[Empowering a group of seniors in a rural community]. / Potencializando um grupo de terceira idade de uma comunidade rural.

OBJECTIVE: To describe the stages of the empowerment process of a group of seniors in a rural community. METHOD: Convergent care research whose foundation is to use the scope of practice. Conducted with the proposal to change the practice of 21 seniors and nine health professionals, with the aim of health promotion empowerment. Data were collected during 22 meetings, and group interviews at the end of the intervention. RESULTS: Showed that despite the initial impact of the change, the group was able to welcome the new change, taking advantage of the space to express anxieties, share joys, and build new knowledge, which led to the incorporation of changes that reflected in the development of healthy habits and improvements in interpersonal relationships. CONCLUSION: The convergent care research consisted of strategy that changed the group's lives, empowering them with health promoting actions.

[Intervening factors in attention flow of professionals injured by biological material]. / Fatores intervenientes no fluxo de atendimento ao profissional acidentado com material biológico.

OBJECTIVE: To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. METHOD: Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. RESULTS: From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. CONCLUSION: The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.

Quality indicators for the processing of health products: A mixed-methods study.

OBJECTIVE: to analyze the use of quality assessment indicators and their implementation to improve quality in the processing of health products. METHOD: a mixed-methods study with a multiple case approach using Structure, Process and Results indicators and elaboration of a plan using Appreciative Inquiry, carried out in four central sterile supply departments from hospital units. RESULTS: the indicators for the Cleaning stage presented 47.8% compliance for Structure and 59.0% for Process: in addition 71.8% of the products were clean. In the Preparation operational stage, 50.0% of the Results indicators were in compliance for Structure and 66.7% for Process. In the Sterilization, Storage and Distribution stage, 43.5% compliance was obtained for Structure, 55.7% for Process and 78.6% for Packaging conservation. Appreciative planning proposed improvements to the physical structure, review of processes and protocols, promotion and appreciation of the work done and strengthening of teaching about processing and service management, highlighting the protagonism of the group and of the leaders. CONCLUSION: using indicators was positive in materializing reality; however, it was verified that the improvements proposed are related to people. The affirmative and constructive view of Appreciative Inquiry presented itself as a path to changes and quality improvements.

A systematic review of the interventions for nipple trauma in breastfeeding mothers.

PURPOSE: To identify the most effective interventions to treat nipple trauma in breastfeeding mothers. DESIGN AND METHODS: Systematic literature review using the PICO strategy. The search was conducted on the electronic information systems Medline-PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), World Health Organization Library Information System (WHOLIS), Cochrane, ScienceDirect (Elsevier), Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), using standardized and unstandardized descriptors. Studies were selected if they were controlled or uncontrolled randomized clinical trials written in English, Portuguese, or Spanish. Two reviewers evaluated the studies independently using a guide, and in case there were disagreements, a third reviewer was called on to reach a consensus. Of the 496 studies located, five were included. FINDINGS: The treatments investigated were lanolin, lanolin in association with breast protection shells, breast milk, hydrogel, adhesive polyethylene film dressings, a spray containing chlorhexidine with alcohol, and distilled water. All the groups in every study received breastfeeding education. The best outcomes for the treatment of nipple trauma used lanolin (recommendation B, evidence level 2) and breast milk (recommendation B, evidence level 2). Although one clinical study was found with positive outcomes resulting from treatment using a spray containing alcohol and chlorhexidine 0.2% (recommendation B, evidence level 2), this treatment modality should be further investigated since literature is not in favor of using antiseptic substances in skin wound treatment. CONCLUSIONS: Considering the treatments investigated, the most favorable evidence indicates the use of lanolin alone or in association with breast protection shells and breast milk expressed and rubbed into the nipple and areola after each feeding session. However, the results obtained in this review are inconclusive, indicating the need for further studies in order to clarify the action of breast milk and lanolin on the damaged tissues, as well as studies involving samples representative of the number needed to treat. CLINICAL RELEVANCE: This study provides evidence for nursing practice, thus contributing to the improvement of lactating mothers with nipple trauma care and, consequently, improving the rates of successful breastfeeding as well as the quality of life of breastfeeding mothers.

[Therapeutic factors in a group of health promotion for the elderly]. / Fatores terapêuticos identificados em um grupo de Promoção da Saúde de Idosos.

The aim of this study was to identify therapeutic factors presented in a group of health promotion for the elderly. This is a descriptive, exploratory study with a qualitative approach. Data were collected between December 2010 and April 2011 in focal groups that included participants and their coordinators. Results were submitted to content analysis and thematic approach. Findings showed convergence of answers among participants, who indicated resonance and complementarity in identification of the following therapeutic factors: cohesion, introduction of hope, socialization, information sharing, existential factors, altruism, interpersonal relationships, and universal learning. The identification of these factors indicates the therapeutic potential of focal groups, especially for attending to the needs of elderly people, keeping these patients healthy, and strengthening their feelings of love and life, and being part of a social group.

[Living with mental disorders: family members' perspective have on primary care]. / Convivendo com transtorno mental: perspectiva de familiares sobre atenção básica.

The objective of this qualitative study was to identify the service that is offered to the family members of patients with mental disorders at Primary Care Units, and understand the everyday life of that family. Data collection was performed from May to June 2007, by means of semi-structured interviews and observation of five families at their homes. Thematic analysis of the data was performed, generating two categories: 1) mental disorder from the family's perspective and the relation with the health service; 2) living with the mental illness. Result confirm the importance of seeing the family of patients with mental disorders as clients of the care process, and the need to prepare health professionals to answer the needs of the people that seek these services.

[Driving and hindering forces for team work in a Material and Sterilization Center of a teaching hospital]. / Forças impulsoras e restritivas para trabalho em equipe em um Centro de Material e Esterilização de hospital escola.

The objective of this descriptive, cross-sectional study was to analyze the driving and hindering forces for team work at a Material and Sterilization Center (MSC) of a teaching hospital, through an approximation of Kurt Lewin's Field Theory,in Goiânia, Goiás. Participants were 35 professionals, who answered a self-administered questionnaire based on the referred theory, which establishes that group situations are permeated by forces that have a positive or negative influence on the individuals' movements, and concern the subjects' involvement (I), the groups interaction (Other) and the working environment (Evnironment). The data were submitted to content analysis, and distributed in the predefined dimensions. Results consolidated 1990 registers, with most (59.3%) being categorized as driving forces, mostly in the I dimension. It was observed there was balance between forces in the Other and Environment dimensions. Outlining the force field permitted an objective, concrete view of the strengths and weaknesses of the studied team, and the possibilities to promote changes.

The setting of research production by nursing and management graduate programs in Brazil. / Cenário das pesquisas na pós-graduação na área de enfermagem e gerenciamento no Brasil.

This documental, descriptive study was performed using a quantitative approach with the objective to characterize the production by nursing graduates in Brazil in the 2007-2009 triennium, with emphasis on nursing management. Data was collected from the CAPES database, which allows access to the abstracts of theses and dissertations. The material was analyzed and categorized according to areas/fields and the respective lines of research, as defined in Nursing. The overall production analysis was descriptive and analytical in the field of organization, namely management. The results showed that, compared to previous studies, production underwent some changes in the triennium, with an increase in the area of health care, maintenance in the organizational area, and decrease in the professional area. Regarding the management theme, most studies addressed health assessment, the conceptions/perceptions regarding planning/organizing work-services and permanent education.

Nursing leadership succession planning: paths for elaboration. / Planejamento de sucessão de lideranças em enfermagem: caminhos para sua elaboração.

OBJECTIVE: To describe the construction of a nursing leadership succession plan for a hospital based on the appreciative reflection of nurses. METHOD: Descriptive exploratory study with a qualitative approach carried out with nurses in a federal public teaching hospital. Data collection was carried out in two stages. The first was an individual interview, and the second was group mediation conducted based on the 4D Cycle and the assumptions of Appreciative Inquiry. Descriptive analysis of the findings was carried out. RESULTS: The data showed a highly qualified team of different generations, concerned with succession planning based on scientific evidence, involving teams and carried out carefully for nurses at different stages of their professional careers. CONCLUSION: The principles of Appreciative Inquiry allowed the construction of a succession plan to enhance leadership development actions in the hospital. The collaborative environment between generations was valued and planning focused on participatory management was created in the process. This aspect can profoundly change the institution's internal policy in several areas and point out ways to implement succession planning in different contexts.

[Support group as embracement strategy for relatives of patients in intensive care unit]. / Grupo de suporte como estratégia para acolhimento de familiares de pacientes em unidade de terapia intensiva.

Admissions to the Intensive Care Unit (ICU) generate needs among relatives, which sometimes do not receive appropriate care. This study aimed at describing a support group (SG) that embraces the relatives of patients admitted to ICU and to evaluate its effectiveness in meeting their needs of information and emotional support. This descriptive study was performed in 2006 in a Hospital of Goiânia/GO, by means sessions of the Support Group for Families (SGF). The sessions were recorded and registered in a field-diary for further analysis of the group process. In addition, individual interviews were performed to evaluate if the needs for information and support were met. The SGF permitted to see to the needs of families, helping them cope with the hospitalization of their relative in the ICU. In conclusion, SGF helps to promote humanized care practice and to overcome care that is historically focused on patient and disease. Nurses should consider reorganizing their practice and the possibility of including the SGF as a strategy to meet the needs of the families.

[Mental health in primary attention: needed constitution of competences]. / Saúde mental na atenção primária: necessária constituição de competências.

The family/people integrally attention is one of health services and professionals challenges, creating spaces for metal health in the primary level health attention. The aim of this study is to reflect about the constitution necessity of new knowledges/dones to the mental health at the primary attention, taking as perspective the competence referential. Essay developed since the historical assumptions ascertains that contextualize the Family Health Strategy and its interfaces with the psychosocial principles and some nurse background implications since the competence development theoretical intentions. We consider that reality transformation, with the health attention improvement asks for knowledges/dones constitution that attends to the psychosocial attention and the Unique Health System rules.

Planned organizational change to transform care to workers exposed to biological material.

OBJECTIVES: to describe the evaluation of the service offered in cases of occupational accidents involving exposure to biological material, from the perspective of the exposed workers, before and after an intervention to obtain planned organizational change. METHODS: descriptive study with a qualitative approach, carried out with workers exposed to biological material who received care at a reference service that was submitted to an intervention based on planned organizational change. Data were collected by using the critical incident technique and analyzed from the perspective of content analysis. RESULTS: twenty exposed workers participated in the study and were split into two groups in the pre- and post-intervention phase. Categories regarding improvement in the guidance they received, reduction in the time they waited once they got to the facility, organization of the process, documentation qualification, and professionalism in carrying out the assistance emerged from the workers' accounts. CONCLUSIONS: the present study allowed the exposed workers to visualize the changes that happened in the care management in case of accidents involving biological material. Additionally, there was the recognition of the adopted methodological path, which allowed the active participation of the people involved.

[Therapeutic factors in a group of people with diabetes]. / Fatores terapêuticos em grupo de diabéticos.

The objective of the present research was to analyze the therapeutic factors identified in the accounts of the participants of a group of people with diabetes. An exploratory, assessing research carried out by means of semi-structured interviews pinpointed the following therapeutic factors: information availability (100%); cohesion (100%); universality (86%); interpersonal learning (57%); development of socialization techniques (57%); altruism (28.5%); imitative behavior (28.5%); and hope stimulus (28.5%). The implementation of group intervention actions for the promotion of self-care towards diabetes carriers can generate a beneficial interaction among group members, thus allowing for experience exchange processes, as well as a broader understanding of the disease and other positive experiences evidenced by the presence of the therapeutic factors.

Nurses' expectations about the succession of leaders in the hospital context.

OBJECTIVE: to analyze the expectation of nurses about the succession of leaders in the hospital context. METHOD: a descriptive and exploratory study of a qualitative approach carried out with 36 nurses from a public university hospital selected using the snowball technique. The data collection was done through semi-structured interviews that were recorded and analyzed based on the assumptions of the Content Analysis technique, Thematic modality. Ethical criteria were adequately met. RESULTS: the reports comprised two central categories, "Who Will Take My Place?" and "Potential and Openness to Plan the Succession of Leadership in Nursing," the latter being divided into two subcategories: "Nursing leadership in the hospital five years from now" and "Strengths for the implementation of a leadership succession plan". CONCLUSION: from the results, positive aspects of the diagnosis of the leadership profile in the institution that favor the development of succession planning were verified. In addition, it was possible to perceive the necessity of the development of this planning in the hospital and its importance for the succession of leadership in Nursing. In this context, this study presents itself with an innovative character for exposing a theme that aims to potentiate the future of Nursing.

Quality indicators for the processing of health products: A mixed-methods study / Indicadores de calidad para el procesamiento de productos para la salud: estudio de método mixto / Indicadores de qualidade para o processamento de produtos para saúde: estudo de método misto

Objective: to analyze the use of quality assessment indicators and their implementation to improve quality in the processing of health products. Method: a mixed-methods study with a multiple case approach using Structure, Process and Results indicators and elaboration of a plan using Appreciative Inquiry, carried out in four central sterile supply departments from hospital units. Results: the indicators for the Cleaning stage presented 47.8% compliance for Structure and 59.0% for Process: in addition 71.8% of the products were clean. In the Preparation operational stage, 50.0% of the Results indicators were in compliance for Structure and 66.7% for Process. In the Sterilization, Storage and Distribution stage, 43.5% compliance was obtained for Structure, 55.7% for Process and 78.6% for Packaging conservation. Appreciative planning proposed improvements to the physical structure, review of processes and protocols, promotion and appreciation of the work done and strengthening of teaching about processing and service management, highlighting the protagonism of the group and of the leaders. Conclusion: using indicators was positive in materializing reality; however, it was verified that the improvements proposed are related to people. The affirmative and constructive view of Appreciative Inquiry presented itself as a path to changes and quality improvements.

Objetivo: analizar el uso y la implementación de indicadores de evaluación de la calidad para mejorar la calidad del procesamiento de productos para la salud. Método: estudio mixto, con enfoque de casos múltiples que usa indicadores de estructura, proceso y resultado y la elaboración de una planificación mediante la investigación apreciativa, realizado en cuatro centros de material y esterilización de unidades hospitalarias. Resultados: los indicadores de la etapa de limpieza mostraron un 47,8% de conformidad en estructura, un 59,0% en proceso y el 71,8% de los productos estaban limpios. En la etapa operativa de la preparación, se registró conformidad en el 50,0% de los indicadores de resultados de estructura y en el 66,7% de proceso. En la etapa de esterilización, almacenamiento y distribución se obtuvo un 43,5% de conformidad en estructura, un 55,7% en proceso y un 78,6% en conservación de los envases. La planificación apreciativa propuso mejoras para la estructura física, revisión de procesos y protocolos, promoción y valoración del trabajo, fortalecimiento de la enseñanza sobre procesamiento y gestión de servicios, y destacó el protagonismo del grupo y del liderazgo. Conclusión: el uso de indicadores fue positivo para materializar la realidad, sin embargo, se observó que las mejoras propuestas tienen que ver con las personas. La visión afirmativa y constructiva de la investigación apreciativa demostró ser útil para cambiar y mejorar la calidad.

Objetivo: analisar o uso de indicadores de avaliação da qualidade e suas implementações para melhoria da qualidade do processamento de produtos para saúde. Método: estudo misto, com abordagem de casos múltiplos utilizando indicadores de estrutura, processo e resultado e a construção de um planejamento utilizando a investigação apreciativa, realizado em quatro centros de material e esterilização de unidades hospitalares. Resultados: os indicadores para a etapa da limpeza apresentaram 47,8% de conformidade para estrutura, 59,0% para processo e 71,8% de produtos estavam limpos. Na etapa operacional do preparo, 50,0% dos indicadores de resultados estiveram em conformidade para estrutura e 66,7%, para processo. Na etapa de esterilização, armazenamento e distribuição, obtiveram-se 43,5% de conformidade para estrutura, 55,7% para processo e 78,6% para conservação das embalagens. O planejamento apreciativo propôs melhorias para a estrutura física, revisão de processos e protocolos, promoção e valorização do trabalho, fortalecimento do ensino sobre processamento e a gerência do serviço, destacando o protagonismo do grupo e da liderança. Conclusão: o uso dos indicadores foi positivo na materialização da realidade, porém verificou-se que as melhorias propostas se relacionam às pessoas. A visão afirmativa e construtiva da investigação apreciativa apresentou-se como caminho para mudanças e melhorias da qualidade.

Analysis of scientific production of mental health researcher and psychiatric nursing specialist meetings.

This literature review was organized on the basis of the Annals of Mental Health Researcher and Psychiatric Nursing Specialists Meetings promoted by the University of São Paulo at Ribeirão Preto College of Nursing. It aimed to describe the history of these events, investigating the scenario and trends through the reading of texts published in these documents. All annals available from 1990 to 2004 were analyzed and read, based on an analysis protocol. The results showed that the published texts reflect the historical momentum of each national mental health policy movement in Brazil, indicating contradictions and advances. The conclusion is that the events provided a privileged forum to discuss and exchange experiences about the future of psychiatric nursing and mental health care, teaching and research in Brazil.

[Teaching of the humanized care: evaluation and trends of the scientific production]. / Ensino do cuidado humanizado: evolução e tendências da produção científica.

From the divulgation of the Curricular Directories of Nursing the degree courses have the mission of to form generalist, critical, reflexive and humanist nurse, what requests efforts of the education institutions in the search of strategies that make possible the development of those abilities. Descriptive study of exploratory of bibliographical nature, had as objective to analyze scientific production in nationals periodic about teaching of the humanized care on the graduation in nursing, among 1990/2008. The occurrence of the production the studied newspapers us allows to affirm that there is a tendency each time bigger about the nurse formation in what he concerns the teaching of the humanized care. In the analysis we identified the Curricular Directories contribution, besides facilitative strategies in the teaching of the humanized care. For the development of that competence it is fundamental emphasis in that dimension in the academic formation and the permanent education.

Functional health literacy and knowledge of renal patients on pre-dialytic treatment. / Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico.

OBJECTIVE:: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. METHOD:: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. RESULTS:: all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition. CONCLUSION:: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

Review of scientific literature on the use of group activities in nursing work in Brazil: 1980 to 2003.

Among the many and diverse activities carried out by nurses, many are organized within the context of a group approach. The realization that there were no systematized studies in Brazil, capable of providing parameters that would help to understand how nurses use this resource, motivated the authors to develop this study, whose objective was to review scientific literature on the use of group activity, as it relates to the work carried out by nurses, between 1980 and 2003. This was a descriptive/exploratory research developed through a bibliographic review in Brazilian journals, on the basis of a specific protocol. We were able to identify 151 articles that were reviewed in terms of the expansion of this knowledge and the different situations in which a group is used by nurses. The qualitative analysis done on pre-established categories enabled the authors to verify that nurses have been using this technique while delivering care, producing knowledge and developing human resources. This investigation allowed us to outline a panoramic view of this literature and to develop a catalogue, identifying important aspects in the construction of this knowledge by Brazilian nursing personnel.

Leads for potentializing groups in Primary Health Care. / Pistas para potencializar grupos na Atenção Primária à Saúde.

OBJECTIVE:: to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants. METHOD:: This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis. RESULTS:: the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership. CONCLUSION:: the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.