Transition to the family caregiver role in Portugal.

HIGHLIGHTS: This paper identifies a set of constraints experienced by FC in the caregiver role.This paper identifies difficulties experienced by FC.Urgent care nurses should address the FC constraints and difficulties. ABSTRACT: This research aims to analyze the transition to the role of family caregiver (FC). The purpose of this study was: to identify factors leading the dependent person of family caregivers to the hospital urgent care (UC); to identify constraints associated with the ability to perform the FC role and difficulties experienced by FC in their ability to perform this role.This was an exploratory, transversal, and descriptive study conducted in two stages with convenience samples. The first stage involved variables related to the dependent person and to the FC, namely to the caretaking process, in the dimensions: cognition, knowledge, perception of support, relationship with the family member, motivation, perception of physical health, perception of self-efficacy, identification of warning signs and management of the therapeutic regimen, underlying the Nursing Outcomes Classification. The study was conducted using a questionnaire delivered to each participant, 43 dependent persons and their FC. The second stage comprised a sample of 6 FC. A semi-structured thematic interview was conducted and submitted to content analysis, using the Transitions Model. Data were analyzed through descriptive and inferential statistics. The difficulties associated with the FC ability to perform were: knowledge, perception of support, motivation, perception of physical health, perception of self-efficacy, coping with the illness, coping with the suffering of the family member and fear.Nurses must take special consideration to admissions of dependent persons cared at home by their FC. This will help to determine if the worsening of the patient's condition is due to the onset of symptoms disease related or is the result of the FC inability to deal with the dependency changes and constant demands.

Descobrindo enfermagem experimentando ser enfermeiro / Discovering nursing through trying out being a nurse / Descubriendo enfermería experimentando ser enfermero

Atividade desenvolvida em 2011 no âmbito do Programa Nacional de Iniciação ao Ambiente Universitário para os estudantes do ensino secundário, em Portugal, promovido pela Universidade do Porto, em parceria com a Escola Superior de Enfermagem do Porto - Portugal. Os estudantes foram desafiados a experimentar um conjunto de procedimentos de enfermagem e a trabalhar num conceito de enfermagem. Durante uma semana os estudantes vivenciaram o ambiente da Escola de Enfermagem, participaram em aulas teóricas, teórico-práticas e práticas, em contexto laboratorial, para construírem e apresentarem sua perspectiva do que é ser enfermeiro. A experiência revelou-se positiva, segundo os participantes, contribuindo para a formação de uma ideia crítico-reflexiva acerca do curso de graduação e da Enfermagem, auxiliando-os na clarificação de percepções e na definição da sua orientação vocacional, além de otimizar a convivência com estudantes do ensino superior, o que se revelou uma oportunidade de amadurecimento.

This activity was carried out in 2011 in the framework of the National Program for Initiation to the University Environment for secondary school pupils, in Portugal, promoted by the University of Porto, in partnership with the Porto Nursing College - Portugal. The students were challenged to try a set of nursing procedures and to work in a nursing concept. For one week the students experienced the atmosphere of the School of Nursing, participated in theory classes, and theory-practice and practice classes in a laboratory context, so as to construct and present their perspective on what it is to be a nurse. The experience was shown to be positive, according to the participants, contributing to the formation of a critical-reflexive idea regarding the undergraduate Nursing course, helping them to clarify their perceptions and define their vocational orientation, as well as to optimize the co-existence with the higher education students, which was shown to be an opportunity to mature.

Actividad desarrollada en 2011 en el ámbito del Programa Nacional de Iniciación al Ambiente Universitario para los estudiantes de la enseñanza secundaria, en Portugal, promovido por la Universidad de Porto, en colaboración con la Escuela Superior de Enfermería de Porto - Portugal. Los estudiantes fueron desafiados a experimentar un conjunto de procedimientos de enfermería y a trabajar en un concepto de enfermería. Durante una semana, los estudiantes vivieron el ambiente de la Escuela de Enfermería, participaron en clases teóricas, teórico-prácticas y prácticas, en contexto laboratorial, para construir y presentar su perspectiva de lo que es ser enfermero. La experiencia se ha revelado positiva, de acuerdo a los participantes, contribuyendo para la formación de una idea crítico reflexiva acerca del curso de graduación y de la Enfermería, auxiliándolos en el esclarecimiento de percepciones y en la definición de su orientación vocacional, además de otimizar la convivencia con estudiantes de la enseñanza superior, lo que se ha revelado una oportunidad de maduración.

Analysis of a health team's records and nurses' perceptions concerning signs and symptoms of delirium.

This study investigates the extent of under-diagnosis of acute confusion/delirium by analyzing the records of a health team and the perception of nurses concerning this phenomenon. This quantitative study was developed in a central university hospital in Portugal and used the documentary and interview techniques. The sample obtained through the application of the NeeCham's scale was composed of 111 patients with the diagnosis of acute confusion/delirium hospitalized in the medical and surgical acute care units. A rate of 12.6% of under-diagnosis was identified in the records and a rate of 30.6% was found taking into account the perception of nurses. No indicators of acute confusion/delirium were found in 8.1% of the 111 cases and only 4.5% of the patients were diagnosed with acute confusion/delirium. The results indicate there is difficulty in identifying acute confusion/delirium, with implications for the quality of care, suggesting the need to implement training measures directed to health teams.

Analysis of a health team's records and nurses' perceptions concerning signs and symptoms of delirium / Análise dos registros produzidos pela equipe de saúde e da percepção dos enfermeiros sobre os sinais e sintomas de delirium / Análisis de registros producidos por el equipo de salud y de la percepción de los enfermeros sobre las señales y síntomas de delirio

This study investigates the extent of under-diagnosis of acute confusion/delirium by analyzing the records of a health team and the perception of nurses concerning this phenomenon. This quantitative study was developed in a central university hospital in Portugal and used the documentary and interview techniques. The sample obtained through the application of the NeeCham's scale was composed of 111 patients with the diagnosis of acute confusion/delirium hospitalized in the medical and surgical acute care units. A rate of 12.6 percent of under-diagnosis was identified in the records and a rate of 30.6 percent was found taking into account the perception of nurses. No indicators of acute confusion/delirium were found in 8.1 percent of the 111 cases and only 4.5 percent of the patients were diagnosed with acute confusion/delirium. The results indicate there is difficulty in identifying acute confusion/delirium, with implications for the quality of care, suggesting the need to implement training measures directed to health teams.

Esta pesquisa pretendeu conhecer a dimensão do subdiagnóstico da confusão aguda/delirium, ao analisar os registros produzidos pela equipe de saúde e percepção dos enfermeiros sobre esse fenômeno. Foi desenvolvido em um hospital universitário central, de Portugal, delineada dentro do paradigma quantitativo, utilizando a técnica documental e entrevista. A amostra obtida, pela aplicação da Escala de Confusão NeeCham, foi de 111 doentes com diagnóstico de confusão aguda/delirium, internados em unidades de cuidados agudos médicos e cirúrgicos. Identificou-se taxa de subdiagnóstico do fenômeno de 12,6 por cento nos registros e de 30,6 por cento tendo em conta a percepção dos enfermeiros. Em 8,1 por cento, dos 111 casos, não foi identificado qualquer indicador de confusão aguda/delirium. Somente 4,5 por cento dos doentes tinha o fenômeno diagnosticado. Os resultados apontam dificuldade para se identificar a confusão aguda/delirium, com implicações para a qualidade dos cuidados, sugerindo a necessidade de medidas formativas dirigidas às equipes de saúde.

Esta investigación pretendió conocer la dimensión del subdiagnóstico de la confusión aguda/delirio, al analizar los registros producidos por el equipo de salud y percepción de los enfermeros sobre este fenómeno. Fue desarrollado en un hospital universitario central de Portugal. Delineada dentro del paradigma cuantitativo, utilizando la técnica documental y la entrevista. La muestra obtenida, por la aplicación de la Escala de Confusión NeeCham, fue de 111 enfermos con diagnóstico de confusión aguda/delirio, internados en unidades de cuidados agudos médicos y quirúrgicos. Se identificó una tasa de subdiagnóstico del fenómeno de 12,6 por ciento en los registros y de 30,6 por ciento teniendo en cuenta la percepción de los enfermeros. En 8,1 por ciento de los 111 casos, no fue identificado cualquier indicador de confusión aguda/delirio. Solamente, 4,5 por ciento de los enfermos tenían el fenómeno diagnosticado. Los resultados apuntan para la dificultad en identificar la confusión aguda/delirio, con implicaciones para la calidad de los cuidados, sugiriendo la necesidad de adoptar medidas formativas dirigidas a los equipos de salud.