; (b) (.961) Safe and qualified care; (c) (.924) Defense of values and rights; (d) (.944) Work conditions; (e) (.933) Ethical infractions; (f) (.914) Work teams. CONCLUSION: The results provide evidence supporting the reliability and trustworthiness of the scale in the selected population.