Double nursing degree: potentialities and challenges of an international student academic experience. / Dupla titulação em enfermagem: potencialidades e desafios de uma experiência de internacionalização acadêmica discente.

Objective To share the experience of a Double Nursing degree promoted between the Nursing School of the Universidade de São Paulo and the Health Sciences Institute of the Universidade Católica Portuguesa, reflecting on the potentialities and challenges of this opportunity for graduate students. Method This is an experience report presented in chronological order and of a descriptive nature. The double degree in Nursing was accomplished over a period of 6 months in a different institution from the institution of origin. Results Among the activities developed during the Double Degree are: participating in examining boards, congresses, seminars, courses, meetings, lectures, colloquium, classes, research groups and technical visits to health services. A table presents and describes the main benefits of the experience experienced by the authors. Conclusion When well-planned and well-developed, a double degree can promote personal, cultural and professional development of the students, favoring internationalization and contributing to the qualification of graduate programs.

Psychometric evaluation of the French version of the questionnaire attitudes towards morphine use; a cross-sectional study in Valais, Switzerland.

BACKGROUND: In Switzerland, nurses are allowed to prescribe and administer morphine in emergency situations without a doctor. Still, nurses and other health professionals are often reluctant to prescribe and administer morphine for pain management in patients. No valid French-speaking instrument is available in Switzerland to assess the attitudes of nurses and other health professionals towards the prescription and administration of morphine. In this study, we evaluated the psychometric properties of the French version of the questionnaire "Attitudes towards morphine use". METHODS: The instrument was derived from an Italian version. Forward and back translations of the questionnaire were performed. Item analysis and construct validity were assessed between April and December 2010 in a cross sectional study including five Swiss hospitals in a sample of 588 health professionals (533 nurses, mean age 38.3 ± 10.2 years). Thirty subjects participated in test-retest reliability. RESULTS: The time to complete the instrument ranged between 12 and 15 minutes and neither floor nor ceiling effect were found. The initial 24-item instrument showed an intraclass correlation (ICC) of 0.69 (95% CI: 0.64 to 0.73, P < 0.001), and a Cronbach's α of 0.700. Factor analysis led to a six-component solution explaining 52.4% of the total variance. After excluding five items, the shortened version showed an ICC of 0.74 (95% CI, 0.70 to 0.77, P < 0.001) and a Cronbach's α of 0.741. Factor analysis led to a five-component solution explaining 54.3% of the total variance. The five components were named "risk of addiction/dependence"; "operational reasons for not using morphine"; "risk of escalation"; "other (non-dependence) risks" and "external (non-operational) reasons". In test-retest, the shortened instrument showed an ICC of 0.797 (95% CI, 0.630 to 0.911, P < 0.001) and a Cronbach's α of 0.797. CONCLUSIONS: The 19-item shortened instrument assessing attitudes towards the prescription and administration of morphine showed adequate content and construct validity.

Hidden Diversity in Eigenmannia (Gymnotiformes: Sternopygidae) Populations from Upper Paraná and Paraguay Rivers.

Eigenmannia is a highly diverse genus within the Sternopygidae family, comprising 30 species. Due to its complex taxonomy, molecular analyses have been crucial for species delimitation within this group. Therefore, the present study presents a genetic analysis using sequences of the mitochondrial gene cytochrome c oxidase subunit 1 (COI) in specimens previously identified through alpha taxonomy as E. correntes (with unpublished data), E. virescens, and E. trilineata, originating from various locations within the Upper Paraná and Paraguay River basins in Brazil. The molecular data confirm the taxonomic complexity of the genus, as individuals morphologically identified as E. virescens and E. trilineata shared the same haplotype (H52). Furthermore, the results of the species delimitation tests suggest that specimens morphologically identified as E. virescens belong to the species E. trilineata. In addition, samples morphologically identified as E. correntes may correspond to more than one Operational Taxonomic Units (OTUs). Furthermore, the intraspecific Kimura-2-parameter (K2P) distances within the different studied populations are significant. This study has contributed valuable information about genetic diversity in Eigenmannia, emphasizing the importance of using integrative analyses to resolve taxonomic conflicts within the group. It also supports biogeographical studies and assists in biodiversity conservation efforts.

Cytogenetic and Molecular Characterization of Eigenmannia aff. desantanai (Gymnotiformes: Sternopygidae): A First Report of System of Sex Chromosomes ZW1W2/ZZ in Gymnotiformes.

Gymnotiformes a monophyletic group of fish endemic to the Neotropics, represent an important component of the freshwater ichthyofauna that presents relevant taxonomic problems. Thus, in view of the morphological complexity involving Eigenmannia (Gymnotiformes) fish species, this study aimed to characterize Eigenmannia aff. desantanai of the upper Paraguay River basin through cytogenetic and molecular analyses, to help in the correct identification and delimitation of species. This study reports a multiple sex system of the type ZW1W2/ZZ, with 2n = 31 for females and 2n = 30 for males. A single pair of chromosomes carrying the nucleolar organizing regions (NORs) was detected. The heterochromatin was colocated in NOR sites and mainly located in the centromeric regions of chromosomes. Besides that, individual sequences COI from the specimens of E. aff. desantanai were obtained, totalizing three haplotypes. The distance p between the haplotypes in E. aff. desantanai, ranged from 0.2% to 7.1%. Species delimitation tests indicated the existence of two possible operational taxonomic units of E. aff. desantanai. Thus, this study reports a new multiple sex system in Gymnotiformes and these specimens previously identified as E. aff. desantanai may belong to two distinct species.

Constitutive heterochromatin heteromorphism in the Neotropical armored catfish Hypostomusregani (Ihering, 1905) (Loricariidae, Hypostominae) from the Paraguay River basin (Mato Grosso do Sul, Brazil).

A cytogenetic analysis based on the integration of a number of different chromosomal methodologies, including chromosome microdissection was carried out to characterize the chromosomally polymorphic Hypostomusregani population from the Paraguay River basin, state of Mato Grosso do Sul in Brazil. All specimens had 2n=72 (FN=116) but two distinct karyotype formulas: karyomorph A (12m+14sm+18s+28a) and karyomorph B (13m+14sm+17st+28a). Karyomorph A and B differed only for pair 19 that consisted of two subtelocentrics in karyomorph A and a large metacentric and a subtelocentric in karyomorph B. This heteromorphism was due to extensive heterochromatinization of the short arm of the large metacentric, as highlighted by C-banding. The microdissection of the large metacentric of pair 19 allowed the production of a probe, named HrV (Hypostomusregani Variant), that hybridized to the whole p arm of the large metacentric and the pericentromeric region of the short arm of its (subtelocentric) homologue (karyomorph B) and of both homologs of pair 19 in karyomorph A. Additional cytogenetic techniques (FISH with 18S and 5S rDNA probes, CMA3 and DAPI staining) allowed a finer distinction of the two karyomorphs. These results reinforced the hypothesis that the novel large metacentric of H.regani (karyomorph B) was the result of the amplification of heterochromatin segments, which contributed to karyotypic diversification in this species.

Comparative Cytogenetics of the Black Ghost Knifefish (Gymnotiformes: Apteronotidae): Evidence of Chromosomal Fusion and Pericentric Inversions in Karyotypes of Two Apteronotus Species.

The karyotype and chromosomal characteristics of Apteronotus albifrons and Apteronotus caudimaculosus collected from populations of two different large Brazilian river basins were analyzed by conventional and molecular cytogenetic techniques, to contribute to the differentiation and identification of the species in this genus. The diploid chromosome number was 2n = 24 for A. albifrons, but with difference in the karyotype structure and fundamental number values between two populations under study. In A. caudimaculosus, the diploid chromosome number was 2n = 26, which was classified as 22 metacentric (m), 2 submetacentric (sm), and 2 acrocentric (a) chromosomes. Heterochromatins were preferentially located in pericentromeric regions for both species. However, there are more C-banded chromosomes in A. caudimaculosus than A. albifrons. The sites of 18S DNA as revealed by fluorescence in situ hybridization (FISH) in the karyotypes of both species corresponded to sites revealed by Ag impregnation, although some additional 18S rDNA sites were observed in the genome of A. caudimaculosus. FISH with 5S rDNA-probe revealed interstitial sites on the m pair No. 1 for individuals of both A. albifrons populations, and in pericentromeric regions on the long arm of pair Nos. 5 and 9 in those of A. caudimaculosus. The karyotypes of A. albifrons and A. caudimaculosus indicated a reduction of 2n resulting from chromosomal fusion, as could be hypothesized from the presence of an interstitial telomere sequence in two chromosome pairs in karyotype of A. caudimaculosus. Thus, the present study demonstrated species-specific cytogenetic markers of otherwise morphologically very similar species A. albifrons and A. caudimaculosus.

Nursing challenges for universal health coverage: a systematic review.

OBJECTIVES: to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. METHOD: systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. RESULTS: thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. CONCLUSIONS: nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

Chromosomal polymorphism in Rineloricaria lanceolata Günther, 1868 (Loricariidae: Loricariinae) of the Paraguay basin (Mato Grosso do Sul, Brazil): evidence of fusions and their consequences in the population.

Rineloricaria is the most species-rich genus of the Loricariinae (armored catfish) with 65 valid species. However, the karyotype structure is known only for eight species in this group. This study provides cytogenetic data for Rineloricaria lanceolata collected from the upper Paraguay basin (Mato Grosso do Sul). The specimens revealed extensive chromosomal polymorphism constituting 10 karyotypes, which differed in the diploid number (48 to 45 chromosomes) and fundamental number (FN) between 52 and 55. Three types of chromosome variants were observed: a medium-sized submetacentric, a large submetacentric, and a small acrocentric form. Internal telomere sequences were demonstrated by a telomeric (TTAGGG)n probe in submetacentric chromosome variants, suggesting Robertsonian and tandem fusions. Considering the karyotype 2n=48 (4m+2st+42a, FN=54) as the starting point for this polymorphism, these rearrangements contributed to the reduction in diploid number (48-45). Furthermore, a remarkable polymorphism of 18S rDNA resulted in three nucleolus organizer region phenotypes (I, II, and III) with variable frequencies. Interestingly, this polymorphism has remained in the population through interbreeding between specimens, resulting in different viable combinations. The data obtained confirm that diversification/karyotype evolution in Rineloricaria was marked by numerous chromosomal rearrangements which appear to be well tolerated in the panmitic population.

Dupla titulação em enfermagem: potencialidades e desafios de uma experiência de internacionalização acadêmica discente / Doble titulación en enfermería: potencialidades y retos de una experiencia de internacionalización académica discente / Double nursing degree: potentialities and challenges of an international student academic experience

RESUMO Objetivo Compartilhar a experiência da dupla titulação em enfermagem promovida entre a Escola de Enfermagem da Universidade de São Paulo e o Instituto de Ciências da Saúde da Universidade Católica Portuguesa, fazendo uma reflexão sobre as potencialidades e os desafios dessa oportunidade para o estudante de pós-graduação. Método Trata-se de um relato de experiência apresentado em ordem cronológica e de natureza descritiva. A dupla titulação em enfermagem foi realizada no período de 6 meses, em instituição diferente da de origem. Resultados Dentre as atividades desenvolvidas durante a dupla titulação destacam-se: participação em bancas de defesa, congressos, seminário, cursos, encontros, palestras, colóquios, aulas, grupos de pesquisa e visita técnica aos serviços de saúde. Um quadro apresenta e descreve os principais benefícios da experiência vivenciada pelas autoras. Conclusão A dupla titulação, quando bem planejada e desenvolvida, pode promover o desenvolvimento pessoal, cultural e profissional do estudante, favorecendo a internacionalização e contribuindo para a qualificação dos programas de pós-graduação.

RESUMEN Objetivo Compartir la experiencia de la doble titulación en enfermería promovida entre la Escuela de Enfermería de la Universidad de São Paulo y el Instituto de Ciencias de la Salud de la Universidad Católica Portuguesa, mediante una reflexión acerca de las potencialidades y los desafíos de esa oportunidad para el estudiante de posgrado. Método Se trata de un relato de experiencia presentado en orden cronológico y de naturaleza descriptiva. La doble titulación en enfermería fue llevada a cabo en el período de seis meses, en centro distinto de aquel de origen. Resultados Entre las actividades desarrolladas durante la doble titulación, se destacan: participación en tribunales de defensa, congresos, seminarios, cursos, encuentros, charlas, coloquios, clases, grupos de investigación y visita técnica a los servicios sanitarios. Un recuadro presenta y describe los principales beneficios de la experiencia vivida por las autoras. Conclusión La doble titulación, cuando bien planificada y desarrollada, puede promover el desarrollo personal, cultural y profesional del estudiante, favoreciendo la internacionalización y contribuyendo a la calificación de los programas de posgrado.

ABSTRACT Objective To share the experience of a Double Nursing degree promoted between the Nursing School of the Universidade de São Paulo and the Health Sciences Institute of the Universidade Católica Portuguesa, reflecting on the potentialities and challenges of this opportunity for graduate students. Method This is an experience report presented in chronological order and of a descriptive nature. The double degree in Nursing was accomplished over a period of 6 months in a different institution from the institution of origin. Results Among the activities developed during the Double Degree are: participating in examining boards, congresses, seminars, courses, meetings, lectures, colloquium, classes, research groups and technical visits to health services. A table presents and describes the main benefits of the experience experienced by the authors. Conclusion When well-planned and well-developed, a double degree can promote personal, cultural and professional development of the students, favoring internationalization and contributing to the qualification of graduate programs.

Sensibilidade moral dos enfermeiros avaliada por scoping review / Moral sensitivity of nurses assessed through scoping review / Sensibilidad moral de los enfermeros evaluada por Scoping review

Esse estudo tem como objetivo identificar os fatores que influenciam a sensibilidade moral dos enfermeiros nos serviços de saúde, a partir de publicações sobre a temática. Para tanto, realizou-se uma scoping review no período de agosto a dezembro de 2015 em bases de dados da literatura em saúde. Foram incluídos artigos teóricos e originais realizados com estudantes de Enfermagem e equipes de saúde com enfermeiros, publicados em inglês, espanhol e português. A amostra foi de 28 estudos. Da análise, resultaram duas categorias: "fatores pessoais" e "fatores contextuais" da sensibilidade moral. Conclui-se que o fator que tem maior peso na formação/expressão da sensibilidade moral dos enfermeiros são os "fatores pessoais". A sensibilidade moral tem uma natureza multidimensional, e que precisa ser complementada com uma preparação do enfermeiro para identificar e lidar de forma responsável e prudente com os problemas éticos da prática (AU).

This study aims to identify the factors that influence the moral sensitivity of nurses in health services, based on publications on the theme. Therefore, we conducted a scoping review for the August-December 2015 period in health literature databases. Theoretical and original studies with nursing students and health teams with nurses, published in English, Spanish and Portuguese, were included. The sample consisted of 28 studies. Two categories emerged from the analysis: "personal factors" and "contextual factors" of moral sensitivity. We concluded that "personal factors" have the greatest impact on the formation/expression of moral sensitivity of nurses. Moral sensibility has a multidimensional nature and must be complemented with nurse's training to identify and deal responsibly and prudently with the ethical problems of clinical practice (AU).

Estudio cuyo objetivo fue identificar los factores que influyen en la sensibilidad moral de los enfermeros en los servicios de salud, a partir de publicaciones sobre la temática. Para ello, se realizó una scoping review entre agosto y diciembre de 2015, en bases de datos de literatura en salud. Fueron incluidos artículos teóricos y originales realizados con estudiantes de Enfermería y equipos de salud con enfermeros, publicados en inglés, español y portugués. La muestra incluyó 28 estudios. Del análisis surgieron dos categorías: "factores personales" y "factores conceptuales" de la sensibilidad moral. Se concluye en que el factor de mayor peso en la formación/expresión de la sensibilidad moral de los enfermeros son los "factores personales". La sensibilidad moral tiene naturaleza multidimensional, que necesita complementarse con preparación del enfermero para identificar y enfrentar de manera responsable y prudente los problemas éticos de la práctica (AU).

Nursing challenges for universal health coverage: a systematic review / Desafios da enfermagem para a cobertura universal de saúde: uma revisão sistemática / Retos de la enfermería para la cobertura universal de salud: una revisión sistemática

Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

Objetivos identificar os desafios da enfermagem para a cobertura universal de saúde, baseado nos resultados de uma revisão sistemática com foco na compreensão da força de trabalho em saúde sobre o papel das práticas de humanização na Atenção Básica. Método revisão sistemática e meta-síntese, partindo das seguintes fontes de informação: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS e Proquest, utilizando-se a palavra-chave Primary Health Care, associada separadamente às seguintes palavras-chave: humanization of assistance (humanização), holistic care/health (cuidado/saúde holístico), patient centred care, user embracement (acolhimento), personal autonomy, holism, attitude of health personnel (atitude dos profissionais). Resultados trinta estudos entre 1999 e 2011. Os processos de trabalho na Atenção Básica são complexos e apresentam dificuldades para a prática assistencial holística, especialmente para a enfermagem. Contudo, as práticas humanizadoras têm demonstrado seu papel importante em direção ao desenvolvimento de ambientes de trabalho positivos, à qualidade da assistência e atenção centrada em pessoas mediante a promoção da acessibilidade e da cobertura universal de saúde. Conclusões os desafios da enfermagem para a cobertura universal de saúde dizem respeito à educação e capacitação, melhores condições de trabalho e uma definição clara do papel da enfermagem na atenção primária. Há dificuldades a serem vencidas, tais como os conceitos fragmentados de saúde e atenção, além dos investimentos no trabalho em equipe multidisciplinar, empoderamento da comunidade, vínculo professional-paciente, acolhimento do usuário, tecnologias leves, com vistas a promover a qualidade de vida, atenção integral e cobertura universal de saúde.

Objetivos Identificar los retos de la enfermería para la cobertura universal de salud basado en los resultados de una revisión sistemática centrado en la comprensión de los profesionales de salud sobre el papel de las prácticas de humanización en la atención primaria. Método revisión sistemática y meta-síntesis, a partir de las siguientes fuentes: PubMed, CINAHL, SciELO, Web of Science, PsycInfo, SCOPUS, DEDALUS y Proquest, usando la palabra clave primary health care (atenção básica), asociada por separado con las siguientes palabras clave: humanization of assistance (humanização), holistic care/health (cuidado/saúde holístico), patient centred care, user embracement (acolhimento), personal autonomy, holism, attitude of health personnel (atitude dos profissionais). Resultados Treinta estudios entre 1999 y 2011. Los procesos de trabajo en la atención primaria son complejas y presentan dificultades para la práctica de atención integral, especialmente para la enfermería. Sin embargo, las prácticas de humanización han demostrado su papel importante hacia el desarrollo de entornos de trabajo positivos, la calidad del cuidado y la atención centrada en personas a través de la promoción de la accesibilidad y la cobertura universal de salud. Conclusiones los retos de la enfermería para la cobertura universal de salud son relacionados con la educación y la capacitación, mejores condiciones de trabajo y una definición clara del papel de la enfermería en la atención primaria. Hay dificultades que hay que superar, como los conceptos fragmentados de salud y de cuidado, así como las inversiones en el trabajo en equipo multidisciplinario, potenciación de la comunidad, la relación profesional-paciente, la aceptación del usuario, las tecnologías blandas, con el fin de promover la calidad de vida, atención integral y la cobertura universal de salud.

Elements and strategies for ethical decision-making in Nursing / Elementos y estrategias para la toma de decisión ética en Enfermería / Elementos e estratégias para a tomada de decisão ética em Enfermagem

ABSTRACT This study aimed to identify the elements and strategies that facilitate the ethical decision-making of nurses faced with ethical problems, from publications on the theme. An integrative literature review was carried out. Data collection was performed between the months of April and May 2014, in the databases: SciELO, CINAHL, LILACS and MEDLINE. Original, theoretical and case study articles, with a health team that included nurses, published in Portuguese, English and Spanish were included. A total of 19 studies were selected, the analysis of which resulted in three categories: external factors of ethical decision-making in nursing, individual factors of ethical decision-making in nursing and facilitating strategies of ethical decision-making in nursing. It was concluded that nurses need to use strategies that develop sensitivity, ability and ethical competence, in order to make prudent ethical decisions, contributing to the quality of health care.

RESUMEN Este estudio tiene como objetivo identificar los elementos y estrategias que faciliten la toma de decisión ética de las enfermeras frente a los problemas éticos, a partir de las publicaciones sobre el tema. Se realizó una revisión integradora de literatura. La recolección de datos se llevó a cabo entre abril y mayo de 2014, en las bases de datos: SciELO, CINAHL, LILACS y MEDLINE. Se incluyeron artículos originales de investigación, estudios teóricos y estudio de caso, publicadas en inglés, español y portugués, con el equipo de salud que incluye enfermeras. Se seleccionaron 19 estudios, el análisis resultó en tres categorías: factores externos de la toma de decisiones éticas en enfermería, factores individuales de la toma de decisiones éticas en enfermería y estrategias facilitadoras de la toma de decisiones éticas en la enfermería. Se concluye que los enfermeros han de utilizar estrategias que desarrollan la sensibilidad, habilidades y competencia ética, para así, tomar decisiones éticas prudentes, lo que contribuye a la calidad de la atención a la salud.

RESUMO Este estudo tem como objetivo identificar os elementos e as estratégias que facilitam a tomada de decisão ética dos enfermeiros frente aos problemas éticos, a partir de publicações sobre a temática. Realizou-se uma revisão integrativa da literatura. A coleta de dados foi realizada entre os meses de abril e maio de 2014, nas bases: SciELO, CINAHL, LILACS e MEDLINE. Foram incluídos artigos de pesquisa empírica, estudos teóricos e estudos de caso, publicados em inglês, espanhol e português, com equipe de saúde que incluísse enfermeiros. Foram selecionados 19 estudos, da análise resultaram três categorias: fatores externos da tomada de decisão ética em enfermagem; fatores individuais da tomada de decisão ética em enfermagem; e, estratégias facilitadoras da tomada de decisão ética em enfermagem. Conclui-se que os enfermeiros precisam utilizar estratégias que desenvolvam a sensibilidade, habilidades e competência ética para, assim, tomar decisões éticas prudentes, contribuindo para a qualidade da atenção à saúde.

Production of nursing thesis and dissertations in Portugal, 2000-2010: a bibliometric study / Producciones de disertaciones y tesis de enfermería en Portugal de 2000-2010: estudio bibliométrico / Produções de teses e dissertações da enfermagem em Portugal de 2000-2010: estudo bibliométrico

The study identifies Portuguese nursing research, produced in the period 2000 - 2010, published via Master's dissertations and doctoral theses, analyzed according to the following variables: institution training masters and doctors, studies' distribution by institution, study supervisors and co-supervisors with their respective titles, supervisors' productions, keywords/descriptors, topics studied, theoretical framework, methodological framework, subjects, data collection and data analysis. In this exploratory, descriptive and bibliometric study, dissertations from the Catholic University of Portugal and the Institute of Biomedical Sciences of the University of Porto were collected, as were doctoral theses from both these institutions and the University of Lisbon, totalling 41 theses and 273 dissertations. The results describe the theoretical, methodological and bibliometric aspects of the strictu sensu scientific production of Portuguese nursing. It is concluded that nurse researchers, in having knowledge of the specific areas of the studies, can improve them to achieve quality and excellence of the training of Master's and doctoral students.

El estudio identifica la investigación de enfermería portugués producido en el período 2000 a 2010, publicado por disertaciones de maestría y tesis de doctorado, analizados por medio de las variables: institución formadora, distribución de los estudios por institución, orientador y co-orientador del estudio con respectiva titulación, productividad de los asesores, palabras clave/descriptores, temas estudiados, referencial teórico, referencial metodológico, sujetos, recolección y análisis de los datos. El estudio es de tipo exploratorio, descriptivo, bibliométrico, realizado mediante el levantamiento de las disertaciones de maestría de la Universidad Católica Portuguesa y del Instituto de Ciencias Biomédicas de la Universidad de Oporto y de las tesis de doctorado de dichas instituciones y de la Universidad de Lisboa, se analizó un total de 41 tesis y 273disertaciones. En los resultados están discriminados aspectos teóricos, metodológicos y bibliométricos de la producción científica stricto sensu de la enfermería portuguesa. Se concluyó que los enfermeros investigadores, al tener conocimiento de las especificidades de los estudios, pueden perfeccionarlos con consecuencias en la calidad y la excelencia de la formación de maestros y doctores.

O estudo identifica as pesquisas da enfermagem portuguesa, produzidas no período de 2000 a 2010, divulgadas por meio de dissertações de mestrado e de teses de doutorado, analisadas pelas seguintes variáveis: instituição formadora, distribuição dos estudos por instituição, orientador e co-orientador do estudo com respectiva titulação, produtividade dos orientadores, palavras-chave/descritores, temas estudados, referencial teórico, referencial metodológico, sujeitos, coleta e análise dos dados. O estudo é do tipo exploratório, descritivo, bibliométrico, realizado a partir do levantamento das dissertações da Universidade Católica Portuguesa e do Instituto de Ciências Biomédicas da Universidade do Porto e das teses de doutorado dessas instituições e da Universidade de Lisboa, totalizando 41 teses e 273 dissertações. Nos resultados, são discriminados aspectos teóricos, metodológicos e bibliométricos da produção científica stricto sensu da enfermagem portuguesa. Conclui-se que os enfermeiros pesquisadores, ao terem conhecimento das especificidades dos estudos, podem aperfeiçoá-las para a qualidade e excelência da formação de mestres e doutores.

Tradução e adaptação transcultural do instrumento Spiritual Assessment Scale no Brasil / Translation and cross-cultural validation of the instrument Spiritual Assessment Scale in Brazil

Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetivou realizar a adaptaçãotranscultural do instrumento “Spiritual Assessment Scale” (SAS) para o Brasil. Foi desenvolvido um instrumento específicopara a adaptação transcultural basedo nos estudos de Lynn (escala de Likert). A primeira etapa consistiu na aplicação doinstrumento desenvolvido pelos autores para avaliação da SAS com 6 experts da área de Espiritualidade e Enfermagem ecom 11 pacientes da unidade de clínica médica, para avaliação do instrumento SAS com 21 questões. Após a realizaçãode testes estatísticos, as questões estavam adequadas para a aplicação na pesquisa, como demonstrado pelo coeficientealfa de Cronbach, que indicou uma confiabilidade aceitável do instrumento. Pode-se afirmar que em ambos os grupos(expert e pacientes) a consistência interna foi elevada, mantendo as características da escala original, após as etapas detradução e adaptação para o Brasil.

Spirituality is considered an integrant part of nursing care. This study aimed to perform a cross-cultural adaptation of the“Spiritual Assessment Scale” (SAS) to Brazil. A specific instrument for cross-cultural adaptation based on Lynn’s studies(Likert scale) was developed. The first step consisted in the application of the instrument developed by the authors to assessthe SAS by 6 “experts” in the area of Spirituality and Nursing and with 11 patients from the clinical medical unit to reviewthe SAS instrument with 21 questions. After conducting statistical tests, the questions were considered appropriate for usein the research as demonstrated by Cronbach’s alpha, which indicated an acceptable reliability of the instrument. It can bestated that in both groups (experts and patients) internal consistency was high, the characteristics of the original scale werepreserved even after the stages of translation and adaptation to Brazil.

A influência da espiritualidade na qualidade de vida do paciente oncológico: reflexão bioética / The influence of spirituality in the quality of life of cancer patients: bioethical reflection

Objetivo: Este estudo objetivou verificar o impacto da espiritualidade no enfrentamento do processo de adoecimento e na qualidade de vida em pacientes com de diagnóstico de câncer. Método: O estudo foi realizado com em 30 pacientes com idade média de 46,6±14 anos, 52% eram do gênero feminino, 56% católicos e 72% casados, Resultados: Identificou-se para o conceito de fé pessoal 32,1 ±3; prática religiosa 29,5 ±7 e paz espiritual 32 ±6, A média dos escores para a qualidade de vida global foi 3,9± 1 e a satisfação com a saúde 3,6± 1, Quanto à associação do escore total da escala de espiritual idade com os domínios de qualidade de vida (físico, psicológico, social e meio ambiente), observou-se apenas a associação da espiritual idade com o domínio físico, Conclusão: Concluindo os elevados escores de paz espiritual em pacientes oncológicos, demonstrou impactar na qualidade de vida promovendo o enfrentamento da doença.

Objective: We examined the impact of spirituality in coping with the disease process and the quality of life in patients with a diagnosis of cancer Method: The study was conducted in 30 patients with mean age of 46,6 ± 14 years, 52% were female, 56% Catholic and 72% rnarried. Results: We identified the concept of personal faith 32,1 ± 3; religious practice and 29.5 ± 7 32 ± 6 spiritual peace. Mean scores for overall quality of life was 3,9 ± 1, and satisfaction with health 3,6 ± 1, In relation the association of the total score of spirituality with the areas of quality of life (physical, psychological, social and environment), we observed the association of the spirituality with the physical domam. Conclusion: In conclusion the high scores of spiritual peace in cancer patient, demonstrated impact on quality of life by promoting coping with the disease.

Objetivo: Valorar el impacto de la espiritualidad para lidiar con el proceso de la enfermedad y la calidad de vida en pacientes con un diagnóstico de cáncer, Método: El estudio se realizó en 30 pacientes con edad media de 46,6 ± 14 anos, el 52 % eran mujeres, 56% católica y se casó con un 72%, Resultados: Se identificó el concepto de Ia fe personal 32,1 ± 3; la práctica religiosa y de 29,5 ± 7 32 ± 6 Ia paz espiritual. Las puntuaciones medias de calidad de vida fue de 3,9 ± 1, Y Ia satisfacción con Ia salud de 3,6 ± 1, En cuanto a la asociación de la puntuación total de la espiritualidad con las áreas de calidad de vida (física, psicológica, social y medio ambiente), que sólo se observa la asociación de la espiritualidad con el dominio físico, Conclusión: Se concluye que las puntuaciones más altas de la paz espiritual demostrado impacto en la calidad de vida mediante la promoción de afrontamiento de la enfermedad.

(Re) descoberta de esperança na família da criança com doença crônica através do genograma e ecomapa / (Re) discovering hope in families of children with chronic disease through genogram and ecomap / (Re) descubrimiento de la esperanza en la familia delniño con enfermedad crónica a partir de genograma y ecomapa

Nos contextos do cuidar da família da criança com doença crônica, vários têm sido os desafios que se colocam às equipes de enfermagem, no âmbito da promoção de esperança, em contexto da avaliação e intervenção familiar. O genograma e ecomapa constituem-se como veículos para uma compreensão mais aprofundada dos vínculos e padrões de interação da família. Pretendemos apresentar a utilização do genograma e ecomapa na identificação dos recursos de esperança junto a mães de crianças com doença crônica. Trata-se de uma investigação qualitativa, onde foram identificados os factores que influenciam a esperança nos grupos de ajuda mútua. A colheita de dados foi realizada através de entrevista semi-estruturada a vinte mães, de Julho de 2009 a Junho de 2010. Os resultados permitiram identificar os padrões de interação em esperança, os atributos pessoais dos seus membros, a base espiritual e as memórias moralizantes, possibilitando uma reflexão acerca da rede familiar, como rede de força, resiliência e empowerment.

Within the care settings of families of children with chronic diseases, there are challenges nursing teams have to face within the scope of fostering hope with the context of family assessment and intervention. The genogram and the ecomap have become vehicles for a deeper understanding of attachments and family interaction patterns. We propose the utilization of genograms and ecomaps in identifying resources for hope for mothers of children with chronic diseases. This is a qualitative study which identified factors that influence hope in mutual help groups. Data was collected through semi-structured interviews with twenty mothers, carried out from July of 2009 to June of 2010. The results permit the identification of patterns of interaction with hope, the personal attributes of its members, spiritual bases, and moralizing memories, enabling reflexion on the family network as a network of strength, resilience, and empowerment.

En el contexto de los cuidados de la familia del niño con enfermedad crónica distintos han sido los retos que se plantean a los equipos de enfermería en el ámbito de la promoción de esperanza en el momento de la evaluación e intervención familiar. El genograma y ecomapa se constituyen en un vehículo para la comprensión más profundizada de los vínculos y de los modelos de interacción de la familia. Tenemos la intención de proponer la construcción de un genograma y ecomapa para identificar los recursos de esperanza con madres de niños con enfermedad crónica. Se trata de una investigación cualitativa, donde se identificaron los factores que influyen en la esperanza en los grupos de ayuda mutua. La recolección de datos se realizó a través de entrevista semi-estructurada de veinte madres, de Julio de 2009 a Junio de 2010. Los resultados muestran los modelos de interacción en esperanza, los atributos personales de sus miembros, la base espiritual y las memorias moralizantes, haciendo posible una reflexión sobre la red familiar, como una red de fuerza, resiliencia y empowerment.