Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study.

OBJECTIVE: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard. METHOD: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed. RESULTS: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes. FINAL CONSIDERATIONS: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

Geropalliative Caring Model analysis and assessment according to Fawcett's criteria.

OBJECTIVES: To analyze and assess Lee Geropaliative Caring Model according to Fawcett's criteria. METHOD: A theoretical-reflective study about the Geropaliative Caring Model. The analysis resulted in a detailed review of the scope, context and content of a situation-specific theory, in order to determine aspects related to nursing practice and research, and assessment addressed the concrete concepts developed in theory, their significance, internal consistency, parsimony, testability and empirical and pragmatic adequacy in nursing as a discipline. RESULTS: Based on the analysis, a situation-specific theory was used based on the science of care and aimed at caring for older adults undergoing palliation and their families, structured into four fields, namely: (1) aligning care; (2) keeping safe; (3) comforting body/mind/spirit; and (4) facilitating transitions. FINAL CONSIDERATIONS: The analyzed and assessed theory leads to a structure that includes well-defined, delimited and interrelated concepts, based on the science of care as a grand theory that allowed Geropaliative Care Model derivation.

Nursing microtheory in the prevention of delirium in older adult in the intensive care unit. / Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos.

OBJECTIVE: to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit. METHOD: prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review. RESULTS: the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated. TWO EMPIRICAL INDICATORS WERE ESTABLISHED IN THE OPERATING SYSTEM: the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced. CONCLUSION: the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos / Nursing microtheory in the prevention of delirium in older adult in the intensive care unit / Microteoria de enfermagem na prevenção do delirium em pessoas idosas na unidade de terapia intensiva

Objetivo: describir una microteoría para cuidados de enfermería en la prevención del delirio en personas mayores en la unidad de cuidados intensivos. Método: investigación teórica prescriptiva, basada en la subconstrucción. Se dedujeron constructos del Modelo de Adaptación de Roy y se indujeron datos del fenómeno de cuidados de enfermería en la prevención del delirium en personas mayores en cuidados intensivos, a partir de una revisión integrativa de la literatura. Resultados: la microteoría posee sistema teórico, operativo y modelo de cuidado. En el sistema teórico se utilizaron los constructos estímulo focal y contextual de Roy. A partir de ellos, se elaboraron los conceptos de cuidado focal y contextual y la variable respuesta adaptativa a la prevención. De las declaraciones relacionales se elaboraron cuatro axiomas, dos postulados, ocho proposiciones y una presuposición epistémica. En el sistema operativo se establecieron dos indicadores empíricos: el Confusion Assessment Method for Intensive Care Units y el historial demográfico/clínico de las personas mayores. Posteriormente, se produjeron dos declaraciones transformacionales, cuatro hipótesis y el modelo de cuidado representado en figura. Conclusión: la microteoría producida prescribe cuidados en la prevención del delirium en personas mayores en cuidados intensivos, por un constructo de interés para la enfermería, y permite intervenciones en el desarrollo de instrumentos que guían la actuación de la enfermería.

Objective: to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit. Method: prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review. Results: the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated. Two empirical indicators were established in the operating system: the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced. Conclusion: the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

Objetivo: descrever uma microteoria para cuidados de enfermagem na prevenção do delirium em pessoas idosas na unidade de terapia intensiva. Método: pesquisa teórica prescritiva, baseada na substrução. Foram deduzidos construtos do Modelo de Adaptação de Roy e induzidos dados do fenômeno dos cuidados de enfermagem na prevenção do delirium em pessoas idosas na terapia intensiva, a partir de revisão integrativa da literatura. Resultados: a microteoria possui sistema teórico, operacional e modelo de cuidado. No sistema teórico utilizaram-se os construtos estímulo focal e contextual de Roy. A partir deles elaboraram-se os conceitos de cuidado focal, contextual e a variável resposta adaptativa à prevenção. Das declarações relacionais elaboraram-se quatro axiomas, dois postulados, oito proposições e um pressuposto epistêmico. No sistema operacional, estabeleceram-se dois indicadores empíricos: o Confusion Assessment Method for Intensive Care Units e o histórico demográfico/clínico das pessoas idosas. Posteriormente, produziram-se duas declarações transformacionais, quatro hipóteses e o modelo de cuidado representado em figura. Conclusão: a microteoria produzida prescreve cuidados na prevenção do delirium em pessoas idosas na terapia intensiva, por um construto de interesse para a enfermagem, além de permitir interceptações ao desenvolvimento de instrumentos que norteiam a atuação da enfermagem

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method.

OBJECTIVE: To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. METHOD: Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. RESULTS: Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. CONCLUSION: There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

Theoretical, Conceptual, and Operational Aspects in Simulation Training With Rapid Cycle Deliberate Practice: An Integrative Review.

SUMMARY STATEMENT: An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study.

AIM: to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BACKGROUND: The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DESIGN: A randomized simulation experimental pre-post interventional study. METHODS: Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. RESULTS: Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. CONCLUSIONS: The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

Systematization of Nursing Care: how did the concept mature?

OBJECTIVES: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. METHODS: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. RESULTS: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. CONCLUSIONS: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Body image of women during breastfeeding: analysis supported by nursing theory.

OBJECTIVE: To describe and interpret a woman's perception of her body image during the breastfeeding process. METHOD: Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding. RESULTS: Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes. CONCLUSION: The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.

Guide for Systematization of Care and Nursing Process: educational technology for professional practice.

OBJECTIVE: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process. METHODS: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout. RESULTS: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges. FINAL CONSIDERATIONS: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

"Readiness for enhanced healthy aging" nursing diagnosis: Content validation by experts.

PURPOSE: To validate the content nursing diagnosis "Readiness for enhanced healthy aging." METHODS: Descriptive, methodological study of diagnostic content validation, using the Fehring model. The sample consisted of 74 nurses experts in gerontology, with knowledge in NANDA-I nursing diagnoses. FINDINGS: The title, one definition, and the three defining characteristics proposed for the diagnosis were validated, as well as the suggestion of domain and location class in NANDA-I Taxonomy II. The Diagnostic Content Validity Index was 0.81. CONCLUSIONS: The validation of the diagnostic content by experts was fundamental for adequacy of the elements of the proposed diagnosis, which supported the elaboration of the diagnostic framework for submission to the NANDA-I taxonomy. IMPLICATION FOR NURSING PRACTICE: The diagnosis "Readiness for enhanced healthy aging" can help nurses understand the phenomenon of "Healthy Aging" and, consequently, will support the planning and implementation of interventions aimed at promoting the health of the elderly population and those in the aging process. In addition, this diagnosis will offer nurses the opportunity to rethink health promotion strategies in their care plan, making a commitment to the population regarding the promotion of healthy aging, as recommended by the Word Health Organization.

Can support surfaces characteristics influence high-quality chest compression? manikin experiment with a mechanical device.

BACKGROUND: Support surfaces variables, such as size, material, and density, can determine chest compression depth in cardiopulmonary resuscitation. OBJECTIVE: to analyze the force required to do a high-quality chest compression concerning different surfaces in CPR. METHOD: This experimental study was developed using a Little Anne manikin and a mechanical device to perform chest compressions. Nine sets of surfaces were tested and compared to a control. RESULTS: 230 experimental tests were done in sets of bed or stretcher + mattress and presence or absence of different backboards. In the control condition, the average force to reach 5 cm of depth was 42.14±0.97 (kgf). Set 9, compatible with a narrow stretcher with a thin mattress, had the best surfaces to reach recommended depth, with or without a backboard. All other sets required significantly more force for high-quality chest compression. Regression analysis confirms that backboard size is not significant for the force for high-quality chest compression. CONCLUSION: There is an association of dimensions and types of beds or stretchers and mattresses with a force increase. Type and dimensions of the backboard are not relevant for the force required, regardless of the characteristics of the set of the bed or stretcher and mattress.

Toward a theorizing strategy with components of terminologies, classifications, and nursing theories.

PURPOSE: This article describes a theorizing strategy that integrates the components of classifications or terminologies with elements of grand or middle-range theories. METHODS: The source of metatheoretical data to support the strategy was the levels of theories by Dickoff et al. (1968). Terminological data sources were professional classifications and terminologies. FINDINGS: The authors synthesized data and philosophical, metatheoretical, theoretical, and terminological knowledge from primary sources on the subject to construct arguments and demonstrate suitable links. CONCLUSIONS: The proposal presented in this article of a strategy for building theories integrates theories and classifications or standardized nomenclatures. It applies levels of theorization: scrutiny of phenomena, description, conceptualization, naming, relationship, modeling, and operationalization to achieve higher levels of explanatory, predictive, and prescriptive properties on generated theory. IMPLICATIONS FOR NURSING PRACTICE: The implications for practice and research are connected to the theorizing strategy proposed in this article. We assume that using professional language at all levels of theorization can ensure that the concepts generated are closer to clinical practice.

Desenvolvimento de protótipo de chatbot para avaliação da maturação da fístula arteriovenosa / Desarrollo de prototipo de chatbot para la evaluación de maduración de la fístula arteriovenosa / Development of a chatbot prototype to assess arteriovenous fistula maturation

Resumo Objetivo Descrever o desenvolvimento e as características de um protótipo de chatbot destinado à coleta e ao registro de dados de avaliação da maturação da fístula arteriovenosa pelo enfermeiro. Métodos Estudo metodológico aplicado para a construção de um chatbot conduzido nas seguintes fases: construção da base de conhecimento; seleção do tipo de assistente virtual; roteirização do conteúdo; criação do diálogo no chatbot; e revisão do diálogo. Resultados Foi construída a base de conhecimento de um chatbot, denominado de "FAViana", a partir do conteúdo de um protocolo de avaliação da maturação da fístula aplicando-se a inspeção, palpação e ausculta. A roteirização do conteúdo deu base para a simulação de um diálogo estruturado em questionário no Google Forms® que foi transformado em conversação por meio do complemento Chat Forms®. As características do "FAViana" foram alinhadas à primeira etapa do processo de enfermagem para documentação dos dados da avaliação e anormalidades da maturação da FAV e ao oferecimento de suporte para a interpretação dos dados anormais, indicando a provável complicação e sugerindo recomendações sobre a possível complicação. Conclusão O protótipo do chatbot poderá fornecer uma alternativa inovadora para a implementação do processo de enfermagem na assistência a pacientes nefrológicos.

Resumen Objetivo Describir el desarrollo y las características de un prototipo de chatbot destinado a la recopilación y al registro de datos de evaluación de la maduración de la fístula arteriovenosa por enfermeros. Métodos Estudio metodológico aplicado para la elaboración de un chatbot conducido en las siguientes etapas: construcción de la base de conocimiento; selección del tipo de asistente virtual; elaboración del guion del contenido; creación del diálogo en el chatbot; y revisión del diálogo. Resultados Se construyó la base del conocimiento de un chatbot, denominado "FAViana", a partir del contenido de un protocolo de evaluación de la maduración de la fístula, en que se aplica la inspección, palpación y auscultación. La producción del guion del contenido estableció la base para la simulación de un diálogo estructurado en un cuestionario de Google Forms® que fue transformado en una conversación por medio del complemento Chat Forms®. Las características de "FAViana" fueron elaboradas de acuerdo con la primera etapa del proceso de enfermería para la documentación de los datos de la evaluación y de anormalidades de la maduración de la FAV y con el ofrecimiento de asistencia para la interpretación de los datos anormales, indicando la complicación probable y sugiriendo recomendaciones sobre la posible complicación. Conclusión El prototipo del chatbot podrá servir como una alternativa innovadora para la implementación del proceso de enfermería en la atención a pacientes nefrológicos.

Abstract Objective To describe the development and characteristics of a chatbot prototype intended for data collection and recording for arteriovenous fistula maturation assessment by nurses. Methods This is a methodological study applied to the construction of a chatbot conducted in the following phases: knowledge base construction; virtual assistant type selection; content scripting; dialogue creation in the chatbot; and dialogue review. Results The knowledge base of a chatbot, called "FAViana", was built from the content of a fistula maturation assessment protocol applying inspection, palpation and auscultation. Content scripting provided the basis for simulating a dialogue structured in a questionnaire on Google Forms®, which was transformed into a conversation using the Chat Forms® add-on. "FAViana" characteristics were aligned with the first step of the Nursing Process for documenting assessment data and abnormalities of AVF maturation and providing support for abnormal data interpretation, indicating the likely complication and suggesting recommendations on the possible complication. Conclusion A chatbot prototype could provide an innovative alternative for the Nursing Process implementation in assisting nephrological patients.

Use of nvivo 10® software in concept analysis study / Uso del software nvivo 10® en el estudio de análisis de conceptos / Uso do software nvivo 10 ® em estudo de análise de conceito

ABSTRACT Objective: to discuss the use of software in concept analysis through: 1) considerations made by peers who apply the package in their nursing practices; 2) correlation between the use of the NVivo 10® software and the stages of concept analysis using the Walker & Avant method. Method: this is a theoretical-reflective essay, based on the stages of concept analysis by Walker and Avant, constructed after a bibliographic survey and discussion with peers who apply the methodological framework and data analysis software in their practices. Results: in the results, the stages of the preparation and coding process of the support software are described from the concept analysis. A table is presented with the demonstration, description and understanding of the stages of the methodological reference in the use of the auxiliary software. Conclusion: the use of a concept analysis program can facilitate the organization, visualization and access to research data. Although it does not replace the investigator's work and the relevance of the framework for analysis, it can allow for maximization of process results with benefits for analytical research.

RESUMEN Objetivo: discutir el uso del software en el análisis de conceptos a través de: 1) consideraciones hechas por pares que aplican el programa en sus prácticas de enfermería; 2) correlación entre el uso del software NVivo 10® y las etapas de análisis de concepto utilizando el método Walker & Avant. Método: se trata de un ensayo teórico-reflexivo, basado en las etapas de análisis del concepto de Walker y Avant, construido después de un levantamiento bibliográfico y discusión con pares que aplican el marco metodológico y el software de análisis de datos en sus prácticas. Resultados: los resultados describen las etapas del proceso de elaboración y codificación del software de soporte a partir del análisis de concepto. Se presenta un cuadro con la demostración, descripción y comprensión de las etapas del referente metodológico en el uso del software auxiliar. Conclusión: el uso de un programa de análisis de conceptos puede facilitar la organización, visualización y acceso a los datos de la investigación. Aunque no reemplaza el trabajo del investigador y la relevancia del marco para el análisis, puede permitir la maximización de los resultados del proceso con beneficios para la investigación analítica.

RESUMO Objetivo: discutir sobre o uso de software na análise de conceito por meio de: 1) ponderações realizadas pelos pares que aplicam o programa em suas práticas na Enfermagem; 2) correlação do uso do software NVivo 10® com as etapas da análise de conceito pelo método de Walker & Avant. Método: trata-se de um ensaio teórico-reflexivo, fundamentado nas etapas da análise de conceito de Walker e Avant, construído após levantamento bibliográfico e discussão com pares que aplicam o referencial metodológico e software de análise de dados em suas práticas. Resultados: nos resultados, são descritas as etapas do processo de preparo e codificação do software de apoio a partir da análise de conceito. É apresentado um quadro com a demonstração, descrição e compreensão das etapas do referencial metodológico no uso do software de auxílio. Conclusão: o uso de programa na análise de conceito pode facilitar na organização, visualização e acesso aos dados da investigação. Embora não substitua o trabalho do investigador e a relevância do referencial para análise, pode permitir a maximização dos resultados do processo com benefícios para a pesquisa analítica.

Geropalliative Caring Model analysis and assessment according to Fawcett's criteria / Análisis y evaluación del Modelo de Cuidado Geropaliativo según criterios de Fawcett / Análise e avaliação do Modelo de Cuidados Geropaliativos segundo critérios de Fawcett

ABSTRACT Objectives: To analyze and assess Lee Geropaliative Caring Model according to Fawcett's criteria. Method: A theoretical-reflective study about the Geropaliative Caring Model. The analysis resulted in a detailed review of the scope, context and content of a situation-specific theory, in order to determine aspects related to nursing practice and research, and assessment addressed the concrete concepts developed in theory, their significance, internal consistency, parsimony, testability and empirical and pragmatic adequacy in nursing as a discipline. Results: Based on the analysis, a situation-specific theory was used based on the science of care and aimed at caring for older adults undergoing palliation and their families, structured into four fields, namely: (1) aligning care; (2) keeping safe; (3) comforting body/mind/spirit; and (4) facilitating transitions. Final considerations: The analyzed and assessed theory leads to a structure that includes well-defined, delimited and interrelated concepts, based on the science of care as a grand theory that allowed Geropaliative Care Model derivation.

RESUMEN Objetivo: Analizar y evaluar el Modelo de Atención Geropaliativa de Lee según los criterios de Fawcett. Método: Estudio teórico-reflexivo sobre el Modelo de Atención Geropaliativa. El análisis resultó en una revisión detallada del alcance, contexto y contenido de una Teoría de Situaciones Específicas, con el fin de determinar aspectos relacionados con la práctica y la investigación de la enfermería, y la evaluación abordó los conceptos concretos desarrollados en la teoría, su significado, consistencia interna, parsimonia, contrastabilidad y adecuación empírica y pragmática en la enfermería como disciplina. Resultados: A partir del análisis, se utilizó una Teoría de Situaciones Específicas basada en la ciencia del cuidado y orientada al cuidado de las personas mayores en paliación y de sus familias, estructurada en cuatro dominios, a saber: (1) alineación del cuidado; (2) mantener la seguridad; (3) comodidad cuerpo/mente/espíritu; y (4) facilitación de los procesos de transición. Consideraciones finales: La teoría analizada y evaluada conduce a una estructura que incluye conceptos bien definidos, delimitados e interrelacionados, basándose en la ciencia del cuidado como una gran teoría que permitió derivar el Modelo de Cuidado Geropaliativo.

RESUMO Objetivo: Analisar e avaliar o Modelo de Cuidados Geropaliativos de Lee segundo os critérios de Fawcett. Método: Estudo teórico-reflexivo acerca do Modelo de Cuidados Geropaliativos. A análise suscitou em uma revisão detalhada do escopo, contexto e conteúdo de uma Teoria de Situação Específica, a fim de determinar os aspectos relacionados à prática e pesquisa na enfermagem, e a avaliação abordou os conceitos concretos desenvolvidos na teoria, sua significância, consistência interna, parcimônia, testabilidade e adequação empírica e pragmática na enfermagem enquanto disciplina. Resultados: A partir da análise, utilizou-se uma Teoria de Situação Específica baseada na ciência do cuidar e direcionada aos cuidados à pessoa idosa em paliação e sua família, estruturada em quatro domínios, a saber: (1) alinhamento dos cuidados; (2) manutenção da segurança; (3) conforto corpo/mente/espírito; e (4) facilitação dos processos de transições. Considerações finais: A teoria analisada e avaliada direciona para uma estrutura que contempla conceitos bem definidos, delimitados e inter-relacionados, com base na ciência do cuidar enquanto grande teoria que permitiu a derivação do Modelo de Cuidados Geropaliativos.

Escala Interativa de Amamentação: avaliação da confiabilidade / Escala Interactiva de la Lactancia Materna: evaluación de la confiabilidade / Interactive Breastfeeding Scale: reliability assessment

Resumo Objetivo avaliar a confiabilidade da Escala Interativa de Amamentação. Método estudo metodológico, que seguiu a terceira etapa do método de Pasquali para elaboração de escalas, desenvolvido com 216 puérperas, em hospital universitário da região Sudeste do Brasil. Para avaliação da confiabilidade, foram utilizados o percentual de concordância (pa) acima de 80%, o Kappa ponderado (Kp), a second-order agreement coefficient (AC2) de Gwet e o alfa de Cronbach. Resultados o percentual de concordância dos itens foi de 83,33%; o valor global do alfa de Cronbach foi de 0,67; o coeficiente AC2 com ponderações quadrática e linear obteve a confiabilidade quase perfeita. Conclusão e implicação para a prática a avaliação da confiabilidade da Escala Interativa de Amamentação foi alta, e foi confirmada pelos resultados que asseguram a qualidade do instrumento na população estudada, mostrando-se um instrumento confiável e válido para avaliar os fatores que interferem na interação mãe-filho durante a amamentação.

Resumen Objetivo evaluar la confiabilidad de la Escala Interactiva de Lactancia Materna. Método estudio metodológico, que siguió el tercer paso del método Pasquali para la elaboración de escalas, desarrollado con 216 puérperas, en un hospital universitario de la región Sureste de Brasil. Para evaluar la confiabilidad, se utilizaron el porcentaje de concordancia (pa) por encima del 80%, el Kappa ponderado (Kp), el coeficiente de concordancia de segundo orden (AC2) de Gwet y el alfa de Cronbach. Resultados el porcentaje de concordancia fue del 83,33%; el valor global del alfa de Cronbach fue de 0,67; el coeficiente AC2 con pesos cuadráticos y lineales obtuvo una confiabilidad casi perfecta. Conclusión e implicación para la práctica la evaluación de la confiabilidad de la Escala Interactiva de Lactancia Materna fue alta, y fue confirmada por los resultados que aseguran la calidad del instrumento en la población estudiada, demostrando ser un instrumento confiable y válido para evaluar los factores que interfieren en la interacción madre-hijo durante la lactancia.

Abstract Objective to assess the Interactive Breastfeeding Scale reliability. Method a methodological study that followed the third stage of Pasquali's method for the elaboration of scales, carried out with 216 postpartum women at a university hospital in southeastern Brazil. To assess reliability, percentage of agreement (pa) above 80%, the weighted Kappa (Kp), Gwet's second-order agreement coefficient (AC2) and Cronbach's alpha were used. Results the percentage of agreement was 83.33%; the overall Cronbach's alpha value was 0.67; the AC2 coefficient with quadratic and linear weights obtained near-perfect reliability. Conclusion and implication for practice the Interactive Breastfeeding Scale reliability assessment was high, and it was confirmed by the results that ensure instrument quality in the population studied, proving to be a reliable and valid instrument to assess factors that interfere in the mother-child interaction while breastfeeding.

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method / Accesibilidad arquitectónica y percepción de caídas del anciano en el peridomicilio: método mixto / Acessibilidade arquitetônica e percepção de quedas de idosos no peridomicílio: método misto

ABSTRACT Objective: To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. Method: Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. Results: Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. Conclusion: There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

RESUMEN Objetivo: Describir contenido, estructura y origen de las representaciones sociales sobre las caídas de los ancianos, las condiciones estructurales peridomiciliares que predisponen a las caídas; y relacionar las implicaciones de estas evidencias empíricas sobre el cotidiano de los ancianos en el contexto arquitectónico. Método: Mixto convergente por triangulación. Enfoque cualitativo: estructural (n=195) y procedimental (n=40) de la Teoría de las Representaciones Sociales y cuantitativo: descriptivo seccional (n=183). Se entrevistó en domicilio a ancianos inscritos en atención primaria (2018). Técnicas de análisis: categórico-temático, prototípico, estadístico y deductivo según Leininger. Resultados: Categorías de análisis: 1) Peridomicilio: escenario de caída y 2) Envejecimiento y vulnerabilidad: riesgo de caídas en peridomicilio. Las siguientes características ambientales fueron precursoras de caídas: pisos irregulares, agujeros, desniveles y objetos en el camino. Se asocian sentimientos y comportamientos alojados en el posible núcleo central, justificando las caídas y apuntando a sus causas. Conclusión: Hubo asociación entre el ambiente arquitectónico peridoméstico y las características predictivas del riesgo de caídas.

RESUMO Objetivo: Descrever conteúdos, estrutura e origem das representações sociais sobre queda apresentadas por pessoas idosas e condições estruturais peridomiciliares que predispõem à queda e relacionar as implicações dessas evidências empíricas na rotina de idosos no contexto arquitetônico. Método: Misto convergente por triangulação. Utilizaram-se as abordagens qualitativa (estrutural, n=195 e processual, n=40 da Teoria das Representações Sociais) e quantitativa (seccional descritiva, n=183). Foram entrevistados idosos no domicílio adscritos à atenção primária, em 2018. Técnicas de análise: categorial-temática, prototípica, estatística e dedutiva segundo Leininger. Resultados: Categorias de análise: 1) Peridomicílio: cenário de queda e 2) Envelhecimento e vulnerabilidade: risco de queda no peridomicílio. Apresentaram-se como características ambientais precursoras de quedas: pisos irregulares, buracos, desníveis e objetos no percurso. Sentimento e comportamentos alocados no possível núcleo central se associam, justificando as quedas e objetivando suas causas. Conclusão: Evidenciou-se a associação entre o ambiente arquitetônico peridomiciliar e as características preditoras do risco de quedas.

Systematization of Nursing Care: how did the concept mature? / Sistematización de la Atención de Enfermería: ¿cómo maduró el concepto? / Sistematização da Assistência de Enfermagem: como amadureceu o conceito?

ABSTRACT Objectives: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. Methods: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. Results: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. Conclusions: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

RESUMEN Objetivos: analizar la maduración conceptual de la Sistematización de los Cuidados de Enfermería en la perspectiva de la utilidad pragmática. Métodos: estudio de análisis de concepto. Los pasos fueron: seleccionar el concepto; elaborar preguntas analíticas; revisar exhaustivamente la literatura; y determinar componentes estructurales del concepto. Se analizaron 61 documentos luego de una búsqueda realizada hasta octubre de 2019. Resultados: ocurrieron cuatro períodos temporales de cambios contextuales desde el surgimiento de ideas de una sistematización en la década de 1960. Esta primera duró hasta 1990. Le siguieron las de 1990 a 2002, de 2002 a 2009 y de 2009 en adelante. Se identificó madurez conceptual parcial, operacionalización a lo largo de los años, a partir de múltiples definiciones, y, actualmente, un concepto de Sistematización de la Atención de Enfermería con atributos gerenciales y organizativo. Conclusiones: el concepto de Sistematización de la Atención de Enfermería está parcialmente maduro, tiene múltiples definiciones y se operativiza en conexiones inciertas con otros conceptos.

RESUMO Objetivos: analisar o amadurecimento conceitual de Sistematização da Assistência de Enfermagem na perspectiva da utilidade pragmática. Métodos: estudo de análise de conceito. As etapas foram: selecionar o conceito; elaborar questões analíticas; revisar a literatura de modo abrangente; e determinar componentes estruturais do conceito. Foram analisados 61 documentos após busca realizada até outubro de 2019. Resultados: quatro períodos temporais de mudanças contextuais ocorreram desde o surgimento das ideias de uma sistematização nos anos de 1960. Esse primeiro perdurou até 1990. Foi seguido pelos de 1990 a 2002, de 2002 a 2009 e a partir de 2009. Foi identificada parcial maturidade conceitual, operacionalização ao longo dos anos, com base em múltiplas definições, e, atualmente, um conceito de Sistematização da Assistência de Enfermagem com atributos gerenciais e organizativos. Conclusões: o conceito de Sistematização da Assistência de Enfermagem é parcialmente maduro, apresenta múltiplas definições, sendo operacionalizado em ligações incertas com outros conceitos.

Guide for Systematization of Care and Nursing Process: educational technology for professional practice / Guía de Sistematización del Proceso de Atención Y Enfermería: tecnología educativa para la práctica profesional / Guia sobre Sistematização da Assistência e Processo de Enfermagem: tecnologia educacional para a prática profissional

ABSTRACT Objective: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process. Methods: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout. Results: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges. Final considerations: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

RESUMEN Objetivo: desarrollar y validar el contenido de una tecnología educativa como guía digital sobre Sistematización de la Atención de Enfermería y del Proceso de Enfermería. Métodos: investigación aplicada de desarrollo tecnológico, desarrollada entre 2020 y 2021, en tres etapas. En primer lugar, se realizó una revisión de alcance para elaborar el contenido. En la segunda etapa, se validó el contenido con 46 jueces de enfermería seleccionados por conveniencia. El criterio mínimo de acuerdo entre los jueces fue del 80%. La tercera etapa consistió en la organización y maquetación del contenido. Resultados: el contenido de la guía fue elaborado a partir de la legislación del Consejo Federal de Enfermería, artículos científicos y libros de texto. El contenido fue considerado adecuado, pertinente y organizado por los jueces. Consideraciones finales: la guía digital es una alternativa que puede contribuir a la ejecución e implementación del PE, apoyando la planificación e implementación de acciones para la calidad de la atención.

RESUMO Objetivo: elaborar e validar o conteúdo de uma tecnologia educacional do tipo guia digital sobre Sistematização da Assistência de Enfermagem e Processo de Enfermagem. Métodos: pesquisa aplicada de desenvolvimento tecnológico, desenvolvida entre 2020 e 2021, em três etapas. Primeiramente, foi realizada uma revisão de escopo, para elaboração do conteúdo. Na segunda etapa, foi validado o conteúdo com 46 juízes enfermeiros selecionados por conveniência. O critério mínimo de concordância entre os juízes foi de 80%. A terceira etapa consistiu na organização e diagramação do conteúdo. Resultados: o conteúdo do guia foi elaborado a partir das legislações do Conselho Federal de Enfermagem, artigos científicos e livros textos. O conteúdo foi considerado adequado, pertinente e organizado pelos juízes. Considerações finais: o guia digital é uma alternativa que pode contribuir para a execução e implementação do PE, embasando o planejamento e a implementação de ações para a qualidade da assistência.