Patient readmission for orthopaedic surgical site infection: an hermeneutic phenomenological approach.

AIM AND OBJECTIVE: To explore the individual experience of being readmitted for surgical site infection resulting from orthopaedic surgery. BACKGROUND: Surgical site infection has been a cause of concern worldwide and contributes to the greatest number of hospital readmission occurrences. Health professionals must understand the meaning of these readmissions for the individual, as an understanding of these exclusive experiences improves the quality of surgical care. DESIGN: Qualitative research based on the existential phenomenology of Martin Heidegger. METHOD: Eleven individuals who were readmitted because of surgical site infection participated in the study. The testimonials were obtained over an 11-month period in 2014-2015 based on the following leading question: What has it been like for you to be readmitted because of orthopaedic surgical site infection? The phenomenological analysis identified the sentiment units of the testimonials and their interrelation, revealing the meanings. RESULTS: The revealed contents were fear and insecurity of the unknown, frustration, and the sense of time passing them by and being unable to live their lives. The individuals felt neglected, and they experienced their social relationality as impaired and sometimes approaching a breakdown. The patients connected with God as an attempt to avoid complications and death. CONCLUSION: We urge healthcare professionals to deepen their knowledge of the dimensions of care by developing competencies that consider the subjectivity of experiences of the health-disease process. When the only listening that takes place is qualified listening, the professional's attitudes compromise his or her ability to provide true care, which transcends the knowledge of doing and reaches the knowledge of doing with sensitivity. RELEVANCE TO CLINICAL PRACTICE: Nursing care requires an attitude that considers the patient as more than a carrier of illness and should not be limited to what is described and prescribed, although the latter cannot be excluded in an organisational point of view.

Maintenance of tobacco withdrawal by former smokers: a phenomenological study. / Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico.

OBJECTIVE To understand the experience of former smokers maintaining tobacco abstinence. METHODS Qualitative research using the theoretical-methodological reference of the Social Phenomenology, as defined by Alfred Schütz. The phenomenological interview was carried out in 2016 with 12 former smokers from a city in the state of Minas Gerais, Brazil. The statements were organized into categories and discussed based on the literature. RESULTS The maintenance of tobacco abstinence was revealed in the categories: "Health, sociability, and financial gains"; "Living with the urge to smoke and with the increase of body weight"; "Self-determination and use of replacement strategies"; and "Staying away from cigarettes." CONCLUSIONS These results alert health professionals to the need to provide support to former smokers so they can remain smoke-free. This implies considering not only the negative effects of the tobacco abstinence, but also the social context in which former smokers are inserted that might have an impact on the maintenance or not of the cigarette withdrawal.

Nursing interventions with people with obesity in Primary Health Care: an integrative review.

Objective Identify the knowledge produced on nursing interventions with people suffering from obesity in Primary Health Care. Method Integrative literature review of publications indexed in the databases: CINAHL, LILACS, MEDLINE, SciELO, SCOPUS and WEB OF SCIENCE, between 2011 and 2016. Results Thirty-three articles were selected. The knowledge produced covered two themes: "Counseling aimed at weight control and promotion of healthy lifestyle habits" and "Perception of Primary Health Care nurses regarding interventions with people with obesity." Conclusion The results may help prompt reflections on professional training, management, and health services in terms of the relevance of nurses working with people suffering from obesity, with the support of digital technologies, motivational techniques, and nursing consultations. This could enhance their activities in the multiprofessional teams in which they participate at this healthcare level.

Intimate partner violence among speaking immigrant adult Portuguese women in Canada.

OBJECTIVE: This study was conducted to understand the experiences of intimate partner violence among women from Portuguese-speaking countries living in the Greater Toronto Area. METHOD: A social phenomenological study was conducted with ten Portuguese-speaking women who had experienced intimate partner violence who were selected by community centre leaders. The interviews were transcribed, translated and analysed by categories. RESULTS: The consequences of violence included health problems, effects on children, and negative feelings among the victims. Factors preventing the women from leaving abusive partners included religious beliefs, challenging daily jobs, and the need to take care of their husband. Factors that encouraged them to leave included getting support and calling the police. Some women expressed hope for the future either with their husband. Others, desired divorce or revenge. Their plans to rebuild their lives without their husband included being happy, learning English, and being financially stable. CONCLUSION: Using these findings can implicate in the improvement of care for these women.

Understanding of the life experience of homeless women.

OBJECTIVE: To understand the life experience of homeless women. METHOD: A social phenomenological study was conducted with 10 women assisted by a shelter. The analysis of the interviews was based on the theoretical framework of social phenomenology of Alfred Schütz and thematic literature. RESULTS: The participants face adversities in the street context, with emphasis on the risk of physical and sexual abuse, and seek shelters as a possibility for minimizing difficulties experienced. They hope to leave the streets; however, they see themselves trapped in this social reality, due to the addiction to alcohol and other drugs. CONCLUSION: The understanding of the life experience of homeless women shows daily confrontations and reveals the conflict between the desire for leaving and remaining on the streets, given the complexity of the reality that keeps them in this condition. OBJETIVO: Compreender a vivência de mulheres em situação de rua. MÉTODO: Pesquisa fenomenológica social realizada com 10 mulheres assistidas por um albergue. A análise das entrevistas ancorou-se no referencial teórico da fenomenologia social de Alfred Schütz e literatura temática. RESULTADOS: As participantes enfrentam adversidades no contexto da rua, com destaque para o risco de violência física e sexual, e buscam o albergue como possibilidade de minimizar as dificuldades vivenciadas. Elas têm como expectativa sair da rua, porém se veem presas a esta realidade social em virtude do vício em álcool e outras drogas. CONCLUSÃO: A compreensão da vivência de mulheres em situação de rua aponta enfrentamentos cotidianos e revela o conflito entre o desejo de sair e permanecer na rua, dada a complexidade da realidade que as mantém nesta condição.

[Understanding unsuccessful attempts to quit smoking: a social phenomenology approach]. / Compreendendo o insucesso da tentativa de parar de fumar: abordagem da fenomenologia social.

OBJECTIVE: The aim of this paper is to understand the experience of smokers in view of unsuccessful attempts to quit smoking. METHOD: This study is based on social phenomenology. Between November and December of 2014, nine interviews were conducted with people that had attempted to quit smoking. The content of these interviews was analyzed and discussed based on the related literature. RESULTS: Unsuccessful attempts to quit smoking are related to tobacco addiction; cigarettes are seen as a support to cope with everyday stressful situations. Attempts to quit the smoking habits were based on the need of health improvement and insistence of family and friends. Smokers reported the use of habit cessation strategies learned in support groups, but they also express expectation of specialized psychological support. CONCLUSION: The study points out the need to expand the strategies of approaching smokers, and reinforcing psychological support in order to achieve success in the attempt to quit smoking.

Older Brazilian women's experience of psychological domestic violence: a social phenomenological study.

BACKGROUND: Domestic violence is a global public health issue, as it is in Brazil. The psychological violence is one of the most prevalent forms of domestic violence, affecting more women than men. However, many older adults do not consider it as a type of domestic violence. In addiction, psychological violence has received little attention from researchers. So, this study aims to further understand the phenomenon of psychological domestic violence perpetrated by relatives against older adult women (60 years and older). METHODS: A qualitative study was conducted using a social phenomenological approach proposed by Alfred Schütz. In-depth interviews were conducted with 11 older Brazilian women from three different agencies, two in Campina Grande and one in São Bernardo do Campo. Data collection took place between November 2012 and February 2013. We performed data analysis using the key concepts (such as the world of everyday life, natural attitude, intersubjetivity, stock of knowledge, biographical situation, social action, motivation and typification) proposed by Alfred Schutz. RESULTS: Despite the fact that participants reported being psychologically abused, they also referred to being neglected and financially abused. They revealed being threatened, disrespected, neglected, financially abused, forced to do housework, and humiliated. Older women expressed feelings of sadness, anger, grief, and fear, which had negative effects on their health. Attempts by the participants to change their current situations were unsuccessful and resulted in feelings of helplessness. The abuser's behaviour will change, and leaving the abusive situation were two possible outcomes pointed for participants. CONCLUSIONS: A support network is crucial to help changing the behaviour of aggressors and/or to help older adult women leave the abusive situation. Further research is needed to understand the risk factors linked to abuse behaviours, to develop educational programs for the abusers, and to design social support for the victims.

[Readmission from orthopedic surgical site infections: an integrative review]. / Readmissão por infecção do sítio cirúrgico ortopédico: uma revisão integrative.

OBJECTIVE: Characterizing readmissions from orthopedic surgical site infections. METHOD: An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS: 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. CONCLUSION: Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

Experiences and expectations of nurses in caring for organ donors and their families. / Experiências e expectativas de enfermeiros no cuidado ao doador de órgãos e à sua família.

Objective Understand the experiences and expectations of intensive care unit nurses in caring for organ donors and their families. Method Qualitative research, with a social phenomenological approach, conducted in 2013 with 20 nurses. Results The experiences of the nurses with the families of donors were represented by two categories: obstacles encountered and interventions performed in the care of the donors' families. The expectations of these professionals in caring for organ donors and their families were described in the category: care to save lives. Conclusion The study showed that the day-to-day work of intensive care nurses in their care of organ donors and their families is permeated with obstacles that interfere in the donation process. In light of this, their goal is to provide intensive care to deceased donors and humanized care to the families, to help family members agree to organ donation and enable organs to be made available for transplants.

[The decision of an obese woman to have bariatric surgery: the social phenomenology]. / A decisão da mulher obesa pela cirurgia bariátrica à luz da fencomenologia social

OBJECTIVE: To understand the process by which an obese woman decides to have bariatric surgery. METHOD: A qualitative survey with a social phenomenology approach, carried out in 2012, with 12 women, using the phenomenological interview. RESULTS: A woman bases the decision to have the surgery on: the inappropriateness of her eating habits; a physical appearance that is incompatible with an appearance that is standardized by society; the social prejudice that she has to live with; the limitations imposed by obesity; and her lack of success with previous attempts to lose weight. Outcomes that she hopes for from the decision to have the surgery include: restoring her health; achieving social inclusion; and entering the labor market. CONCLUSION: This study allows one to reflect that prescriptive actions do not give a satisfactory response to a complexity of the subjective questions involved in the decision to have surgery for obesity. For this, what is called for is a program of work based on an interdisciplinary approach, and training that gives value to the bio-psycho-social aspects involved in a decision in favor of surgical treatment.

Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers.

Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

[Elderly women: revealing their experiences and care needs]. / Mulheres idosas: desvelando suas vivências e necessidades de cuidado.

This qualitative study used a social phenomenology approach to elucidate the experiences, care needs and expectations of the elderly women. Nine elderly women were interviewed between February and May 2011 using a semi-structured questionnaire. The elderly women referred to their physical, mental, and social limitations. They valued ​​the preservation of their autonomy in daily activities and in self-care and considered their families to be a fundamental support. They had expectations of remaining healthy, pursuing leisure activities, and having improved access to healthcare information and treatment. The absence of prospects at this stage of life was related to the loss of significant people and the loss of health. The results of this study reveal important aspects of the experiences of elderly women and encourage further research and improvement in teaching, clinical practice and management policies in relation to the needs of these women.

[The daily life of men who lives with chronic venous ulcer: phenomenological study]. / O cotidiano do homem que convive com a úlcera venosa crônica: estudo fenomenológico.

The chronic venous leg ulcer is the major therapeutic problem of lower limb injuries, which can trigger changes in the daily life of the person affected by it. This study aimed to understand the daily life of men who lives with chronic venous ulcers. A phenomenological study was conducted with eight men, who were interviewed during June and July of 2001. The study asked questions related to: "Restrictions in social life" and "Recovering the skin integrity and restart the activities affected by the wound". The answers revealed that men with these ulcers have social implications in the areas of productivity and sexuality. This leads to restrictions in everyday life with loss in performance of socially established roles for men, leading to anxiety for his return at full performance of his social role. The findings suggest significant experiential aspects that may guide professionals in the planning and implementation of health actions aimed to treat these patients.

[The social phenomenology of Alfred Schütz and its contribution for the nursing]. / A fenomenologia social de Alfred Schütz e sua contribuição para a enfermagem.

Nursing care can be considered a social action that is set in the everyday world, where intersubjective relations are established and must be valued by the nurse in the different contexts in which it acts. It is a theoretical study which aimed to highlight the main concepts of the social phenomenology of Alfred Schütz's and its contribution to Nursing as a knowledge and professional practice field. The following questions guided this study: what is the understanding of caring in Nursing from the perspective of the social phenomenology of Alfred Schütz's? How to apply Alfred Schütz's theoretical concepts in the action of caring in Nursing? The theoretical concepts of the social phenomenology and their interface with Nursing were delimited. By incorporating the concepts of the t theory of social action developed by Alfred Schütz into Nursing, this study allows nurses to value and apply the aspects highlighted by this theoretical framework within healthcare, education and scientific research.

[Adolescent abortions experience and care needs]. / Abortamento na adolescência: vivência e necessidades de cuidado.

This is a qualitative research based on the social phenomenology approach, performed in 2010 with eight adolescents who experienced abortion and were assisted in a philanthropic hospital institution in the state of Minas Gerais. This research aimed at understanding the experience and care needs regarding adolescents in an abortion situation. The results show that the pregnancy impact led to the fear of non acceptance by the family and at the same time, the feeling of happiness for the possibility of being a mother. The abortion experience was marked by suffering and the care provided was considered satisfactory, being highlighted the need for more attention and information. The adolescents plan to continue their studies and have in mind the possibility of a new pregnancy. The planning of preventive actions aimed at this audience, and the development of new scientific investigations that include the perspective of family members and health professionals begin to emerge.

[The care needs of women infected with the human papilloma virus: a comprehensive approach]. / Necessidades de cuidados de mulheres infectadas pelo papilomavírus humano: uma abordagem compreensiva.

This study is founded on the phenomenology of Martin Heidegger, with the objective to understand the care needs of women infected with the human papilloma virus. Participants were fourteen women who had been diagnosed with this infection. The guiding questions were: What is it like to have this diagnosis? Tell me your experience, from when you received your diagnosis until today. What has your health care been like? The questions revealed the theme - seeking care as solitude - which showed the importance of the support of family and friends. The presence of the infection as the cause of marital conflicts and separation was another highlighted aspect. The statements showed that there was a sense of resignation after an unsuccessful attempt to find accurate and clear information in order to make assertive decisions. Health interventions for infected women must overcome the traditional models of care, including interventions for health promotion and prevention, with trained professionals who are sensitive to the subjective dimension.

[Evidence-based practices published in Brazil: identification and analysis studies about human health prevention]. / Práticas baseadas em evidências publicadas no Brasil: identificação e reflexão na área da prevenção em saúde humana.

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

[Experiencing care in the birthing center context: the users' perspective]. / Vivenciando o cuidado no contexto de uma casa de parto: o olhar das usuárias.

In Brazil, the delivery and birth care model in Brazil has been the topic of many studies and discussions about introducing obstetric practices that take women's autonomy into account in the parturition process. Birthing Centers propose models that represent a new scenario to deliver such care. The objective of this was to understand the experience of women in labor in the context of a Birthing Center located in the city of São Paulo. Data was collected from March to October 2007 and analyzed according to the Alfred Schütz social phenomenology framework. Seven women participated in this study. Results showed that women choose the Birthing Center expecting to receive humanized care and that, within this context, they have positive and negative experiences. It is imperative to discuss public policies for delivery care, as well as its implementation and impact on perinatal health indicators.

[Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches]. / Práticas baseadas em evidências publicadas no Brasil: identificação e análise de suas vertentes e abordagens metodológicas.

This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.

[Bachelor and teaching degree in nursing: experiences and expectations of nursing students]. / Licenciatura e bacharelado em enfermagem: experiências e expectativas de estudantes.

This is a phenomenological study that aimed to understand the experience of the student enrolled in both the Bachelor and the teaching undergraduate degree in nursing at the same time. Interviews with eight nursing students from a public university of Minas Gerais, Brazil, were undertaken. Analyses were conducted based on the social phenomenology of Alfred Schütz. Results showed that according to the pupils, there is no connection between the teaching courses and the Bachelor ones, but they also highlighted that the teaching degree helps educational activities in nursing. The students have interest in working with health education and to become nursing teachers. They also consider that the dual degree allows the expansion of knowledge and generates better expectations related to professional practice. However, it has gaps which need to be reviewed by those who work in nursing education, addressing the specific theoretical and practical needs of nursing students.