Pressure injury prevention in older people: construction and validation of an instrument for caregivers.

OBJECTIVES: to construct and validate an instrument to assess the knowledge, attitudes, and practices related to pressure injury prevention among caregivers of institutionalized older people. METHODS: this is a three-stage methodological study that consisted of instrument construction, analysis by experts, and semantic and appearance analysis, with 78 participants, observing the validation process steps for psychometric instruments in the criteria of clarity and relevance. RESULTS: in the Delphi I round, the validity index of the general content in the clarity criterion was 0.66, in relevance 0.85, and the Kappa value was >0.76. In Delphi II, clarity was 0.95, relevance 1.00, and the Kappa value was >0.97. CONCLUSIONS: this is a valid instrument in terms of content and appearance, which allows further analysis of its reliability for the measurement of the constructs for which it is intended. Therefore, it can be considered a tool for care management in pressure injury prevention.

Construction of an Ophthalmological Calendar for the Therapeutic Follow-Up of Glaucoma in the Elderly.

Health teams in primary care play a key role in the eye health of users as they understand that early identification of any visual change can result in satisfactory outcomes and better prognoses, preventing damage that is often irreversible to health. Building an ophthalmological calendar for the therapeutic follow-up of glaucoma in the elderly, this is a methodological study, as the process of constructing the calendar's content followed the Raymundo theoretical framework. The calendar was built in the following steps: bibliographic survey, content development, transformation of the language of scientific information into easy-to-understand expressions, creation and production of illustrations of the first draft, evaluation of the first draft made by the examining board, diagramming and presentation of the product. The construction of the calendar covers a specific theme for the elderly with glaucoma, which emphasizes the need to invest more in the inclusion of new technologies that will provide greater effectiveness and adherence of the user and the health team for the management of comprehensive care. The implementation of the produced calendar will allow for a better understanding and bond between the team professionals and the user and, consequently, a better monitoring of the therapeutic process of the patient involved.

Medicines Delivery Proximity Programme (PEMProxi) survey results.

OBJECTIVES: To evaluate patients' and community pharmacies' satisfaction towards the Medicines Delivery Proximity Programme (PEMProxi), including patients' level of satisfaction with pharmaceutical services, medication dispensing and delivery, cost, and time saved, community pharmacies' satisfaction with PEMProxi-related information and procedures, contact with the patients, and timings. Additionally, to evaluate patients' and community pharmacies' perception of PEMProxi's advantages and disadvantages. METHODS: Patients and the community pharmacies included in PEMProxi were contacted by telephone to answer a survey. The patient survey included questions regarding their satisfaction level towards PEMProxi, medication dispensing and delivery, and cost and time saved. Patients were also asked to point out the advantages and disadvantages of PEMProxi and give improvement suggestions. The community pharmacy survey included questions regarding satisfaction with entering PEMProxi, related information, procedures, contact with the patients on PEMProxi, and timings. Programme-related advantages, disadvantages and improvement suggestions were also solicited. RESULTS: A total of 101 patients and 49 community pharmacies were included in the analysis. A large majority of patients were very satisfied with PEMProxi (93.1%). The Programme allowed each patient to save on average 30€ and 8 hours per month. More than 95% of the patients reported medication delivery in adequate conditions (n=100), in a timely manner (n=95) and according to the prescription (n=95). Most pharmacies were satisfied or very satisfied with their participation in PEMProxi (63.3%). Nearly half (53.1%) were surprised by its implementation and 98% would be available to participate with more patients if the Programme was extended. CONCLUSIONS: The PEMProxi programme contributed to more convenient and equitable access to medications by chronic patients, thus avoiding unnecessary trips to the hospital, saving them precious time and money.

Pressure injury prevention in older people: construction and validation of an instrument for caregivers / Prevención de lesiones por presión en ancianos: construcción y validación de instrumento orientado al cuidador / Prevenção de lesão por pressão em idosos: construção e validação de instrumento voltado ao cuidador

ABSTRACT Objectives: to construct and validate an instrument to assess the knowledge, attitudes, and practices related to pressure injury prevention among caregivers of institutionalized older people. Methods: this is a three-stage methodological study that consisted of instrument construction, analysis by experts, and semantic and appearance analysis, with 78 participants, observing the validation process steps for psychometric instruments in the criteria of clarity and relevance. Results: in the Delphi I round, the validity index of the general content in the clarity criterion was 0.66, in relevance 0.85, and the Kappa value was >0.76. In Delphi II, clarity was 0.95, relevance 1.00, and the Kappa value was >0.97. Conclusions: this is a valid instrument in terms of content and appearance, which allows further analysis of its reliability for the measurement of the constructs for which it is intended. Therefore, it can be considered a tool for care management in pressure injury prevention.

RESUMEN Objetivos: construir y validar un instrumento pera evaluación del conocimiento, actitud y práctica relacionado a la prevención de lesiones por presión entre cuidadores de ancianos institucionalizados. Métodos: estudio metodológico realizado en tres fases: construcción del instrumento, análisis de los evaluadores y análisis semántico y de apariencia, con 78 participantes siguiendo las etapas del proceso de validación de instrumentos psicométricos para los criterios claridad y pertinencia. Resultados: en la ronda Delphi I el índice de validez de contenido general del criterio "claridad" fue de 0,66, "pertinencia" 0,85, y valor de Kappa > 0,76. En Delphi II, el criterio de "claridad" fue 0,95, "pertinencia" 1,00 y valor de Kappa > 0,97. Conclusiones: se tiene un instrumento válido respecto de contenidos y apariencia, para continuar analizando su confiabilidad para medir los constructos a los cuales se propone, para que sirva como herramienta de gestión del cuidado en la prevención de lesiones por presión.

RESUMO Objetivos: construir e validar instrumento relacionado à prevenção de lesão por pressão para avaliação do conhecimento, da atitude e da prática de cuidadores de idosos institucionalizados. Métodos: estudo metodológico realizado em três fases: construção do instrumento, análise dos juízes e análise semântica e aparente, com 78 participantes, seguindo as etapas do processo de validação de instrumentos psicométricos para os critérios clareza e pertinência. Resultados: na rodada Delphi I, o índice de validade de conteúdo global do critério "clareza" foi de 0,66, "pertinência" 0,85 e valor de Kappa > 0,76. Em Delphi II, o critério de "clareza" foi de 0,95, "pertinência" 1,00 e valor de Kappa > 0,97. Conclusões: dispõe-se de instrumento válido quanto a conteúdo e aparência para dar seguimento à análise da sua confiabilidade em medir os construtos aos quais se propõe, para que possa servir de ferramenta para gestão do cuidado na prevenção de lesão por pressão.

Burnout among nurses: a multicentric comparative study.

OBJETIVO: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. METHOD: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. RESULTS: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. CONCLUSION: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.

Burnout among nurses: a multicentric comparative study / Burnout entre enfermeiros: um estudo multicêntrico comparativo / Burnout entre enfermeros: un estudio multicéntrico comparativo

Objetivo: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. Method: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. Results: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. Conclusion: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.

Objetivo: identificar e comparar os níveis de burnout entre enfermeiros portugueses, espanhóis e brasileiros. Método: estudo quantitativo, descritivo, correlacional, comparativo e transversal, realizado com 1.052 enfermeiros em hospitais e unidades básicas de saúde. Um questionário sociodemográfico e o Maslach Burnout Inventory foram aplicados com enfermeiros de Porto-Portugal (n=306), Oviedo-Espanha (n=269) e São Paulo-Brasil (n=477). Os dados foram analisados por meio de estatística descritiva, inferencial e multivariada. Resultados: aproximadamente 42% dos enfermeiros apresentaram níveis moderados/altos de burnout, não sendo encontradas diferenças entre os países (Portugal e Brasil com 42%, Espanha com 43%). Apenas a dimensão despersonalização apresentou diferenças entre os países, com um nível mais elevado na Espanha e mais baixo em Portugal. A análise comparativa mostrou níveis mais elevados de burnout em enfermeiros jovens e naqueles que trabalhavam em turnos. Em relação às escalas de trabalho, burnout foi associada ao trabalho por turnos em Portugal e aos horários fixos na Espanha e no Brasil. Conclusão: esses resultados sugerem que essa síndrome em enfermeiros é um fenômeno global. Estressores diários e maiores demandas da profissão de enfermagem são elementos cruciais para preparar os enfermeiros para lidar com situações complexas, evitar burnout e reduzir o impacto negativo na sua saúde e na qualidade dos cuidados que prestam.

Objetivo: identificar y comparar los niveles de burnout entre enfermeros portugueses, españoles y brasileños. Método: estudio cuantitativo, descriptivo, correlacional, comparativo y transversal, realizado con 1.052 enfermeros de hospitales y unidades básicas de salud. Se aplicó un cuestionario sociodemográfico y el Maslach Burnout Inventory a enfermeras de Porto, Portugal (n=306), Oviedo, España (n=269) y São Paulo, Brasil (n=477). Los datos se analizaron mediante estadística descriptiva, inferencial y multivariada. Resultados: aproximadamente el 42% de los enfermeros presentaban niveles moderados/altos de burnout y no se encontraron diferencias entre países (Portugal y Brasil 42%, España 43%). Solo la dimensión de despersonalización mostró diferencias entre países, con un nivel mayor en España y menor en Portugal. El análisis comparativo mostró mayores niveles de burnout en enfermeros jóvenes y en los que trabajaban por turnos. En cuanto a los horarios de trabajo, el burnout se asoció con el trabajo por turnos en Portugal y con horario fijo en España y Brasil. Conclusión: estos resultados sugieren que el síndrome de burnout en enfermeros es un fenómeno global. Los estresores cotidianos y las mayores exigencias de la profesión de Enfermería son elementos cruciales para preparar a los enfermeros para enfrentar situaciones complejas, evitar el burnout y reducir el impacto negativo en la salud de los enfermeros y la calidad de la atención que brindan.

Presenteeism in nurses: comparative study of Spanish, Portuguese and Brazilian nurses.

AIM: To compare presenteeism levels among three samples of nurses and to identify the relationship between presenteeism and sociodemographic and professional characteristics. BACKGROUND: Presenteeism (going to work ill) is a phenomenon studied from different perspectives, and it has become especially important during the current COVID-19 outbreak; its connection to high healthcare costs, patient safety breaches and negative nurse well-being has been proved. INTRODUCTION: The nursing profession is particularly associated with caring for the culture of teamwork, loyalty to colleagues and professional identity. This condition enhances the 'super nurse phenomenon', even though nurses do not feel physically and psychologically able to work. METHODS: A multicentre, cross-sectional study was conducted in three different country contexts: Oviedo (Spain), Porto (Portugal) and São Paulo (Brazil). Nurses performing functions in hospitals and primary health care were enrolled. Informed consent and data collection questionnaires were hand delivered. The Stanford Presenteeism Scale-6 was applied. RESULTS: A total of 659 nurses participated. Portuguese nurses showed greater prevalence of presenteeism, followed by Brazilian and Spanish nurses. Younger nurses with less professional experience presented lower levels of presenteeism but greater psychological commitment. Male participants showed lower capacity to complete work when ill than female participants. CONCLUSIONS: Age and length of professional experience proved to be significant predictors of total presenteeism, although only professional experience revealed statistical significance in the adjusted model. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The knowledge of this phenomenon among nurses highlights the need for the development of strategies in the curriculum of nursing students and organizations. Resilience and ergonomic training should be applied in the training programmes of the students and reinforced by the health centre managers. It is essential that healthcare systems design worksite wellness programmes that pursue greater physical and mental well-being for healthcare professionals.

Personalidade, ansiedade e vulnerabilidade ao burnout em enfermeiros: um estudo comparativo portugal/espanha / Personality, anxiety and vulnerability to burnout among nurses: a comparative study Portugal/Spain

Introduction: Nowadays nurses execute their tasks in demanding and stressful contexts, where the stress accumulates and can trigger burnout. This one seems to be the result from the combination of organizational factors with individual vulnerability, in particular predisposition for anxiety and personality traits such as neuroticism. Objectives: This study aims, by comparing nurses from Portugal/Spain, to identify burnout levels and to analyse if personality and anxiety predict burnout. Methodology: This is a quantitative, exploratory, descriptive and transversal study, using a demographic/professional characterization questionnaire, the Eysenck Personality Questionnaire, State-Trait Anxiety Inventory, and Maslach Burnout Inventory. After institutional authorizations, participated anonymously and volunteer, 337 Portuguese nurses and 309 Spanish nurses. Results: We found 55% of nurses without burnout, 35% with moderate burnout and 11% with high burnout, without differences between countries. However, the Portuguese nurses present significantly more exhaustion and less depersonalization, less anxiety trait, and more extroversion and Social Desirability, all with a moderate level. In Portugal, the age and professional experience correlate negatively with burnout, and anxiety predicts 32% of burnout. In Spain, anxiety explains 36% of burnout and personality traits only 2%. Discussion: These findings are consistent with studies in which anxiety is a vulnerability factor for burnout, but contradicted the influence of other personality traits, reinforcing the influence of organizational factors. Conclusion: The results are useful, in the field of occupational health, to develop organizational strategies that enhance individual characteristics of stress management, which, lately, have been applied using Mindfulness among nurses and nursing students

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Eficácia dos programas de promoção de saúde nos locais de trabalho: revisão integrativa / Effectiveness of workplace health promotion programs: integrative review

Introduction and Objective: The current perspective of healthy workplaces implies reinventing new approaches to the relationships between health and work, emphasizing it as a health-promoting agent. Thus, welfare programmes have emerged that include best practices in occupational health. The aim of this study is to present the data gathered on the effectiveness of health promotion programmes in the workplace, through an integrative review. Methodology: Integrative review of the literature according to the Whittemore and Knafl methods, based on English and Portuguese literature published between 2010 and 2019 in the Medline (via PubMed) and EBSCO databases. Grey literature collection was based on searches in the Open Access Scientific Repositories of Portugal and Google Scholar. Studies with experimental, quasi-experimental and descriptive design were included. Results: A total of 57 studies were extracted, in which 98% of the programmes were included in the generation of well-being, namely programmes focused on disease management, treatment of chronic diseases, lifestyle management or prevention of chronic diseases. Most of the programmes showed positive results, since participants decreased body weight, blood pressure, cholesterol level, glycaemia, tobacco consumption, sedentarism and stress level, and increased the level of knowledge, confidence, physical activity, overall health and consumption of healthy food. Conclusion: The results of this study are of potential interest for health professionals and policy-makers, as they provide valuable information for the design of new strategies to promote the health of employees

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Úlcera por pressão em idosos institucionalizados: escores de risco e determinantes clínicos / Pressure ulcer in institutionalized elderly: the risk scores and clinical determinants

Introduction: The term senescence translates the natural process of aging, which includes a sum of physiological, anatomical and functional changes. These changes can lead to morbidities and, when associated with chronic diseases, provide a situation of fragility and dependence, which may leave the elderly vulnerable to the appearance of wounds, which usually present a chronic evolution. Objective: to determine the prevalence and characteristics of pressure ulcers among institutionalized elderly people, the association between risk scores and clinical conditions of the elderly, and the measure of intensity of association of these variables with the development of the lesion. Method: This is a cross-sectional, population-based study with a quantitative approach, based on the analysis of part of the database. All the elderly included in the database (N = 324), enrolled in long-term institutions, were included in the study. Results: The prevalence of pressure ulcer was 8% in institutionalized elderly. It can be verified that of the five variables related to clinical conditions, they had a significant association (p≤0.05). The estimates of the coefficients of the binary logistic regression model showed that positive values, such as urinary incontinence, osteoarticular, neurological diseases and negative values for the change in vision, may increase and / or decrease the chance of developing the lesion. Conclusion: Pressure ulcers are preventable wounds that require constant observa-tion by the professionals responsible for the planning and implementation of care

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Saúde mental dos enfermeiros: Contributos do burnout e engagement no trabalho / Nurses' mental health: Contributions of burnout and job engagement / Salud mental de enfermeros: Contribuciones de lo burnout y engagement no trabajo

INTRODUÇÃO: As novas exigências profissionais e laborais na Enfermagem constituem fatores de risco para a saúde mental dos enfermeiros, cujas consequências individuais podem ser o burnout e a desmotivação no trabalho, bem como, a nível organizacional, a qualidade dos cuidados prestados. OBJETIVO: Conhecer os níveis de burnout e de engagement numa amostra de enfermeiros, a sua inter-relação e variação em função de características sociodemográficas/laborais. MÉTODOS: Estudo transversal, descritivo e correlacional, desenvolvido no âmbito do projeto INT-SO “Dos contextos de trabalho à saúde ocupacional dos profissionais de enfermagem”. Foram aplicadas versões portuguesas do Maslach Burnout Inventory e da Utrecht Work Engagement Scale, e um questionário de caracterização sociodemográfica/laboral a 346 enfermeiros do distrito do Porto, com participação anónima e voluntária. RESULTADOS: Encontraram-se níveis elevados de engagement, moderados de exaustão emocional e baixos de despersonalização, existindo 54% de enfermeiros com nível baixo de burnout, 36% com moderado e 9% com elevado. O burnout diminui com a idade e anos de serviço, surge associado a turnos rotativos, a trabalhar em hospitais, tem correlação negativa com o engagement e prediz mais fortemente o engagement (entre 19,6 e 39,6%) do que o inverso (entre 7,5 e 37,9%). CONCLUSÕES: A existência de 9% de enfermeiros em burnout confirma este grupo como em risco do adoecer psicológico. Os resultados apontam para a importância da saúde mental dos enfermeiros no contexto de trabalho, reforçando a prevenção do burnout e valorizando a saúde mental positiva expressa nas dimensões do engagement dedicação e vigor dos enfermeiros.

BACKGROUND: The new professional and labour demands in nursing are risk factors for nurses' mental health, having as individual consequences burnout and job disengagement, as well as, at the organizational level, the quality of care provided. AIM: To identify the levels of burnout and engagement in a sample of nurses, its interrelationships and its variation according sociodemographic/labour characteristics. METHODS: A cross-sectional, descriptive and correlational study was developed under the project INT-SO "From work contexts to nursing professionals' occupational health. We applied Portuguese versions of Maslach Burnout Inventory and Utrecht Work Engagement Scale, and a questionnaire to demographic/labour characterization to 346 nurses in Porto district, with anonymous and volunteer participation. RESULTS: We found high levels of engagement, moderate emotional exhaustion and low depersonalization, having 54% of nurses a low level of burnout, 36% a moderate and 9% a high level. Burnout decreases with age and job experience, it is associated with rotating shifts, working in hospitals, has negative correlation with the engagement, and predicts more strongly engagement (between 19,6 and 39,6%) than the reverse (between 7,5 and 37,9%). CONCLUSIONS: The existence of 9% of nurses in burnout confirms this group as at risk of the psychologic sickness. The results point to the importance nurses' mental health of in the context of work, strengthening the prevention of burnout and valuing the positive mental health expressed in the dimensions of engagement nurses' dedication and vigour.

INTRODUCCIÓN: Las nuevas demandas profesionales y ocupacionales en enfermería constituyen factores de riesgo para la salud mental de los enfermeros, cuyas consecuencias individuales pueden ser agotamiento y desmotivación en el trabajo, así como, a nivel organizativo, la calidad de los cuidados proporcionados. OBJETIVO: Conocer los niveles de agotamiento y motivación en una muestra de enfermeras, su interrelación y su variación segundo características sociodemográficas/profesionales. METODOLOGÍA: Estudio transversal, descriptivo y correlacional, desarrollado bajo el proyecto INT-SO "Desde los contextos de trabajo hasta la salud ocupacional de profesionales de enfermería". Se aplicaron versiones portuguesas de Maslach Burnout Inventory y Utrecht Work Engagement Scale, y un cuestionario de caracterización sociodemográfica/laboral a 346 enfermeros en el distrito de Porto, con participación anónima y voluntaria. RESULTADOS: Se encontraron altos niveles de motivación, moderado agotamiento emocional y baja despersonalización, con 54% de enfermeros con nivel bajo de burnout, 36% con moderado y 9% con alto. El agotamiento disminuye con la edad y años de servicio, se asocia con turnos rotativos, a trabajar en hospitales, tiene correlación negativa con la motivación y predice más fuertemente la motivación (entre 19,6 y 39,6%) y non tanto lo inverso (entre 7,5 y 37,9%). CONCLUSIONES: La existencia de 9% de enfermeros en burnout confirma este grupo como de riesgo para la enfermedad psicológica. Los resultados señalan la importancia de la salud mental de los enfermeros en el contexto de trabajo, fortaleciendo la prevención de burnout y la valoración de la salud mental positiva, expresada en las dimensiones de motivación dedicación y vigor de los enfermeros.

Bullying and engagement among nurses

Workplace bullying has become a growing issue among nurses, which can have a negative impact on engagement. Due to the relevance of this matter, the purpose of this study was to identify the presence of workplace bullying and engagement and to analyze the relationship between the two and the sociodemographic and professional variables among nurses. This is a quantitative, cross-sectional and correlational study. The sample consis-ted of 173 primary care nurses from one of Azores' Islands (Portugal). The sample was of 88.4% female nurses; 58.4% of which 38 years old or older and with an avera-ge of 16.1 years of professional experience. A questionnaire was applied respecting the nurses' confidentiality, consisting of three groups for the nurses' sociodemo-graphic, workplace bullying (NAQ-R) and engagement (UWES) evaluation. Among the results, there was a prevalence of workplace bullying of 9.2%. Nurses 37 years old or younger, working a rotating shifts and with stressful work, were more exposed to workplace bullying. Good levels of engagement were identified (Mean = 4.3). Female nurses with partners and children, working fixed shifts, with 14 or more years of professional experience and who did not perceive their work stressful, presented higher levels of engagement. There was a negative relationship between workplace bullying and engagement. The results of this study suggest the need to invest in antibullying policies / pro-cedures and occupational health programs to minimize the impact of workplace bullying and to promote the maintenance of good levels of engagement among nurses

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Persona mayor con limitaciones funcionales diarias / Elderly person with daily functional limitations

Introducción: el creciente proceso de envejecimiento de la población tiende a provocar cambios sociales, económicos y de salud y la creación de nuevas demandas en el sector público, debido a las limitaciones funcionales impuestas por el envejecimiento. Sin embargo, aunque la mayoría de las personas mayores es un portador de al menos una enfermedad crónica, no todos están limitados por ella, llevando una vida normal con sus enfermedades cuando se controla. Objetivo: comprender la vida cotidiana de las personas mayores con limitaciones funcionales. Métodos: cualitativo, descriptivo y exploratorio, guiado por el método de la historia oral, realizado con 15 personas de edad matriculados en una Unidad Familiar Estrategia de Salud en Bahía (Brasil noreste). Como la recolección de datos técnica se utilizó una entrevista semi-estructurada. Las entrevistas fueron grabadas, transcritas y sometidas a análisis de contenido de Bardin. Resultados: las personas mayores con limitaciones funcionales desarrollaban sus actividades diarias, relacionadas con el cuidado de la casa, esposo, hijos y nietos, sociales y de ocio. Las actividades realizadas por los hombres se relacionan con el espacio exterior de la casa y las tareas que requieren fuerza física, mientras que las mujeres desarrollan el papel de los cuidadores de la casa y la familia. Conclusión: las limitaciones funcionales hacen que sea difícil llevar a cabo las actividades cotidianas, así como mantener una vida social activa, pero no excluye el anciano realizarlas(AU)

Introduction: The growing process of population aging tends to cause social, economic and health changes, creating new demands on the public sector, because of the functional limitations imposed by aging. However, although most of the elderly is a carrier of at least one chronic disease, not all are limited by it, leading a normal life with their infirmities, when controlled. Objective: To understand the daily life of the elderly with functional limitations. Method: qualitative, descriptive and exploratory, guided by the method of oral history, conducted with 15 elderly people enrolled in a Health Strategy Unit Family in Bahia (northeastern Brazil). As data collection technique was used a semi-structured interview. Interviews were recorded, transcribed and subjected to content analysis of Bardin. Results: Unveiled that older people with functional limitations develop in their daily activities of daily living and instrumental activities of daily living, which are related to the care of the home, social and leisure activities, and the activities performed by men bind If the external space of the house and the tasks that require physical strength, while women develop the role of caretakers of the home and family, caring for husband, children and grandchildren. Conclusion: The functional limitations make it difficult to carry out everyday activities as well as maintaining an active social life, but does not preclude the elder perform them(AU)

Relação familiar da pessoa idosa com comprometimento da capacidade funcional / Relación familiar del adulto mayor con comprometimiento de la capacidad funcional / Family Relationships of Elderly Adults with Compromised Functional Capacity

Objetivo: compreender a relação familiar da pessoa idosa com comprometimento da capacidade funcional. Materiais e métodos: estudo exploratório e descritivo de abordagem qualitativa, fundamentado no método da história oral, realizado com 15 pessoas idosas assistidas por uma unidade de saúde da família, residentes com familiares e que apresentavam comprometimento da capacidade funcional. Os dados foram coletados no período de março a abril de 2012, por meio de entrevistas em profundidade. As categorias temáticas foram: bom relacionamento familiar, mudanças na relação familiar, sentindo-se um incômodo para a família, sentindo-se abandonado pela família. Resultado: o estudo revelou que as pessoas idosas com comprometimento da capacidade funcional vivenciam sentimentos variados, que vão desde a alegria, por serem respeitadas e terem suas necessidades atendidas, à tristeza e revolta, pela adaptação negativa da família e o abandono dos filhos. Conclusão: a relação familiar da pessoa idosa passa por reajustes após o comprometimento da capacidade funcional, o que repercute significativamente na dinâmica das relações. A partir dessa compreensão, os profissionais de saúde, sobretudo de enfermagem, devem reconhecer os desafios enfrentados pela família, orientá-la e capacitá-la para o atendimento às demandas de cuidado apresentadas pela pessoa idosa com comprometimento da capacidade funcional, e favorecer a realização do cuidado sem que haja desgaste das relações.

Objetivo: comprender la relación familiar de la persona adulta con comprometimiento de la capacidad funcional. Materiales y métodos: estudio exploratorio y descriptivo de abordaje cualitativo, fundamentado en el método de la historia oral, realizado con 15 adultos mayores asistidos por una unidad de salud de la familia, residentes con familiares y que presentaban comprometimiento de la capacidad funcional. Se recolectaron los datos en el período de marzo y abril del 2012, por medio de entrevistas en profundidad. Las categorías temáticas fueron: buena relación familiar, cambios en la relación familiar, sintiéndose un estorbo para la familia, sintiéndose abandonado por la familia. Resultado: el estudio ha revelado que las personas mayores con comprometimiento de la capacidad funcional vivencian sentimientos diversos que van desde la alegría porque son respetadas y tienen sus necesidades atendidas, hasta la tristeza y revuelta, por la adaptación negativa de la familia y el abandono de los hijos. Conclusión: la relación familiar de la persona mayor pasa por reajustes luego del comprometimiento de la capacidad funcional, lo que repercute significativamente en la dinámica de las relaciones. Desde esta comprensión, los profesionales de salud, sobre todo de enfermería, deben reconocer los retos a los que la familia afronta, orientarla y capacitarla para la atención a las demandas de cuidado presentadas por la persona mayor con comprometimiento de la capacidad funcional, y favorecer la realización del cuidado sin que esto desgaste las relaciones.

Objective: This research was intended to understand the family relationships of adults with compromised functional capacity. Materials and Methods: It is an exploratory, descriptive study with a qualitative approach, based on the oral history method. The sample included 15 elderly adults who were being assisted by a family health unit, were living with family members, and had compromised functional capacity. The data were collected between March and April 2012, through in-depth interviews. The subject categories were: good family relationships, changes in family relationships, feeling of being a nuisance to the family, and feeling abandoned or neglected by the family. Result: The study found that elderly adults with compromised functional capacity experience a variety of feelings that range from joy, because they are respected and their needs are met, to sadness and shock over their family's negative adjustment to the situation and by being abandoned or neglected by their children. Conclusion: The dynamics of the family relationships of elderly adults change significantly when the person's functional capacity is compromised. With this in mind, health professionals, especially nurses, must recognize the challenges the family faces and be prepared to guide and train family members to satisfy the demands of caring for an elderly relative with compromised functional capacity and to favor rendering the care that is needed without jeopardizing family relationships.

Crenças de adolescentes portugueses sobre o uso do preservativo / Portuguese adolescent's beliefs in relation to the use of the condom / Creencias de adolescentes portugueses con respecto al uso del condón

Esta pesquisa revela os resultados obtidos durante Doutorado Sandwich, que incluiu trabalho de campo realizado em Portugal e que teve a CAPES como agência financiadora. Seus objetivos foram: identificar as crenças comportamentais e normativas de adolescentes em relação ao uso do preservativo durante as relações sexuais e apresentar sugestões práticas que possam contribuir à definição de estratégias sólidas relacionadas ao Programa de Educação da Sexualidade na Escola. Estudo quantitativo, com base na Theory of Reasoned Action ? TRA, realizado em escolas públicas do Porto, de janeiro a março de 2008. A amostra constou de 252 adolescentes, de 13 a 19 anos, que responderam a um questionário estruturado. A idade média dos participantes foi de 14,7 anos. As vantagens para o uso do preservativo foram: prevenção de DSTs, da gravidez e da SIDA. As desvantagens foram: risco de romper, diminuição do prazer e incômodo. Entre os referentes positivos se destacaram amigos, pais e família. Os resultados obtidos revelaram crenças positivas e negativas, podendo àquelas serem reforçadas e estas minimizadas ou transformadas em positivas, durante as estratégias do programa que vem sendo desenvolvido nas escolas, servindo de contribuição para que os jovens exerçam uma vida sexual saudável.

This research shows the results obtained during PhD Sandwich that includes work carried in Portugal and had the funding agency CAPES. The goals were: to identify adolescents' behavior and normative beliefs toward condom use during the sexual relationships and to develop practical suggestions that can contribute to the definition of solid strategies related to the Sexuality Education Program in the School. Quantitative study, based on the Theory of Reasoned Action - TRA, accomplished at public schools of Porto, from January to March of 2008. The sample consisted in 252 teenagers from 13 to 19 years old that answered a structured questionnaire. The medium age was of 14, 7 years old. The advantages for the use of the condom were: prevention of DSTs, of the pregnancy and of SIDA. The disadvantages were: risk of breaking, decrease of the pleasure and discomfort. Among positives persons were highlighted friends, parents and family. The results showed beliefs positive and negative, the positive can be strengthened and the negative minimized or turned into positive during the strategies of the program, that it has been developed at the schools, serving as a contribution to young people carry on a healthy sexual life.

Esta investigación muestra los resultados obtenidos durante el Doctorado Sandwich que incluye el trabajo del campo llevado a cabo en Portugal y tenía como organismo de financiación la CAPES. Las metas fueran: identificar las creencias de comportamiento y normativas de adolescentes con respecto al uso de condón durante las relaciones sexuales y proponer sugerencias prácticas que pueden contribuir a la definición de estrategias sólidas relacionadas al Programa de Educación de Sexualidad en la Escuela. Investigación cuantitativa, basado en la Theory of Reasoned Action-TRA, realizado en escuelas públicas de Porto, de enero a marzo de 2008. La muestra consistió en 252 adolescentes de 13 a 19 años que contestaron un cuestionario estructurado. La edad media de los participantes fue de 14,7 años. Las ventajas para el uso del condón fueran: la prevención de DSTs, del embarazo y de SIDA. Las desventajas fueran: el riesgo de romper, disminución del placer y incómodo. Entre los referentes positivos se destacaran amigos, padres y familia. Fue pequeño el número de referentes negativos mencionados. Los resultados mostraron las creencias positivas y negativas, el positivo puede fortalecerse y el negativo minimizarse o se convirtir en el positivo durante las estrategias del programa que se ha desarrollado en las escuelas, sirviendo de contribución a que los jóvenes desempeñen una vida sexual saludable.

[A rare case of multiple sclerosing hemangiomas of the lung]. / Um caso raro de hemangioma esclerosante múltiplo do pulmão.

Sclerosing hemangioma of the lung is an uncommon benign tumour which usually presents as an asymptomatic solitary nodule. Multiplicity is very rare. The authors describe a case of a 50 year-old asymptomatic woman with multiple nodular lesions involving all the lobes of both lungs, which underwent diagnostic thoracotomy after thorough investigation to exclude extra-pulmonary neoplasia. The biopsies obtained led to the diagnosis of pulmonary sclerosing hemangiomas. This is one of the few cases described with this presentation.

[Emphysema and lung volume reduction surgery--a case report]. / Enfisema pulmonar e cirurgia de redução de volume - a propósito de um caso clínico.

Lung volume reduction surgery (LVRS) has been proposed as a palliative therapy in severe emphysema, with good results in lung function improvement, exercise capacity and quality of life. The authors present a case report of a 34 years old man with severe, heterogeneous lung emphysema submit to bilateral LVRS in 2000 January. Pre-surgical conditions, clinical and radiological evolution after surgery and for a 30 months follow up were analysed. Based on a literature revision, some technical aspects of LVRS, selection criteria and comparative study of medical and surgical therapy were discussed.

[Bronchoalveolar lavage in HIV patients]. / Lavado broncoalveolar nos doentes VIH.

Lung is the preferential target organ of diseases associated with immunodeficiency virus infection. Taking into consideration that fiberoptic bronchoscopy (FB) with collection of bronchoalveolar lavage fluid (BAL) is a procedure of the highest utility for the etiological clarification of the pulmonary complications in AIDS patients, the authors carried out a review of the most frequent pathologies in this context and present the most frequent indications for FB with BAL. They also compare the results obtained in an American hospital and in two Portuguese ones.

[Wegener's granulomatosis - a case report]. / granulomatose de Wegener-a propósito de um caso clínico.

The Wegener granulomatosis (WG) is a rare vasculite which involves preferentially the upper airways, lungs and kidneys, although it can presents in a multissistemic form. The authors present a clinical case of WG, its diagnostic methodology and respective follow-up from de last two years and half. There are discussed the most often presentation forms of the disease, the importance of histologic results and the contribution of ANCA's determination for disease diagnosis and follow-up. Although important, the histological results, are not essential for WG diagnosis, since clinic presentation and immunological data (ANCA's) are suggestive of the disease. Airways infections and ANCA's presence seems to be important in the etiopathogenesis of WG.