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1.
Res Theory Nurs Pract ; 32(4): 400-412, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30567912

RESUMO

Background and Purpose: Although lifestyle interventions have been shown to be effective in losing weight and increasing physical activity in community settings, little is known whether these programs may also ameliorate negative mood states in healthy overweight/obese adults when such programs are delivered in workplace settings. The aim of the study was to determine whether a health partner program may alleviate depressive symptoms among healthy overweight/obese individuals at 1 year. Methods: A secondary data analysis was performed using the Center for Health Discovery and Well Being database at Emory University in the United States. A total of 297 healthy overweight/obese university employees were recruited from the health partner program. Participants worked with health partners to establish an individualized health action plan, which might include changes in diet or exercise, modification of risk-related behaviors (e.g., tobacco use, alcohol use), and stress reduction strategies such as yoga. Depressive symptoms were measured by the Beck Depression Inventory-II at baseline and one-year follow-up. Results: At baseline, 9.7% of participants had depressive symptoms. At one-year follow-up, these participants had a small-to-moderate improvement in depressive symptoms (Cohen's d = 0.423), and the changes in depressive symptoms were statistically significant (p < 0.001). Implications for Practice: Since overweight/obese individuals are more likely to experience depressive symptoms than normal-weight individuals, early interventions to steer these individuals to better mental health are therefore essential. This study has demonstrated the potential benefits of a health partner program on alleviating depressive symptoms among overweight/obese individuals and this should be integrated into clinical practice.


Assuntos
Transtorno Depressivo/psicologia , Comportamentos Relacionados com a Saúde , Relações Enfermeiro-Paciente , Obesidade Mórbida/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/enfermagem , Sobrepeso/complicações , Sobrepeso/enfermagem , Sobrepeso/psicologia , Resultado do Tratamento
2.
Aust Crit Care ; 31(1): 37-41, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28320611

RESUMO

BACKGROUND: Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care. OBJECTIVE: To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients. METHODS: A focused ethnographic approach was adopted. Participant observation of care practices and interviews with intensive care doctors and nurses were undertaken over a four month period. Qualitative analysis was conducted using constant comparison. SETTING: An 18 bedded tertiary intensive care unit in New Zealand. PARTICIPANTS: Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40kg/m2. FINDINGS: Morbidly obese patients present significant physical and language challenges for intensive care practice. The physical shape of morbidly obese patients did not appropriately fit the different equipment used. Staff used specific knowledge of the patient's body size and shape to adapt care practices and keep patients safe and comfortable. There were also specific language challenges where staff expressed concern about what words were most appropriate to use to describe body mass when in the presence of morbidly obese patients. CONCLUSIONS: Bariatric care pathways need to be developed that use more suitable body measurements to inform the use of bariatric equipment. Intensive care staff need to engage in debate about what is acceptable, respectful, and appropriate language in the delivery of bariatric patient care.


Assuntos
Antropologia Cultural , Estado Terminal/enfermagem , Unidades de Terapia Intensiva , Obesidade Mórbida/enfermagem , Adulto , Feminino , Humanos , Masculino , Nova Zelândia , Pesquisa Qualitativa
3.
Res Theory Nurs Pract ; 31(4): 393-401, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29137697

RESUMO

BACKGROUND AND PURPOSE: Currently, there is no guideline or standard of practice for performing the psychiatric/psychological evaluation that is a requirement for approval for bariatric surgery. The Readiness to Change for Bariatric Surgery Assessment Tool (RCB-SAT) establishes a means for psychiatric evaluators to objectively assess the patient's cognition, beliefs, and motivation around the bariatric diet and lifestyle changes. Development of a clinical decision-making tool for assessing readiness to change in bariatric patients will be useful regarding The Strategic Plan for NIH Obesity Research. The strategic plan outlines 6 overarching themes, with the last 3 centering around creation of such a clinical decision-making tool to assess a bariatric patient's readiness to change: evaluate promising strategies for obesity prevention and treatment in realworld settings and diverse populations, harness technology and tools to advance obesity research and improve health care delivery, and facilitate integration of research results into community programs and medical practice (National Institutes of Health, 2011). METHODS: The pilot tool was administered to 153 potential bariatric patients, with 61 patients completing the survey a second time. Face and content validity of the items were established through an expert review process. RESULTS: Principle axis factoring by means of varimax rotation with Kaiser normalization identified 15 items loading on 3 factors associated with Prochaska and DiClemente's transtheoretical model of health behavior change: precontemplation, contemplation, and action (DiClemente & Prochaska, 1998). Test-retest reliability was also established for the tool. IMPLICATIONS FOR PRACTICE: The proposed RCB-SAT demonstrates potential for assessing a patient's readiness to change regarding the bariatric diet and lifestyle.


Assuntos
Comportamentos Relacionados com a Saúde , Obesidade Mórbida/cirurgia , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Obesidade Mórbida/enfermagem , Obesidade Mórbida/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
5.
J Wound Ostomy Continence Nurs ; 44(3): 293-298, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28472817

RESUMO

BACKGROUND: A 54-year-old morbidly obese woman with a small bowel obstruction and large ventral hernia was admitted to hospital. She underwent an exploratory laparotomy, lysis of adhesions, and ventral hernia repair with mesh placement. She subsequently developed an enteroatmospheric fistula; several months of hospital care was required to effectively manage the wound and contain effluent from the fistula. METHODS: Several approaches were used to manage output from the fistula during her hospital course. She was initially discharged to a skilled nursing facility where a fistula management pouch was used for several months to encompass the wound and contain effluent, but this method ultimately proved ineffective. The fistula was then isolated using a collapsible enteroatmospheric fistula isolation device and an ostomy appliance to contain effluent. CONCLUSION: The application of the collapsible enteroatmospheric fistula isolation and effluent containment devices in conjunction with negative-pressure wound therapy produced positive patient outcomes; it improved patient satisfaction with fistula management, promoted wound healing, and diminished cost.


Assuntos
Fístula Intestinal/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Complicações Pós-Operatórias/enfermagem , Cicatrização , Técnicas de Fechamento de Ferimentos Abdominais/enfermagem , Técnicas de Fechamento de Ferimentos Abdominais/normas , Feminino , Enfermagem Domiciliar/métodos , Enfermagem Domiciliar/normas , Humanos , Laparotomia/efeitos adversos , Pessoa de Meia-Idade , Tratamento de Ferimentos com Pressão Negativa/normas , Obesidade Mórbida/complicações , Obesidade Mórbida/enfermagem , Estomia/instrumentação , Nutrição Parenteral Total/enfermagem
6.
West J Nurs Res ; 39(8): 1151-1168, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28322638

RESUMO

This cross-sectional, descriptive study explored perspectives of discharge planners regarding transitions of hospitalized patients who are severely obese seeking discharge to a nursing home. Attention has been focused on care transitions regarding high hospital readmission rates, yet specific needs of patients who are severely obese have been largely overlooked. Ninety-seven (response rate 39.8%) discharge planners returned surveys addressing frequency of, and issues encountered when, arranging placements. Community and hospital characteristics were also collected. One third of the respondents from Pennsylvania and Arkansas reported inability to transfer patients; barriers included reimbursement, staffing, and equipment. Respondents perceiving nursing homes to have equipment concerns were nearly 7 times more likely to report patient size as a barrier ( p = .001). Given increasing obesity rates, health care delivery systems must be prepared to provide necessary resources and all levels of care, including transitions for hospitalized patients who are severely obese needing nursing home care post-discharge.


Assuntos
Hospitais/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Obesidade Mórbida/enfermagem , Alta do Paciente/estatística & dados numéricos , Arkansas , Estudos Transversais , Humanos , Pennsylvania , Inquéritos e Questionários , Recursos Humanos
7.
Crit Care Nurse ; 36(5): 17-26, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27694354

RESUMO

More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment.


Assuntos
Atitude do Pessoal de Saúde , Índice de Massa Corporal , Enfermagem de Cuidados Críticos/métodos , Unidades de Terapia Intensiva/organização & administração , Obesidade Mórbida/enfermagem , Guias de Prática Clínica como Assunto , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Obesidade Mórbida/diagnóstico
9.
Crit Care Nurse ; 36(4): 58-63, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27481802

RESUMO

Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36[4]:58-63).


Assuntos
Índice de Massa Corporal , Comorbidade , Enfermagem de Cuidados Críticos/organização & administração , Hospitalização/estatística & dados numéricos , Obesidade Mórbida/enfermagem , Cuidados Críticos/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/terapia , Prognóstico , Medição de Risco , Resultado do Tratamento
10.
Int J Nurs Stud ; 58: 82-89, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27087301

RESUMO

BACKGROUND: Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges in the intensive care setting. These are resultant from specific physiological responses to critical illness in this population and the nature of the interventional therapies used in the intensive care environment. An additional challenge arises for this population when considering the social stigma that is attached to being obese. Intensive care staff therefore not only attend to the physical and care needs of the critically ill morbidly obese patient but also navigate, both personally and professionally, the social terrain of stigma when providing care. AIM: To explore the culture and influences on doctors and nurses within the intensive care setting when caring for critically ill morbidly obese patients. DESIGN AND METHODS: A focused ethnographic approach was adopted to elicit the 'situated' experiences of caring for critically ill morbidly obese patients from the perspectives of intensive care staff. Participant observation of care practices and interviews with intensive care staff were undertaken over a four month period. Analysis was conducted using constant comparison technique to compare incidents applicable to each theme. SETTING: An 18 bedded tertiary intensive care unit in New Zealand. PARTICIPANTS: Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40kg/m(2). FINDINGS: Interactions between intensive care staff and morbidly obese patients were challenging due to the social stigma surrounding obesity. Social awkwardness and managing socially awkward moments were evident when caring for morbidly obese patients. Intensive care staff used strategies of face-work and mutual pretence to alleviate feelings of discomfort when engaged in aspects of care and caring. This was a strategy used to prevent embarrassment and distress for both the patients and staff. CONCLUSIONS: This study has brought new understandings about intensive care situations where social awkwardness occurs in the context of obesity and care practices, and of the performances and behaviours of staff in managing the social awkwardness of fat-stigma during care situations.


Assuntos
Atitude do Pessoal de Saúde , Unidades de Terapia Intensiva , Obesidade Mórbida/terapia , Comportamento Social , Antropologia Cultural , Humanos , Relações Enfermeiro-Paciente , Obesidade Mórbida/enfermagem , Relações Médico-Paciente
11.
Oncol Nurs Forum ; 43(3): 273-6, 2016 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-27105188

RESUMO

Increasing weight and body fat composition has an impact on cancer detection and staging. Obese women are less likely to engage in breast and cervical screening practices. Excessive adipose tissue makes physical assessment more difficult, and patients with a BMI greater than 35 kg/m2 may have deeper and wider pelvic structures, which make internal examinations problematic. A retrospective review of 324 primary surgical patients found that patients with a BMI greater than 40 kg/m2 are seven times less likely to undergo complete surgical staging for endometrial cancer compared with individuals with a BMI less than 40 kg/m2. In addition, healthcare provider bias against the need for screening, feelings of discomfort and embarrassment, as well as patient's fears of guilt, humiliation, and shame pose significant barriers to addressing the issue of obesity in clinical care with patients and family members. 
.


Assuntos
Índice de Massa Corporal , Comorbidade , Detecção Precoce de Câncer , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/enfermagem , Obesidade Mórbida/complicações , Obesidade Mórbida/enfermagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Endométrio/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Estudos Retrospectivos
12.
Home Healthc Now ; 34(3): 140-5, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26925939

RESUMO

Obesity is becoming more prevalent in the United States with almost 40% of the population being overweight or obese. A new category, defining super obesity as a body mass index of 50 or higher, has been added. The purpose of this article is to use a case study to develop a more thorough understanding of the complex care needs of the super obese patient and how home healthcare clinicians can use technology to advocate for super obese patients who are home and bedbound. A review of the literature and discussion will be provided. Potential technologies involved in provision of care will also be explored. Finally, a summary of the case along with proposed solutions will be offered.


Assuntos
Visitadores Domiciliares , Enfermagem Domiciliar/métodos , Pacientes Domiciliares/reabilitação , Obesidade Mórbida/enfermagem , Índice de Massa Corporal , Progressão da Doença , Custos de Cuidados de Saúde , Visitadores Domiciliares/economia , Enfermagem Domiciliar/economia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/economia , Medição de Risco , Estados Unidos
13.
J Nurs Meas ; 24(3): 340-355, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-28714441

RESUMO

BACKGROUND AND PURPOSE: Nurses' attitudes play an important role in the consistent practice of safe patient handling behaviors. The purposes of this study were to develop and assess the psychometric properties of a newly developed instrument measuring attitudes of nurses related to the care and safe handling of patients who are obese. METHODS: Phases of instrument development included (a) item generation, (b) content validity assessment, (c) reliability assessment, (d) cognitive interviewing, and (e) construct validity assessment through factor analysis. RESULTS: The final data from the exploratory factor analysis produced a 26-item multidimensional instrument that contains 9 subscales. CONCLUSIONS: Based on the factor analysis, a 26-item instrument can be used to examine nurses' attitudes regarding patients who are morbidly obese and related safe handling practices.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Obesidade Mórbida/enfermagem , Segurança do Paciente , Psicometria/normas , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/prevenção & controle , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas
14.
J Appl Gerontol ; 35(3): 286-302, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25515758

RESUMO

PURPOSE OF THE STUDY: Care challenges have been described for hospitalized morbidly obese (MO) patients. These challenges likely persist post discharge. As a result, nursing homes (NHs) may be reluctant to admit these patients, potentially leaving them "stranded in hospitals". This study identified issues NHs consider in admission decisions for MO patients transitioning from hospitals. DESIGN AND METHOD: Approved surveys were mailed to nursing directors at federally-certified NHs in Arkansas (n = 234) and Pennsylvania (n = 710) to collect NH experience in the admission of patients weighing ≥ 325 pounds. Analyses included descriptive and inferential statistics to summarize and identify predictors of MO patient admission decisions. RESULTS: In total, 360 surveys were returned (38.1% response rate). Although two-thirds of respondents reported patient size as an admission barrier, only 6% reported that MO patients were always refused admission. Adjusted analysis showed that NHs with adequate staff were significantly (p = .04) less likely to report obesity as an admission barrier whereas NHs reporting concerns about availability of bariatric equipment were significantly (p < .0001) more likely to report obesity as a barrier. IMPLICATIONS: Lack of staff and bariatric equipment in NHs appears to negatively affect the transition of MO patients out of the hospital to NHs. Additional research, including examination of current regulations and reimbursement policies, should be undertaken to understand NH staffing and equipment acquisition decisions in light of the current obesity epidemic. Such research has implications for the optimal care of obese individuals during times of transition.


Assuntos
Casas de Saúde/estatística & dados numéricos , Obesidade Mórbida/enfermagem , Admissão do Paciente/estatística & dados numéricos , Transferência de Pacientes , Arkansas , Estudos Transversais , Bases de Dados Factuais , Humanos , Modelos Logísticos , Pennsylvania , Inquéritos e Questionários , Recursos Humanos
15.
Arch Psychiatr Nurs ; 29(2): 76-82, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25858198

RESUMO

BACKGROUND: Obesity is a critical social and health issue, adversely impacting life expectancy, quality of life, and mental health. Minorities are disproportionately impacted by obesity with African Americans experiencing the highest prevalence among minority groups. PURPOSE: The aim of this study was to determine if a lifestyle program that integrated chair exercises, nutrition and educational counseling, and scripture readings would help under-served obese African American women make lifestyle changes that would positively impact their quality of life, especially mental health. METHODS: A repeated measures intervention study was conducted (24-weeks). Weeks 1-12 involved meeting twice a week for a total of 4h with participants engaged in chair exercises, educational counseling, and scripture readings. During weeks 13-24, the participants were "on their own" but were encouraged to exercise and eat healthy. Focus groups were held at 12 and 24-weeks. Participants were recruited from a nurse managed center and a primary care clinic for the uninsured. Mental health data were collected at baseline, 12, and 24-weeks. The Medical Outcomes Study Short Form Version 2 (SF-36v2) was used to measure changes in mental health. Higher scores indicate better perceived health status. Group scores less than 47 indicate impaired functioning. FINDINGS: 55 women had complete data for all three data collection points, with a mean age of 50 and a mean BMI of 41.2. Repeated ANOVAs detected significant differences on the mental component summary of the SF-36v2: this score improved from baseline (M=44.1) to 12-weeks (M=50.7) but decreased at 24-weeks (M=47.9) (p=.000). The four domains (vitality, social functioning, role emotional, mental health) were also significantly different over the three data collection points. IMPLICATIONS: The findings have significant implications for psychiatric nurses in terms of education, clinical practice, and future research. The study contributed to the participants' mental health through the various group activities including scripture readings, socialization with "like minded" women and structured exercises. These findings offer psychiatric nurses additional tools for effective care.


Assuntos
Afro-Americanos/psicologia , Estilo de Vida Saudável , Obesidade Mórbida/etnologia , Obesidade Mórbida/enfermagem , Afro-Americanos/estatística & dados numéricos , Bíblia , Terapia Combinada , Aconselhamento , Estudos Transversais , Exercício , Feminino , Educação em Saúde , Humanos , Pessoa de Meia-Idade , Necessidades Nutricionais/etnologia , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/psicologia , Religião e Psicologia
16.
Rehabil Nurs ; 40(2): 92-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25044311

RESUMO

PURPOSE: The purpose of this article is to describe the care of a "super bariatric" patient. DESIGN AND METHODS: We used a case study approach to describe the complex interdisciplinary care challenges posed in the care of a super bariatric patient at a Veterans Administration Hospital in the Midwest. FINDINGS: Nurses and other healthcare providers discovered ways to provide high-quality patient-centered care under challenging conditions and also ensure the safety and well-being of nursing staff and other providers. CONCLUSIONS/CLINICAL RELEVANCE: An interdisciplinary, patient-centered approach with advance planning and coordination is necessary to ensure the delivery of safe, high-quality nursing care to veterans with complex health problems who are "super bariatric."


Assuntos
Bariatria/métodos , Obesidade Mórbida/enfermagem , Obesidade Mórbida/reabilitação , Equipe de Assistência ao Paciente/organização & administração , Assistência Centrada no Paciente/organização & administração , Enfermagem em Reabilitação/organização & administração , Veteranos , Adulto , Bariatria/instrumentação , Educação Continuada em Enfermagem , Pessoal de Saúde , Hospitais de Veteranos , Humanos , Masculino , Recursos Humanos de Enfermagem , Segurança do Paciente , Guias de Prática Clínica como Assunto , Qualidade da Assistência à Saúde , Wisconsin
17.
Br J Nurs ; 23(2): 95-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24605393

RESUMO

Gastric banding is an established and effective form of weight-loss surgery. However, the nursing contribution to it remains largely unexplored. Using semi-structured interviews, this study explored the experiences and opinions of 20 purposively recruited patients about their nurses' contribution to weight-loss surgery. The data were analysed using thematic analysis. Three themes emerged. First, the provision of knowledge and fostering of understanding, both before and after surgery, focusing on information that addresses patients'needs. Second, staying in touch throughout the treatment period,being available whenever problems arise and advice or interventions are needed. The third theme concerned qualities demonstrated by the nurses. Open-minded patient engagement combined with person centered care fostered confidence in patients and promoted a close therapeutic relationship. Nurses make a substantial contribution to weight-loss surgery, caring for their patients' physical, surgical and,most importantly, psychosocial needs. Their role descriptions should emphasise the psychological, supportive aspects of this role.


Assuntos
Gastroplastia/enfermagem , Obesidade Mórbida/enfermagem , Obesidade Mórbida/cirurgia , Pacientes/psicologia , Enfermagem Perioperatória , Adulto , Idoso , Feminino , Gastroplastia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Metodológica em Enfermagem , Obesidade Mórbida/psicologia , Percepção , Pesquisa Qualitativa
18.
Rev. eletrônica enferm ; 15(4): 886-896, out.-dez. 2013.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: lil-717973

RESUMO

Questiona-se a percepção dos profissionais de enfermagem sobre as pessoas que fazem cirurgia para redução de peso, objetivando compreender o cuidado da enfermagem às pessoas que se submetem a esta cirurgia. Pesquisa compreensiva realizada por meio de entrevistas semiestruturadas e observação participante junto aos profissionais de enfermagem, no período de fevereiro a maio de 2011. A análise utilizada foi a temática e as categorias encontradas foram: o cuidado ao corpo físico, que relaciona o conhecimento técnico-científico às condições adequadas de trabalho e de recurso humanos, asseguradas legalmente, mas não garantidas institucionalmente; e o cuidado ao corpo social, que diz respeito às tecnologias relacionais, com ênfase na observação, na escuta, na fala, no diálogo e no vínculo. Os resultados evidenciam que a perspectiva sociocultural valoriza os comportamentos, as crenças e os significados como elementos importantes para a qualificação do cuidado.


This study investigated the perception that nursing professionals make of weight reduction surgery patients, aiming to understand the nursing care that is provided to people who undergo this particular surgery. This comprehensive study was performed by means of semi-structured interviews and participant observation of nursing professionals, in the period from February to May of 2011. Thematic analysis was used and the identified categories were: physical body care, which relates technical-scientific knowledge with adequate working and staffing conditions, legally ensured, but not institutionally guaranteed; and social body care, which refers to relational technologies, with emphasis on observation, listening, talking, dialogue and bonding. Results show that the sociocultural perspective values behaviors, beliefs, and meanings as important elements to improve the quality of care.


Se apunta a averiguar la percepción de los profesionales de enfermería acerca de las personas que se efectúan cirugía de reducción de peso, objetivando comprender el cuidado de enfermería para dichas personas. Investigación comprensiva, realizada mediante entrevistas semiestructuradas y observación participante, con los profesionales de enfermería, de febrero a mayo de 2011. Se utilizó análisis temático, las categorías encontradas fueron: el cuidado del cuerpo físico, que relaciona el conocimiento técnico-científico con las adecuadas condiciones laborales y de recursos humanos, aseguradas legalmente pero no garantizadas institucionalmente; y el cuidado al cuerpo social, que se expresa respecto a las tecnologías relacionales, con énfasis en la observación, la escucha, el discurso, el diálogo y el vínculo. Los resultados evidenciaron que la perspectiva sociocultural valoriza los comportamientos, las creencias y los significados como elementos importantes para la calificación del cuidado.


Assuntos
Humanos , Cirurgia Bariátrica/enfermagem , Cirurgia Bariátrica/psicologia , Cuidados de Enfermagem , Obesidade Mórbida/enfermagem
20.
Gastroenterol Nurs ; 36(2): 129-35, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23549216

RESUMO

The prevalence of obesity in the United States has more than doubled from 1980 to 2008. Obesity leads to a multitude of comorbidities, most notably diabetes and cardiovascular diseases, resulting in more than $147 billion annually in healthcare costs. Bariatric surgery is becoming a common weight loss option for morbidly obese individuals. Studies in this review examine patients who have undergone laparoscopic adjustable gastric banding or Roux-en-Y gastric bypass surgery. Patients initially lose large amounts of weight postoperatively; unfortunately, around 30% of these individuals begin to regain weight 18-24 months after surgery. The purpose of this article is to analyze the current literature to ascertain which self-care variables are predictors of successful long-term weight loss after bariatric surgery. The studies analyzed in this review found that patients who undergo a surgical weight loss intervention lose more weight faster than patients who do not have a surgical weight loss intervention. However, patients reported feeling unprepared for the extreme psychosocial and lifestyle changes after bariatric surgery. Findings from these studies point to the need for future research in the area of postsurgical psychosocial support for successful long-term weight loss maintenance.


Assuntos
Cirurgia Bariátrica/enfermagem , Obesidade Mórbida/enfermagem , Autocuidado , Perda de Peso , Cirurgia Bariátrica/métodos , Índice de Massa Corporal , Doenças Cardiovasculares/complicações , Complicações do Diabetes , Derivação Gástrica/enfermagem , Gastroplastia/enfermagem , Humanos , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Valor Preditivo dos Testes , Qualidade de Vida , Fatores de Risco , Inquéritos e Questionários , Resultado do Tratamento
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