A critical perspective on institutional violence against hospitalized children: Testimonies by health professionals and family members.

The purpose of this study is to understand institutional violence (IV) in the relationships between health professionals, hospitalized children, and family members. This is a qualitative study developed at the pediatric inpatient unit of a university hospital in the city of Salvador, Bahia, Brazil. The research participants consisted of 39 health professionals who specialized in pediatrics and 10 family members of hospitalized children. Semi-structured interviews were the method used for data collection. Using discourse analysis as a basis and taking a Foucauldian perspective, the researchers observed that the expressions of IV could be traced to abusive power relations within the system. We found four discursive forms within the data set: communication problems as IV, violence through inattention and neglect, violence as an action and consequent materialization on the body, and psychological violence as a submission mechanism. Based on these findings, we argue that professionals, managers, the scientific community, and users might be able to better guarantee the safety of children by recognizing IV and effectively intervening in it.

A policy analysis of teamwork as a proposal for healthcare humanization: implications for nursing.

AIM: To analyse the implications of the political devices of the Brazilian National Humanization Policy, Singular Therapeutic Project and Reference Team and Matrix Support, for nursing as a professional discipline. BACKGROUND: The Brazilian Unified Health System, SUS-Brazil, has as its principles regarding health care: universal access at all levels of care; equality and non-discrimination; integrality; community participation; and political and administrative decentralization, regionalization, and hierarchization. The National Humanization Policy is a public health policy that serves as the methodological apparatus for the application of the SUS-Brazil principles. Reference Teams refers to inter- and transdisciplinary/professional teams. These team approaches are associated with increased quality of care. METHODS: Qualitative lexical content policy analysis of the official documents for the Brazilian National Humanization Policy. FINDINGS: The Reference Team model that is used to carry out Singular Therapeutic Projects leads to discussion of disciplinary boundaries in the context of health care. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The Brazilian National Humanization Policy demands inclusion of various kinds of knowledge and networking. Research is needed to elucidate the nature of nursing care and its distinctive character in relation to the work objectives of other professional disciplines.

Psychometric properties analysis of helping relationships skills inventory for Portuguese nurses and doctors.

This paper answered some authors' requests to analyze the Helping Relationships Skills Inventory psychometric properties, a four dimensions measure. At this level, the study contributed to accessing the first reliable and valid instrument headed to Portuguese nurses and doctors. Methods: An online survey with Portuguese nurses and doctors (n = 262) was managed to assess the psychometrics properties analysis of the Helping Relationships Skills Inventory. Data were analyzed using descriptive statistics, confirmatory factor analysis, the average variance extracted (AVE), the heterotrait-monotrait ratio of correlations (HTMT), Cronbach's Alpha, and McDonald's Omega were computed. Results: The four-factor of the original Helping Relationships Skills Inventory was only supported by Exploratory Factor Analysis, with good internal consistency. Our study accepted this correlational structure hypothesis, which demonstrated acceptable to good sensitivity, convergent validity (AVE: 0.84-0.67), and reliability (Cronbach's Alpha: 0.92-0.88; McDonald'Omega: 0.93-0.79). Also stays verified discriminant validity for the majority of the factors with some reserves between Generics and Emphatics dimensions (HTMT: 0.90), revealing high commonality among them (r = 0.84; p < .001) Conclusions: The findings support the sensitivity, construct validity, and reliability of the Helping Relationships Skills Inventory among Portuguese nurses and doctors. However, will be useful to associate qualitative methodologies to explore the phenomenon better.

Humanized oncology nursing care in a person with gastric cancer: A case report.

Cancer impacts the person's physical health, psychosocial and spiritual wellbeing. The humanization of care is an essential element to achieve integral wellbeing of the individual. The aim of this article is to present a clinical case, using the nursing process with the NANDA, NOC and NIC taxonomies, and based on the principles of Watson's theory of humanized care. The participant is a 45-year-old woman with gastric cancer in palliative stage. The assessment was performed using Gordon's functional patterns and the Watson Caritas Patient Score scale to evaluate the care received previously in the health system. Eight nursing diagnoses were identified, prioritizing 3 diagnoses using the clinical reasoning web (decisional conflict, anxiety, and ineffective self-management of health). Expected outcomes and nursing interventions were planned and implemented through moments of care using health education through tele-nursing and the intentional use of Caritas processes of care in the transpersonal relationship. The results were evaluated with the scales of the indicators and anxiety was also evaluated with the Beck Anxiety Inventory. Health education in oncology nursing contributed to improve informed decision making, reducing anxiety and providing emotional support to facilitate self-management of health. The participant perceived as humanized care throughout the sessions, reflected in the final evaluation with the Watson Caritas Patient Score scale.

Factors associated with puerperal women's perception of the support received from their companions during labor and delivery.

OBJECTIVE: The aim of the current study was to associate sociodemographic characteristics and satisfaction with the support received from companions during labor and delivery. METHOD: An analytical cross-sectional study was performed in a maternity hospital in Fortaleza, Brazil, from March to August 2019, with 320 postpartum women. A form containing sociodemographic and obstetric questions, companion-related information, type of support provided, and the Birth Companion Support Questionnaire (BCSQ) were used to assess the frequency of social support behaviors. χ2 and Fisher exact tests were used for statistical analyses. RESULTS: Nonpharmacological methods were associated with an unsatisfactory perception of support, but the emotional support provided by companions was positively associated with women's satisfaction. CONCLUSION: The findings of the current study concerning women's perceptions of the support received from their companions may allow improvements in the delivery of care to women in labor toward the humanization of obstetric practices.

[Humanized prenatal care in Latin America: a stat of the art]. / Atención prenatal humanizada en américa latina: un estado del arte.

Objetive: To identify contributions of the scientific literature produced in the 2009-2019 period in Latin America on humanized prenatal care. Data sources:Articles produced in Latin America that addressed humanized prenatal care, published between 2009 and 2019 in indexed journals (reported in MIAR) and located in recognized databases, were selected. Study selection: A selection based on the source, quality and relevance of the studies was taken into account, excluding gray literature. After applying filters, 26 articles were obtained. Data extraction: The data was recorded, subsequently using an analytical matrix for its coding. Data: the studies, especially from Colombia and Brazil, were largely qualitative. It is established that the quality of care is reflected in the accessibility and satisfaction of the users with the services. Humanized prenatal care affects maternal-perinatal health. The recognition of the particular needs of pregnant women is relevant. The studies recommend qualifying health personnel to strengthen humanized prenatal care, assuming pregnant women as protagonists of the process, dispelling their doubts and concerns, and providing evidence on the relationship humanized prenatal care / reduction of maternal morbidity and mortality. Conclusions: The studies carried out recognize the pregnant woman as the protagonist and her needs as the starting point for humanized prenatal care, conceived as an essential reference for the quality of services with a positive impact on the satisfaction of pregnant women and maternal outcomes. Training of health personnel is required.

Objetivo: Identificar aportes de la literatura científica producida en el periodo 2009-2019 en América Latina sobre atención prenatal humanizada. Fuentes de datos: Se seleccionaron artículos producidos en América Latina que abordaran la atención prenatal humanizada, publicados entre 2009 y 2019 en revistas indexadas (reportadas en MIAR) y localizados en bases de datos reconocidas. Selección de los estudios: Se tuvo en cuenta una selección basada en la fuente, calidad y pertinencia de los estudios, excluyendo la literatura gris. Luego de aplicar filtros se obtuvieron 26 artículos. Extracción de datos: Los datos fueron fichados, utilizando posteriormente una matriz analítica para su codificación. Datos: los estudios, sobre todo provenientes de Colombia y Brasil, fueron en buena parte cualitativos. Se establece que la calidad de la atención se refleja en la accesibilidad y la satisfacción de las usuarias con los servicios. El cuidado prenatal humanizado incide en la salud materno-perinatal. Es relevante el reconocimiento de las necesidades particulares de las gestantes. Los estudios recomiendan cualificar el personal de salud para fortalecer el cuidado prenatal humanizado, asumir las gestantes como protagonistas del proceso, disipando sus dudas y preocupaciones y aportar evidencia sobre la relación atención prenatal humanizada/reducción de la morbimortalidad materna. Conclusiones: Los estudios realizados reconocen a la gestante como protagonista y sus necesidades como el punto de partida para la atención prenatal humanizada, concebida como referente esencial de la calidad de los servicios con impacto positivo sobre la satisfacción de las gestantes y los resultados maternos. Se requiere formar al personal de salud.

Satisfaction of Patients Undergoing Hand Surgery.

Objective To assess the satisfaction of patients undergoing hand surgery in relation to their hospitalization, their feelings, and the consequences resulting from the surgical procedure as well as to evaluate their opinion and feelings in relation to the surgical procedure and to detect possible weaknesses in the health care of patients undergoing hand surgery. Method Cross-sectional observational clinical study, with a quali-quantitative focus, carried out in an outpatient clinic of a teaching hospital specialized in hand care, with patients of both genders, aged 18 to 75 years, who have undergone corrective surgical procedures of hand pathologies in the last 5 years. Results We obtained a total of 54 participants, 26 females and 28 males, with a minimum age of 18 years and a maximum of 73 years. Patient satisfaction for the 11 moments evaluated had means between 8 and 10, showing great satisfaction. For the other five moments evaluated, the means were between five and eight. We did not get any satisfaction average below fivr. Conclusion The absolute satisfaction of patients undergoing hand surgery is dependent on the humanization of health care, especially in relation to surgical consequences, which require further follow-up. The surgical consequences that require greater follow-up and hinder the routine activities of patients are pain on hand mobilization, limitation of the range of motion, and parathesthesia; thus, proper management of these complaints leads to greater satisfaction.

The experience of giving birth in a hospital in Spain: Humanization versus technification.

AIM: To explore and describe the experiences of women giving birth in a tertiary public hospital, with special focus on experiences related to humanized care and women's participation in decision making. METHOD: This is a qualitative phenomenological study through semi-structured interviews to postpartum women giving birth in a tertiary hospital between January and May 2017. Data were analysed through content analysis. RESULTS: The two overarching themes emerged were the professional-information dyad and privacy. Subthemes of the first main theme were the therapeutic relationship, decision-making, feeding the baby, procedures, and the time factor. Subthemes of the second topic were the feelings generated by the hospital environment, the delivery room, and the maternity ward. CONCLUSIONS: If the therapeutic relationship is good, technology is not seen as dehumanising but rather as necessary to ensure continuing safety. "Humanising" material resources are not a priority for women in the birth process and are little used. Privacy was experienced as being a particularly intense need, which women called for throughout the healthcare process.

[Humanized care in a death for COVID-19: A case study]. / El cuidado humanizado en la muerte por COVID-19: a propósito de un caso.

The world population is experiencing a pandemic due to infection with the SARS-Cov-2 virus, which causes the COVID-19 disease. In Spain, the growth rate of the epidemic is 6.79% since the alarm activation with 9,1% of deaths of the total infected. Recommendations of the National Government to prevent health professional contagion include the placement of personal protection devices (FPP2 mask, gloves, waterproof gown, hat, and protective glasses or screen). Once healthcare professionals are using protective equipment, it is necessary to argue about the humanization of nursing caring in people suffering dying situation, who are infected with COVID-19, regarding a clinical case. The aim is to enhance nursing thinking to bridge that distance, and maintain care as human and close as possible, at the end of life.

Humanized Care from the Perception of Oncology Patients from Southern Chile.

OBJECTIVES: This work sought to determine the perception of behaviors of humanized nursing care and its relation with sociodemographic and clinical variables in patients hospitalized in a Hemato-Oncology Department. METHODS: Analytic cross-sectional study conducted with 51 patients hospitalized in the Hemato-Oncology Unit at Hospital Base Valdivia, Chile. A survey containing sociodemographic and clinical information was applied together with the questionnaire on Perception of Behaviors of Humanized Nursing Care 3rd version" -PBHNC 3v (32 items distributed in the categories: Qualities of nursing work, Openness to nurse-patient communication, and Willingness to care). RESULTS: Of the participants, 51% were women, with mean age of 46.5±16.6 years; 54.9% were diagnosed with Lymphoma and 78.4% were in the treatment induction stage. In 30 of the 32 items of the instrument, > 90% of the participants evaluated compliance with the behavior of caring at level of "always". By categories, it was observed that for "Willingness to care" there was significantly lower score among patients from 18 to 49 years of age (p=0.0455). For the category "Openness to nurse-patient communication" lower median score existed in patients with Myeloma (p=0.0043) and in patients in the Remission-Consolidation stage (p=0.0084). Days of hospitalization were associated significantly with the category "Willingness to care", being lower with 16 days and more (p=0.0242). CONCLUSIONS: High frequency was observed of humanized-care behaviors and small differences in their assessment that were associated with demographic factors like age, and clinical factors, like diagnosis, treatment stage, and days of hospitalization.

[Relational dynamics of primary health care teams and their impact on co-management]. / Dinámica relacional de los equipos de salud de atención primaria y su impacto en la construcción de la cogestión.

Co-management is one of the guidelines found in Brazil's National Humanization Policy, a policy that promotes the creation of collective spaces for its construction. Based on a social constructionist approach, qualitative research was carried out between 2015 and 2018 in order to describe and analyze the relational dynamics established in two primary care facilities - a Primary Care Unit and a Family Health Center - with the aim of analyzing organizational cultures and the social construction of co-management. Research was carried out in two phases: fieldwork and interviews. Given that the Family Health Center presented a culture closer to the idea of co-management, we describe and analyze factors contributing to this dynamic. Whereas in the case of the Primary Care Unit, which proved to be farther from co-management, we look at obstacles. Our goal is to demonstrate the complex and fluid nature of relational dynamics, and to show that their transformation requires that efforts be tailored to each specific context, and therefore the "implementation" of collective spaces is not sufficient on its own to generate effective co-management.

La cogestión es uno de los lineamientos de la Política Nacional de Humanización de Brasil, que propone la apertura de espacios colectivos como dispositivos para su construcción. Desde una perspectiva construccionista social, entre 2015 y 2018 se realizó una investigación cualitativa que buscó describir y analizar las dinámicas relacionales en dos contextos de atención primaria de la salud, una unidad de atención primaria tradicional y un centro de salud de la familia, con el propósito de abordar la cultura organizacional y el proceso de construcción social de la cogestión. El trabajo se llevó a cabo en dos etapas: el trabajo de campo y las entrevistas. El núcleo de salud familiar, al tener una cultura más cercana a la cogestión, se describen y analizan facilitadores, mientras que la unidad de atención primaria de la salud tradicional, al alejarse de la cogestión, se detallan los obstaculizadores. Buscamos mostrar que las dinámicas relacionales son complejas y fluidas y que, para su transformación, requieren de un trabajo artesanal y específico en cada contexto, por lo que la "implementación" de espacios colectivos no es suficiente para una cogestión efectiva.

Nursing Students' Relational Skills with Elders Improve through Humanitude Care Methodology.

Nursing students have difficulties interacting with cognitively impaired elders. This study aimed to identify students' difficulties in interacting with elders, the causes of the difficulties in interacting with elders, the strategies used to reduce these difficulties, and the importance attributed to the Structured Sequence of Humanitude Care Procedures (SSHCP). It also aimed to assess the contribution of the Humanitude Care Methodology (HCM) to the development of interaction skills in nursing students. An exploratory descriptive study with a quasi-experimental design was conducted with a sample of 64 nursing students during their hospital clinical training. A control group (usual training) and an experimental group (HCM training) were used. Data were collected through a questionnaire applied at baseline and follow-up. Content analysis, chi-square tests, and Student's t-tests were performed. The main difficulty identified was caring for agitated and confused elders. Difficulties were associated with a lack of theoretical-practical teaching, the clinical training context, lack of experience, and personality traits. HCM impacted positively on the development of students' interaction skills. This study shows that HCM is an innovative methodology in nursing education that will allow for moving from an instrumental and technicist education into a more humanized training capable of transforming care.

Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study.

BACKGROUND: Many women are victims of disrespect and abuse during childbirth period. In Brazil, the prevalence of these acts has varied between 11.3% and 18.3%. Despite the high prevalence and grave consequences of mistreatment of women during birth care, women's mental health during this period, and its determining factors, are still poorly understood. The main objective is to investigate the association between mistreatment of women during childbirth and postpartum depression. METHODS: national survey in childbirth care carried out between 2011 and 2012. The sample was composed of 23,378 puerperal women. Disrespect and abuse was composed by seven indicator.We assessed postpartum depression using Edinburgh Postnatal Depression Scale screening questions. We applied multigroup structural equation modelling (childbirth payment source), considering different theoretical models for vaginal births and C-sections. RESULTS: Disrespect and abuse towards women during childbirth were associated with postpartum depression both in the public and private sectors, for both vaginal births and C-sections. In the public healthcare sector, disrespect and abuse were associated with maternal hospitalization. Presence of fundal pressure manoeuvre, not be white, and not receiving the desired mode of birth (only for C-sections). In the private sector, for both vaginal births and C-sections, not having the desired mode of birth was the only characteristic associated with disrespect and abuse. CONCLUSION: Disrespect and abuse towards women during childbirth may contribute to the development of postpartum depression. Identifying its causes may help prevent the problem and strengthen public policies that favor the good quality of childbirth care.

Pôster como estratégia de aprendizado na disciplina de humanidades: contribuições para a formação do médico / Use of posters as a learning strategy in the humanities discipline: contributions to the training of medical professionals

RESUMO Introdução: Com a implementação do Sistema Único de Saúde (SUS) no Brasil, houve a reformulação do currículo médico sob uma perspectiva biopsicossocial. Para atender a essa demanda no âmbito acadêmico, o componente de humanidades médicas (HM) foi delineado para estimular reflexões interdisciplinares de cunho ético-humanista. A proposta é potencializada com o desenvolvimento de estratégias educacionais capazes de garantir a execução da disciplina no contexto das metodologias ativas. Nessa perspectiva, no ano de 2020, devido à pandemia da Covid-19, o formato tradicional de aulas presenciais necessitou de adaptação para o ensino remoto, o que suscitou a concepção e proposta de adoção de pôster criativo como recurso metodológico. Objetivo: Este estudo teve como objetivo analisar as possíveis contribuições da produção do pôster criativo para o aprendizado e processo de formação do médico, no contexto da disciplina de HM. Método: Trata-se de um estudo de abordagem qualitativa de viés exploratório-descritivo. A coleta foi realizada mediante entrevista individual semiestruturada, por meio virtual, no período de agosto a novembro de 2022. Após a transcrição, utilizou-se a análise de conteúdo temática desenvolvida por Bardin para auxiliar na análise dos relatos transcritos e na elaboração de unidades temáticas. A interpretação seguiu referenciais teóricos interdisciplinares do campo da saúde e componentes da disciplina de HM. Resultado: No total, 20 acadêmicos de uma universidade pública do estado do Pará compuseram a amostra deste estudo. A partir da organização e leitura das transcrições, emergiram as seguintes categorias: experiência no ensino presencial; experiência no ensino remoto; processo de elaboração do pôster; arte e humanidades médicas; contribuições da disciplina e do pôster. Conclusão: O uso da ferramenta pôster destaca o papel dos acadêmicos como protagonistas do seu aprendizado no recorte de HM. A maioria referiu o uso do pôster como elemento potencializador para a reflexão proposta pela disciplina, favorecido pela mediação da arte, em diversas modalidades de expressão. Houve a oportunidade de os acadêmicos exporem seus sentimentos e compreensões acerca de temáticas sensíveis à formação médica.

ABSTRACT Introduction: The implementation of the Unified Health System in Brazil led to a need to reformulate the medical curriculum from a biopsychosocial perspective. In the academic field, the Medical Humanities (MH) component has stimulated interdisciplinary reflections of an ethical-humanist nature. This exercise is streamlined with the development of educational strategies capable of guaranteeing the execution of the discipline in the context of active methodologies. From this perspective, in 2020, due to the COVID 19 pandemic, the traditional format of face-to-face classes was forced to be adapted for remote teaching, which led to the conception and proposal for adoption of posters as a methodological resource. Objective: To analyze the possible contributions of creative poster production to the physician's learning and training process, in the context of the medical humanities discipline. Method: A qualitative exploratory-descriptive approach. The data was collected through virtual, semi-structured, individual interviews, from August to November 2022. Following transcription of the interviews, thematic content analysis developed by Bardin (2011) was used to assist in the analysis of the transcribed reports and the development of thematic units. The interpretation followed interdisciplinary theoretical references in the field of health and components of the medical humanities discipline. Result: The study sample was composed of 20 academics from a public university in the state of Pará. From the organization and reading of the transcripts, the following thematic units emerged: experience in face-to-face teaching; experience in remote teaching; poster creation process; art and medical humanities; contributions from the discipline and the poster. Conclusion: The use of posters as a tool highlights the role of academics as protagonists of their own learning in the medical humanities field. The majority referred to the use of the poster as an element that enhanced the reflection proposed by the discipline, favored by the mediation of art, in different forms of expression. It offered an opportunity for academics to express their feelings and understandings about topics sensitive to medical training.

Reflexión sobre las ventajas y desventajas de trabajar en un servicio oncológico identificadas por estudiantes de posgrado en oncología, Facultad de Enfermería - Udelar

Desde el año 2017, la Facultad de Enfermería de la Universidad de la República forma licenciados especialistas en enfermería oncológica. Profesionales con competencias específicas para brindar cuidados en relación a la enfermedad asociada a la segunda causa de muerte en Uruguay. Cómo parte del proceso enseñanza-aprendizaje es necesario conocer el perfil de los estudiantes, a través de un sondeo diagnóstico aplicado a la generación en curso (2023/2024) se obtuvo información que da origen a la reflexión desarrollada en el manuscrito a continuación. La percepción de los estudiantes sobre las ventajas y desventajas que implican el ejercicio profesional de enfermería dentro de un servicio de oncología identificadas por los estudiantes. Ventajas que incluyen: aumento de los ingresos económicos, mejor régimen laboral y satisfacción personal. Desventajas que incluyen: desgaste emocional, riesgo ante la exposición a drogas antineoplásicas y riesgo ante el escaso marco normativo frente a la exposición a dichas drogas. Cómo conclusión se considera que la enfermería oncológica es un área que demanda compromiso interpersonal entre los profesionales y el usuario, este compromiso implica esfuerzo pero a su vez empodera los roles y conlleva a la satisfacción personal. A sí mismo, se identifica que es un área poco desarrollada a nivel de reglamentación en relación a la salud ocupacional. El equipo docente además de guiar y acompañar durante el proceso de aprendizaje busca formar profesionales con conciencia crítica capaces de identificar debilidades y amenazas del ejercicio, con la capacidad de generar cambios en pro del avance la de profesión y con ello, el avance de la calidad de atención.

Since 2017, the Faculty of Nursing of the University of the Republic has been training graduates specializing in oncology nursing. Professionals with specific skills to provide care in relation to the disease associated with the second cause of death in Uruguay. As part of the teaching-learning process, it is necessary to know the profile of the students; through a diagnostic survey applied to the current generation (2023/2024), information was obtained that gives rise to the reflection developed in the manuscript below. Students' perception of the advantages and disadvantages of professional nursing practice within an oncology service identified by students. Advantages that include: increased economic income, better work regime and personal satisfaction. Disadvantages that include: emotional exhaustion, risk from exposure to antineoplastic drugs and risk from the scarce regulatory framework against exposure to these drugs. In conclusion, it is considered that oncology nursing is an area that demands interpersonal commitment between professionals and the user. This commitment implies effort but at the same time empowers roles and leads to personal satisfaction. In itself, it is identified that it is an underdeveloped area at the level of regulation in relation to occupational health. The teaching team, in addition to guiding and accompanying during the learning process, seeks to train professionals with critical awareness capable of identifying weaknesses and threats in the practice, with the ability to generate changes in favor of the advancement of the profession and with it, the advancement of quality. of attention.

Desde 2017, a Faculdade de Enfermagem da Universidade da República forma licenciados especializados em enfermagem oncológica. Profissionais com competências específicas para prestar cuidados em relação à doença associada à segunda causa de morte no Uruguai. Como parte do processo de ensino-aprendizagem é necessário conhecer o perfil dos alunos através de um inquérito diagnóstico aplicado à geração atual (2023/2024), foram obtidas informações que dão origem à reflexão desenvolvida no manuscrito abaixo. Percepção dos estudantes sobre as vantagens e desvantagens da prática profissional de enfermagem dentro de um serviço de oncologia identificadas pelos estudantes. Vantagens que incluem: aumento do rendimento económico, melhor regime de trabalho e satisfação pessoal. Desvantagens que incluem: exaustão emocional, risco de exposição a medicamentos antineoplásicos e risco do escasso marco regulatório contra a exposição a esses medicamentos. Concluindo, considera-se que a enfermagem oncológica é uma área que exige comprometimento interpessoal entre profissionais e usuário. Esse comprometimento implica esforço, mas ao mesmo tempo potencializa papéis e leva à satisfação pessoal. Por si só, identifica-se que se trata de uma área subdesenvolvida ao nível da regulação em relação à saúde ocupacional. A equipe docente, além de orientar e acompanhar durante o processo de aprendizagem, busca formar profissionais com consciência crítica capaz de identificar fragilidades e ameaças na prática, com capacidade de gerar mudanças em favor do avanço da profissão e com ela, o avanço da qualidade da atenção.

Percepção de mães sobre a visitação aberta na unidade de terapia intensiva neonatal / Mothers' perception of open visitation in the neonatal intensive care unit / Percepción de las madres sobre las visitas abiertas en la unidad de cuidados intensivos neonatales

Objetivo: compreender a percepção de mães sobre a visitação aberta na unidade de terapia intensiva neonatal. Métodos: estudo descritivo, qualitativo, realizado por meio de entrevista semiestruturada e individualizada, em uma maternidade pública situada no interior de São Paulo, Brasil, em 2019. A amostra foi definida pelo método de saturação de dados e constou de 14 mães. Os dados foram submetidos a Análise de Conteúdo Temática. Resultados: elencaram-se duas categorias: evidenciando os benefícios da visitação aberta e desafios a serem superados. Os benefícios incluíram a satisfação em permanecer com o filho, participar dos cuidados, fortalecer o vínculo maternal, acompanhar a evolução do bebê, evidenciar a qualidade do cuidado e o envolvimento afetivo, redução de sentimentos negativos e visitação do pai no período noturno. Em contrapartida, os desafios incluíram a impossibilidade de permanecer com o filho, estar presente somente em horários pré-estabelecidos para receber informações de médicos, prioriza-las em relação as fornecidas pela enfermagem, receber informações parciais, ter receio em expressar as dúvidas e vivenciar sentimentos negativos. Conclusão: os achados deste estudo fornecem subsídios para que a equipe de saúde e os gestores promovam a adesão de mães à visitação aberta em unidades de terapia intensiva neonatais. (AU)

Objective: understand the perception of mothers about open visitation in the neonatal intensive care unit. Methods: descriptive, qualitative study, carried out through semi-structured and individualized interviews, in a public maternity hospital located in the interior of São Paulo, Brazil, in 2019. The sample was defined by the data saturation method and consisted of 14 mothers. Data were submitted to Thematic Content Analysis. Results: two categories were listed: showing the benefits of open visitation and challenges to be overcome. The benefits included the satisfaction of staying with the child, participating in care, strengthening the maternal bond, monitoring the baby's evolution, showing the quality of care and affective involvement, reducing negative feelings and visiting the father at night. On the other hand, the challenges included the impossibility of staying with the child, being present only at preestablished times to receive information from doctors, prioritizing it in relation to that provided by nurses, receiving partial information, being afraid to express doubts and experience negative feelings. Conclusion: the findings of this study provide support for the health team and managers to promote the adherence of mothers to open visitation in neonatal intensive care units. (AU)

Objetivo: comprender la percepción de las madres sobre la visita abierta en la unidad de cuidados intensivos neonatales. Métodos: estudio descriptivo, cualitativo, realizado a través de entrevistas semiestructuradas e individualizadas, en una maternidad pública ubicada en el interior de São Paulo, Brasil, en 2019. La muestra fue definida por el método de saturación de datos y estuvo conformada por 14 madres. Los datos se enviaron a Análisis de contenido temático. Resultados: se enumeraron dos categorías: mostrando los beneficios de la visita abierta y los desafíos a superar. Los beneficios incluyeron la satisfacción de quedarse con el niño, participar en los cuidados, fortalecer el vínculo materno, monitorear la evolución del bebé, mostrar la calidad del cuidado y el involucramiento afectivo, reducir los sentimientos negativos y visitar al padre por la noche. Por otro lado, los desafíos incluían la imposibilidad de quedarse con el niño, estar presente solo en horarios preestablecidos para recibir información de los médicos, priorizarla en relación a la brindada por enfermeras, recibir información parcial, tener miedo a expresar dudas y experimentar sentimientos negativos. Conclusión: los hallazgos de este estudio brindan apoyo al equipo de salud y gerentes para promover la adherencia de las madres a la visita abierta en las unidades de cuidados intensivos neonatales. básico sobre las conductas frente a los accidentes, a pesar de desconocieren el flujo de atención del servicio. (AU)

Problemas e intervenções de enfermagem identificados na consulta de enfermagem a pessoas que vivem com HIV / Nursing problems and interventions identified in the nursing consult for people living with HIV / Problemas e intervenciones de enfermería identificados en la consulta de enfermería para personas que viven con VIH

Objetivo: identificar os problemas e as respectivas intervenções registrados pelos profissionais de enfermagem no primeiro atendimento de pessoas que vivem com HIV em um Serviço de Atendimento Especializado de um Centro Municipal de Saúde. Método: trata-se de um estudo descritivo, quantitativo, retrospectivo e documental. Em um universo de 300 pacientes admitidos em 2021, foram incluídos 110 prontuários de ambos os sexos e adultos. Resultados: em 88,5% das consultas, os enfermeiros registraram problemas de natureza biológica/física e 91,6% das intervenções foram solicitações de exames laboratoriais. Em 47,3% não havia conexão entre o problema de enfermagem e a intervenção. Conclusão: os principais problemas e as intervenções identificadas durante a consulta de enfermagem estão relacionados com os aspectos físicos e biológicos das pessoas que vivem com HIV, demonstrando que o cuidado de enfermagem ainda está centrado em um paradigma biomédico e que urge ser superado.

Objective: to identify the problems and their interventions registered by nursing professionals in the first nursing consult of people living with HIV in a Specialized Care Service of a Municipal Health Center. Method: this is a descriptive, quantitative, retrospective and documentary study. In a universe of 300 medical records admitted in 2021, 110 patients of both sexes and adults were included.Results: in 88.5% of the consultations, nurses registered biological/physical problems and 91.6% of the interventions were requests for laboratory tests. In 47.3% there was no connection between the nursing problem and the intervention. Conclusion: the main problems and interventions identified during the nursing consultation are related to the physical and biological aspects of people living with HIV, demonstrating that nursing care is still attached to a biomedical paradigm and that it urgently needs to be overcome.

Objetivo: identificar los problemas y sus intervenciones registradas por los profesionales de enfermería en la primera consulta de enfermería de personas que viven con VIH en un Servicio de Atención Especializada de un Centro Municipal de Salud. Método:se trata de un estudio descriptivo, cuantitativo, retrospectivo y documental. En un universo de 300 historias clínicas admitidas en 2021, se incluyeron 110 pacientes de ambos sexos y adultos. Resultados: en el 88,5% de las consultas, las enfermeras registraron problemas biológicos/físicos y el 91,6% de las intervenciones fueron solicitudes de pruebas de laboratorio. En el 47,3% no hubo conexión entre el problema de enfermería y la intervención. Conclusión: los principales problemas e intervenciones identificados durante la consulta de enfermería están relacionados con los aspectos físicos y biológicos de las personas que viven con VIH, demostrando que el cuidado de enfermería todavía está apegado a un paradigma biomédico y que necesita ser superado con urgencia.

Representações sociais da humanização em pediatria hospitalar entre profissionais de saúde / Representaciones sociales de la humanización en pediatría hospitalaria entre profesionales de la salud / Social representations of humanization in hospital pediatrics among health professionals

RESUMO A humanização visa a transformação do modelo institucional de saúde por meio da valorização dos aspectos subjetivos, históricos e socioculturais dos processos de saúde e doença. Entretanto, por carregar múltiplos sentidos, sua implementação tem sido um desafio em diversos serviços públicos de saúde. Diante disso, este trabalho teve como objetivo apreender as representações sociais sobre humanização na pediatria entre profissionais de saúde que atuam neste contexto. Trata-se de uma pesquisa qualitativa, realizada em um hospital universitário do Nordeste, que contou com a participação de 12 profissionais de saúde de oito categorias. Para apreensão dos dados recorreu-se à entrevista semiestruturada, cujos dados foram analisados por meio da análise categorial temática. Os dados permitiram a construção de três categorias temáticas: o contexto da pediatria, práticas assistenciais e humanização. Constatou-se que embora seja gratificante trabalhar na pediatria, existem dificuldades nas relações entre os próprios profissionais e entre os profissionais e as cuidadoras das crianças. As práticas assistenciais respaldam-se principalmente em valores humanísticos expressos nas vinculações afetivas e no uso eficaz do raciocínio clínico e dos materiais. A humanização, por sua vez, foi representada predominantemente por valores humanísticos, embora existam alguns elementos representacionais que referenciem aspectos da Política Nacional de Humanização. Constatou-se a ausência de argumentos pautados no direito do usuário a uma assistência de qualidade. Fazem-se necessárias, portanto, ações que possam promover reflexões e estratégias em humanização, no sentido de favorecer ressignificações no modo de pensar e concretizar a proposta da humanização em saúde.

RESUMEN La humanización tiene como objetivo transformar el modelo institucional de salud mediante la valoración de los aspectos subjetivos, históricos y socioculturales de los procesos de salud y enfermedad. Sin embargo, debido a que tiene múltiples significados, su implementación ha sido un desafío en varios servicios de salud pública. Por lo tanto, este estudio tuvo como objetivo aprehender las representaciones sociales de la humanización en pediatría entre los profesionales de la salud que trabajan en este contexto. Es una investigación cualitativa, realizada en un hospital universitario del noreste, con la participación de doce profesionales de la salud de ocho categorías. Para aprehender los datos, se utilizó una entrevista semiestructurada, cuyos datos se analizaron mediante análisis categórico temático. Los datos permitieron la construcción de tres categorías temáticas: el contexto de la pediatría, las prácticas de atención y la humanización. Se descubrió que, aunque es gratificante trabajar en pediatría, existen dificultades en las relaciones entre los propios profesionales y entre los profesionales y los cuidadores de los niños. Las prácticas de atención se basan principalmente en valores humanísticos expresados ​​en lazos afectivos y en el uso efectivo del razonamiento clínico y los materiales. La humanización, a su vez, estuvo representada predominantemente por valores humanistas, aunque hay algunos elementos de representación que se refieren a aspectos de la Política Nacional de Humanización. Se encontró la ausencia de argumentos basados en el derecho del usuario a una asistencia de calidad. Por lo tanto, es necesario tomar acciones que puedan promover reflexiones y estrategias en humanización, a fin de promover nuevos significados en la forma de pensar y concretar la propuesta de humanización en salud.

ABSTRACT. Humanization aims at transforming the institutional model of health by valuing the subjective, historical and socio-cultural aspects of health and disease processes. However, because it carries multiple meanings, its implementation has been a challenge in several public health services. Therefore, this study aimed to apprehend the social representations about humanization in pediatrics among health professionals who work in this context. It is a qualitative research, carried out in a university hospital in the northeast, with the participation of twelve health professionals from eight categories. To apprehend the data, a semi-structured interview was used, whose data were analyzed through thematic categorical analysis. The data allowed the construction of three thematic categories: the context of pediatrics, care practices and humanization. It was found that although it is gratifying to work in pediatrics, there are difficulties in the relationships between the professionals themselves and between the professionals and the caregivers of the children. Care practices are mainly supported by humanistic values ​​expressed in affective ties and in the effective use of clinical reasoning and materials. Humanization, in turn, was represented predominantly by humanistic values, although there are some representational elements that refer to aspects of the National Humanization Policy. The absence of arguments based on the user's right to quality assistance was found. Therefore, it is necessary to take actions that can promote reflections and strategies in humanization, in order to promote new meanings in the way of thinking and concretizing the proposal of humanization in health.

Cuidados en salud humanizados: Construyendo camino desde la universidad

Introducción: La formación de estudiantes de la salud sobre buen trato y cuidado humanizado es fundamental, al ser un referente de calidad en la atención sanitaria. Lo anterior, debería ser coherente con el trato que reciben los estudiantes por parte de docentes y tutores clínicos, modelando culturas más humanizadas. Sin embargo, investigaciones evidencian la normalización del maltrato a estudiantes de medicina y enfermería. Se implementó una Unidad de Formación Humanizada en una escuela de enfermería chilena, que incluyó potenciar un Programa de acompañamiento a los estudiantes por parte de sus docentes entre 2020 y 2021. Objetivo: Indagar los impactos del Programa en el ejercicio de un cuidado humanizado, desde la perspectiva estudiantil. Material y Método: Estudio de caso intrínseco con enfoque cualitativo. Se realizaron 12 entrevistas semiestructuradas vía zoom a jóvenes que habían sido tutorizados virtualmente, por docentes del Programa entre 1 mes y 2 años durante su período estudiantil. Análisis de datos con el método de las comparaciones constantes y cumplimiento de criterios de rigor cualitativo. Resultados: El Programa tuvo impactos positivos en ámbitos personales, académicos y profesionales, permitiendo que los estudiantes se sintieran cuidados por sus docentes y reconociendo el desarrollo de habilidades transferibles a su relación con los usuarios para un cuidado más humanizado. Conclusiones: El Programa es replicable a otras carreras e instituciones, requiriendo tiempo, disposición y capacitación docente, lo cual puede ser una limitación. Los beneficios evidenciados justifican la utilidad del Programa para potenciar culturas de cuidado más humanizado en espacios educativos y sanitarios.

Background: The training of health students regarding good treatment and humanized care is essential; it is a quality benchmark in health care. The relevance of good treatment and humanized care should be consistent with the treatment students receive from teachers and clinical tutors, modeling humanized cultures. However, research shows the normalization of mistreatment of medical and nursing students. A Humanized Training Unit was implemented in a Chilean nursing school, which included promoting a support Program for students by their teachers between 2020 and 2021. Aim: Explore the Program's impact on the exercise of humanized care from the student's perspective. Material and Methods: An intrinsic case study with a qualitative approach, with the objective of 12 semi-structured interviews carried out via Zoom with young people who had been tutored virtually by program teachers for one month and two years during their student period. We performed the data analysis using the constant comparisons method and in compliance with qualitative rigor criteria. Results: The Program positively impacted personal, academic, and professional areas, allowing students to feel cared for by their teachers and recognizing the development of skills transferable to their relationship with users for more humanized care. Conclusions: The Program is replicable to other careers and institutions, requiring time, disposition, and teacher training, which can be a limitation. The benefits evidenced by our study demonstrate the program's usefulness in promoting cultures of more humanized care in educational and health spaces.

Vídeo educativo participativo para humanização da assistência em saúde / Participatory educational video for the humanization of health care

Comunicar más notícias envolve, além de conhecimentos, complexidades afetivas e éticas. Sensibilizar médicos utilizando um vídeo participativo sobre a comunicação de más notícias em Unidade de Terapia Intensiva Neonatal, fundamentado no SPIKES e na antropologia visual. Qualitativa, descritiva exploratória, em três etapas: 1) Diagnóstico-participação de médicos e mães; 2) Desenvolvimento-produção do vídeo; e 3) Avaliação-percepção de médicos sobre o vídeo. Foi utilizada análise de conteúdo de Bardin.A Etapa 1 indicou: ambiência inadequada, pouca preocupação com as mães, pouco suporte emocional, inadequado convite para o diálogo, linguagem e comunicação inadequadas, pouca empatia e necessidade de melhorar a humanização. Sobre o vídeo baseado na Etapa 1, a percepção dos médicos indicou: aumento do seu grau de responsabilidade, reflexão sobre suas práticas profissionais e estímulo ao aprendizado teórico e à empatia nas relações profissionais na Unidade de Terapia Intensiva. Há dificuldades no processo de comunicação de más notícias, e a utilização de vídeo educativo participativo representa importante estratégia de incentivo à humanização da assistência em saúde.

Delivering bad news involves not only knowledge, but also affective and ethical difficulties.To raise the awareness of physicians using a participatory video about delivering bad news in an Intensive Care Therapy, based on SPIKES and on visual anthropology. Qualitative, descriptive, and exploratory study in three stages: 1) Diagnosis - participation of physicians and mothers; 2) Development - video production; 3) Evaluation - perception from physicians about the video. Bardin's content analysis was used;Stage 1 showed: inadequate environment, little concern about the mothers, little emotional support, inadequate openness for dialog, inadequate language and communication, little empathy, and need to improve humanization. About the video based on Stage 1, the perception of physicians indicated: increased degree of responsibility, reflections on their professional practices, and encouragement to theoretical knowledge and to empathy in professional relations in the Intensive Care Unit. There are issues in the process of delivering bad news, and the use of educational participatory videos is an important strategy to humanize health care.