[Suffering in laryngeal cancer]. / O adoecimento pelo câncer de laringe.

With the purpose of improving the care of laryngectomized patients, the aim is to understand the illness experience of patients and families of having larynx cancer. The participants were 14 laryngectomized patients and their families, in different post-surgical periods. The narrative analysis searched for categories which were understood on the basis of an anthropological focusing the culture. The understanding that the participants had of the illness experience of having a larynx cancer shows us that this process is one of suffering, of searching of strategies of coping, of evaluating the survival to the surgical treatment, which were based on the cultural system, which is different from the biomedical model of the health professionals and they must be considered in the approach for the rehabilitation.

[Analysis of proxemic factors in the communication with laryngectomized patients]. / Análise dos fatores proxêmicos na comunicação com o paciente laringectomizado.

The present study analyzed the proxemic factors of interactions between health professionals and laryngotomized patients in mediate post-surgery. We used the non-participant observation technique with pre-established guidelines. Data were analyzed according to Hall's theoretical framework. The speakers' sex or color did not influence the distance maintained in the interactions; the nursing technical care category was predominant; the attitude adopted was compatible with the meeting goals; instrumental touch with visual contact was predominant, voice tone was adequate to the distances maintained and the authors observed the presence of obstacles in some interactions, which demonstrated that communication was impaired.

[Leadership and communication: essential strategies for the management of nursing care in the hospital context]. / Liderança e comunicação: estratégias essenciais para o gerenciamento da assistência de enfermagem no contexto hospitalar.

Leadership and communication are strategies that enable nurses to improve the management of nursing care within the hospital context. The present study aimed at reporting a Continuing Education Program developed by nurses from a private hospital on leadership and communication and to present the application of situational leadership in their professional practice. The technique of critical incidents was applied in data collection. The subjects evaluated positively the contributions of the Program and authors found the viability of the application of situational leadership in nursing daily practice.

[Leadership and communication: opinion of nurses in charge of nursing services at a public hospital]. / Liderança e comunicação: opinião dos enfermeiros responsáveis pelos serviços de enfermagem de um hospital governamental.

In the actual nursing scenery, we believe that leadership and communication are the essential strategies for nurse's professional practice. The present study aimed at identifying the opinion of nurses responsible for the nursing services of a government hospital about the theme of leadership and communication. Data were obtained in february and march of 1999 through structured interviews with twelve nurses. Findings showed that the opinions are mostly the same as the concepts found in the literature on the theme. The study had the purpose to give elements for other investigations as we believe in the need of investments for the improvement of the formation of nurses leaders for the future.

Humanizing nurse-patient communication: a challenge and a commitment.

Nurse-patient communication has been a pre-established, unvarying, technical professional and impersonal form of manifestation, reflecting mainly the achievement of nurse's instrumental role. This situation is opposed to our nursing concept as well as to the professional values that we incorporated during our professional life, all of which emphasize the importance of the person and the patient and the meaning of the visualisation of care to a total human being. The present study aims at discussing this question, propitiating an opportunity of reflection about the necessity of humanizing this relationship in the Brazilian scenery. Thus, we focused on the importance of nurse-patient relationship not only as an essential component of nursing assistance but also as a treatment in itself. In addition, we stimulate nurses to examine the way they are taking care of human beings: as objects to be manipulated and treated or as persons that need care and comprehension. The article is concluded with the thesis that nursing is not a technical profession that manipulates knowledge and technologies but a work of valuing human beings, their freedom and dignity.

[Leadership and communication: development of a measurement tool for graduating nursing students]. / Liderança e comunicação: construção de instrumento de medida para alunos de graduação em enfermagem.

Leadership and communication are themes of importance for the development of Nurse's work so that the upbringing of this professional needs to begin in the undergraduate course and continue through professional life. The present study aimed to identify the knowledge of students of the 4th year of the Nursing School of a public University about leadership na communication. In order to achieve this goal, the authors elaborated an instrument and submitted it to apparent and content validation, pilot test and statistic treatment. Data was collected through the application of the instrument to 67 students in October of 1998. The analysis of the results indicated that the students showed knowledge about leadership and communication, although they did not affirm that what they had learned it in the Undergraduate Course about it was enough.

[Fatigue in patients with laryngeal cancer]. / A fadiga nos pacientes com câncer de laringe.

This study searched for subjective elements in the fatigue of laryngectomized patients. The authors used an instrument proposed by YOSHITAKE that investigates the symptoms of physical indisposition, mental weariness and a specific sensation of fatigue. Data were analysed considering the literature, demonstrating that the psychological factors, the treatment and phases of the disease are directly related.

[Interprofessional assistance in the rehabilitation of communication skills of laryngectomized patients]. / Assistência multiprofissional na reabilitação da comunicação da pessoa laringectomizada.

The purpose of this study was to bring basic information about the work of a multiprofessional group involved with the laryngectomees rehabilitation and vocal rehabilitation. Those patients take part in the GARPO-Laryngectomees. The authors describe the different possibilities of vocal rehabilitation for the patients and the framework of the activities and steps of the process. They emphasize the laryngectomees characteristics, the surgical results, and the meaning of being a laryngectomee, as the basis to direct the nurses and the speech therapeutists assistance.

[Invasion of the personal space of hospitalized patients: adaptation of an instrument of measurement in Brazilian culture]. / Invasão do território e espaço pessoal do paciente hospitalizado: adaptação de instrumento de medida para a cultura Brasileira.

The invasion of patient's territorial and personal space and its effects have been object of several international studies. In view of its importance and searching for an instrument of measure to develop research in this area, the present study aimed at adapting the instrument "anxiety due to territory and space instrucsion questionnaire" to the brazilian culture. Authors fully described the phases of this process and utilized the software SPSS for the psychometric analysis.

[Situational leadership: structures of reference for the work of head nurses in a hospital context]. / Liderança situacional: estrutura de referência para o trabalho do enfermeiro-líder no contexto hospitalar.

Authors studying the theme of leadership developed models that can be applied in the organizational context. In the present study, we selected the model proposed by Hersey and Blanchard, named Situational Leadership. Through the technique of critical incidents, we identified and analyzed the behaviour of nurses from surgical units. Based on the analysis of data, we were able to infer that situational leadership can be used as a theoretical structure to base nurses' leadership skills, in order to improve the quality of nursing care and the development of nursing personnel.

[Leadership of nurses in the XXI century: various considerations]. / A liderança do enfermeiro no século XXI: algumas considerações.

The present article approaches the theme of leadership in it essential aspects and considers the transformations contemporary organizations are experiencing. Based on the literature authors found the role of the nurse--leader of the future and the importance of the auxiliary personnel--led to the efficacy of the leading process and the need of learning on leadership.

[Situational leadership: a model for application in Brazilian nursing]. / Liderança situacional: um modelo para aplicação na enfermagem brasileira.

Leadership is a very important theme to the management of nursing care provided to the patient. This study aimed at presenting key-concepts of the leadership model developed by Hersey and Blanchard, entitled Situational Leadership. We believe that this model can bring relevant contributions to nurse's leadership skills.

[The leadership style exercised by nurses in surgical wards focuses on situational leadership]. / O estilo de liderança exercido pelo enfermeiro de unidade de internação cirúrgica sob o enfoque da liderança situacional.

The present study was oriented to the leadership theme focussing nurses inside surgical ward unities. As a theoretical reference, the authors used the Situational Leadership Model proposed by Hersey and Blanchard. This study aimed at analysing the correspondence between the opinions of nurses and auxiliary personnel about the leadership style exerted by nurses in the surgical ward unit regarding the six categories of the assistance activity that were studied. Authors noticed that nurses, from the two studied hospitals, adopted the directive leadership styles (E2/selling or E1/telling) with the auxiliary personnel.

[The surgical nurse: his/her leadership of auxiliary nursing personnel]. / Enfermeiro cirúrgico: seu estilo de liderança com o pessoal auxiliar de enfermagem.

This investigation as carried out in order to promote follow-up in the studies concerning nurse's leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey and Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in accordance with the maturity level of an element of the auxiliary personnel based on six categories of activities that were studied. Authors found out that nurses should adopt the styles of participant leadership, such as E3 (participating) and/or E4 (delegating).

Personal and territorial space of the patients: a nursing ethics question.

Using the technique of the critical incidents, situations and behaviors mentioned by hospitalized patients were identified as far as the invasion of their personal and territorial space was concerned. The analysis of 80 reports of critical incidents revealed: a) 80 situations which were grouped in 11 categories; b) 95 health personnel behaviors related to personal and territorial invasion. These reports were distributed in nine behavior categories related to invasion of personal space and seven categories related to invasion of territorial space. Considering the reported behaviors, the authors emphasize: lack of respect for the patients, making noises and turning the lights on. The data showed that the health personnel do not respect the personal and territorial space of the hospitalized patients. This fact has several negative consequences to the patients such as: negative feelings, decreased quality of assistance, alteration in the pattern of sleep, among others.

The importance of nonverbal communication during the preanesthesia period.

This article discusses the phenomenon of nonverbal communication as evidenced between preoperative patients and the nurses attending them. Ten such patients and the nursing group assigned to them were directly observed for frequency of nonverbal interaction during the period immediately preceding surgery. Patients' nonverbal expressions of tension, fear, anxiety, and so on were noted, videotaped, and then analyzed according to three categories of interaction: positive, neutral, and negative. Of 2,173 registered nonverbal interactions, 65.1% (1,416) were rated as negative, a finding that should alert nurses to the need to identify patients' manifestations of anxiety so as to provide assurance and a sense of courage preceding surgery. Positive means of communicating nonverbally are discussed.

[Nursing student expectations regarding the teaching unit "Nursing care for the patient in intensive therapy"]. / As expectativas dos alunos de enfermagem quanto à unidade de ensino "a assistência de enfermagem ao paciente de terapia intensiva".

The previous knowledge which nursing students have about intensive care and critically ill patients were identified by a pre-test. The study revealed also the student's expectations for the teaching unit dealing with the nursing care of patients in the intensive care unit. The data showed that the students' knowledges and expectations are intermixed with prejudices owing to stigmata usually attached to the themes. The study provided bases for the replanning of the teaching, taking into account the students' expectations.