RESUMO
OBJECTIVES: To analyze nurses' perspectives on nurses' work methods in the hospital context. METHODS: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. RESULTS: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." FINAL CONSIDERATIONS: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.
Assuntos
Enfermeiras e Enfermeiros , Pesquisa Qualitativa , Humanos , Portugal , Adulto , Feminino , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Atitude do Pessoal de Saúde , Masculino , Pessoa de Meia-Idade , Entrevistas como Assunto/métodos , PercepçãoRESUMO
BACKGROUND: Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of physical activity during pregnancy on the incidence of GDM compared to women who do not perform physical activity. METHODS: A search was conducted in Cochrane, CSIC, Ebscohost, Proquest, Pubmed, Scielo, and Scopus. The search focused on systematic reviews and meta-analyses published in the last five years. The AMSTAR-2 scale was used as a quality assessment tool for the final sample. RESULTS: A total of 18 systematic reviews and meta-analyses were included. Sixteen of them found out that physical activity during pregnancy has preventive effects for GDM compared with women who lacked physical activity. Among the studies, we found a reduction in the risk of GDM of between 24% and 38% and odds ratios ranging between 0.39 and 0.83 calculated for a 95% CI. Only two studies did not find statistically significant effects. Other variables such as type and duration of physical activity, overweight and obesity, gestational age, etc., were also considered. CONCLUSIONS: Physical activity prevents the incidence of GDM. The main characteristics that enhance this preventive effect are starting at the initial stages of pregnancy and maintaining during the whole pregnancy as well as combining strength and aerobic exercise at a low to moderate intensity.
RESUMO
Background and Aim: Cervical spondylotic myelopathy (CSM) causes progressive spinal cord compression and consequent functional decline. Surgical decompression is considered effective in halting disease progression, producing improvements in neurological prognosis. During hospitalization, several conditions may alter these patients' dependency levels. This study aimed to describe patients with CSM and their evolution regarding dependence in activities of daily living (ADL), from hospital admission to discharge. Methods and Materials: Descriptive and correlational study based on document analysis. Results: Included 96 files of patients with CSM who were admitted to Neurosurgery Department. The sample was 58.3% men, with a mean age of 64.4 years. Of the participants, 96.9% had surgery, mainly an anterior cervical approach. Hygiene was the ADL involving most dependence, both at admission (39.6%) and at discharge (71.9%). Worsening of dependence levels in ADLs was found at the midterm evaluation (mean 13.34; SD 5.59) and at discharge (mean 11.59; SD 5.28) in relation to the functional condition at admission (mean 9.77; SD 6.06). Gender was not associated with any differences, but age and days of hospitalization were associated with variations in participants' dependency levels (P<.05). Conclusion: The level of dependence on ADLs increased during the hospitalization of patients with CSM.
RESUMO
OBJECTIVES: This study aims to develop and validate the Serious Educational Game in Nursing Appraisal Scale (SEGiNAS), a tool designed to evaluate the implementation of serious games within nurse education contexts of quantity of process, quality of process, and learning outcomes. METHODS AND MATERIALS: This methodological and psychometric study aimed to develop and validate a scale. The item generation phase was based on the cognitive theory of multimedia learning, resulting in a 20-item scale. The validation phase involved evaluating the psychometric scale by surveying 160 Portuguese nurses. RESULTS: A factor analysis revealed a three-factor structure corresponding to the scale's designed dimensions, explaining a total variance of 64.5%. The scale demonstrated high internal consistency for all factors, including engagement and teaching effectiveness (0.925), learning impact and practical application (0.883), and content relevance and clarity (0.848). The dimensions were engagement and teaching effectiveness, learning impact and practical application, and content relevance and clarity. CONCLUSIONS: The SEGiNAS scale represents a valid and reliable tool for evaluating serious games in nursing education. Its development fills an existing gap in assessing the teaching-learning process with serious games. This study was not registered.
RESUMO
OBJECTIVE: To systematically synthesize studies that analyze the relationship between a healthy practice environment and quality of nursing care in hospital settings; to identify the most commonly used instruments to assess nurses' perceptions of a healthy practice environment; to identify the most commonly used instruments to assess nurses' perceptions of quality of nursing care. METHOD: A systematic literature review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search will be conducted in the principal databases. Review of international scientific articles published in the last ten years, accessed through the database of the Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, on nurses' perceptions of the influence of the environment on healthy nursing practice and quality of care. Inclusion: Articles published after 2012 in Portuguese, Spanish, and English. The identified, selected and included studies will be highlighted for the selection process using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). If possible, quantitative data will be pooled into a meta-analysis using the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (MASTARI).
RESUMO
Living with spinal cord injury (SCI) is a challenge that begins in the acute phase, when the disease, the limitations, and the treatments fill the days at the hospital. This study aims to understand the healthcare experience of the person with SCI in the acute phase, based on the Activities of Living Nursing Model (ALNM). It is a qualitative and phenomenological study based on the Standards for Reporting Qualitative Research. Data were collected via semi-structured interviews. Content analysis was performed using the ATLAS.ti software and Bardin's methodology. The article was written following the COREQ guidelines. The categories were defined using the Roper-Logan-Tierney Model for Nursing. The sample included 16 people with incomplete SCI, different etiology, and neurological levels. Eleven of the twelve ALNM emerged from the interviews. The activities of mobilizing, eliminating, maintaining a safe environment, and communicating were emphasized the most. Controlling body temperature was not relevant. Mobility deficits and pain increased dependence. Feelings of motivation, encouragement, and frustration were highlighted. Professional expertise, rehabilitation resources, and support equipment promoted independence. The results in this sample revealed that people with SCI in the acute phase have complex challenges related to dependence awareness and treatments, but they always keep recovery expectations in mind.
RESUMO
OBJECTIVE: To analyze the perspective of doctors, nurses, and social workers about practices for older people health in primary care and in hospitals; to create guidelines for the practice of interdisciplinary consultations. METHOD: Cross-sectional study involving 291 professionals from public institutions in the northern region of Portugal. Data were collected between May/2018 and March/2019, using a questionnaire which was then subjected to descriptive and analytical statistical analysis. RESULTS: The usefulness of scales for elderly people showed no differences between hospital and primary care. Hospital professionals collected the following data: eyesight/hearing; medication; direct contact or contact by writing between professionals; daily team meetings; need to share information among colleagues. Primary care professionals, in turn, valued: weight/height, swallowing; the need for home visits; direct contact or via e-mail between professionals; weekly team meetings. CONCLUSION: The practices of the professionals suggested an intervention model with common aspects in both groups, but with specificities for both primary and hospital care.
Assuntos
Hospitais , Atenção Primária à Saúde , Humanos , Idoso , Estudos Transversais , Portugal , Encaminhamento e ConsultaRESUMO
BACKGROUND: Aging exposes individuals to new health disorders and debilitating chronic diseases, yet most older adults, even in functional decline, do not want to leave their homes. Nevertheless, for many, institutionalization in a nursing home (NH) may become essential to ensure their continued safety and health. Depression is one of the most common psychiatric disorders among older adults, especially among those who are institutionalized. Depressed NH residents face a high risk of future functional decline and falls, decreasing their quality of life. The relationship between depression and falls is complex and bidirectional. Previous reviews have focused on home-dwelling older adults or explored the relationship between antidepressant drugs and falls. To the best of our knowledge, no integrative literature reviews have explored the relationship between depression and falls among NH residents. OBJECTIVE: Analyze studies on the relationship between depression and falls among NH residents. METHODS: We will conduct an integrative literature review of published articles in relevant scientific journals on the relationship between depression and depressive symptomatology and falls among NH residents. As usually defined, we will consider NH residents to be people aged 65 years and older who can no longer live safely and independently in their homes. We will also consider older adults on short-term stays in an NH for rehabilitation after hospital discharge. Retrieved articles will be screened for eligibility and analyzed following previously reported steps. The most pertinent bibliographical databases will be examined for qualitative, quantitative, and mixed methods studies, from inception until August 31, 2023, thus ensuring that all relevant literature is included. We will also hand-search the bibliographies of all the relevant articles found and search for unpublished studies in any language. If appropriate, we will consider conducting a meta-analysis of the studies retrieved. RESULTS: A first round of data collection was completed in March 2023. We retrieved a total of 2276 references. A supplementary literature search to ensure the most up-to-date evidence is ongoing. We anticipate that the review will be completed in late September 2023, and we expect to publish results at the end of December 2023. CONCLUSIONS: This integrative review will increase knowledge and understanding of the complex relationship between depression and falls in NH environments. Its findings will be important for developing integrated, multidisciplinary models and care recommendations, adaptable to each NH resident's situation and health status, and for creating preventive interventions to help them maintain or recover optimal health stability. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46995.
RESUMO
Map the interventions/components directed to the caregivers of heart disease patients in cardiac rehabilitation programs that promote their role and health. METHODS: The Joanna Briggs Institute method was used to guide this scoping review. Two independent reviewers assessed articles for relevance and extracted and synthesized data. Inclusion criteria comprised articles published in English, Spanish, and Portuguese since 1950. The following databases were searched: CINAHL Complete (Via EBSCO), Medline (via PubMed), Scopus, PEDro, and Repositórios Científicos de Acesso Aberto de Portugal (RCAAP). RESULTS: From 351 articles retrieved, 10 were included in the review. The interventions identified directed to the caregiver were: educational interventions and lifestyle changes; physical exercise; psychological interventions/stress management; and a category "Other" with training interventions in basic life support, elaboration of guidelines/recommendations, and training for the role of caregiver. CONCLUSIONS: It was found that most of the related cardiac rehabilitation interventions are aimed at the dyad heart failure patient and their caregivers/family. Including specific interventions targeting caregivers improves the caregiver's health and empowers them. Patient care planning should include interventions specifically aimed at them that result in health gains for caregivers and patients, striving to improve the quality of care. This study was not registered.
RESUMO
Emery-Dreifuss muscular dystrophy is a rare hereditary neuromuscular disease. Its manifestations begin primarily in childhood. The most frequent manifestations are progressive muscle weakness, atrophy that usually begins in the scapula-vertebral region, extending later to the pelvic girdle, and spinal stiffness. Patients can also manifest cardiac involvement as palpitations, syncope, exercise intolerance, congestive heart failure, and variable heart rhythm disturbances. 1 - 3 The presence and severity of these manifestations can vary according to the individual and the disease's subtypes. 2 Cardiac involvement is the most worrisome feature of this disease, and there are some reports of the need for heart transplantation in this dystrophy. 4.
A distrofia muscular de Emery-Dreifuss é uma doença neuromuscular hereditária rara. Suas manifestações começam principalmente na infância. As manifestações mais frequentes são fraqueza muscular progressiva, atrofia que geralmente se inicia na região escápulo-vertebral, estendendo-se posteriormente para a cintura pélvica e rigidez da coluna vertebral. Os pacientes também podem manifestar envolvimento cardíaco como palpitações, síncope, intolerância ao exercício, insuficiência cardíaca congestiva e distúrbios variáveis do ritmo cardíaco. 1 - 3 A presença e a gravidade dessas manifestações podem variar de acordo com o indivíduo e os subtipos da doença. 2 O envolvimento cardíaco é a característica mais preocupante desta doença, havendo alguns relatos da necessidade de transplante cardíaco nesta distrofia. 4.
Assuntos
Reabilitação Cardíaca , Insuficiência Cardíaca , Transplante de Coração , Distrofia Muscular de Emery-Dreifuss , Humanos , Arritmias CardíacasRESUMO
Objetivo: analisar a percepção dos enfermeiros sobre o uso das 3S - Smart Safe Shoes na sua fase de protótipo e os resultados da avaliação do seu uso por idosos internados. Método: estudo de carater exploratório, descritivo e misto, entre novembro de 2021 e março de 2022. Incluiu idosos internados com capacidade de deambulação e identificados com risco de queda; e enfermeiros especialistas. Os dados quantitativos foram analisados por estatística descritiva e os qualitativos a partir de análise temática. Resultados: participaram 28 idosos e sete enfermeiros, ambos concordaram que as 3S Smart Safe Shoes são confortáveis. Os enfermeiros consideram que as meias se adaptaram perfeitamente às diferentes regiões anatômicas do pé e que apresentam propriedades antiderrapantes nos pisos testados; e na maioria das situações, permitem uma boa mobilidade dos dedos, em todos os movimentos tibiotársicos (86%). Todos os enfermeiros destacam a facilidade de calçar as meias e consideram que estas devem ser incluídas como um elemento em estratégia de prevenção de quedas. Conclusão: as 3S - Smart Safe Shoes reunem as características necessárias para garantir uma marcha segura em idosos internados e o seu uso deve ser considerado em outros contextos.
Objective: to analyse nurse's perception about 3S - Smart Safe Shoes use in their prototype phase and describe their evaluation about this use by hospitalized elderly patients. Method: exploratory, descriptive and mixed study, between November 2021 and March 2022. It included hospitalized elderly people who were able to walk and identified as being at risk of falling; and specialist nurses. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. Results: 28 seniors and seven nurses participated, both agreed that the 3S Smart Safe Shoes are comfortable. The nurses consider that the socks adapt perfectly to the different anatomical regions of the foot and that they have non-slip properties on the tested floors; and in most situations, they allow good mobility of the fingers, in all tibiotarsal movements (86%). All nurses highlight the ease of putting on stockings and consider that these should be included as an element in a fall prevention strategy. Conclusion: 3S - Smart Safe Shoes have the necessary characteristics to guarantee a safe gait in hospitalized elderly patients and their use should be considered in other contexts.
Assuntos
Garantia da Qualidade dos Cuidados de Saúde , Sapatos , Acidentes por Quedas , Enfermagem , Prevenção de AcidentesRESUMO
Background and purpose: Measuring nurses' perceptions of the activities contributing to the quality of care needs to be emphasized, providing visibility to professional practice and their contributions to achieving health quality. This study aimed to translate, validate, and culturally adapt the "Perception of Nursing Activities that Contribute to the Quality of Care" (EPAECQC), scale to provide a reliable instrument to assist nurse managers in measuring nurses' perceptions of their activities in French reality. Methods: A quantitative, descriptive, and cross-sectional study, in two phases, was conducted. First, by translation and cultural adaptation, and second, through the validation of the scale. Results: The factor structure of the final version was reduced to 22 items. Content and construct validity and reliability were supported by internal consistency (Cronbachs' alpha = .913). Conclusions: The results show that the final version is a reliable and valid instrument, showing a high potential to be used in research and clinical practice.
RESUMO
La persona trasplantada de corazón y la familia experimentan diferentes tipos de transición, y un acompañante facilitador de su formación para una transición saludable es fundamental.La Enfermería de Rehabilitación (ER), debido a sus habilidades, puede ayudar a las personas a recuperar la estabilidad y el bienestar, sin embargo, existe poca difusión de su fundamento en lasteorías de enfermería. Objetivo: Analizar el aporte de la Teoría de las Transiciones en la práctica dela enfermería rehabilitadora orientada al empoderamiento de la persona trasplantada al corazón ya la familia. Metodología: Estudio crítico-reflexivo guiado por la Teoría de las Transiciones de AfafMeleis y por la legislación reguladora para la práctica del enfermero rehabilitador. Resultado: Sepercibe que la teoría de las Transiciones sustenta la intervención de Enfermería de Rehabilitaciónen las áreas de conocimiento y aprendizaje de habilidades de la persona trasplantada cardíaca y sufamilia, conduciendo a su empoderamiento, toma de decisiones y acción, haciendo que la personase sienta empoderada para superar los retos diarios derivados de su proceso de transición. Conclusión: Es fundamental demostrar la conceptualización en la práctica de enfermería, siendo la transición un foco significativo para la Enfermería de Rehabilitación.(AU)
Assuntos
Humanos , Enfermagem em Reabilitação , Transplante de Coração , Teoria de Enfermagem , Cuidado Transicional , Enfermagem , Cuidados de EnfermagemRESUMO
BACKGROUND: Person- and family-centered care is one of the recommendations to achieve quality of care and patient safety. However, many health professionals associate the family with insecurity in care. OBJECTIVE: To analyze, based on nurses' statements, the advantages and disadvantages of the family's presence in hospitals for the safety of hospitalized patients. METHODS: This was a qualitative interpretative study based on James Reason's risk model, conducted through semi-structured interviews with 10 nurses selected by convenience. A content analysis was performed using Bardin's methodology and MAXQDA Plus 2022 software. RESULTS: We identified 17 categories grouped according to the representation of the family in patient safety: The family as a Potentiator of Security Failures (7) and Family as a Safety Barrier (10). CONCLUSIONS: The higher number of categories identified under Family as a Safety Barrier shows that nurses see strong potential in the family's involvement in patient safety. By identifying the need to intervene with and for families so that their involvement is safe, we observed an increase in the complexity of nursing care, which suggests the need to improve nursing ratios, according to the participants.
RESUMO
RESUMO: Objetivo: analisar o modelo assistencial na Atenção Primária à Saúde na perspectiva do acesso e integralidade do cuidado. Método: pesquisa qualitativa, com dados coletados no período de maio a dezembro de 2021, em cada regional de saúde do estado do Paraná, por meio de entrevistas gravadas, de roteiro semiestruturado com 26 gestores. Utilizou-se o software IRAMUTEQ para processamento e agrupamento dos dados em cinco classes. A análise dos resultados foi conduzida pela Hermenêutica dialética. Resultados: evidenciaram-se em duas classes ações relacionadas aos atributos acesso e integralidade, presentes no modelo assistencial. As ações para ampliação do acesso contaram com a participação de equipe multiprofissional na promoção da integralidade do cuidado e inserção de recursos tecnológicos, mantendo, porém, o modelo biomédico. Considerações finais: durante a pandemia, houve adaptação e resiliência por parte dos gestores que organizaram o modelo assistencial, a inclusão de ferramentas tecnológicas para facilitar o acesso e a continuidade do cuidado.
ABSTRACT Objective: To analyze the care model in Primary Health Care from the perspective of access and comprehensive care. Method: Qualitative research, with data collected from May to December 2021 in each regional health center in the state of Paraná through recorded interviews using a semi-structured script with 26 managers. IRAMUTEQ software was used to process and group the data into five classes. The results were analyzed using dialectical hermeneutics. Results: Two classes showed actions related to the attributes of access and comprehensiveness present in the care model. Actions to increase access included the participation of a multi-professional team to promote comprehensive care and the use of technological resources while maintaining the biomedical model. Final considerations: During the pandemic, there was adaptation and resilience on the part of managers who organized the care model and the inclusion of technological tools to facilitate access and continuity of care.
RESUMEN Objetivo: analizar el modelo asistencial en Atención Primaria a la Salud desde la perspectiva del acceso y la atención integral. Método: investigación cualitativa, con datos recogidos de mayo a diciembre de 2021, en cada centro regional de salud del estado de Paraná, a través de entrevistas grabadas, utilizando un guion semiestructurado con 26 gestores. Se utilizó el software IRAMUTEQ para procesar y agrupar los datos en cinco clases. Los resultados se analizaron utilizando la hermenéutica dialéctica. Resultados: dos clases mostraron acciones relacionadas con los atributos de acceso e integralidad, presentes en el modelo de atención. Las acciones para aumentar el acceso incluyeron la participación de un equipo multiprofesional para promover la atención integral y la inclusión de recursos tecnológicos, manteniendo el modelo biomédico. Consideraciones finales: durante la pandemia, hubo adaptación y resiliencia por parte de los gestores que organizaron el modelo de atención, incluyendo herramientas tecnológicas para facilitar el acceso y la continuidad de la atención.
RESUMO
OBJECTIVE: To develop and validate the content of the Nurses' Work Methods Assessment Scale. METHODS: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. RESULTS: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. CONCLUSIONS: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.
Assuntos
Enfermeiras e Enfermeiros , Cuidados de Enfermagem , Humanos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Psicometria/métodosRESUMO
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place−rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants' homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg's perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the older adults' lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults.
RESUMO
ABSTRACT Objective: To analyze the perspective of doctors, nurses, and social workers about practices for older people health in primary care and in hospitals; to create guidelines for the practice of interdisciplinary consultations. Method: Cross-sectional study involving 291 professionals from public institutions in the northern region of Portugal. Data were collected between May/2018 and March/2019, using a questionnaire which was then subjected to descriptive and analytical statistical analysis. Results: The usefulness of scales for elderly people showed no differences between hospital and primary care. Hospital professionals collected the following data: eyesight/hearing; medication; direct contact or contact by writing between professionals; daily team meetings; need to share information among colleagues. Primary care professionals, in turn, valued: weight/height, swallowing; the need for home visits; direct contact or via e-mail between professionals; weekly team meetings. Conclusion: The practices of the professionals suggested an intervention model with common aspects in both groups, but with specificities for both primary and hospital care.
RESUMEN Objetivo: Analizar la visión de médicos, enfermeros y asistentes sociales, sobre las prácticas de atención al anciano en la atención primaria y hospitalaria; crear directrices para la práctica de consultas interdisciplinarias. Método: Estudio transversal, con la participación de 291 profesionales de instituciones públicas de la región norte de Portugal. Se recogió los datos entre mayo de 2018 y marzo de 2019, a través de un cuestionario, y se los sometió a un análisis estadístico descriptivo y analítico. Resultados: La utilidad de las escalas para las personas mayores no mostró diferencias entre la atención hospitalaria y la atención primaria. Mientras que los profesionales hospitalarios recogieron los datos sobre visión/audición; medicación; contacto directo o por escrito entre profesionales; reuniones de equipo diarias; y necesidad de compartir información entre colegas, los profesionales de atención primaria valoraron: peso/altura, deglución; necesidad de visita domiciliaria; contacto directo o por correo electrónico entre profesionales; reuniones de equipo semanales. Conclusión: Las prácticas de los profesionales sugieren un modelo de intervención con aspectos comunes en ambos grupos, pero con especificidades tanto para la atención primaria como para la hospitalaria.
RESUMO Objetivo: Analisar a visão de médicos, enfermeiros e assistentes sociais, sobre práticas na assistência a idosos na atenção primária e hospital; criar orientações para a prática de consultas interdisciplinares. Método: Estudo transversal, envolvendo 291 profissionais de instituições públicas da região norte de Portugal. Dados coletados entre maio/2018 e março/2019, mediante questionário e submetidos à análise estatística descritiva e analítica. Resultados: A utilidade de escalas para pessoas idosas não mostrou diferenças entre hospital e atenção primária. Enquanto os profissionais do hospital coletaram os dados: visão/audição; medicação; contato direto entre profissionais ou por escrito; reuniões de equipe diárias; necessidade de partilhar informações entre colegas; os profissionais da atenção primária valorizaram: peso/altura, deglutição; necessidade de visita domiciliar; contato direto entre profissionais ou por e-mail; reuniões de equipe semanais. Conclusão: Práticas dos profissionais apontaram para um modelo de intervenção com aspectos comuns nos dois grupos, mas com especificidades para atenção primária e hospital.
RESUMO
RESUMO Objetivo compreender como os enfermeiros vivenciam o planejamento da sucessão na gestão. Métodos estudo qualitativo assente na teoria fundamentada nos dados como referencial teórico e metodológico, com uma amostra de 20 enfermeiros. A coleta dos dados foi efetuada por entrevista e análise de conteúdo, e do processo de codificação emergiu o modelo conceitual. Resultados verificou-se que o planejamento da sucessão é um processo implementado informalmente no diagnóstico dos enfermeiros gestores, mas persistem algumas lacunas na sistematização do processo. Os concursos, o perfil de liderança e a experiência assumem destaque no diagnóstico, e a experiência casual em gestão é relevante na preparação dos enfermeiros gestores. Apesar da sua necessidade, subsistem entraves como a resistência dos gestores, a rotatividade dos conselhos de administração hospitalares e a pandemia da COVID-19. Conclusão os enfermeiros destacam muitos benefícios com o planejamento da sucessão, mas identificam obstáculos à sua implementação, o que contribui para a relutância na participação ativa dos enfermeiros gestores. Contribuições para a prática o modelo conceitual teórico pode contribuir para a mudança e a estruturação sistemática do percurso construtivo dos enfermeiros gestores e permite identificar as condições promotoras e limitantes no diagnóstico, formação e desenvolvimento destes profissionais.
ABSTRACT Objective to understand how nurses experience the succession planning of manager nurses. Methods qualitative study using grounded theory as a theoretical and methodological reference, with a sample of 20 nurses. Data collection took place through interviews, content analysis, and the conceptual model originated from the coding process. Results the process of succession planning is informally implemented in the diagnosis of head nurses, but there are some gaps in the systematization of the process. The selection processes, the leadership profile, and experience stand out in the diagnosis, and a casual experience in management is relevant for the preparation of head nurses. Although this is necessary, there are still obstacles, such as the resistance of managers, the turnover of hospital administration councils, and the COVID-19 pandemic. Conclusion nurses interviewed highlighted many benefits from the planning of succession, but find obstacles to its implementation, which contributes to the reluctance of head nurses to actively participate. Contributions to practice the theoretical-conceptual model can contribute to change and systematically structure the constructive path of manager nurses, allowing the identification of conditions that promote or limit the diagnosis, education, and development of these professionals.
Assuntos
Administração de Serviços de Saúde , Enfermagem , Desenvolvimento de Pessoal , Teoria Fundamentada , Papel do Profissional de EnfermagemRESUMO
ABSTRACT Objective: to analyze the challenges found in nurse-managers' work in the Brazilian and Portuguese hospital contexts. Method: a mixed-methods research study with a sequential explanatory approach, carried out between March 2019 and March 2020 with nurse-managers from four hospitals. The study was initiated with the quantitative stage, applying a survey to 143 participants and analyzing the data by means of analytical and inferential statistics. The qualitative stage was carried out with 71 of these participants using interviews, in order to understand the challenges inherent to this job, and the data were submitted to content analysis. Integration of the findings was performed through data connection. Results: in the quantitative stage, the results evidenced that the managerial activities carried out by nurses by scenario included planning, people management, management of care processes, management of materials, quality management and leadership, with higher mean values for the first four. The qualitative stage allowed deepening the previous findings, contrasting invisibility of the planning, confirming people management as the common challenge to the realities, explaining the mean values in the national and Portuguese scopes. Integration of the findings detailed the relevance of the conflicts and the deficit of professionals in people management and leadership. Conclusion: managing people, care processes and materials are challenges for nurses in hospital management in both countries. Nurses lack structural support and ongoing training for better management and improvement of planning and leadership.
RESUMEN Objetivo: analizar los desafíos presentes en el trabajo de enfermeros gerentes en el contexto hospitalario, tanto en Brasil como en Portugal. Método: investigación de métodos mixtos con enfoque explicativo secuencial, realizado entre marzo de 2019 y marzo de 2020 con enfermeros gerentes de cuatro hospitales. El estudio se inició con la etapa cuantitativa, aplicando una encuesta a 143 participantes y analizando los datos por medio de estadística analítica e inferencial. La etapa cualitativa se condujo con 71 de estos participantes por medio de entrevistas para comprender los desafíos de este trabajo, y los datos se sometieron a análisis de contenido. La integración de los hallazgos se realizó por medio de conexión de datos. Resultados: en la etapa cuantitativa, los resultados evidenciaron que las actividades de gestión realizadas por los enfermeros y por escenario incluyeron planificación, gestión de personas, de procesos asistenciales, de materiales, de la calidad, y liderazgo, con valores medio más elevados para las cuatro primeras. La etapa cualitativa permitió profundizar los hallazgos anteriores, contrastando la invisibilidad de la planificación y confirmando que la gestión de personas es un desafío común am ambas realidades, explicando los valores medios en los ámbitos de Brasil y de Portugal. La integración de los hallazgos detalló la relevancia de los conflictos y el déficit de profesionales en la gestión de personas y en el liderazgo. Conclusión: gerenciar personas, procesos asistenciales y materiales se erige como un desafío que deben afrontar los enfermeros en la gestión hospitalaria en ambos países. Los enfermeros carecen de soporte estructural y de formación continua para una mejor gestión y para perfeccionar la planificación y el liderazgo.
RESUMO Objetivo: analisar os desafios presentes no trabalho de enfermeiros gestores no contexto hospitalar, no Brasil e em Portugal. Método: pesquisa de métodos mistos, abordagem explanatório sequencial, realizada com enfermeiros gestores de quatro hospitais, entre março de 2019 e março de 2020. O estudo iniciou com a etapa quantitativa, aplicando um survey a 143 participantes e dados analisados por estatística analítica e inferencial. A etapa qualitativa foi realizada com 71 destes participantes utilizando entrevistas, para compreender os desafios deste trabalho, e os dados foram submetidos à análise de conteúdo. A integração dos achados foi realizada por meio de conexão de dados. Resultados: na etapa quantitativa os resultados evidenciaram que as atividades de gestão realizadas pelos enfermeiros por cenário, incluíram planejamento, gestão de pessoas, de processos assistenciais, de materiais, da qualidade e liderança, com maiores médias para os quatro primeiros. A qualitativa permitiu aprofundar os achados anteriores, contrastando a invisibilidade do planejamento, confirmando a gestão de pessoas como o desafio comum às realidades, explicando as médias nas realidades nacional e portuguesa. A integração dos achados detalhou na gestão de pessoas e liderança a relevância dos conflitos e do déficit de profissionais. Conclusão: gerenciar pessoas, processos assistenciais e materiais se mostram desafios dos enfermeiros na gestão hospitalar nos dois países. Os enfermeiros carecem de suporte estrutural e formação continuada para melhor gestão e aprimoramento do planejamento e liderança.