Women's temporality after cardiac surgery: contributions to nursing care.

OBJECTIVE: to unveil women's existential movement after cardiac surgery. METHOD: qualitative phenomenological study. The research setting was a hospital in Minas Gerais, in which ten women were interviewed between December 2011 and January 2012. RESULTS: after hospital discharge, the women experienced physical, social and emotional impairments, and expressed the desire to go back to the time before their diagnosis, because they felt as though they still had heart disease. This vague and average understanding led to three units of meaning that, from a Heideggerian hermeneutic point of view, revealed the phenomenon of cardiac surgery as a present circumstance that limited the participants' daily lives. CONCLUSION: nurses supporting women patients after cardiac surgery should promote health considering existential facets that are expressed during care. The bases for comprehensive care are revealed in singular and whole meetings of subjectivity.

[Applicability of ICNP® based on the theory of modeling and role-modeling]. / Aplicabilidade da CIPE® fundamentada na teoria da modelagem e modelagem de papel.

This study aimed to analyze the proposal of educational plan organized through the Nursing Process, using the International Classification for Nursing Practice (ICNP®), based on the Theory of Modeling and Role Modeling, to one group of women in Maracanaú-CE, Brazil. A case study was carried out in an educational group of women. A qualitative approach conducted the data production guided by the Creative and Sensitive Method. Two main diagnoses emerged from the needs presented by the group: compromised health and adequate knowledge, as well as formulation of results and nursing interventions. This study indicates the possibility of Nursing Process supported by INCP® and educational activities based on the Theory of Modeling and Role Modeling.

The WHO Surgical Safety Checklist: knowledge and use by Brazilian orthopedists.

OBJECTIVE: The research examined Brazilian orthopedists' degree of knowledge of the World Health Organization Surgical Safety Checklist. METHODS: A voluntary survey was conducted among the 3231 orthopedists taking part in the 44th Brazilian Congress of Orthopedics and Traumatology in November 2012, using a questionnaire on the use of WHO Surgical Safety Checklist. A statistical analysis was done upon receipt of 502 completed questionnaires. RESULTS: Among the 502 orthopedists, 40.8% reported the experience of wrong site or wrong patient surgery and 25.6% of them indicated "miscommunication" as the main cause for the error. 35.5% of the respondents do not mark the surgical site before sending the patient to the operating room and 65.3% reported lack of knowledge of the World Health Organization (WHO) Surgical Safety Checklist, fully or partially. 72.1% of the orthopedists have never been trained to use this protocol. DISCUSSION: Medical errors are more common in the surgical environment and represent a high risk to patient safety. Orthopedic surgery is a high volume specialty with major technical complexity and therefore with increased propensity for errors. Most errors are avoidable through the use of the WHO Surgical Safety Checklist. The study showed that 65.3% of Brazilian orthopedists are unaware of this protocol, despite the efforts of WHO for its disclosure.

OBJETIVO: A pesquisa analisou o grau de conhecimento do Protocolo de Cirurgia Segura da OMS pelos ortopedistas brasileiros. MÉTODOS: Foi feita uma pesquisa voluntária entre os 3.231 ortopedistas participantes do 44° Congresso Brasileiro de Ortopedia e Traumatologia (CBOT), em novembro de 2012, por meio de um questionário sobre o uso do Protocolo de Cirurgia Segura da OMS. Após o recebimento de 502 questionários respondidos, foi feita a análise estatística dos resultados. RESULTADOS: Dentre os 502 ortopedistas respondentes, 40,8% relataram ter vivenciado a experiência de cirurgia em paciente ou em local errado e 25,6% deles apontaram "falhas de comunicação" como responsáveis pelo erro. Do total de respondentes, 36,5% relataram não marcar o local da cirurgia antes de encaminhar o paciente ao centro cirúrgico e 65,3%, desconhecer total ou parcialmente o Protocolo de Cirurgia Segura da OMS. Desses ortopedistas, 72,1% nunca foram treinados para o uso do protocolo. DISCUSSÃO: Erros médicos ocorrem, principalmente em ambiente cirúrgico, e representam um alto risco para a segurança dos pacientes. Considerando que a cirurgia ortopédica é uma especialidade de grande volume e frequentemente de alta complexidade, envolve uma probabilidade grande de ocorrência de erros, a maioria evitável por meio do uso do Protocolo de Cirurgia Segura da OMS. Na amostra pesquisada, restou evidenciado que 65,3% dos ortopedistas brasileiros desconhecem tal protocolo, apesar dos esforços da OMS para a sua divulgação.

[Nursing care: how nursing assistants perceive it]. / Cuidado de enfermagem: percepção dos enfermeiros assistenciais.

This is a descriptive, exploratory study wih a qualitative approach performed in a University Hospital from the Federal Public Network of the city of Fortaleza, state of Ceará, Brazil. It aimed to understand how nursing assistants perceive nursing care and to know the actions performed by nurses that are recognized as care activities. Eight nurses from the surgical intensive care unit participated in the study. A questionnaire with open questions was used as an instrument of data collection. Analysis was performed through content analysis with the formation of thematic categories and a framework that allowed the best visualization of results. Results show that, although they know and conceptualize nursing care, nurses have difficulties in achieving the larger care, maybe because they are overloaded with technical procedures performed in hospital environments.

[Evaluation of pain intensity and vital signs in the cardiac surgery postoperative period]. / Avaliação da intensidade de dor e sinais vitais no pós-operatório de cirurgia cardíaca.

The objective of this study is to analyze the changes in vital signs of postoperative cardiac surgery patients, according to the referred pain intensity. This descriptive-exploratory study was performed using quantitative analysis to investigate 38 patients submitted to a first dressing change. The analysis of the data, measured before and after performing the nursing procedure, indicated that the manifestation of pain occurred at different levels. The main changes in vital signs referred to blood pressure. In conclusion, there is a relationship between pain intensity and vital signs, and the care that is delivered is indispensible to reestablishing the health state of the postoperative patient.

[Barriers to hypertension treatment]. / Barreiras ao tratamento da hipertensão arterial.

The objective was to describe the barriers faced by people with hypertension for non compliance to treatment and control the levels of blood pressure. This is a transversal and descriptive study which was carried out in 6 basic health units in Fortaleza-Ceará, Brazil. The population consisted of 246 people enrolled in the program to Control Hypertension for at least a year. Data were collected using a structured interview and electronic chart. Of them, 69 showed normal blood pressure levels. The main barriers discovered were: poor financial condition, continuous treatment with many medicines and practice physical activity. It was concluded that barriers to the anti-hypertensive treatment include the sick people, their environment and their access to health care.

[Permanent care: 24 hours nursing care, our way to take care]. / Cuidar permanência: enfermagem 24 horas, nossa maneira de cuidar.

Theoretical-reflexive study motivated by the epistemology of Gaston Bachelard and by the project "Thousand and one ways to take care in Nursing" by Maria José Coelho. We had as objective to trace new ways to take care in dialysis nursing, creating a system of cares offered to chronic kidney patients. Seven nursing cares that involve care of people in dialysis treatment were described: reception; bonding; specialized techniques; support to self-care; assessment of the treatment, facing the unstimulating routine; and citizenship rescue. Permanent care emerged, understood as an articulate and complementary relation between the scientific knowledge present in nursing care and the valorization of the other's essence, as a complex being in its whole.

[Perceptions of people about hypertension and concepts of Imogene King]. / Percepção de pessoas sobre a hipertensão arterial e conceitos de Imogene King.

As the discussion on cardiovascular diseases is a relevant matter, this paper aims to analyze the perceptions of a group of hypertensive people about their sickness process related to King's conceptual models of personal and interpersonal systems. This descriptive and exploitative study was developed in a reference unit in Fortaleza, Ceará, Brazil, accepted by the Ethics Committee of Ceará State University Fifty hypertensive people participated (34 women and 16 men), ages 23 to 84. Results show fear of complications, satisfaction in adapting to treatment, dissatisfaction with the changes in their life style and resignation towards the disease. The nurse, seen as part of the initial assistance and in contrast with the insecurity shown by the patients, reveals the need of reflexion on the way patients are taken care.

Cuidado crítico e criativo: contribuições da educação conscientizadora de Paulo Freire para a enfermagem / Cuidado crítico y creativo: contribuciones de la educación de Paulo Freire para la enfermería / Critical and creative care: contribution of Paulo Freire education for nursing

O presente artigo discute a possibilidade de transformação da prática de enfermagem por meio do cuidado crítico e criativo, propondo a educação em saúde como ferramenta para este fim. Apresenta ainda, em linhas gerais, a proposta educativa de Paulo Freire, ressaltando como os seus princípios podem superar o modelo de educação em saúde vigente, que pouco colabora para a emancipação dos sujeitos envolvidos no processo de cuidado.

This article discuss the possibility of transformation of nursing practice through critical and creative care, and propose the health education as instrument for this. It shows the Paulo Freire education proposal, pointing out how his principles can overcome the current health education model, that scarcely collaborate with the individual independence involved in care process.

El presente artículo discute la posibilidad de cambios en las prácticas de enfermería por medio del cuidado crítico y creativo, y propone la educación en salud como instrumento para ello. Se presenta, de modo general, la propuesta educativa de Paulo Freire, destacando cómo sus principios pueden superar el modelo actual, que colabora escasamente en la emancipación de los sujetos participantes en el proceso del cuidado.

[Nursing diagnoses in cardiac surgery patients]. / Diagnósticos de enfermagem em pacientes submetidos à cirurgia cardíaca.

Exploratory and transversal research accomplished with postoperative patients outgoing coronary bypass. It was aimed at identifying nursing diagnoses according to Taxonomy II of NANDA and nursing interventions according to Nursing Interventions Classification, associating with the results of Nursing Outcomes Classification. The data were collected fom 22 patients using formularies and physical examination. The information made possible the identification of fifteen nursing diagnosis, according to Taxonomy II of NANDA. Among them, stand out: risk of infection; Risk of constipation; Deficit in self-care intimate hygiene and integrity of harmed skin. The study revealed being fundamental to develop studies about nursing diagnoses to direct analyses of problems that concern to the demanding patients of specific nursing actions, that contribute to the devepoment of the profession.

[Education of the nurse for caring: reflections of professional practice]. / Formação do enfermeiro para o cuidado: reflexes da prática profissional.

It is a reflective study that aimed at discussing the education of the nurse concerning the care in a perspective of change of the professional practice. The curricular guidelines for the profession are based Guidelines and Basis for National Edcucation which have aims to educate capable nurses to transform the practical reality of the Brazilian nursing. However, we realize that only the implementation of such guidelines does not make possible the education of critical, reflexive and transforming professionals regarding the real world.

[Health education: object of study in dissertations and theses by Brazillian nurses]. / Educação em saúde: objeto de estudo em dissertações e teses de enfermeiras no Brasil.

This study was aimed at surveying the quantity of dissertations and theses written by nurses on health education, identifying and analyzing their methodological steps. 17 Catalogs of Information about Research and Researchers from CEPEn/ABEn--published from 1979 to 1999--have been examined. The sample comprises 105 dissertations and 15 theses about the theme. Chronic diseases, pregnancy-puerperal cycle, health education, management and perisurgery situation have stood out as objects of study. The populations were adults, nursing professionals, women, children and adolescents. Interviewing was the most used technique. Authors indicated the need to improve educative practices and considered that health education motivates changes in lifestyle. It was concluded that there is a need to strengthen research into the everyday of Nursing in a historical and social context.

[Nursing course of the State University of Ceara -- history and current political-pedagogical project]. / Curso de enfermagem da Universidade Estadual do Ceará--a história e o projeto político-pedagógico atual.

This paper describes important moments along the route of the Nursing Program at State University of Ceará and their influences on their current process of professional education. It outlines their program, their professors and students, as well as their political-pedagogical project. Finally, it highlights the importance of this instrument to warrant professional qualification.