Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process.

A person living with Alzheimer's disease (PA) can experience difficulty during bodily care and therefore may show resistance to care behaviours (RTCBs). Nurses must take a clinical approach to planning care that meets the person's needs. Therefore, it is necessary to identify training strategies for bedside nurses and nursing students. AIMS AND OBJECTIVES: To describe and discuss how the FOC practice process (FOC-PP) can help nurses understand PAs who show RTCBs during bodily care. BACKGROUND: Resistance to care behaviour phenomenon and the importance of bodily care as fundamental care are described. The FOC-PP enables nurses to apply the FOC framework in their practice. DESIGN: This discursive paper is based on the literature of the FOC framework and PP. METHOD: A clinical scenario that develops through the five stages of the FOC-PP. RESULTS: The scenario centres on Mrs. Emily Morgan, 81, who lives in a nursing home and is not receiving the bodily care that she needs. Camille, a nursing student, and her supervisor Florence collaborate with Mrs. Morgan's family to improve the quality of her care. Three particular aspects of nursing practice based on the FOC-PP are described: the critical thinking process, relational process and pedagogical process. CONCLUSION: The FOC-PP promotes holistic care centred on the person and his or her needs and encourages the nurse to use his or her skills and knowledge. All these dimensions are fundamental for high-quality nursing care. RELEVANCE TO CLINICAL PRACTICE: Mrs. Morgan's scenario enables us to perceive that the FOC-PP is very useful for nursing students and bedside nurses. However, given the amount of specific and diverse knowledge required by the FOC-PP, it is necessary to identify avenues for teaching them. Using clinical scenarios could facilitate the integration of the FOC-PP, with taking into account the specific characteristics of individual clients.

Mal de Simioto: práticas de saúde às crianças no interior do Brasil / Simioto's disease: health practice for children in the interior of Brazil

The "Simioto'sDisease" is a disease that has popular legitimacy and influences the search for treatment for infant health problems. This study aimed to understand the health practices related to Simioto'sDisease in a city in the interior of Brazil, from the perspective of parents of treated children. This is a qualitative and descriptive study performed by obtaining data using a semi-structured questionnaire with parents of children who were diagnosed and treated for the Simioto'sDisease. The data were subjected to content analysis. The categories discussedwere: The Simioto'sDisease pathology and its cultural aspects: symptoms, diagnosis, treatment and its indications and effectiveness; Relationship between Simioto'sDisease and professionalhealth care; The profile of healers or informal care and religiosity in the care of Simioto'sDisease. It was concluded that diagnosis and treatment are practices based on symptoms that generate a popular diagnosis. By describing the parent perspective, this practice is based on the belief of the treatmentefficacy and is legitimized by the healer reception, guidelines and precautionary measures of the disease that are passed, among other care, in addition to the baths performing frequency.

O "Mal de Simioto" é uma doença que possui legitimidade popular e queinfluencia a busca por tratamento para problemas de saúde infantil. Objetivou-se compreender as práticas de saúde relacionadas ao Mal de Simioto em um município no interior do Brasil, na perspectiva dos pais das crianças tratadas. Estudo qualitativo, descritivo, realizado através da obtenção de dados com o uso de questionário semiestruturado com os pais de crianças que foram diagnosticadas e tratadas com o Mal de Simioto. Os dados foram submetidos à análise de conteúdo.As categorias discutidas foram: A patologia Mal de Simioto e seus aspectos culturais: os sintomas, o diagnóstico, o tratamento e sua indicação e eficácia; Relação entre Mal de Simioto e os cuidados profissionais de saúde;Operfil dos curandeiros ou cuidadores informais e a religiosidade no cuidado ao Mal de Simioto. Concluiu-se queo diagnóstico e o tratamento são práticas baseadas em sintomas que geram um diagnóstico popular. Através da descrição pela perspectiva dos pais, essa práticabaseia-se na crença da eficácia do tratamento e é legitimada pelo acolhimento do curandeiro,das orientações e medidas de precaução da doença que são repassadas, entre outros cuidados, além da periodicidade de realização dos banhos.

Banho de ofurô em recém-nascidos no alojamento conjunto: um relato de experiência / Baño de ofuro en recién nacidos en el alojamiento conjunto: un relato de experiencia / O furo bath in newborns in the rooming-in center: an experience report

Objective: To report the experience of the nursing staff of the rooming-in center of a maternity in Rio de Janeiro with regard to the use of the technique of ofuro bath, by associating the benefits of relaxation and humanized care already described in the literature. Method: This is an experience report of the introduction of a new relaxation technique for newborns. The team was sensitized and trained to use the technique and, subsequently, its members started to perform the care shares in the previously selected neonates. Results: The achieved results showed that, after a few minutes of immersion in the ofuro bucket, the newborns were quieter, thereby ceasing the weeping and falling into asleep during the bath. It was observed an improvement of suction and maintenance of the latch during the breastfeeding, since they become more relaxed after the use of the technique. Conclusion: This experience should be considered as enriching, because it allows the transformation of the care model, thereby favoring the comprehensive care of newborns.

Objetivo: Relatar a experiência da equipe de enfermagem do alojamento conjunto de uma maternidade do Rio de Janeiro quanto ao uso da técnica de banho de ofurô, associando aos benefícios do relaxamento e assistência humanizada já descritos na literatura. Método: Relato de experiência da introdução de uma nova técnica de relaxamento para recém-nascidos. A equipe foi sensibilizada e capacitada para utilização da técnica e, após isso, iniciaram a realização nos cuidados aos neonatos previamente selecionados. Resultados: Os resultados alcançados demonstraram que, após poucos minutos de imersão no balde de ofurô, os recém-nascidos apresentaram-se mais tranquilos, cessando o choro e adormecendo no decorrer do banho. Também observou-se melhoria de sucção e manutenção da pega no aleitamento materno, pois estes encontravam-se mais relaxados após a utilização da técnica. Conclusão: Considera-se esta experiência enriquecedora, pois possibilita a transformação do modelo assistencial, favorecendo o cuidado integral aos recém-nascidos.

Objetivo: Relatar la experiencia del equipo de enfermería del alojamiento conjunto de una maternidad de Rio de Janeiro para el uso de la técnica del baño de ofuro, asociando a los beneficios de la relajación y asistencia humanizada ya descritos en la literatura. Método: Relato de experiencia de la introducción de una nueva técnica de relajación para los recién nacidos. La equipo fue sensibilizada y capacitada para la utilización de la técnica, y después de eso, empezaron a actuar en el cuidado de los recién nacidos previamente seleccionados. Resultados: Los resultados alcanzados mostraron que después de algunos minutos de inmersión en el cubo de ofuro los recién nacidos se quedaban más tranquilos, dejando el lloro y adormeciendo durante el baño. También se observó mejoría de succión y manutención de agarrar el pecho durante la lactancia materna, pues ellos se encontraban más relajados después de la utilización de la técnica. Conclusión: Se considera esta experiencia enriquecedora, pues permite la transformación del modelo asistencial, favoreciendo la atención integral a los recién nacidos.

Waterbirth and GBS.

The literature provides a single case of early onset newborn Group B Strep (GBS) among 4432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth. The last reported rate of newborn GBS for dry births was 1 in 1450. Several theories for this phenomenon are suggested in this article: (1) inoculating the baby with mother's intestinal flora at birth protects against GBS infection; (2) water washes off the GBS bacteria acquired during the descent through the vagina; (3) the water dilutes the GBS bacteria and mixes it with a multitude of other intestinal bacteria that compete with GBS; (4) early onset GBS is elicited by complications and interventions at birth, which occur less often at water-births; (5) kangaroo care at birth promotes healthy newborns; (6) GBS and antibiotic-resistant GBS are more prevalent in hospital environments, where waterbirths are not an option; (7) a higher rate of underreporting of adverse events at waterbirths compared to dry births; and/or (8) a massively successful international campaign has covered up the reporting of all deaths and disease from GBS after waterbirths.

Neonatal skincare: why change is vital.

'Newborn skin is thinner, more permeable and less able to withstand the sensitising effects of modern detergents. It is also important to remember that anything placed on, in or around a baby has the capacity to harm' (Trotter, 2004a). The anatomical and functional differences of neonatal skin have been thoroughly reported over the years and there is now a body of evidence to support the above statement (Fatter, 1997; Gelmetti, 2001; Lund, 2001a, 2001b; Medves, 2001; Ertel, 2003; Trotter, 2002, 2004a). The aim of this article is to inform midwives about the potential dangers of chemical ingredients used in personal care products and to suggest simpler skincare regimes. It is anticipated that doing so will reduce the risks of conditions like eczema, asthma and related allergies.