Background: Approximately two percent of the population in Sweden suffers from heart failure. The next three decades will see a dramatic increase in people at risk of heart failure and with a shortage of available donors, alternatives to transplantation need to be used. The heart-assist device can be obtained as destination therapy or as bridge to transplantation and implies challenges for patient’s quality of life. Aim: To examine how patients living with a heart-assist device experience their quality of life from the perspectives of physical, mental, and social health.  Method: A literature review with qualitative design. The results of the study are based on eleven qualitative studies acquired from the databases PubMed, CINAHL and Web Of Science. Selected articles were examined using the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU: s) template for qualitative methodology.  Result: Three main categories and ten subcategories were identified. One category was physical health, with the following subcategories: Adaptations to deal with everyday life, limitations in everyday life and physical ability. Another category was mental/ spiritual health with following subcategories: negative emotions, strategies for dealing with the situation, beliefs and experiences of control and acceptance. The final category was social health, with the following subcategories: relationship with family and friends, social support and changed self-image.  Conclusion: To receive and carry a heart-assist device poses great challenges for patients and their social environment. Through a holistic approach nurses can create good conditions for patients to experience a good quality of life. / Bakgrund: Cirka två procent av Sveriges befolkning drabbas av hjärtsvikt. De förestående tre decennierna kommer innebära en dramatisk ökning av människor med risk att drabbas av hjärtsvikt och med brist på tillgängliga donatorer, behöver alternativ till transplantation nyttjas. Det mekaniska hjälphjärtat kan erhållas som destinationsterapi eller i väntan på transplantation. Behandlingen är krävande och innebär utmaningar för patienten och dennes livskvalitet. Syfte: Att undersöka hur patienter som lever med ett mekaniskt hjälphjärta upplever sin livskvalitet utifrån perspektiven fysisk, psykisk och social hälsa. Metod: Allmän litteraturöversikt med analys av kvalitativa studier. Studiens resultat baseras på elva kvalitativa studier som inhämtats från databaserna PubMed, CINAHL och Web Of Science. Valda artiklar kvalitetsgranskades med hjälp av SBU:s mall för studier med kvalitativ forskningsmetodik.  Resultat: Tre huvudkategorier och tio underkategorier identifierades. En kategori var fysisk hälsa med underkategorierna: anpassningar för att hantera det vardagliga livet, begränsningar i vardagen och fysisk förmåga. Den andra kategorin var psykisk-/spirituell hälsa med underkategorierna: negativa känslor, strategier för att hantera situationen, tro, samt upplevelser av kontroll och acceptans. Den tredje kategorin var social hälsa som innefattade följande underkategorier: relationen till familj och vänner, socialt stöd och förändrad självbild.  Slutsats: Att bära ett mekaniskt hjälphjärta ställer stora krav på patienten och dennes omgivning. Sjuksköterskan kan genom ett holistiskt arbetssätt skapa goda förutsättningar för att patienten ska uppleva en god livskvalitet.

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Cardiopulmonary resuscitation is a skill that all registered nurses should maintain. In South Africa, a new healthcare trend towards accreditation in this skill is emerging. It is assumed that nurses are competent in cardiopulmonary resuscitation, but studies indicate a problem of poor retention ofboth knowledge and skills in this area. A non-experimental, quantitative, descriptive and contextual research project was undertaken with the aim of exploring the knowledge of cardiopulmonary resuscitation of registered nurses working in the wards of selected private hospitals in the Western Cape Peninsula. A convenience sample of thirty registered nurses completed a multiple-choice questionnaire. The questions in the questionnaire were derived from a literature review as well as the basic and advanced cardiopulmonary resuscitation algorithms. Analysis of the data indicated that the level of knowledge of cardiopulmonary resuscitation was inadequate particularly in the areas of medication and the rationale underlying interventions. Recommendations that were made included proposals that cardiopulmonary resuscitation training programmes be revised; and that employers ensure that registered nursing ,staff are formally trained on an annual basis. / Health Studies / M.A. (Nursing Science)

The main purpose of this quantitative, descriptive, non-experimental study was to explore the perceptions of nurses in supervisory roles (NSRs) regarding competence of novice professional nurses (NPNs) in health education. The study’s conceptual frameworks were the objectives of the Regulation R.425 programme and the scope of practice of professional nurses. The study sought to reveal whether the NPNs were competent in health education and in identifying barriers to health education, and to make recommendations. A structured questionnaire was used for data collection from the professional nurses in supervisory roles. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0 program. The results revealed that NPNs were competent in health education, however, paid less attention to family involvement and patients’ level of education (a barrier to health education). The study recommended assessment of the level of education of patients and involvement of family members when giving health education / Health Studies / M.A. (Health Studies)

This study explored and described the impact of the rights and obligations of nurses on the delivery of quality patient care in a clinical setting. Quantitative research approach was utilised. Data was collected using a self-administered questionnaire. The research results revealed that respondents who participated in this study were aware of their rights and obligations, the effects and impact of factors influencing such rights and obligations on patient care. It was established that “patient abandonment” observed when nurses embark on a strike as their constitutionally enshrined right is not due to a lack of insight about their rights and obligations, but on how such rights and obligations are implemented. The researcher recommends that further research be undertaken to explore the causes of nurses embarking on strike actions despite their high level of knowledge concerning the impact of such actions on patient care in a clinical setting / Health Studies / M.A. (Health Studies)

Nurses face ongoing difficulties in using evidence and making a reality of evidence-based practice. Studies of the factors that facilitate or impede evidence-based practice suggest that nurse managers should have a key role, but the nature of this role has not yet been fully articulated. This study aimed to explore and explain the roles of nurse managers in relation to evidence-based practice implementation. Four case studies in Scottish NHS Acute Trusts provide rich data on evidence-based practice implementation, drawing on interviews (n = 51), observation and documentary analysis. A wide literature on evidence use in nursing suggests that implementation is hindered by confusion and debate about what counts as evidence, and by an incomplete understanding by staff of the complexity of implementation processes. This study confirms such conclusions. Moreover, the study reveals that the roles of nurse managers in facilitating evidence use are currently limited, largely passive and under-articulated. As such, the findings expose significant discrepancies between nurse managers' roles in practice and those espoused in much of the literature. Partial explanation for this can be found in the organisational contexts in which nurses and their managers work (e.g. competing demands; confused communication; diffuse and overloaded roles and limits to authority and autonomy). In particular, the role of the contemporary nurse manager is one that places considerable emphasis on aspects of general management to the detriment of clinical practice issues. More positively, the study uncovered genuine facilitation in two study sites where hybrid roles of nurse manager and clinical nurse specialist were in place. In both sites, these roles had been successful in supporting and progressing implementation in discrete areas of practice and show some potential for advancing evidence-based practice more widely. These findings have significant implications for research, policy and practice in relation to evidence-based practice in nursing.

The main purpose of this quantitative, descriptive, non-experimental study was to explore the perceptions of nurses in supervisory roles (NSRs) regarding competence of novice professional nurses (NPNs) in health education. The study’s conceptual frameworks were the objectives of the Regulation R.425 programme and the scope of practice of professional nurses. The study sought to reveal whether the NPNs were competent in health education and in identifying barriers to health education, and to make recommendations. A structured questionnaire was used for data collection from the professional nurses in supervisory roles. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0 program. The results revealed that NPNs were competent in health education, however, paid less attention to family involvement and patients’ level of education (a barrier to health education). The study recommended assessment of the level of education of patients and involvement of family members when giving health education / Health Studies / M.A. (Health Studies)

Patients who are hospitalized and are without voice would like to participate in their care. This requires clear communication. Speak for Myself™ (SFM) was developed for use at the bedside so that communication may be facilitated between patient and nurse when the patient is voiceless. The objective of this study was to evaluate Speak for Myself™ at the bedside and to measure the outcomes. This was a mixed methods, one group pre-test-post-test, quasi-experimental study. Twenty adult patients in three hospitals in South Florida agreed to use Speak for Myself™ during their acute care hospital stay (M = 8.86 hours). This group of participants (n = 20) ranged from 45 to 91 years old (males = 14; females = 6). Of the participants, 15 (75%) self-identified as European American, 2 (10%) self-identified as Hispanic, 2 (10%) self-identified as African American, and 1 (5%) self-identified as Asian. Ten of the participants (50%) were in respiratory failure. Two (10%) were receiving oxygenation measures related to unspecified complications of their illnesses. Of the remaining eight participants (40%), one each was receiving oxygenation measures due to atrial fibrillation, arteriosclerotic heart disease, cardiogenic shock, endocarditis, neck abscess, renal failure, status post seizure activity, and tongue metastasis. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

A úlcera por pressão, considerada um evento adverso, compromete a segurança do paciente sob os cuidados dos profissionais de saúde. Uma das formas de proporcionar segurança é por meio da prática baseada em evidência que pode ser implementada com estudantes pelo uso de metodologias ativas de ensino- aprendizagem. O objetivo geral do estudo foi propor uma metodologia de ensino para estudantes do curso de Enfermagem da Universidade Estadual de Londrina, pela avaliação do risco de desenvolvimento da úlcera por pressão em pacientes internados em uma unidade médico-cirúrgica e pela identificação das prescrições de enfermagem para a prevenção nos registros em prontuários. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa institucional e realizou-se utilizando métodos quantitativos e qualitativos, com delineamento descritivo, ocorrendo em três fases. A primeira foi um workshop sobre prática baseada em evidência. A segunda foi desenvolvida pelos estudantes e pesquisadora e a coleta de dados foi realizada com 21 pacientes hospitalizados em unidade médico-cirúrgica durante 15 dias sequenciais, em que avaliou-se o risco para úlcera por pressão por meio da Escala de Braden e os registros das prescrições de enfermagem relacionados ao uso das evidências para prevenção de úlcera por pressão. A terceira foi desenvolvida com os estudantes para investigar o significado da experiência com a metodologia de ensino. Os 21 pacientes avaliados tinham a média de idade de 44,76 anos e diagnósticos médicos mais frequentes de doenças do sistema osteomuscular e do tecido conjuntivo (42,86%). No primeiro dia de avaliação, considerando a escore total da Escala de Braden, 17 pacientes (80,95%) tinham risco entre moderado e muito alto. Na inspeção da pele foram identificadas 25 úlceras por pressão, sendo a localização mais frequente na região sacral (44%) e as classificações predominantes foram no estágio I e II. Na análise dos prontuários, não foram identificadas anotações dos enfermeiros referentes à avaliação do risco e nem ao uso da Escala de Braden. As prescrições de enfermagem mais frequentes para a prevenção da úlcera foram mudança de decúbito, uso de coxins, proteção contra a umidade e uso de cremes hidratantes, e a menos frequente foi a manutenção da cabeceira até 30 graus. Não foi encontrada associação entre as medidas de prevenção prescritas e os subescores da escala de Braden. O significado das experiências de oito estudantes que participaram da pesquisa foi investigado pela análise de conteúdo das falas obtidas nas discussões em grupo e identificaram-se duas categorias: aprendendo sobre o tema úlcera por pressão e conhecendo a realidade da instituição e da enfermagem sobre a úlcera por pressão. Concluiu-se que os estudantes relacionaram a teoria à prática, identificaram as competências do enfermeiro na avaliação do paciente com risco para úlcera por pressão, aprimoraram o conhecimento nos estágios da úlcera por pressão e identificaram a Escala de Braden como suporte para avaliação de risco para a úlcera por pressão. Os estudantes, ainda, identificaram a falta de cuidados pela equipe de enfermagem e a importância da presença da família e perceberam a necessidade da prática segura em relação à úlcera por pressão / Pressure ulcers, considered an adverse event, compromise the safety of patients under the care of health professionals. One way to provide safety is through evidence-based practice, which can be implemented with students through the use of active teaching-learning methods. The general study objective was to propose a teaching method for students from the Nursing program at the Universidade Estadual de Londrina, to assess the risk of pressure ulcer development in patients hospitalized at a medical-surgical unit and to identify the nursing prescriptions for this prevention in the records in patient files. Approval for the research was obtained from the institutional Research Ethics Committee and quantitative and qualitative methods were applied, with a descriptive design, involving three phases. The first was a workshop on evidence-based practice. The second was developed by the students and researcher and the data were collected with 21 patients, hospitalized at the medical-surgical unit for 15 continuous days, in which the risk of pressure ulcer was assessed through the Braden Scale and the records of the nursing prescriptions related to the use of evidences to prevent pressure ulcers. The third was developed with the students to investigate the meaning of the experience with the teaching method. The 21 patients assessed had a mean age of 44.76 years and the most frequent medical diagnoses were diseases of the musculoskeletal system and connective tissue (42.86%). On the first assessment day, considering the total score on the Braden Scale, 17 patients (80.95%) had a moderate to very high risk. In the skin inspection, 25 pressure ulcers were identified, with the sacral region as the most frequent location (44%) and stages I and II as the predominant classifications. In the analysis of the files, no nursing notes were identified with regard to the risk assessment, nor related to the use of the Braden Scale. The most frequent nursing prescriptions to prevent ulcers were decubitus change, use of cushions, protection against humidity and use of hydrating creams, and the least frequent was the maintenance of the headrest at 30 degrees. No association was found between the prescribed prevention measures and the subscores of the Braden scale. The meaning of the experience of the eight students who participated in the research was investigated by means of the content analysis of the statements obtained in the group discussions and two categories were identified: learning about the theme pressure ulcer and getting to know the reality of the institution and nursing with regard to pressure ulcer. In conclusion, the students related the theory with the practice, identified the nurses\' competences in the assessment of patients with risk of pressure ulcers, improved the knowledge on the pressure ulcer stages and identified the Braden Scale to support the risk assessment for pressure ulcer. The students also identified the lack of care by the nursing team and the importance of the family\'s presence and perceived the need for safe practice with regard to pressure ulcers

Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-03-29T14:52:26Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Viviane_Ribeiro_Pereira.pdf: 4549226 bytes, checksum: e19206a1b56da2d23bb09ecb54f31a4a (MD5) / Made available in DSpace on 2018-04-03T18:42:11Z (GMT). No. of bitstreams: 2 Dissertacao_Viviane_Ribeiro_Pereira.pdf: 4549226 bytes, checksum: e19206a1b56da2d23bb09ecb54f31a4a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-01-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / O presente estudo objetivou compreender as contribuições das Intervenções Assistidas por Animais (IAAS) na percepção da criança em contextos de vulnerabilidade social, por meio do método photovoice. Neste estudo, entende-se “crianças em vulnerabilidade social” as vítimas de abandono, violência física, psicológica, e emocional. Trata-se de uma esquisa participativa de abordagem qualitativa, realizada em uma escola pública da rede municipal de ensino da cidade de Pelotas, no estado do Rio Grande do Sul/Brasil. As atividades lúdicas com os cães foram desenvolvidas no espaço escolar (quadra de esportes). Os participantes deste estudo foram cinco crianças, na faixa etária entre 6 e 9 anos, cursando do 1º ao 4º ano do ensino fundamental. Os cães fazem parte do Projeto de Extensão do Curso de Medicina Veterinária da Universidade Federal de Pelotas/UFPel, conhecido na comunidade como Projeto Pet Terapia, com aprovação no COCEPE sob nº 52702026. A coleta de dados ocorreu entre os meses de junho e julho de 2016. Foi utilizado o método photovoice, que possibilitou aos participantes fazerem registros de suas percepções em relação às IAAS através da foto. A escolha desta metodologia se deu por entender-se que as crianças precisam ser vistas e ouvidas nas pesquisas, possibilitando que ganhem voz através das suas narrativas visuais. Para analisar os dados, utilizou-se a Análise Temática, da qual emergiu o tema: “O olhar da criança sobre a intervenção lúdica com os cães”. A metodologia empregada permitiu que a criança pudesse externalizar seus medos e anseios de forma descontraída, lúdica e divertida, por meio do ato de fotografar. O photovoice mostrou ser um instrumento valioso para estudos cujo o objetivo é tornar a criança protagonista de suas histórias de vida. Constatou- se que as IAAS, aliadas ao método photovoice, elevou a autoestima e a autoconfiança das crianças, observado durante os momentos de brincadeiras entre elas e os cães. Acariciar e afagar o cão foi um incremento importante para a redução do estresse e da ansiedade. A presença dele promoveu um conforto emocional e atmosfera acolhedora. Além de estimular o vínculo de amizade entre o grupo, melhorou a relação com seus pares. Neste sentido, pretende-se com os resultados obtidos neste estudo contribuir para divulgação desta abordagem terapêutica e apoiar a sua utilização como uma forma eficiente e inovadora, para promover as ações de cuidado à saúde de crianças em contextos de vulnerabilidade social. / The present study aimed to understand the contributions of Assisted Interventions by animals (AIA) in the perception of the child in contexts of social vulnerability, through photovoice method. In this study, “children with social vulnerability” are considered the victims of abandonment, physical, psychological and emotional violence. It is a Qualitative participatory research, realized in a public school of the municipal school of Pelotas, in the State of Rio Grande do Sul/Brazil. Playful activities with the dogs were developed in the school space (sports court). The participants of this study, there were five children, aged between 6 and 9 years, studying from 1st to 4th year of elementary school. The dogs are part of the extension project of the Veterinary Medicine course at the Federal University of Pelotas/UFPel, known in the community as project Pet therapy, with approval in COCEPE number 52702026. Data collection happen between the months of June/July 2016, we used the photovoice method, which enabled the participants make records of their perceptions about the IAAS via the photo. The choice of this methodology took place since we understand that children need to be seen and heard on the research, this method enables they win voice through their visual narratives. To analyze the date using the thematic analysis, from which emerged the theme: “The look of the child about the playful intervention with dog”. The methodology employed allowed the child could outsource their fears and desires so relaxed, playful and fun, through the Act of shooting. The photovoice method increased the self-esteem and self-confidence of children, observed during the moments of banter between them and dogs. Caressing and stroking the dog was an important increment to the reduction of stress and anxiety, his presence promoted a emotional comfort and cozy atmosphere, besides stimulating the bond of friendship between the group, improved relationship with their peers. In this sense it is intended with results obtained in this study contribute to dissemination of this therapeutic approach and support its use as a efficient and innovative contributions to promote the actions of the health care of children in contexts of social vulnerability.