At present very little is known of the various problems mothers experience when their children are admitted to a day care unit in terms of the increased responsibility which is placed upon them for the preparation of their children and their care at home following discharge. The purpose of this study was to identify some of the major concerns expressed by mothers who participated in a day care unit in a children's hospital in Vancouver. A sample of twenty mothers was selected and the kinds of nursing activities in which they participated in the unit were assessed and rated by a participation scale. The data were collected by the researcher who took on the role of participant observer in the day care unit. Field notes were written on the mothers while they were in the unit and post hospital interviews recorded approximately one week to ten days following discharge. The participation scales, field notes and post hospital interviews were analyzed and the frequency and percentages of the expressed concerns determined. Seventy per cent of the mothers in the study group needed help in assisting with the care of their children in the unit. Concerns expressed by the mothers were centered on the notion of time and a desire for information related to the child's diagnosis, the anaesthetic, and operation performed. Postoperatively they expressed concerns related to symptoms caused by the anaesthetic, operation or examination. They seemed particularly apprehensive about the anaesthetic and its possible effects on the children. Seventy-five per cent of the mothers had previous experience with the hospitalization of their children. This factor seemed most characteristic of the group and influenced their participation in the day care activities. Only two mothers had prior knowledge of the day care unit and they participated independently, requiring little assistance from the nurse. Ninety per cent of the mothers were satisfied with the day care experience. Two mothers were unhappy about the arrangements and would have preferred having their children in hospital for a few days postoperatively. These mothers would have benefited from a home visit by a nurse. The remaining 90 per cent stated they did not feel they needed a visit from a nurse postoperatively. All mothers appreciated a telephone call from the hospital following surgery. The mothers contacted their doctors if problems arose at home. They felt the instructions they received by mail prior to admission were adequate. The success of surgical day care units for children is dependent upon the interest and support of parents. Mothers can prepare their children for surgery and cope with post hospital care, if they receive help and support from the nursing staff. Mothers whose children have been treated in a day care unit are most enthusiastic about this type of hospital care. / Applied Science, Faculty of / Nursing, School of / Graduate

Introduction: Thromboprophylaxis recommendations for hospitalized cancer are based on trials done for the general medically patients, as there are no randomized clinical trials(RCTs) looking at thromboprophylaxis in medically ill patients with cancer. Methods: To determine if thromboprophylaxis is safe and effective to prevent VTE these patients, a Systematic Review(SR) was done. A survey was performed to assess: clinical equipoise, trial design and minimally clinically important difference(MCID) for a potential trial. Lastly, a pilot study for an RCT was designed. Results: The pooled RR of VTE was 0.91 (95%CI:0.21 to 4.0;I2:68%) among hospitalized cancer patients receiving thromboprophylaxis compared to placebo. 63.9% believe there is clinical equipoise and 58.3% would consider participating in a RCT comparing different agents/dosing. The MCID for absolute reduction in symptomatic VTE between two arms was 2% and for “acceptable” increase in major bleeding events was 1%. Conclusion: The risk-benefit ratio of current doses of thromboprophylaxis administered to hospitalized cancer patients is unclear and additional RCTs are necessary.

The present experiment is designed to test certain hypotheses made concerning the nature of conditioning in a verbal operant paradigm, and the relationship of such conditioning with awareness of contingencies.

People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.

No description available.

La relation médicale est en permanente mutation du fait des évolutions techniques ou des changements de mentalité. La charte des droits de la personne hospitalisée a reconnu des droits aux patients qui deviennent alors des partenaires incontournables de la relation médicale prenant un rôle de plus en plus actif. Ces droits ont profondément marqué les esprits des professionnels de santé qui se sentent stigmatisés par une société de consommation et de preuve. La relation de confiance perd de son intérêt au profit de l'information, du recueil du consentement, du respect de la dignité et de la confidentialité. Parler d'obligations et de devoirs n'est pas anodin. Ce concept a un double intérêt vu le contexte et les enjeux de notre société et il pourrait trouver tout naturellement une application dans le domaine sanitaire, notamment lors d'une hospitalisation. La réelle question est de savoir s'il existe, dans ce dernier cas, des obligations et des devoirs à la charge de la personne hospitalisée. Une première approche permettra de rechercher des éléments de réponse alors qu'une seconde approche aura pour but de recenser les obligations avec leurs sanctions éventuelles. Mettre en parallèle les droits et les obligations des personnes hospitalisées devrait permettre de relier enfin le praticien au patient, d'équilibrer la relation et reconnaître ainsi un contre poids aux droits, un complément et non un opposant à la Charte. Faut-il encore que ces obligations soient connues… / Medical relation is in permanent mutation due to technical evolutions or mentality changes. Patients have been awarded rights by the Charter of hospitalized people's rights that make them major partners in the medical relation taking a more and more active role. These rights have profoundly marked the minds of health professionals who feel stigmatized by a consumption and proof society. The trust relation loses its interest for the benefit of information, obtaining consent, dignity's respect and confidentiality. Talking about obligations and duties is not insignificant. This concept has a dual interest in view of the context and the stakes of our society and it could naturally find a scope in the sanitarian field, especially during hospitalization. The real question is to know if, in the latter case, obligations and duties dependent on the hospitalized people exist. A first approach will permit to search for answers, while a second approach will try to list obligations and their possible penalties. To draw a parallel between the rights and obligations of hospitalized people should finally permit to link practitioner and patient, to balance the relation and so to acknowledge a counterbalance to the rights, a complement not an opponent to the Charter. Still, these obligations have to be known...

Made available in DSpace on 2015-05-08T14:47:26Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1280961 bytes, checksum: 704c707d724630fe3de7dc54cec64863 (MD5) Previous issue date: 2012-02-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The right of children and teenage to continue enjoying the school process during the hospitalization is guaranteed through resolution No. 02 of 2001 of the National Council of Education/Chamber of basic education. Despite so many laws and documents violations of those rights is a daily fact in Brazil. Our goals were to identify the design of managers of education and health professionals about the education of children and teenage during hospitalization; and seize the family conception of school-age children and teenage regarding the expulsion of the schooling process, during hospitalization. We use in our study the qualitative approach of exploratory type descriptive. The empirical material was produced through semi structured interview and focus group conducted in University Hospital Lauro Wanderley (HULW) and at the Children s Hospital Arlinda Marques (HIAM) in the period April to August 2011. The subject of the research were 21. Among them, 7 were managers, 6 professional and 8 family/caregivers. For the interpretation of empirical material we use thematic analysis. Resolution N° 196/96 National Health Council, and resolution COFEN no 311/2007 guided the development of this research. In the process of analysis of the empirical material resulted in three categories: Hospitalization and Schooling: implications of remoteness and coping strategies; Formal Schooling in Hospital: knowledge of the laws imposed; Pedagogical care Hospital: perception of managers and professionals. These categories have revealed hospitalization is shown that considered moment that makes the child/teenage experience painful experiences due to the remoteness of friends and daily routine; the idleness and lack of activities that will remember the school everyday cause child/teenage retract themselves and forget the healthy childhood. Family members and professionals they blame the management for the non fulfillment of hospital school service polictic, in the absence of that family care seeks ways of tackling school losses of their children. Sometimes managers do not believe that the family recognizes the importance of education for the life of their children. The limited perception of possibility of continuity of cognitive and intellectual formation process demonstrates lack of knowledge and sensitivity of some managers and professionals. Therefore, we infer that, the lack of hospital grade is fact, so we call attention to the need for a face-to-face discussion that should result in effectiveness/implementation this educational strategy. The problems faced by children and adolescents have urgency to be solved, and should be addressed, thus avoiding the aggravation of the situation and the losses. We believe that the political will and looks more human and less welfare of managers will be able to consolidate the implementation of public policies imposed. / O direito de crianças e de adolescentes de continuar desfrutando da escolarização durante a hospitalização é garantido na Resolução Nº 02 de 2001 do Conselho Nacional de Educação/Câmara de Educação Básica. Apesar de tantas leis e documentos, a violação desses direitos é um fato diário no Brasil. Nossos objetivos foram identificar a concepção dos gestores da educação e da saúde e dos profissionais de saúde acerca da escolarização da criança/adolescente durante a hospitalização; e apreender a concepção da família de crianças em idade escolar e adolescentes quanto ao afastamento do processo de escolarização, por ocasião de internação hospitalar. Utilizamos em nosso estudo a abordagem qualitativa do tipo exploratório descritiva. O material empírico foi produzido por meio de entrevista semi estruturada e grupo focal, realizados no Hospital Universitário Lauro Wanderley (HULW) e no Hospital Infantil Arlinda Marques (HIAM) no período de Abril a Agosto de 2011. Os sujeitos da pesquisa foram 21. Dentre eles, 7 eram gestores, 6 profissionais e 8 familiares/acompanhantes. Para a interpretação do material empírico utilizamos a análise temática. A Resolução Nº 196/96 do Conselho Nacional de Saúde, e a Resolução COFEN Nº 311/2007 nortearam o desenvolvimento desta pesquisa. No processo de análise do material empírico, foram identificadas três categorias empíricas: Hospitalização e Escolaridade: implicações do afastamento e estratégias para o enfrentamento; Escolarização Formal no Hospital: conhecimento da legislação vigente; Atendimento Pedagógico Hospitalar: percepção de gestores e profissionais. Essas categorias revelaram que a hospitalização é considerada momento que faz a criança/adolescente vivenciar experiências dolorosas devido ao afastamento dos amigos e da rotina diária; a ociosidade e a ausência de atividades que relembrem o cotidiano escolar fazem com que crianças/adolescentes se retraiam e esqueçam da infância saudável. Familiares e profissionais responsabilizam a gestão pela não efetivação da política de atendimento escolar hospitalar, e não dispondo desse atendimento, a família busca formas de enfrentar as perdas escolares de seus filhos. Gestores, por vezes, não acreditam que a família reconheça a importância da educação para a vida de seus filhos. A percepção limitada diante da possibilidade de continuidade do processo de formação cognitiva e intelectual demonstra falta de conhecimento e de sensibilidade de alguns gestores e profissionais. Diante disso, inferimos que, os problemas enfrentados por crianças e adolescentes têm urgência em serem resolvidos, devendo ser solucionados, evitando assim o agravamento da situação e os prejuízos. A inexistência da classe hospitalar é fato, portanto chamamos atenção para a necessidade de uma discussão presencial que culmine na efetivação/implantação dessa estratégia. Acreditamos que a vontade política e os olhares mais humanos e menos assistencialistas dos gestores poderão se consolidar na implementação das políticas públicas instituídas.

Ward environment as assessed by the Ward Atmosphere Scale was the focus of this exploratory study. The Ward Atmosphere scores of 110 patients hospitalized on two units for acute psychiatric care in a state hospital were analyzed for determining differences along the dimensions of population factors, sex and program change. Significant differences in attitude were obtained on certain of the ten scales for each of the three comparisons. The premise of ward atmosphere being a global entity as implied in the literature was not upheld in this population. Sex differences were noted and introduction of an individualized patient management program evoked significant changes in opinions concerning ward atmosphere. A number of interpretations for these results were offered and implication for future research was suggested.

Crianças e adolescentes podem fornecer informações importantes para a melhoria dos serviços de saúde, por exemplo, no que se refere à comunicação com a equipe de enfermagem e à qualidade da assistência recebida durante a hospitalização. Podem, ainda, dizer a respeito de sua relação com a equipe multidisciplinar, em particular com os enfermeiros, pois identificam o que os torna bons profissionais. Sendo assim, o presente estudo tem como objetivo compreender as perspectivas de crianças e adolescentes hospitalizados sobre o que significa ser um bom enfermeiro. Considerando o objeto e objetivo do estudo, optamos por adotar o referencial da Grounded Theory ou Teoria Fundamentada nos Dados. O estudo, desenvolvido na unidade de pediatria de um hospital universitário do estado de São Paulo, teve a participação de 17 crianças e adolescentes, com idades entre 5 e 17 anos. Os dados foram coletados por meio de entrevista intermediada por estratégias lúdicas de comunicação, complementada por informações clínicas dos prontuários. A análise dos dados seguiu as recomendações da Teoria Fundamentada nos Dados e permitiu a elaboração de três categorias temáticas: enfermeiro ou enfermeira: as questões de gênero no trabalho da enfermagem; a comunicação como instrumento de trabalho do enfermeiro no cuidado a crianças e adolescentes hospitalizados e competências do enfermeiro diante da realização de procedimentos dolorosos na assistência a crianças e adolescentes hospitalizados. As questões de gênero no trabalho da enfermagem foram observadas quando os participantes, embora tenham mencionado a presença ainda discreta de homens na profissão, reconheceram que todos eram enfermeiros e que, desde que realizassem o cuidado corretamente, não deveria haver distinção. A comunicação desses profissionais foi considerada essencial durante a hospitalização e um importante atributo para o bom enfermeiro, sendo esta uma estratégia capaz de tornar o ambiente hospitalar mais acolhedor, amenizando o sofrimento provocado pelo período de hospitalização. As competências do enfermeiro diante da realização de procedimentos dolorosos também foram apontadas como atributo de um bom profissional. Os participantes destacaram a punção venosa como fonte de desconforto e dor, os quais poderiam ser amenizados mediante aprimoramento profissional, paciência, interação do enfermeiro com o paciente durante a realização deste procedimentos e tempo de experiência prática. Os resultados deste estudo preenchem uma lacuna na literatura brasileira sobre a temática, pois evidenciam implicações para a prática do enfermeiro e contribuem para a compreensão das experiências de crianças e adolescentes hospitalizados sobre a qualidade dos cuidados de saúde e o processo de hospitalização. Destaca, ainda, que crianças e adolescentes demonstram entendimento acerca dos cuidados realizados, sendo capazes de apontar o que esperam de um bom enfermeiro e de expressar suas perspectivas / Children and adolescents can provide important information for the improvement of health services, such as communication with the nursing team and the quality of care they receive during hospitalization. They can also say about their relationship with the multidisciplinary team, in particular with the nurses, they know, for example, what makes them good professionals. Thus, the present study aims to understand the perspectives of hospitalized children and adolescents about what it is to be a good nurse. Considering the object and purpose of the study, we rely on Grounded Theory. The study was carried out in a university hospital in the state of São Paulo, in the pediatric unit, with the participation of 17 children and adolescents, aged between 5 and 17 years. The data were collected through an interview intermediated by playful communication strategies and complemented by clinical information obtained in the medical record. Data analysis was performed according to the recommendations of the Grounded Theory. From the analysis of the empirical material, three thematic categories emerged: nurse: gender issues in nursing work, communication as a nurses work tool in the care of the hospitalized child and adolescent, and nurses competencies in the face of painful assistance procedures hospitalized child and adolescent. Gender issues in nursing work have implications when children and adolescents have pointed out the discreet presence of men in the profession, but that all are nurses and that by doing the right care there should be no distinction. The nurses communication was considered essential during hospitalization and an important attribute for the good nurse, being this a strategy to make the hospital environment more welcoming, alleviating the suffering caused by the hospitalization period. The nurses\' competences regarding painful procedures were also pointed out as an attribute of the good professional. The participants emphasized venous puncture as a source of discomfort and pain, which could be softened by professional improvement through study, patience, interaction of the nurse with the patient during the performance of the procedures and their time of practical experience. The results of this study fill a gap in the Brazilian literature on the subject, identifying implications for the practice of nurses and contributing to the understanding of the experiences of hospitalized children and adolescents about the quality of health care and the hospitalization process. It is also worth noting that children and adolescents demonstrate an understanding of the care they perform, being able to point out what they expect from a good nurse, as well as express their perspectives

Do atendimento a cardiopatas internados, criou-se a categoria vivência de perdas, desencadeada por evento(s) significativo(s) que implica no processo do luto. Segundo Freud (1916), o luto é um trabalho psíquico que requer um tempo para elaboração da perda e de transformação da realidade psíquica, desestruturada pela falta do objeto perdido. Entende-se que o luto é o correlato psicodinâmico da reação manifesta de depressão. Com estes fundamentos, esta pesquisa teve por objetivo geral: investigar vivência de perdas, estados de luto e de depressão. Foram avaliados 44 pacientes com os diagnósticos médicos de infarto agudo do miocárdio e angina, de 33 a 65 anos, 50% mulheres e 50% homens. Utilizados três instrumentos: entrevista semi-estruturada, para avaliação do luto; Inventário de Depressão de Beck, para depressão; Escala de Avaliação e Reajustamento Social de Holmes e Rahe, que avalia porcentagem de probabilidade de apresentar problemas de saúde. Os resultados foram relacionados através do programa Statistical Package for Social Sciences, versão 11.0. Apresenta estado de luto 65,9%, sendo significativas as relações entre: luto e depressão (p<0,05); luto e gênero (p=0,000); presente em 90,9% das mulheres; depressão e gênero (p<0,05). Os eventos significativos relatados com maior freqüência foram: morte de familiares, 47% ou de pessoa próxima, 13%. Também é significativa a relação estatística entre luto e quantidade de mortes relatadas por participante como evento significativo (p<0,05). Sugere vivência de perdas como indicativo de risco psicológico para doença arterial coronariana, apontando para a associação entre luto e depressão / Since the attendance of hospitalized cardiac patients was created the category experience of losses caused by significative(s) event(s) that implicated in the mourning process. According to Freud (1916), mourning is a psychic process that requires time for the loss elaboration and changing of the psychic reality, shaped by the lost object missing. Mourning is understood as a psychodynamic correlation of the manifested depression reaction. On this basis, this research aimed: investigate experience of losses, mourning and depression. 44 patients with medical diagnosis of severe heart attack and angina were evaluated, from 33 to 65 years old, 50% women and 50 % men. Three instruments were used: semi-structured interview for mourning evaluation; Beck Depression Inventory, for depression; Holmes and Rahe Social Readjustment Rating Scale, which evaluates the probability of presenting health problems. The results were treated by the software Statistical Package for Social Sciences version 11.0 . 65,9% presented state of mourning and the association between : mourning and depression were significative (p<0,05); mourning and gender (p=0,000), presented in 90,9% of the women; depression and gender (p<0,05). The significative events more frequently reported were: death of a relative 47%, or closer person 13%. It is also significative the statistical relation between mourning and deaths related by the participants as significative event (p<0,05). Experience of losses is suggested as indicative of psychological risk for coronary artery disease, highlighting the association with mourning and depression