[Nursing care in the perspective of complexity for nursing professors]. / Cuidado de enfermagem para enfermeiros docentes na perspectiva da complexidade.

The complex nursing care is essential for understanding the human being as unique and multidimensional. This study aimed at knowing what nursing care means to nurse-teachers in the perspective of complexity. It is a qualitative research, carried out with seven nurse-teachers of a nursing school from central Rio Grande do Sul, Brazil. Data were collected in November 2011, through focus group,from three meetings, systematized with themes which considered the objective of this study. Discursive text analysis was used for data analysis. Results evinced nursing care as unique construction that goes beyond a technical-prescriptive, punctual and linear care. It is concluded that nursing care cannot be conceived as a reductionist action, but as a unique construction, which involves interactions, reflections and self-knowledge.

[Educational geronto-technology for ostomized seniors from a complexity perspective]. / Gerontotecnologia educativa voltada ao idoso estomizado à luz da complexidade.

We aimed to present the educational booklet as a geronto-technological product for caring for ostomized seniors from a complexity perspective. This was accomplished in the second semester of 2007 in a hospital in the south of Brazil. The data were collected through interviews and presented in the form of an educational booklet. The booklet was validated by ostomized seniors and by a nurse who had been working with these elderly patients. The booklet was presented as a geronto-technology able to help ostomized seniors and their families understand the rights of ostomized people; concepts and types of stomas; care of ostomy; and the importance of the family and the support group for care. In conclusion, the educational booklet is presented as a health promotion tool which makes the health educative process easier.

[The characterization of elderly medication users living in long-term care facilities]. / Caracterização dos idosos usuários de medicação residentes em instituição de longa permanência.

The objectives of this study were to characterize the elderly living in a long-term care facility in terms of their medication use and verify the existence of polypharmacy. This descriptive quantitative study was performed using a database from the research: The profile of the elderly living in a long-term care institution for the aged: a proposal for nursing/health action. A total of 39 elderly individuals who used medications were selected. It was found that most were women, aged between 80-89 years, who were literate and widowed. Circulatory system diseases were the most frequent. The elderly used a mean of 3.7 medications, and 30.8% took multiple medications. The most commonly used medications were for the cardiovascular system. It was found that some individuals used medications considered inappropriate for the elderly population. We hope to sensitize health professionals to promote a rational and careful use of medications among institutionalized elderly individuals.

[Risk of falls in the elderly: an integrative review based on the North American Nursing Diagnosis Association]. / Risco de quedas em idosos: revisão integrativa pelo diagnóstico da North American Nursing Diagnosis Association.

The objective of this study was to analyze the scientific production regarding risk factors for falls in the elderly, based on the North American Nursing Diagnosis Association found in the Brazilian and international literature from 2005 to 2010. This integrative review was performed using the descriptors: accidental falls and elderly, utilizing the following databases: Cumulative Index to Nursing and Allied Health Literature and Latin-American and Caribbean Health Sciences Literature. Thirty-two articles were selected for content analysis. The results are presented according to the risk factors indicated by the North American Nursing Diagnosis Association, which are: environmental risk factors, such as rooms with excessive furniture and objects/rugs on the floor, poor illumination, and slippery floors; cognitive risk factors such as reduced mental state; risk factors in adults such as age above 65 years; physiological risk factors such as impaired balance, visual difficulties, incontinence, difficulty in walking, and neoplasms; and risk factors associated with the use of certain medications. An examination of the risk factors for falls in the elderly shows the need to develop new strategies to change environments and intrinsic components.

[The scientific nursing production about the clinic: an integrativa review]. / A produção científica de enfermagem acerca da clínica: uma revisão integrativa.

The objective of this study was to learn about the production of nursing knowledge in Brazil associated with the clinic theme. This is a qualitative study performed by means of an integrative review. Data collection was performed on the SciELO database using the keywords nursing and clinic, present in the abstracts of articles. It was found that the clinic is seen as an instrument used to establish connections between research and nursing care, having a constant movement of constructing and deconstructing knowledge and practices. The study results may contribute with the production of research and knowledge in nursing, providing elements to subsidize improvements in nursing care, in which there is an interaction between practice and biological and non-biological knowledge.

[Moral distress and the ethical dimension in nursing work]. / Sofrimento moral e a dimensão ética no trabalho da enfermagem.

Nurses face moral problems, moral dilemmas and moral distress in their professional daily. The moral distress manifests itself when nurses demonstrate difficulties to face situations morally appropriate following their conscious. The study aims to focus about the nurses' moral distress and their relationship with moral problems and moral dilemmas presenting concepts, moral distress experiences and possible strategies to be adopted to face it. To focus on the moral distress provoked by facing the moral problems and dilemmas in nursery work seems to be primordial not just to reveal a phenomenon still a little known even experienced almost every day but, also to headline the need of problematization and valorization of the ethical dimension of work in health.

[Constructing knowledge about solid waste in health services in the education of health professionals]. / Construção do saber sobre resíduos sólidos de serviços de saúde na formação em saúde.

The need to implement policies to manage solid residues in health services (SRHS) in different health institutions is unquestionable, considering the risks they pose to public health and the environmental degradation caused by them. In order to find out how knowledge about SRHS has been constructed in the education of the health professional, data were collected with semistructured interviews with students, professors and coordinators in four schools (Nursing and Obstetrics, Odontology, Veterinary Sciences, and Medicine) at a Higher Education Institution located in the south of Brazil. The data content and document analysis identified based on the Complexity Theory ideas, show the need for a teaching reform which should include new concepts, such as integrality, articulation, dialog, and problematization, in the Teaching Projects developed by those courses, so that future health professionals can construct their knowledge about solid residues with responsibility and commitment.

Assessment of health/functioning of older adults who consume psychoactive substances.

OBJECTIVE: To assess the health/functioning of the older adult who consumes psychoactive substances through the International Classification of Functioning, Disability and Health, considering the theory of complexity. METHOD: Qualitative case study, with 11 older adults, held between December 2015 and February 2016 in the state of Rio Grande do Sul, using interviews, documents and non-systematic observation. It was approved by the ethics committee. The analysis followed the propositions of the case study, using the complexity of Morin as theoretical basis. RESULTS: We identified older adults who consider themselves healthy and show alterations - the alterations can be exacerbated by the use of psychoactive substances - of health/functioning expected according to the natural course of aging such as: systemic arterial hypertension; depressive symptoms; dizziness; tinnitus; harmed sleep/rest; and inadequate food and water consumption. Final consideration: The assessment of health/functioning of older adults who use psychoactive substances, guided by complex thinking, exceeds the accuracy limits to risk the understanding of the phenomena in its complexity.

The daily lives of people with Parkinson's disease.

OBJECTIVE: To understand the daily lives of people with Parkinson's disease. METHOD: Qualitative research, using as methodological and theoretical referential the Grounded Theory and Symbolic Interactionism, respectively. The in-depth interview was conducted with 30 people with Parkinson's disease. RESULTS: From data analysis, three themes were selected: Living with the disease - living with the treatment and changes in lifestyle; Modifying of one's job performance - revealing incapacity for work and the need to anticipate retirement and; Living with the stigma - the feeling of prejudice against the disease and the perceived limitations of the health services. FINAL CONSIDERATIONS: Living with a chronic and non-transferable disease encompasses social, physical and cultural effects, along with the personal experiences of each unique individual. This study assists the improvement of care to people with the disease, because the care practice emerges from the interactions between the subjects.

Complex educational and care (geron)technology for elderly individuals/families experiencing Alzheimer's disease.

Objective: To describe the contributions of the Integrated Multidisciplinary Care Group for Caregivers of Individuals with Alzheimer's Disease as an educational and care (geron)technology in the context of Alzheimer's disease in elderly individuals from the perspective of family members/caregivers. Method: Exploratory, descriptive study with a qualitative approach conducted with 13 family members/caregivers of elderly people participating in the support group of a university institution of the state of Rio Grande do Sul, Brazil. Data collected between January and April 2016 through a semi-structured interview were submitted to discursive textual analysis. Results: Family members/caregivers pointed out education and care as contributions of the group; education for care and for the future; exchange, socialization, and development of knowledge through the range of knowledge existing in the Group. Conclusion: The Group contributes as a (geron)technology of care and education for care in which knowledge is built and applied in practice, supporting the experienced disorders and improving the quality of care provided for elderly individuals with Alzheimer's disease.

Objetivo: Descrever as contribuições do Grupo de Assistência Multidisciplinar Integrada aos Cuidadores de Pessoas com a Doença de Alzheimer como (geronto)tecnologia cuidativo-educacional no contexto da doença de Alzheimer em pessoas idosas, na perspectiva de familiares/cuidadores. Método: Pesquisa exploratório-descritiva, qualitativa, realizada com 13 familiares/cuidadores de pessoas idosas, participantes do grupo de apoio de uma instituição universitária do Rio Grande do Sul, Brasil. Os dados coletados entre janeiro a abril/2016, com uma entrevista semiestruturada, foram submetidos à análise textual discursiva. Resultados: Os familiares/cuidadores referiram como contribuições do Grupo a educação e o cuidado; a educação para o cuidado e para o futuro; a troca, socialização e construção do conhecimento por meio dos diversos saberes existentes no Grupo. Conclusão: O Grupo contribui como (geronto)tecnologia de cuidado e educação para o cuidado; nele, são construídos conhecimentos que, aplicados na prática, auxiliam nas desordens vivenciadas, melhorando o cuidado à pessoa idosa com doença de Alzheimer.

[Teaching of gerontogeriatric nursing and complexity]. / O ensino da Enfermagem Gerontogerlatrica e a complexidade.

The present study had the objectives of identifying the characteristics of gerontogeriatric nursing and of reflecting on this teaching, based on identified characteristics, in the light of Complexity. A qualitative research, its data sources were nine proceedings volumes of Brazilian Nursing congresses and seven Brazilian nursing publications of the 1991-2000 period. The main body of this article was comprised of 16 scientific articles; QRSNUD* IST4 was used for analysis. Results showed that this teaching does take place, and it is carried out through: mandatory disciplines in the curriculum; practical activities; activities during curricular training; extra-curricular activities; participation on specific or general Nursing events in which studies are presented; other activities. To use the principles of Complexity is tantamount to perceiving educative teaching as trying to convey a culture that will enable future workers to understand the human condition and to think in a contextualized, open, globalized, ethical way.

[Profile of nursing schools graduates according to the National Curriculum Guidelines: an approach]. / Perfil de egresso de curso de enfermagem nas Diretrizes Curriculares Nacionais: uma aproximação.

The curriculum restructuration in the nursing graduation course, that is necessary according to the National Curriculum Guidelines (NCG), starts its activities with a critical reading of the Resolution 03/2201. In this Resolution, there is, besides others orientations, the egresses profile. This critical review of literature aimed at reflecting about the words or categories that the egresses profile contains, according to the NCG. It will be made by using dictionaries (of Portuguese language and philosophy) and literature diverse (of the nursing course and others subjects) to understand them better and perceive them relevant to the nurse professional formation and, consequently, essential in the Pedagogical Political Project (PPP). The values of the egresses profile proposal in the nurse's formation are recognized, but it is important to realize that it is not a matter of establish new marks, prioritize new objectives, change the profile, restructure subjects, reestablish functioning conditions or schedule only, but realize a collective work with a group growth.

O consumo de substâncias psicoativas entre pessoas idosas: um olhar complexo / The consumption of psychoactive substances among older adults: a complex perspective / El consumo de sustancias psicoactivas en personas mayores: una mirada compleja

OBJETIVO: descrever o padrão de consumo de substâncias psicoativas entre pessoas idosas sob a ótica da complexidade. Método: qualitativo do tipo estudo de caso múltiplo, realizado com onze pessoas idosas no domicílio/serviço de saúde; os dados foram coletados através de documentos, observação assistemática e entrevista semiestruturada; foram analisados de forma geral, analítica e teórica por meio da comparação dos casos; teve como eixo teórico a complexidade, sendo aprovado pelo comitê de ética em pesquisa. RESULTADOS: quanto ao padrão de consumo de substâncias psicoativas foram achados dois temas: encontro com a substância, que identificou pessoas idosas utilizando substâncias lícitas e ilícitas, e formas de consumo; consequências e motivações do consumo e/ou abandono das drogas. São consequências as perdas materiais/econômicas e criminalidade e motivações a socialização e fuga do estresse/ansiedade. Os idosos que pararam ou diminuíram o consumo aderiram à estratégia de redução de danos. CONCLUSÃO: evidenciou-se o consumo de substâncias psicoativas por pessoas idosas, verificando-se espaço para o sucesso de intervenções de saúde/enfermagem com a criação de ações/programas de abordagem específica para redução de danos.

OBJECTIVE: to describe the pattern of consumption of psychoactive substances among older adults from the perspective of complexity. METHOD: a qualitative survey of the multiple-case study type, carried out with eleven older adults at their homes and/or at a health service; data was collected through documents, unsystematic observation and semi-structured interview; they were analyzed in a general, analytical and theoretical way by comparing the cases; its theoretical axis was complexity, being approved by the research ethics committee. RESULTS: regarding the pattern of consumption of psychoactive substances, two themes were found: encounter with the substance, which identified older adults using legal and illegal substances, and forms of consumption; consequences and motivations of drug use and/or abandonment. Consequences are material/economic losses and crime, and motivations for socialization and escape from stress/anxiety. The older adults who stopped or reduced their consumption adhered to the harm reduction strategy. CONCLUSION: the consumption of psychoactive substances by older adults was evidenced, with space for the success of health/nursing interventions, with the creation of actions/programs with a specific approach to harm reduction.

OBJETIVO: describir el patrón de consumo de sustancias psicoactivas en personas mayores desde la perspectiva de la complejidad. MÉTODO: estudio cualitativo, de tipo caso múltiple, realizado con once ancianos en el domicilio/servicio de salud; los datos se recopilaron a través de documentos, observación no sistemática y entrevista semiestructurada; se analizaron de forma general, analítica y teórica comparando los casos; su eje teórico fue la complejidad, siendo aprobado por el comité de ética en investigación. RESULTADOS: en cuanto al patrón de consumo de sustancias psicoactivas, se encontraron dos temas: contacto con la sustancia, que identificó a personas mayores que consumen sustancias legales e ilegales, y formas de consumo; consecuencias y motivaciones del consumo y/o abandono de las drogas. Las consecuencias son pérdidas materiales/económicas y delitos, y motivaciones para socializar y escapar del estrés/ansiedad. Las personas mayores que suspendieron o disminuyeron su consumo se adhirieron a la estrategia de reducción de daños. CONCLUSIÓN: se evidenció el consumo de sustancias psicoactivas por los adultos mayores, con espacio para el éxito de las intervenciones de salud/enfermería, con la creación de acciones/programas con un enfoque específico de reducción de daños.

[Depression among the elderly in a long-term residential institution: proposal for nursing action]. / Depressão em idosos de uma Instituição de Longa Permanência (ILP): proposta de ação de enfermagem.

The objectives of this study were: identifying the presence of depression among elderly dwelling in an Elderly Clinic; proposing a nursing action in order to prevent depression among these elderly guests. Descriptive research carried out at Abrigo Cristo Redentor, in Recife, Pernambuco, Brazil, with a sampling of 41 aged people. Seven out of them presented depression. The main symptoms were: hopelessness; uselessness feeling; insomnia; sadness among others. We concluded by recognizing the difficulties faced by the elderly who need to live in an Elderly Clinic and the importance of the nurse presence to better handle their difficulties.

[Nursing curricula in Brazil and guidelines -- new perspectives]. / Curriculos de enfermagem do Brasil e as diretrizes--novas perspectivas.

This bibliographic clipping is aimed at presenting the history of current undergraduate nursing curricula, starting with the first school that came into existence in Brazil--"Escola de Enfermelros e enfermeiras do Rio de Janeiro", in 1890, until the Administrative Act CNE/CES, from March/2001, a document that established a new curriculum for nursing education in our country. I have noticed that the changes in the curricula were obligatory, and now I notice that participation of nurses and a stronger collective interest has evolved, and they seem to be engaged in educating more humanized, reflexive, and critical nurses for the future.

[Research on nursing in light of Edgar Morin's concept of complexity]. / Pesquisa em enfermagem à luz da complexidade de Edgar Morin.

This paper aims at introducing Complexity by showing its importance through research carried out in the Nursing area. It consists of a reflection divided into two parts: the Complexity's principles, by Edgar Morin; and research on Nursing originating from Complexity. By taking into account the Complexity involving the objects of study in Nursing, it is desirable to choose a methodological path which is more appropriate to its comprehension, that is, to choose only one method which is more likely to portray a real picture of the subject. By understanding such method as a path to investigation combined with and originating from theory and not as a support to scientific practice, the concept of Complexity, by Edgar Morin, when used as a theoretical choice, ends up as a guide to a methodological path.

[The family in the Pediatric Unit: living with rules and hospital routines]. / A família na Unidade de Pediatria: convivendo com normas e rotinas hospitalares.

The study aimed to know, in Foucault's view, how the family caregiver of the child deals with the rules and routines in the hospital. Descriptive qualitative study, conducted in the second half of 2011. It had the Grounded Theory as methodological framework. It was developed in the pediatric unit of a university hospital in southern Brazil, with eighteen family caregivers. The data collection was performed by semi-structured interviews and the analysis through open, axial and selective coding. It was noticed that the family tends to conform to such rules and routines in the hospital, but recognizes the importance of its flexibility, exercising endurance, as dialoguing, or as trespassing such rules and routines, in search of autonomy, when they realize that these do not address their needs. It is important to use rules and routines to enable the family practices and spaces of freedom, autonomy and resistance.

[Ecosystemic and gerontotechnological actions in complex nursing care to the elderly with ostomy]. / Acoes ecossistemicas e gerontotecnologicas no cuidado de enfermagem complexo ao idoso estomizado.

The goal was to identify the ecosystem and gerontogeriatric technological actions to be done in a complex nursing care for the elderly patients of ostomy. To do so, a qualitative and descriptive research was made on a Case Study. The data were collected through interviews. The elderly were classified due to the Functioning, Disability and Health. They also went through physical exams and systematic observation. Ten people from the Estomatherapy Service of the south of Brazil took part in the research along the period of June to August of 2012. A theoretical model was developed and the data were compared with a protocol. The ecosystem actions identified the construction of a therapeutic environment, the guaranty of physical access and environmental adaptation. The gerontogeriatric technological actions identified a health educative process, the routing to the support group and the material and necessary equipment distribution for self-care. Being the nursing care primordial for the elderly patients of ostomy, they are able to face their limitations, demystifying their deficiency/ disability /health.

Fatores comportamentais associados à adesão medicamentosa em idosos em atendimento ambulatorial / Behavioral factors associated to medication adhesion in elderly in outpatient care

Objetivo: avaliar a relação entre fatores comportamentais e adesão à terapêutica medicamentosa em idosos em atendimento ambulatorial. Método: estudo transversal com amostra de 107 idosos em atendimento ambulatorial em um hospital universitário. Os dados foram coletados por meio de entrevista. Aplicaram-se: instrumento de caracterização do idoso, Miniexame do Estado Mental e Medida de Adesão aos Tratamentos. Realizou-se análise estatística descritiva e inferencial dos dados. Resultados: 86,9% dos idosos eram aderentes à terapêutica medicamentosa. Houve associação entre a variável adesão e as variáveis comportamentais "acreditar que os medicamentos são importantes para manutenção da saúde" e "ter vontade de não tomar os medicamentos". Os idosos que não acreditavam na importância do uso dos medicamentos, não sabiam o nome destes, usavam-nos somente na quando apresentavam sintomas, esqueciam-se de utilizá-los ou não seguiam a prescrição conforme a indicação médica, tinham menor mediana de adesão do que os que não apresentavam esses comportamentos. Conclusão: fatores comportamentais apresentam associação com a adesão à terapêutica medicamentosa em idosos em atendimento ambulatorial. É importante identificar os fatores comportamentais que podem interferir no uso de medicamentos por idosos porque eles podem ser modificados, por meio de ações com vistas a promover a adesão medicamentosa.

Objective: to evaluate the relationship between behavioral factors and adherence to drug therapy in elderly patients in outpatient care. Methods: an exploratory, descriptive, cross - sectional, and quantitative study was carried out with a sample of 107 elderly patients in outpatient care at a university hospital. The data were collected by means of interviews to evaluate: instrument of characterization of the elderly, mini-mental state examination, and measure of adherence to the treatment. A descriptive and inferential statistical analysis was performed. Results: a total of 86.9% of the elderly were adherent to the drug therapy. There was association between the adherence variable and the behavioral variables "believing that medicines are important for maintaining health" and "being willing to not take the medicines". The elders who did not believe in the importance of using medications did not know the medicine names; they used drugs only when there were the presence symptoms; they forgot to use the medicines or did not follow the prescription according to the medical indication; they had a lower average adherence rate than those who did not present these behaviors. Conclusion: behavioral factors are associated with adherence to drug therapy in the elderly in ambulatory care. It is important to identify the behavioral factors that might interfere in the use of drugs by the elderly since it can be modified through actions that would promote more adherence.

Objetivo: evaluar la relación entre los factores conductuales y la adhesión al tratamiento farmacológico en los ancianos en la atención ambulatoria. Método: estudio exploratorio, descriptivo, transversal, cuantitativo, con muestra de 107 ancianos en atención ambulatoria en un hospital universitario. Los datos fueron recolectados por medio de una entrevista, cuando se aplicaron: instrumento de caracterización de los ancianos, mini examen del estado mental y medida de adhesión a los tratamientos. Se realizaron análisis estadísticos descriptivos e inferenciales de los datos. Resultados: 86,9% de los ancianos fueron adherentes a la farmacoterapia. Ha sido identificado una asociación entre la adhesión variable y las variables conductuales "creyendo que los fármacos son importantes para el mantenimiento de la salud" y "queriendo no tomar los fármacos". Los ancianos que no creían en la importancia del uso de fármacos, tampoco sabían sus nombres, sólo se los usaban en el momento en que mostraron síntomas, se olvidaron de usarlos o no siguieron la prescripción de acuerdo con la indicación médica, tuvieron menor media que los que no presentaron estos comportamientos. Conclusión: los factores del comportamiento presentan la asociación con la adhesión a la terapia con fármacos en los ancianos en atención ambulatoria. Es importante identificar los factores conductuales que pueden intervenir con el uso de fármacos por los ancianos porque pueden ser modificados a través de acciones con el fin de promover la adhesión.

[International classification of functioning, disability and health: use in nursing care for the elderly]. / Classificação internacional de funcionalidade, incapacidade e saúde: utilização no cuidado de enfermagem a pessoas idosas.

The objective was to reflect on the International Classification of Functioning, Disability and Health and its use in nursing care for the elderly. It was conducted a brief history of the Classification; it was addressed the functional assessment of the elderly and importance to the proper planning to care actions; and it was showed the applicability of the International Classification of Functioning, Disability and Health by nurses. The classification is able to direct the functional assessment of the elderly, by the nurses, making the integral, realizing this human being as having a body, with needs to perform activities and participation, and belonging to a context /environment.