Nurse Managers Coping Strategies for Crisis Management: Qualitative Systematic Review.

Stressor-related disorders are a growing issue for both the individual and the organizations. The aim of the study was to analyze the strategies used by nurse managers to face crises. A systematic review of the literature, including qualitative studies was performed. Data were analyzed using framework-based synthesis and summarized into domains. Quality was evaluated using the JBI QARI Checklist. 10 studies met the inclusion criteria. Data collection was based on interviews, followed by questionnaires and focus groups. Good communication, organizational commitment and emotional support were the principal domains. Institutions should support nurse managers to cope with stress and make suggestions for adaptations.

Percepção de enfermeiros acerca dos processos de cuidado durante a pandemia da covid-19 / Nurses' perception about care processes during the covid-19 pandemic / Percepción de las enfermeras sobre los procesos de atención durante la pandemia de covid-19

Objetivo: analisar a percepção do enfermeiro acerca dos processos de cuidado durante a pandemia da COVID-19. Métodos: estudo de campo, descritivo e abordagem qualitativa, realizado entre dezembro de 2020 a abril de 2021. Participaram 45 enfermeiros atuantes há três anos ou mais na Atenção Primária de municípios paraibanos classificados em urbano, intermediário adjacente e remoto, rural adjacente e remoto. Realizou-se a coleta através de entrevistas semiestruturadas pela plataforma Google Meet, essas eram gravadas pela própria plataforma e transcritas na íntegra para análise. A análise de dados deu-se por meio da Análise de Conteúdo considerando as etapas de pré-análise, codificação do texto e a inferência e interpretação dos resultados. O estudo atendeu ao que preconiza os padrões éticos. Resultados: no contexto pandêmico, os enfermeiros identificaram déficits existentes em suas práticas, elencando desafios e limitações nas condutas, como as de biossegurança e prevenção de doenças, fazendo-os repensar sobre futuras mudanças a serem realizadas após o período de pandemia. Conclusão: infere-se que os enfermeiros atuantes da Atenção Primária obtiveram novas percepções relacionadas ao cuidado, a preocupação com a saúde física e mental no planejamento desse cuidado, não apenas do usuário, mas de si mesmo e às pessoas do convívio. (AU)

Objective: to analyze nurses' perceptions of care processes during the COVID-19 pandemic. Methods: field study, descriptive and qualitative approach, carried out between December 2020 and April 2021. Participated 45 nurses working for three years or more in Primary Care in municipalities in Paraíba classified as urban, intermediate adjacent and remote, rural adjacent and remote. The collection was carried out through semi-structured interviews through the Google Meet platform, these were recorded by the platform itself and transcribed in full for analysis. Data analysis was carried out through Content Analysis considering the pre-analysis steps, text coding and the inference and interpretation of results. The study complied with ethical standards. Results: in the pandemic context, nurses identified existing deficits in their practices, listing challenges and limitations in conduct, such as biosecurity and disease prevention, making them rethink about future changes to be made after the period of pandemic. Conclusion: it is inferred that nurses working in Primary Care obtained new perceptions related to care, the concern with physical and mental health in the planning of this care, not only of the user, but of himself and the people around him. (AU)

Objetivo: analizar las percepciones de los enfermeros sobre los procesos de atención durante la pandemia de COVID-19. Métodos: estudio de campo, de abordaje descriptivo y cualitativo, realizado entre diciembre de 2020 y abril de 2021. Participaron 45 enfermeros que actúan desde hace tres años o más en Atención Básica en municipios de Paraíba clasificados como urbano, intermedio adyacente y remoto, rural adyacente y remoto. La recolección se realizó a través de entrevistas semiestructuradas a través de la plataforma Google Meet, estas fueron grabadas por la propia plataforma y transcritas en su totalidad para su análisis. El análisis de los datos se realizó a través del Análisis de Contenido considerando las etapas del preanálisis, la codificación del texto y la inferencia e interpretación de los resultados. El estudio cumplió con las normas éticas. Resultados: en el contexto de la pandemia, los enfermeros identificaron déficits existentes en sus prácticas, enumerando desafíos y limitaciones en la conducta, como la bioseguridad y la prevención de enfermedades, lo que les hizo repensar sobre los cambios futuros que se deben realizar después del período de pandemia. Conclusión: se infiere que los enfermeros que actúan en la Atención Primaria obtuvieron nuevas percepciones relacionadas con el cuidado, la preocupación por la salud física y mental en la planificación de este cuidado, no sólo del usuario, sino de sí mismo y de las personas que lo rodean. (AU)

Trabalho interdisciplinar e condições de trabalho de enfermeiros que atuam na atenção primária à saúde / Interdisciplinary work and working conditions of nurses working in primary health care / Trabajo interdisciplinario y condiciones de trabajo de los enfermeros que actúan en la atención primaria de salud

Objetivo: Discutir acerca do trabalho interdisciplinar na prática do enfermeiro na Atenção Primária à Saúde e as suas condições de trabalho. Métodos: Pesquisa descritiva, qualitativa, realizada com 45 profissionais Enfermeiros, que atuam na Atenção Primária à Saúde do estado da Paraíba, de dezembro de 2020 a abril de 2021. A coleta de dados foi guiada por um roteiro semiestruturado. Os dados foram interpretados com base na Análise de Conteúdo e discutidos a partir da literatura existente. Resultados: Evidenciou-se que, apesar de os enfermeiros conseguirem firmar parceria com os outros trabalhadores da unidade, usuários e gestão, e sentirem autonomia para realizar procedimentos, existem condições que dificultam suas práticas, como o pouco reconhecimento profissional, os problemas com a gestão, a falta de insumos e a sobrecarga de função. Conclusão: Os enfermeiros na Atenção Primária vêm buscando seu espaço e melhores condições de trabalho que facilitem suas práticas e favoreçam o cuidado ao usuário. Dessa forma, tais profissionais necessitam de visibilidade e reconhecimento social de suas competências técnicas. (AU)

Objective: Discuss about the interdisciplinary work in the practice of nurses in Primary Health Care and their working conditions. Methods: Descriptive, qualitative research, carried out with 45 professional nurses, who work in Primary Health Care in the state of Paraíba, from December 2020 to April 2021. Data collection was guided by a semi-structured script. Data were interpreted based on Content Analysis and discussed from the existing literature. Results: It was evidenced that, although the nurses manage to establish a partnership with the other workers of the unit, users and management, and feel autonomy to carry out procedures, there are conditions that hinder their practices, such as little professional recognition, problems with management, the lack of inputs and the function overload. Conclusion: Nurses in Primary Care have been seeking their space and better working conditions that facilitate their practices and favor user care. Thus, such professionals need visibility and social recognition of their technical skills. (AU)

Objetivo: Discutir sobre el trabajo interdisciplinario en la práctica de los enfermeros en la Atención Primaria de Salud y sus condiciones de trabajo. Métodos: Investigación descriptiva, cualitativa, realizada con 45 enfermeros profesionales, que actúan en la Atención Primaria de Salud en el estado de Paraíba, de diciembre de 2020 a abril de 2021. La recolección de datos fue guiada por un guión semiestructurado. Los datos fueron interpretados con base en el Análisis de Contenido y discutidos a partir de la literatura existente. Resultados: Se evidenció que, aunque los enfermeros logran establecer una sociedad con los demás trabajadores de la unidad, usuarios y gerencia, y sienten autonomía para realizar los procedimientos, existen condiciones que dificultan sus prácticas, como poco reconocimiento profesional, problemas con la gestión, la falta de insumos y la sobrecarga de funciones. Conclusión: Los enfermeros en Atención Básica vienen buscando su espacio y mejores condiciones de trabajo que faciliten sus prácticas y favorezcan la atención al usuario. Por lo tanto, estos profesionales necesitan visibilidad y reconocimiento social de sus habilidades técnicas. (AU)

Detección de violencia machista entre las mujeres atendidas por tentativa autolítica en un servicio de urgencias / Detection of interpersonal partner violence among women treated for attempted suicide in an emergency department

Introducción: Existe evidencia sobre una asociación directa entre la Violencia Machista/Violencia de Género (VdG) y el suicidio, e incluso se señala que la VdG es el principal factor precipitante para que una mujer realice una tentativa suicida. Además, se ha demostrado que las mujeres con enfermedades mentales crónicas sufren especialmente más violencia que la población en general. Sin embargo, existen relativamente pocos datos sobre la capacidad de detección de VdG de los servicios de urgencias. En Catalunya, el Programa Código Riesgo de Suicidio (CRS) atendió a 12.596 persones con episodios de conducta suicida y ha demostrado su eficacia en nuestro hospital. Objetivo principal: Cuantificar el grado de detección de la VdG de nuestros registros sanitarios en mujeres visitadas en el servicio urgencias de nuestro hospital por ideación y/o tentativa suicida y que han sido incluidas en el Programa CRS. Hipótesis principal: La detección actual de VdG en las mujeres es <10%. Metodología: Estudio descriptivo retrospectivo basado en registros electrónicos sanitarios. Se identificaron todas las mujeres que habían estado en seguimiento telefónico en los últimos 12 meses por haber acudido al servicio de urgencias de nuestro Hospital por ideación y/o intento suicida. El período de análisis incluyó del 1 de enero al 31 de diciembre de 2020. Se realizó una revisión completa de todos los informes de alta de estas mujeres visitadas en urgencias y de los registros clínicos de todos los profesionales (médicos, psiquiatrías, enfermeras...) disponibles en la historia clínica informatizada. Se realizó un análisis descriptivo simple de los datos. Resultados: Durante el período de estudio, se detectaron cuatro casos de violencia machista/VdG (1,92%) y dos casos de violencia familiar entre las 208 mujeres que se visitaron por ideación y/o intento autolítico...(AU)

Introduction: There is evidence of a direct association between interpersonal partner/sexist/gender violence (IPV) and suicide, and it is even pointed out that IPV is the main precipitating factor for a woman to make a suicide attempt. In addition, it has been shown that women with chronic mental illness suffer especially more violence than the general population. However, there is relatively little data on the IPV detection capacity of emergency departments. In Catalonia, the Suicide Risk Code Program (CRS) treated 12,596 people with episodes of suicidal behaviour and has demonstrated its effectiveness in our hospital. Main objective: To quantify the degree of detection of IPV in our health records in women visited in the emergency department of our hospital for suicidal ideation and/or attempt and who have been included in the CRS Program.Main hypothesis: Current detection of IPV in women is <10%. Methodology: Retrospective descriptive study based on electronic health records. All the women who had been in telephone follow-up in the last 12 months for having gone to the emergency department of our hospital for suicidal ideation and/or attempt were identified. The analysis period included from January 1 to December 31, 2020. A complete review of all the discharge reports of the women visited in the emergency room and of all the clinical records of all the professionals (doctors, psychiatrists, nurses...) available in the computerized medical record was carried out. A simple descriptive analysis of the data was performed. Results: During the study period, four cases of IPV (1.92%) and two cases of family violence were detected among the 208 women who were visited for suicidal ideation and/or attempt. All the women who were detected with IPV were recommended to visit the Women’s Care Center, but it is unknown if they were actually referred to other professionals or if they actually attended...(AU)

Appropriateness of behavioural scales in the monitoring of pain in the critically ill patient unable to self-report.

Appropriateness is a dimension of quality that evaluates the effective use of technologies, resources or interventions in specific situations or populations, assessing whether our interventions do more benefit than harm. The evidence regarding pain monitoring in the critically ill patient points to the periodic assessment of pain using appropriate tools, with the aim of improving pain management and more efficient use of analgesics in the intensive care unit. The first step would be to assess the patient's ability to communicate or self-report and, based on this, to select the most appropriate pain assessment tool. In patients who are unable to self-report, behavioural pain assessment tools are recommended. When we talk about the suitability of behavioural scales for pain monitoring in critically ill patients unable to self-report, we refer to their use with a clear clinical benefit, i.e. using the right tool for pain assessment to be effective, efficient and consistent with bioethical principles. To our knowledge, there are no published data on the suitability of pain assessment tools in unable to self-report critically ill patients, so, in the framework of continuous quality improvement in pain care, new research should incorporate this approach by integrating the best scientific evidence with current clinical practice.

Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care.

OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity. DESIGN: Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study. LOCATION: 27 PC teams from Catalonia. PARTICIPANTS: >50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. INTERVENTION: 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training. MEASUREMENTS: Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated. RESULTS: The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was -357.95€ (95% CI: -2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: -15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference -0.01, 95% CI -0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY. CONCLUSIONS: Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

Cuidados de enfermagem no banho de aspersão em instituição de longa permanência: revisão integrativa / Nursing care in the spray bath in a long-term care institution: integrative review

Identificar os cuidados de enfermagem necessários para o banho de aspersão seguro para idosos no quotidiano de uma instituição de longa permanência. Método: Revisão Integrativa da literatura, recorte entre 2001 e 2022. Os dados dos estudos incluídos resultaram em uma síntese descritiva, fundamentada na Teoria das Necessidades Humanas Básicas. Resultados: Obteve-se 13 estudos sobre cuidados no banho com e sem auxílio, envolvendo o equilíbrio psicobiológico, psicossocial e psicoespiritual, remoção de barreiras ambientais, adaptação domiciliar, maneiras de abordagem, musicoterapia e cuidados com a integridade da pele, oportunizando segurança e qualidade nas ações prestadas. Conclusões: Os cuidados precisam estar integrados às necessidades humanas básicas, respeitando as peculiaridades do processo de envelhecimento e as fragilidades dos idosos mais vulneráveis. A qualificação dos profissionais de enfermagem/cuidadores formais visa a padronização da execução do procedimento e a redução de ocorrência de desvios de procedimento.(AU)

To identify the nursing care necessary for safe spray baths for elderly people in daily life in a long-term care institution. Method: Integrative literature review, cut between 2001 and 2022. Data from the included studies resulted in a descriptive synthesis, based on the Theory of Basic Human Needs. Results: 13 studies were obtained on bath care with and without assistance, involving psychobiological, psychosocial and psychospiritual balance, removal of environmental barriers, home adaptation, approaches, music therapy and care for the integrity of the skin, providing safety and quality in the actions provided. Conclusions: Care needs to be integrated with basic human needs, respecting the peculiarities of the aging process and the weaknesses of the most vulnerable elderly people. The qualification of nursing professionals/formal caregivers aims to standardize the execution of the procedure and reduce the occurrence of procedural deviations.(AU)

Identificar los cuidados de enfermería necesarios para baños de aspersión seguros para personas mayores en la vida diaria en una institución de cuidados a largo plazo. Método: Revisión integrativa de la literatura, cortada entre 2001 y 2022. Los datos de los estudios incluidos resultaron en una síntesis descriptiva, basada en la Teoría de las Necesidades Humanas Básicas. Resultados: Se obtuvieron 13 estudios sobre cuidados del baño con y sin asistencia, involucrando equilibrio psicobiológico, psicosocial y psicoespiritual, remoción de barreras ambientales, adaptación domiciliaria, abordajes, musicoterapia y cuidado de la integridad de la piel, brindando seguridad y calidad en las acciones. proporcionó. Conclusiones: Los cuidados deben integrarse con las necesidades humanas básicas, respetando las peculiaridades del proceso de envejecimiento y las debilidades de las personas mayores más vulnerables. La calificación de los profesionales de enfermería/cuidadores formales tiene como objetivo estandarizar la ejecución del procedimiento y reducir la ocurrencia de desviaciones procesales.(AU)

Percepción del uso del humor por parte de enfermeras y pacientes en los servicios de salud mental / Perception of the use of humour by nurses and patients at Mental Health Units

Objetivo: conocer, en función de la literatura disponible, el significado del sentido del humor entre enfermeras y pacientes en el contexto de servicios de salud mental, así como determinar los factores que facilitan o dificultan el uso del sentido del humor en las unidades de salud mental. Métodos: se llevó a cabo una revisión narrativa en el periodo 2022-2023. Las búsquedas se realizaron en Pubmed, PsycINFO, LILACS y CINAHL, usando los descriptores: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, "psychiatric nursing”. Se incluyeron todo tipo de documentos que abordaran el tema según los objetivos, publicados desde 2012 hasta noviembre de 2022 en inglés, español o portugués. Se añadió un artículo traducido del coreano por su relevancia. Resultados: se incluyeron 10 manuscritos en la revisión. Los hallazgos sugieren que el sentido del humor se percibe como una herramienta esencial para fortalecer la relación entre enfermeras y pacientes en entornos psiquiátricos. No obstante, se destaca la existencia de factores que podrían conducir a un uso inapropiado del humor, llevando a la deshumanización de la atención y la posible ruptura del vínculo terapéutico. Conclusiones: es importante considerar cuidadosamente el empleo del humor en el contexto de la salud mental, para garantizar su efectividad sin comprometer la calidad asistencial. (AU)

Objective: based on the literature available, to understand the meaning of sense of humour between nurses and patients in the setting of Mental Health Units, as well as to determine the factors that facilitate its use, o make it difficult. Methods: a narrative review was conducted during the 2022-2023 period. Searches were conducted in Pubmed, PsycINFO, LILACS and CINAHL, using the descriptors: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, “psychiatric nursing”. All type of documents addressing this matter according to the objectives were included, published from 2012 until November 2022 in English, Spanish or Portuguese. An article translated from Korean was added due to its relevance. Results: ten (10) manuscripts were included in the review. Findings suggested that sense of humour was perceived as an essential tool in order to strengthen the relations between nurses and patients in psychiatric settings. However, it was highlighted that there are factors which could induce an inadequate use of humour, leading to dehumanization in care and a potential breach in the therapeutic link. Conclusions: it is important to carefully consider the use of humour in the mental health setting, in order to guarantee its effectiveness without compromising the quality of care. (AU)

La importancia de los valores profesionales desde la perspectiva de las enfermeras clínicas / The Importance of Professional Values from Clinical Nurses' Perspective

Introducción: Los valores se vuelven necesarios para orientar el comportamiento profesional de la enfermera como una profesión digna. Objetivo: Esta investigación tuvo como objetivo identificar los valores profesionales de las enfermeras de Indonesia y explorar elementos esenciales de valor profesional basados en las percepciones de las enfermeras. Material y métodos: Esta investigación utilizó una investigación de método mixto. Hasta 517 enfermeras completaron el cuestionario Revisado de la Escala de Valor Profesional de Enfermería (NPVS-R) de abril a mayo de 2019 y se incluyeron diez enfermeras clínicas en la entrevista semiestructurada. Resultados: Los resultados cuantitativos obtuvieron que la puntuación media de los valores profesionales de las enfermeras fue de 97,30 ± 14,15. Tanto como el 74,3% de las enfermeras perciben los valores profesionales de las enfermeras en un nivel alto. Hubo una diferencia significativa entre el nivel educativo y el cuidado de la enfermera (valor de p 0,001 <0,05). La dimensión más dominante de los valores profesionales de enfermería fue la dimensión de cuidar de 56,55 ± 8,19. De la investigación cualitativa se obtuvieron tres temas, a saber: Cuidado, Profesionalismo y Confianza. Conclusiones: Como sugieren los hallazgos, debemos prestar más atención a los valores profesionales, especialmente la profesionalidad y la confianza de las enfermeras para trabajar en el complejo contexto sanitario actual (AU)

Introduction: Values become necessary to direct nurses' professional behavior as a dignified profession. Objective: This research aimed to identify Indonesian nurses' professional values and explore essential professional value items based on clinical nurses' perceptions. Methods: This research used mixed method research. As many as 517 nurses filled out the Nursing Professional Value Scale Revised (NPVS-R) questionnaire from April to May 2019 and ten clinical nurses were included in the semi-structured interview.Results: The professional values of nurses were 97.30 ± 14.15. As many as 74.3% of nurses perceived the professional values of nurses at a high level. There was a significant difference between education level and nurse caring (P value 0.001 <0.05). The most dominant dimension of nurse professional values was the caring dimension of 56.55 ± 8.19. Three themes were obtained from the qualitative research, namely: Caring, Professionalism and Trust. Conclusions: As the findings suggest, we need to pay more attention to professional values, especially professionalism and trust for the nurses to work in today's complex healthcare context (AU)

Identificación y manejo de situaciones emocionales vividas por los estudiantes de enfermería durante las prácticas clínicas / Identification and management of emotional situations experienced by student nurses during clinical placements

Introducción: La Enfermería es una profesión en la que se viven situaciones emocionales muy complejas y difíciles, por lo que adquiere especial importancia el saber gestionar de forma adecuada las emociones para poder evitar estados de estrés crónico.Objetivo: Identificar las situaciones emocionales que experimentan los estudiantes de enfermería durante su experiencia clínica y la relación de ésta con las habilidades de la profesión enfermera, así como su gestión emocional. Método: Estudio de diseño mixto cualitativo/cuantitativo. La parte cualitativa se basa en el estudio de las situaciones emocionales percibidas por el alumnado en las prácticas clínicas, recabado a través de una pregunta abierta sobre situaciones que le habrían generado une emoción intensa. La cuantitativa, por su parte, se centra en la IEP (Inteligencia Emocional Percibida) del alumnado medido por cuestionario Trait Meta-Mood Scale (TMMS-24).Resultados: En la primera parte se identifican dos categorías principales: Las habilidades y la falta de habilidades, entre las cuales, la categoría más identificada es la de las “habilidades”, siendo la subcategoría más representativa la de “empatía”, seguida del “autoconocimiento”. En ambas, la situación emocional primordialmente identificada es la muerte.En la segunda parte, se examinan los resultados y se infiere una asociación entre la dimensión Comprensión de la IEP y las habilidades de la profesión enfermera.Conclusión: La muerte está muy presente en las emociones del alumnado de prácticas clínicas siendo la empatía, la habilidad más presente. La comprensión emocional puede ayudar a estimular la empatía y promover el autoconocimiento (AU)

Introduction: Nursing is a profession in which very complex and challenging emotional situations are experienced. Therefore, knowing how to manage emotions properly is particularly important to avoid chronic stress. Objective: Identifying Emotional situations experienced by nursing students during their clinical experience and their relationship with the skills of the nursing profession, as well as emotional management. Method: Study with a mixed qualitative and quantitative design. The qualitative part is based on the study of emotional situations experienced by students in clinical practices, gathered through an open question on situations that have generated intense emotion. In turn, the quantitative part is focused on the PEI of the students, measured by the Trait Meta-Mood Scale (TMMS-24) questionnaire. Results: The first section identifies two main categories: skills and lack of skills. Among these, the most identified category is that of "skills", the most representative subcategory being that of "empathy", followed by "self-knowledge". In both, the emotional situation identified primarily is death. In the second section, the results are examined, and an association is inferred between the Comprehension dimension of PEI and the skills of the nursing profession. Conclusion: Death is very present in students' emotions in clinical practices, with empathy being the skill with the most significant presence. Emotional comprehension may help to stimulate empathy and promote self-knowledge (AU)

The diary in the intensive care unit: Concept analysis.

INTRODUCTION: Admission to an intensive care unit can cause sequelae to both patients and family members. In some countries, the use of diaries is a preventive action. AIM: This research proposes to critically examine the concept of 'Intensive Care Unit Diary' by analysing the current state of the scientific literature to develop a precise conception of this phenomenon in nursing practice, since there are multiple unknowns regarding its use and content. METHOD: A bibliographic search was carried out in the PubMed, Cochrane Library, Scopus and CINAHL databases in January 2023. The terms used to search for their use and definitions in the databases included Nurse, Concept analysis, Family, Uci Diary, Patient Critical, Intensive Care Unit. We use Wilson's concept analysis, later developed by Walker and Avant. RESULTS: The concept analysis shows that the 'ICU Diary' is a record made in colloquial language by health workers and relatives of the patient admitted to the intensive care unit. Aimed at the patient, with an empathic and reflective style, which offers a narrative of the process, daily life and the conduct or behaviour of the patient during his stay. It is a therapeutic tool led by nurses accepted by patients, families and professionals. Its use benefits the recovery process, reducing post-traumatic stress in family members and patients. It favours communication and the bond between nurses, family members and patients, helping to express feelings and emotions. CONCLUSIONS: The concept of 'UCI Diary' is complex. Through Wilson's model, a clarification of the concept has been achieved, creating a starting point for more precise research on this phenomenon and its effects on patients, family members, professionals and the health system.

Image of nurses in Chile through children's drawings: An iconographic study / A imagem de enfermeiras(os) no Chile por meio de desenhos infantis: um estudo iconográfico / Imagen de enfermeras(os) en Chile a través del dibujo infantil: un estudio iconográfico

Abstract Objective To reveal the image of nursing professionals in Chile through the analysis of children's drawings. Method This is an exploratory qualitative study, involving the collection of information through nine drawings made by children aged between 7 and 10 years, using free technique, and then were analyzed with the Iconographic Method proposed by Erwin Panofsky. Results Most drawings depict clinical activities of nurses, focusing predominantly on the technical dimension of the profession. Although nursing is commonly associated with a mostly female occupation, permeated by gender stereotypes, some participants were able to identify the presence and importance of the male role in this professional field. No iconographic elements were identified that would reinforce stigmas associated with nursing professionals, such as the view that they are supporters, aides, or mere medical assistants. Conclusions and implications for practice Children's drawings serve as a reflection of the collective imagination of society. By studying them in relation to nursing, we can identify the advances of the profession and glimpse its near future. This research contributes to understanding the current image of the profession in society, and allows an analysis that goes further, helping to establish future directions and the evolution of this collective perception.

Resumo Objetivo Revelar a imagem do profissional de enfermagem no Chile por meio da análise iconográfica de desenhos infantis. Método Estudo qualitativo exploratório, envolvendo a coleta de informações por meio de nove desenhos elaborados por crianças com idades entre 7 e 10 anos, utilizando técnica livre e posteriormente examinados com base no Método Iconográfico proposto por Erwin Panofsky. Resultados A maioria retrata as atividades clínicas do enfermeiro, enfocando predominantemente em sua dimensão técnica. Embora a enfermagem seja comumente associada a uma ocupação majoritariamente feminina, permeada por estereótipos de gênero, alguns participantes conseguiram identificar a presença e a importância do papel masculino nesse campo profissional. Não foram identificados elementos iconográficos que reforçassem estigmas associados aos profissionais de enfermagem, como a visão de serem simples assistentes, ajudantes ou meros auxiliares dos médicos. Conclusões e implicações para a prática Os desenhos infantis são reflexo do imaginário coletivo da sociedade. Ao estudá-los em relação à enfermagem, podemos identificar avanços na profissão e vislumbrar seu futuro próximo. Esta pesquisa contribui para compreender a imagem atual da profissão na sociedade e possibilita uma análise que ajuda a estabelecer direções futuras e a evolução dessa percepção coletiva.

Resumen Objetivo Revelar la imagen de los profesionales de enfermería en Chile a través del análisis de dibujos infantiles. Método Estudio cualitativo exploratorio, que involucra la recolección de información a través de nueve dibujos en técnica libre realizados por niños entre siete y diez años, posteriormente analizados mediante el Método Iconográfico propuesto por Erwin Panofsky. Resultados La mayoría representa las actividades clínicas de las enfermeras, centrándose predominantemente en la dimensión técnica. Aunque la enfermería se asocia comúnmente a una ocupación mayoritariamente femenina, impregnada de estereotipos de género, algunos participantes identificaron la presencia y la importancia del papel masculino en la profesión. No se identificaron elementos iconográficos que reforzaran estigmas asociados a los profesionales de enfermería, como la visión de que son simples asistentes, ayudantes o meros auxiliares médicos. Conclusiones e implicaciones para la práctica Los dibujos son reflejo del imaginario colectivo de la sociedad. Al estudiarlos en relación con la enfermería, podemos identificar avances en la profesión y vislumbrar su futuro próximo. Esta investigación contribuye a comprender la imagen actual de la profesión en la sociedad y permite un análisis que ayuda a establecer las orientaciones futuras y la evolución de esta percepción colectiva.

Pé diabético: o cuidado de enfermeiras / Diabetic foot: nurses' care / Pie diabético: cuidados de enfermeira

Objetivo: Descrever o cuidado para prevenção do pé diabético realizado por enfermeiras. Método:revisão integrativa da literatura a partir do levantamento realizado em janeiro de 2024 através da biblioteca virtual da PubMed. Foram incluídos artigos nos idiomas inglês e português, artigos originais relacionados ao tema e disponíveis na íntegra com acesso gratuito, publicados entre os anos de 2012 até o ano de 2024. Como critérios de exclusão: artigos que não atendam o objeto de estudo, duplicados, teses, livros, revisões e artigos não originais.Resultados:O levantamento resultou na seleção de 15 artigos que evidenciaram que o cuidado para prevenção do pé diabético se desenvolvem a partir da atuação do enfermeiro, e por meio da aplicação de cuidados, como avaliação do paciente, educação em saúde para os pacientes e a educação permanente para os profissionais de saúde, controle glicêmico, verificação do Índice tibial braquial-ITB para diagnóstico de doença arterial obstrutiva periférica (DAOP), uso de termometria cutânea ou imagem infravermelha, criação de software e exames laboratoriais. Conclusão:O estudo poderá contribuir para melhoria da qualidade de vida dos pacientes diabéticos através do conhecimento dos profissionais de enfermagem acerca dos cuidados elencados para melhor atender aos pacientes bem como contribuir com a diminuição de casos de úlceras em pé diabético.

Objective: To describe the care to prevent diabetic foot provided by nurses. Method:integrative literature review based on the survey carried out in January 2024 through the PubMed virtual library. Articles in English and Portuguese were included, original articles related to the topic and available in full with free access, published between 2012 and 2024. Exclusion criteria were: articles that do not meet the object of study, duplicates, theses, books, reviews and non-original articles. Results:The survey resultedin the selection of 15 articles that showed that care to prevent diabetic foot develops from the role of nurses, and through the application of care, such as patient assessment, health education for patients and continuing education for health professionals, glycemic control, verification of the brachial tibial index-ABI for diagnosing peripheral arterial obstructive disease (PAOD), use of skin thermometry or infrared imaging, creation of software and laboratory tests. Conclusion:The study may contribute to improving the quality of life of diabetic patients through the knowledge of nursing professionals about the care provided to better serve patients as well as contributing to the reduction of cases of diabetic foot ulcers.

Objetivo: Describir los cuidados para la prevención del pie diabético brindados por enfermeras. Método:revisión integrativa de la literatura a partir de la encuesta realizada en enero de 2024 a través de la biblioteca virtual PubMed. Se incluyeron artículos en inglés y portugués, artículos originales relacionados con el tema y disponibles íntegramente con acceso gratuito, publicados entre 2012 y 2024. Los criterios de exclusión fueron: artículos que no cumplan con el objeto de estudio, duplicados, tesis, libros, reseñas y artículos no originales. Resultados:La encuesta resultó en la selección de 15 artículos que mostraron que los cuidados para prevenir el pie diabético se desarrollan desde el rol del enfermero, y a través de la aplicación de cuidados, como la evaluación del paciente, la educación en salud de los pacientes y la educación continua de los profesionales de la salud, la glucemia. control, verificación del índice braquial tibial-ITB para el diagnóstico de enfermedad arterial obstructiva periférica (EAP), uso de termometría cutánea o imágenes infrarrojas, creación de software y pruebas de laboratorio. Conclusión:El estudio puede contribuir a mejorar la calidad de vida de los pacientes diabéticos a través del conocimiento de los profesionales de enfermería sobre los cuidados brindados para atender mejor a los pacientes, así como contribuir a la reducción de casos de úlceras del pie diabético.

Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review.

INTRODUCTION: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. MATERIAL AND METHODS: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. RESULTS: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. DISCUSSION: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. CONCLUSION: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.

Workloads of intensive care nurses. Validity of their estimation using mobile applications and comparison with Nursing Activities Score. Systematised review of the literature.

INTRODUCTION: Adjusting human resources to intensive care units (ICU) workload is essential. The development of software for estimating nursing workload using mobile devices (smartphone, smartwatch and/or tablets) could be a useful tool and complement and/or improve the measurements made with the Nursing Activities Score (NAS), a validated scale. OBJECTIVES: To analyze the validity of devices and mobile applications for estimating ICU nurses' workloads and their comparison with NAS. METHODOLOGY: Systematised literature review from 2009 to 2021 informed by flowchart PRISMA-2020 and its extension PRISMA-S. Critical reading (CASPe). Steps:elaboration of the research question, concept identification (English and Spanish natural language and descriptors MesH, Emtree and CINAHL Headings), search strategy and data collection in MEDlars online (MEDLINE), OVID, Excerpta Medica dataBASE (EMBASE), Elsevier, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EBSCO and Web of Science (WoS); data extraction and evaluation, analysis and synthesis of results. We included studies with abstracts published in English and Spanish conducted in ICU with workload measurement (preferably NAS) using mobile devices. RESULTS: 223 studies of which 84 in MEDLINE, 50 in CINAHL, 48 in EMBASE, 33 in WOS and 8 in other sources. 117 were eligible for screening, of which 95 did not meet the inclusion criteria. 22 studies were screened for eligibility, of which 17 were excluded. Five articles were selected for final review. None of the studies provided results on costs, acceptance testing, validity, reliability, system problems, advantages, disadvantages or resource estimation. DISCUSSION AND CONCLUSIONS: The use of mobile devices and applications to measure ICU workloads is not yet validated and has not been shown to be more accurate than traditional NAS assessment.

Rol del coordinador de enfermería en las subdirecciones de gestión del cuidado / The role of nursing coordinators within care management sub-directorates / Papel do coordenador de enfermagem nas subdiretorias de gestão assistente

Objetivo: El objetivo de esta reflexión fue explorar de acuerdo con la evidencia científica disponible, las funciones y atributos del rol de las enfermeras coordinadoras en atención cerrada. Desarrollo: En Chile la gestión del cuidado de enfermería para atención cerrada de establecimientos hospitalarios de mediana y alta complejidad se encuentra regulada por la norma general administrativa N° 19, con resolución exenta 1127 de 2007. A más de 15 años de su implementación se ha cuantificado una desigualdad en cuanto a estructura y alta heterogeneidad de las funciones enmendadas a través de la norma que las regula. A nivel internacional y nacional no existe consenso en relación con la estructura de enfermería y con ello el rol de coordinadoras de enfermería dentro de las subdirecciones de gestión del cuidado. Esta investigación demuestra divergencia en las estructuras de Enfermería y las definiciones con respecto a las coordinaciones de Enfermería, aspecto fundamental para la gobernanza de Enfermería. El estilo de liderazgo, motivación, comunicación efectiva, acompañamiento y el conocimiento de sistemas complejos, pueden determinar características de las enfermeras coordinadoras. Conclusiones: La definición y funciones del desarrollo del rol de la coordinación de enfermería es divergente. En la actualidad las estructuras son disímiles entre los establecimientos hospitalarios. Se sugiere establecer una estructura orgánica general desde el nivel central para la universalidad de las subdirecciones de enfermería, considerando las diferencias de acuerdo con carteras de servicios, complejidad y especialidad de los hospitales chilenos.

Objective: This reflection aimed to explore, based on the existing scientific evidence, the functions and attributes of the nurse coordinator's role in hospital care. Development: In Chile, nursing management for hospital care in medium- and high-complexity establishments is regulated by general administrative standard No. 19 through the exempt resolution 1127, 2007. More than 15 years after its implementation, some inequalities have been detected in its structure, as well as high heterogeneity in the functions that have been amended through the norm that regulates them. There is no consensus regarding the structure of nursing roles, whether at the international or national level; this includes the role of nursing coordinators within care management sub-directorates. This reflection reveals the divergence that exists among the structures of Nursing and the definitions related to nursing coordination, a fundamental aspect of governance in Nursing. Leadership style, motivation, effective communication, support, and knowledge of complex systems can determine the characteristics of nursing coordinators. Conclusions: The definition and functions of the nursing coordination role are divergent. Currently, the structures are dissimilar among hospital facilities. It is suggested that a general organizational structure is developed from a central level and universalized to all nursing sub-directorates, considering differences according to the service portfolios, complexity, and specialty of hospitals in Chile.

Objetivo: O objetivo desta reflexão foi explorar, de acordo com a evidência científica disponível, as funções e atributos da atuação dos enfermeiros coordenadores no cuidado fechado. Desenvolvimento: No Chile, a gestão da assistência de enfermagem para atendimento fechado em estabelecimentos hospitalares de média e alta complexidade é regulamentada pela norma administrativa geral nº 19, com isenção da resolução 1.127 de 2007. Mais de 15 anos após sua implementação, quantificou-se uma desigualdade em termos de estrutura e elevada heterogeneidade das funções alteradas pela norma que as regulamenta. A nível internacional e nacional não existe consenso em relação à estrutura de enfermagem e, portanto, ao papel dos coordenadores de enfermagem nas subdireções de gestão do cuidado. Esta reflexão demostra divergências nas estruturas e definições de enfermagem em relação à coordenação de enfermagem, um aspecto fundamental para a governança em enfermagem. O estilo de liderança, a motivação, a comunicação eficaz, o suporte e o conhecimento de sistemas complexos podem determinar características dos enfermeiros coordenadores. Conclusões: A definição e funções do desenvolvimento do papel da coordenação de enfermagem são divergentes. Atualmente, as estruturas são díspares entre os estabelecimentos hospitalares. Sugere-se estabelecer uma estrutura orgânica geral a partir do nível central para a universalidade das subdireções de enfermagem, considerando as diferenças segundo carteiras de serviços, complexidade e especialidade dos hospitais chilenos.

Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review / Tendencias emergentes en los programas de atención dirigidos por enfermeras para el manejo de pacientes con artritis reumatoide establecida: Revisión sistemática de la literatura

Introduction: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. Material and methods: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. Results: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. Discussion: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. Conclusion: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.(AU)

Introducción: En los pacientes con artritis reumatoide, las enfermeras se consideran esenciales, no solo para garantizar la seguridad farmacológica, sino también en la prestación de promoción en el autocuidado y la toma de decisiones, favoreciendo el empoderamiento de los pacientes. Esta revisión sistemática tuvo como objetivo resumir la literatura disponible sobre la educación sanitaria por parte de la enfermera en pacientes con artritis reumatoide. Material y métodos: Siguiendo los procedimientos de la Colaboración Cochrane, la declaración PRISMA y la lista de comprobación PRISMA, se recuperaron los estudios cuantitativos relevantes publicados en las bases de datos CINAHL, Scopus, PubMed y Medic y, a continuación, se revisaron sistemáticamente. La búsqueda finalizó en agosto de 2021. Diecinueve estudios fueron retenidos para su inclusión y evaluados con la Scottish Intercollegiate Guidelines Network for Systematic Reviews. ResultadosSe encontró una mejoría estadísticamente significativa en el autocuidado (cinco estudios), la actividad de la enfermedad (tres estudios), la calidad de vida (dos estudios), la satisfacción (cinco estudios) y la adherencia (un estudio) con el manejo dirigido por enfermería de pacientes con artritis reumatoide establecida. Discusión: Aunque siempre ha habido evidencias de mejora en la satisfacción y el autocuidado, parece haber una tendencia a mejorar también otros resultados, como el de Disease Activity Score in 28 Joints (DAS28), a partir de las recomendaciones de la European League Against Rheumatism (EULAR), la ampliación del arsenal terapéutico para la artritis reumatoide y la toma de decisiones compartida. Además, recientemente y debido a la implantación de las nuevas tecnologías, se ha evaluado el papel de la enfermera a través de las consultas virtuales. Los resultados de estudios recientes han demostrado que se trata de un nuevo enfoque...(AU)

Yvonne Lara: enfermeira brasileira / Yvonne Lara: Brazilian nurse / Yvonne Lara: enfermera brasileña

Objetivo: apresentar a trajetória de Yvonne da Silva Lara na enfermagem brasileira. Método: método histórico com base documental na perspectiva da microanálise com ênfase em biografia. Os dados coletados dos documentos pessoais e institucionais foram triangulados com a literatura de aderência e organizados nos eixos: dados pessoais, processo de formação na enfermagem e trajetória profissional. Resultados: a análise desses dados esclareceu a divergência no ano de nascimento da biografada e a revelou como enfermeira de formação com especialização, diversidade de conhecimentos e significativa vivência prática. Conclusão: o legado deixado foi ter articulado seus saberes e ideais em prol do ethos do cuidado ao ser humano.

Objective: to present the trajectory of Yvonne da Silva Lara in Brazilian nursing. Method: historical method based on documents from the perspective of microanalysis with an emphasis on biography. Data collected from personal and institutional documents were triangulated with the adherence literature and organized into axes: personal data, nursing education process and professional trajectory. Results: the analysis of these data clarified the divergence in the biographed woman's year of birth and revealed her as a trained nurse with specialization, with a diversity of knowledge and significant practical experience. Conclusion: the legacy she left was having articulated her knowledge and ideals in favor of the ethos of caring for human beings.

Objetivo: presentar la trayectoria de Yvonne da Silva Lara en la enfermería brasileña. Método: método histórico basado en documentos desde la perspectiva del microanálisis con énfasis en la biografía. Los datos recolectados de los documentos personales e institucionales fueron triangulados con la literatura de adherencia y organizados en los ejes: datos personales, proceso de formación de enfermería y trayectoria profesional. Resultados: El análisis de estos datos aclaró la divergencia en el año de nacimiento de la biografiada y la reveló como siendo una enfermera de formación con especialización, con diversidad de saberes y significativa experiencia práctica. Conclusión: El legado que dejó fue haber articulado sus saberes e ideales a favor del ethos del cuidado del ser humano.

[The role of the nurse in the field of public health]. / El rol de la enfermería en el ámbito de la salud pública.

OBJECTIVE: Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. METHOD: Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. RESULTS: The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to "care" and the "global vision" of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. CONCLUSIONS: This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.

Pertinencia de enfermería, según las competencias percibidas por los graduados de la Universidad de Guayaquil

Fundamento: la pertinencia en salud se relaciona con la coherencia existente en un proyecto de intervención según las necesidades de sus beneficiarios; en ello es muy importante que el profesional posea facultades para combinar sus capacidades en el logro de un propósito determinado. Objetivo: determinar indicadores de empleabilidad según las competencias en graduados de la carrera de Enfermería de la Universidad de Guayaquil . Métodos: estudio descriptivo/explicativo con una muestra representativa de 136 graduados de los últimos cinco años, a los que se les aplica un instrumento validado por juicio de expertos (0,89: alfa de Cronbach). Se midieron 17 indicadores de empleabilidad interna y seis de empleabilidad externa. Resultados: los graduados de enfermería perciben la empleabilidad como atributos y competencias del ser, con habilidades de resolución de problemas, ser reflexivos, pensamiento crítico, conductas éticas y liderazgo efectivo. En relación con la empleabilidad externa los egresados se consideraron con competencias de atributos que los hacen competitivos en el entorno laboral de enfermería. Conclusiones: los graduados de la carrera de enfermería de la universidad de Guayaquil poseen los atributos y competencias de una empleabilidad interna y externa de acuerdo con los objetivos y perfiles del profesional de enfermería.

Foundation: the relevance in health is related to the existing coherence in an intervention project according to the needs of its beneficiaries; In this it is very important that the professional has the faculties to combine his capacities in the achievement of a certain purpose. Objective: to determine employability indicators according to the competencies in graduates of the Guayaquil University nursing career. Methods: descriptive/explanatory study with a representative sample of 136 graduates of the last five years, to whom an instrument validated by expert judgment (0.89: Cronbach's alpha) was applied. 17 indicators of internal employability and six of external employability were measured. Results Nursing graduates perceive employability as attributes and competencies of being, with problem-solving skills, being reflective, critical thinking, ethical behaviors, and effective leadership. In relation to external employability, graduates were considered to have attribute competencies that make them competitive in the nursing work environment. Conclusions: Nursing graduates from the Guayaquil University have the attributes and competencies of internal and external employability in accordance with the expectations of the objectives and the nursing professional's profiles.