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AIM: To identify and synthesize the experiences and attitudes of nursing staff regarding the deaths of COVID-19 patients. REVIEW METHODS: A qualitative evidence synthesis was carried out, using Noblit and Hare's meta-ethnographic approach. The review protocol was listed in PROSPERO (CRD42022330928). Studies published from January 2020 to January 2022 that met the criteria were searched in PubMed, Web of Science, Scopus, CINAHL, CUIDEN and PsycInfo. A total of 12 articles were included. RESULTS: Thirty-three metaphors emerged, which were grouped into three main themes: Determining factors of care, Feelings about death and Strategies for coping with death. Nurses reported the high emotional toll, the absence of family and the lack of staff, protocol and training as determining factors. Furthermore, staff had doubts about the quality of care that COVID-19 patients received. As coping strategies, nurses developed avoidance behaviours towards COVID-19 patients, selective memories, resilience, and/or leaving the profession. CONCLUSIONS: The difficulty in providing adequate nursing care and the high number of deaths has increased anxiety and stress among nurses. These factors, alongside their lived experiences of seeing patients suffering, many dying alone without family members, have had psychological repercussions on nursing staff. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The results demonstrate a high emotional toll and doubts surrounding their caregiving role caused by the lack of professional training needed to face a pandemic. This research shows what has been learned for future pandemics and highlights basic components that could provide a foundation for coping interventions for healthcare professionals. IMPACT: WHAT PROBLEM DID THE STUDY ADDRESS?: The challenges posed by COVID-19 patient deaths for nursing staff around the world and also by the pandemic circumstances in which those deaths occurred. WHAT WERE THE MAIN FINDINGS?: The high number of deceased patients who were isolated from family members, communication with family members and doubts surrounding care given during the pandemic have created feelings of fear, stress and anxiety, as well as obsessive thoughts that have changed nursing staff's perception of death due to COVID-19. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Results will be useful for preparing for future pandemics, and for policymakers and health staff in supporting healthcare professionals by creating programmes to help them cope with the emotional toll they have felt after dealing with death in such unprecedented circumstances. REPORTING METHOD: The authors have adhered to the PRISMA guidelines and the eMERGe Reporting Guidance. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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COVID-19 , Recursos Humanos de Enfermagem , Humanos , Pessoal de Saúde , Atitude , Família , Pesquisa QualitativaRESUMO
AIM: To assess the efficacy and safety of the application, during stoma hygiene, of a pH-neutral gel containing organic EVOO (oEVOO) for the maintenance of peristomal skin integrity. METHOD: Patients with a colostomy or ileostomy were enrolled in a pilot randomized controlled trial and assigned treatment with a pH-neutral gel made from natural products including oEVOO or usual stoma hygiene gel. The primary outcome was three domains of abnormal peristomal skin: Discolouration, Erosion and Tissue overgrowth. Secondary outcomes that were evaluated included skin moisture; oiliness; skin elasticity; water-oil balance; patients' perceptions; difficulty inserting and removing the pouching system; pain, any other chemical, infectious, mechanical, or immunological complications of concern. The intervention lasted 8 weeks. RESULTS: Twenty-one patients were recruited for the trial and randomly assigned to either the experimental group (n = 12) or the control group (n = 9). The groups did not differ significantly in terms of patient characteristics. No significant differences between groups were identified either at baseline (p = 0.203) or at the end of the intervention (p = 0.397). In the experimental group, domains of abnormal peristomal skin improved after the intervention. The difference observed before and after the intervention was statistically significant (p = 0.031). CONCLUSION: The use of a gel containing oEVOO has shown similar levels of efficacy and safety to other gels commonly used for peristomal skin hygiene. It is also relevant to highlight that a significant improvement in skin condition was observed in the experimental group before and after the intervention.
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Colostomia , Pele , Humanos , Azeite de Oliva/farmacologia , Azeite de Oliva/uso terapêutico , Projetos Piloto , HigieneRESUMO
AIMS: The purpose of this paper was to perform a bibliometric analysis of the production of qualitative research in scientific journals through aggregation by levels and to identify factors of diversity, such as types of designs, in qualitative research on the experience of having an intestinal stoma between 2002 and 2018. DESIGN: Descriptive bibliometric study focused on the production of qualitative research on the subject of study, on three levels: micro, meso and macro. METHODS: Databases such as PubMed, CINAHL, Web of Knowledge, Scopus, SciELO, CUIDEN, Lilacs and Google Scholar were used to collect the data, between August - November 2018. RESULTS: Nursing was the main area of knowledge. Brazil was the predominant country of origin. The most productive journal was the Journal of Wound, Ostomy & Continence Nursing. English and Portuguese were the main languages of scientific communication. The number of authors was typically between 2 and 6. Authors conducted descriptive and phenomenological studies. CONCLUSION: The present bibliometric study helps us to map the qualitative research on the experiences of individuals with an intestinal stoma and to understand patterns in the designs, methods, disciplines and journals involved in this area of research. This will allow nurses to have a leading contribution to stoma care at their disposal.
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Bibliometria , Estomia/psicologia , Satisfação do Paciente/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Estomas Peritoneais , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Enfermagem , Pesquisa QualitativaRESUMO
The main aim of this article is to explore the experiences and life situations of people living with intestinal stomas. Previous studies indicated the need to investigate the concerns of ostomy patients and how these concerns can affect their quality of life and their approaches to the comprehensive conceptualization of the bodily changes. A qualitative systematic review and metasynthesis design was carried out by using the main scientific databases. Original articles from 2002 to 2015 were selected based on their qualitative methodology. Methodological quality was evaluated using the Critical Appraisal Skills Program. The findings were synthesized using the metasynthesis procedure of Sandelowski. The final number of articles included was 95 and 1,982 participants. Regarding the metasummary, the data generated 191 thematic statements that were organized into eight categories. The findings support an explanatory model of the experience of people with ostomy based on three aspects: Acceptance, Adaptation, and Autonomy.
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Adaptação Psicológica , Enterostomia/psicologia , Qualidade de Vida/psicologia , Humanos , Relações Interpessoais , Relações Profissional-Paciente , Pesquisa Qualitativa , Participação SocialRESUMO
Aim: To determine nursing outcomes in individuals with intestinal stoma and the relationships between them and sociodemographic and clinical variables. Design: Cross-sectional study performed with 102 subjects at the General Surgery Unit of a first-level hospital. Methods: Data on the presence of nursing outcomes were collected using the Nursing Outcomes Classification. Data on sociodemographic and clinical variables were also collected. Univariate and bivariate data analyses were performed. Results: Outcomes related to participation in making health decisions and knowledge of ostomy care were assessed across the study sample. Period of care (post-operative and follow-up) was the most common significant variable (p < 0.05) among the outcomes. The outcome scores ranged from 2 to 3, indicating a moderate level of impairment in the physical, psychological, and social spheres of these patients. The scores in the indicators on Participation in making health decisions and Knowledge of stoma care improved in the period of continuity of care compared to the postoperative period, being this difference statistically significant (p < 0.001). Conclusions: The care plan for individuals with intestinal stoma needs to include indicators measuring patient participation in making decisions related to their condition, as well as indicators related to their knowledge and self-care of their stoma. Relevance to clinical practice: This study aims to determine the nursing outcomes in individuals with intestinal stoma and the relationships between them and sociodemographic and clinical variables. It provides the opportunity to plan achievable objectives with patients using a system of indicators that facilitate their assessment and monitoring.
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PURPOSE: To determine which nursing interventions are used in individuals with a digestive stoma and the relationships between nursing interventions used and sociodemographic and clinical variables. METHODS: The present study is an observational, cross-sectional, descriptive. Data from 102 individuals in the general surgery unit of a first-level hospital (University Hospital Complex of Granada, Spain) were analyzed. Data on the use of nursing interventions and sociodemographic and clinical variables were collected. Univariate, bivariate, and multivariate data analyses were conducted. FINDINGS: Interventions: Decision-Making Support (5250) and Ostomy Care (0480) were the most prevalent interventions in the sample. The period of care (postoperative and follow-up) was the most common significant variable (p < 0.05) among the interventions observed. Anxiety Reduction (5820), Nutritional Counseling (5246), Self-Esteem Enhancement (5400), and Body Image Enhancement (5220) were also relevant findings. CONCLUSIONS: The present study contributes to determining which nursing interventions are used in individuals with a digestive stoma. IMPLICATIONS FOR NURSING PRACTICE: This study could be useful in planning nursing interventions in individuals with a digestive stoma.
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Terminologia Padronizada em Enfermagem , Estomas Cirúrgicos , Colostomia , Estudos Transversais , Humanos , IleostomiaRESUMO
The aim of this article was to explore the experiences and attitudes of people with HIV/AIDS. A systematic review of qualitative studies was carried out. Twenty-seven articles were included, with sample sizes ranging from 3 to 78. Articles from North America, South America, Central America, Europe, and Africa were included. Five topics emerged from the synthesis: feelings about the diagnosis of HIV/AIDS; stigma and HIV/AIDS; changes in sexual behavior after becoming infected; living with the virus; and pregnancy and motherhood in seropositive women. The moment of diagnosis is of vital importance for these people due to feelings such as disappointment, sadness, fear, despair, lack of awareness, and pain. Social support is highly valued among these people and is linked to an improvement in these peoples' quality of life. Different kinds of stigma accompany people with HIV/AIDS throughout their life, like social stigma, self-stigma, and health professionals' stigma. Seropositive women who decide to become mothers can feel frustration because they cannot breastfeed. Spirituality helps some people to deal with the fact of being a virus or disease carrier.
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Adaptação Psicológica , Atitude , Infecções por HIV/psicologia , Acontecimentos que Mudam a Vida , Comportamento Sexual , Estigma Social , Feminino , Humanos , Masculino , GravidezRESUMO
PURPOSE: To determine nursing diagnoses in people with a digestive stoma and their relationship with sociodemographic and clinical variables. METHOD: A cross-sectional descriptive study of 102 subjects in the General Surgery Unit of a first-level hospital (Granada, Spain) was conducted. Data were collected on the presence of nursing diagnoses, sociodemographic and clinical variables. RESULTS: NANDA-I: "Deficient knowledge (00126)" and "Readiness for enhanced health management (00162)" were present in the entire sample studied. The period of care (postoperative vs. follow-up) was the most common significant variable among diagnoses. CONCLUSIONS: This work contributes to the determination of NANDA-I diagnoses in people with digestive stomas. IMPLICATIONS FOR NURSING PRACTICE: The results provide a guide to help nursing professionals develop individual care plans.
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Intestinos/cirurgia , Diagnóstico de Enfermagem , Estomas Cirúrgicos , Estudos Transversais , Demografia , Humanos , Fatores Socioeconômicos , Espanha , Terminologia Padronizada em EnfermagemRESUMO
INTRODUCTION: High performance sport requires that the athletes maintain a constant intensity and control of their personal resources, as well as a balance between self-regulation and performance. Likely, such requirements involve the influence of their beliefs regarding the tasks to be performed to improve the confidence in their own resources to face the competition. Theoretical arguments provide new insights for understanding multidimensional perfectionism and its relationships with other variables such as affective experiences, among others. In this study, perfectionism was conceptualized as a "stable personality disposition," whereas the impulsiveness components were defined as "representing psychological mechanisms (or processes)" underlying the relationships between perfectionism and athletic experiences. AIM: This study aims to establish and show profiles of perfectionist beliefs and impulsive responses according to sport modality and the relationships between all these variables. Team athletes were expected to show more functional resources than those in combat or endurance sports. METHODS: The psychological responses of 487 athletes (273 boys; 214 girls) practicing high-performance sport were examined. A non-randomized, cross-sectional design was used. Self-reports were used to measure impulsiveness, perfectionism and competence self-perceptions. RESULTS: Athletes with functional responses of impulsivity and perfectionism showed higher perceived self-competence. Athletes with more reflective thoughts, more careful planning and generally less sensitive to rewards and behaviors were more self-regulated and planned (functional impulsivity) and showed more moderate relationships between the most dysfunctional perfectionist beliefs and self-competence. In addition, perfectionism seems to be useful to the striver athletes that want to be the best, and they are focused on and committed to future goals and performance and self-improvement. It is important for coaches and athletes to understand how the processes of self-regulation (impulsivity) and self-knowledge (perfectionism) could be formed to try to offer better opportunities for building psychological resources that enhance high-performance mental abilities.