Pain: clinical validation with postoperative heart surgery patients.

PROBLEM: To estimate the content validity of the nursing diagnosis of pain in postoperative heart surgery patients. METHODS: Observation of and interviews with postoperative heart surgery patients (N = 80), 40 experiencing pain and 40 without pain. FINDINGS: The group experiencing pain had statistically different results from the group without pain, with a higher frequency in the following 19 defining characteristics: verbal report of pain, discomfort, fear of reinjury, sleep disturbance, guarding behavior, distraction behavior, irritability, restlessness, facial mask of pain, increased heart rate, immobility, anxiety, loss of appetite, self-focus, withdrawal, impaired thought process, unusual posture, increased blood pressure, and changes in respiratory patterns. CONCLUSIONS: These defining characteristics support the idea that pain is a complex phenomenon of clinical interest to nursing that needs better understanding. Studies using the same defining characteristics in other sample groups of patients with acute and chronic pain might be useful in the refinement of this nursing diagnosis.

[Evaluation of patients with chronic pain in nursing consultations: Proposal of an instrument for nursing diagnosis]. / Avaliação do doente com dor crônica em consulta de enfermagem: proposta de instrumento segundo diagnósticos de enfermagem.

This article describes the tool used to collect data for nursing evaluation of patients with chronic pain patient in the League Against Pain of the University of São Paulo at Ribeirão Preto Faculty of Medicine, Brazil. The aim is to identify the patients' nursing care needs. The nursing diagnoses proposed by the North American Nursing Diagnosis Association (NANDA) were used to point out the patients' nursing care needs. The Human Response Patterns, in which the nursing diagnoses are classified by NANDA, were used as a framework to construct the tool. The way it is used by nursing undergraduate students, members of the League Against Pain, is also described.

[Human resources for the intensive care unit at the municipal district of São Paulo]. / Recursos humanos das unidades de terapia intensiva do Município de São Paulo.

The study had the purpose to investigate aspects of the ICUs from the Municipal district of São Paulo, regarding the composition of the clinical staff; characteristics of the nursing personnel and nurses' characterization. Data were collected through 47 questionnaires distributed in 32 hospitals. Results show that: the morning and the afternoon shifts have a larger number of people from all clinical categories, the majority of the nursing personnel work 36 hours per week, nurses' wages varied from 700 to 1,500 "reais" and 66.1% of them were enrolled in Master Programs. Authors concluded that 79.2% of the clinical staff was formed by the nursing personnel.

The influence of nursing diagnosis on information processing by undergraduate students.

PURPOSE: To examine the influence of a nursing diagnosis course on the information processing by undergraduate students. METHODS: A quasi-experimental study conducted with two groups (experimental, n = 15; control, n = 22) of undergraduate nursing students, subjecting only one to a nursing diagnosis course. The students' ability to identify, cluster, and name clusters of relevant data were compared between and within groups. FINDINGS: After the course, the experimental group performed better than the control group in the three activities studied. CONCLUSIONS: The results of this study suggest that the nursing diagnosis content in teaching favors clinical reasoning to determine the patient's nursing care.

[Continuing education of the intensive care units nursing staff in the city of Sao Paulo]. / Educação continuada da equipe de enfermagem nas UTIs do município de São Paulo.

This study is part of a project about ICU's characteristics in São Paulo city. This article describes the continuing education programs for nursing staff. 43 ICUs were analysed and the questionnaire answered by the ICU nurse coordinator was used to collect data. Results showed that 34 (79.1%) of the ICUs have initial program for training each nursing staff category and 18 (41.9%) had regular continuing education program focusing primarily on nursing procedures and routines and the update in pathologies. Continuing education programs are developed primarily by ICU's nurses. 50.2% of the nurses answered that they attended specialisation/extension courses too, in Medical Surgical Nursing or in other areas or in both areas. Due to this result and the development of the ICU's nurses as specialists, some suggestions are presented to improve the continuing education program in these Units.

[League against pain: a teaching experience]. / Liga de dor: uma experiência de ensino.

The anatomical and physiological basis of pain are subjects of the basic sciences in health sciences undergraduate curriculum. Disciplines focussing pain concepts and pain therapy are not traditional in the medical and nursing schools programs. The description of the organization of the League Against Pain and the presentation the students' opinions about their participation in this educational program were the objectives of the study. The League is composed by nursing and medical students and professionals (physicians of many specialties and nurses). The objectives of the League are: the improvement of the teaching about pain subjects in the nursing and medical schools; the development of research in epidemiological, clinical and therapeutic aspects of pain; the development and promotion of a model of multidisciplinary and multiprofessional assistance to chronic pain patients. The students considered had improved their abilities in pain control and in professional-patients relationship; usefulness and satisfaction with the program; need for inclusion of the program in the undergraduate courses and that the League is a good model for teaching of medical and nursing students in pain.

[League against pain: an experiment in extracurricular teaching]. / Liga de dor: uma experiência de ensino extracurricular.

Although anatomical and physiological base of pain are subject of the basic sciences in health undergraduate curriculum, it is not usually to have pain concepts and therapy into undergraduate programs. Describing the League Against Pain objectives and organization and the students' opinions about their participation in this league were the aim of this study. The League Against Pain Statute was consulted to describe its objectives and organization. The opinions of all of the students that attended the League Against Pain program in 1995 and 1996 were investigated. The League Against Pain was organized at an university hospital in 1995. It is composed by nurses and medical students and professionals (physicians in varied specialties and nurses). All the activities are voluntary and the students are the managers of the League. The objectives of the League are: improving the quality of teaching of pain subjects in nursing and medical schools; developing research in epidemiological, clinical and therapeutics aspects of pain and to promote a model of multidisciplinary and multiprofessional assistance. The most frequent students' opinions about their participation in the League were: their abilities in pain control and in professional and client relationship were improved; they achieved their objectives; that pain should be included into undergraduate courses; and they would recommend the League for other students. The results are promising. The students' opinions about their experience in the League Against Pain have showed that the League Against Pain could be an usefull model to introduce pain subjects to undergraduate nursing and medical students.

[Nursing diagnosis in patients in intensive care units]. / Diagnósticos de enfermagem de pacientes em unidades de terapia intensiva.

The aim of this study was to identify the nursing care needs of patients of critical care unit. The nursing diagnoses of 32 patients was formulated. The data was collected by interview and physical examination and the Functional Health Patterns was the framework to collect the data and to identify the predominant dysfunctional health areas.

[The physical assessment and the intensive care unit nurse]. / O exame físico e o enfermeiro de UTI.

The goal of this study was to analyse some practicing, teaching and learning aspects of physical examination done by ICU's nurses. It was accomplished with 26 ICU nurses that concluded the Intensive Care Nursing Specialization Course at the School of Nursing at São Paulo University. The results showed that 31 (68.9%) of the 45 presented items were done frequently by more than 50% of the nurses. The professional practice was considered the most important moment to physical examination learning. The responsibility by teaching was attributed to undergraduation course by 69.2% of the nurses.

[The teaching of patient evaluation: the delineation of the content of nursing diagnosis]. / O ensino da avaliação do paciente: delineamento do conteúdo pelo diagnóstico de enfermagem.

The nursing care is based on the nursing assessment. In the nurse's professional activity there aren't clarity and consensus about the clinical entities, problems or phenomenons that nurses intended to care. Difficulties in deciding what should be collected are determined by this indefinition, that it is also present in nursing graduate courses. In this article the authors discuss that the Nursing Diagnosis can be the framework for the nursing assessment.

[The characterization of the patients in 2 intensive therapy units (ICU): the biosocial conditions, the hospitalization process and the therapeutic interventions]. / Caracterização dos pacientes de duas unidades de terapia intensiva (UTI): condições bio-sociais, processo de internação e intervenções terapêuticas.

The objective of this study was to characterize the patients of two intensive care units (ICU) considering the structural variables, provenance, permanence and the destination after the discharge, the main diagnosis, invasive procedures and to classify them based on therapeutic procedures.

[The nursing diagnosis of patients hospitalized for chronic Chagas cardiopathy]. / Diagnósticos de enfermagem de pacientes internados por cardiopatia chagásica crônica.

The undertaking of an interview and physical examination in 30 inpatients with chronic Chagas cardiopathy, taking into account the health functional patterns approach, led us to data for establishing the nursing diagnosis of these patients.