RESUMO
OBJECTIVES: The authors investigated the effect of active work with positive airway pressure (PAP) in addition to chest physiotherapy (CP) on pulmonary atelectasis (PA) in patients undergoing cardiac surgery with cardiopulmonary bypass. DESIGN: A randomized controlled study. SETTING: At a single-center tertiary hospital. PARTICIPANTS: Eighty adult patients undergoing cardiac surgery (coronary artery bypass grafting, valve surgery, or both), and presenting with PA after tracheal extubation on postoperative days 1 or 2, were randomized from November 2014 to September 2016. INTERVENTION: Three days of CP, twice daily, associated with active work with PAP effect (intervention group) versus CP alone (control group). Pulmonary atelectasis was assessed by using the radiologic atelectasis score (RAS) measured from daily chest x-rays. All radiographs were reviewed blindly. MEASUREMENTS AND MAIN RESULTS: Among included patients, 79 (99%) completed the trial. The primary outcome was mean RAS on day 2 after inclusion. It was significantly lower in the intervention group (mean difference and 95% CI: -1.1 [-1.6 to -0.6], p < 0.001). The secondary outcomes were the sniff nasal inspiratory pressure measured before and after CP and clinical variables. Sniff nasal inspiratory pressure was significantly higher in the intervention group on day 2 (7.7 [3.0-12.5] cmH2O, p = 0.002). The respiratory rate was lower in the intervention group (-3.2 [95% CI -4.8 to -1.6] breaths/min, p < 0.001) on day 2. No differences were found between the 2 groups for percutaneous oxygen saturation/oxygen requirement ratio, heart rate, pain, and dyspnea scores. CONCLUSIONS: Active work with the PAP effect, combined with CP, significantly decreased the RAS of patients undergoing cardiac surgery after 2 days of CP, with no differences observed in clinically relevant parameters.
Assuntos
Atelectasia Pulmonar , Adulto , Humanos , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/etiologia , Atelectasia Pulmonar/terapia , Ponte de Artéria Coronária , Modalidades de Fisioterapia , Ponte CardiopulmonarRESUMO
INTRODUCTION: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. OBJECTIVES: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. METHOD: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. RESULTS: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. DISCUSSION: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.
Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.
Assuntos
Educação de Pós-Graduação em Enfermagem , Pesquisa em Enfermagem , Humanos , Masculino , Feminino , França , EstudantesRESUMO
Introduction: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. Objectives: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. Method: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. Results: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. Discussion: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.
Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.
Assuntos
Enfermeiras e Enfermeiros , Pesquisa em Enfermagem , Humanos , Feminino , Masculino , França , Estudantes , UniversidadesRESUMO
Among the different forms of knowledge, experiential knowledge is widely used in certain activities in the field of health. Most often connected to patients, it is also discussed in relation to health professionals, but less frequently. This article offers some points of reference and clarifies what underlies experiential knowledge. These points of reference are based on definitions of experience and knowledge, as well as work on the type of knowledge created by experience. An exploration of the contexts in which “experiential knowledge” has emerged and the focus of the disciplines that discuss it finds few epistemological connections between knowledge and experience. In the humanities and social sciences, experiential knowledge is most often connected to patients or adults in educational situations. With regard to nursing knowledge, the analysis of Carper and Lechasseur’s work on the nature of nursing knowledge reveals how the characteristics of experience are integrated into their typologies, particularly when it comes to artistic and personal knowledge. The explicit absence of experience in these typologies is then questioned with regard to the scientific imperatives that nursing science, at this particular period in its construction, is determined to promote.
Assuntos
Pessoal de Saúde , Conhecimento , HumanosRESUMO
When a newborn baby is in need of rapid care outside the hospital where the mother has given birth, the nursery nurses work specifically to support the baby during the separation from its parents. They intervene before, during and after the separation of mother and child, particularly during the transfer of the baby to the mobile paediatric emergency and resuscitation unit.
Assuntos
Enfermeiros Pediátricos , Relações Pais-Filho , Criança , Feminino , Humanos , Recém-Nascido , Mães , Pais , Enfermagem PediátricaRESUMO
In recent years, professional skills and the nursing profession in France have undergone major transformations. These have included the recognition of advanced nursing practice and its implementation in 2018, and the creation by the National Council of Universities in 2019 of a "Nursing" section (n° 92), which has paved the way for the development of research and teaching in nursing in an academic environment in France.To support these transformations, the Association de recherche en soins infirmiers (Arsi) (Nursing Research Association) has for several years been organizing seminars and symposia. The seminar "The discipline of nursing : Knowledge, teaching, and care," held on November 16, 2019 in Paris, was a continuation of those organized in 2014 and 2016.This seminar focused on the acquisition of nursing knowledge, in particular through the analysis of clinical situations using two middle-range theories : comfort and symptom management.The first part of this article describes the objectives and the working methodology of the seminar. The second part provides a recap of the theoretical foundations, while the third and final part presents the results of what the workshops participants produced.
RESUMO
In recent years, professional skills and the nursing profession in France have undergone major transformations. These have included the recognition of advanced nursing practice and its implementation in 2018, and the creation by the National Council of Universities in 2019 of a “Nursing” section (n° 92), which has paved the way for the development of research and teaching in nursing in an academic environment in France.To support these transformations, the Association de recherche en soins infirmiers (Arsi) (Nursing Research Association) has for several years been organizing seminars and symposia. The seminar “The discipline of nursing : Knowledge, teaching, and care,” held on November 16, 2019 in Paris, was a continuation of those organized in 2014 and 2016.This seminar focused on the acquisition of nursing knowledge, in particular through the analysis of clinical situations using two middle-range theories : comfort and symptom management.The first part of this article describes the objectives and the working methodology of the seminar. The second part provides a recap of the theoretical foundations, while the third and final part presents the results of what the workshops participants produced.
Assuntos
Conhecimento , Enfermagem/organização & administração , Congressos como Assunto , França , HumanosRESUMO
Introduction: Treating venous leg ulcers involves replacing dressings and applying compression bandages (CB). The technique for applying these bandages set out in the best practice guidelines shows nurses how to achieve the required level of pressure. Considerable differences have been observed between these guidelines and the actual application of CB. Methodology: An observational study combining a quantitative and a qualitative component was conducted to analyze CB application and explore the elements taken into account by nurses when they perform this procedure. Results: For the 261 patients included in the study, 27% of CB were applied as described in the guidelines. The main difference was that the heel was not included in the bandage in 48% of patients. The freelance nurses interviewed reported taking patient views into account in order to encourage adherence. Discussion: The nursing knowledge identified from the nurse interviews was compared to Carper's "Patterns of Knowing" classification. It would seem that Carper's empirical knowledge is not the only "pattern of knowing" taken into consideration. Patient involvement in the choice of CB application technique, which could be likened to Carper's "esthetic knowledge," helps guide nursing practice.
Assuntos
Bandagens Compressivas , Úlcera Varicosa/enfermagem , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Pesquisa em Avaliação de Enfermagem , Participação do Paciente , Guias de Prática Clínica como Assunto , Pesquisa QualitativaRESUMO
At once time devoted to medical projects, clinical research in paediatrics opened up to nursing protocols when funding became available to paramedical professionals. Structures are now in place to help researchers carry out their project. The recognition of nursing sciences at university is thereby likely to result in support for such research approaches.
Assuntos
Pesquisa Biomédica , Enfermagem Pediátrica , Criança , HumanosRESUMO
INTRODUCTION: the lifestyles of individuals with myotonic dystrophy type 1 (DM1), also known as Steinert's disease, are poorly understood and yet they need to be considered when it comes to effective long-term care. The nursing care provided in referral centers is mindful of the clinical diversity of Steinert's disease when it comes to interdisciplinary care, but the disease is more complex from a relational point of view. The objective of this qualitative study was to understand the life experiences of individuals with Steinert's disease, by looking at the limitations of their bodies and the adaptation strategies they develop. METHOD: this social science and nursing science study examines this problem of care, adopting an ethno-sociological perspective. RESULTS: The study brought to light the changes that Steinert's disease imposes on a body. These changes contribute to individuals' construction of a body schema and social identity, which, despite allowing them to maintain a "normal" daily life for as long as possible, can also reach limits, requiring them to make radical life changes. The study's results are discussed using an analytical framework based on the four different ways of interpreting the body proposed by Nicolas Vonarx: the "material body," the "able body," the "feeling body," and the "knowing/judging body." To discuss the role the body plays for people living with Steinert's disease within a normative society, we propose that the concept of the "socializing body" be added to this framework.