Relação enfermeiro-pessoa afetada pela Tuberculose fundamentada na teoria do alcance de metas de imogene king / La relación enfermería-Persona afectada por la Tuberculosis, según la Teoría del logro de objetivos de imogene king / The nurse-tuberculosis patient relationship according to Imogene King's theory of goal achievement

Resumo Introdução: As ações desenvolvidas na Atenção Primária à Saúde são um dos pontos fortes de combate à tuberculose. Nesse nível de atenção, o contato contínuo do enfermeiro por meio da consulta de enfermagem permite manter relação com a população adoecida. Diante da relação enfermeiro-pessoa cuidada para o estabelecimento do vínculo e adesão ao tratamento contra tuberculose, compreende-se a importância do referencial teórico de Imogene King para estruturar a interação enfermeiro-pessoa cuidada e oferecer uma dinâmica para esse processo. Objetivo: Analisar a relação enfermeiro-pessoa afetada pela tuberculose fundamentada na Teoria do Alcance de Metas de Imogene King. Método: Estudo descritivo com abordagem qualitativa, com 14 enfermeiros da APS, selecionadas por conveniência. A coleta de dados ocorreu de agosto a novembro de 2018, por meio de entrevista semiestruturada, elaborada com base no Registro Meta-Orientado de Enfermagem de Imogene King. Os dados foram analisados de forme qualitativa pelo Software IRAMUTEQ. A pesquisa foi aprovada pelo Comitê de Ética. Resultados: Após a análise, emergiram quatro classes: 1) relação estabelecida com base no acolhimento; 2) relação enfermeiro-pessoa com tuberculose e o apoio de outros profissionais e familiares; 3) relação estabelecida com vistas ao cumprimento do tratamento; e 4) relação estabelecida para enfrentamento do preconceito diante da tuberculose. Conclusão: O acolhimento, a família e o vínculo entre profissional, paciente e equipe da Atenção Primária à Saúde fortalecem o enfrentamento da doença e reforçam a adesão ao tratamento medicamentoso.

Resumen Introducción: Uno de los puntos fuertes de la lucha contra la tuberculosis son las acciones desarrolladas en la atención primaria de salud. En este nivel asistencial, el contacto continuo de las enfermerías a través de la consulta de enfermería permite mantener una relación con la población enferma. Frente a la relación enfermería-persona para el establecimiento del vínculo y la adherencia al tratamiento contra la tuberculosis, se entiende la importancia del referente teórico de Imogene King para estructurar la interacción enfermería-persona y ofrecer una dinámica para este proceso. Objetivo: Análisis de la relación entre el personal de enfermería y las personas afectadas por la tuberculosis, a partir de la teoría del logro de objetivos de Imogene King. Método: Estudio descriptivo con abordaje cualitativo, con 14 enfermeras de atención primaria de salud, seleccionadas por conveniencia. La recolección de datos ocurrió de agosto a noviembre de 2018, a través de una entrevista semiestructurada, elaborada con base en el registro meta-orientado de enfermería de Imogene King. Los datos fueron analizados cualitativamente utilizando el software IRAMUTEQ. La investigación fue aprobada por el Comité de Ética. Resultados: Después del análisis, surgieron cuatro clases: 1) relación establecida con base en la recepción, 2) relación enfermería-persona con tuberculosis y apoyo de otras personas profesionales y familiares, 3) relación establecida con miras al cumplimiento del tratamiento y 4) relación establecida para combatir los prejuicios contra la tuberculosis. Conclusión: La acogida, la familia y el vínculo entre profesional, paciente y equipo de atención primaria de salud fortalecen el afrontamiento de la enfermedad y refuerzan la adherencia al tratamiento farmacológico.

Abstract Introduction: One of the main aspects in the fight against tuberculosis are the actions developed in Primary Health Care (PHC). At this level of care, the nurse's continuous contact through the nursing consultation allows them to maintain a relationship with the sick population. Regarding the nurse-patient relationship for establishing a bond and the compliance with tuberculosis treatment, we understand the importance of Imogene King's theoretical framework for structuring the nurse-patient interaction and offering a dynamic for this process. Objective: To analyze the nurse-tuberculosis patient relationship based on Imogene King's Theory of Goal Achievement. Method: A descriptive study with a qualitative approach, with 14 PHC nurses, selected by convenience. Data were collected from August to November 2018 through semi-structured interviews based on Imogene King's Meta-Oriented Nursing Record. The data were analyzed qualitatively using the IRAMUTEQ software. The research was approved by the Ethics Committee. Results: After the analysis, four classes emerged: 1) relationship established on the basis of welcoming; 2) nurse-tuberculosis patient relationship and the support of other professionals and family members; 3) relationship established towards treatment compliance; and 4) relationship established to confront prejudice associated with tuberculosis. Conclusion: The welcoming, the family, and the bond between the professional, the patient and Primary Health Care team strengthen the coping with the disease and reinforce the compliance with the pharmacological treatment.

[The added value of a patient pathway nurse coordinator in prehabilitation and rehabilitation in surgery]. / La plus-value d'un infirmier coordinateur de parcours patient dans la préhabilitation et la réhabilitation en chirurgie.

The nurse coordinator works within a healthcare network to ensure the continuity and quality of the care provided to patients. They act as the interface between medical, paramedical and social care. In some departments, they coordinate the surgical prehabilitation and enhanced rehabilitation program, which aims to optimize the physical, nutritional and psychological state of each patient prior to major surgery. Knowing how to guide patients and their families, advise them and re-explain the medical prescription for discharge sheds light on their situation and reassures them, while enabling them to plan their discharge.

Nurse-to-patient ratios and readiness for hospital discharge: A moderated mediation model.

AIM: To explore whether and to what extent, nurse-patient assessment differences mediate the association between nurse-to-patient ratios and readiness for hospital discharge, and examine whether nurse-patient characteristics moderate the indirect and/or direct effect of mediation model. DESIGN: A cross-sectional study was carried out from March 2021 to December 2022. METHODS: A total of 523 pairs of gastrointestinal cancer patients with PICC and their nurses were recruited. All the participants were invited to complete the general information questionnaire and the Readiness for Hospital Discharge Scale. Outcome measure was patient-reported readiness for hospital discharge. This study was reported according to the STROBE checklist. RESULTS: The patients reported a low level of readiness for hospital discharge. Nurse-patient assessment differences were positively associated with nurse-to-patient ratios but negatively associated with readiness for hospital discharge. Furthermore, nurse-patient assessment differences fully mediated the effect of nurse-to-patient ratios on readiness for hospital discharge, and age and gender of patients only moderated the indirect path of mediation model.

Estrategias de comunicación enfermero-paciente: propuesta de un video educativo para estudiantes de enfermería / Nurse-patient communication strategies: A proposal of an educational video for Nursing students / Estratégias de comunicação enfermeiro-paciente: proposta de um vídeo educativo para estudantes de enfermagem

Objetivo: elaborar, validar y evaluar un video educativo sobre estrategias de comunicación enfermero-paciente para estudiantes de la carrera de enfermería. Método: se trata de un estudio metodológico, con diseño longitudinal y análisis cuantitativo. El público objetivo cumplió las etapas de preproducción, producción, postproducción y evaluación del video. Resultados: cinco enfermeras evaluaron el storyboard del video y consideraron que la comprensión del tema, los tópicos abordados y el lenguaje utilizado eran apropiados y relevantes para el tema. Otras cinco enfermeras consideraron que la calidad de la técnica audiovisual utilizada, el ambiente simulado, la caracterización de los personajes y el desarrollo de las estrategias de comunicación enfermero-paciente estaban presentes y eran adecuados. La versión final del video fue evaluada por nueve estudiantes de enfermería que tuvieron un nivel de comprensión de los ítems igual o superior al 96%. El video presenta las siguientes estrategias: Estrategias Generales de Comunicación, Comunicación Intercultural, NURSE, Tell me more, Ask-Tell-Ask, Comunicación Terapéutica y Comunicación de Malas Noticias. Conclusión: este estudio describe la creación de un video, la validación que realizaron del mismo los expertos y la evaluación del público objetivo, quienes consideraron que es un recurso educativo importante para el proceso de enseñanza-aprendizaje de las estrategias de comunicación. Los jueces y el público objetivo consideraron que el video era un instrumento válido para enseñar las estrategias de comunicación enfermero-paciente.

Objective: to create, validate and evaluate an educational video on nurse-patient communication strategies for undergraduate Nursing students. Method: this is a methodological study with a longitudinal design and quantitative analysis. The following stages were conducted: pre-production, production, post-production and evaluation of the video by the target population. Results: five female nurses evaluated the video storyboard and indicated understanding of the subject matter, the topics addressed and the language used as adequate and pertinent to the theme. Another five female nurses considered the following as present and desirable elements: quality of the audiovisual technique employed, simulated environment, characterization of the characters, and development of the nurse-patient communication strategies The final version of the video was evaluated by nine Nursing students that presented a level of item understanding of at least 96%. The video presents the following strategies: General communication strategies, Intercultural Communication, NURSE, Tell me more, Ask-Tell-Ask, Therapeutic Communication and Communicating Bad News. Conclusion: this study portrays the creation of a video, its validation by experts and its evaluation by the target population, which indicated it as a relevant educational resource for the teaching-learning process regarding communication strategies. Both the evaluators and the target population considered that the video is a valid instrument to teach content about the nurse-patient communication strategies.

Objetivo: construir, validar e avaliar um vídeo educativo sobre estratégias de comunicação enfermeiro-paciente para estudantes da graduação em enfermagem. Método: trata-se de um estudo metodológico, com delineamento longitudinal e análise quantitativa. Foram percorridas as etapas de pré-produção, produção, pós-produção e avaliação do vídeo pelo público-alvo. Resultados: cinco enfermeiras avaliaram o storyboard do vídeo e apontaram a compreensão do tema, os tópicos abordados e a linguagem utilizada como adequadas e pertinentes à temática. Outras cinco enfermeiras consideraram presentes e desejáveis: qualidade da técnica audiovisual empregada, ambiente simulado, caracterização das personagens e desenvolvimento das estratégias de comunicação enfermeiro-paciente. A versão final do vídeo foi avaliada por nove estudantes de enfermagem que apresentaram nível de compreensão dos itens igual ou acima de 96%. O vídeo apresenta as seguintes estratégias: Estratégias gerais de comunicação, Comunicação Intercultural, NURSE, Tell me more, Ask-Tell-Ask, Comunicação Terapêutica e Comunicação de Más Notícias. Conclusão: este estudo retrata a criação de um vídeo, sua validação por peritos e sua avaliação pelo público-alvo, que manifestaram tratar-se de um recurso educativo relevante para o processo de ensino-aprendizagem de estratégias de comunicação. Os juízes e o público alvo consideraram o vídeo como um instrumento válido para ensinar sobre as estratégias de comunicação enfermeiro-paciente.

"Daring to deal with the difficult and unexpected" registered nurses' confidential conversations with patients with palliative care needs: a qualitative interview study.

BACKGROUND: In palliative care, registered nurses provide advanced nursing care to relieve patients' symptoms and increase their quality of life based on physical, mental, social and existential dimensions. Conversations, often about existential issues, are an important part of nursing and can affect quality of life positively. Confidential conversations between patients and nurses occur naturally while other nursing activities are being performed. Despite their great importance for palliative care these are rarely described. AIM: To gain a deeper understanding of how nurses in palliative care experience and describe confidential conversations with patients. METHOD: Secondary analysis of data from 17 open-ended face-to-face interviews with registered nurses in palliative care was conducted. Qualitative content analysis using an inductive approach was used to gain a deeper understanding and analyse the latent content. RESULTS: The confidential conversation was considered an important part of palliative care and is the nurse's responsibility. This responsibility was described as complex and placed various demands on the nurses, both personal and professional. A prerequisite for the conversation was the interpersonal relationship. The conversation allowed the patient to process important matters not previously addressed or put into words. It had no predetermined content, was unplanned and entirely on the patient's terms. For nurses the conversation could be experienced both as draining and a source of power and strength. The nurses also described safeguarding the patient through the conversation. CONCLUSION: Nurses' confidential conversations with patients are essential in palliative care and must be highlighted more to increase the quality of palliative care. The confidential conversations often have an existential content and are challenging for the nurses. Therefore, nurses need time, knowledge, and supervision to increase their conversation skills.

Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework.

AIMS: To test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results. DESIGN: A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework. METHODS AND DATA SOURCES: A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence. RESULTS: The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions. CONCLUSIONS: The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: What Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient-nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain. REPORTING METHOD: Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.

The effect of the training of presence in care (TPinCare) on the care-oriented patient-nurse interaction and the caring behaviors of nurses working with oncology patients: A randomized controlled trial.

AIM: The aim of this study is to investigate the effects of "The Training of Presence in Care-TPinCare" of nurses working with oncology patients on care-oriented patient-nurse interaction and caring behaviors. BACKGROUND: Helping the individual to realize, protect and maintain his/her existence can be considered as the basis of "good nursing care". Presence is a way of care for the nurse and patient that fosters human-to-human bonding and deep contact experience and healing. DESIGN: This is a randomized controlled study. METHOD: Data were collected between January 2019 and May 2019. The sample selection consisted of 52 nurses working with oncology patients, 26 interventions and 26 controls in accordance with the criteria of inclusion, exclusion and exemption by randominization and blinding. The data were collected by using the "Nurses Introductory Features Form", "Caring Behaviors Scale - 24 " and "Caring Nurse-Patient Interaction Scale". The training was applied to nurses in the intervention group. In data analysis used SAS 9,4 program; statistically Mean score, t test, Repeated Measures ANOVA. In the context of these effect sizes, the power of the study was calculated to be 0.99 for each scale. This study was conducted in line with the principles of the Declaration of Helsinki. RESULTS: According to the control group of nurses in the intervention group, there were no statistically significant differences in the mean scores of caring behaviors at different measurement times. A statistically significant difference was found in favor of the intervention group for caring nursing patient interaction general, sub-dimensions of "importance", "competence" and "practicality", in nursing interventions (p < 0.05). Although the pretest mean scores of the nurses in the intervention group were lower compared with the control group, it was found that the posttest mean scores increased and the level of follow-up was maintained by a little increasing or decreasing. It was determined that there was no significant change in the posttest and follow-up scores of the nurses in the control group according to the pre-test mean scores. CONCLUSIONS: This study showed that TPinCare has a positive effect on nurses working with oncology patients with respect to care quality perception and viewing "importance", "competence" and "practicality", of attitude and behaviours related to care-focused patient nurse interactions. In this context, it can be suggested to continue the trainings which will contribute to caring behaviors and patient-nurse interactions of nurses and to support them with institutional contribution.

Percepción de autoeficacia para brindar cuidados humanizados por parte de estudiantes y personal de enfermería de Buenos Aires, Argentina / Perceived self-efficacy to provide humanized care among nursing students and staff in Buenos Aires, Argentina / Percepção de auto-eficácia na prestação de cuidados humanizados por estudantes e pessoal de enfermagem em Buenos Aires, Argentina

OBJETIVO: Evaluar la percepción de autoeficaciapara brindar cuidados y relacionarse con sus pacientes que tienen los estudiantes y profesionales de enfermería (académicos y asistenciales)concurrente a un tallerde extensión de una universidad privada de Buenos Aires, Argentina. METODOLOGÍA: Estudio descriptivo, transversaly cuantitativo. La muestra estuvo constituida por 76 sujetos equivalentes al 84,44% de los concurrentes a la actividad. Se implementó el instrumento Caring Efficacy Scale en su versión en español.Se realizó un análisis descriptivo e inferencial utilizando el software Infostat. Se implementó el consentimiento informado y no se recolectaron datos filiatorios. RESULTADOS: Los encuestados tuvieron una media de edad de 37,1 años, y fueron mayormente mujeres, de estado civil solteras, con hijos, y con más de cinco años de experiencia laboral.Se halló una relación entre no tenerhijos, ser estudiante y tener formación de grado con mayores puntajes en las dimensiones empatía (p=0,028), seguridad al brindar atención (p=0,005) y habilidades de comunicación (p=0,037), respectivamente.Se identificaron aspectos positivos que evidencian humanización en la práctica.CONCLUSIONES: Se hallaron niveles moderadamente positivos depercepción de autoeficacia para otorgar cuidados humanizados, siendo lasdimensionesrelación interpersonal y empatía la mejor y peor evaluadas, respectivamente. Se requiere implementaractividades de capacitación encuidados humanizadostendientes a evitar la despersonalizacióndel personal de enfermería.

OBJECTIVE:To assess perceptions of self-efficacy to provide care and relate to their patients among nursing students and professionals (academic and nursing assistants) attending an extension workshop at a private university in Buenos Aires, Argentina. METHODOLOGY: Descriptive, cross-sectional and quantitative study. The sample consisted of 76 subjects, representing 84.44% of those who participated in the activity. The Caring Efficacy Scale instrument was administered in its Spanish version. Descriptive and inferential analyses were performed using Infostat software. Informed consent was given and nophiliatory data were collected. RESULTS: Respondents had a mean age of 37.1 years and were mostly women, single, with children, and with more than five years of work experience. An association was found between not having children, being a student, and having a bachelor's degree with higher scores in the dimensions of empathy (p=0.028), confidence in providing care (p=0.005), and communication skills (p=0.037), respectively. Positive aspects demonstrating humanization in practice were identified. CONCLUSIONS: Moderately positive levels of perceived self-efficacy to provide humanized care were found, with the interpersonal and empathy dimensions being the best and worst rated, respectively. It is necessary to implement training activities in humanized care to avoid depersonalization of caregivers

OBJETIVO: Avaliar a percepção de autoeficácia em cuidar e relacionar-se com seus pacientes entre estudantes e profissionais de enfermagem (acadêmicos e da saúde) participantes de uma oficina de extensão em uma universidade privada em Buenos Aires, Argentina. METODOLOGIA: Estudo descritivo, transversal e quantitativo. A amostra foi composta por 76 sujeitos equivalentes a 84,44% dos frequentadores da atividade. O instrumento Caring Efficacy Scale foi implementado em sua versão em espanhol. Foi realizada análise descritiva e inferencial por meio do software Infostat. O consentimento informado foi implementado e nenhum dado filiado foi coletado. RESULTADOS: Os respondentes tinham idade média de 37,1 anos, eram em sua maioria mulheres, solteiras, com estado civil, com filhos e com mais de cinco anos de experiência profissional. Encontrou-se relação entre não ter filhos, ser estudante e ter curso superior com escores mais elevados nas dimensões empatia (p=0,028), segurança no cuidado (p=0,005) e habilidades de comunicação (p=0,037), respectivamente. Foram identificados aspectos positivos que evidenciam a humanização na prática. CONCLUSÕES: Foram encontrados níveis moderadamente positivos de autoeficácia percebida para prestar cuidados humanizados, sendo as dimensões relacionamento interpessoal e empatia as melhores e piores avaliadas, respectivamente. É necessário implementar ações de capacitação em atendimento humanizado visando evitar a despersonalização do pessoal de enfermagem.

Comunicación terapéutica y terapia narrativa: aplicaciones en el cuidado de enfermería / Therapeutic communication and narrative therapy: applications in nursing care / Comunicação terapêutica e terapia narrativa: aplicações no cuidado de enfermagem

Introducción: La comunicación terapéutica y la terapia narrativa permiten establecer una relación empática con la persona a quien se brinda cuidado, además de atender las necesidades en salud y mejorar su calidad de vida. Metodología: Se realizó una revisión narrativa de la literatura, utilizando bases de datos como Scielo, Pubmed, Proquest, Lilacs, Redalyc y Google Scholar, mediante la búsqueda de las palabras clave "patient care" and "narrative therapy" and "attention" and "nurse-patient relations". Se seleccionaron 50 artículos correspondientes a los últimos 15 años y se realizó análisis y síntesis crítica. Resultados: Las características de la comunicación terapéutica son la escucha activa, compresión, empatía, observación y humanización, al considerar las emociones y experiencias de la persona; su aplicación en el cuidado de Enfermería permite identificar los roles entre la persona y el enfermero. La terapia narrativa comprende la comunicación verbal y no verbal, lo cual facilita la relación entre la persona y el enfermero. La teoría interpersonal de Hildegard Peplau potencializa estas aplicaciones al enfocarse en las relaciones interpersonales terapéuticas. Conclusiones: Las aplicaciones de la comunicación terapéutica y terapia narrativa en el cuidado por enfermería comprenden la orientación, identificación, aprovechamiento y resolución para un abordaje holístico del individuo y su familia.

Introduction: Therapeutic communication and narrative therapy allow establishing an em-pathic relationship with the person to whom care is provided, in addition to meeting health needs and improving their quality of life. Methodology: A narrative review of the litera-ture was carried out, using databases such as Scielo, Pubmed, Proquest, Lilacs, Redalyc and Google Scholar, by searching for the keywords "patient care" and "narrative therapy" and "attention" and "nurse-patient relations". Fifty articles corresponding to the last 15 years were selected and critical analysis and synthesis were performed. Results: The characteristics of therapeutic communication are active listening, understanding, empathy, observation and hu-manization, by considering the person's emotions and experiences; its application in nursing care allows identifying the roles between the person and the nurse. Narrative therapy involves verbal and nonverbal communication, which facilitates the relationship between the person and the nurse. Hildegard Peplau's interpersonal theory potentiates these applications by focus-ing on therapeutic interpersonal relationships. Conclusions: The applications of therapeutic communication and narrative therapy in nursing care comprise orientation, identification, utili-zation and resolution for a holistic approach to the individual and his or her family.

Introdução: A comunicação terapêutica e a terapia narrativa permitem estabelecer uma relação empática com a pessoa a quem se presta o cuidado, além de atender às necessidades de saúde e melhorar sua qualidade de vida. Metodologia: Foi realizada uma revisão narrativa da literatura usando bancos de dados como Scielo, Pubmed, Proquest, Lilacs, Redalyc e Google Scholar, pesquisando as palavras-chave "patient care" e "narrative therapy" e "attention" e "nurse-patient relations". Foram selecionados 50 artigos dos últimos 15 anos e foram realizadas uma análise crítica e uma síntese. Resultados: As características da comunicação terapêutica são a escuta ativa, a compreensão, a empatia, a observação e a humanização, considerando as emoções e as experiências da pessoa; sua aplicação na assistência de enfermagem permite identificar os papéis entre a pessoa e o enfermeiro. A terapia narrativa envolve comunicação verbal e não verbal, o que facilita o relacionamento entre a pessoa e o enfermeiro. A teoria interpessoal de Hildegard Peplau potencializa essas aplicações ao se concentrar nas relações interpessoais terapêuticas. Conclusões: As aplicações da comunicação terapêutica e da terapia narrativa no cuidado de en-fermagem compreendem a orientação, a identificação, o aproveitamento e a resolução para uma abordagem holística do indivíduo e de sua família

Relación interpersonal entre el profesional de enfermería y la persona con un proceso oncológico / Interpersonal relationship between the nursing professional and the person with an oncological condition

INTRODUCCIÓN. La calidad de la interacción humana entre el profesional de la salud y la persona atendida es fundamental en la oncología tanto a nivel ético como práctico. El presente artículo de naturaleza teórica tiene como OBJETIVO: Reflexionar sobre la conceptualización de cómo debe ser la relación interpersonal entre el profesional de enfermería y la persona con un proceso oncológico, es decir, conocer a partir de determinados conceptos su relevancia en el trato humano para una mejor praxis del cuidado de enfermería. METODOLOGÍA: Reflexión teórica basada en conceptos de intersubjetividad y cuidado de enfermería a través de la revisión de literatura. Se enfocará fundamentalmente en el pensamiento de Hildegard E. Peplau dada la relevancia de la visión interactiva - integrativa de su teoría de las relaciones interpersonales como un proceso interpersonal significativo, terapéutico. Asimismo, del Filósofo Martin Heidegger. RESULTADOS: Abordar el cuidado de enfermería bajo la perspectiva de la comprensión del "Ser" con su entorno y no solo el "estar ahí" significa para la persona la importancia del cuidado adecuado en pro de la recuperación, prestando atención empática de las emociones y sentimientos para comprender el sufrimiento del otro y de esta forma se pueda brindar un cuidado significativo. CONCLUSIONES: Los profesionales de enfermería tienen un rol fundamental en la construcción del vínculo terapéutico a través de la relación interpersonal de modo que les permita satisfacer las necesidades de la persona con un proceso oncológico y brindar cuidados significativos de enfermería.

INTRODUCTION. The quality of the human interaction between the health professional and the person being cared for is essential in oncology, both ethically and practically. The present article of theoretical nature has as OBJECTIVE: To reflect on the interpersonal relationship between the nursing professional and the person with an oncological condition, and to examine its relevance in the humane treatment of such persons in the provision of nursing care. METHOD: Theoretical reflection based on concepts of intersubjectivity and nursing care through literature review. It will focus primarily on the concepts of Hildegard E. Peplau, given the relevance of her interactive-integrative vision of interpersonal relationships as key to a meaningful, therapeutic interpersonal process. It also considers the concepts of the philosopher Martin Heidegger. RESULTS: Approaching nursing care from the perspective of understanding the "Being" within its environment, and not only "being there", facilitates recovery. By paying empathic attention to emotions and feelings in an effort to understand the suffering of the other, meaningful care can be provided. CONCLUSIONS: Nursing professionals have a fundamental role in building therapeutic bonds through interpersonal relationships in a way that allows them provide meaningful nursing care to persons with oncologic conditions.

Cuidados de salud mental durante la pandemia por COVID-19: experiencias con una persona en crisis / Mental health care during the COVID-19 pandemic: experiences with an individual in a crisis situation

INTRODUCCIÓN. La pandemia por COVID-19 ha sido un fenómeno con implicaciones biológicas, psicológicas y sociales que ha afectado a las personas en diferentes circunstancias. Por momentos, aumentando su vulnerabilidad y generando situaciones de sufrimiento, lo que provocó la implementación de servicios de salud mental específicos alrededor del mundo. En ese contexto, se presenta la relación interpersonal de Enfermería de Salud Mental guiada por el Modelo de Stuart de Adaptación al Estrés con una persona en una situación de crisis. OBJETIVO. Analizar la intervención de Enfermería de Salud Mental en caso de crisis desde el Modelo de Stuart de Adaptación al Estrés. METODOLOGÍA. El abordaje se desarrolló en modalidad virtual con una persona adulta media. Se guio por el Modelo de Stuart de Adaptación al Estrés siguiendo las etapas del Proceso de Enfermería de tercera generación y de la terapia de intervención en crisis. Se utilizó el lenguaje estandarizado NANDA-I, NOC, NIC para desarrollar el plan de intervenciones. RESULTADOS. Se implementó el plan de cuidados acorde a las necesidades de la persona obteniendo una respuesta adaptativa frente a la crisis. A la evaluación, los indicadores alcanzaron puntuaciones más altas validando la efectividad de la intervención. CONCLUSIONES. El Modelo de Stuart de Adaptación al Estrés facilita la comprensión de fenómenos de cuidado particulares en la Enfermería de Salud Mental. Su inclusión en la práctica fortalecería la función profesional con mayor validez científica.

INTRODUCTION. The COVID-19 pandemic has been a phenomenon with biological, psychological and social implications that have affected people in a variety of circumstances. At times it has increased their vulnerability and suffering, which led to the implementation of specific services around the world to address their mental health needs. In this context, we presentthe interpersonal relationship between the Mental Health nurse, guided by The Stuart Stress Adaptation Model, with an individual in a crisis situation. OBJECTIVE. Analyze a Mental Health Nursing intervention in a crisis situation based on The Stuart Stress Adaptation Model. METHODOLOGY. The approach was developed in a virtual modality with a middle-aged adult. It was guided by The Stuart Stress Adaptation Model, following the application of third generation Nursing Process and crisis intervention therapy. The standardized languages NANDA-I, NOC, NIC were used to develop the intervention plan. RESULTS. The care plan was implemented according to the person's needs, generating an adaptive response to the crisis. On evaluation, the indicators reached higher scores, validating the effectiveness of the intervention. CONCLUSIONS. The Stuart Stress Adaptation Model facilitates the understanding of specific care phenomena in Mental Health Nursing. Its inclusion in practice would strengthen professional practice with greater scientific validity.

Relação interpessoal no cuidado de enfermagem a pessoas com diabetes tipo 2 / Interpersonal relationships in the nursing care of people with type 2 diabetes / Relación interpersonal en el cuidado de enfermería a personas con diabetes tipo 2

Objetivo: analisar a efetividade da relação interpessoal no cuidado de enfermagem e sua relação com as práticas de autocuidado geral e com os pés em pessoas com diabetes tipo 2. Método: estudo transversal, analítico, realizado em um Hospital Universitário, com 150 pessoas com diabetes tipo 2 que responderam ao Questionário relação interpessoal no cuidado de enfermagem, questionário de atividades de autocuidado com diabetes e questionário da avaliação da adesão ao autocuidado com os pés. Resultados: os resultados mostraram que a efetividade da relação interpessoal no cuidado variou de moderada a alta. Os escores do questionário mostraram significância comorbidades nefropatia, acidente vascular encefálico, aderir à dieta e receber orientações sobre cuidados som os pés. Conclusão: a relação interpessoal no cuidado efetiva pode fortalecer a criação de vínculos, a confiança e verbalização de sentimentos, contribuindo para melhoria na educação em diabetes e para adesão de comportamentos de autocuidado.

Objectives: to analyze the effectiveness of the interpersonal relationship in nursing care and its relationship with general self- care and foot care in people with type 2 diabetes. Method: this cross-sectional, analytical study was conducted at a University Hospital with 150 people with type 2 diabetes who answered the Interpersonal Relationship in Nursing Care Questionnaire, a questionnaire on self-care activities with diabetes, and a questionnaire to assess adherence to feet self-care. Results: the results showed that the effectiveness of the interpersonal relationship in care ranged from moderate to high. The questionnaire scores were significant with nephropathy comorbidities, cerebrovascular accident, diet adherence, and receiving foot care guidance. Conclusion: interpersonal relationships in effective care can strengthen bonding, trust, and verbalization of feelings, improving diabetes education and adherence to self-care behaviors.

Objetivos:analizar la efectividad de la relación interpersonal en el cuidado de enfermería y su relación con las prácticas generales de autocuidado y con los pies en personas con diabetes tipo 2. Método: estudio transversal, analítico, realizado en un Hospital Universitario, con 150 personas con diabetes tipo 2 que respondieron el Cuestionario de Relación Interpersonal en el Cuidado de Enfermería, cuestionario sobre actividades de autocuidado con diabetes y cuestionario para la evaluación de adherencia al autocuidado con los pies. Resultados:los resultados mostraron que la efectividad de la relación interpersonal en el cuidado varió de moderada a alta. Los puntajes del cuestionario mostraron significación con las comorbilidades de la nefropatía, el accidente cerebrovascular, la adherencia a la dieta y recibir orientación sobre el cuidado de los pies. Conclusión:la relación interpersonal en el cuidado efectivo puede fortalecer la creación del vínculo, la confianza y la verbalización de los sentimientos, contribuyendo para una mejoría en la educación en diabetes y la adherencia a las conductas de autocuidado.

Assistência de enfermeiros a crianças em cuidados paliativos: estudo à luz da teoria de Jean Watson / Asistencia de enfermeros a niños en cuidados paliativos: un estudio a la luz de la teoría de Jean Watson / Nurses assistance to children in palliative care: a study in the light of Jean Watson's theory

Resumo Objetivo Compreender a assistência de enfermeiros a crianças com câncer em cuidados paliativos à luz da Teoria de Jean Watson. Método Estudo qualitativo, tendo como referencial a teoria de Jean Watson, realizado com dez enfermeiros assistenciais de um hospital de referência em câncer de João Pessoa, PB. A coleta do material empírico ocorreu entre outubro e dezembro de 2020, por meio da técnica de entrevista semiestruturada, posteriormente analisado sob a Técnica de Análise de Conteúdo. Resultados Os depoimentos dos enfermeiros trouxeram reflexões contundentes acerca dos conhecimentos no campo da enfermagem oncológica, com ênfase na assistência a crianças em cuidados paliativos, uma vez que as estratégias implementadas neste cenário são coerentes com a Teoria de Jean Watson, pautada nos elementos contidos no Processo Clinical Caritas. Conclusão e Implicações para a prática A atuação dos enfermeiros a partir de uma assistência humanizada, com o escopo na promoção de conforto e alívio da dor e nas práticas dialógicas, lúdicas e transpessoais, é imprescindível neste processo de doença. Deste modo, as estratégias identificadas poderão contribuir para a prática clínica de enfermeiros ao cuidar de crianças com câncer em cuidados paliativos, fundamentada na Teoria de Jean Watson.

Resumen Objetivo Comprender los cuidados que brindan los enfermeros a los niños con cáncer en cuidados paliativos a la luz de la Teoría de Jean Watson. Método Estudio cualitativo, basado en la Teoría de Jean Watson, realizado con diez enfermeros clínicos de un hospital de referencia en cáncer de João Pessoa, Paraíba. La recolección del material empírico se realizó entre octubre y diciembre de 2020, mediante la técnica de entrevista semiestructurada, posteriormente analizado bajo la Técnica de Análisis de Contenido. Resultados Los testimonios de los enfermeros aportaron fuertes reflexiones sobre el conocimiento en el campo de la enfermería oncológica, con énfasis en la asistencia a los niños en cuidados paliativos, ya que las estrategias implementadas en este escenario son coherentes con la Teoría de Jean Watson, a partir de los elementos contenidos en el Proceso Clinical Caritas. Conclusión e Implicaciones para la práctica El papel del enfermero a partir de la prestación de un cuidado humanizado, enfocado en la promoción del confort y del alivio del dolor y en las prácticas dialógicas, lúdicas y transpersonales, es fundamental en este proceso patológico. Así, las estrategias identificadas pueden contribuir para la práctica clínica del enfermero en el cuidado de niños con cáncer en cuidados paliativos, con base en la Teoría de Jean Watson.

Abstract Objective To understand the care provided by nurses to children with cancer in palliative care in the light of Jean Watson's Theory. Method Qualitative study, based on Jean Watson's theory, carried out with ten clinical nurses from a reference hospital for cancer in João Pessoa, PB. The collection of empirical material took place between October and December 2020, through the semi-structured interview technique, later analyzed under the Content Analysis Technique. Results The nurses' testimonies brought strong reflections on knowledge in the field of oncology nursing, with an emphasis on assistance to children in palliative care, since the strategies implemented in this scenario are consistent with Jean Watson's Theory, based on the elements contained in the Clinical Caritas Process. Conclusion and Implications for practice The role of nurses based on humanized care, with the scope of promoting comfort and pain relief, and dialogical, playful and transpersonal practices, is essential in this disease process. In this way, the identified strategies may contribute to the clinical practice of nurses, when caring for children with cancer in palliative care, based on Jean Watson's Theory.

Cuidado humanizado de personal de enfermería y satisfacción del paciente hospitalizado por dengue con signos de alarma / Humanized care of nursing staff and satisfaction of patients hospitalized for dengue with warning signs

El dengue, infección vírica transmitida por Aedes aegypti, puede evolucionar a cuadros clínicos grave. En pacientes con signos de alerta, es necesario el monitoreo constante de los signos vitales, requiriendo hospitalización. El personal de enfermería ha sido considerado clave en los algoritmos de abordaje de estos pacientes. Por lo que, el buen desempeño de atención y una relación armoniosa con el paciente, puede ser indispensable. La humanización de los cuidados es imperativa para contribuir a salvaguardar la dignidad humana en armonía con los principios bioéticos. Por tanto, se realizó una revisión sistemática de la literatura con el propósito de identificar el estado del arte sobre el cuidado humanizado de enfermería y su relación con la satisfacción del paciente hospitalizado. Se identificaron 50 artículos relacionados con las variables de investigación. Los resultados señalan a la escala en la medición del cuidado humano transpersonal basada en la teoría Watson, como las más frecuente; asimismo, el cuestionario de satisfacción del paciente con la calidad de la atención de enfermería, como el método más utilizado. En cuanto a los elementos del cuidado de enfermería se agrupan en dos dimensiones; cuidado humanizado y praxis. Finalmente, los pacientes asocian calidad de servicio con satisfacción al usuario, percibiendo de manera positiva la humanización de los cuidados. Se recomienda implementar estrategias e identificar puntos críticos de la atención, planes de mejoras y capacitación para la sensibilización del personal de enfermería hacía un buen trato al paciente, desde un abordaje holístico e integral(AU)

Dengue, a viral infection transmitted by Aedes aegypti, can evolve into severe clinical pictures. In patients with warning signs, constant monitoring of vital signs is necessary, requiring hospitalization. The nursing staff has been considered key in the approach algorithms for these patients. Therefore, good care performance and a harmonious relationship with the patient may be essential. The humanization of care is imperative to help safeguard human dignity in harmony with bioethical principles. Therefore, a systematic review of the literature was carried out with the purpose of identifying the state of the art on humanized nursing care and its relationship with the satisfaction of the hospitalized patient. 50 articles related to the research variables were identified. The results point to the scale in the measurement of transpersonal human care based on Watson's theory, as the most frequent; likewise, the patient satisfaction questionnaire with the quality of nursing care, as the most used method. Regarding the elements of nursing care, they are grouped into two dimensions; humanized care and praxis. Finally, patients associate quality of service with user satisfaction, positively perceiving the humanization of care. It is recommended to implement strategies and identify critical points of care, improvement plans and training to sensitize nursing staff towards good patient treatment, from a holistic and comprehensive approach(AU)

Exploring nurses' experiences of caring for patients participating in cancer clinical trials.

AIMS: Drawing on the experiences of cancer research nurses (CRNs) from the Cancer Research UK Excellence in Research Programme, this article aims to provide an insight into managing cancer patients' expectations of participating in clinical trials. It also outlines what CRNs consider are the key elements when supporting patients through side-effect management. METHOD: Through group work and discussions, CRNs' reflective experiences were captured by workshop facilitators around three topics by exploring nurses' experiences of caring for patients participating in cancer clinical trials. Reflective CRN experiences for each of the three topics were reviewed and themes were developed by the author, who also facilitated this workshop. RESULTS: Developing relationships, patient education and effective communication were all identified as important factors when helping to manage patient expectations and aid side-effect management. CONCLUSION: The findings, based on CRN experiences, give an understanding of aspects of the role that nurses have within cancer clinical trials, what patient expectations of clinical trial are and strategies on how best to support patients within this area of nursing.

Patient Engagement in Oncology Practice: A Qualitative Study on Patients' and Nurses' Perspectives.

Patient engagement has gained increasing attention in cancer care as it is widely acknowledged as an essential element of high-quality care. There are limited data on how oncology nurses might apply techniques that encourage patient engagement. Therefore, this study aims to understand which nursing strategies can favour patient engagement in oncological care from patients' and nurses' perspectives. We conducted a qualitative study involving oncology patients and oncology nurses. Patients were interviewed, while nurses were involved in focus groups (FGs). Both interviews and FGs were analysed by the means of thematic analysis. We interviewed six patients and conducted two FGs, involving 17 nurses. Five themes were identified from patients' interviews: effective information, having the opportunity to choose, being considered a person, trusted relationship with nurses, and receiving support and advice. Additionally, five themes were identified from the FGs: the nurse-patient relationship, personalisation of care, information style, engagement strategies, and the team. The participants highlighted the importance of comprehensive information in order for patients to feel more involved. Great importance was given to the nurse-patient relationship, which must be based on trust and mutual respect. Both nurses and patients emphasised the importance of person-centred care. A more systematic implementation of suggestions from the participants in this study is desirable for the future.

Escucha activa: base de la relación terapéutica con persona mayor por teleenfermería en contexto pandémico / Active listening: basis of the therapeutic relationship with the elderly person by Telenursing in a pandemic context

El estudio de caso que se presenta a continuación busca resolver el desafío de establecer una relación terapéutica mediante la escucha activa en el contexto remoto de teleenfermería. Para ello se trabajó en un plan de cuidados de enfermería, en base a encuentros remotos con una usuaria de un condominio de viviendas tuteladas por medio de videollamadas, poniendo a prueba la forma en que se realizaba la escucha activa al encontrarse en espacios físicos diferentes. Se realizó una valoración a través de los 11 patrones funcionales de Gordon, priorizando las necesidades detectadas en la usuaria y estableciendo objetivos e intervenciones. Dentro de los resultados obtenidos se destaca que, al existir una óptima metodología de trabajo y retroalimentaciones constantes junto con un buen uso del tiempo, se puede lograr a cabalidad la escucha activa por medio de la teleenfermería a pesar de estar en espacios físicos diferentes. Esto último permite el establecimiento de una relación terapéutica entre el profesional de enfermería y la persona. Se concluye que la teleenfermería es un recurso valioso que es necesario continuar trabajando para que las diferencias entre una atención presencial y una atención remota sean cada vez mínimas[AU]

The case study presented below seeks to resolve the challenge of establishing a therapeutic relationship through active listening in the remote context of tele-nursing. To this end, we worked on a nursing care plan, based on remote meetings with a user of a supervised housing condominium by means of video calls, testing the way in which active listening was carried out when they were in different physical spaces. An assessment was carried out through Gordon's 11 functional patterns, prioritizing the needs detected in the user and establishing objectives and interventions. Among the results obtained, it stands out that, with an optimal work methodology and constant feedback together with a good use of time, active listening can be fully achieved by means of teleconferencing despite the fact that they are in different physical spaces. The latter allows the establishment of a therapeutic relationship between the nurse and the person. It is concluded that tele-nursing is a valuable resource that needs to be further developed so that the differences between face-to-face and remote care become increasingly minimal[AU]

O estudo de caso apresentado abaixo procura resolver o desafio de estabelecer uma relação terapêutica através da escuta activa no contexto remoto da tele-nursão. Para o efeito, trabalhámos num plano de cuidados de enfermagem, baseado em reuniões remotas com um utilizador de um condomínio habitacional supervisionado através de videochamadas, testando a forma como a escuta activa era realizada quando se encontravam em diferentes espaços físicos. Foi feita uma avaliação através dos 11 padrões funcionais de Gordon, dando prioridade às necessidades detectadas no utilizador e estabelecendo objectivos e intervenções. Entre os resultados obtidos, destaca-se que, com uma metodologia de trabalho óptima e um feedback constante juntamente com uma boa utilização do tempo, a escuta activa pode ser plenamente alcançada por meio de teleconferência, apesar de se encontrarem em espaços físicos diferentes. Este último permite o estabelecimento de uma relação terapêutica entre a enfermeira e a pessoa. Conclui-se que a tele-nurmagem é um recurso valioso que precisa de ser mais desenvolvido para que as diferenças entre cuidados presenciais e remotos se tornem cada vez mais mínimas[AU]

Dialogue is a prerequisite for the nurse-patient relationship in nutritional care: A secondary analysis using the fundamentals of care framework.

BACKGROUND: Providing good nutritional care is complex as it goes beyond assessing and ensuring the patients' dietary needs. So far, nutritional research has mainly focused on establishing evidence for the nutritional treatment, while less attention has been on the complexity of providing nutritional care. The Fundamentals of Care (FoC) describes five elements (focus, knowledge, anticipate, evaluate and trust) essential for establishing a nurse-patient relationship as a foundation for quality care. By studying how these elements shape nutritional care and dialogue, we can explore and describe the complexity of nutritional care. AIM: By using the FoC framework as an analytic framework, this study explores how the nurse-patient relationship shapes the nutritional care of orthopaedic patients. METHOD: This study is a secondary analysis using deductive content analysis of interviews with patients undergoing major orthopaedic surgery, nursing staff and observations of interactions between nursing staff and patients. The core dimension of the FoC framework, 'Establishment of relationship,' was used as an analytic framework. RESULT: The nurses perceived serving meals and providing nutritional supplements as an essential part of the nutritional care. Still, the nutritional care was organised as a routine task to be less time-consuming. Appropriate care was initiated when the nursing staff explored patients´ food preferences. When the nursing staff failed to familiarise themselves with the patient's preferences, the patients interpreted nutritional care as unrelated to their needs, resulting in a lack of trust. CONCLUSION: The need for efficiency within nutritional care must not compromise the patients' need for dialogue with the nurse. Establishing a trusting relationship between nurses and patients prevents nutritional care from becoming a routine task unrelated to the patients' needs.