Percepções de usuárias do ambulatório ginecológico sobre o atendimento em um hospital universitário / Perceptions of users of the gynaecological outpatient clinic on care at a university hospital

Resumo: Introdução: A graduação no curso de Medicina se dá por meio de uma formação teórico-prática que tem nos hospitais universitários o seu principal cenário de práticas. Nas consultas que envolvem questões da intimidade do paciente, o constrangimento é uma possibilidade. Isso pode comprometer a qualidade da assistência e/ou da formação médica. Objetivo: Este estudo teve como objetivo investigar os aspectos psicoafetivos da consulta ginecológica, a partir da percepção das pacientes, de modo a encontrar elementos que possam favorecer a adequação da formação médica à humanização do atendimento. Método: Trata-se de um estudo observacional, transversal, de abordagem qualitativa, realizado no ambulatório de ginecologia de um hospital universitário. Foram incluídas as usuárias do ambulatório que estavam na sala de espera para atendimento ginecológico, configurando-se como uma amostra por acessibilidade. A coleta de dados se deu entre os meses de fevereiro e agosto de 2021, por meio de uma entrevista semiestruturada com perguntas norteadoras previamente elaboradas. Realizaram-se 50 entrevistas, cujos discursos foram posteriormente transcritos e analisados pelo software IRaMuTeQ. Resultado: Sob a perspectiva das pacientes, o momento da consulta ginecológica envolve duas esferas de interesse principais: a assistência médico-ginecológica dada a elas e o ensino-aprendizado destinado aos estudantes. A partir dessa divisão, emergem duas perspectivas: aquela que parte da demanda pessoal, e a que considera o interesse do outro (o estudante). Nos discursos sobre a assistência ginecológica, as falas concentram o olhar para si, para o constrangimento vivenciado durante a assistência. Já nos discursos sobre o ensino e a aprendizagem dos estudantes, as falas referem-se, em sua maioria, ao reconhecimento da importância da prática clínica na formação médica. Dessa forma, ocorre uma intersecção entre "a assistência fornecida a mim" e o "processo de ensino-aprendizagem do outro". O constrangimento das pacientes parece ser superado em favor de um objetivo maior: contribuir para a formação de futuros médicos. Conclusão: Apesar do constrangimento experimentado na consulta ginecológica em ambiente acadêmico, a compreensão das usuárias acerca da sua contribuição para a formação médica promove um posicionamento colaborativo, revelando-se como elemento facilitador da assistência nesse cenário. Foi revelada também uma atenuação do constrangimento proporcional à experiência da mulher nesse tipo de atendimento.

ABSTRACT Introduction: Undergraduate medical training involves both theoretical and practical learnings, with university hospitals being the main practice setting. In consultations involving issues of patient intimacy, embarrassment is a possibility. This may compromise the quality of care and/or medical training. Objective: The objective of this study was to investigate the psycho-affective aspects of gynecological consultation, based on the patients' perceptions, in order to find elements to help shape medical education toward humanized care. Method: This is an observational, cross-sectional, qualitative study, carried out in the gynecology outpatient clinic of a university hospital. Outpatient users who were in the waiting room for gynecological care were included, representing a sample for accessibility. Data collection took place between the months of February and August 2021 through a semi-structured interview with previously prepared guiding questions. A total of 50 interviews were conducted, which were later transcribed and analyzed by the IRaMuTeQ software. Result: From the perspective of the patients, the gynecological consultation involves two main spheres of interest: the medical-gynaecological assistance given to them and the teaching-learning aimed at students. Within this division, two perspectives emerge: firstly, that which draws on the personal demand and, secondly, that which considers the interest of the other (the student). In the discourses on medical- gynecological assistance, the speakers focus on themselves, on the embarrassment experienced during the assistance. In the discourses on the teaching and learning of the students, the speakers primarily focus on the importance of clinical practice in medical training. Thus, there is an intersection between "the care provided to me" and the "other's teaching-learning process". The patient's embarrassment seems to be overcome in favour of a greater goal: to contribute to the training of future doctors. Conclusion: Despite the embarrassment experienced in gynecological consultation in an academic environment, the users' understanding of their contribution to medical education promotes a collaborative attitude, which is found to facilitate care in this scenario. The attenuation of the embarrassment was also found to be proportional to the experience of the woman in this type of care.

Repensar la formación y la práctica especializada de enfermería desde la óptica unitaria del ser humano / Rethinking specialized nursing training and practice from the unitary perspective of the human being

El propósito del presente texto es repensar la formación y la práctica especializada de enfermería desde la óptica de las ciencias humanas que estudian la subjetividad y que encuentran su sentido científico más allá del saber disciplinar. Se trata de distinguir con claridad entre las ciencias de la naturaleza y las ciencias del espíritu a partir de la óptica unitaria del ser humano. Esto debido a la creciente percepción de deshumanización y tecnificación de la práctica del cuidado de enfermería vinculada a la formación especializada para el manejo de determinados procedimientos y aparatos que parcelan el conocimiento y desvían la perspectiva y el enfoque disciplinar. Por lo tanto, pensar en cómo se puede comprender mejor el fenómeno de la salud y la enfermedad humanas desde la formación y la práctica de enfermería tiene la posibilidad de reconsiderar el perfil académico de formación básica y especializada de enfermería, congruentemente articulados los saberes de una enfermería contemporánea con los sentires y los saberes de las personas que cuidan con las otras personas a las que se cuida.

The purpose of this text is to rethink specialized nursing training and practice from the perspective of the human sciences that study subjectivity and find its scientific meaning beyond disciplinary knowledge. It is about clearly distinguishing between the sciences of nature and the sciences of the spirit from the unitary perspective of the human being. This is due to the growing perception of dehumanization and technification of nursing care practice linked to specialized training for the management of certain procedures and devices that fragment knowledge and divert the disciplinary perspective and approach. Thus, thinking about how the phenomenon of human health and disease can be better understood from nursing training and practice has the possibility of reconsidering the academic profile of basic and specialized nursing training, coherently articulated the knowledge of contemporary nursing with the feelings and knowledge of the people who care for with the other people who are cared for.

Escuta e valorização dos usuários: concepções e práticas na gestão do cuidado na Estratégia Saúde da Família / Listening and valuing clients: conceptions and practices in the care management in the Family Health Strategy

Resumo Objetivou-se analisar as práticas de acolhimento, vínculo e corresponsabilização na produção do cuidado da Estratégia Saúde da Família. Estudo exploratório de natureza qualitativa, na dimensão da hermenêutica-dialética, realizado entre agosto e novembro de 2021, em Iguatu, Ceará. Participaram 25 profissionais coordenadores das equipes da Estratégia Saúde da Família. Utilizou-se entrevista semiestruturada para coleta de dados. Identificaram-se diferentes concepções entre os coordenadores sobre acolhimento, vínculo e corresponsabilização, sendo eles: aspectos conceituais ligados ao modo de experienciação das práticas de cuidado vivenciadas pela equipe, e os aspectos intervenientes nesses processos e nas relações construídas na gestão e produção do cuidado. Evidenciaram-se contribuições para a avaliação e o aprimoramento da gestão e produção do cuidado na Estratégia Saúde da Família e no Sistema Único de Saúde. As práticas de acolhimento, vínculo e corresponsabilização mostraram-se como ferramentas potenciais na qualificação da gestão do cuidado na Estratégia Saúde da Família. Considera-se que o aperfeiçoamento das habilidades profissionais e o investimento nas tecnologias relacionais são exigências para a prática humanizada em saúde.

Abstract We aimed to analyze the practices of receiving, bonding, and shared responsibility in producing care in the Family Health Strategy. This qualitative, exploratory study in the dimension of hermeneutics-dialectics was conducted from August and November 2021 in Iguatu, Ceará, with 25 professional coordinators of the Family Health Strategy teams. A semi-structured interview was adopted to collect data. We identified different conceptions among the coordinators about reception and bonding. We shared responsibility: conceptual aspects linked to the experimental care practice mode the team experienced, the aspects that intervened in these processes, and the relationships built through care management and production. We evidenced contributions to evaluating and improving care management and production in the Family Health Strategy and the Unified Health System (SUS). Reception, bonding, and shared responsibility were proven potential tools in qualifying care management in the Family Health Strategy. Improving professional skills and investing in relational technologies are required for humanized health practice.

Cuidado humanizado de personal de enfermería y satisfacción del paciente hospitalizado por dengue con signos de alarma / Humanized care of nursing staff and satisfaction of patients hospitalized for dengue with warning signs

El dengue, infección vírica transmitida por Aedes aegypti, puede evolucionar a cuadros clínicos grave. En pacientes con signos de alerta, es necesario el monitoreo constante de los signos vitales, requiriendo hospitalización. El personal de enfermería ha sido considerado clave en los algoritmos de abordaje de estos pacientes. Por lo que, el buen desempeño de atención y una relación armoniosa con el paciente, puede ser indispensable. La humanización de los cuidados es imperativa para contribuir a salvaguardar la dignidad humana en armonía con los principios bioéticos. Por tanto, se realizó una revisión sistemática de la literatura con el propósito de identificar el estado del arte sobre el cuidado humanizado de enfermería y su relación con la satisfacción del paciente hospitalizado. Se identificaron 50 artículos relacionados con las variables de investigación. Los resultados señalan a la escala en la medición del cuidado humano transpersonal basada en la teoría Watson, como las más frecuente; asimismo, el cuestionario de satisfacción del paciente con la calidad de la atención de enfermería, como el método más utilizado. En cuanto a los elementos del cuidado de enfermería se agrupan en dos dimensiones; cuidado humanizado y praxis. Finalmente, los pacientes asocian calidad de servicio con satisfacción al usuario, percibiendo de manera positiva la humanización de los cuidados. Se recomienda implementar estrategias e identificar puntos críticos de la atención, planes de mejoras y capacitación para la sensibilización del personal de enfermería hacía un buen trato al paciente, desde un abordaje holístico e integral(AU)

Dengue, a viral infection transmitted by Aedes aegypti, can evolve into severe clinical pictures. In patients with warning signs, constant monitoring of vital signs is necessary, requiring hospitalization. The nursing staff has been considered key in the approach algorithms for these patients. Therefore, good care performance and a harmonious relationship with the patient may be essential. The humanization of care is imperative to help safeguard human dignity in harmony with bioethical principles. Therefore, a systematic review of the literature was carried out with the purpose of identifying the state of the art on humanized nursing care and its relationship with the satisfaction of the hospitalized patient. 50 articles related to the research variables were identified. The results point to the scale in the measurement of transpersonal human care based on Watson's theory, as the most frequent; likewise, the patient satisfaction questionnaire with the quality of nursing care, as the most used method. Regarding the elements of nursing care, they are grouped into two dimensions; humanized care and praxis. Finally, patients associate quality of service with user satisfaction, positively perceiving the humanization of care. It is recommended to implement strategies and identify critical points of care, improvement plans and training to sensitize nursing staff towards good patient treatment, from a holistic and comprehensive approach(AU)

Humanização do cuidado ao paciente e familiares frente as doenças e complicações cardíacas / Humanization of care for patients and families in front of heart diseases and complications / Humanización de la atención a pacientes y familias ante enfermedades y complicaciones del corazón

Introdução: Pacientes com patologias cardiovasculares apresentam comprometimento nas dimensões física, emocional e sócio espiritual devido a alterações patológicas, podendo repercutir cotidianamente no processo saúde-doença. Diante das fragilidades e possíveis complicações, cabe à equipe de enfermagem o domínio de conhecimento técnico e científico, bem como de humanização. Assim, por meio da assistência humanizada a equipe de enfermagem buscará estratégias adequadas para tratar os aspectos emocionais, sociais, psicológicos e físicos, os quais deverão ser avaliados continuamente. Objetivo: Descrever as principais práticas da equipe de enfermagem relacionadas a humanização junto aos pacientes portadores de doenças cardiovasculares e seus familiares. Material e Método: Estudo de revisão bibliográfica, descritivo, qualitativo, cuja coleta de dados foi realizada no banco de dados LiLACS, acessado por meio do portal eletrônico da Biblioteca Virtual em Saúde. Resultados: Foram utilizados cinco artigos das 2843 publicações localizadas, guiados pelos descritores que contemplavam o tema abordado e criadas pelo cruzamento das palavras-chave estabelecidas. Duas categorias temáticas: Práticas humanizadas realizadas pela equipe de enfermagem ao paciente cardíaco e Percepção do familiar em relação as práticas humanizadas realizadas pela equipe de enfermagem ao paciente cardíaco. Conclusão: A assistência, bem como bons resultados no tratamento, decorrem e tem relevância nas práticas humanizadas oferecidas pela equipe de enfermagem no atendimento de pacientes com afecções cardíacas e seus familiares.

Introduction: Patients with cardiovascular pathologies present impairment in the physical, emotional and socio-spiritual dimensions due to pathological changes, which may have daily repercussions on the health-disease process. Faced with weaknesses and possible complications, it is up to the nursing team to master technical and scientific knowledge, as well as humanization. Thus, through humanized care, the nursing team will seek appropriate strategies to deal with emotional, social,psychological and physical aspects, which should be continuously evaluated. Objective: To describe the main practices of the nursing team related to humanization with patients with cardiovascular diseases and their families. Material and Method: Bibliographic review, descriptive, qualitative study, whose data collection was carried out in the LiLACS database, accessed through the electronic portal of the Virtual Health Library. Results: Five articles from the 2843 publications located were used, guided by the descriptors that contemplated the topic addressed and created by crossing the established keywords. Two thematic categories: Humanized practices performed by the nursing team to the cardiac patient and Perception of the family member in relation to the humanized practices carried out by the nursing team to the cardiac patient. Conclusion: Assistance, as well as good treatment results, derive from and are relevant to the humanized practices offered by the nursing team in the care of patients with cardiac conditions and their families.

Introducción: Los pacientes con patologías cardiovasculares presentan afectaciones en las dimensiones física, emocional y socioespiritual debido a cambios patológicos, que pueden repercutir en el día a día del proceso salud-enfermedad. Frente a las debilidades y posibles complicaciones, corresponde al equipo de enfermería dominar los conocimientos técnicos y científicos, así como la humanización. Así, a través del cuidado humanizado, el equipo de enfermería buscará estrategias adecuadas para el enfrentamiento de los aspectos emocionales, sociales, psicológicos y físicos, que deben ser evaluados continuamente. Objetivo: Describir las principales prácticas del equipo de enfermería relacionadas con la humanización con pacientes con enfermedades cardiovasculares y sus familias. Material y Método: Revisión bibliográfica, estudio descriptivo, cualitativo, cuya recolección de datos se realizó en la base de datos LiLACS, accedida a través del portal electrónico de la Biblioteca Virtual en Salud. Resultados: Se utilizaron cinco artículos de las 2843 publicaciones localizadas, guiados por los descriptores que contemplaban el tema abordado y creados a partir del cruce de las palabras clave establecidas. Dos categorías temáticas: Prácticas humanizadas realizadas por el equipo de enfermería al paciente cardíaco y Percepción del familiar en relación a las prácticas humanizadas realizadas por el equipo de enfermería al paciente cardíaco. Conclusión: La asistencia, así como los buenos resultados del tratamiento, se derivan y son relevantes para las prácticas humanizadas ofrecidas por el equipo de enfermería en el cuidado de los pacientes con condiciones cardíacas y sus familias.

The Impact of Contemplative Practice in Dental Education: A Qualitative Study in General Dentistry.

Aim: This study explored perceptions of dental postgraduates regarding the impact of contemplative practice in a patient care aspect. Materials and Methods: The qualitative research approach using semi-structured interview was employed. Postgraduate students from the General Dentistry Residency Training Program were selected by purposive sampling by considering sex and working experience. The retrieved data were transcribed using a verbatim technique and analyzed using framework analysis. Results: There were 12 students participating in this research. The retrieved data were analyzed and categorized into two main themes, which were mindfulness and humanized patient-centered care paradigm. Mindfulness can be categorized into four subthemes to represent its required skills, including concentration, deep listening, emotional regulation, as well as critical thinking and problem-solving skill. There were six subthemes for humanized patient-centered care paradigm, which were understanding in patients' context, development of individualized comprehensive treatment planning, treatment with humanization and compassion, management with phycological integrated care, rapport establishment with patients, and good attitudes toward special care needs patients. These skills are considered necessary for patient-centered dental practice, which could be expected from the learning process through contemplative practice. Conclusion: This research supports the implementation of contemplative practice in dental education, as the data demonstrated the positive impact of contemplative practice in both personal and professional perspectives. These included the cultivation of mindfulness and other relevant skills, which were required for humanized patient-centered care in dental practice.

Development of a constant temperature disinfection device and evaluation of its clinical application effect / 中国实用护理杂志

Objective:To develop a constant temperature disinfection device and evaluate its clinical effect in perineal disinfection after delivery.Methods:A total of 300 cases of puerpera who met the inclusion and exclusion criteria were selected from Heping Hospital Affiliated to Changzhi Medical College from November to December 2020. The study was designed as a randomized control study. Subjects were randomly divided by random digit table into the control group and the experimental group of 150 cases respectively. The former used conventional methods for perineal disinfection after delivery. The latter performed perineal disinfection assisted by a thermostatic disinfection device. The temperature comfort of perineal disinfection and the perineal wound healing of perineal tear or lateral incision were compared between two groups.Results:The score of temperature comfort feeling of puerpera in the control group and the experimental group was 3 (1.5) and 5 (0), respectively. The maternal temperature comfort feeling score in the experimental group was higher, and the difference between the two groups was statistically significant ( Z=-13.78, P<0.05). There was no grade C healing of perineal wounds in the two groups. The composition ratios of grade A and grade B healing of perineal wounds in the control group were 89.61% (69/77) and 10.39% (8/77), and those in the experimental group were 93.75% (90/96) and 6.25% (6/96). The healing of perineal wound in the latter group was better, but the difference between the two groups was not statistically significant ( Z=0.99, P>0.05). Conclusions:The constant temperature disinfection device meets the clinical nursing needs, enhances the comfort experience of puerpera, and has certain effect on promoting the healing of perineal wound after delivery.

Humanized Care From the Nurse-Patient Perspective in a Hospital Setting: A Systematic Review of Experiences Disclosed in Spanish and Portuguese Scientific Articles.

Nowadays, humanized care is an essential component in the field of health because the professional work of nursing seeks to provide quality services to patients who are suffering and fear illness or the dying process. Nurses recognize the need to incorporate humanized care into their daily work, as supported by Jean Watson, who states that caring entails establishing an adequate nurse-patient therapeutic relationship, where health education is a tool that promotes self-care in the patient, family, and community. The main objective of this work was to find scientific evidence on humanized care from the perspectives of nurses and hospitalized patients. To meet those research objectives, an exploratory systematic review of articles published in high-quality scientific journals from 2016 to 2020 using the PRISMA methodology in the Scopus and Scielo databases was conducted, yielding 26 studies that were analyzed. The findings show that nurses and patients perceive the need to remove the barriers that limit the advancement of humanized care in hospital institutions because they urgently demand that health professionals in all settings, especially critical ones, strengthen their humanizing role by sharing cordial, empathetic health experiences, and respecting their customs and beliefs during the hospitalization process. As a conclusion of the findings, the nurse-patient professionals agree that health personnel training is critical to providing humanized attention with quality in the hospital context, emphasizing that professional training should develop in practice soft skills, communication, safety environment, and human values.

Efectos del clown de hospital en la calidad de vida de personas en una unidad de cuidados paliativos pediátricos oncológicos / Effects of hospital clowns on the quality of life of patients in a paediatric oncology palliative care unit

Objetivo: El objetivo de esta investigación es comprender las percepciones de las familias acerca de los efectos de clowns de hospital en la calidad de vida de niños y familias en una unidad de cuidados paliativos pediátricos oncológicos de un hospital público chileno. Método: Bajo un diseño de tipo cualitativo, emergente, transversal y estrictas consideraciones éticas, utilizamos la técnica de entrevistas en profundidad y grupo de discusión. 16 madres que pasaron por la experiencia de cuidados paliativos con sus hijos fueron entrevistadas usando un guion en base a 6 dimensiones de calidad de vida: percepción sobre actividad física y salud, estado psicológico, autoestima, familia, amistades y escuela. Además, se efectuó un grupo de discusión con las madres para consolidar lo social de los temas del análisis de las entrevistas. Las transcripciones y los documentos se analizaron primero por separado y luego se realizó un proceso de triangulación de datos. Un paradigma interpretativista guía el análisis a través de las técnicas teoría fundamentada y análisis del discurso. Resultados: Los discursos de las participantes revelan que la presencia de clowns produce efectos psicológicos en la regulación emocional, además de ser un mecanismo para sobrellevar tanto los periodos de cuidados paliativos como los de después del fallecimiento al establecer vínculos “familiares” con los clowns. Asimismo, tanto los clowns como el espacio que estos ocupan en el hospital inciden en la construcción de comunidad en este contexto sanitario, aspecto de suma relevancia para las familias en el cuidado provisto. Conclusiones: La presencia de clowns incide especialmente en 2 de las 6 dimensiones de calidad de vida, el estado psicológico y las relaciones familiares, siendo además de suma relevancia en este contexto para proporcionar cuidado humanizado, contribuyendo a sobrellevar la situación a las madres durante los cuidados paliativos y tras el fallecimiento de sus hijos. (AU)

Objective: The aim of this research was to understand the perceptions of families about the effects of hospital clowns on the quality of life of children and their families in an Oncological Palliative Care Unit of a Chilean public hospital. Method: Under a qualitative, emergent, cross-sectional design and strict ethical considerations, we used an in-depth interview technique and discussion group. Sixteen mothers who went through the experience of palliative care with their children were interviewed using a script based on 6 quality of life dimensions: perception of physical activity and health, psychological state, self-esteem, family, friends and school. In addition, a discussion group was held to consolidate the topics of the analysis of the interviews. The transcripts and documents were first analyzed separately and then a data triangulation process was performed. An interpretivist paradigm guides the analysis, through discourse analysis and grounded theory techniques. Results: The discourses of participants reveal that the presence of clowns produces psychological effects on emotional regulation, as well as being a mechanism to cope with both the periods of palliative care and after death by establishing “family” ties with clowns. Likewise, both the clowns and the space they occupy in the hospital affect the construction of community in this health context, an aspect of great relevance for families in the the type of care provided. Conclusions: The presence of clowns has impacts especially on 2 of the 6 quality-of-life dimensions, psychological state and family relationships, being also highly relevant in the context of delivering humanized care, helping mothers to cope with the situation during palliative care and after the death of their children. (AU)

A educação emocional pode influenciar na qualidade das competências e habilidades da Enfermagem? / Can emotional education influence the quality of nursing skills and abilities? / ¿Puede la educación emocional influir en la calidad de las habilidades y habilidades de enfermería?

Objetivo: Discutir as contribuições das competências e habilidades emocionais, identificadas no trabalho de enfermeiras e enfermeiros, em atuação em serviços da Rede de Atenção à Saúde, no município de João Pessoa - PB, para a qualificação do cuidado integral, afetuoso e humanizado ao indivíduo, família e comunidade. Método: Pesquisa de abordagem quantitativa e qualitativa, desenvolvida em serviços da Rede de Atenção à Saúde do município de João Pessoa ­ PB. Os dados foram coletados com base no Inventário de Educação Emocional Gonsalves (IEEG). Para o processamento dos dados utilizou-se o Epidemiological Information (EpiInfo), versão 3.5.2. Resultados: A partir da análise das respostas dos enfermeiros e enfermeiras pesquisados foram evidenciadas duas expressões de emoções: "empatia e o altruísmo". Conclusões: Dentre os núcleos de competências requeridas no trabalho de enfermagem, observa-se que para o núcleo "Cuidado de Enfermagem na Atenção à Saúde Humana", existem distintas assertivas que se sobressaem caracterizando a empatia e o altruísmo, a quais são potencializadoras das ações das enfermeiras e enfermeiros no exercício da prática profissional, sendo determinantes para a produção do cuidado integral, afetuoso e humanizado em saúde. (AU)

Objective: To discuss the contributions of emotional skills and abilities, identified in the work of nurses and nurses, working in services of the Health Care Network, in the city of João Pessoa - PB, for the qualification of comprehensive, affectionate and humanized care to the individual , family and community. Methods: Research with a quantitative and qualitative approach, developed in services of the Health Care Network in the city of João Pessoa - PB. Data were collected based on the Gonsalves Emotional Education Inventory (IEEG). For data processing, Epidemiological Information (EpiInfo), version 3.5.2 was used. Results: From the analysis of the responses of the nurses and nurses surveyed, two expressions of emotions were evidenced: "empathy and altruism". Conclusion: Among the core competencies required in nursing work, it is observed that for the core "Nursing Care in Human Health Care", there are different assertions that stand out characterizing empathy and altruism, which enhance actions nurses and nurses in the exercise of professional practice, being determinant for the production of comprehensive, affectionate and humanized health care. (AU)

Objetivo: Discutir las contribuciones de las habilidades y habilidades emocionales, identificadas en el trabajo de enfermeras y enfermeras, que trabajan en los servicios de la Red de Atención de Salud, en la ciudad de João Pessoa - PB, para la calificación de la atención integral, afectiva y humanizada para el individuo, la familia y la comunidad. Métodos: Investigación con enfoque cuantitativo y cualitativo, desarrollada en los servicios de la Red de Atención de la Salud de la ciudad de João Pessoa - PB. Los datos se recolectaron con base en el Inventario de Educación Emocional de Gonsalves (IEEG). Para el procesamiento de datos se utilizó Información Epidemiológica (EpiInfo), versión 3.5.2. Resultados: A partir del análisis de las respuestas de los enfermeros y enfermeros encuestados, se evidenciaron dos expresiones de emociones: "empatía y altruismo". Conclusion: Entre las competencias centrales requeridas en el trabajo de enfermería, se observa que para el núcleo "Atención de Enfermería en la Atención de la Salud Humana", se destacan diferentes aseveraciones que caracterizan la empatía y el altruismo, que potencian las acciones de enfermeras y enfermeras en el ejercicio de la profesión. práctica, siendo determinante para la producción de una atención de salud integral, afectuosa y humanizada. (AU)

Influence of humanized care on self-efficacy, sleep and quality of life of patients in cardiovascular surgery intensive care unit.

OBJECTIVE: The present study aims to investigate the influence of humanized care on self-efficacy, sleep quality (SQ) and quality of life (QOL) of patients in a cardiovascular surgery intensive care unit (CSICU). METHODS: A total of 134 patients hospitalized in CSICU from July, 2017 to September, 2019 were randomly allocated into control group and observation group, of which 64 in control group were given routine nursing care, and 70 in observation group were given humanized care additionally. The cardiopulmonary function, self-efficacy, SQ, incidence of adverse reactions, anxiety and depression, QOL, and patient satisfaction were evaluated. RESULTS: After nursing, patients in the observation group showed enhanced cardiopulmonary function and self-efficacy, better SQ and QOL, as well as lower incidence of adverse reactions and anxiety and depression, and higher satisfaction. CONCLUSION: Humanized care contributes to the recovery of cardiopulmonary function, and is effective in alleviating anxiety and depression and enhancing self-efficacy, SQ and QOL of patients in CSICU.

Effect of humanized care in the treatment of neonatal jaundice and its effect on oxygen saturation.

OBJECTIVE: This study aimed to investigate the effect of humanized care in the treatment of neonatal jaundice and its effect on oxygen saturation. METHODS: A total of 202 infants with neonatal jaundice admitted to our hospital from January 2018 to June 2020 were divided into group A (n=102) and group B (n=100) according to their parents' choice. Group A received humanized care and group B received routine nursing. The clinical efficacy, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL) levels and arterial blood oxyhemoglobin saturation (SaO2), cerebral oxygen saturation (rSO2), mean arterial pressure (MAP) levels were determined between the two groups. RESULTS: Compared with group B, group A had significantly shorter time of fetal stool turning yellow, time of jaundice regression and duration of blue light irradiation (P < 0.05), lower serum AST, ALT and TBIL levels (P < 0.05), higher levels of SaO2, rSO2 and MAP (P < 0.05), higher average sleep time per day and mean daily milk consumption (P < 0.05). The incidence of adverse events in group A was significantly lower than that in group B (P < 0.05). Parental satisfaction with care in group A was significantly higher than that in group B (P < 0.05). CONCLUSION: Humanized care can significantly improve the prognosis and recovery speed and is conducive for SaO2 to return to normal level, and can reduce the adverse reactions with high parental satisfaction.

A lifeworld theory-led action research process for humanizing services: improving "what matters" to older people to enhance humanly sensitive care.

Purpose: Using a theory-led action research process test applicability of humanizing care theory to better understand what matters to people and assess how the process can improve human dimensions of health care services. Consideration of the value of this process to guide enhancements in humanly sensitive care and investigate transferable benefits of the participatory strategy for improving human dimensions of health care services. Methods: Action research with service users, practitioners and academics, with participatory processes led through the application of theory via a novel Humanizing Care Framework in two diverse clinical settings. Results: Participants engaged in a theory-led participatory process, understood and valued the framework seeing how it relates to own experiences. Comparative analysis of settings identified transferable processes with potential to enhance human dimensions of care more generally. We offer transferable strategy with contextualized practical details of humanizing processes and outcomes that can contribute to portable pathways to enhance dignity in care through application of humanizing care theory in practice. Conclusion: The theoretical framework is a feasible and effective guide to enhance human dimensions of care. Our rigorous participative process facilitates sharing of patient and staff experience, sensitizing practitioners' understandings and helping develop new ways of providing theoretically robust person-centred care based on lifeworld approaches.

Desafios do Brincar com Idosos: Narrativas de Estudantes de Medicina do Programa Amigos do Sorriso / Challenges of Playing with the Elderly: Medicine Students Narratives of the Amigos do Sorriso Program

Resumo: Introdução: O programa de extensão Amigos do Sorriso foi construído a partir da compreensão da extensão universitária como integrante da formação dos estudantes, ao proporcionar vivências e trocas na aproximação entre a academia e a sociedade em geral. Os participantes são estudantes da área da saúde e desenvolvem atividades lúdicas com foco no processo de humanização, na educação em saúde e nos seus efeitos multiplicadores. Desde 2010, o programa realiza atividades quinzenais numa instituição de longa permanência para idosos (Ilpi), com o objetivo de oportunizar momentos lúdicos, com estratégias criativas e comunicativas, no sentido de ressignificar a velhice por meio do brincar. Este artigo tem como objetivos descrever as vivências e compreender quais foram os aprendizados desenvolvidos pelos estudantes de Medicina nesse âmbito. Método: Trata-se de uma pesquisa qualitativa, desenvolvida a partir de 13 narrativas redigidas entre 2018 e 2019 por estudantes de Medicina que participaram das atividades lúdicas na Ilpi. Realizou-se análise temática de conteúdo dos materiais em diálogo com os referenciais teóricos e a literatura relacionada. Resultados: As três categorias temáticas foram: o brincar com o idoso, construção artesanal da comunicação e partilha entre gerações sobre o envelhecer. Os extensionistas discutiram as diversas formas do brincar, sua relação com a promoção da saúde e as especificidades de desenvolver atividades lúdicas com o idoso. Utilizaram diversas formas de comunicação para interação com os idosos, conversando, ouvindo e contando histórias e respeitando os silêncios, o que provocou encontros e desencontros, todos disparados pelo brincar. Discutiram sobre o processo de envelhecimento, a saúde do idoso, a velhice asilar e o próprio encontro de gerações por meio do qual puderam refletir sobre si mesmos. Conclusões: As atividades na Ilpi proporcionaram aos estudantes a percepção da potência das estratégias lúdicas, promotoras da autonomia e saúde, sem infantilização dos idosos. Possibilitaram o reconhecimento de estratégias para aproximação e vínculo, respeitando limites individuais e coletivos, ao compartilharem histórias e sentimentos de forma empática. Dessa forma, destaca-se o desenvolvimento de competências para o futuro médico, tanto gerais como para o cuidado com as pessoas idosas, no reconhecimento de que todos estão envolvidos no universo do florescer do envelhecimento.

Abstract: Introduction: The community outreach program Amigos do Sorriso (Friends of Smiling) is based on the understanding that community outreach programs are part of academic training because they provide experiences that result in exchanges between the students and the society. The participants are undergraduate students from the healthcare field, who develop ludic activities focusing on humanization, health education and the resulting multiplying effects. Since 2010, fortnightly activities have been conducted at an old people's home with the aim of offering playful experiences involving creative and communicative strategies, in order to give new meaning to old age through playing. The objective of this article is to describe these experiences and understand what the medicine students have learned from them. Methods: this article presents a qualitative study, based on 13 narratives written between 2018 and 2019 by undergraduate medicine students who were involved in activities at the old people's home. The content was analyzed from a thematic perspective and correlated to the theoretical framework. Results: Three thematic categories were identified: playing with the elderly, handcrafted construction of communication and sharing between generations about aging. The participants discussed the different forms of play, its relations with health promotion and the specific characteristics of developing Ludic activities with the elderly. Through play they were also able to explore various forms of communication: talking, listening, sharing stories, and respecting the moments of silence, that led to agreement and disagreement. Finally, they discussed the aging process, elderly heath, elderly people in care and the contact itself between generations, allowing the students to reflect on themselves. Conclusions: The activities in the old people's home enabled the students to appreciate the potential that strategies of play offer in terms of promoting autonomy and health, without infantilizing the elderly. It allowed them to identify strategies to form closer relationships and ties with the elderly subjects, respecting individual and collective boundaries when sharing stories and feelings with empathy. Hence the highlight of the program was the development of skills, both general and specific for elderly care, among future medics, recognizing that the aging is a process that involves us all.

Bioética Sinfonológica aplicada al cuidado humanizado de la mujer durante el parto en Cuba / Symphonological Bioethics Applied to Humanized Women Care during Childbirth in Cuba

Introducción: La enfermería obstétrica desarrolla como un objetivo fundamental de su actuar, el cuidado humanizado a la mujer durante su proceso de parto, para ello requiere conocimientos científicos y valores humanos, éticos y morales, aspectos en los cuales se enfoca la teoría de la Bioética Sinfonológica. Objetivo: Relacionar las contribuciones teóricas de la teoría Bioética Sinfonológica al logro del cuidado humanizado a la mujer durante el parto en los servicios obstétricos hospitalarios cubanos. Métodos: Se realizó una revisión bibliográfica sistemática para desarrollar un análisis crítico reflexivo de documentos durante los meses de septiembre-octubre del 2018. Se utilizaron las bases de datos bibliográficas: PubMed, CUMED, CINAHL, CUIDEN PLUS, Lilacs y Metabuscador Google Scholar. Los términos de búsqueda incluyeron las palabras clave en inglés y en portugués, para su delimitación se utilizó el tesauro de Descriptores en Ciencias de la Salud (DeCS). El operador booleano utilizado fue el AND. Se siguieron los principios de análisis de contenido, incluyendo la identificación de significados que se señalaban de forma más repetitiva, la consistencia, explicaciones y relaciones de estos, a través de todos los estudios incluidos en esta revisión. Conclusiones: La sinfonología le aporta al profesional de la Enfermería Obstétrica un incentivo para un cambio de paradigma respecto al proceso del parto enfocado al logro de su humanización al impulsar el cuidado humanizado enmarcado en la mujer como protagonista de su propio parto desde el respeto a sus derechos(AU)

Introduction: Obstetric nursing develops, as a fundamental objective of its action, the humanized care of women during the childbirth process. For this, it requires scientific knowledge and human, ethical and moral values, aspects focused within the bioethical theory of symphonology. Objective: To relate the theoretical contributions of the bioethical theory of symphonology to the achievement of humanized care for women during childbirth in Cuban hospital obstetric services. Methods: A systematic literature review was carried out, in order to develop a critical reflexive analysis of documents during the months from September to October 2018. The bibliographic databases used were PubMed, CUMED, CINAHL, CUIDEN PLUS, Lilacs, and the metasearch engine Google Scholar. The search terms included keywords in English and Portuguese. For their definition, the Thesaurus of Descriptors in Health Sciences (DeCS) was used. The Boolean operator used was AND. Principles of content analysis were followed, including the identification of meanings that were pointed out more repetitively, together with consistency, explanations and relationships among these, throughout all the studies included in this review. Conclusions: Symphonology provides the obstetric nursing professional with an incentive for a paradigm shift regarding the process of childbirth focused on the achievement of their humanization, insofar as it promotes humanized care focused on women as the protagonist of her own birth upon respect for her delivery-related rights(AU)

O "singular" do projeto terapêutico: (im)possibilidades de construções no CAPSi / The singular of therapeutic project: (im)possibilities of constructions in CAPSi / El "singular" del proyecto terapéutico: (im) posibilidades de construcciones en CAPSi

O presente estudo tem como objetivo compreender como são consideradas as singularidades do usuário no processo da construção de seu Projeto Terapêutico Singular, a partir da percepção dos profissionais da equipe de um Centro de Atenção Psicossocial da Infância e Adolescência, localizado no interior do Rio Grande do Sul. A pesquisa, de caráter exploratório e descritivo, e de natureza qualitativa utilizou, como método de obtenção de dados, a técnica do grupo focal, o qual ocorreu em um encontro, com seis profissionais de núcleos profissionais distintos do Centro de Atenção Psicossocial da Infância e Adolescência em questão. Os dados foram submetidos à técnica de Análise de Conteúdo, resultando em três categorias: Considerações sobre o singular na construção do Projeto Terapêutico Singular; O desejo e seus (des)encontros no processo do Projeto Terapêutico Singular; O Projeto Terapêutico Singular como uma possibilidade de construção no Centro de Atenção Psicossocial da Infância e Adolescência. Considera-se que o Projeto Terapêutico Singular é um instrumento de trabalho utilizado no campo da saúde mental, o qual possibilita o enlace entre instituição e sujeito, ao pensar sua totalidade e incluir nesse processo seu contexto sócio-histórico-cultural, família, sua singularidade e desejos. Evidencia-se como essencial considerar o usuário em um lugar de sujeito singular nesse processo, ao modo que esse caracteriza o Projeto Terapêutico Singular e possibilita um cuidado humanizado.

The present study aims to comprehend how the singularities of the user are considered in the process of constructing of their Singular Therapeutic Project, based on the perception of the staff of a Center for Psychosocial Attention of Infancy and Adolescence, located in the interior of Rio Grande do Sul. The research of exploratory and descriptive character, of a qualitative nature was used as a method of obtaining data from the focal group technique, which occurred in one meeting, with six professionals of different professional areas from the Center for Psychosocial Attention of Infancy and Adolescence in question. The data were submitted to a content analysis technique, which resulted in three categories, being: Considerations about the singular in the construction of the Singular Therapeutic Project; Desire and its (dis) encounters in the Singular Therapeutic Project process; The singular therapeutic project as a building possibility in Center for Psychosocial Attention of Infancy and Adolescence. It is considered that the Singular Therapeutic Project is a working tool used in the field of mental health which allows the link between institution and subject, considering its totality and including in this process its socio-historical-cultural context, family, its singularity and desires. It is essential to consider the user in a place of singular subject in this process, as it characterizes the Singular Therapeutic Project and allows a humanized care.

El presente estudio tiene como el objetivo de comprender cómo se consideran las singularidades del usuario en el proceso de la construcción de su Proyecto Terapéutico Singular, a partir de la percepción de los profesionales del equipo de un Centro de Atención a la Infancia y Adolescencia, ubicado en el interior de Rio Grande do Sul. La investigación, de carácter exploratorio y descriptivo, y de naturaleza cualitativa, ha utilizado como método de obtención de datos, la técnica de grupo focal, que ha ocurrido en un encuentro; con seis profesionales de núcleos profesionales distintos del Centro de Atención Psicosocial de la Infancia y Adolescencia en cuestión. Los datos fueron sometidos a la técnica de Análisis de Contenido, resultando en tres categorías: Consideraciones sobre lo singular en la construcción del Proyecto Terapéutico Singular; El deseo y sus (des)encuentros en el proceso del Proyecto Terapéutico Singular; El Proyecto Terapéutico Singular como una posibilidad de construcción en el un Centro de Atención a la Infancia y Adolescencia. Se considera que el Proyecto Terapéutico Singular es un instrumento de trabajo utilizado en el campo de la salud mental, el cual posibilita un enlace entre institución y sujeto, al pensar en su totalidad e incluir en ese proceso su contexto socio-histórico-cultural, familia, su singularidad y deseos. Se evidencia como esencial considerar al usuario en un sitio de sujeto singular en ese proceso, de modo que eso caracteriza al Proyecto Terapéutico Singular y posibilita un cuidado humanizado.

Qualidade do cuidado na Rede de Atenção Psicossocial: experiências de usuários no Nordeste do Brasil / Quality of care in the Psychosocial Care Network: experiences of users in the Northeast of Brazil

Resumo Este artigo objetiva compreender, com base nas experiências de usuários, como se revela a qualidade do cuidado na Rede de Atenção Psicossocial (RAPS). Trata-se de pesquisa qualitativa crítico-interpretativa, desenvolvida por meio de análise de prontuários, observação sistemática e entrevistas narrativas com usuários (e seus familiares) em três serviços da RAPS de Fortaleza-CE. Os resultados apontaram a humanização e a integralidade enquanto dimensões da qualidade do cuidado, em seus aspectos formais, a centralidade dos psicofármacos, a ambiência e os aspectos relacionais nos modos de cuidar. Conclui-se que somente uma rede pautada pela qualidade do cuidado é capaz de fazer face à complexidade das demandas e de garantir resolutividade e a promoção de autonomia e cidadania às pessoas com sofrimento psíquico.

Abstract This article aims to understand, based on users' experiences, how the quality of care in the Psychosocial Care Network (RAPS) is revealed. This is a critical-interpretative qualitative research, developed through the analysis of medical records, systematic observation and narrative interviews with users (and their families) in three RAPS services in Fortaleza-CE, Brazil. The results pointed to humanization and comprehensiveness as dimensions of the quality of care, in its formal aspects, the centrality of psychoactive drugs, the ambience, and the relational aspects in care modes. It concludes that only a network based on the quality of care is able to cope with the complexity of the demands and to guarantee resolutiveness and the promotion of autonomy and citizenship to people with psychic suffering.

Concepción integral del cuidado humanizado a la mujer durante el trabajo de parto y parto / Comprehensive Perspective about Humanized Care to Women during Labor and Delivery

RESUMEN Introducción: El reto actual de los profesionales de enfermería es valorar la persona no como objeto sino como sujeto de cuidado. El cuidado de enfermería durante el trabajo de parto y parto requiere de consideraciones especiales hacia la mujer al implicar la sensibilidad y la creatividad en la acción de cuidar. Objetivo: Identificar los referentes teóricos y metodológicos que sustentan el cuidado humanizado a la mujer durante el trabajo de parto y parto. Métodos: Revisión bibliográfica sistemática para desarrollar un análisis crítico reflexivo del contenido de documentos, artículos originales y de revisión disponible en Internet, así como de tesis de maestrías y doctorado publicados entre 1992 y 2015 en español portugués e inglés. La búsqueda fue realizada en la base de datos Google académico de marzo a mayo de 2016, las palabras clave utilizadas fueron "cuidados"; "cuidados humanizados"; "trabajo de parto y parto"; "profesionales de enfermería". Tras la identificación de los estudios pre-seleccionados se llevó a cabo la lectura de los títulos, resumen y palabras clave, comprobando la pertinencia con el estudio. Conclusiones: Se fundamenta la relevancia del cuidado humanizado que se le brinda a la mujer durante el trabajo de parto y parto pues conlleva a la satisfacción de las necesidades físicas, emocionales y espirituales de la mujer(AU)

ABSTRACT Introduction: The current challenge of nursing professionals is to evaluate the person not as an object but as a subject of care. Nursing care during labor and delivery requires special considerations for women, involving sensitivity and creativity in the act of caring. Objective: To identify the theoretical and methodological references that support humanized care for women during labor and delivery. Methods: Systematic bibliographic review for developing a reflexive-critical analysis of the content of documents, original and review articles available on the Internet, as well as master's degree theses and doctoral dissertations published between 1992 and 2015 in Spanish, Portuguese and English. The search was made in the database Academic Google, from March to May 2016. The keywords used were cuidados [care];cuidados humanizados [humanized care], trabajode parto y parto [labor and delivery],profesionales de enfermería [ nursing professionals]. After the identification of the pre-selected studies, the titles, summary and key words were read, verifying their relevance with the study. Conclusions: The relevance of the humanized care to women during labor and delivery is based on the satisfaction of the physical, emotional and spiritual needs of women(AU)

Percepción de las usuarias sobre calidad del cuidado humanizado que brinda el profesional de enfermería / Perception of users on quality of humanized care provided by the nursing professional

El presente artículo está orientado a determinar la percepción y satisfacción de las usuarias sobre la calidad del cuidado Humanizado que brinda el Profesional de Enfermería en el Hospital Gineco Obstétrico y Neonatal Dr. Jaime Sánchez Porcel. Es un estudio cuantitativo, de tipo descriptivo y de corte transversal. Como técnica de recolección de datos se utilizó la entrevista y como instrumento el cuestionario, la muestra del estudio estuvo conformado por 136 usuarias a quiénes se les aplico una encuesta y 14 Licenciadas en Enfermería a las que se aplicó la ficha de observación, que permitió describir la situación actual de la atención brindada por el personal de Enfermería. Se aplicó tratamiento estadístico descriptivo a los datos y se obtuvo los resultados de que un 48.97% de las usuarias indica que existe una baja satisfacción con referencia al cuidado humanizado que brinda el profesional de enfermería, el 49.48% indica que no son atendidas oportunamente, y el 46.39 90% manifiesta su insatisfacción con la atención recibida por parte del personal de enfermería. Se concluye que el cuidado humanizado es dado en forma regular y es necesario implementar estrategias, planes de mejoras y capacitación continua con la finalidad de generar la sensibilización del personal de enfermería para aplicar buen trato al paciente desde un abordaje basado en valores humanos.

This article is aimed at determining the perception and satisfaction of the users about the quality of Humanized care provided by the Nursing Professional at the Dr. Jaime Sánchez Porcel Gynecological and Neonatal Hospital. It is a quantitative, descriptive and cross-sectional study. The interview was used as a data collection technique and as a questionnaire instrument, the sample of the study was made up of 136 users to whom a survey was applied and 14 Nursing Graduates to whom the observation sheet was applied, which allowed describing the current situation of the care provided by the Nursing staff. Descriptive statistical treatment was applied to the data and the results were obtained that 48.97% of the users indicate that there is low satisfaction with reference to the humanized care provided by the nursing professional, 49.48% indicate that they are not treated in a timely manner, and 46.39 90% expressed dissatisfaction with the care received by the nursing staff. It is concluded that humanized care is given on a regular basis and it is necessary to implement strategies, improvement plans and continuous training in order to generate the awareness of nursing staff to apply good treatment to the patient from a human values based approach.