Usefulness of the comfort theory in the clinical nursing care of new mothers: critical analysis. / Utilidade da teoria do conforto para o cuidado clínico de enfermagem à puérpera: análise crítica.

OBJECTIVE: The aim of this study was to evaluate the usefulness of the comfort theory for the clinical nursing care of new mothers. METHODS: This is a reflexive-theoretical study conducted in November and December 2014, based on the usefulness criterion proposed in the critical analysis of the Barnum nursing theory. RESULTS: The comfort theory in nursing care for new mothers applied to study analysis revealed that this theory meets the criteria of usefulness because it provides applicable concepts that facilitated the clinical nursing care of women in the postpartum period and helped increase their comfort level. The verification of these concepts showed that the theory can be applied in different settings of clinical care for new mothers. CONCLUSION: The theory can be used to support and improve clinical nursing care for postpartum women, and help improve puerperal comfort.

Subset of nursing diagnoses for the elderly in Primary Health Care.

OBJECTIVE: To develop a subset of nursing diagnoses for the elderly followed in primary health care based on the bank of terms for clinical nursing practice with the elderly, in the International Classification for Nursing Practice (ICNP(r)) version 2013, and on the Model of Nursing Care. METHOD: Descriptive study developed in sequential steps of construction and validation of the bank of terms, elaboration of the nursing diagnoses based on the guidelines of the International Council of Nurses and the bank of terms, and categorization of diagnostics according to the Care Model. RESULTS: The total of 127 nursing diagnoses were elaborated from 359 validated terms, distributed according to the basic human needs. CONCLUSION: It is expected that these diagnoses will form the basis for the planning of nursing care and use of a unified language for documentation of clinical nursing practice with the elderly in primary care. OBJETIVO: Desenvolver um subconjunto de diagnósticos de enfermagem para idosos acompanhados na Atenção Primária à Saúde, com base no banco de termos para a prática clínica de enfermagem com idosos, na Classificação Internacional para a Prática de Enfermagem (CIPE(r)) Versão 2013 e no Modelo de Cuidados de Enfermagem. MÉTODOS: Pesquisa descritiva, desenvolvida em etapas sequenciadas de construção e validação do banco de termos, elaboração dos enunciados de diagnósticos de enfermagem, com base nas diretrizes do Conselho Internacional de Enfermeiros e no banco de termos, e categorização dos diagnósticos segundo o Modelo de Cuidados. RESULTADOS: A partir de 359 termos validados foram elaborados 127 enunciados de diagnósticos de enfermagem, distribuídos segundo as necessidades humanas fundamentais. CONCLUSÃO: Acredita-se que esses enunciados servirão de base para o planejamento dos cuidados de enfermagem e utilização de uma linguagem unificada para a documentação da prática clínica de enfermagem com idosos na atenção primária.

[Methodological approach for the development of terminology subsets ICNP®: an integrative review]. / Percurso metodológico para elaboração de subconjuntos terminilógicos CIPE®: revisão integrative.

OBJECTIVE: To analyze the methodological aspects used for the preparation of terminology subsets of the International Classification for Nursing Practice (ICNP®), in dissertations and theses in the Brazilian nursing. METHOD: This is an integrative review of the Brazilian dissertations and theses defended in the period from 2007 to 2013, which were included seven dissertations. RESULTS: The increasing production of studies on the theme by Brazilian nurses shows a concern for a unified language for the profession. However, the results demonstrate the lack of uniformity in the conduct of studies, especially in relation to the stages of content validation. The initiatives of some authors to systematize alternative methods for creating these subsets also stood out. CONCLUSION: We suggest the development of new terminology subsets, following standards of methodological rigor, as well as its application and validation by the selected clientele, to ensure greater reliability of results and desired changes for the profession.

ICNP® nursing diagnoses for clinical practice in spinal cord injury rehabilitation.

OBJECTIVES: to construct statements of nursing diagnoses for the clinical practice of rehabilitation of people with spinal cord injury using the International Classification for Nursing Practice (ICNP®) and Orem's theory of self-care. METHODS: methodological study developed in four steps: identification of relevant terms to clinical nursing practice in the rehabilitation of people with spinal cord injury; mapping of selected terms with ICNP® terms; construction of nursing diagnoses statements; mapping of statements constructed with pre-coordinated concepts of the ICNP®. RESULTS: 241 statements of nursing diagnoses were constructed and categorized according to the self-care requisites of the theory. The most prevalent statements were those related to universal requisites, followed by developmental requisites and health deviation requisites. CONCLUSIONS: the constructed nursing diagnoses reflect the complexity of phenomena evidenced in the clinical practice of rehabilitation, allowing a systematic and comprehensive care to the person with spinal cord injury.

The importance of logical thinking for clinical nursing care.

OBJECTIVE: To present a reflection on the importance of logical thinking for clinical nursing care. METHOD: Reflection paper. REFLECTION: The exercise of an effective clinical care brings with it the need for logical thinking and adequate reasoning for safe and effective nursing practices. Therefore, training based on philosophical principles that encourage the increase of logical and critical thinking is considered unquestionable, ensuring professionals the systematization of assistance with the application of the nursing process based on scientific understanding and strong arguments supported by the path of truthfulness, morality, ethics and critical self-reflection in order to value clinical practices. FINAL CONSIDERATIONS: The importance of logical thinking for nursing care is ratified here, supporting nursing care systematization and the nursing process stages. Thus, nurses can use clinical reasoning skills to deliver a humane, ethical, and effective professional performance.

Construction of nursing diagnoses for people with spinal cord injury in rehabilitation. / Construção de diagnósticos de enfermagem para pessoas com lesão medular em reabilitação.

OBJECTIVE: To construct nursing diagnosis statements of the International Classification for Nursing Practice (ICNP®) for the spinal cord rehabilitation specialty based on the Callista Roy Adaptation Model. METHOD: Descriptive study developed in sequential steps of identification and cross-mapping of terms relevant to care with the health priority, construction and cross-mapping of nursing diagnosis statements based on the ICNP®, and categorization of diagnoses according to adaptive modes. RESULTS: Ninety-two statements of nursing diagnoses were developed, of which 66 were classified in the Physiological Mode, 12 in Functional Role Mode, 10 in Self-Concept Mode and four in Interdependence Mode. CONCLUSION: The nursing diagnoses developed portray focuses of attention for nursing care to people with spinal cord injury in rehabilitation and contribute to the direction of nursing care actions in a systematic, individualized and resolutive way.

[Frequent nursing diagnoses and interventions for women under critical care]. / Diagnósticos e intervenções de enfermagem frequentes em mulheres internadas em uma unidade de terapia intensiva.

This study aimed at identifying the most frequent Nursing Diagnoses and propose interventions for women under critical care into a maternal intensive care unit in a public hospital in Fortaleza, CE, Brazil. Retrospective study conducted with women's hospital health records. Ten Nursing Diagnoses were elaborated, being four risk: risk of infection, risk of unbalance of liquids volume, risk of aspiration, risk of damaged skin integrity and six real: altered maternity, impaired physical mobility, anxiety and impaired verbal communication. For the referred Nursing Diagnoses, nursing interventions are proposed according to the link between NANDA, NIC and NOC. It was concluded that the use of ND is a necessary technology for the Nursing reality, as it makes possible the integral care.

Nursing diagnoses for institutionalized elderly people based on Henderson's theory.

OBJECTIVE: To develop nursing diagnostic statements for institutionalized elderly people. METHOD: Descriptive study conducted with elderly subjects of a Long Stay Institution through the application of forms for the support of anamnesis and physical examination and a search of medical records. The diagnostic statements were developed based on the International Classification for Nursing Practice and categorized according to the Henderson's theoretical model. RESULTS: Participation of 203 elderly people. A total of 153 nursing diagnoses were developed and distributed as follows: 115 (75.1%) in the Biological/Physiological Component, 14 (9.1%) in the Psychological Component, 21 (13.7%) in the Social Component, and three (1.9%) in the Spiritual/Moral Component. CONCLUSION: The diagnostic statements portray situations of vulnerability to the health of institutionalized elderly that are influenced by biological, psychological, social and cultural factors and require a systematized, individualized and resolutive care for this public.

Specialized nursing terminology for the care of people with spinal cord injury.

OBJECTIVE: To develop a bank of terms of specialized nursing language based on the International Classification for Nursing Practice (ICNP®) for the care of the person with spinal cord injury. METHOD: Descriptive, quantitative study guided by the guidelines of terminological studies. Terms were extracted from an official document of the Ministry of Health through use of a computer tool, and were standardized and mapped with the ICNP® Version 2015. RESULTS: We identified 446 relevant terms, of which 265 were equal, 68 were similar, 23 were more comprehensive, 66 were more restricted, and 24 were not in concordance with terms of the ICNP®. Terms classified as equal and similar were considered as constant. Thus, the bank of terms consisted of 333 constant terms and 113 not contained in the classification. Terms included in the Focus, Action, Means and Location axes predominated. CONCLUSION: The bank of terms will contribute to the construction of the ICNP® terminology subset for the care of people with spinal cord injury.

ICNP ® nursing diagnoses, outcomes and interventions for community elderly.

OBJECTIVE: To construct a nomenclature of nursing diagnoses, outcomes and interventions for elderly people under follow-up in the Family Health Strategy by using the International Classification for Nursing Practice and the theoretical reference of Virginia Henderson. METHOD: Methodological study developed according to guidelines of the International Council of Nurses. RESULTS: A total of 127 concepts of nursing diagnoses/outcomes were constructed and distributed according to nursing care components in the subcategories of Biological/Physiological, Psychological, Social and Spiritual/Moral components. For these diagnoses, were proposed 551 nursing interventions. CONCLUSION: The concepts constructed may favor integral care for the elderly in the Family Health Strategy and the structuring of a terminological subset for this clientele.

Publicações científicas sobre direção veicular por pessoas idosas: revisão de escopo / Scientific publications on driving by older adults: scope review

Resumo Objetivo Mapear evidências científicas nacionais e internacionais sobre a condução veicular por pessoas idosas. Método Revisão de escopo baseada no manual proposto pelo Joanna Briggs Institute. Para as buscas foram acessadas as bases MEDLINE, Web of Science, Scopus, SciELO e a literatura cinzenta, por meio do Google Scholar. Resultados Dos 1.194 estudos encontrados, selecionaram-se 189 artigos submetidos aos critérios de elegibilidade. Os países precursores nas publicações foram Austrália e Estados Unidos, e o ápice das pesquisas ocorreu entre 2013 e 2014. Os participantes dos estudos eram pessoas idosas saudáveis, 63,49% (120); seguidos de 17,46% (33) com doença de Alzheimer; 11,11% (21) com Transtorno Neurocognitivo Leve; 6,88% (13) com doença de Parkinson; e 19,58% (37) com outras comorbidades. Diferentes tipos de intervenções foram identificadas nos estudos, destas, 94,02% (178) avaliaram a eficácia de instrumentos que mensuram a aptidão do motorista idoso. Conclusão Houve predominância de estudos na busca de instrumentos de avaliação que mensurassem a funcionalidade do condutor idoso. Esse fato ratifica a importância de avaliação padronizada, validada e economicamente viável que colabore na identificação do motorista em risco. Evidenciou-se a necessidade de intervenções para a prática da geriatria e gerontologia, por meio de ações para formação de equipe multidisciplinar especializada em condução veicular, de modo a adequar as diretrizes de licenciamento a fim de atender às especificidades dos condutores idosos, considerando os aspectos sociais, econômicos, políticos e educacionais, especialmente nos departamentos de trânsito brasileiro.

Abstract Objective To map national and international scientific evidence regarding driving by older adults. Method Scope review based on the manual proposed by the Joanna Briggs Institute. Searches were conducted in the MEDLINE, Web of Science, Scopus, SciELO databases, and grey literature through Google Scholar. Results Out of 1,194 studies identified, 189 papers meeting eligibility criteria were selected. Pioneering countries in publications were Australia and the United States, with the peak of research occurring between 2013 and 2014. Study participants included healthy older adults (63.49%, 120), followed by those with Alzheimer's disease (17.46%, 33), Mild Neurocognitive Disorder (11.11%, 21), Parkinson's disease (6.88%, 13), and other comorbidities (19.58%, 37). Various interventions were identified, with 94.02% (178) assessing the effectiveness of instruments measuring the fitness of older drivers. Conclusion There was a prevalence of studies aimed at identifying assessment tools to measure the functionality of older drivers. This underscores the importance of standardized, validated, and economically viable assessments that contribute to identifying at-risk drivers. The need for interventions in geriatrics and gerontology was evident, emphasizing the necessity for actions to establish a specialized multidisciplinary team in vehicular driving. This approach seeks to align licensing guidelines with the specific needs of older drivers, taking into account social, economic, political, and educational aspects, particularly within the Brazilian traffic departments.

Nursing care to patients with diabetes based on King's Theory.

OBJECTIVE: To verify the effectiveness of nursing interventions based on the Imogene King's Theory of Goal Attainment, on improving care for people with diabetes and adherence to treatment. METHOD: Quasi-experimental, longitudinal, randomized, simple study in a Primary Health Care Unit, in the city of Fortaleza, Ceará state, Brazil. The sample consisted of 60 people with diabetes, divided into intervention and control groups, whose collection occurred from February to August 2013. RESULTS: In the intervention group, a significant adherence of the patients to the goals defined in the study was found. In the control, there was improvement in some aspects of the treatment. CONCLUSION: With these results, it was possible to conclude the feasibility of using Theory of Goal Attainment in the positive aspects for adherence to diabetes treatment and improvement of quality of life.

Brazilian Unified Health System and democracy: nursing in the context of crisis.

OBJECTIVE: to discuss, taking for reference the crisis in Brazil and its impact on public health policies, the insertion of Brazilian nursing in that context and its ways of practicing the profession, based on the study about the politicality of care. METHOD: the reflection is divided into two topics, the first is about public policies, the Brazilian Unified Health System and the deconstruction of the right to health with neoliberal offensive; and the second is about the nursing political action in the fight for the right to health and for democracy. FINAL CONSIDERATIONS: we emphasize that nursing must assume its sociopolitical role to contribute to the construction of a better and fairer Brazil, saying no to neoliberal reforms, as well as fighting for rights already acquired and for the resumption of the democratic stability in the country.

Validity and reliability of the Brazilian version of the Caregiver Reaction Assessment.

OBJECTIVE: To analyze the validity based on the internal structure and reliability of the Brazilian version of the Caregiver Reaction Assessment (CRA) applied to informal caregivers of dependent elderly. METHOD: A methodological study with 120 informal caregivers of the elderly. Validity based on the internal structure evaluated by exploratory factorial analysis, with extraction of main factorial axes, varimax orthogonal rotation and retention of factors by parallel analysis. Reliability assessed by Cronbach's alpha. RESULTS: The instrument revealed a factorial structure different from the original version: three factors were identified, equivalent to subscales, self-esteem, daily activities and family support, with explained variance of 42%. The values of the Cronbach alpha for the items belonging to each subscale were, respectively: 0.71, 0.81 and 0.83. CONCLUSION: The Brazilian version of CRA presents good evidence of validity based on internal structure and is reliable, and can be used to assess the overload of informal caregivers of dependent elderly.

The Tidal Model: analysis based on Meleis's perspective.

OBJECTIVE: To critically reflect on the conceptual components of the Tidal Model in the application of the mental healthcare process. METHOD: Critical analysis based on the Models of Theory Analysis, focused on the clarity and consistency of the theoretical components of the Tidal Model. RESULTS: The clarity of the theory was verified through the demonstration of the following components: functional, presuppositions, concepts and propositions. The consistency is due to the possibility of proven application in several countries with different populations. CONCLUSION: There is a vast field of research and possibilities of application in the Brazilian nursing consultation, in search of usefulness and support in nursing care.

Finalidades da interdisciplinaridade na residência multiprofissional em saúde no contexto da atenção primária / Purposes of interdisciplinarity in multidisciplinary health residency in the context of primary care

A prática interdisciplinar tem o potencial de contribuir para a superação de uma visão fragmentária em saúde, encontrando potencialidade de desenvolvimento na formação da residência multiprofissional em saúde. Assim, objetivou-se reconhecer as vertentes da interdisciplinaridade na residência multiprofissional em saúde com lócus na atenção primária sob a ótica dos campos de operacionalização. Trata-se de um estudo exploratório, com abordagem qualitativa, que contemplou as perspectivas de 13 profissionais envolvidos no processo organizacional e pedagógico dos programas de residência multiprofissional em saúde do estado do Ceará, Nordeste do Brasil. Os dados foram organizados conforme proposta da análise de conteúdo. Quatro categorias analíticas foram estruturadas, condizentes com as finalidades da interdisciplinaridade: científica, escolar, profissional e prática. Reconheceu-se a presença transversal de todas as finalidades da interdisciplinaridade nessa modalidade de formação. No entanto, identificou-se uma maior valorização da finalidade escolar, embricada no processo formativo baseado em competências estruturadas na articulação de conhecimentos, habilidades e atitudes. Ao passo, a finalidade científica demonstrou-se menos perceptível no conteúdo analisado, implicando na menor proposição e incentivo dos programas de residência a essa prática. Destarte, suscitam-se reflexões relevantes à saúde coletiva ao enfatizar a interdisciplinaridade como possibilidade para a formação efetiva em saúde.

Interdisciplinary practice has the potential to contribute to overcoming a fragmented view of health, finding potential for development in the formation of multidisciplinary residency in health. Thus, the objective was to recognize the purposes of interdisciplinarity in multiprofessional residency in health with a locus in primary care from the perspective of operational fields. This is an exploratory study with a qualitative approach, which included the perspectives of 13 professionals involved in the organizational and pedagogical process of multidisciplinary residency programs in health in the state of Ceará, Northeastern Brazil. Data were organized according to the content analysis proposal. Four analytical categories were structured, consistent with the purposes of interdisciplinarity: scientific, academic, professional and practical. The transversal presence of all the purposes of interdisciplinarity in this training modality was recognized. However, a greater appreciation of the school purpose was identified, embedded in the training process based on structured competences in the articulation of knowledge, skills and attitudes. At the same time, the scientific purpose proved to be less noticeable in the analyzed content, implying a lower proposition and encouragement of residency programs to this practice. Thus, reflections relevant to collective health are raised by emphasizing interdisciplinarity as a possibility for effective training in health.

ICNP® nursing diagnoses for clinical practice in spinal cord injury rehabilitation / Diagnósticos de enfermería de la CIPE® para la práctica clínica de la rehabilitación en lesiones de la médula espinal / Diagnósticos de enfermagem da CIPE® para a prática clínica de reabilitação em lesão medular

ABSTRACT Objectives: to construct statements of nursing diagnoses for the clinical practice of rehabilitation of people with spinal cord injury using the International Classification for Nursing Practice (ICNP®) and Orem's theory of self-care. Methods: methodological study developed in four steps: identification of relevant terms to clinical nursing practice in the rehabilitation of people with spinal cord injury; mapping of selected terms with ICNP® terms; construction of nursing diagnoses statements; mapping of statements constructed with pre-coordinated concepts of the ICNP®. Results: 241 statements of nursing diagnoses were constructed and categorized according to the self-care requisites of the theory. The most prevalent statements were those related to universal requisites, followed by developmental requisites and health deviation requisites. Conclusions: the constructed nursing diagnoses reflect the complexity of phenomena evidenced in the clinical practice of rehabilitation, allowing a systematic and comprehensive care to the person with spinal cord injury.

RESUMEN Objetivos: construir enunciados de diagnósticos de enfermería para la práctica clínica de rehabilitación de personas con lesión medular utilizando la Clasificación Internacional para la Práctica de Enfermería (CIPE®) y la teoría del autocuidado de Orem. Métodos: estudio metodológico desarrollado en cuatro etapas: identificación de términos relevantes para la práctica clínica de enfermería en la rehabilitación de personas con lesión medular; mapeo de términos seleccionados con términos CIPE®; construcción de enunciados de diagnósticos de enfermería; mapeo de enunciados construidos con conceptos pre-coordinados de la CIPE®. Resultados: fueron construidos 241 enunciados de diagnósticos de enfermería, categorizados de acuerdo con los requisitos de autocuidado de la teoría. Los enunciados más prevalentes fueron los relacionados con los requisitos universales, seguidos de los requisitos de desarrollo y las desviaciones de la salud. Conclusiones: los diagnósticos de enfermería construidos reflejan la complejidad de los fenómenos evidenciados en la práctica clínica de rehabilitación, permitiendo una atención sistemática e integral a la persona con lesión medular.

RESUMO Objetivos: construir enunciados de diagnósticos de enfermagem para a prática clínica de reabilitação da pessoa com lesão medular utilizando a Classificação Internacional para a Prática de Enfermagem (CIPE®) e a teoria do autocuidado de Orem. Métodos: pesquisa metodológica desenvolvida em quatro etapas: identificação de termos relevantes para a prática clínica de enfermagem na reabilitação de pessoas com lesão medular; mapeamento dos termos selecionados com os termos da CIPE®; construção dos enunciados de diagnósticos de enfermagem; mapeamento dos enunciados construídos com os conceitos pré-coordenados da CIPE®. Resultados: foram construídos 241 enunciados de diagnósticos de enfermagem, categorizados conforme os requisitos de autocuidado da teoria, destacando-se com maior prevalência os enunciados relacionados aos requisitos universais, seguidos pelos requisitos de desenvolvimento e de desvios de saúde. Conclusões: os diagnósticos de enfermagem construídos refletem a complexidade dos fenômenos evidenciados na prática clínica de reabilitação, possibilitando um cuidado sistematizado e integral à pessoa com lesão medular.

The importance of logical thinking for clinical nursing care / La importancia del pensamiento lógico para el cuidado de enfermería clínica / A importância do pensamento lógico para o cuidado clínico de enfermagem

ABSTRACT Objective To present a reflection on the importance of logical thinking for clinical nursing care. Method Reflection paper Reflection The exercise of an effective clinical care brings with it the need for logical thinking and adequate reasoning for safe and effective nursing practices. Therefore, training based on philosophical principles that encourage the increase of logical and critical thinking is considered unquestionable, ensuring professionals the systematization of assistance with the application of the nursing process based on scientific understanding and strong arguments supported by the path of truthfulness, morality, ethics and critical self-reflection in order to value clinical practices. Final considerations The importance of logical thinking for nursing care is ratified here, supporting nursing care systematization and the nursing process stages. Thus, nurses can use clinical reasoning skills to deliver a humane, ethical, and effective professional performance.

RESUMEN Objetivo Presentar una reflexión sobre la importancia del pensamiento lógico para el cuidado de enfermería. Método Estudio de reflexión. Reflexión El ejercicio de un cuidado clínico efectivo trae consigo la necesidad de un pensamiento lógico y un razonamiento adecuado para prácticas de enfermería seguras y efectivas. Por tanto, se considera incuestionable la formación basada en principios filosóficos que propicien el pensamiento lógico y crítico, asegurando la sistematización de la asistencia y el proceso de enfermería basados en la comprensión científica y argumentos sólidos sustentados en el camino de la verdad, moral, ética. y autocrítica, con el fin de favorecer la valorización de prácticas clínicas. Consideraciones finales Se confirma la importancia del pensamiento lógico para el cuidado de enfermería, apoyando la sistematización del cuidado y las etapas del proceso de enfermería. De esta manera, las enfermeras pueden utilizar las habilidades de razonamiento clínico, proporcionando un desempeño profesional humano, ético y eficaz.

RESUMO Objetivo Apresentar uma reflexão sobre a importância do pensamento lógico para o cuidado clínico de enfermagem. Método Estudo de reflexão. Reflexão Pensar em exercer o cuidado clínico eficaz remete à necessidade de um pensamento lógico e raciocínio adequado para a realização de práticas de enfermagem seguras e eficazes. Para tanto, considera-se inquestionável a formação baseada nos princípios filosóficos que estimulem o incremento do pensamento lógico e crítico, assegurando aos profissionais a sistematização da assistência com aplicação do processo de enfermagem a partir do entendimento científico e argumentos sólidos abalizados pelo caminho da verdade, moral, ética e autocrítica, de forma a favorecer a valorização das práticas clínicas. Considerações finais Ratifica-se a importância do pensamento lógico para o cuidado de enfermagem fundamentando a Sistematização da Assistência de Enfermagem e as etapas do Processo de Enfermagem. Desta forma, o enfermeiro pode fazer uso do raciocínio clínico propiciando uma atuação profissional humana, ética e eficaz.

Cuidados terminais: reflexão filosófica sob a ótica da ética e da moral / Cuidados terminales: reflexión filosófica desde la perspectiva de la ética y la moral / Terminal care: philosophical reflection from ethical and moral perspectives

RESUMO Objetivo Objetivou-se refletir sobre a prática assistencial do cuidado ao paciente com doença terminal sob a ótica da ética e da moral. Método Trata-se de estudo teórico-reflexivo realizado a partir da análise crítica de textos filosóficos sobre ética e moral no contexto do desenvolvimento moral humano e das práticas de saúde. Resultados Na época dos filósofos gregos, a ética se baseava na busca pela felicidade; contudo, com o advento do cristianismo, ela passou a ser vista como um dever. Pela ótica de Kant, a ética e a moral são também um dever, um imperativo categórico, e a questão da manutenção da vida deve ser perseguida, abrindo espaço para a ocorrência de práticas de distanásia. Já para Hans Jonas, o dever dos profissionais de saúde é considerar a qualidade de vida dos pacientes mais do que da quantidade de vida, introduzindo conceitos dos cuidados paliativos. Conclusão e implicações para a prática Tais conceitos se modificaram ao longo da história, sendo necessário conhecê-los, fazer uma reflexão crítica sobre a finitude humana e repensar as condutas nesse processo.

RESUMEN Objetivo El objetivo fue reflexionar sobre la práctica del cuidado al paciente con enfermedad terminal desde una perspectiva de la ética y la moral. Método Se trata de un estudio teórico-reflexivo, basado en el análisis crítico de textos filosóficos sobre ética y moral en el contexto del desarrollo moral humano y las prácticas de salud. Resultados La ética, en la época de los filósofos griegos, se basaba en la búsqueda de la felicidad, sin embargo, con el advenimiento del cristianismo, ésta pasó a ser vista como un deber. Desde el punto de vista de Kant, la ética y la moral también son un deber, un imperativo categórico y la cuestión del mantenimiento de la vida debe ser perseguida, abriendo espacio para la ocurrencia de prácticas distanásicas. Para Hans Jonas, el deber de los profesionales de la salud es considerar la calidad de vida de los pacientes por encima de la cantidad de vida, introduciendo conceptos de cuidados paliativos. Conclusión e implicaciones para la práctica Tales conceptos han cambiado con la historia, requiriendo conocimiento y reflexión crítica sobre la finitud humana y repensar el comportamiento en este proceso.

ABSTRACT Objective To reflect on the care practice for patients with a terminal illness from ethical and moral perspectives. Method This is a theoretical-reflective study carried out from the critical analysis of philosophical texts on ethics and morals in the context of human moral development and health practices. Results At the time of Greek philosophers, ethics was based on the search for happiness. However, with the advent of Christianity, this came to be seen as a duty. According to Kant, ethics and morals are duties as well — a categorical imperative — and the life maintenance issue must be pursued, opening space for the occurrence of dysthanasia practices. From Hans Jonas' point of view, otherwise, health professionals must consider the quality of life of the patient over their life span, introducing concepts of palliative care. Conclusion and implications for the practice The above-mentioned concepts changed over time, and knowing them is necessary for critically reflecting on human finitude and rethinking practices that revolve around this process.

Pensamento complexo e formação em enfermagem: possibilidades da extensão universitária / Complex thinking and education in nursing: possibilities of university extension / Pensamiento complejo y educación en enfermería: posibilidades de extensión universitaria

Objetivo:Objetivou-se discutir à luz do Pensamento Complexo as possibilidades da extensão universitária na formação do Enfermeiro. Método:Trata-se de estudo teórico reflexivo com base referencial do pensamento complexo proposto por Edgar Morinem articulação com as cinco diretrizes da extensão universitária. Para articular o conceito propostopeloautor a temática em estudo, foram realizadasbuscas eletrônicas não sistemática sobre o tema, realizando-seleitura crítica de suas obras e de outros estudiosos.Resultados:As discussões utilizaram o referencial do pensamento complexo de Edgar Morin e as cinco diretrizes da extensão universitária: Interação Dialógica; Interdisciplinaridade e Interprofissionalidade; Indissociabilidade Ensino-Pesquisa-Extensão; Impactos na Formação dos estudantes e Impacto e Transformação social, no ensino superior em Enfermagem. Evidenciaram-se contribuições e possibilidades das práticas extensionistas para a formação do enfermeiro direcionadas ao desenvolvimento do pensamento complexo, crítico, reflexivo, humano e cidadão. Considerações finais:Conclui-se que (re)pensar as práticas pedagógicas e curriculares da extensão na formação em Enfermagem em articulação com o pensamento complexo é imprescindível para uma práxis emancipatória e transdisciplinar.

Objective:The objective was to discuss, in the light of ComplexThinking, the possibilities of university extension in the training of nurses. Method:This is a reflective theoretical study based on the complex thinking proposed by Edgar Morin in conjunction with the five guidelines of university extension. In order to articulate the concept proposed by the author to the subject under study, non-systematic electronic searches were carried out on the subject, carrying out a critical reading of his works and those of other scholars. Results:The discussions used Edgar Morin's complex thinking framework and the five university extension guidelines: Dialogical Interaction; Interdisciplinarity and Interprofessionality; Inseparability Teaching-Research-Extension; Impacts on Student Training and Impact and Social Transformation in Nursing Higher Education. Contributions and possibilities of extension practices were evidenced for the training of nurses aimed at the development of complex, critical, reflective, human and citizen thinking. Final considerations:It is concluded that (re)thinking the pedagogical and curricular practices of extension in Nursing education in conjunction with complex thinking is essential for an emancipatory and transdisciplinary praxis.

Objetivo:El objetivo fue discutir, a la luz del Pensamiento Complejo, las posibilidades de la extensión universitaria en la formación de enfermeros. Método:Se trata de un estudio teórico reflexivo basado en el pensamiento complejo propuesto por Edgar Morin en conjunto con los cinco lineamientos de la extensión universitaria. Para articular el concepto propuesto por el autor al tema en estudio, se realizaron búsquedas electrónicas no sistemáticas sobre el tema, efectuando una lectura crítica de sus obras y de las de otros estudiosos. Resultados: Las discusiones utilizaron el marco de pensamiento complejo de Edgar Morin y las cinco directrices de la extensión universitaria: Interacción Dialógica; Interdisciplinariedad e Interprofesionalidad; Inseparabilidad Docencia-Investigación-Extensión; Impactos en la Formación de Estudiantes e Impacto y Transformación Social en la Educación Superior de Enfermería. Se evidenciaron aportes y posibilidades de prácticas extensionistas para la formación de enfermeros encaminados al desarrollo del pensamiento complejo, crítico, reflexivo, humano y ciudadano. Consideraciones finales:Se concluye que (re)pensar las prácticas pedagógicas y curriculares de extensión en la formación de Enfermería en conjunto con el pensamiento complejo es fundamental para una praxis emancipatoria y transdisciplinar.