Antineoplastic therapy administration: Nursing intervention in the relief of suffering.

OBJECTIVE: To identify the nursing interventions with potential to act on the suffering and to evaluate the results of the nursing intervention designed. METHOD: We used a multi method study. After the identification of the scientific evidence and having found the supporting theory, the intervention process to relieve the suffering of hospitalized patients was modeled using the methodology of qualitative research. Then, training conditions were created for the implementation of the intervention Chemotherapy Administration as an Individualized Nursing Intervention, with a Quasi Experimental, longitudinal piloting study. RESULTS: The patients of the experimental group showed values of suffering lower than the control group . Having finished the pilot study, we would return to qualitative research to understand the variation of some data. FINAL CONSIDERATIONS: The use of mixed methods of investigations allowed the understanding of the different components of drug chemotherapy administration as an individualized nursing intervention.

Antineoplastic therapy administration: Nursing intervention in the relief of suffering / Administração de terapia antineoplásica: intervenção de enfermagem no alívio do sofrimento / Administración de terapia antineoplásica: Intervención de enfermería en el alivio del sufrimiento

ABSTRACT Objective: To identify the nursing interventions with potential to act on the suffering and to evaluate the results of the nursing intervention designed. Method: We used a multi method study. After the identification of the scientific evidence and having found the supporting theory, the intervention process to relieve the suffering of hospitalized patients was modeled using the methodology of qualitative research. Then, training conditions were created for the implementation of the intervention Chemotherapy Administration as an Individualized Nursing Intervention, with a Quasi Experimental, longitudinal piloting study. Results: The patients of the experimental group showed values of suffering lower than the control group . Having finished the pilot study, we would return to qualitative research to understand the variation of some data. Final Considerations: The use of mixed methods of investigations allowed the understanding of the different components of drug chemotherapy administration as an individualized nursing intervention.

RESUMO Objetivo: Identificar intervenções de enfermagem com o potencial de atuar sobre o sofrimento e avaliar os resultados da intervenção de enfermagem criada. Método: Uma abordagem de estudo multimétodo foi utilizada. Após identificar as evidências científicas e encontrar a teoria de apoio, o processo de intervenção para aliviar o sofrimento de pacientes hospitalizados foi modelado utilizando a metodologia da pesquisa qualitativa. Em seguida, foram criadas as condições de treinamento para a implementação da intervenção Administração da Quimioterapia como Intervenção de Enfermagem Individualizada, com estudo piloto quase experimental, longitudinal. Resultados: Os pacientes do grupo experimental apresentaram valores de sofrimento inferiores ao grupo controle. Após o término do estudo piloto, retornaríamos à pesquisa qualitativa para entender a variação de alguns dados. Considerações finais: O uso de métodos mistos de pesquisa permitiu a compreensão dos diferentes componentes da administração da quimioterapia medicamentosa como uma intervenção de enfermagem individualizada.

RESUMEN Objetivo: Identificar las intervenciones de enfermería con potencial para actuar sobre el sufrimiento y evaluar los resultados de la intervención de enfermería diseñada. Método: Utilizamos un estudio de varios métodos. Tras identificarse la evidencia científica y determinarse su fundamentación teórica, se modeló el proceso de intervención para aliviar el sufrimiento de los pacientes hospitalizados, aplicándose metodología cuantitativa. Posteriormente, se crearon las condiciones de capacitación para implementar la intervención Administración de Quimioterapia como una Intervención de Enfermería Individualizada, con un estudio piloto longitudinal cuasi -experimental. Resultados: Los pacientes del grupo experimental mostraron valores de sufrimiento inferiores a los del grupo control. Habiendo finalizado la prueba piloto, habríamos de retomar la investigación cualitativa para comprender la variación de algunos datos. Consideraciones finales: La aplicación de métodos mixtos de investigación permitió comprender los diferentes componentes de la administración de la quimioterapia farmacológica como una intervención de enfermería individualizada.

Nursing practices in peripheral venous catheter: phlebitis and patient safety / Práticas de enfermería en el cateterismo venoso periférico: la flebite y la seguridad del paciente / Práticas de enfermagem no cateterismo venoso periférico: a flebite e a segurança do doente

ABSTRACT Objective: to understand the nursing practices related to peripheral venous catheter and to identify deviations related to the scientific evidence regarding the prevention of phlebitis. Method: qualitative study with data collection by means of participant observation techniques and semi-structured interviews, with 26 and 15 nurses, respectively, from a Portuguese hospital. Data content analysis was performed. Results: In the category "nursing actions", nursing practices related to: selection of catheter insertion site and its caliber size, evaluation of insertion site for signs of inflammation, insertion site dressing, disinfection of accessories, hand hygiene and patient participation in care emerged. There were situations of deviations in these practices in relation to scientific evidence. Conclusion: Nursing practices presented deviations in relation to scientific evidence, and were influenced by the size of the institution, patient characteristics, and lack of knowledge of nurses regarding certain actions that pose a risk to patient safety. The creation of protocols and the implementation of continuous education are fundamental for the acquisition of competencies by nurses, for correcting deviations and providing a safe quality nursing care to the patient.

RESUMEN Objetivo: conocer las prácticas de enfermería relacionadas con el cateterismo venoso periférico e identificar desvíos relativos a las evidencias científicas en lo que se refiere a la prevención de flebitis. Método: estudio cualitativo con la recolección de datos a través de técnicas de observación participante y entrevistas semiestructuradas con 26 enfermeros y 15, respectivamente, de un hospital portugués. Se realizó un análisis de contenido de los datos. Resultados: en la categoría Acciones de enfermería, surgieron prácticas de enfermería relacionadas con: selección del lugar de inserción del catéter y su calibre, evaluación del lugar de inserción en cuanto a los signos inflamatorios, curativo en la inserción, desinfección de accesorios, higienización de las manos y participación del paciente en el cuidado. Se verificaron situaciones de desvíos en esas prácticas en relación a las evidencias científicas. Conclusión: las prácticas de enfermería presentaban desvíos a las evidencias científicas, siendo influenciadas por dimensiones institucionales, características de los enfermos, y desconocimiento de los enfermeros acerca de determinadas acciones que ponen en riesgo la seguridad del paciente. La elaboración de protocolos y la implementación de la Educación Continua son fundamentales para la adquisición de competencias por los enfermeros, para la corrección de las desviaciones y la prestación de una asistencia de enfermería segura y con calidade para el paciente.

RESUMO Objetivo: conhecer as práticas de enfermagem relacionadas com o cateterismo venoso periférico e identificar desvios relativos às evidências científicas no que diz respeito à prevenção de flebite. Método: estudo qualitativo com coleta de dados através das técnicas de observação participante e entrevista semiestruturada, com 26 e 15 enfermeiros, respectivamente, de um hospital Português. Foi realizada análise de conteúdo dos dados. Resultados: na categoria Ações de enfermagem, emergiram práticas de enfermagem relacionadas com: seleção do local de inserção do cateter e seu calibre, avaliação do local de inserção quanto aos sinais inflamatórios, curativo na inserção, desinfecção de acessórios, higienização das mãos e participação do doente nos cuidados. Verificaram-se situações de desvios nessas práticas em relação às evidências científicas. Conclusão: as práticas de enfermagem apresentavam desvios em relação às evidências científicas, sendo influenciadas por dimensões institucionais, características dos doentes, e desconhecimento dos enfermeiros acerca de determinadas ações que colocam em risco a segurança do doente. A elaboração de protocolos e a implementação da Educação Continuada são fundamentais para a aquisição de competências pelos enfermeiros, para correção dos desvios e prestação de uma assistência de enfermagem segura e com qualidade para o doente.

Plataforma PEnsinar®: a learning tool for teaching the nursing process.

OBJECTIVE: to describe the construction and transition phases undertaken in the development of a virtual learning environment named Plataforma PEnsinar® (PEnsinar Platform®). This platform aims at teaching the nursing process and the nursing classifications NANDA International, NIC, NOC and ICNP®. METHOD: this is a methodological and technological development research that used construction and transition phases of the software development process named Rational Unified Process. RESULTS: the software was developed in the construction phase. Unit and integration tests of components of interfaces were held. In the transition phase, the complete system was showed to the users. It was completely working considering the applicability and employment, under conditions to be implemented and evaluated. CONCLUSION: the study showed how the construction and transition phases of the Plataforma PEnsinar® were developed. It was based on a proposal that inserts the student as an active agent in the nursing process and the professor as a mediator, providing tools that will contribute to a better learning.

Plataforma PEnsinar®: a learning tool for teaching the nursing process / Plataforma PEnsinar®: herramienta de aprendizaje para la enseñanza del proceso de enfermería / Plataforma PEnsinar®: ferramenta de aprendizagem para o ensino do processo de enfermagem

ABSTRACT Objective: to describe the construction and transition phases undertaken in the development of a virtual learning environment named Plataforma PEnsinar® (PEnsinar Platform®). This platform aims at teaching the nursing process and the nursing classifications NANDA International, NIC, NOC and ICNP®. Method: this is a methodological and technological development research that used construction and transition phases of the software development process named Rational Unified Process. Results: the software was developed in the construction phase. Unit and integration tests of components of interfaces were held. In the transition phase, the complete system was showed to the users. It was completely working considering the applicability and employment, under conditions to be implemented and evaluated. Conclusion: the study showed how the construction and transition phases of the Plataforma PEnsinar® were developed. It was based on a proposal that inserts the student as an active agent in the nursing process and the professor as a mediator, providing tools that will contribute to a better learning.

RESUMEN Objetivo: describir las etapas de construcción y transición realizadas en el desarrollo de un ambiente virtual de aprendizaje (Plataforma PEnsinar®) destinado para la enseñanza del proceso de enfermería y de las clasificaciones Nanda Internacional, NIC, NOC y CIPE®. Método: se trata de una investigación metodológica y de desarrollo tecnológico que utilizó las etapas de construcción y transición del proceso de desarrollo de programa (software): Rational Unified Process. Resultados: en la etapa de construcción fue desarrollado el software y se ejecutaron las pruebas unitarias e integradas de los componentes de las interfaces. En la transición, se mostró a los usuarios el sistema completo y en funcionamiento para la aplicabilidad y el empleo, en condiciones de ser implementado y evaluado. Conclusión: el estudio mostró como fue desarrollada la construcción y la transición de la Plataforma PEnsinar®, basada en una propuesta que inserta el discente cómo agente activo en el proceso de enfermería, y el docente como mediador, suministrando las herramientas que posibilitarán un mejor aprendizaje.

RESUMO Objetivo: descrever as etapas de construção e transição realizadas no desenvolvimento de um ambiente virtual de aprendizagem (Plataforma PEnsinar®) voltado para o ensino do processo de enfermagem e das classificações Nanda Internacional, NIC, NOC e CIPE®. Método: trata-se de uma pesquisa metodológica e de desenvolvimento tecnológico que utilizou as fases de construção e transição do processo de desenvolvimento de software: Rational Unified Process. Resultados: na fase de construção foi desenvolvido o software e executaram-se os testes unitários e integrados dos componentes das interfaces. Na transição, mostrou-se aos usuários o sistema completo e em funcionamento para a aplicabilidade e emprego, em condições de ser implementado e avaliado. Conclusão: o estudo mostrou como foi desenvolvida a construção e transição da Plataforma PEnsinar®, baseada em uma proposta que insere o discente como agente ativo no processo de enfermagem, e o docente como mediador, fornecendo ferramentas que possibilitarão um melhor aprendizado.

Impact of a structured multicomponent educational intervention program on metabolic control of patients with type 2 diabetes.

BACKGROUND: Diabetes is one of the most common metabolic disorders, with a high prevalence of patients with poor metabolic control. Worldwide, evidence highlights the importance of developing and implementing educational interventions that can reduce this burden. The main objective of this study was to analyse the impact of a lifestyle centred intervention on glycaemic control of poorly controlled type 2 diabetic patients, followed in a Community Care Centre. METHODS: A type 2 experimental design was conducted over 6 months, including 122 adults with HbA1c ≥ 7.5%, randomly allocated into Experimental group (EG) or Control Group (CG). EG patients attended a specific Educational Program while CG patients frequented usual care. Personal and health characterization variables, clinical metrics and self-care activities were measured before and after the implementation of the intervention. Analysis was done by comparing gains between groups (CG vs EG) through differential calculations (post minus pre-test results) and Longitudinal analysis. RESULTS: Statistical differences were obtained between groups for HbA1c and BMI: EG had a decrease in 11% more (effect-size r2 = .11) than CG for HbA1c (p < .001) and 4% more (effect-size r2 = .04) in BMI (p < .05). When controlling for socioeconomic characteristics and comorbidities that showed to be associated to each parameter in pre-test, from pre to post-test only EG participants significantly decreased HbA1c [Wilks' ʎ = .702; F(1,57) = 24.16; p < .001; ηp2 = .298; observed power = .998]; BMI values [Wilks' ʎ = .900; F(1,59) = 6.57; p = .013; ηp2 = .100; observed power = .713]; systolic Blood pressure [Wilks' ʎ = .735; F(1,61) = 21.94; p < .001; ηp2 = .265; observed power = .996] and diastolic Blood pressure [Wilks' ʎ = .795; F(1,59) = 15.20; p < .001; ηp2 = .205; observed power = .970]. CONCLUSIONS: The impact of a structured multicomponent educational intervention program by itself, beyond standard educational approach alone, supported in a Longitudinal analysis that controlled variables statistically associated with clinical metrics in pre-test measures, has demonstrated its effectiveness in improving HbA1c, BMI and Blood pressure values. TRIAL REGISTRATION: RBR-8ns8pb . (Retrospectively registered: October 30,2017).

Collaboration: a SWOT analysis of the process of conducting a review of nursing workforce policies in five European countries.

AIM: This paper critically reviews the literature on international collaboration and analyses the collaborative process involved in producing a nursing workforce policy analysis. BACKGROUND: Collaboration is increasingly promoted as a means of solving shared problems and achieving common goals; however, collaboration creates its own opportunities and challenges. Evidence about the collaboration process, its outcomes and critical success factors is lacking. METHODS: A literature review and content analysis of data collected from six participants (from five European countries) members of the European Academy of Nursing Science Scholar Collaborative Workforce Workgroup, using a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis template. RESULTS: Two major factors affecting scholarly collaboration were identified: Facilitators, which incorporated personal attributes and enabling contexts/mechanisms, including individual commitment, responsibility and teamwork, facilitative supportive structures and processes. The second, Barriers, incorporated unmet needs for funding; time; communication and impeding contexts/mechanisms, including workload and insufficient support/mentorship. CONCLUSIONS: The literature review identified a low level of evidence on collaboration processes, outcomes, opportunities and challenges. The SWOT analysis identified critical success factors, planning strategies and resources of effective international collaboration. IMPLICATIONS FOR NURSING MANAGEMENT: Collaboration is an important concept for management. Evidence-based knowledge of the critical success factors facilitating and impeding collaboration could help managers make collaboration more effective.

The opinion of patients with COPD: the process of becoming chronically sick / Vozes das pessoas com DPOC: o processo de tornar-se doente crónico

Many earlier studies have contributed to a general understanding of the symptoms and signs of chronic obstructive pulmonary disease (COPD), yet very little is known about the transition from a healthy to a chronically sick individual. The scope of this study was to understand how people live with their chronic illness, using Grounded Theory¹. Twenty-two participants with COPD were interviewed. Findings revealed "the basic social process" of becoming sick with COPD: The significance of living with COPD; Stages of becoming a sick individual; Strategies for management of the process used by participants. The conclusion reached is that understanding the process of "becoming sick" from the person's perspective assists nurses to develop personalized interventions with individuals suffering from COPD, focussing on the subject of care.

Os vários estudos realizados no âmbito da DPOC têm focalizado o seu objeto de estudo na compreensão dos sinais e sintomas da doença, no entanto pouco se conhece sobre a transição de saudável a doente. Então como é que as pessoas com DPOC vivem o processo de transição de saudável a doente? O método utilizado foi a Teoria Fundamentada. Realizámos 22 entrevistas abertas a pessoas com DPOC. O Processo Social Básico (PSB), encontrado neste estudo é "tornar-se doente" expressa o conceito central do estudo e procura dar resposta à questão de investigação: O PSB é composto pelos seguintes códigos temáticos: O significado de viver com a DPOC; Estádios do processo de tornar-se doente; Estratégias de gestão do processo. Consideramos que o conhecimento do processo de "tornar-se doente", ajuda os enfermeiros a desenvolver intervenções individualizadas às pessoas com DPOC, focalizando-se no sujeito de cuidados.

The opinion of patients with COPD: the process of becoming chronically sick.

Many earlier studies have contributed to a general understanding of the symptoms and signs of chronic obstructive pulmonary disease (COPD), yet very little is known about the transition from a healthy to a chronically sick individual. The scope of this study was to understand how people live with their chronic illness, using Grounded Theory. Twenty-two participants with COPD were interviewed. Findings revealed "the basic social process" of becoming sick with COPD: The significance of living with COPD; Stages of becoming a sick individual; Strategies for management of the process used by participants. The conclusion reached is that understanding the process of "becoming sick" from the person's perspective assists nurses to develop personalized interventions with individuals suffering from COPD, focussing on the subject of care.