Thesis (PhD. (Nursing Science)(Faculty of Health Sciences))--University of Pretoria, 2006. / Summary in English. Includes bibliographical references.

Background/Problem: Preoperative anxiety is common with patients undergoing surgery. The anxiety may be associated with severe postoperative complications which are costly and sometimes life threatening. It is therefore necessary to investigate what kind of interventions could be valid and effective to prevent or treat preoperative anxiety. Aim: This study aims to describe the nursing care interventions that proves to prevent and/or relieve preoperative anxiety within surgical patients. Method: A literature search was made within PubMed and Cinhal databases. Both randomised controlled studies (RCT) and Quasi-experimental studies were included. A total of 388 articles were screened and 13 articles included in the study. Results: All interventions had a significant lowering effect on the preoperative anxiety within surgical patients but in different levels. Relaxation exercises showed the most effective to lower the preoperative anxiety. Thereafter nature sounds and acupressure showed to have a similar lowering effect. Calm music generally showed a moderate effect. Acupuncture, information and education showed a similar varying low effect. Conclusion: Interventions like relaxation exercises, listening to nature sounds, acupressure, acupuncture, listening to music, giving information and education can all be valid and effective nursing care interventions which can easily be used and implemented by nurses in the preoperative care. / Bakgrund/Problemformulering: Preoperativ oro är vanligt förekommande hos patienter som ska genomgå operation. Denna oro kan vara förknippad med eller innebära en ökad risk för allvarliga postoperativa konsekvenser vilka är kostsamma och ibland livshotande. Det är därför av vikt att undersöka vilka typer av interventioner som kan vara validerade och effektiva för att förebygga eller lindra preoperativ oro. Syfte: Syftet med studien är att beskriva de omvårdnadsåtgärder som bevisas förebygga och lindra preoperativ oro för kirurgiska patienter. Metod: En litteraturstudie utfördes inom databaserna PubMed och Cinahl. Både randomiserade kontrollerade studier (RCT) och quasi-experimentella studier inkluderades. Totalt undersöktes 388 artiklar och 13 artiklar inkluderades i studien. Resultat: Alla interventioner hade en signifikant minskande effekt för att minska preoperativ oro hos kirurgpatienter men i olika grad. Avslappningsövningar visade sig ha störst effekt för att minska preoperativ oro. Därefter redovisades naturljud och akupressur vilka hade en liknande god effekt. Lugn musik hade generellt en måttlig effekt. Akupunktur, Information och undervisning hade en varierande låg effekt. Slutsats: Interventioner som avslappningsövningar, att lyssna på naturljud, akupressur, akupunktur, att lyssna på musik, informationsgivning och undervisning kan alla vara adekvata och effektiva omvårdnadsåtgärder som lätt kan användas och implementeras av sjuksköterskor i den preoperativa vården.

Submitted by Gercilene Cristiane Silveira (ger_silveira@hotmail.com) on 2018-07-04T11:33:59Z No. of bitstreams: 1 Gercilene.pdf: 41236528 bytes, checksum: 8264191d636324be0a8ac84588afad81 (MD5) / Approved for entry into archive by Luciana Pizzani null (luciana@btu.unesp.br) on 2018-07-04T18:40:36Z (GMT) No. of bitstreams: 1 silveira_gc_me_bot.pdf: 41236528 bytes, checksum: 8264191d636324be0a8ac84588afad81 (MD5) / Made available in DSpace on 2018-07-04T18:40:36Z (GMT). No. of bitstreams: 1 silveira_gc_me_bot.pdf: 41236528 bytes, checksum: 8264191d636324be0a8ac84588afad81 (MD5) Previous issue date: 2018-06-08 / A alta prevalência de pacientes críticos tem aumentado a demanda pela terapia nutricional para recuperação da saúde. As sondas enterais possibilitam a oferta de nutrientes e a melhora do estado nutricional de pacientes com problemas de deglutição, desde que o sistema digestório mantenha sua capacidade de absorção. A equipe que assiste o paciente com necessidade de receber terapia nutricional por meio de sonda enteral deve ter conhecimento sobre a passagem da sonda e sobre a administração das dietas, com treinamento para prevenir, reconhecer e tratar as possíveis complicações. O objetivo deste estudo foi descrever por meio de análise de questionário as dificuldades encontradas para a passagem e posicionamento de sondas nasoenterais na instituição hospitalar, bem como os eventos adversos relacionados ao procedimento de introdução dessas sondas. A partir desse conhecimento sobre problemas enfrentados, o trabalho teve ainda o objetivo de desenvolver manual padronizado sobre a introdução e o posicionamento da sonda enteral. Trata-se de estudo observacional, analítico e transversal em que o método utilizado foi a aplicação de um questionário preenchido por enfermeiros na instituição hospitalar Irmandade de Misericórdia do Jahu, registrando opiniões e problemas enfrentados durante o processo de introdução e posicionamento da sonda enteral. Os resultados apontaram algumas carências de padronizações e certa resistência na exposição de dúvidas, mesmo por meio do questionário. Assim, conclui-se que a equipe de enfermagem apresenta envolvimento na terapia de nutrição enteral, participando ativamente do procedimento de passagem, fixação e manutenção da sonda enteral e também da infusão de dieta através dela. Após o conhecimento sobre as respostas dos entrevistados, elaborou-se manual de orientação padronizado sobre a introdução e o posicionamento da sonda enteral, com o objetivo de contribuir com a atualização da equipe para a realização de procedimentos mais seguros. / The high prevalence of critically ill patients has increased the demand for nutritional therapy aiming the health recovery. Enteral tubes provide nutrients and improve the nutritional status of patients with swallowing problems, as long as the digestive system maintains its absorption capacity. The staff that assists the patient needing nutritional support should have knowledge on the tube placement, being trained about the administration of the diets and being ready to prevent, recognize and treat any complications. The aim of this study was to describe the problems faced by the nursing staff during the placement of nasoenteric tubes in the hospital, also showing the adverse events related to the procedure. From this knowledge, the work also aimed to develop a standardized manual to guide the nasoenteric tube placement. This work was an observational, analytical and cross-sectional study in which a questionnaire was answered by nurses at the Hospital institution of the Jahu's Brotherhood of Misericordia, registering opinions and problems during the placement of nasoenteric tubes. The results pointed to a lack of standardization and some avoidance of mentioning doubts and problems occurred during the procedure, even when fulfilling the questionnaire. Thus, it was concluded that the nursing staff is deeply involved in the enteral nutrition therapy, participating in the nasoenteric tube placement and taking care of the diet infusion through it. After knowing the subjects' answers, a standardized guidance manual was developed, in order to contribute to the updating of the staff and allowing safer procedures of nasoenteric tube placing.

Theoretical approaches: Neurosurgery is a wide and sophisticated field and given the variety of neurological issues, this thesis focuses on the brain (vascular issues and tumors). Goals: This thesis has two goals. 1. To single out the specifics of caring for patients after brain surgery (of selected conditions). 2. To find out, whether the nurses know the specifics of caring for a patient after brain surgery. Hypotheses and research questions: H1: Nurses with tertiary education have greater theoretical knowledge of caring for patients after brain surgery than the nurses without tertiary education. H2: Nurses after getting the job of caring for patients after brain surgery didn't have an instructor.H3: Nurses after getting the job of caring for patients after brain surgery, most commonly struggle with an external ventricular drainage system. H4: Nurses most commonly gain the required knowledge to care for patients after brain surgery from literature. Research question 1: What is the level of knowledge of novice nurses about the specifics of caring for a patient with a brain condition? Methodology: The research was split in two parts. For the quantitative part of the research, the questionnaire method was selected. The questionnaire had 22 questions, 17 of them closed, 4 of them semi-open, 1 was an open question. The researchers handed out 300 questionnaires and received 246 (82%) of them back. 49 questionnaires had to be discarded as invalid. The final research sample consisted of 197 (100%) filled-out questionnaires. For the qualitative part of the research, the method of semi-structured interviews with open questions was selected. There were a total of 8 interviews conducted. Results: The goal of quantitative part of the research was to confirm or disprove the 4 hypotheses. H1: Nurses with tertiary education have greater theoretical knowledge of caring for patients after brain surgery than the nurses without tertiary education. Based on the data, we can see that the knowledge of nurses with tertiary education is not different from the knowledge of nurses without tertiary education. H1 was disproved. H2: Nurses after getting the job of caring for patients after brain surgery didn't have an instructor. Based on the questionnaire data, nurses did have an instructor. H2 was disproved. H3: Nurses after getting the job of caring for patients after brain surgery, most commonly struggle with an external ventricular drainage system. Based on the research data, an external ventricular drainage system is indeed the most commonly quoted problematic procedure when caring for a patient after brain surgery. H3 was confirmed. H4: Nurses most commonly gain the required knowledge to care for patients after brain surgery from literature. The research shows that this is not the case. Nurses most commonly learn the specifics of caring for patients after brain surgery from their instructors. H4 was disproved. For the qualitative part of the research, the method of semi-structured interviews with open questions was selected. The research question was: What is the level of knowledge of novice nurses about the specifics of caring for a patient with a brain condition? The interviews have shown that the knowledge of novice nurses about the specifics of caring for patients with a brain condition is on an appropriate level they know the specifics of caring for patients after brain surgery. Conclusion:The conducted original research as well as secondary literature has led us to several questions and recommendations: Is the nurse who has just started at the neurosurgery division properly being instructed about the specifics of her new job and is the adaptation process being conducted in the proper fashion? The results of this thesis suggest that a "Caring for patients in neurosurgery" manuscript could be written for general care nurses just starting at neurosurgery. This option was mentioned by some of the respondents in the questionnaire research

The Thesis consists of the theoretical and research part. The theoretical part of the Thesis deals with the anatomy and physiology of the small intestine of the child. It also brings detailed characteristics of celiac disease and for the sake of interest we mentioned the interesting history of coeliac disease. Furthermore, we focus on the types, symptoms, diagnosis, treatment and complications of celiac disease. Substantial part is devoted to nutrition, where we focus on its basic elements and, gradually, we walk through proper nutrition in children. In descending order we go through individual child periods, from infancy to adolescence, mentioning what nutrition is the best for the particular age period. The next chapter gives the detailed description of the gluten-free diet which must be kept by the coeliac patients during all of their lives. Research part of the Thesis is processed using the quantitative strategy. The objective of the Thesis was to find out which problems the coeliac children appearing at the paediatric gastroenterologist and the general practitioner for children and adolescents suffer from, as well as the assessment of these problems using nursing diagnosis: 0002 Imbalanced nutrition: less than the organism needs. The second objective of the Thesis was to determine differences in the incidence of celiac disease in children by sex and age when diagnosing this disease. The objectives faced 2 hypotheses. H1: There is a difference in the incidence of determining the signs and related factors in children registered in gastroenterology clinics and general paediatricians. H 2: The incidence of celiac disease will be higher in girls than in boys. To collect data, we chose a content analysis of documents, in our case, analysis of medical records of children at a gastroenterology outpatient department and at a general practitioner for children and adolescents. The data were being collected in the period from January to February 2014. The survey was conducted at the paediatric gastroenterology office of MUDr. Ivana Ženíšková in České Budejovice and at the general practitioner's office for children and adolescents of MUDr. Zdeňka Soukopová in Náměšt nad Oslavou. So as to process the research data we developed a research form - a record sheet, which contained 24 defining characters and 6 related factors from the nursing diagnose: 0002 Imbalanced nutrition: less than the organism needs. Furthermore, the research form included some demographic data: age, sex, home address, family predispositions, duration of breastfeeding, cage of the child at the introduction of complementary feeding, age when the disease is diagnosed, and what foods were first administered to the child. Another point we decided to include in the research form was the defining characteristics and related factors supplemented from the medical records of children. When processing the research data we used the linear method and recorded frequency of the incidence. The results of NANDA diagnoses validation were processed according to Fehring's DCV where we calculated the arithmetic mean, assigned appropriate values and included them in summary tables. The values in the tables are marked in colours, where the green colour marked very significant characteristics according to Fehring and the red one marked very little significant characteristics according to Fehring.

Presented diploma thesis titled "Activation in the care of seniors" deals with the issue and the use of activation aktivities in nursing care of seniors in homes for the eldery in the South Bohemia region, Central Bohemia Region, West Bohemia region and in tha Vysočina region. The main objective of this diploma thesis was to map out what activation activities are used by nursing staff and what activation activities contribute to the self-sufficiency of the clients in the homes for elderly. The theoretcal part of this diploma thesis contains an information about the age and aging issues. Further part of the diploma thesis is dedicated to the definition and characterization of the notion of activation and description of the role of nurses in the care of seniors. It also approaches using of communication, motivation and sensual activation from the nurse's point of view. The following objectives have been set: Identify nurse's share of senior activation in providing nursing care in homes for elderly and also identify, which activities in the context of activation in nursing care are expected from family members of seniors from nursing staff. To achieve the goals have been set following research questions: Which activities are used by nursing staff in the context of activation in the providing of nursing care? How do activation activities contribute to the self-sufficiency of clients in seniors homes? What are activation activities from the perspective of family members expected from nurses? To achieve the objectives was chose a qualitative research, and the research sample consisted of nurses and family members. The results showed that the activation of providing nursing care to seniors is really important to them. Under the notion of activation, the nurses imagine the clients keep their self-sufficiency. An important factor that greatly affects the activation process is the lack of qualified staff in the homes for the elderly. Therefore we supposed that one of the possible solutions how to improve the activation in nursing care is to increase the number of professional and qualified staff. The research also showed, nurses activate the clients with the support of communication, mobilization, but also with the help of all day activities.

Submitted by PATRICIA APARECIDA FRANCELINO CREPALDE null (patyfrancelino@hotmail.com) on 2016-04-25T18:37:18Z No. of bitstreams: 1 Dissertação final 25042016.pdf: 2555633 bytes, checksum: 7dd6dc7e149f14d20c4a3b7468c1c711 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-04-27T20:05:32Z (GMT) No. of bitstreams: 1 crepalde_paf_me_bot.pdf: 2555633 bytes, checksum: 7dd6dc7e149f14d20c4a3b7468c1c711 (MD5) / Made available in DSpace on 2016-04-27T20:05:32Z (GMT). No. of bitstreams: 1 crepalde_paf_me_bot.pdf: 2555633 bytes, checksum: 7dd6dc7e149f14d20c4a3b7468c1c711 (MD5) Previous issue date: 2016-03-02 / Introdução: O estomizado é o indivíduo submetido à cirurgia de desvio do trânsito intestinal, que consiste na abertura da parede abdominal de um segmento, desviando os efluentes para o meio externo. Objetivo: Avaliar a qualidade de vida dos estomizados assistidos em serviço especializado e estudar a associação destes desfechos com as características sociodemográficas e clínicas. Método: Trata-se de um estudo transversal analítico. Este estudo foi realizado no Núcleo de Assistência ao Ostomizado, do Hospital das Clínicas de Botucatu, no período de outubro de 2014 a agosto de 2015, e aprovado pelo Comitê de Ética e Pesquisa da Faculdade de Medicina de Botucatu-Unesp, por meio do protocolo nº 291.707/2013. A amostra foi composta de 60 pacientes. Para a coleta de dados utilizou-se dois instrumentos, sendo o primeiro um formulário, compreendido pelas etapas: caracterização sociodemográficas e clínicas, aspectos fisiológicos, psicossociais, nutricionais e legais; e para a avaliação da QV, utilizou-se o instrumento WHOQOL-bref, composto por 2 questões gerais de QV e 24 facetas, que se referem a quatro domínios: físico, psicológico, relações sociais e meio ambiente. Resultados: Do total de 60 pacientes estomizados predominou o sexo feminino (51,7%), idade acima de 61 anos (60%), da cor branca (93,3%), residentes em Botucatu (53,3%), vivem com companheiro (55%), têm renda familiar entre 1 a 3 salários mínimos (78,3%), são aposentados (63,3%) e o ensino fundamental, com (61,7%). Referente ao tempo de estomizado (71,7%), está em média há 6 anos. O motivo que levou a confecção do estoma foi câncer (61,7%) e o agravo crônico que prevaleceu entre os indivíduos estomizados foi a hipertensão arterial sistêmica (31,7%). Quanto à derivação, evidenciaram-se as colostomias descendentes, com (53,3%). O seguimento médico regular é evidente em (90%) dos indivíduos. No que diz respeito ao dispositivo coletor, (80%) utiliza de uma peça drenável, variando de 25 a 102 milímetros de diâmetro; com relação à troca do dispositivo, (33,3%) troca a cada três dias e relata ter “muita” dificuldade no autocuidado com o estoma (65%) e com a bolsa coletora (61,7%). Quanto à presença da insônia, (35%) referiu insônia após a estomia. A atividade sexual foi mantida pela minoria, (31,5%), após a presença do estoma. Referente aos aspectos emocionais de dependência (50%) evidenciou ser fato, após o estoma. A respeito da ajuda recebida após estomia, (100%) relata ter a família como suporte. Quanto às orientações recebidas no pós-operatório, (96,7%) dos indivíduos relataram ter recebido orientação. Do total de 60 pacientes estomizados, (80%) relatou que os dispositivos são suficientes no mês e apenas (20%) dos indivíduos estomizados conhecem os seus direitos legais. O domínio psicológico apresentou a média mais elevada, 70,8, evidenciando que mesmo a autoimagem podendo estar prejudicada pela confecção de um estoma, esse domínio teve uma avaliação melhor, comparada com outros domínios da QV. Considerando p>0,10, as seguintes associações, foram realizadas: ter diabetes mellitus, fazer seguimento médico regularmente, sentir dependência após estomia, ter atividade sexual após estomia, visitar os amigos após estomia, índice de massa corporal ser mais elevado e conhecer os direitos legais. As variáveis que associaram negativamente na QV no domínio físico foram “diabetes mellitus” (p=0,021) e “sente dependência após a estomia” (p=0,016). Nos domínios físico e psicológico, a variável “faz seguimento médico regularmente” (p=0,007 e p=0,062) melhorou a QV, respectivamente. A variável “visitar os amigos após estomia” (p=0,000 e p=0,007) associou positivamente nos domínios psicológico e social. Ainda no domínio psicológico, a variável “ter atividade sexual após estomia” (p=0,035) contribui para uma melhor QV. A variável “conhecer os direitos” (p=0,001), no domínio ambiental, associou positivamente na QV do indivíduo estomizado. Como produto deste estudo foi construído uma cartilha com a descrição de conceitos sobre o estoma e suas causas, o fluxo de atendimento nos diferentes níveis de atenção à saúde, e as diretrizes legais que subsidiam a assistência do indivíduo estomizado. Conclusão: Portanto, pode-se concluir que os indivíduos estomizados deste estudo, avaliaram a QV de maneira positiva e que com a aquisição de novos conhecimentos dos direitos legais, poderá haver uma melhora da QV. / Introduction: An ostomized individual is the one who underwent an intestinal transit bypass surgery, which consists of opening the abdominal wall of a segment to diverting the effluent to the outside. Objective: To evaluate the quality of life of ostomized patients assisted in specialized service and study the association of those outcomes with the sociodemographic and clinical characteristics. Method: This is an analytical cross-sectional study. This study was conducted at the Ostomized Patients Assistance Center of Botucatu Clinical Hospital, from October 2014 to August 2015, and approved by the Research Ethics Committee of Botucatu - Unesp Medical School, through protocol No. 291,707 / 2013. The sample consisted of 60 patients. To collect the data we used two instruments: first, a form consisting of sociodemographic and clinical characterization, physiological, psychosocial, nutritional and legal aspects. To evaluating their quality of life, we used the WHOQOL -BREF instrument , consisting of two general questions of quality of life and 24 facets, which relate to four realms: physical, psychological, social relationships and environmental. Results: Of the 60 ostomized prevalences were: females (51.7%) , above the age of 61 years (60%), white (93.3%), living in Botucatu (53.3%), living with partner (55%), family income between 1-3 minimum wages (78.3%), retired (63.3%) and elementary schooling (61.7%). Referring to a colostomy time, (71.7%) had been ostomized for 6 years on average. The reason that led to the stoma was cancer (61.7%) and the chronic aggravation that prevailed among the ostomized individuals was hypertension (31.7%). As for the derivation, the descending colostomies stood out (53.3%). Regular medical follow-up is evident in (90%) of the individuals. With respect to pickup device 80 uses a draining % workpiece, ranging from 25 to 102 mm diameter; regarding the device exchange, (33.3%) changed every three days and reports having "a lot of of" difficulty in self-care of the stoma and 65% with the collection bag (61.7%). For the presence of insomnia, (35%) reported insomnia after ostomy. Sexual activity was maintained by the minority (31.5%) after the presence of stoma. Referring to the emotional aspects of dependence, (50%) showed to be real. Regarding the aid received after ostomy, (100%) reported having help in the family. The Guidelines received in the postoperative period, (96.7%) reported having received guidance. Of the total 60 ostomized patients, (80%) reported that the devices are sufficient in the month and only (20%) knew their legal rights. The psychological domain had the highest average (70.8%), showing that even the self-image can be impaired by making a stoma, this area had a better evaluation, compared with other areas of quality of life. Associations were made, but only a few were associated ( p> 0.10) , as having diabetes mellitus, regular medical follow-up, dependency feeling after ostomy, sexual activity after ostomy , visit friends after ostomy, body mass index being higher and knowledge of legal rights. The variables that negatively associated quality of life in the physical domain were "diabetes mellitus" (p = 0.021) and "feels dependence after stoma" (p = 0.016). The physical and psychological domains, the variable" makes regular medical follow-up" (p = 0.007 and p = 0.062) improved quality of life, respectively. The variable visiting friends after stoma" (p = 0.000, p = 0.007) positively associated in the psychological and social domains. Even in the psychological domain, the variable "sexual activity after stoma" (p = 0.035) contributes to a better quality of life. The variable "know your rights" (p = 0.001), in the environmental field, associated positively on the quality of life of ostomized patients individual. As a product of this study a booklet was made, with descriptions of concepts about the stoma and its causes, the flow of care at different levels of health care, and legal guidelines that support the care of ostomized individuals. Conclusion: Therefore, we can conclude that the ostomized individuals in this study evaluated their quality of life in a positive way and that, with the acquisition of new knowledge of their legal rights, there can be a better quality of life.

Made available in DSpace on 2014-06-11T19:28:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-05Bitstream added on 2014-06-13T19:57:33Z : No. of bitstreams: 1 razera_apr_me_botfm.pdf: 848184 bytes, checksum: 13d0d4a85353b2bc99b09cde1bd57242 (MD5) / Secretaria de Saúde do Estado de São Paulo / Este estudo teve como objetivo conhecer as orientações pós-operatórias fornecidas pela equipe de enfermagem a pacientes e/ou familiares de uma instituição privada e apreender a percepção destes indivíduos acerca das orientações recebidas. Foi um estudo transversal, com abordagem qualitativa, que utilizou o referencial teórico da Comunicação Interpessoal e o referencial metodológico da Análise de Conteúdo. Foram entrevistados 16 pacientes submetidos a procedimentos cirúrgicos eletivos, de urgência e/ou emergência que permaneceram, no mínimo, 3 dias internados. Os resultados evidenciaram que a equipe de enfermagem se preocupa com as técnicas instrumentais da profissão em si desconsiderando o indivíduo de forma holística, ou seja, além das necessidades físicas, as emocionais e espirituais. Também foi possível perceber que, quando o profissional enfermeiro permanece afastado do paciente e/ou não presta informações adequadas gera sentimentos de ansiedade, medo, insegurança e sensação de falta de cuidado. Por outro lado, quando a equipe de enfermagem se fez presente com cuidado e informações coerentes, os clientes relataram a sensação de ser bem cuidado. As conclusões deste estudo nos permitem considerar que a competência em comunicação é uma condição para o exercício da Enfermagem com qualidade e cidadania, que a capacitação em comunicação prepara a equipe de enfermagem para serem os profissionais exigidos pelos clientes do sistema de saúde e, finalmente, que a comunicação é um alicerce importante para que a relação de cuidado se estabeleça de forma efetiva e eficaz, proporcionando a compreensão do cliente em sua complexidade, com resultados qualitativos de atenção, dignidade e respeito ao ser cuidado. / This study aims to identify the guidelines provided by the nursing team of a private institution to patients and family as well as learn with their perception of the aid received. It consists of a cross-sectional study with qualitative approach based on a theoretical reference of Interpersonal Communication and methodological reference of Content Analysis. 16 patients underwent elective surgical procedures of emergency and remained in the hospital for at least 3 days. Results showed that the nursing team is concerned about the instrumental techniques of the job disregarding the patient as a holistic individual, that is, besides their physical, emotional and spiritual needs. When the nurses stayed away from patients and did not provide appropriate guidelines which caused anxiety, fear and feeling of neglect. On the other hand, when nurses were present providing coherent care and assistance, patients reported to feel well cared. This study concluded that communicative competence is an essential condition for nurses to offer qualified assistance. Good communicative skills enable the nursing team to be the professionals required by the patients of the health system and are fundamental to provide effective care, resulting in the patients’ comprehension that are assisted with attention, dignity and respect.

Orientador: Magda Cristina Queiroz Dell'Acqua / Resumo: Introdução: O estomizado é o indivíduo submetido à cirurgia de desvio do trânsito intestinal, que consiste na abertura da parede abdominal de um segmento, desviando os efluentes para o meio externo. Objetivo: Avaliar a qualidade de vida dos estomizados assistidos em serviço especializado e estudar a associação destes desfechos com as características sociodemográficas e clínicas. Método: Trata-se de um estudo transversal analítico. Este estudo foi realizado no Núcleo de Assistência ao Ostomizado, do Hospital das Clínicas de Botucatu, no período de outubro de 2014 a agosto de 2015, e aprovado pelo Comitê de Ética e Pesquisa da Faculdade de Medicina de Botucatu-Unesp, por meio do protocolo nº 291.707/2013. A amostra foi composta de 60 pacientes. Para a coleta de dados utilizou-se dois instrumentos, sendo o primeiro um formulário, compreendido pelas etapas: caracterização sociodemográficas e clínicas, aspectos fisiológicos, psicossociais, nutricionais e legais; e para a avaliação da QV, utilizou-se o instrumento WHOQOL-bref, composto por 2 questões gerais de QV e 24 facetas, que se referem a quatro domínios: físico, psicológico, relações sociais e meio ambiente. Resultados: Do total de 60 pacientes estomizados predominou o sexo feminino (51,7%), idade acima de 61 anos (60%), da cor branca (93,3%), residentes em Botucatu (53,3%), vivem com companheiro (55%), têm renda familiar entre 1 a 3 salários mínimos (78,3%), são aposentados (63,3%) e o ensino fundamental, com (61,7%). Refe... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: An ostomized individual is the one who underwent an intestinal transit bypass surgery, which consists of opening the abdominal wall of a segment to diverting the effluent to the outside. Objective: To evaluate the quality of life of ostomized patients assisted in specialized service and study the association of those outcomes with the sociodemographic and clinical characteristics. Method: This is an analytical cross-sectional study. This study was conducted at the Ostomized Patients Assistance Center of Botucatu Clinical Hospital, from October 2014 to August 2015, and approved by the Research Ethics Committee of Botucatu - Unesp Medical School, through protocol No. 291,707 / 2013. The sample consisted of 60 patients. To collect the data we used two instruments: first, a form consisting of sociodemographic and clinical characterization, physiological, psychosocial, nutritional and legal aspects. To evaluating their quality of life, we used the WHOQOL -BREF instrument , consisting of two general questions of quality of life and 24 facets, which relate to four realms: physical, psychological, social relationships and environmental. Results: Of the 60 ostomized prevalences were: females (51.7%) , above the age of 61 years (60%), white (93.3%), living in Botucatu (53.3%), living with partner (55%), family income between 1-3 minimum wages (78.3%), retired (63.3%) and elementary schooling (61.7%). Referring to a colostomy time, (71.7%) had been ostomized for 6 years on... (Complete abstract click electronic access below) / Mestre

Metformin is the first-line oral antidiabetic drug for patients with type 2 diabetes mellitus. As the rate of new diagnosed cases of diabetes increases year-on-year, the number of patients who are prescribed metformin rises as well. In the Czech Republic only, 858,010 patients were treated for diabetes in 2015. 786,586 of them were treated for the type 2 diabetes mellitus. Metformin intoxication, called also MALA (metformin- associated lactic acidosis) after its main symptom, is a rare complication (≤ 10 cases per 100,000 patients per year) in the metformin treatment, but the mortality is high (up to 50%). Metformin-induced lactic acidosis develops when the contraindications of metformin therapy are not respected or in the event of an acute disease linked with dehydration and hypoxia. Patients with MALA are hospitalized at the int ernal medicine intensive care unit or the department of anesthesiology and critical care with multiple organ failure. This thesis aims at determining whether procedural nursing care standards, implemented in the form of a nursing process, are actively used in practice on intensive care beds. Methodology: The empirical part is compiled in the form of a qualitative research, as a case study of a female patient suffering from metformin intoxication, caused by a suicide...