A empatia é uma habilidade socialmente aprendida e fundamental para as relações interpessoais de ajuda, especialmente em profissões como a enfermagem, cujo objeto é o cuidado ao ser humano em suas diferentes dimensões. Assim sendo, é substancial pensar em tecnologias que possibilitem a potencialização desta habilidade na formação profissional do enfermeiro. Este estudo trata da avaliação da eficácia de um Programa de Desenvolvimento da Empatia (PDE) para graduandos de enfermagem. Foi utilizado o método experimental, no qual 17 estudantes participaram de 16 encontros de treinamento com três horas de duração cada enquanto 16 estudantes compuseram o grupo de controle. Os procedimentos utilizados incluíram: relaxamento, exposição dialogada sobre empatia, vivência, desempenho de papéis com videofeedback e prática das habilidades aprendidas em ambiente natural. Os participantes dos dois grupos foram avaliados antes da intervenção, imediatamente após e com follow-up de 30-40 dias. Os componentes cognitivos e afetivos da empatia foram avaliados através do Inventário da Empatia. Para a avaliação do comportamento empático verbal, foram gravadas em áudio as verbalizações dos participantes eliciadas a partir das interações em situações de desempenho de papéis. Estas verbalizações foram avaliadas por três juízes treinados previamente e cegos para os dois grupos. O PDE foi avaliado pelos sujeitos através de suas verbalizações espontâneas durante o treinamento e através de um questionário respondido no final do programa. Os resultados da análise estatística evidenciaram que o PDE foi eficaz em melhorar significativamente a compreensão e a verbalização empática do grupo experimental quando comparado ao de controle. A avaliação dentro do grupo experimental também revela mudança significativa no desempenho empático verbal dos participantes nos três momentos avaliativos. A análise qualitativa dos relatos dos participantes evidenciou alguns benefícios do programa, entre outros, a redução da angústia pessoal diante do sofrimento do paciente e a generalização das habilidades aprendidas para seus contextos relacionais, o que favoreceu a qualidade de seus relacionamentos em diferentes esferas sociais. / Empathy is a socially learned ability and is fundamental for interpersonal relations of helping, specially for professions as nursing, which object is human caring in all its different dimensions. Thus, it is substantial to think in technologies that make possible the potencialization of this ability in nurse professional formation. The present study approaches on the efficacy evaluation of a Empathy Development Program (EDP) for nursing undergraduate students. Experimental method was used and 17 students participated in 16 three-hour training sessions while 16 students composed control group. The procedures used included: relaxation, dialog exposition on empathy, experience, role playing with videofeedback and natural environment application of learned abilities. The participants of both groups were evaluated before intervention, immediately after and in follow-up of 30-40 days. Cognitive and affective components of empathy were assessed by Empathy Inventory. For the assessment of verbal empathic behavior, the participants verbalizations in role playing interaction situations were recorded in audio. These verbalizations were assessed by three previously trained judges that were blind to group division. The EDP was evaluated by the participants through their spontaneous verbalizations during the training and through a questionnaire, answered at the end of the program. Statistical analyses showed that EDP was effective in improving significantly the empathic comprehension and verbalization of experimental group compared to control group. The evaluation inside experimental group also reveals significant changes in verbal empathic performance of participants over the three evaluation moments. Qualitative analysis of participants reports showed some benefits of the program, such as the reduction of personal anguish face to patients suffering and the generalization of learned abilities over other relational contexts, what favored improvement in relationship quality in different social spheres.

Pressupõe-se que o cotidiano do cuidar da integralidade do cliente com câncer de cavidade bucal (CCB) reveste-se de significado especial devido à sensibilidade e responsabilidade dos profissionais de enfermagem; e, do mesmo modo, exige destas pessoas competência e habilidades técnicas e sociais para atuar constantemente com o sofrimento. Portanto, foram elaboradas as questões de pesquisa: quais são os limites e possibilidades da aplicação do processo clínico de cuidar em enfermagem ao cliente com câncer na cavidade bucal? Os objetivos foram: descrever os limites e possibilidades de aplicação do Process Clinical Caritas, formulado por Jean Watson, aos clientes com câncer na cavidade bucal; identificar as características individuais e profissionais dos membros da equipe de enfermagem atuantes na área de oncologia; identificar os aspectos do cuidar componentes do Process Clinical Caritas (PCC) aplicados pela equipe de enfermagem junto aos clientes com CCB, analisando a autopercepção da equipe de enfermagem sobre o seu desenvolvimento de tecnologias de cuidados, comparando-o à aplicação do PCC proposto por Jean Watson. O estudo centra-se na teorização do cuidado transpessoal, visando à compreensão dos aspectos do bem-estar propiciado, inclusive pela autêntica relação interpessoal entre profissional de enfermagem e cliente. Escolheu-se a abordagem de pesquisa quantitativa, aplicando-se o método descritivo e a técnica de autorrelato. A investigação ocorreu no período de agosto a setembro de 2012 em uma Instituição de Saúde Federal do Rio de Janeiro, Brasil, especializada em oncologia. Foram sujeitos do estudo 33 membros da equipe de enfermagem, atuantes em serviço de tratamento de CCB. Para implementar a técnica de autorrelato, utilizou-se um formulário, contendo, na primeira parte, as variáveis sociodemográficas e profissionais, e na segunda, uma adaptação dos 10 aspectos do PCC. Os dados quantitativos foram tratados mediante estatística descritiva simples, e as respostas sobre a aplicação do PCC foram submetidas à análise de conteúdo. Constatou-se que, do total de 33 sujeitos, 88% eram do sexo feminino, 37% na faixa etária de 30 a 39 anos. Predominou a renda individual de 4 a 8 salários mínimos. A maioria da equipe era composta por técnicos de enfermagem. Havia 26 especialistas em oncologia; 78% eram estatutários com carga horária de 40 horas semanais, com exercício predominante de 11 a 15 anos. Referente à aplicação dos 10 aspectos do PCC, foram delimitadas quatro categorias: respeitando as praticas espirituais e a religiosidade; proporcionando ao cliente uma relação de cuidado e conforto; ser presente e tratar o cliente com empatia e respeito; competência e orientação ao autocuidado para o cuidado integral ao cliente. Aplicando o critério de avaliação à prática dos aspectos do PCC, verificou-se que somente três: práticas de amor e gentileza; desenvolvendo relação de ajuda; e ajudar nas necessidades básicas atenderam ao PCC. Conclui-se, que além da realização dos cuidados técnicos ao cliente com CCB, é necessário que a equipe de enfermagem se conscientize da importância do cuidado transpessoal para a reconstituição do equilíbrio corporal físico, mental e espiritual do cliente, visando seu bem-estar, apesar das dificuldades do adoecimento. / Assuming the daily care for the client with oral cavity cancer (OCC) as a whole person becomes especially meaningful due to the nursing professionals sensitivity and responsibility; likewise, it requires competence, as well as technical and social skills from these individuals, in order to experience a routine in which constant suffering takes place. Therefore, the following research questions were formulated: which are the limits and possibilities to apply the clinical nursing care process to the client with oral cavity cancer? The aims include: to describe the limits and possibilities to apply the Clinical Caritas Process, devised by Jean Watson, to clients with oral cavity cancer; to identify the individual and professional features of the nursing team members who work in the oncology field; to identify the caregiving aspects that comprise the Clinical Caritas Process (CCP) and are applied by the nursing team in clients with OCC, analyzing the nursing teams self-awareness on their development of caregiving technologies, and comparing it to the application of CCP as proposed by Jean Watson. The study focuses the theorizing of the transpersonal caring, with a view to understanding the aspects of well-being provided, also through the authentic transpersonal relationship between the nursing professional and the client. The quantitative research approach was chosen, with the application of the descriptive method and self-report technique. The research took place between August and September 2012, in a State-Owned Health Care Institution specialized in oncology, located in Rio de Janeiro-Brazil. 33 members of the nursing team, who work in OCC treatment services, were subjects of the study. In order to implement the self-report technique, a form was used; it contained the socio-demographic and professional variables in the first part, and an adaptation of the 10 aspects of CCP in the second part. The quantitative data were addressed through simple descriptive statistics, and the answers on the application of CCP were submitted to content analysis. We observed that, from a total of 33 subjects, 88% are women, 37% of which with age ranging from 30 to 39 years. There is a predominance of those with individual income of 4 - 8 minimum wages. Most of the team is comprised by nursing technicians. 26 oncology experts were found. 78% of them are statutory employees with weekly workload of 40 hours, whose prevailing seniority is 11 - 15 years. As regards the application of the 10 aspects of CCP, four categories were set out: respecting spirituality and religiousness, providing the client with a relationship of care and comfort; being present and treating the client with empathy and respect; competence and self-care orientation for integral care of the client. By applying the assessment criteria to the practice of aspects of CCP, we observed that only three of them - practices of love and kindness; developing a help-trusting relationship; assisting with basic needs - were according to the CCP. We conclude that, besides the technical care to the client with OCC, it is necessary that the nursing team becomes aware of the importance of transpersonal care for the recovery of the clients physical, mental and spiritual balance, aiming at his/her well-being, despite the difficulties of his/her condition.

Hjärtsvikt är ett allvarligt tillstånd som är förknippat med hög dödlighet. Tillståndet medför ett frekvent behov av sjukvård och utgör en stor del av den svenska hälso- och sjukvården. Hjärtsviktsvården har även påverkan på ett samhällsekonomiskt plan, då en betydande del av den svenska sjukvårdsbudgeten går till denna vård. Personer med hjärtsvikt lever under oförutsägbara förhållanden och kan behöva genomgå stora livsstilsförändringar. Tillståndet är både fysiskt samt psykiskt påfrestande och påverkar såväl patienter som deras närstående. Syftet var att genom en allmän litteraturstudie belysa sjuksköterskors omvårdnad av patienter med hjärtsvikt. Litteraturstudiens resultat grundades på 10 vetenskapliga artiklar som framkommit genom en systematisk litteratursökning. I resultatartiklarna kunde tre kategorier av omvårdnad identifieras: sjuksköterskors stödjande funktion, sjuksköterskors utbildande funktion samt sjuksköterskors instrumentella funktion. Den stödjande funktionen innebär att omvårdnaden personcentreras samt att sjuksköterskor samarbetar med och agerar som psykosocialt stöd för patienter. Den utbildande funktionen innefattar att sjuksköterskor informerar samt utbildar patienter om hjärtsvikt, dess inverkan på patienters liv samt egenvård. Informationen och utbildningen syftar till att öka patienters medvetenhet samt göra dem kapabla att hantera tillståndet. Den instrumentella funktionen innebär att sjuksköterskor utifrån mätvärden och bedömningar kan utvärdera patienters symtom och tecken på hjärtsvikt samt medicinska och omvårdnadsmässiga behov. / Heart failure is a serious condition associated with high mortality. The condition entails a frequent need for medical care and constitutes a major part of the Swedish health care system. Heart failure care also has an impact on a socioeconomic level, as a significant part of the Swedish health care budget is dedicated to this care. People with heart failure live under unpredictable conditions and may need to undergo major lifestyle changes. The condition is both physically and psychologically stressful and affects both the patients and their relatives. The purpose of the general literature study was to illustrate nurses’ care of patients with heart failure. The results of this literature study are based on 10 scientific articles, which were found through a systematic literature search. Three categories of nursing care were identified in these articles: the nurses’ supporting function, the nurses’ educational function, and the nurses’ instrumental function. The supportive function includes a person-centred nursing approach, and also that nurses cooperate with and act as a psychosocial support for patients. Within the educational function, nurses inform and educate patients about heart failure, its impact on patients’ lives, and self-care. This information and education aim to increase patient awareness and enable them to manage their condition. The instrumental function is comprised of nurses’ evaluation of patients’ symptoms and signs of heart failure, as well as the evaluation of medical and nursing needs based on measurements and assessments.

From the nursing care point of view, health represents one of the most basic terms. Many authors claim as priority, that nurse is endowed with knowledge concerning health, illness, patients' as well as her own values on the understanding effective managing of the skills from the fields of systematic observation, effective communication, the ability to show willingness to help and permanent recording of patients´ state of health. As well as many theoreticians, every individual recalls something else under the term "health". Therefore, it is needed to be patterned on the definition of health, helping to understand human actions and human own health. Aim of the research method was to find out, what specific interventions can be used by nurses in the field of the hospitalised patients' health on the basis of this value disruption. To reach this aim, it was necessary to divide the research into several fields, namely how the value of health is perceived by the hospitalised patients, what is their scale of values when they are hospitalised, what values were significant for the patient before his hospitalisation and how does the hospitalisation affect the patients´ scale of values during the hospitalisation in view on the future life after the discharge. From the patients´ point of view, it was crucial to recognize, what aspects within nurses´ nursing activity are the most essential in connection with hospitalisation and his state of health and also what options nurse has got to saturate the value of health. The other group of respondents was concentrated on nursing staff. Crucial intention was to discover, how do the nurses perceive possible affection of patients´ scale of values in connection with hospitalisation and how do they perceive their own possibilities in saturation of this value. Methodology: For the research method, the method of qualitative research and data analysis has been chosen by using half-structured interviews. The first part of the interviews was aimed at patients, who have been admitted on surgical, rehabilitation and traumatological ward without any even more specific determination. The second parts of the interviews were held with nurses in same wards. The data collecting took place in January and February 2018 directly in medical facility. After data satiety, categorisation has been proceeded by using opened coding namely by method "paper-and-pencil". Results: On the basis of qualitative method of research, several interesting findings came out. Only one respondent perceives his health from a holistic point of view, as being stated in the worldwide respected WHO definition of health. It was also confirmed, that the value of health is not for every patient the priority value in comparison with other values. Also the value of health perception from time point of view relates to it. It has been proved, that the hospitalisation on its own or development of problems leading to hospitalisation, has caused a change in a positive way in perceiving the value of health within almost one half of the respondents. But there were individuals among the respondents, who do not feel any difference and do not assume one. Asked patients have also proved that the hospitalisation is a crucial event, leading them to being aware of the circumstances causing the hospitalisation. Consequences of the experienced emotions are different expectations from themselves and nurses. It was also discovered, that the patients demand different approach and interest of the nurse, so that the most effective saturation of value of health can be achieved. Nurses did acknowledge the value of health as priority, even though they could not find any feasible solution, how to attend properly to this value also in practice. Although they perceive the value of health a

Abstract Present Situation: Research investigation deals with nursing care of the child with glycogen storage disease type I., as well as its diagnosis, nutritional management and complications. Glycogen storage disease (GSD) belongs among rare hereditary metabolic disorders. There are several types of GSD, divided into hepatic, myopathic and generalized forms. Early diagnosis is essential for effective treatment of the disease, the signs and symptoms of which first appear in babies soon after birth. The aim of this thesis was to describe the nursing care of the child with glycogen storage disease type I and identify the problems parents of affected children have to face. Methodology: Quantitative research method was used for empirical part of the thesis. The data collection was carried out through In-depth interviews with paediatric-ward nurses and a mother of the child with GSD type I. All interviews were audio recorded, transcribed and coded using paper-and-pencil method and finally categorized. The research sample consisted of nine paediatric-ward nurses and the mother taking care of the child with glycogen storage disease type I, also known as Gierke's disease. Selection of the sample was purposive and its size was determined by theoretical saturation of data. Results: Nursing care of children with glycogenosis type I requires regular feedings of a special diet enriched with corn starch substances to maintain the level of glycemia in the physiological range and to avoid dangerous hypoglycaemia. Problems for nursing staff mainly involve the unstable health condition of a child, fluctuating glycemia levels and limited knowledge of the disease. Parents not only worry about potential health complications of their child but they are also concerned about technical problems with feeding aids, poor recognition of hypoglycaemia and the child's mental welfare. The disease presents increased physical and emotional demands on the patient and their family. Conclusions and recommendations for practice: The thesis presents an outlook on the issue of paediatric-ward nursing care of the child with glycogen storage disease type I and indicates the common problems of the family with a child affected by the disease. The effort was to thoroughly understand the nature of the disease and to identify basic nursing care procedures which can benefit nurses in other facilities dealing with the same diagnosis. The results of the research will be presented in the magazine "Pediatrie pro praxi" in the nursing section.

The goal of the presented study is to assess patient safety during nursing care from two different points of view. The first view represented the opinions of the staff working in direct contact with patients, and the second view represented the management`s opinions of activities leading to quality improvement and care safety. The combination of a quantitative and qualitative study was used to meet the purpose of the thesis. The quantitative part used standardized questionnaires called The Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ), and Systems of Quality Improvement in European Hospitals designed for quality managers and coordinators within the project called Deepening of our Understanding of Quality Improvement in Europe (DUQuE) while this part was complemented by a qualitative study using a semi-structured dialogue. The sample consisted of 427 respondents (331 non-medical healthcare professionals working in direct contact with patients and 96 non-medical healthcare managers. The study using the HSOPSC tool showed that the respondents did not perceive patient safety at their workplace as problematic. They did not expect that patient safety would be put at risk during information handovers and patient transfers. Similarly, the management`s activities leading to patient safety improvement were assessed positively, which is one of key elements of ensuring safety culture. Higher attention should be paid to team cooperation across hospital wards, which influences the care coordination, and also to the personnel measures that influence the management of workload and development of errors. It was studied using the DUQUeE tool which sources and methods were the most common for quality improvement and care safety. Clinical audits and monitoring of work of individual staff nurses were mentioned as the most common systematic activities. Improvement efforts should be focused on the area of supporting information technologies and training dealing with internal peer review, and further projects of quality improvement. The sample of the qualitative study consisted of 9 respondents ? managers responsible for the coordination of quality improvement activities. The qualitative study used a semistructured dialogue, and complemented the quantitative study by the information on the ways of putting some areas into practice. Among others, it was found out that the range and quality of evaluated results corresponded with the absence of training in particular methods at the level of management of non-medical healthcare professions. This thesis has produced both theoretical and practical benefits. The practical benefit includes the recommendation of a suitable combination of testing methods for hospital self-assessments within the concept of safe care. The involvement of staff nurses and management will contribute to more effective promotion of safety and the whole process of continuous improvement, and repeated assessments will enable monitoring of the effect of safety measures. In the theoretical area, this study can extend the approach to management education since it provides various innovative views of safety problems and care quality.

Submitted by TATIANE ROBERTA FERNANDES TEIXEIRA null (tatianebt@ig.com.br) on 2016-04-27T14:10:26Z No. of bitstreams: 1 mestrado final 2016.pdf: 2224865 bytes, checksum: 8f91df194587a0744ed8ece2327c6d46 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-04-29T18:54:48Z (GMT) No. of bitstreams: 1 teixeira_trf_me_bot.pdf: 2224865 bytes, checksum: 8f91df194587a0744ed8ece2327c6d46 (MD5) / Made available in DSpace on 2016-04-29T18:54:48Z (GMT). No. of bitstreams: 1 teixeira_trf_me_bot.pdf: 2224865 bytes, checksum: 8f91df194587a0744ed8ece2327c6d46 (MD5) Previous issue date: 2016-02-29 / A Organização Mundial da Saúde classificou as doenças cardiovasculares como as principais causas de mortes no mundo, responsáveis por altas taxas de internação e elevados custos hospitalares. A expressividade desses valores tem elevado os investimentos das técnicas e tecnologias utilizadas na elucidação diagnóstica e terapêuticas eficazes com intenção do controle dessas doenças. Esses avanços contribuem para o aprimoramento de estudos realizados em laboratórios de hemodinâmica como o cateterismo cardíaco. Esse exame, considerado padrão ouro no diagnóstico das obstruções coronárias, tem cerca de 80% dos procedimentos ambulatoriais, com a vantagem da redução do tempo de permanência no hospital e a desvantagem de diminuir o tempo de contato com a equipe, contribuindo para falhas na comunicação e interferindo na percepção dos profissionais no que se refere as necessidades e sentimentos do usuário em relação ao procedimento. Diante do exposto, este estudo tem por objetivo compreender o significado e descrever as informações recebidas sobre o cateterismo cardíaco aos usuários de um serviço de hemodinâmica, com vistas a elaborar orientações de enfermagem no pré-procedimento. É um estudo descritivo com abordagem qualitativa, que foi realizado no setor de hemodinâmica, de um Hospital de Ensino do Interior do Estado de São Paulo. Participaram do estudo 31 pacientes adultos que, pela primeira vez, estavam em procedimento de cateterismo cardíaco eletivo os quais aceitaram participar, assinando o Termo de Consentimento Livre e Esclarecido. Os dados foram coletados por meio de entrevista semiestruturada, realizada pela pesquisadora e a análise dos dados foi realizada pelo método de Análise de Conteúdo. Dos discursos dos entrevistados emergiram as seguintes categorias: os usuários conseguem relatar os sintomas e a trajetória que os levaram à realização do cateterismo cardíaco; as informações para o procedimento de cateterismo cardíaco são fornecidas na forma escrita, porém parcialmente assimiladas pelos usuários; os usuários desconhecem o procedimento de cateterismo cardíaco; a realização do cateterismo cardíaco mobiliza sentimentos de ansiedade e os usuários têm esperança de que o cateterismo cardíaco promova mudanças que melhorem a qualidade de vida. Os resultados do estudo permitem concluir que os usuários demonstram conhecimento insatisfatório acerca do cateterismo cardíaco e que as informações recebidas são parcialmente assimiladas, evidenciando a importância da equipe investir em capacitação comunicativa e no planejamento de orientações que fortaleçam os indivíduos na promoção da saúde, esperança e autonomia, além de estimular o reconhecimento das ações de Enfermagem. / The World Health Organization ranked cardiovascular diseases as the leading cause of death worldwide, being responsible for high rates of hospitalization and high hospital costs. These remarkable values have led to high investments in techniques and technology used in laboratory diagnosis and effective treatment in order to control these diseases. These advances contribute to the improvement of studies in hemodynamic laboratories, such as cardiac catheterization. This exam, considered gold standard in the diagnosis of coronary obstructions, amounts to about 80 % of outpatient procedures, with the advantage of reducing the patient's stay in hospital and the disadvantage of reducing the contact time with the team, contributing to failures in communication, and thus interfering with the staff’s perception of the user’s needs and feelings about the procedure. Given the above, this study aims to understand the meaning and describe the information received by the users of a hemodynamic service about the cardiac catheterization in order to prepare pre-procedure nursing guidelines. It is a descriptive qualitative study, which was conducted in the hemodynamic sector of a school hospital in São Paulo State. The study included 31 adult first-time patients who were under elective cardiac catheterization procedure and agreed to participate by signing the Instrument of Consent. Data were collected through a semi-structured interview, conducted by the researcher and data analysis was performed by the content analysis method. From the interviews the following categories emerged: users can report symptoms and the path that led to cardiac catheterization; the information for the cardiac catheterization procedure is provided in written form, but partially assimilated by users; users are unaware of the cardiac catheterization procedure; the cardiac catheterization mobilizes feelings of anxiety and users hope that the cardiac catheterization may promote changes which will improve their quality of life. The study results support the conclusion that the patients have poor knowledge about cardiac catheterization and the received information is partially assimilated, showing the importance for the staff to invest in communication training and planning guidelines which can reinforce individuals in health promotion, hope and autonomy in addition to stimulate the recognition of Nursing actions.

Este estudo de caráter qualitativo exploratório descritivo, teve como objetivo conhecer o processo de aprendizagem do cuidado na percepção dos alunos do primeiro e sétimo semestres de um curso de graduação em Enfermagem. Foi realizado na Universidade Regional Integrada do Alto Uruguai e das Missões – URI – campus de Erechim, RS, no período de abril a junho de 2007. Para a coleta de dados, utilizou-se a técnica do grupo focal. Os dados foram analisados mediante a análise temática de conteúdo e evidenciaram dois temas e seis categorias temáticas assim constituídas: Primeiras Impressões Sobre o Processo de Formação. A Visão da Enfermagem; Expectativas com a formação: maneiras de cuidar; Expectativas com a profissão. Refletindo sobre a Formação. Visão da Enfermeira: O conhecimento da profissão; O processo de formação: A aprendizagem do cuidado e Expectativas com a finalização do curso. Os achados permitiram depreender que os alunos, de algum modo, deixam emergir que a temática do cuidado, pode ser visualizada ao longo do seu processo de formação. Percebeu-se, pelos depoimentos, que a transversalidade do tema ocorre de maneira implícita durante o seu processo formativo, o que leva a inferir que, no curso de Enfermagem estudado, há uma preocupação em assegurar a linearidade do conteúdo referente ao cuidado, e que foi evidenciado pelas percepções dos alunos. / This study, which has a descriptive, exploratory and qualitative feature, aimed to know the learning process of care under the view of the students from the first and the final terms of a Nursing Graduation Course. The study was accomplished at Universidade Regional Integrada do Alto Uruguai e das Missões – URI – Campus de Erechim, from April/2007 to June/2007. For data collection, the technique of focal group was used. The data were analysed through the thematic analysis of the content and evidenced two themes and six thematic-categories, which are: First Impressions about the Education Process; The view of Nursing; Expectancies with the education: ways of caring; Expectancies regarding the profession; Reflection about the education; The Nurse's view: the Knowledge about the profession; The process of education: the learning of care and expectancies with the end of the course. The findings allowed to infer that the students, somehow, state that the theme of Care can be visualized during the process of education. Through the statements, it could be noticed that the transversality of the theme occurs implicitly during the educational process, which leads us to infer that in the Nursing course under study there is a concern in assuring linearity of the content regarding care, which was evidenced by the student's perception. / Este estudio de carácter cualitativo exploratorio descriptivo tuvo como objetivos conocer el proceso de aprendizaje del cuidado desde la óptica de los alumnos de los semestres iniciales y finales de un curso de graduación en Enfermería. Fue realizado en la Universidade Regional Integrada do Alto Uruguai e das Missões – URI – Campus de Erechim, RS, en el periodo de abril a junio de 2007. Para la colecta de datos, se ha utilizado la técnica del grupo focal. Los datos fueron analizados a partir de análisis temático del contenido y evidenciaron dos temas y seis categorías temáticas así constituidas: Primeras Impresiones Sobre el Proceso de Formación. La visión de la Enfermería; Expectativas con la formación: maneras de cuidar; Expectativas con la profesión. Reflexionando sobre la Formación. Visión de la Enfermería: El conocimiento de la profesión; El proceso de formación: El aprendizaje del Cuidado y Expectativas con la finalización del curso. Los resultados permitieron percibir que los alumnos, de algún modo, entienden que la temática del Cuidado, puede ser visualizada a lo largo de su proceso de formación. Se ha percibido, por las declaraciones, que la transversalidad del tema ocurre de manera implícita durante su proceso formativo, lo que leva a inferir que, en el curso de Enfermería estudiado, hay una preocupación en asegurar la linearidad del contenido referente al Cuidado y que fue evidenciado por las percepciones de los alumnos.

Os pacientes submetidos ao transplante de medula óssea (TMO) necessitam de um acesso venoso seguro para a infusão da medula óssea sem que haja comprometimento do enxerto, assim a implantação de um cateter venoso central é parte da terapêutica, sendo o de Hickman o mais utilizado atualmente; entretanto, sua presença impõe riscos aos pacientes, sendo a infecção, o mais preocupante. A implementação da prática baseada em evidências fundamenta a tomada de decisão do enfermeiro, uma vez que a utilização de resultados de pesquisa é um dos pilares desta abordagem. O presente estudo é uma revisão integrativa da literatura, que teve como objetivo buscar e avaliar as evidências sobre os cuidados de enfermagem relacionados ao cateter de Hickman após a sua implantação, no paciente submetido ao TMO. Para a seleção dos artigos utilizamos as bases de dados Lilacs, Medline, Cinahl e o periódico Bone Marrow Transplantation, e a amostra constituiu-se de 18 artigos. O curativo recomendado é o de poliuretano trocado a cada 7 dias. O método de coleta de sangue observado foi o de descarte, sendo que a dosagem de ciclosporina não deve ser coletada da mesma via onde foi infundida. A redução do número de manipulações do cateter é considerada uma medida eficaz na prevenção e no controle de infecção. As evidências extraídas dos estudos analisados podem auxiliar a implementação de cuidados de enfermagem eficazes relacionados ao cateter de Hickman visando principalmente a melhoria da assistência à saúde. / Patients submitted to Bone Marrow Transplantation (BMT) need a safe venous access for the infusion of bone marrow, without jeopardizing the graft. Thus, the implantation of a central venous catheter is a part of therapy, with Hickman s catheter as the most commonly used type; however, its presence entails risks for the patients, the most preoccupying of which is infection. The implementation of evidence-based practice, with the use of research results as one of its pillars and supports nurses decision making. This integrative literature review aimed to look for and evaluate evidence on nursing care related to Hickman s catheter after its implantation in patients submitted to BMT. Articles were selected from the Lilacs, Medline and Cinahl databases and from the journal Bone Marrow Transplantation. The sample consisted of 18 articles. Polyurethane dressings are recommended, to be changed every 7 days. The observed blood collection method was through discarding, in which the cyclosporine dose should not be collected from the same pathway it was infused in. Reducing the number of catheter manipulations is considered an efficient measure for infection prevention and control. The evidence taken from the studies that were analyzed can be of help in the implementation of efficient nursing care related to Hickman s catheter, mainly with a view to better health care.

Trata-se de estudo descritivo, com o objetivo de analisar a aplicabilidade de intervenções da NIC, para situações de Risco de Quedas em pacientes hospitalizados por meio do mapeamento cruzado. Participaram do estudo 10 enfermeiros que atuam na Clínica Médica de um Hospital Geral Regional de segundo porte na cidade de Querétaro, Qro., México. O estudo foi realizado em três etapas; na primeira, foram descritas pelos enfermeiros quais atividades eram realizadas para os pacientes com risco de quedas. Na segunda etapa, foi realizado o mapeamento cruzado das atividades e das intervenções da NIC para o diagnóstico Risco de quedas pela pesquisadora. Na terceira etapa, foi realizado o refinamento do mapeamento comparativo por enfermeiros expertos e a NIC com as Intervenções identificadas pela pesquisadora. Quanto aos resultados, dos 10 enfermeiros nove eram sexo feminino, com idade entre 31 e 40 anos e com experiência no trabalho com média de sete anos e meio. Foram citadas 173 atividades para Risco de quedas pelos enfermeiros que participaram no estudo. Já no mapeamento cruzado, foram listadas 14 intervenções e 70 atividades das quais seis intervenções estavam no Domínio Segurança com 40 atividades, quatro intervenções no Domínio Fisiológico Básico com 20 atividades e duas intervenções no Domínio Fisiológico Complexo com 10 atividades. Além das atividades propostas na ligação NANDA/NIC foram mapeadas duas intervenções não propostas nessa ligação, mas citadas na NIC - Contenção Física e Identificação do Risco - nomeadas pelos enfermeiros como realizadas junto aos pacientes com Risco de quedas. As intervenções que tiveram o maior numero de atividades mapeadas foram principalmente às relacionadas com o Domínio de Segurança. Estas intervenções mapeadas mostram o atuar dos enfermeiros e sua contribuição na prevenção de quedas. Os achados do estudo poderão ser empregados para desenvolver programas, políticas e estratégias que contribuam para segurança do paciente, por meio do das taxonomias, no contexto da enfermagem mexicana. / This is a descriptive study which main objective is to analyze the feasibility of NIC interventions on falling risk situations among hospitalized patients through cross mapping method. During this study, ten Intern Medicine Service nurses from a second level hospital in Queretaro City, Mexico participated. The study was designed into three stages. At first stage, there were described the activities made by nurses with falling risk patients. At second stage, there was made a cross mapping from NIC\'s activities and interventions for the falls risk diagnosis of the researcher. At third stage, a comparative fine tuning mapping was made among expert nurses and the NIC compared with the identified interventions from the researcher. The results of the research were as follows: From ten nurses, nine were 31 to 40 year old female with an average working experience of seven years and a half. There were mentioned 173 falls risk activities by nurses who attended the study. There were listed 14 interventions and 70 activities on the cross mapping from which six interventions were on the Security Dominion with 40 activities, six interventions were on the Basic Physiological Dominion with 20 activities and two interventions were on the Complex Physiological Dominion with 10 activities. On the NANDA/INC interrelations activities were mapped two non-proposed interventions in the Restraint Physical and Risk Identification mentioned by nurses during their attendance with falling risk patients. The higher number of mapped intervention activities were of the Security Dominion. This mapped interventions show the contribution of nurses toward falls prevention. Current results of this study may contribute to the creation of prevention programs, politics and strategies which enhance patient\'s security through taxonomy\'s usage within the Mexican nursing context.