RESUMO
OBJECTIVE: To describe the nurses' actions of the Family Health Strategy about the First Week for Integral Health regarding the care devoted to the newborn. METHOD: It is a descriptive, exploratory research with qualitative approach carried out from October 2014 to February 2015, through a semi-structured interview, with nine nurses from the Family Health Strategy of João Pessoa-PB. Data were submitted to thematic analysis. RESULTS: The actions identified at the first visit to the newborn child are based on maternal guidance on basic newborn care, breastfeeding, neonatal screening, immunization and childcare, as well as evaluation of the puerperal, but it was sometimes performed outside the period recommended and with incomplete and outdated guidelines. CONCLUSION: Although there are potentialities in nurses' actions to this population, the fragilities compromise the care of the newborn and the puerperium, and it is necessary to sensitize these professionals about the importance and effectiveness of First Week for Integral Health.
Assuntos
Visita Domiciliar , Cuidado do Lactente , Recém-Nascido , Enfermagem Materno-Infantil/organização & administração , Enfermeiros de Saúde Comunitária/psicologia , Cuidados de Enfermagem/organização & administração , Padrões de Prática em Enfermagem , Atitude do Pessoal de Saúde , Aleitamento Materno , Feminino , Humanos , Entrevistas como Assunto , Masculino , Enfermagem Materno-Infantil/educação , Mães/educação , Programas Nacionais de Saúde/organização & administração , Papel do Profissional de Enfermagem , Cuidados de Enfermagem/psicologia , Pesquisa Qualitativa , Estudos de AmostragemRESUMO
The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce.
Assuntos
Assistência Integral à Saúde/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Enfermeiros de Saúde Comunitária/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Assistência Centrada no Paciente/organização & administração , Adulto , Etnicidade , Humanos , Masculino , Países Baixos , Religião , Integração de SistemasRESUMO
PURPOSE: Describe community nurses' experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. METHOD: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. FINDINGS: Healthy aging was characterized by the interconnection of older persons, older persons' family members, and the community. Healthy aging was associated with two themes: "being strong" and "being a supporter and feeling supported." The nurses' experiences in promoting healthy aging were described by the themes "providing health assessment," "sharing knowledge," and "having limited resources." CONCLUSIONS: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centeredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy aging strategies in Thailand.
Assuntos
Atitude do Pessoal de Saúde , Envelhecimento Saudável/psicologia , Enfermeiros de Saúde Comunitária/psicologia , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiros de Saúde Comunitária/tendências , Pesquisa Qualitativa , TailândiaRESUMO
OBJECTIVE: To examine amongst healthcare professionals in England; knowledge of vaccinations in pregnancy, their perceived roles in these programmes and whether they recommend scheduled vaccines to pregnant women. DESIGN: Cross sectional survey (online questionnaire) Setting: Healthcare workers in contact with pregnant women in England. PARTICIPANTS: The survey analysis included 3441 healthcare workers who had been surveyed during May to August 2015. The participants were midwives, practice nurses and health visitors, working in England who were members of the Royal College of Midwives, Royal College of Nursing and the Institute of Health Visiting. RESULTS: We found that knowledge of vaccination in pregnancy was high in all professional groups. Seventy three percent of all respondents would recommend the influenza vaccine and 74% would recommend the pertussis vaccine to pregnant women. They were more likely to recommend vaccination in pregnancy if they would personally have the influenza and pertussis vaccines themselves and/or if they had the influenza vaccine as a healthcare worker. Practice nurses were significantly more likely to recommend the pertussis and influenza vaccines to pregnant women than midwives and health visitors. Health professionals who had received immunisation training were more confident in giving advice to pregnant women. CONCLUSION: Immunisation training is essential if healthcare workers are to be informed and confident in effectively delivering the maternal immunisation programme and thus improving uptake of vaccines in pregnancy. These findings are important in tailoring educational programmes and addressing the training needs of different healthcare professional groups.
Assuntos
Atitude do Pessoal de Saúde , Tocologia , Enfermeiros de Saúde Comunitária/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Vacinação/psicologia , Adulto , Idoso , Estudos Transversais , Inglaterra , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Vacina contra Coqueluche/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Cuidado Pré-Natal/psicologia , Inquéritos e Questionários , Coqueluche/microbiologia , Coqueluche/prevenção & controle , Adulto JovemRESUMO
Resumo OBJETIVO Descrever as ações de enfermeiros da Estratégia Saúde da Família acerca da Primeira Semana Saúde Integral no cuidado ao recém-nascido. MÉTODO Pesquisa descritiva, exploratória com abordagem qualitativa realizada de outubro de 2014 a fevereiro de 2015, por meio de entrevista semiestruturada, com nove enfermeiros da Estratégia Saúde da Família de João Pessoa-PB. Os dados foram submetidos à análise temática. RESULTADOS As ações identificadas na primeira visita ao bebê se baseiam nas orientações maternas acerca dos cuidados básicos ao recém-nascido, aleitamento materno, testes de triagem neonatal, imunização e puericultura, bem como avaliação da puérpera, no entanto, por vezes eram realizadas fora do período recomendado e com orientações incompletas e desatualizadas. CONCLUSÃO Embora haja potencialidades nas ações dos enfermeiros prestadas a essa população, as fragilidades comprometem a assistência ao neonato e à puérpera, sendo necessário sensibilizar esses profissionais acerca da importância e eficácia da Primeira Semana Saúde Integral.
Resumen OBJETIVO Describir las acciones de enfermeros de la Estrategia Salud de la Familia acerca de la Primera Semana Salud Integral en la atención al recién-nacido. MÉTODO Investigación descriptiva, exploratoria con abordaje calitativo, realizada de octubre de 2014 hacia febrero de 2015, por medio de entrevista semiestructurada, con nueve enfermeros de la Estrategia Salud de la Familia de João Pessoa-PB. Los datos fueron sometidos al análisis temático. RESULTADOS Las acciones identificadas en la primera visita al bebé se basan en las orientaciones maternas sobre los cuidados básicos al recién nacido, la lactancia materna, las pruebas de selección neonatal, la inmunización y la puericultura, así como la evaluación de la puérpera, pero a veces se realizaban fuera del período recomendado y con directrices incompletas y obsoletas. CONCLUSIÓN Aunque hay potencialidades en las acciones de los enfermeros prestadas a esa población, las fragilidades comprometen la asistencia al neonato y a la puérpera, siendo necesario sensibilizar a esos profesionales acerca de la importancia y eficacia de la Primera Semana Salud Integral.
Abstract OBJECTIVE To describe the nurses' actions of the Family Health Strategy about the First Week for Integral Health regarding the care devoted to the newborn. METHOD It is a descriptive, exploratory research with qualitative approach carried out from October 2014 to February 2015, through a semi-structured interview, with nine nurses from the Family Health Strategy of João Pessoa-PB. Data were submitted to thematic analysis. RESULTS The actions identified at the first visit to the newborn child are based on maternal guidance on basic newborn care, breastfeeding, neonatal screening, immunization and childcare, as well as evaluation of the puerperal, but it was sometimes performed outside the period recommended and with incomplete and outdated guidelines. CONCLUSION Although there are potentialities in nurses' actions to this population, the fragilities compromise the care of the newborn and the puerperium, and it is necessary to sensitize these professionals about the importance and effectiveness of First Week for Integral Health.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Enfermagem Materno-Infantil/organização & administração , Padrões de Prática em Enfermagem , Enfermeiros de Saúde Comunitária/psicologia , Visita Domiciliar , Cuidado do Lactente , Cuidados de Enfermagem/organização & administração , Aleitamento Materno , Atitude do Pessoal de Saúde , Entrevistas como Assunto , Estudos de Amostragem , Enfermagem Materno-Infantil/educação , Papel do Profissional de Enfermagem , Pesquisa Qualitativa , Mães/educação , Programas Nacionais de Saúde/organização & administração , Cuidados de Enfermagem/psicologiaRESUMO
OBJECTIVES: Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. METHODS: A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analyse the quantitative data. The qualitative data were analysed thematically. RESULTS: Motivations for health visiting as a career choice were similar for fast track and standard entry students, with career progression and interest in health promotion being key motivators. There was consensus that personal qualities and characteristics were more important than experience or qualifications. However, fast track students were significantly less confident about their public health competencies in leadership and management (p < 0.05) and communication (p < 0.02). Practice teachers and managers also reported that fast track students required more intensive supervision particularly at the beginning of the programme. Programme completion including pass rates and academic achievement showed no significant difference by route of entry (p > 0.5). CONCLUSION: Fast tracking offers a useful recruitment strategy in order to expand the health visitor workforce, but longitudinal research is needed to confirm benefits such as retention and career trajectories.
Assuntos
Escolha da Profissão , Motivação , Enfermeiros de Saúde Comunitária/organização & administração , Medicina Estatal/organização & administração , Inglaterra , Mão de Obra em Saúde , Humanos , Tocologia/educação , Tocologia/organização & administração , Enfermeiros de Saúde Comunitária/educação , Enfermeiros de Saúde Comunitária/psicologiaRESUMO
PURPOSE: This study aimed to explore patient and nurse satisfaction, compliance with best practice, technical feasibility and safety of home infusion of the bisphosphonate zoledronic acid (ZOL). METHODS: This was a prospective 1-year survey of home ZOL therapy (4 mg Zometa, 15-min i.v., every 3-4 weeks) in patients with bone metastases secondary to a solid malignancy. A physician questionnaire, nurse satisfaction/feasibility questionnaire and patient satisfaction questionnaire were administered at several time-points. RESULTS: Physician participation rate was 56.5% (87/154). Physicians enrolled 818 patients visited by 381 predominantly community nurses. Of the 788 case report forms received, 763 met inclusion criteria. Patient characteristics were as follows: median age, 68 years (30-95); M/F, 40/60; ECOG-PS 0 or 1, 78.6%; and primary tumour site, breast (55.2%), prostate (28.4%), lung (7.2%) or other (9.4%). Nurse satisfaction rates were high: organisation of home ZOL therapy, 90.9%; ease of infusion, 96.7%; patient-nurse relationship, 97.5%; and relationship with hospital staff, 73%. Patient satisfaction was also very high (95.3%). The main reasons were quality of the nurse-patient relationship (57.6%), less travel/waiting (68.8%), home environment (52.9%) and less disruption to daily routine (36.6%). ZOL therapy was well tolerated, the discontinuation rate due to adverse events (including deaths whether related to diseases progression or not) was 33.6%. The incidence of osteonecrosis of the jaw was 0.6% and of fractures, 0.2%. Practitioner compliance with best practice was 76.7-83.7% for recommended and/or tolerated dosage, 73% for dental hygiene checks at inclusion and 48-56% thereafter, 66% for pre-infusion hydration, and often undocumented for calcium/vitamin D supplementation. CONCLUSIONS: Home ZOL therapy was well tolerated. Both patient and nurse satisfaction were very high. However, better compliance with best practice should be encouraged.