[A dialectical view of curriculum changes in nursing training]. / Um olhar dialético para as mudanças curriculares na formação do enfermeiro.

OBJECTIVE: To understand the contradictions involved in the process of curriculum reconstruction in the training of nurses, on the professors' perception. METHOD: Qualitative interpretative study, in which professors of nursing courses from three public and three private institutions were interviewed. The analysis was based on dialectical hermeneutics. RESULTS: 21 professors participated in the study. The proposals of changes are associated with advances and resistances, since the extended view of the health-disease process is opposed to the biological view; the diversification of learning scenarios is confronted with the hegemony of the hospital scenario; the integration of teaching and service faces the inequality of participation of the parties; and integration between the basic and the clinical cycle finds resistance in the knowledge accumulated in each discipline. CONCLUSION: The contradictions found, although inherent to the change process, indicate that persistence and continuous movement towards curriculum reformulation are necessary.

Experience of hypertensive patients with self-management of health care.

AIMS: The aim of this study was to interpret how hypertensive patients experience health care self-management. BACKGROUND: Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. DESIGN: Qualitative study. METHODS: Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. FINDINGS: The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. CONCLUSION: This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities.

[Living and health conditions of elderly people over 80]. / Condições de vida e de saúde de idosos acima de 80 anos.

OBJECTIVE: This article proposes to describe demographic data and health conditions of elderly people at age 80 or more. METHOD: Quantitative-descriptive study of 95 elderlies from five units of the Family Health Strategy in the period from September to December 2013, using script with general data of the living conditions and health, including validated scales in geriatrics and gerontology. RESULTS: The average age was 85.4 years. There was a predominance of women. Most were widowers with family income, more frequently between 2 or 3 minimum wages and economic participation is for means of sharing responsibility. They present dependency for many of Daily Living Instrumental Activities and, on average, reported 2.2 diseases. Fear of falling, decreased vision and hearing as well as pain in different body regions are reported. CONCLUSION: It appears that they have more intense needs than the elderly in general, requiring new ways of organizing their health care.

Medical student in the family health strategy on the first years of college: perception of graduates.

There is a lack of knowledge about the effective value of the experience gained by medical students who participate in the Family Health Strategy (Estratégia Saúde da Família (ESF)) during the early stages of their medical training. This teaching strategy is based on learning by experiencing the problems that exist in real life. This study proposed to understand the value of this teaching strategy from the viewpoint of the students who had participated, after their graduation. The method adopted was a qualitative study conducted through interviews with students who graduated in the years 2009, 2010 and 2011. The data analysis used the hermeneutic dialectic technique as its model. The graduates considered that this experience enabled them to understand the organization and functioning of the health service and the context of the daily life of the users. This experience facilitated the doctor patient relationship, the development of clinical reasoning and the bond with the user. However the students emphasized that a lack of maturity prevented them gaining a higher level of benefit from the experience. Therefore, although the structure of the course is permeated by advances and challenges, it was concluded that this experience contributed to the student's learning of certain essential elements of medical training.

Students' and graduates' perceptions on problem-based learning in nursing undergraduate education. / Perspectivas de estudantes e egressos sobre a aprendizagem baseada em problemas na formação de enfermeiros.

This study aimed to analyze students' and graduates' perceptions regarding the use of Problem-Based Learning (PBL) in nurse education. This is a qualitative study that employs the comprehensive and interpretative approach proposed by Dialectical Hermeneutics. Four focus groups were conducted with the participation of 17 students and 16 graduates from a higher education institution that implements PBL in nurse education. The analysis of results allowed for the identification of five thematic categories: difficulty in adapting to the method; attainment of autonomy in one's own learning; encouragement of clinical reasoning development; enhancement of communication and interpersonal relationships; and integration between theory and practice. It is evident that the use of PBL promotes alignment with the propositions of curriculum guidelines for nurse education by fostering the development of skills and competencies such as autonomy, communication, interpersonal relationships, and clinical reasoning through comprehensive and contextualized practices. However, students encounter challenges with the changes observed when introduced to PBL, which are overcome during the implementation process.

Objetivou-se analisar a percepção de estudantes e egressos sobre a utilização da Aprendizagem Baseada em Problemas (ABP) na formação do enfermeiro. Trata-se de um estudo qualitativo que utiliza a modalidade compreensiva e interpretativa proposta pela Hermenêutica-Dialética. Realizaram-se quatro grupos focais com a participação de 17 estudantes e 16 egressos de uma instituição de ensino superior que aplica a ABP na formação de enfermeiros. A análise dos resultados permitiu a definição de cinco categorias temáticas: dificuldade de adaptação em relação ao método; conquista de autonomia sobre o próprio aprendizado; incentivo ao desenvolvimento do raciocínio clínico; aprimoramento da comunicação e das relações interpessoais e integração entre teoria e prática. Evidencia-se que a utilização da ABP favorece a aproximação com as proposições das diretrizes curriculares para a formação do enfermeiro por meio do desenvolvimento de habilidades e competências como autonomia, comunicação, relações interpessoais e raciocínio clínico mediante práticas integrais e contextualizadas. Entretanto, os estudantes enfrentam dificuldades com as mudanças observadas ao serem inseridos nela ABP, as quais são superadas no decorrer do processo de implementação.

Curcumin: A Golden Approach to Healthy Aging: A Systematic Review of the Evidence.

Aging-related disorders pose significant challenges due to their complex interplay of physiological and metabolic factors, including inflammation, oxidative stress, and mitochondrial dysfunction. Curcumin, a natural compound with potent antioxidant and anti-inflammatory properties, has emerged as a promising candidate for mitigating these age-related processes. However, gaps in understanding the precise mechanisms of curcumin's effects and the optimal dosages for different conditions necessitate further investigation. This systematic review synthesizes current evidence on curcumin's potential in addressing age-related disorders, emphasizing its impact on cognitive function, neurodegeneration, and muscle health in older adults. By evaluating the safety, efficacy, and mechanisms of action of curcumin supplementation, this review aims to provide insights into its therapeutic potential for promoting healthy aging. A systematic search across three databases using specific keywords yielded 2256 documents, leading to the selection of 15 clinical trials for synthesis. Here, we highlight the promising potential of curcumin as a multifaceted therapeutic agent in combating age-related disorders. The findings of this review suggest that curcumin could offer a natural and effective approach to enhancing the quality of life of aging individuals. Further research and well-designed clinical trials are essential to validate these findings and optimize the use of curcumin in personalized medicine approaches for age-related conditions.

[Projections and expectations of students enrolled in a teaching qualification in a technical health professional education course]. / Projeções e expectativas de ingressantes no curso de formação docente em educação profissional técnica na saúde.

This research aims at analyzing the projections and expectations of students enrolled in a teaching qualification in technical health professional education course, aiming at overcoming disciplinary fragmentation and further approaching the working world. This was a qualitative study that included interviews with 33 students enrolled in the course, and the data analysis was performed using a content analysis technique. The following categories were identified among the results: the possibility of teaching-learning; the need for pedagogical qualification and the constant search for learning; and the possibility of changing reality. We conclude that students enrolled in this course foresee the transformation of their social reality, taking into account the need to acquire new skills and professional competences to effectively perform their job and compete within the working world.

Perception of graduates about the education of Nursing Technicians.

OBJECTIVES: to interpret the perception of graduates from the nursing technician program on the learning process developed during their education. METHODS: a qualitative study was conducted from March to September 2021, based on interviews with 20 graduates from a nursing technician program at a school in the Midwest of São Paulo, using thematic analysis and the NVivo tool. RESULTS: the following themes were identified: traditional teaching methods, active learning strategies, valuing proactivity and experiences in professional practice. FINAL CONSIDERATIONS: according to the graduates, the teaching process is essentially based on traditional methods, although there are initiatives to implement active strategies and recognition of the importance of advancing student proactivity and practical experience.

[The perception of hypertensive elderly patients regarding their health needs]. / Percepção de idosos hipertensos sobre suas necessidades de saúde.

Considering the prevalence of arterial hypertension among the elderly, the present study analyzes their perception of health needs, in a qualitative way, from focal groups with elderly users of Family Health Units. Data analysis was performed according to the hermeneutic-dialectical perspective and resulted in three nuclei of meaning: recognizing the possibility of having access to basic health care together with the desire to consume services of greater complexity and understanding the shortcomings of the State; attachment and welcoming as fundamental elements in the feelings of support and security and autonomy permeated by the tranquility to deal with the disease and the difficulties imposed by conditions inherent to the subjects' life style. Therefore, it is understood that the Family Health Strategy has been complying with its role in terms of the access to the healthcare system and regarding the professional-user attachment. However, health care continues to be centered on the disease rather than the individual.

Experiences of alcohol-dependent elderly: grounded theory.

OBJECTIVE: To interpret the experiences of alcohol-dependent elderly people. METHOD: Qualitative research developed through the theoretical and methodological assumptions of the Grounded Theory in the Straussian version. It was carried out in a small town in the mid-western region of the state of São Paulo. The selection was by theoretical sampling, totaling 25 participants from three sample groups. Semistructured interviews were conducted from March 2019 to January 2020. RESULTS: The phenomenon "Experiencing alcohol dependence in old age", is conditioned by the category "Initiating Alcohol Consumption", are actions/interactions "Justifying alcohol consumption" and "Coping with alcohol treatment and abstinence" whose consequences are "Experiencing the harms of alcohol dependence" and "Expressing feelings". CONCLUSION: It was evidenced that the elderly participants consider alcohol dependence as a way to deal with negative emotions, and, in this trajectory, they experience physical, mental, and social consequences. The elderly in abstinence express feelings of loneliness, regret, and desire for a life with quality, and indicate that behavioral change occurs through treatment and awareness of its harmful effects.

Mental health promotion and protection actions aimed at the elderly in the context of primary health care: an integrative review. / Ações de promoção e proteção à saúde mental do idoso na atenção primária à saúde: uma revisão integrativa.

The increase in the elderly population requires rethinking the organization of society, especially health services. The aim was to analyze actions aimed at promoting and protecting the mental health of the elderly in the context of primary health care, through an integrative review. The databases used were: Lilacs, Scopus, IBECS, Medline, CINAHL, BDENF and Index Psicologia. The descriptors used were "elderly", "health promotion", "mental health" and "primary health care". The final sample included 15 articles. The results indicate that group actions contribute to the reduction of depressive symptoms; health education in the perspective of active learning, aiming at health literacy and memory workshop strengthening spaces for socialization. Matrix support is highlighted as an indispensable tool for new mental health practices. We conclude that the moment is right for expanding the scope of actions offered to the elderly in psychological distress. Efforts have been detected in the production of care aiming at integrality, which is still incipient.

O aumento da população de idosos exige repensar a organização da sociedade, especialmente os serviços de saúde. Por meio de revisão integrativa, o objetivo foi analisar ações de promoção e proteção à saúde mental do idoso no contexto da atenção primária à saúde. As bases de dados foram: LILACS, Scopus, IBECS, Medline, CINAHL, BDENF e Index Psicologia. Os descritores foram "idoso", "promoção da saúde", "saúde mental" e "atenção primária à saúde". A amostra final foi constituída por 15 artigos. Os resultados apontam ações em grupo contribuindo para a redução de sintomas depressivos, educação em saúde na perspectiva da aprendizagem ativa, visando à alfabetização em saúde, e oficina de memória, fortalecendo espaços de socialização. Ressalta-se o apoio matricial como ferramenta indispensável a novas práticas em saúde mental. Conclui-se que o momento é de ampliação do escopo de ações oferecidas aos idosos em sofrimento psíquico. Detectam-se esforços para a produção do cuidado na direção da integralidade, mas ainda incipientes.

Elderly victims of violence: family assessment through the Calgary model.

OBJECTIVE: To understand the structure, development, and functionality of the family of the elderly victim of violence. METHOD: Descriptive research with a qualitative approach, based on the Calgary Family Assessment Model. Four elderly people who suffered violence and their family members were assessed at home, from October to November 2019. Data analysis was based on the genogram and ecomap, as proposed in the model. RESULTS: It was found that the members of the four families had low schooling and financial difficulties. As for the social support network, the neighbors, the health unit and the Church stood out. The members of each family nucleus expressed feelings of fear, insecurity, anger, nervousness, sadness and impotence, resulting from the conflict between the couple. FINAL CONSIDERATIONS: In the assessed families, weaknesses and potentialities in the structure, development and functioning are highlighted, which must be considered in the elaboration of the care plan.

[The community health agent and working as a team: the easy and difficult aspects]. / O agente comunitário de saúde frente ao processo de trabalho em equipe: facilidades e dificuldades.

The objective of this study is to analyze the easy and difficult aspects of teamwork according to community health agents. Qualitative analysis was carried out from the hermeneutical and dialectic perspective; the reference point was the senses interpretation method. The strengths and weaknesses they pointed out revealed that working as a team requires emotional relationships, with emphasis on communication, respect and cooperation, and that team meetings is an important strategy to achieve this. In conclusion, there is a need for continuous investments in team member relationships.

Perspective of nursing students about active learning and insertion in the job market.

OBJECTIVE: to understand the perception of alumni from a nursing course which uses active learning methods about their insertion in the job market. METHODS: descriptive and exploratory study with a qualitative approach, carried out through 17 interviews with alumni from 2012 and 2014. The analysis took place using Dialectic Hermeneutics, as subsidized by the theoretical framework of the Theory of Complexity. RESULTS: the statements of the alumni showed aspects related to safety to act in the job market, to stimulating proactivity and initiative for learning as proposed by the active method, to difficulties in teamwork, and to the lack of experience in certain specialized fields. FINAL CONSIDERATIONS: there are advances and challenges marked by contradictions in the way the alumni act and think as they enter the job market, which is an inherent condition to processes of change, from the perspective of complex thinking.

Points and counterpoints in the development of interdisciplinarity in nursing technical training. / Pontos e contrapontos no desenvolvimento da interdisciplinaridade na formação técnica em enfermagem.

OBJECTIVE: To characterize the points and counterpoints in the development of interdisciplinarity in the nursing technical training. METHOD: This is an exploratory-descriptive study with a qualitative approach conducted through interviews with 30 teachers and coordinators of nursing technical courses from 12 different regions of the state of São Paulo. Data analysis was performed through theme-based content analysis. RESULTS: Regarding the theme of institutional orientation, it was found that, although there are initiatives to promote interdisciplinarity, since there is teacher training and definition of goals for articulation with other courses and for the joint work among the teachers of the disciplines, these are still vague and ineffective. As for the theme, the implementation of interdisciplinarity by the teachers, it is observed that they seek different forms of integration, but they come across the curricular structure, the form of teacher hiring, and the resistance to changes. With respect to the comprehension of the concept, relevant aspects of its meaning are recognized; however, they admit the existence of limits. CONCLUSION: The institution defines a trajectory aiming at interdisciplinarity, the teachers try to follow the path for its implementation; however, they find structural obstacles, little comprehension of the concept, and resistance to changes. It appears that efforts are needed to advance the curricular implementation with the logics of interdisciplinarity.

Experiencing the education process in physical rehabilitation.

OBJECTIVE: To interpret and build a theoretical model of the user's experience in the education process in physical rehabilitation settings. METHOD: Qualitative research, based on the Grounded Theory. The setting was a Rehabilitation Center of Rede Lucy Montoro, located in an inland city of the State of São Paulo. Data collection took place from January to October 2019, based on 28 interviews with three sample groups. The collection and analysis process was guided by theoretical sampling. RESULTS: A total of 122 conceptual codes emerged. The main category established was "Experiencing education in rehabilitation"; as Conditions, the categories: relying on team support, and considering the group dynamics; as Actions-Interactions, the category: experiencing instructions; and as Consequences, the categories: promoting change of habits, and finding resistance in the follow-up. CONCLUSION: The experience in the education process in rehabilitation indicates that this is an action that requires adequate communication and acceptance by the team. In group activities, although there are experiences exchanges among the members, the heterogeneity of situations shall be considered.

Social, health, and working conditions among hospital workers.

OBJECTIVES: to compare social, health and working conditions among nursing, nutrition and hospital cleaning service workers. METHODS: a quantitative cross-sectional, descriptive and correlational study carried out in a public hospital in the countryside of São Paulo, including workers from nutrition, cleaning and nursing services. Data collection occurred during working hours. Validated questionnaires and Karasek's Demand-Control model were used to assess psychosocial dimensions and the Self-Reporting Questionnaire-20 to measure the common mental disorder. As dependent variable, the groups professionals and chi-square test were used for associations with p≥ 0.05. RESULTS: 227 workers participated. Positive associations were found between professional groups and socioeconomic, health and work characteristics. CONCLUSIONS: social, health, and working conditions differ between the professional groups studied.

Strategies of active learning methodologies in nursing education: an integrative literature review.

OBJECTIVES: to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training. METHODS: integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases. RESULTS: among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students. FINAL CONSIDERATIONS: the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.

Evaluation strategies in active learning in higher education in health: integrative review.

OBJECTIVES: to analyze scientific evidence on evaluation strategies for active learning methods in health undergraduate programs. METHODS: integrative literature review in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases. RESULTS: different evaluation strategies are used: Presentation of seminars, Self-evaluation, Evaluation of student performance in Tutotest-Lite tutoring, Peer Evaluation, Active Learning and Critical Thinking Self-evaluation Scale, Objective and Structured Clinical Exam, Portfolio, Progressive Disclosure Questions, Modified Dissertation Questions, Progression Test, Dissertation Test, Objective Test, Immediate Learning Checks, Clinical Case Resolution and Cumulative Test. FINAL CONSIDERATIONS: evaluation strategies in active learning are used in combination, aiming at the affective, cognitive and psychomotor development of the student. However, studies with greater power of scientific evidence would be needed.

Simulation in nursing baccalaureate courses of Brazilian educational institutions.

OBJECTIVE: to characterize simulation practices in nursing courses in Brazil, considering the attributes developed, facilities, and challenges encountered. METHODS: this is a cross-sectional and descriptive study, with a quantitative approach. Ninety-one coordinators of undergraduate courses participated in the study. An electronic questionnaire was used with open- and closed-ended questions. RESULTS: the most used simulation modality is Specific Skills. Private courses and courses with integrated curricula most often use High Fidelity Simulation. Understanding the mobilization of affective attributes is still insufficient. CONCLUSION: it is important that undergraduate course managers are aware and take ownership of the elements that permeate simulation and invest to create a favorable environment for its effectiveness.