[Caregivers of individuals with spinal cord injury: caregiver burden]. / Cuidadores de indivíduos com lesão medular: sobrecarga do cuidado.

A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.

Knowledge on pressure ulcer prevention among nursing professionals.

This study aimed to describe and to analyze knowledge on pressure ulcer prevention among nursing team members working in direct care to adult and elderly patients at a university hospital. A descriptive and exploratory research was carried out between January and March 2009, after approval by the Research Ethics Committee at the study institution. Data were collected through a validated questionnaire. Participants were 386 professionals, of whom 64.8% were nursing auxiliaries/technicians and 35.2% baccalaureate nurses (BSN). The mean percentage of correct answers on the knowledge test was 79.4% (SD=8.3%) for nurses and 73.6% (SD=9.8%) for nursing auxiliaries/technicians. Both professional categories display knowledge deficits in some areas related to the theme. The identification of deficient areas can guide strategic planning with a view to the dissemination and adoption of prevention measures by the team.

[From the production to the use of research results in care practice: a consolidating experience]. / Da produção à utilização de resultados de pesquisa na prática assistencial: uma experiência em consolidação.

Although it is desirable that professionals use research results, often they are not prepared for that. This article aims to present the process of development and establishment of innovations, based on Rogers' model, through strategies to train nurses to use the best evidences for a quality clinical practice. It is a partnership between a educational institution and a hospital care institution. Following identification of problems from nurses' own practice in a health institution research proposals were developed to search for evidences and to test interventions. Results of this experience evidenced the viability of use of a model presented as a methodological framework what contributed to reach the institutions' goal.

Omission of nursing care in hospitalization units.

OBJECTIVE: to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital. METHOD: a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson's Chi-square or Fisher's exact tests were used to compare differences in the prevalence of omission among professional categories. RESULTS: among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient's health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). CONCLUSION: according to our study, there is high prevalence of omission of nursing care elements from the professionals' perspective. Factors related to human and material resources were more reported as causes for such omission.

Using the Braden and Glasgow scales to predict pressure ulcer risk in patients hospitalized at intensive care units.

Pressure ulcers remain a major health issue for critical patients. The purpose of this descriptive and exploratory study was to analyze the risk factors for the development of pressure ulcers in patients hospitalized at an intensive care unit of a university hospital. Patients were assessed through the Braden scale to determine the risk for the development of pressure ulcers and to identify individual risks, and the Glasgow scale was used to assess their consciousness. It was found that the risks associated with pressure ulcer development were: low scores on the Braden Scale on the first hospitalization day and low scores on the Glasgow scale. The results showed that these tools can help nurses to identify patients at risk, with a view to nursing care planning.

Cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for use in Brazil.

OBJECTIVE: To carry out the cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) for use in Brazil and analyze the internal consistency of the adapted version. METHOD: This was a methodological study. The PZ-PUKT is a knowledge test consisting of 72 items, divided into: prevention, staging, and wound description. The present study was developed in two phases: (1) translation of the questionnaire from English to Brazilian Portuguese, back-translation, and assessment of equivalence between the original and back-translated version by an expert panel; (2) pre-testing with nurses. RESULTS: The questionnaire showed face and content validity according to the opinions of the experts. Cronbach's alpha for the total test score was higher than 0.70. The adapted version presented satisfactory internal consistency for the studied sample. CONCLUSION: The adapted version of the instrument for Portuguese can be used in intervention studies as a tool to measure "nursing knowledge about pressure injury/ulcers" as a dependent variable.

Systematic review of topic treatment for venous ulcers.

Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.

Validation of the MISSCARE-BRASIL survey - A tool to assess missed nursing care.

OBJECTIVE: to analyze the metric validity and reliability properties of the MISSCARE-BRASIL survey. METHOD: methodological research conducted by assessing construct validity and reliability via confirmatory factor analysis, known-groups validation, convergent construct validation, analysis of internal consistency and test-retest reliability. The sample consisted of 330 nursing professionals, of whom 86 participated in the retest phase. RESULTS: of the 330 participants, 39.7% were aides, 33% technicians, 20.9% nurses, and 6.4% nurses with administrative roles. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. The correlation between "satisfaction with position/role" and "satisfaction with teamwork" and the survey's missed care variables was moderate (Spearman's coefficient =0.35; p<0.001). The results of the Student's t-test indicated known-group validity. Professionals from closed units reported lower levels of missed care in comparison with the other units. The reliability showed a strong correlation, with the exception of "institutional management/leadership style" (intraclass correlation coefficient (ICC)=0.15; p=0.04). The internal consistency was adequate (Cronbach's alpha was greater than 0.70). CONCLUSION: the MISSCARE-BRASIL was valid and reliable in the group studied. The application of the MISSCARE-BRASIL can contribute to identifying solutions for missed nursing care.

Use of the Diffusion of Innovation Model in venous ulcers by specialized professionals.

OBJECTIVE:: To analyze the influence of the evidence and of the opinion of peers on the decisions of specialists regarding the agreement with recommendations for prevention and treatment of venous ulcer. METHODS:: This is a quasi-experimental study with two interventions: provision of studies with the evidence of the recommendations and provision of the opinion of peers, with sample of 73 specialized doctors and nurses. Delphi technique was used in the search for agreement, with three rounds. RESULTS:: The participants evaluated 82 recommendations organized into eight domains: evaluation of patient and wound; documentation of clinical findings; care with the wound and surrounding skin; indication of dressing; use of antibiotics; improvement of venous return and prevention of recurrence; referrals of patients; and professional training. The interventions resulted in statistically significant changes in four domains. CONCLUSION:: The interventions were able to change the opinion of participants, leading them to agreement regarding the recommendations, regardless of the level of evidence. OBJETIVO:: Analisar a influência das evidências e da opinião dos pares sobre as decisões dos especialistas quanto à concordância com recomendações para prevenção e tratamento de úlcera venosa. MÉTODO:: Estudo quase-experimental com duas intervenções: fornecimento de estudos com as evidências das recomendações e opinião dos pares, com amostra de 73 especialistas médicos e enfermeiros. Utilizou-se a técnica Delphi na busca de concordância, com 3 rodadas. RESULTADOS:: Os participantes avaliaram 82 recomendações organizadas em 8 domínios: avaliação do paciente e de sua lesão; documentação dos achados clínicos; cuidado com a lesão e pele ao redor; indicação da cobertura; uso de antibiótico; melhoria do retorno venoso e prevenção de recidiva; encaminhamentos dos pacientes; e capacitação profissional. As intervenções resultaram em mudanças estatisticamente signifi cativas em 4 domínios. CONCLUSÃO:: As intervenções foram capazes de modificar a posição dos participantes, levando-os para a posição de concordância a respeito das recomendações, independentemente do nível de evidência.

Profile of patients with spinal cord injuries and occurrence of pressure ulcer at a university hospital.

Patients with traumatic spinal cord injury (TSCI) have an increased risk of developing pressure ulcers (PU). It is a retrospective study done by review of records in order to identify the characteristics of patients who were assisted at a tertiary hospital as well as the occurrence of PU. Most patients were male, white and 36,2% between 21 and 30 years. The most common causes of TSCI were wound by fire weapons followed by vehicle crash/overturn. There was a predominance of injury at the toracic level followed by cervical. The PU occurred in 20 pacientes (42,5%). The most frequent regions of occurrence were the sacral and heels. Only 25% of the records had PU's dimensions charted, 80% stated the aspect, and 52.1% did not state the stage. There is a need for better documentation of PU so that interventions used for treatment can be evaluated.

Knowledge on diabetes mellitus in the self care process.

This descriptive study in the interior of São Paulo aimed to verify diabetes mellitus patients' knowledge about the disease, causes and complications, highlighting its importance in self care. Data were collected through interviews with 84 persons and analyzed through descriptive statistics. Average age was 53.3 +/- 13 years, time of disease 12.9 +/- 9 years and 58% of the participants did not finish basic education. Only 28.6% of the participants gave correct answers to "what is diabetes" and "what are its causes"; 71% were diagnosed without presenting classic symptoms and 64% had already been hospitalized due to an acute or chronic complication. We indicated aspects that turn the learning process more difficult; little knowledge about the disease, its causes and symptoms, thus affecting the prevention and early diagnosis and entailing predisposition towards complications. Furthermore, the interference of biopsychosocial factors in the self care process is highlighted.

Health-Related Quality of Life Among Caregivers of Individuals With Spinal Cord Injury.

UNLABELLED: The consequences of spinal cord injury (SCI) not only affect patients' health-related quality of life (HRQoL) but also extend to the entire family. The health condition the injury imposes requires the participation of a family caregiver, who will be responsible for taking care of the individual in a disabling condition. This is an observational, exploratory study using a cross-sectional design that aimed to study the association between HRQoL and gender, age, presence of comorbidities, and characteristics of the care among caregivers of individuals with SCI with the purpose of identifying potential factors that are associated with HRQoL in this population. Participants were 59 caregivers of individuals with traumatic SCI. The data were collected by consulting the patient histories and applying questionnaires. To assess the caregivers' HRQoL, the Short Form-36 was used. For analysis, exploratory and inferential statistics were used. Most of the caregivers of the individuals with SCI were female, with a mean age of 44.8 years. The domains that most contributed to a worse HRQoL were physical aspects, pain, vitality, and emotional aspects. No statistically significant associations were found between HRQoL and the variables gender, hours per day spent on care, and length of activity as caregiver. The associations between HRQoL and self-reported diseases and age were statistically significant. The results support the planning of nursing interventions from the perspective of aspects of the care demands, which can affect the caregiver's HRQoL. RELEVANCE TO CLINICAL PRACTICE: Interventions to prepare the individuals with SCI and their caregivers are a strategy aimed at improving the HRQoL of both.

Spinal cord injury and pressure ulcers.

The SCI person is at high risk for pressure ulcers; thus, pressure ulcer prevention is a critical component of care. Guidelines exist to promote evidenced-based practice for the prevention and treatment of pressure ulcers in the SCI. There is a discrepancy between what persons with SCI know about pressure ulcer prevention and what they are doing to reduce their risk of developing this serious complication. Objective data demonstrate that adherence to a skin care regimen contributes to the prevention of pressure ulcers. Knowledge about pressure ulcer prevention and treatment must be appropriately focused for the patient, family, and the health care team and must be reinforced over time.

[Decubitus ulcer and nutritional status: literature review]. / Ulcera de pressão e estado nutricional: revisão da literatura.

In order to better understand aspects related to the nutritional assessment of patients in risk for pressure ulcers, we reviewed the national and international literature indexed on Medline and LILACS bibliographic databases, from 1987 to 2001. The aim of this research was to investigate the knowledge production on pressure ulcers and nutritional status, as well as to learn about the authors and the publication focus. We concluded that patients in risk for pressure ulcers can be early identified based on nutritional assessment, including biochemical data, anthropometric evaluation, clinical data, diet history and energetic consumption. The alterations are frequent in elderly patients, hospitalized patients, patients with a chronic disease such as a vascular cerebral accident, cancer and spinal cord injury.

Construção e validação de um website sobre lesão por pressão / Elaboración y validación de un sitio web sobre úlceras por presión / Construction and validation of a website about pressure injuries

Resumo Objetivo Descrever a construção e validação de um website para prevenção e manejo da lesão por pressão, a ser utilizado como recurso educacional em cursos on-line como estratégia complementar de ensino para graduandos de enfermagem. Métodos Estudo descritivo, metodológico, de produção tecnológica. O website foi construído seguindo as fases de análise, design e desenvolvimento, implementação e avaliação. O conteúdo foi baseado em recomendações internacionais e nacionais e na revisão da literatura. As avaliações de conteúdo, de qualidade das informações e qualidade técnica foram feitas por dois grupos de juízes, sendo sete enfermeiros docentes e três profissionais da informática. Resultados Para o estudo, o endereço do website utilizado foi www.recursoeducacional.com.br. O conteúdo é composto de cinco módulos com 66 tópicos, 37 figuras e 36 fotos, abordando temas essenciais sobre lesão por pressão: segurança do paciente e ocorrência, intervenções para prevenção e tratamento, manejo da lesão e cuidados com pacientes mais vulneráveis. Todos os tópicos do conteúdo foram considerados importantes pelos juízes enfermeiros, 66,67% foram aceitos sem mudanças na redação e apresentação e os outros foram revisados. Todos os tópicos dos conteúdos obtiveram Índice de Validade de Conteúdo >0,8, com média de 0,99, portanto o website foi considerado validado. A qualidade das informações e a qualidade técnica do website foram consideradas excelentes pelos dois grupos de juízes. Conclusão O website foi validado e poderá ser utilizado como recurso educacional para auxiliar o ensino sobre lesão por pressão a graduandos de enfermagem.

Resumen Objetivo Describir la elaboración y validación de un sitio web para prevención y manejo de úlceras por presión, que será utilizado como recurso educativo en cursos en línea como estrategia complementaria de enseñanza para estudiantes universitarios de enfermería. Métodos Estudio descriptivo, metodológico, de producción tecnológica. El sitio web fue elaborado de acuerdo con las siguientes fases: análisis, diseño y desarrollo, implementación y evaluación. El contenido se basó en recomendaciones internacionales y nacionales y en la revisión de la literatura. Las evaluaciones de contenido, de calidad de la información y de calidad técnica fueron realizadas por dos grupos de jueces, formados por siete enfermeros docentes y tres profesionales de la informática. Resultados La dirección del sitio web utilizada en el estudio fue www.recursoeducacional.com.br. El contenido se compone de cinco módulos con 66 temas, 37 figuras y 36 fotos, que abordan asuntos esenciales sobre úlceras por presión: seguridad del paciente y episodios, intervenciones para prevención y tratamiento, manejo de la úlcera y cuidados con pacientes más vulnerables. Todos los temas del contenido fueron considerados importantes por los jueces enfermeros, el 66,67 % se aceptó sin cambios de redacción ni presentación y el resto fue revisado. Todos los temas del contenido obtuvieron un Índice de Validez de Contenido >0,8, con promedio de 0,99, por lo tanto el sitio web fue considerado válido. Tanto la calidad de la información, como la calidad técnica del sitio web fueron consideradas excelentes por los dos grupos de jueces. Conclusión El sitio web se consideró válido y podrá ser utilizado como recurso educativo para complementar la enseñanza sobre úlceras por presión a estudiantes universitarios de enfermería.

Abstract Objective Describe the construction and validation of a website for pressure injury prevention and management, for use as an online educational resource and supplementary teaching strategy for nursing students. Methods Descriptive, methodological, technology production study. The website was built in the following stages: analysis, design and development, implementation and evaluation. The content was based on international and national recommendations and a literature review. The assessment of content, information quality and technical quality was performed by two groups of judges, comprised of seven nursing professors and three informatics professionals. Results The address of the website used for the study was: www.recursoeducacional.com.br. The content was composed of five modules with 66 topics, 37 figures and 36 photos, addressing essential pressure injury issues: patient safety and occurrence, prevention and treatment interventions, pressure injury management and care of more vulnerable patients. All the content topics were deemed important by the nursing judges: 66.67% were accepted without any changes to the text and presentation and others were revised. All the content topics obtained Content Validity Index scores >0.8, with a mean of 0.99. Therefore, the website was considered validated. The quality of the information and technical quality of the website were appraised as excellent by the two groups of judges. Conclusion The website was validated and may be used as an educational resource to help teach nursing students about pressure injuries.

Omission of nursing care in hospitalization units / Omissão do cuidado de enfermagem em unidades de internação / Omisión del cuidado de enfermería en unidades de internación

Objective: to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital. Method: a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson's Chi-square or Fisher's exact tests were used to compare differences in the prevalence of omission among professional categories. Results: among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient's health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). Conclusion: according to our study, there is high prevalence of omission of nursing care elements from the professionals' perspective. Factors related to human and material resources were more reported as causes for such omission.

Objetivo: descrever a prevalência e as razões da omissão de cuidados de enfermagem, segundo a percepção de profissionais de enfermagem de um hospital de ensino. Método: estudo transversal realizado com 267 profissionais de dez unidades de internação. Os dados foram coletados por meio do instrumento MISSCARE-Brasil. Utilizou-se estatística descritiva e testes qui-quadrado de Pearson ou exato de Fisher para comparar diferenças na prevalência de omissão entre as categorias profissionais. Resultados: dentre os elementos do cuidado de enfermagem, as maiores prevalências de omissão foram: sentar o paciente fora do leito (70,3%), deambulação três vezes ao dia (69,1%) e participação em discussão da equipe interdisciplinar sobre a assistência ao paciente (67,2%). As razões mais frequentes foram: número inadequado de pessoal (85,4%), número inadequado de pessoal para a assistência ou tarefas administrativas (81,6%) e aumento inesperado no volume e/ou gravidade dos pacientes (79,8%). Os enfermeiros relataram maior omissão do que os técnicos/auxiliares de enfermagem em quatro elementos do cuidado (p<0,05). Conclusão: o estudo evidencia alta prevalência de omissão de elementos do cuidado de enfermagem na perspectiva dos profissionais. Fatores relacionados aos recursos humanos e materiais foram mais relatados como causas para esta omissão.

Objetivo: describir la prevalencia y las razones de la omisión de cuidados de enfermería, según la percepción del personal de enfermería de un hospital de enseñanza. Método: estudio transversal realizado con 267 profesionales de diez unidades de internación. Los datos se recopilaron por medio del instrumento MISSCARE-Brasil. Se emplearon estadística descriptiva y prueba chi cuadrado de Pearson o exacto de Fisher para comparar diferencias en la prevalencia de omisión entre las categorías profesionales. Resultados: entre los elementos del cuidado de enfermería, las mayores prevalencias de omisión fueron: sentar al paciente fuera de la cama (70,3 %); deambulación tres veces al día (69,1 %) y participación en la discusión del equipo interdisciplinar sobre la asistencia al paciente (67,2 %). Las razones más frecuentes fueron: el número inadecuado de personal (85,4 %); el número inadecuado de personal para la asistencia o tareas administrativas (81,6 %) y el aumento inesperado del volumen o gravedad de los pacientes (79,8 %). Los enfermeros relataron una mayor omisión que los técnicos/auxiliares de enfermería en cuatro elementos del cuidado (p<0,05). Conclusión: el estudio pone de manifiesto la alta prevalencia de omisión de elementos del cuidado de enfermería desde la perspectiva de los profesionales. Factores relacionados con los recursos humanos y materiales han sido los más relatados como causas para esta omisión.

Omission of nursing care in hospitalization units / Omissão do cuidado de enfermagem em unidades de internação / Omisión del cuidado de enfermería en unidades de internación

Objective: to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital. Method: a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson's Chi-square or Fisher's exact tests were used to compare differences in the prevalence of omission among professional categories. Results: among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient's health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). Conclusion: according to our study, there is high prevalence of omission of nursing care elements from the professionals' perspective. Factors related to human and material resources were more reported as causes for such omission.

Objetivo: descrever a prevalência e as razões da omissão de cuidados de enfermagem, segundo a percepção de profissionais de enfermagem de um hospital de ensino. Método: estudo transversal realizado com 267 profissionais de dez unidades de internação. Os dados foram coletados por meio do instrumento MISSCARE-Brasil. Utilizou-se estatística descritiva e testes qui-quadrado de Pearson ou exato de Fisher para comparar diferenças na prevalência de omissão entre as categorias profissionais. Resultados: dentre os elementos do cuidado de enfermagem, as maiores prevalências de omissão foram: sentar o paciente fora do leito (70,3%), deambulação três vezes ao dia (69,1%) e participação em discussão da equipe interdisciplinar sobre a assistência ao paciente (67,2%). As razões mais frequentes foram: número inadequado de pessoal (85,4%), número inadequado de pessoal para a assistência ou tarefas administrativas (81,6%) e aumento inesperado no volume e/ou gravidade dos pacientes (79,8%). Os enfermeiros relataram maior omissão do que os técnicos/auxiliares de enfermagem em quatro elementos do cuidado (p<0,05). Conclusão: o estudo evidencia alta prevalência de omissão de elementos do cuidado de enfermagem na perspectiva dos profissionais. Fatores relacionados aos recursos humanos e materiais foram mais relatados como causas para esta omissão.

Objetivo: describir la prevalencia y las razones de la omisión de cuidados de enfermería, según la percepción del personal de enfermería de un hospital de enseñanza. Método: estudio transversal realizado con 267 profesionales de diez unidades de internación. Los datos se recopilaron por medio del instrumento MISSCARE-Brasil. Se emplearon estadística descriptiva y prueba chi cuadrado de Pearson o exacto de Fisher para comparar diferencias en la prevalencia de omisión entre las categorías profesionales. Resultados: entre los elementos del cuidado de enfermería, las mayores prevalencias de omisión fueron: sentar al paciente fuera de la cama (70,3 %); deambulación tres veces al día (69,1 %) y participación en la discusión del equipo interdisciplinar sobre la asistencia al paciente (67,2 %). Las razones más frecuentes fueron: el número inadecuado de personal (85,4 %); el número inadecuado de personal para la asistencia o tareas administrativas (81,6 %) y el aumento inesperado del volumen o gravedad de los pacientes (79,8 %). Los enfermeros relataron una mayor omisión que los técnicos/auxiliares de enfermería en cuatro elementos del cuidado (p<0,05). Conclusión: el estudio pone de manifiesto la alta prevalencia de omisión de elementos del cuidado de enfermería desde la perspectiva de los profesionales. Factores relacionados con los recursos humanos y materiales han sido los más relatados como causas para esta omisión.

[The Nursing School of Ribeirao Preto, of the University of Sao Paulo, and the International Pro Sigma Theta Tau Honorary Society of Nursing]. / A Escola de Enfermagem de Ribeirão Preto, da USP, e a Sociedade Honorífica de Enfermagem Pró Sigma Theta Tau Internacional.

The FIERP Honor Society will become a Sigma Theta Tau International chapter in 2002. The Honor Society had to face significant challenges, but the opportunity to participate in this international network will be of great importance to Brazilian and Latin American Nursing.

Case management: evolution of the concept in the 80's and 90's.

Case Management is a term that is present in almost every American health care situation. It is mostly used to coordinate community services with satisfactory results for the patient within a certain period of time, with limited resources. Through time, it has been used for different purposes. The goal of this study was to show the historical evolution of case management as expressed by the American nursing literature, in the 80's and 90's, according to its use, meaning, and application, and following a theoretical framework for concept analysis. The data was extracted from two journals: "Nursing Management" and "Journal of Nursing Administration". The publications showed case management portrayed as a process that serves a common goal; where quality and cost of care were the prevalent and influential elements along time, and its practice focusing in a given population defined as of high risk and high cost for health care.

[Case management: a new focus on health care]. / Gerenciamento de caso: um novo enfoque no cuidado à saúde.

The study is a literature review and has the goal to present a new modality of health care delivery called case management. Authors emphasize essential aspects related to this modality of care: care methodology, history, goals, practice areas. It is considered the use of case management in the Brazilian reality.