Nursing effectiveness reconsidered: Some fundamental reflections on the nature of nursing.

Despite being considered the proverbial backbone of our healthcare systems, nursing still seems to struggle to scientifically demonstrate its contribution to care experiences and patient outcomes. This leads to erosive tendencies that threaten the development of the profession and its progress as an academic discipline. With this paper, we want to contribute to the theoretical discourse concerning the nature of nursing and the research into its effectiveness. We begin by outlining a set of prevailing paradoxes and their consequences relating to nursing and nursing research: the issue of demonstrating its unique contribution despite a clear societal mandate; a discrepancy between subjectively experienced effectiveness and objectively ascertainable effectiveness; and a mismatch between theoretical premises of nursing and task-oriented cultures in practice environments. Using an example of a seemingly simple nursing intervention, we intend to demonstrate the qualities and complexities of nursing. We further illustrate this by drawing on several of our research projects using theory-based evaluation methodologies. From these illustrative examples, we distil two insights relating to nursing interventions that we consider fundamental: the nurse, as a person, is central to its unique effectiveness; and there is always an interplay between context, intervention and its intended effect. We summarise our considerations and argue the case for conceiving research designs in alignment with theoretical premises of nursing.

Valuing Nursing Practice: Laying the Future Foundations for Nursing.

Nursing has always been a cost for the institutions within which nurses work. This fact has influenced almost everything that affects how nurses are utilized and valued. As a cost, nurses are closely managed on the margin, always constrained by the resource machinations of organizations and systems with little determination or enumeration of the contributions nurses make to the service and financial value represented by algorithms and metrics that enumerate and demonstrate nurse's impact and contribution to service and financial value. This article further pushes the boundaries of this circumstance, challenging nurse and health leaders to reconceptualize nursing contribution and recalibrate the determination and calculation of nursing value as a sustainable baseline for nursing leadership for the future.

Deconstructing nursing's paradoxical relationship with the concept of complexity.

Although nursing seems to understand itself and its practice as complex, the literature is less clear about what this actually means. While complexity is discussed as an attribute of nursing, it is also suggested that complexity in nursing remains misunderstood and poorly articulated, is devalued, is not considered as a measure of health outcomes and remains invisible. Despite the overarching lack of a definition, some nurse scholars have conceptualized complexity as a complex intervention. For these authors, complexity becomes a complex intervention defined as that which is composed of component parts interacting in a variety of ways that influence the delivery of and outcomes of health-related interventions for populations. Conceptualizing complexity as a complex intervention forces nursing to embrace and adopt a received interpretation of complexity as expressed through complexity theory and complexity science. While complexity theory may afford us some tools for thinking about complexity, when we deconstruct nursing complexity to explicitly determinate and quantifiable tasks, this artificially narrowed orientation to complexity reveals an oversimplified explanation of the complexities associated with nursing and serves to blind us to its real qualities. Through a consideration of complexity from a Western philosophical tradition, I demonstrate that when nursing adopts the received interpretation of complexity as a complex intervention, this perspective on complexity contains nursing epistemologically and ontologically. I offer an extended conceptualization of complexity framed upon the consideration that nurses assume complexity and do not reduce it; that nurses have the capacity to not be paralysed by complexity and have developed logics to mobilize it in productive ways. Mobilizing complexity through navigating paradox and contradiction shapes an orientation to complexity that embraces an extended epistemology. This extended epistemology is characterized by a 'yes/and' mindset that expresses the dynamic and generative relationship between forms of knowledge which reflects complexity that characterizes nursing.

The public's perception of the nursing profession: Validity and reliability of the Chinese version of the nursing image scale in Taiwan.

The public's perception of the nursing image deeply influences nurses' work and professional development. However, the Taiwanese public's perception of nursing remains unclear. This study aimed to determine the validity and reliability of a Chinese version of the Nursing Image Scale (NIS) in Taiwan. This was a psychometric study using a cross-sectional survey. Participants were recruited via the snowball sampling method through the online community software LINE from August 1 to 13, 2019. After data collection, the construction and validation of the NIS to measure public opinion were assessed, including content validity, corrected item-total correlation, exploratory factor analysis (EFA), and reliability. A total of 1331 valid responses were included in the analysis. After EFA analysis, the 20 scale items were divided across the four domains of prudence and care, innovation and cooperation, efficiency and division, and professionalism and respect. The NIS (Chinese version) was valid and reliable for measuring public opinion and may be used to examine changes in public perceptions of nursing.

Lean methodology: contributions to improving work processes in health and nursing.

OBJECTIVE: to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects. METHOD: an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively. RESULTS: the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod. CONCLUSION: three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.

Subjectivity through the lens of Guattari: A key concept for nursing.

Félix Guattari, a French philosopher and psychotherapist often recognized for his collaboration with Gilles Deleuze, also published important work of his own. The way he conceptualizes subjectivity and schizoanalysis (later developed into institutional analysis) can incite us to interpret our social contexts differently and to help frame an emancipatory path in nursing. At La Borde, a psychiatric clinic, subjectivity was seen as the real power that lies within the institutions; invisible and flowing through all levels of the hierarchal structure-like waves-each of them unique but still part of the same ocean. Even with its elusive character, this concept can be wielded through psychotherapeutic techniques of analysis which aim to reduce hierarchies, encourage collaborations, decentralize levers of power and promote initiatives that arise from the base. These concepts deserve further exploration when it comes to modern institutional issues like the ones present in Quebec's (Canada) healthcare system. Therefore, this article borrows theorizations elaborated through psychotherapy and applies them to the hospital institution which is seen as an organized, stable structure (the molar line), while paying attention to fluid, changing processes and the multiplicity of desires for transformation (the molecular line), to promote nursing movements that escape and abolish these structures, creating new possibilities and new forms of thinking (the line of flight).

Socio-cognitive mindfulness in nursing: A scoping review.

BACKGROUND: While research on meditative mindfulness in nursing is abundant, research on socio-cognitive mindfulness is in its early stages despite its potential advantages to nursing practice and nursing education. This study introduces the under-examined concept of socio-cognitive mindfulness to the nursing field. OBJECTIVE: To identify what is known in the research field of socio-cognitive mindfulness in nursing. Specific aims were to identify the effects of socio-cognitive mindfulness on nurses and nursing students, and the application of socio-cognitive mindfulness interventions and their effectiveness in nursing. DESIGN: A scoping review following the Arksey and O'Malley framework. METHODS: An electronic search of PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, ERIC, and ProQuest databases was conducted. The search included full-text papers published in peer-reviewed journals in English. The included studies were independently examined by the two authors to ensure the thorough inclusion of relevant research by screening of titles and abstracts and screening of full-texts. The selected papers were categorized based on the specific objectives of the review. RESULTS: Out of 5,798 papers, six quantitative studies and one mixed method study were included in the review. Among the seven studies, two studies investigated the effects of socio-cognitive mindfulness on nurses, four examined the effects of socio-cognitive mindfulness on nursing students, and one conducted an intervention study applying socio-cognitive mindfulness and identified its effects on nurses. The findings revealed several benefits of applying socio-cognitive mindfulness to nursing practice and nursing education. Specifically, socio-cognitive mindfulness enhanced nurses' and nursing students' positive emotions and effective emotion regulation, which would positively influence nurses' nursing performance as well as students' academic outcomes and quality of college life. CONCLUSIONS: This study raises researchers' awareness of the significance of socio-cognitive mindfulness in nursing, and strongly recommends applying socio-cognitive mindfulness to nursing practice and nursing education and evaluating its effects.

Teoría de las transiciones y empoderamiento: un marco para las intervenciones enfermeras durante la transición del paciente de la unidad de cuidados intensivos / Transitions and empowerment theory: A framework for nursing interventions during intensive care unit patient transition

Objetivos: 1) Explorar las principales características de la transición de la unidad de cuidados intensivos de acuerdo a la experiencia vivida de los pacientes y 2) identificar la terapéutica enfermera para facilitar la transición de los pacientes desde la unidad de cuidados intensivos a la unidad de hospitalización. Metodología: Análisis secundario de los hallazgos de un estudio cualitativo descriptivo sobre la experiencia de los pacientes ingresados en una UCI durante la transición a la unidad de hospitalización, en base a la teoría de las transiciones de enfermería. Los datos para el estudio primario se generaron de 48 entrevistas semiestructuradas de pacientes que habían sobrevivido a una enfermedad crítica en 3 hospitales universitarios de tercer nivel. Resultados: Se identificaron 3 temas principales durante la transición de los pacientes de la unidad de cuidados intensivos a la unidad de hospitalización: 1) naturaleza de la transición de la UCI, 2) patrones de respuesta y 3) terapéutica enfermera. La terapéutica enfermera incorpora la información, educación y promoción de la autonomía del paciente; además del apoyo psicológico y emocional. Conclusiones: La teoría de las transiciones como marco teórico ayuda a comprender la experiencia de los pacientes durante la transición de la UCI. La terapéutica enfermera de empoderamiento integra las dimensiones dirigidas a satisfacer las necesidades y expectativas de los pacientes durante la misma.(AU)

Objectives: 1) To explore the main characteristics of intensive care unit transition according to patients’ lived experience and 2) to identify nursing therapeutics to facilitate patients’ transition from the intensive care unit to the inpatient unit. Methodology: Secondary analysis of the findings of a descriptive qualitative study on the experience of patients admitted to an ICU during the transition to the inpatient unit, based on the nursing transitions theory. Data for the primary study were generated from 48 semi-structured interviews of patients who had survived critical illness in three tertiary university hospitals. Results: Three main themes were identified during the transition of patients from the intensive care unit to the inpatient unit: 1) nature of ICU transition, 2) response patterns and 3) nursing therapeutics. Nurse therapeutics incorporates information, education and promotion of patient autonomy; in addition to psychological and emotional support. Conclusions: Transitions theory as a theoretical framework helps to understand patients’ experience during ICU transition. Empowerment nursing therapeutics integrates the dimensions aimed at meeting patients’ needs and expectations during ICU discharge.

Percepción de la cultura de seguridad del paciente en un área de críticos / Perception of the safety culture in a critical area

Introducción: El área de críticos (AC) es una de las más complejas dentro del sistema hospitalario, se requiere un elevado número de intervenciones e información, por tanto, son susceptibles de padecer más incidentes que comprometan la seguridad del paciente. Objetivo: Determinar la percepción de la cultura de seguridad del paciente del equipo asistencial en un área de críticos. Método: Estudio descriptivo transversal, septiembre de 2021, en un AC polivalente con 45 camas, 118 sanitarios (médicos, enfermeras, técnicos en cuidados auxiliares de enfermería). Se recogieron variables sociodemográficas, conocimiento del responsable en seguridad del paciente (SP), formación en SP y en el sistema de notificación de incidentes. Se utilizó el cuestionario validado Hospital Survey on Patient Safety Culture que evalúa 12 dimensiones. Se consideró una dimensión como fortaleza con ≥ 75% respuestas positivas y debilidad con ≥ 50% respuestas negativas. Estadística descriptiva y análisis bivariante: prueba de χ2 y t de Student, y ANOVA. Significación estadística p ≤ 0,05. Resultados: Se recogieron 94 cuestionarios (79,7% muestra). La valoración del grado de SP fue 7,1 (1,2) sobre 10. El personal polivalente la puntuó con 6,9 (1,2) vs. 7,8 (0,9) del personal sin rotación (p = 0,04); 54,3% (n = 51) conocía el procedimiento para notificar un incidente, de los cuales, 53% (n = 27) no notificó ninguno en el último año. Ninguna dimensión alcanzó grado de fortaleza. Fueron detectadas como debilidad: percepción de seguridad: 57,7% (IC 95%: 52,7-62,6), dotación de personal: 81,7% (IC 95%: 77,4-85,2) y apoyo de gerencia: 69,9% (IC 95%: 64,3-74,9)...(AU)

Introduction: Critical Care Area (CCA) is one of the most complex in the hospital system, requiring a high number of interventions and handling of amounts of information. Therefore, these areas are likely to experience more incidents that compromise patient safety (PS). Aim: To determine the perception of the healthcare team in a critical care area about the patient safety culture. Method: Cross-sectional descriptive study, September 2021, in a polyvalent CCA with 45 beds, 118 health workers (physicians, nurses, auxiliary nursing care technicians). Sociodemographic variables, knowledge of the person in charge in PS and their general training in PS and incident notification system were collected. The validated Hospital Survey on Patient Safety Culture questionnaire, measuring 12 dimensions was used. Positive responses with an average score ≥75%, were defined as an area of strength while ≥50% negative responses were defined as an area of weakness. Descriptive statistics and bivariate analysis: χ2 and t-Student tests, and ANOVA. Significance p ≤ 0.05. Results: 94 questionnaires were collected (79.7% sample). The PS score was 7.1 (1.2) range 1-10. The rotational staff scored the PS with 6.9 (1.2) compared to 7.8 (0.9) for non-rotational staff (p = 0.04). A 54.3% (n = 51) was familiar with the incident reporting procedure, 53% (n = 27) of which had not reported any in the last year. No dimension was defined as strength.There were three dimensions that behaved like a weakness: security perception: 57.7% (95% CI: 52.7-62.6), staffing: 81.7% (95% CI: 77.4-85.2) and management support: 69 .9% (95% CI: 64.3-74.9)...(AU)

Repensar la formación y la práctica especializada de enfermería desde la óptica unitaria del ser humano / Rethinking specialized nursing training and practice from the unitary perspective of the human being

El propósito del presente texto es repensar la formación y la práctica especializada de enfermería desde la óptica de las ciencias humanas que estudian la subjetividad y que encuentran su sentido científico más allá del saber disciplinar. Se trata de distinguir con claridad entre las ciencias de la naturaleza y las ciencias del espíritu a partir de la óptica unitaria del ser humano. Esto debido a la creciente percepción de deshumanización y tecnificación de la práctica del cuidado de enfermería vinculada a la formación especializada para el manejo de determinados procedimientos y aparatos que parcelan el conocimiento y desvían la perspectiva y el enfoque disciplinar. Por lo tanto, pensar en cómo se puede comprender mejor el fenómeno de la salud y la enfermedad humanas desde la formación y la práctica de enfermería tiene la posibilidad de reconsiderar el perfil académico de formación básica y especializada de enfermería, congruentemente articulados los saberes de una enfermería contemporánea con los sentires y los saberes de las personas que cuidan con las otras personas a las que se cuida.

The purpose of this text is to rethink specialized nursing training and practice from the perspective of the human sciences that study subjectivity and find its scientific meaning beyond disciplinary knowledge. It is about clearly distinguishing between the sciences of nature and the sciences of the spirit from the unitary perspective of the human being. This is due to the growing perception of dehumanization and technification of nursing care practice linked to specialized training for the management of certain procedures and devices that fragment knowledge and divert the disciplinary perspective and approach. Thus, thinking about how the phenomenon of human health and disease can be better understood from nursing training and practice has the possibility of reconsidering the academic profile of basic and specialized nursing training, coherently articulated the knowledge of contemporary nursing with the feelings and knowledge of the people who care for with the other people who are cared for.

In Australian hospitals and residential aged care facilities, how do we train nursing and direct care staff to assist patients and residents to move? A national survey.

Objective Nursing workplace injuries related to staff-assisted patient/resident movement occur frequently, however, little is known about the programs that aim to prevent these injuries. The objectives of this study were to: (i) describe how Australian hospitals and residential aged care services provide manual handling training to staff and the impact of the coronavirus disease 2019 (COVID-19) pandemic on training; (ii) report issues relating to manual handling; (iii) explore the inclusion of dynamic risk assessment; and (iv) describe the barriers and potential improvements. Method Using a cross-sectional design, an online 20-min survey was distributed by email, social media, and snowballing to Australian hospitals and residential aged care services. Results Respondents were from 75 services across Australia, with a combined 73 000 staff who assist patients/residents to mobilise. Most services provide staff manual handling training on commencement (85%; n = 63/74), then annually (88% n = 65/74). Since the COVID-19 pandemic, training was less frequent, shorter in duration, and with greater online content. Respondents reported issues with staff injuries (63% n = 41), patient/resident falls (52% n = 34), and patient/resident inactivity (69% n = 45). Dynamic risk assessment was missing in part or in whole from most programs (92% n = 67/73), despite a belief that this may reduce staff injuries (93% n = 68/73), patient/resident falls (81% n = 59/73) and inactivity (92% n = 67/73). Barriers included insufficient staff and time, and improvements included giving residents a say in how they move and greater access to allied health. Conclusion Most Australian health and aged care services provide clinical staff with regular manual handling training for staff-assisted patient/resident movement, however, issues with staff injuries, as well as patient/resident falls and inactivity, remain. While there was a belief that dynamic in-the-moment risk assessment during staff-assisted patient/resident movement may improve staff and resident/patient safety, it was missing from most manual handling programs.

Cuidado de la temperatura en personas sometidas a procedimientos quirúrgicos electivos en una institución de salud / Temperature care in persons undergo-ing elective surgical procedures in a health institution

Objetivo: Analizar la adherencia a las actividades para el control de la termorregulación en procedimientos quirúrgicos por parte de técnicos y profesionales de cirugía para el año 2021 en una institución de salud de tercer nivel en la ciudad de Medellín, Colombia. Metodología: Investigación descriptiva transversal. Se revisaron registros clínicos de pacientes sometidos a cirugía electiva mayor a una hora, también se realizó encuesta autoaplicada a personal que labora en el área quirúrgica, indagando por variables demográficas, del servicio y de adherencia al protocolo de termorregulación. Resultados: Se evidencia baja adherencia a la toma de temperatura. En el servicio de recuperación hay mejor adherencia por medio del calentamiento activo. Conclusión: La temperatura es un signo vital al que no se le da la importancia suficiente, constituyéndose así como una constante vital olvidada.(AU)

Objective: To analyze adherence to activities for the control of thermoregulation in surgical procedures by surgical technicians and professionals for the year 2021, in a tertiary health institution in the city of Medellín, Colombia. Methods: Cross-sectional descriptive research. Clinical records of patients undergoing elective surgery greater than one hour were reviewed, a self-applied survey was also carried out on personnel working in the surgical area, inquiring for demographic variables, service and adherence to the thermoregulation protocol. Results: Low adherence to temperature measurement is evident. In the recovery service there are better adherence through active heating. Conclusions: Temperature is a vital sign that is not given enough importance, thus becoming a forgotten vital sign.Objective: To analyze adherence to activities for the control of thermoregulation in surgical procedures by surgical technicians and professionals for the year 2021, in a tertiary health institution in the city of Medellín, Colombia. Methods: Cross-sectional descriptive research. Clinical records of patients undergoing elective surgery greater than one hour were reviewed, a self-applied survey was also carried out on personnel working in the surgical area, inquiring for demographic variables, service and adherence to the thermoregulation protocol. Results: Low adherence to temperature measurement is evident. In the recovery service there are better adherence through active heating. Conclusions: Temperature is a vital sign that is not given enough importance, thus becoming a forgotten vital sign.(AU)

La Ciencia de la Enfermería por una vejez saludable, sin violencia ni maltrato / The Nursing Science for a Health Old Age, without Violence or Mistreatment

Introducción: Cuba se ubica en la actualidad entre los tres primeros países de América Latina con mayor envejecimiento poblacional y los pronósticos indican que en los próximos años estará al frente del listado. Objetivo: Reflexionar sobre las particularidades de los retos de la Ciencia de la Enfermería, en favor de una vejez saludable, sin violencia ni maltrato. Métodos: A través de la sistematización de literatura científica, se realizó un ensayo teórico, en el cuarto trimestre del año 2022, concebido como una argumentación reflexiva, al hacer una aproximación a los retos a afrontar por la Ciencia de la Enfermería, en favor de una vejez saludable, sin violencia ni maltrato. La búsqueda se realizó en las bases de datos SciELO, Redalyc, Lilacs, Medline PubMed, e-libro y Google Scholar, con las palabras clave "violencia"; "enfermería"; "anciano"; "maltrato al anciano". Se incluyeron artículos publicados entre 2017 y 2022 en idioma inglés, español y portugués. Para el análisis se utilizó el método análisis de contenido de Bardin. Conclusiones: Los profesionales de la Enfermería en su interacción con las personas son conscientes de los cambios, necesidades, expectativas y realidades de los adultos mayores en la actualidad. Cuba es un ejemplo en el avance de la promoción de los derechos humanos de las personas de la tercera edad a nivel mundial, por lo que se necesita un proceso de readaptación a las nuevas realidades, y ahí está el más grande de los retos a afrontar por la Ciencia de la Enfermería(AU)

Introduction: Cuba is currently among the first three countries in Latin America with the highest population aging and forecasts indicate that, in the coming years, it will be at the top of this list. Objective: To reflect on the particularities of the challenges faced by the nursing science in favor of a healthy old age, without violence or mistreatment. Methods: Through the systematization of scientific literature, a theoretical essay was carried out in the fourth quarter of the year 2022, conceived as a reflective argumentation, by making an approach to the challenges to be faced by the nursing science in favor of a healthy old age, without violence or mistreatment. The search was performed in the SciELO, Redalyc, Lilacs, Medline PubMed, e-book and Google Scholar databases, with the keywords Violencia [Violence], Enfermería [nursing], Anciano [elderly], Maltrato al anciano [elder mistreatment]. Articles published between 2017 and 2022 in the English, Spanish and Portuguese languages were included. Bardin's method was used for content analysis. Conclusions: Nursing professionals, in their interaction with people, are aware of the changes, needs, expectations and realities of older adults today. Cuba is an example regarding the advancement in the promotion of the human rights of the elderly worldwide, a reason why a process of readaptation to the new realities is needed; and therein lies the greatest challenge to be faced by the nursing science(AU)

Practice standards for nurses providing pediatric cancer care in atlantic canada: tradução e validação em português / Practice standards for nurses providing pediatric cancer care in atlantic canada: traducción y validación en portugués / Practice standards for nurses providing pediatric cancer care in atlantic canada: translation and validation in portuguese

Objetivos: realizar tradução, adaptação cultural e validação de conteúdo e aparência do instrumento Practice Standards for Nurses Providing Pediatric Cancer Care in Atlantic Canada para o português do Brasil. Método: trata-se de um estudo de tradução, adaptação cultural e validação de conteúdo e aparência de instrumento. Participaram 8 profissionais no comitê de juízes. Resultados: houve a necessidade de adequar a semântica e correções gramaticais com a versão aprovada pela Associação Canadense de Enfermeiros em Oncologia. Adotou-se o Índice de Validade de Conteúdo. Foram realizadas três rodadas para atingir o Índice de Validade de Conteúdo ?0,8 em 100% dos itens: primeira 233 itens (96%), segunda 9 itens (90%), terceira rodada 1 item. No pré-teste obteve-se 100% de compreensão. Conclusão: a versão traduzida do instrumento original está adequada para utilização no Brasil.

Objetivos: realizar traducción, adaptación cultural y validación de contenido y apariencia del instrumento "Practice Standards for Nurses Providing Pediatric Cancer Care in Atlantic Canada" para el portugués de Brasil. Método: se trata de un estudio de traducción, adaptación cultural y validación de contenido y apariencia de instrumento. Participaron 8 profesionales en el comité de jueces. Resultados: hubo la necesidad de adecuar la semántica y correcciones gramaticales con la versión aprobada por la Asociación Canadiense de Enfermeros en Oncología. Se adoptó el Índice de Validez de Contenido. Se realizaron tres rondas para alcanzar el Índice de Validez de Contenido ?0,8 en el 100% de los ítems: primera 233 ítems (96%), segunda 9 ítems (90%), tercera ronda 1 ítem. En el pre-test se obtuvo 100% de comprensión. Conclusión: la versión traducida del instrumento original está adecuada para su uso en Brasil.

Objective: to perform translation, cultural adaptation and validation of content and appearance of the instrument "Practice Standards for Nurses Providing Pediatric Cancer Care in Atlantic Canada" into Brazilian Portuguese. Method: this is a study of translation, cultural adaptation and validation of content and appearance of instrument. Eight professionals participated in the committee of judges. Results: there was a need to adapt the semantics and grammatical corrections with the version approved by the Canadian Association of Nurses in Oncology. The Content Validity Index was adopted. Three rounds were performed to achieve the Content Validity Index ?0.8 in 100% of items: first 233 items (96%), second 9 items (90%), third round 1 item. In the pre-test, 100% comprehension was obtained. Conclusion: the translated version of the original instrument is suitable for use in Brazil.

The Top News Stories of 2021: Nursing: A Profession Reshaped by COVID-19.

The pandemic has brought new public awareness of nursing's role.

Toque terapêutico no cuidado da enfermagem: uma análise conceitual / Tacto terapéutico en el cuidado de enfermería: un análisis conceptual / Therapeutic touch in nursing care: a conceptual analysis

Resumo Objetivo Analisar o conceito de toque terapêutico no cuidado de enfermagem, especificando seus atributos, antecedentes e consequentes. Métodos Trata-se de uma análise conceitual na visão evolutiva de Rodgers (2000), sobre o conceito de toque terapêutico na assistência de enfermagem, juntamente com a revisão integrativa da bibliografia baseada na questão da pesquisa: Qual é o conceito de toque terapêutico no cuidado de enfermagem? Quais são os atributos, antecedentes e consequentes do toque terapêutico no cuidado com a enfermagem? A pesquisa foi realizada nas bases de dados eletrônicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, na Biblioteca do Conhecimento Online b-on, através da conjugação dos descritores DeCS/MESH "therapeutic touch", "nursing" e "nursing care" e do operador booleano AND no período temporal de 2000 a 2020. Resultados A amostra foi formada por oito estudos que identificaram três pilares temáticos: (i) atributos: método complementar e eficaz, técnica, ferramenta, intervenção de enfermagem, uso de mãos, intenção de ajudar ou curar, tratamento complementar, toque intencional e transferência de energia; (ii) antecedentes: dor, ansiedade, fadiga, demência, doença de Alzheimer, cefaleia de tensão, síndrome de fibromialgia e problemas cardiovasculares; (iii) consequentes: promove um efeito calmante; aumenta a empatia, satisfação, interação, respeito, senso de valor e vida; promove bem-estar, conforto, tranquilidade e paz, esperança, segurança, motivação, humor e qualidade do sono; reduz o estresse e comportamentos perturbadores; promove melhor estado funcional e qualidade de vida. Conclusão O toque terapêutico está implícito na prática profissional dos enfermeiros, exigindo um ajuste concreto e singular às circunstâncias e necessidades reais da pessoa, em favor de uma prática que promova o conforto.

Resumen Objetivo Analizar el concepto de tacto terapéutico en el cuidado de enfermería y especificar sus atributos, antecedentes y consecuentes. Métodos Se trata de un análisis conceptual en la visión evolutiva de Rodgers (2000), sobre el concepto de tacto terapéutico en la atención de enfermería, junto con la revisión integradora de la bibliografía basada en la pregunta de investigación: ¿Cuál es el concepto de tacto terapéutico en el cuidado de enfermería? ¿Cuáles son los atributos, antecedentes y consecuentes del tacto terapéutico en el cuidado de enfermería? El estudio fue realizado en las bases de datos electrónicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, en la Biblioteca do Conhecimento Online b-on, a través de la unión de los descriptores DeCS/MESH "therapeutic touch", "nursing" y "nursing care" y del operador booleano AND en el período temporal de 2000 a 2020. Resultados La muestra fue formada por ocho estudios que identificaron tres pilares temáticos: (i) atributos: método complementario y eficaz, técnica, herramienta, intervención de enfermería, uso de manos, intención de ayudar o curar, tratamiento complementario, tacto intencional y transferencia de energía; (ii) antecedentes: dolor, ansiedad, fatiga, demencia, enfermedad de Alzheimer, cefalea tensional, síndrome de fibromialgia y problemas cardiovasculares; (iii) consecuentes: promueve un efecto calmante; aumenta la empatía, satisfacción, interacción, respeto, sentido de valor y vida; promueve bienestar, consuelo, tranquilidad y paz, esperanza, seguridad, motivación, humor y calidad de sueño; reduce el estrés y comportamientos perturbadores; promueve mejor estado funcional y calidad de vida. Conclusión El tacto terapéutico está implícito en la práctica profesional de los enfermeros y exige una adaptación concreta y singular a las circunstancias y necesidades reales de la persona, a favor de una práctica que promueva el bienestar.

Abstract Objective To analyze the concept of therapeutic touch in nursing care, specifying its attributes, antecedents, and consequents. Methods This is a conceptual analysis of the evolutive view of Rodgers (2000), about the concept of therapeutic touch in nursing care, together with an integrative literature review based on the research question: What is the concept of therapeutic touch in nursing care? What are the attributes, antecedents, and consequents of therapeutic touch in nursing care? The search was conducted in the electronic databases CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, in the b-on Online Knowledge Library, by combining the descriptors DeCS/MESH "therapeutic touch", "nursing" e "nursing care" and the Boolean operator AND over the period from 2000 to 2020. Results The sample was composed of eight studies that identified three thematic pillars: (i) attributes: complementary and effective method, technique, tool, nursing intervention, use of hands, intention to help or heal, complementary treatment, intentional touch, and energy transfer; (ii) antecedents: pain, anxiety, fatigue, dementia, Alzheimer's disease, tension headache, fibromyalgia syndrome, and cardiovascular problems; (iii) consequents: promotes a calming effect; increases empathy, satisfaction, interaction, respect, sense of worth and life; promotes well-being, comfort, tranquility and peace, hope, security, motivation, mood and sleep quality; reduces stress and disruptive behaviors; promotes better functional status and quality of life. Conclusion Therapeutic touch is implicit in the professional practice of nurses, requiring concrete and unique adjustment to the real circumstances and needs of the person, towards a practice that promotes comfort.

Educação permanente em saúde como prática possível: uma experiência na atenção primária / Educación permanente en salud como práctica posible: experiencia en atención primaria / Permanent health education as a possible practice: an experience in primary care

RESUMO Objetivo: descrever o processo de análise de necessidades, execução e avaliação de um programa educativo na Atenção Primária à Saúde, na lógica da Educação Permanente em Saúde (EPS). Método: pesquisa-ação com abordagem mista, desenvolvida entre 2014 e 2016, com trabalhadores da saúde. A coleta de dados ocorreu nos encontros de grupo focal, oficinas do programa educativo e aplicação de questionários. Os dados qualitativos foram submetidos à análise de discurso do sujeito coletivo, e os dados quantitativos, à análise estatística descritiva. Resultados: a necessidade priorizada foi a comunicação prejudicada no ambiente de trabalho; e, durante a execução do programa educativo, os participantes pactuaram acordos para superação dos problemas identificados, a exemplo da criação de espaços de diálogo e fluxos definidos de comunicação. Sentiram-se satisfeitos em participar, e percebeu-se que o programa educativo causou impacto positivo no trabalho. Considerações finais: o objetivo de descrever todo processo da EPS foi alcançado. Houve maior estímulo para um movimento de transformação no processo de trabalho, em referência ao aprimoramento da comunicação na dimensão profissional da gestão do cuidado, a partir de um paradigma dialógico e crítico, capaz de ressignificar o processo de ensino-aprendizagem no trabalho. Como produto, tem-se um modo mais efetivo de operar a EPS.

RESUMEN Objetivo: describir el proceso de análisis de necesidades, ejecución y evaluación de un programa educativo en la Atención Primaria de Salud, en la lógica de la Educación Permanente en Salud (EPS). Método: investigación-acción con enfoque mixto, desarrollada entre 2014 y 2016, con trabajadores de la salud. La recolección de datos tuvo lugar en los encuentros de grupo focal, talleres del programa educativo y aplicación de cuestionarios. Los datos cualitativos fueron sometidos al análisis de discurso del sujeto colectivo, y los datos cuantitativos, al análisis estadístico descriptivo. Resultados: la necesidad priorizada fue la comunicación perjudicada en el ambiente de trabajo; y, durante la ejecución del programa educativo, los participantes pactaron acuerdos para superar los problemas identificados, a ejemplo de la creación de espacios de diálogo y flujos definidos de comunicación. Se sintieron satisfechos de participar, y se percibió que el programa educativo causó impacto positivo en el trabajo. Consideraciones finales: el objetivo de describir todo el proceso de EPS fue alcanzado. Hubo mayor estímulo para un movimiento de transformación en el proceso de trabajo, en referencia al perfeccionamiento de la comunicación en la dimensión profesional de la gestión del cuidado, a partir de un paradigma dialógico y crítico, capaz de resignificar el proceso de enseñanza-aprendizaje en el trabajo. Como producto, se tiene un modo más efectivo de operar la EPS.

ABSTRACT Objective: to describe the process of needs analysis, execution and evaluation of an educational program in Primary Health Care, in the logic of Permanent Health Education (PHE). Method: action research with mixed approach, developed between 2014 and 2016, with health workers. Data collection occurred in focus group meetings, educational program workshops and questionnaire application. The qualitative data were submitted to discourse analysis of the collective subject, and quantitative data were submitted to descriptive statistical analysis. Results: the prioritized need was impaired communication in the work environment; and, during the implementation of the educational programme, participants agreed agreements to overcome the identified problems, such as the creation of dialogue spaces and defined communication flows. They were satisfied to participate, and it was noticed that the educational program had a positive impact on the work. Final considerations: the objective of describing the entire Process of PHE was achieved. There was a greater stimulus for a movement of transformation in the work process, in reference to the improvement of communication in the professional dimension of care management, from a dialogical and critical paradigm, capable of resignifying the teaching-learning process at work. As a product, there is a more effective way to operate PHE.