Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-15T15:10:05Z No. of bitstreams: 1 Milena da Rocha de Andrade.pdf: 1677470 bytes, checksum: b07dae4ae2ff268bf6af002f0680af86 (MD5) / Made available in DSpace on 2015-12-15T15:10:05Z (GMT). No. of bitstreams: 1 Milena da Rocha de Andrade.pdf: 1677470 bytes, checksum: b07dae4ae2ff268bf6af002f0680af86 (MD5) Previous issue date: 2011 / Metalúrgica Trinca Ferro / Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro / Mestrado Profissional em Enfermagem Assistencial / O objetivo deste estudo é avaliar o processo adaptativo dos pacientes com úlceras venosas ao tratamento com uma nova tecnologia no âmbito do cuidar em feridas (hidrogel). Os objetivos específicos são: caracterizar a clientela portadora de úlcera venosa atendida no ambulatório de Reparo de Feridas em uso do hidrogel produzido na farmácia universitária da Universidade Federal Fluminense; identificar os estímulos focais, contextuais e residuais e a partir problemas comuns de adaptação da clientela com úlcera venosa em uso do hidrogel, de acordo com a teoria de Roy e propor intervenções frente às situações de difícil adaptação à sua nova condição e na aderência ao tratamento a partir dos diagnósticos de enfermagem. Utilizou-se como marco teórico de referência a teoria de adaptação de Callista Roy, que refere serem os estímulos focal, contextual e residual os agentes causadores de uma situação-problema, pois que o homem é um ser inserido num contexto social, econômico e político e o papel do enfermeiro é promover a adaptação do ser humano através da avaliação e da intervenção de enfermagem. Trata-se de um estudo clínico observacional, descritivo, com abordagem quanti-qualitativa do tipo estudo de caso, realizado no Ambulatório de Reparo de Feridas de um hospital universitário, no município de Niterói. Os dados foram coletados com 15 pacientes portadores de úlceras venosas em tratamento com o hidrogel, através de um questionário semi-estruturado e da análise dos prontuários destes pacientes. Os resultados apontaram que a clientela mais acometida foram as mulheres (67%), acima de 60 anos (70%), com ensino fundamental incompleto (47%), predomínio de renda de até 2 salários mínimos (73%), e interrupção na atividade laboral de todas as mulheres entrevistadas. Em relação aos hábitos de vida, todos os homens fumam e fazem uso de bebida alcoólica. A doença de base mais presente foi a hipertensão arterial em mulheres (40%). O tempo de úlcera variou entre 5 a 10 anos (40%), sendo mais acometido o membro inferior esquerdo (47%). Os produtos mais utilizados, antes do tratamento com hidrogel, foram: colagenase, sulfadiazina de prata e ácidos graxos essenciais. Em relação à cobertura utilizada (hidrogel) na úlcera venosa (47%) fazem uso há mais de um ano, 80% fazem os curativos sozinhos, 53% fazem o curativo mais de uma vez ao dia, 73% relatam orientação do enfermeiro sobre ações de auto-cuidado, entretanto todos relatam a mesma técnica para realização do curativo domiciliar. A queixa relacionada ao produto foi ardência leve (27%) e ardência moderada ou intensa (13%). Demais queixas: dor localizada e constrangimento pela presença da úlcera também foram mencionados. Assim, foi possível comparar através dos dados relacionados com o tamanho da úlcera que houve a remissão da ferida, com apenas um caso de aumento da lesão após o tratamento com o hidrogel. Foram encontrados 22 diagnósticos de enfermagem, sendo os principais: oxigenação, mobilidade física prejudicada, integridade da pele prejudicada, risco de infecção, risco de quedas, nutrição desequilibrada, ansiedade e baixa auto-estima. Conclui-se que a partir das concepções teóricas de Roy sobre os problemas comuns de adaptação foi possível evidenciar os diagnósticos e as intervenções de enfermagem dos pacientes com úlcera venosa em uso do hidrogel, propondo a substituição de respostas ineficazes por adaptativas / The objective of this study is to evaluate the adaptation process of patients with venous ulcers to the treatment with a new technology under the care of wounds (hydrogel). Specific objectives are: to characterize the patients suffering from venous ulcers treated at the outpatient Wound Repair in use at the phamacy of the hydrogel produced the Universidade Federal Fluminense, identify the focal, contextual and residual stimuli, and from common problems of adaptation of the clientele with ulcer intravenous use in the hydrogel, according to Roy's theory and propose interventions when confronted with difficult adjustment to their new condition and adherence to treatment from the nursing diagnoses. It was used as theoretical reference the theory of adaptation Callista Roy, referring to the focal, contextual and residual stimuli the causative agents of a problem situation, because that man is a being housed in social, economic and political context, and the nurse´s role is to promote the adaptation of human beings through the assessment and nursing intervention. This is a clinical observational, descriptive, quantitative and qualitative case study, conducted at the Outpatient Wound Repair of a university hospital in Niteroi. Data were collected from 15 patients with venous ulcers treated with the hydrogel through a semi-structured questionnaire and analysis of the records of these patients. The results showed that the customers most affected were women (67%), over 60 years (70%) with incomplete primary education (47%), predominance of income of up to two minimum wages (73%), and interruption work activity of all women interviewed. In relation to lifestyle, all men smoke, and make use of alcohol. The most common underlying disease was systemic hypertension in women (40%). The duration of ulcer ranged from 5 to 10 years (40%), being more involved the left lower limb (47%). The products most commonly used before treatment with hydrogel, were: collagenase, sulfadiazine and essential fatty acids. Regarding the coverage hydrogel used in venous ulcers (47%) use more than one year, 80% do the dressings alone, 53% make the dressing more than once daily, 73% of nurses reporting guidance on actions of self-care, but all report the same technique for making the bandage at home. The complaint related to the product has been mild burning (27%) and moderate or severe burning (12%). Other complaints: localized pain and embarrassment by the presence of the ulcer were also mentioned. So, it was possible to compare with the data related to the size of the ulcer that was a remission of the wound with only one case of increased lesion after treatment with the hydrogel. There were 22 nursing diagnoses, which are: oxygenation, impaired physical mobility, impaired skin integrity, risk of infection, risk of falls, unbalanced nutrition, anxiety and low self-esteem. It follows that from the theoretical conceptions of Roy on the common problems of adaptation, it was possible to pinpoint the diagnosis and nursing interventions of patients with venous ulcers in the use of hydrogel, proposing the replacement of ineffective responses by adaptive ones

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-13T17:19:37Z No. of bitstreams: 1 thaismendoncaresende.pdf: 906942 bytes, checksum: b513957d643a3e7999ca1cd602c8ca52 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:36:25Z (GMT) No. of bitstreams: 1 thaismendoncaresende.pdf: 906942 bytes, checksum: b513957d643a3e7999ca1cd602c8ca52 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:36:39Z (GMT) No. of bitstreams: 1 thaismendoncaresende.pdf: 906942 bytes, checksum: b513957d643a3e7999ca1cd602c8ca52 (MD5) / Made available in DSpace on 2016-01-25T17:36:39Z (GMT). No. of bitstreams: 1 thaismendoncaresende.pdf: 906942 bytes, checksum: b513957d643a3e7999ca1cd602c8ca52 (MD5) Previous issue date: 2014-07-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introdução: O câncer tem sido considerado um problema de saúde pública mundial. Estratégias de controle vêm sendo desenvolvidas, incluindo os cuidados paliativos, que preconizam a assistência espiritual com o intuito de minimizar a dor espiritual comumente vivenciada pelos pacientes. A acupuntura tem sido utilizada nesse contexto e tem apresentado bons resultados no controle dos desconfortos físicos e emocionais; porém, não existem pesquisas que demonstrem sua atuação direta sobre a dimensão espiritual. Esta terapêutica encontra adesão entre os profissionais enfermeiros e respaldo teórico por meio da teoria do cuidado transpessoal de Jean Watson. A teórica propõe o resgate do cuidar enquanto prática sagrada e aposta no uso dessa tecnologia para o alcance do objetivo citado acima. Influenciado pela psicologia transpessoal de Ken Wilber, o cuidado espiritual nessa perspectiva consiste em estimular o desenvolvimento consciencial em direção ao nível mais elevado de consciência, que é o transcendental, visto como forma de promover a realização plena do ser humano, ou seja, a harmonia integral. Objetivos: Identificar o desenvolvimento dos elementos espirituais dos pacientes oncológicos em tratamento ambulatorial submetidos à acupuntura, segundo a teoria transpessoal de Jean Watson e Ken Wilber e avaliar a ação da acupuntura sobre a dimensão espiritual desses pacientes como uma prática complementar ao tratamento convencional e, também, como uma prática ampliadora do cuidado de enfermagem. Metodologia: Investigação de natureza qualitativa, com abordagem exploratória. O cenário foi uma instituição filantrópica e especializada no tratamento do câncer em um município mineiro. A coleta de dados ocorreu no ambulatório de radioterapia no período de agosto a outubro de 2013. Participaram do estudo treze pacientes do sexo feminino, com faixa etária entre 41-75 anos e período diagnóstico de um mês a cinco anos. Foram realizadas dez sessões de acupuntura, três vezes na semana, e com duração de trinta minutos cada sessão. Foram tonificados por meio do agulhamento os pontos dos aspectos mentais e espirituais (B42, B44, B47, B49 e B52). Os dados foram coletados por meio da entrevista semi-estruturada desenvolvida antes das dez sessões e ao término dessas. Os depoimentos foram gravados em mini gravador e posteriormente transcritos. A coleta de dados ocorreu após a aprovação do Comitê de Ética em Pesquisa com Seres Humanos. Resultados: Os dados foram analisados por meio da análise de conteúdo de Bardin e divididos em três categorias. Na primeira, “A vivência de experiências transformadoras”, a maioria das entrevistadas relatou momentos de paz profunda e relaxamento, além da remissão dos desconfortos físicos. Na segunda categoria, “O redescobrimento: uma nova forma de ‘Ser’”, os relatos apontaram para novas possibilidades de ‘Ser’, como aceitar, perdoar e adaptar-se. Na terceira, “A conscientização do ‘Eu’: ampliando a visão”, identificamos a emersão de elementos como clareza, harmonia, discernimento, força e coragem. Conclusão: A acupuntura parece ter atuado diretamente sobre a dimensão espiritual ao aliviar a dor espiritual e se mostrou como possível tecnologia ampliadora do cuidar. Os resultados encontrados propiciaram reflexões e novas indagações que apontam para a possibilidade da presente pesquisa ser explorada e desencadear novos olhares. / Introduction: Cancer has been considered a global public health care issue. Control strategies have been developed, including palliative care, which endorse spiritual assistance to minimize the spiritual pain commonly experienced by the patients. Acupuncture has been utilized in such context presenting good results in the control of physical and emotional discomfort, although there is no research demonstrating its direct action over the spiritual dimension. This therapy finds accession among nursing professionals and theoretical support by means of the transpersonal care theory by Jean Watson. The author proposes the redemption of caring as a sacred practice and proposes the use of such technology to reach that goal. Influenced by the transpersonal psychology by Ken Wilber, spiritual care in this perspective consists on stimulating the consciential development towards a greater awareness level; the transcendental, as a form of promoting the full realization of the human being, that is, the integral harmony. Objectives: Identifying the development of the spiritual elements in oncologic patients in ambulatory treatment subjected to acupuncture, according to the transpersonal theory by Jean Watson and Ken Wilber and assessing the action of acupuncture over these patients’ spiritual dimension as a complementary practice to conventional treatment, highlighting the nursing care. Methodology: Investigation of qualitative nature, with exploratory approach. The setting was a philanthropic institution specialized in cancer treatment at a municipality in Minas Gerais. Data gathering took place at the radiotherapy ambulatory from August to October of 2013. Thirteen female patients took part in the study, with ages ranging from 41 to 75 years, and diagnostic period from one month to five years. They had ten acupuncture sessions, three times a week and thirty minutes each. Mental and spiritual aspects were toned by means of needle punctures (B42, B44, B47, B49 e B52). The data collected by means of semi structured interview developed before the ten sessions and after they had finished. Data gathering took place after approval by the Ethics Committee of Research with Human Beings – Brazil Platform. Results: The data was analyzed by means of Bardin’s content analysis and divided into three categories. In the first one “Living transformative experiences”, most of the interviewees related moments of profound peace and relaxation, beyond the remission of physical discomforts. In the second category “Rediscovering: a new form of ‘Being’”, the statements pointed to new possibilities of ‘Being’ as acceptance, forgiveness and adaptation. In the third one “Awareness of ‘Self’: magnifying the vision” we identified the immersion of elements like clarity, harmony, discernment, strength and courage. Conclusion: Acupuncture acted over the spiritual dimension by relieving the spiritual pain and presented itself as a possible technology in amplifying care. The results found made it possible to reflect and new considerations which point towards the possibility of the present research be explored and set in motion new perspectives.

This dissertation presents a Parsesciencing study of the universal humanuniverse living experience of feeling pulled in different directions. Concept inventing reveals feeling pulled in different directions as pondering inspirations surfaces with desire amid tenuous integrity in a whirling inertia of possibility. Personal foreknowings illuminate feeling pulled in different directions as aw(e)ful delight surfaces with the struggles of taking a bearing along an unfolding, diverging way. Stories of ten historians, as presented and heuristically interpreted through several levels of abstraction, reveal feeling pulled in different directions as constrained vigor surfaces with wavering amid cherished potentials which is transmogrified as restricted endeavoring surfaces with capricious yearning. Core ideas of constrained vigor and wavering with cherished potentials are discussed in relation to extant literature. To inspire future inquiry, new knowings of this Parsesciencing are discussed in relation to nursing education, research, and care. / Graduate / 2022-12-31

Bakgrund: I mars 2020 klassade WHO covid-19 som en pandemi. Sjukhus världen över var oförberedda på en massiv tillströmning av svårt sjuka patienter. Andningssvikt var ett allvarligt symtom som kunde orsaka att patienter blev inlagda på intensivvårdsavdelning. Sjuksköterskors uppgift var att tillhandahålla god omvårdnad, minska lidande och tillgodose patienternas grundläggande behov trots rådande omständigheter. Syfte: Att beskriva sjuksköterskors erfarenheter av omvårdnad under covid-19-pandemin utifrån Hendersons omvårdnadsteori. Metod: Studien är baserad på en kvalitativ metod med deduktiv analys. En litteraturstudie har genomförts där kvalitativa artiklar har granskats och totalt sammanställdes 14 kvalitativa vetenskapliga artiklars resultat. Resultat: Presenteras utifrån tre teman som är; bristande basal omvårdnad, brister i etiskt ansvar och svårigheter att skapa goda patientrelationer. Teman presenteras sedan i underteman som är; svårigheter i att hjälpa patienten andas, brister i patientsäkerhet, besöksrestriktioner skapade etiska dilemman och starkare relation mellan sjuksköterska och patient. I dessa teman har svårigheter utifrån Hendersons omvårdnadsteori identifierats. Kritiskt sjuka patienter och ett högt patientflöde på sjukhus orsakade svårigheter i omvårdnad för sjuksköterskor. Konklusion: Brist på resurser, brister i teamsamverkan, kritiskt sjuka patienter och ett högt patientflöde ansågs hota vårdkvaliteten. Sjuksköterskors erfarenheter av covid-19-pandemin tyder på att sjukvården behöver fler resurser inför kommande pandemier / Background: In March 2020, the WHO classified covid-19 as a pandemic. Hospitals worldwide were unprepared for a massive influx of seriously ill patients. Respiratory failure was a serious symptom that could cause patients to be admitted to the intensive care unit. Nurses' job was to provide good care, reduce suffering and meet the basic needs of patients despite prevailing circumstances. Aim: To describe nurses' experiences of nursing during the covid-19 pandemic based on Henderson's nursing theory. Method: The study is based on a qualitative method with deductive analysis. A literature study has been carried out where qualitative articles have been reviewed and a total of 14 qualitative scientific articles' results were compiled. Findings: Presented based on three themes which are; lack of basic care, shortcomings in ethical responsibility and difficulties in creating good patient relationships. The themes are then presented in sub-themes which are; difficulties in helping the patient breathe, deficiencies in patient safety, visiting restrictions created ethical dilemmas and stronger relationship between nurse and patient. In these themes, difficulties based on Henderson's nursing theory have been identified. Critically ill patients and a high patient flow in hospitals caused difficulties in nursing for nurses. Conclusion: Lack of resources, deficiencies in team cooperation, critically ill patients and a high patient flow were considered to threaten the quality of care. Nurses' experiences with the covid-19 pandemic indicate that healthcare needs more resources for future pandemics.

Thesis advisor: Jane Flanagan / Background: Over the past decade, increasing numbers of emerging adults, defined as ages 18 to 22, have journeyed to the United States (US) from Guatemala, Honduras and El Salvador. Upon arrival to the US, many experience inequities in health and healthcare access. The inequities are shaped by US political practices and choices attributed to broad structural and systemic-level barriers within planetary, social, economic and necropolitical forces. Applying a critical framework of antiracism, anti-oppression and anticolonialism, nurses and other healthcare providers must seek to understand the health patterning and life experiences of emerging adult im/migrants from Guatemala, Honduras, and El Salvador so that their health and healthcare needs may be supported. Approach: This qualitative research project aimed to explore health patterning of emerging adult immigrants from Guatemala, Honduras, and El Salvador using the nursing specific research praxis of Health as Expanding Consciousness (HEC). The second aim explored themes across the group. Critical posthuman, feminist, and new materialist assumptions also informed the approach to the study. Between June 2021 to November 2022 thirteen emerging adult participants from Guatemala and Honduras were interviewed twice. Enrollment occurred through community-based recruitment and snowball sampling methods. Each person’s individual story was explored using the HEC praxis method. Results: Participants’ stories uncovered unique profiles with situated, context-specific individual health patterning. Four themes were identified across stories using the qualitative analytic method of Sort and Sift, Think and Shift: Family is Fundamental, The Journey Holds Meaning, Opportunities Exist Amidst Constraints, and Movement and Art are Healing. Conclusions: The discussion section reviews main implications for building critical nursing praxis; understanding intersections of health, nursing care and human mobility; advancing nursing policy for people excluded from care; advancing research using HEC praxis as a caring act of accompaniment; and transforming nursing education for social justice and radical possibility. Im/migration and asylum-seeking were viewed as fundamental human rights including critically advancing the right to health and safety for people in mobility contexts. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Bakgrund: Hälsa för barn är enligt WHO en grundläggande rättighet och relateras till både yttre och inre förutsättningar och förhållningssätt.Övervikt och obesitas bland barn är utbrett och kan leda till hälsoproblem. Skolsköterskor har en unik roll att främja hälsa och förebygga ohälsa bland barn i skolan men stöter på utmaningar i att möta behoven hos barn med övervikt och obesitas. Barns rättigheter, enligt barnkonventionen och Agenda 2030, är centrala för skolsköterskans profession och vägleder deras arbetet inom elevhälsan. Attityder är avgörande i skolsköterskans interaktion med barnen och deras hälsoutveckling.    Syfte: Syftet var att utforska skolsköterskors attityder och erfarenheter i arbetet med barn och övervikt.     Metod: Tolv semistrukturerade intervjuer genomfördes via videosamtal med skolsköterskor från södra Sverige. Det manifesta innehållet analyserades sedan.  Resultat:  Analysen mynnade ut i tre huvudsakliga kategorier; Skolsköterskans syn på övervikt, som beskriver vikten av föräldrarnas ansvar och hur övervikt kan ses som symtom för något annat. Att navigera ett minerat område, belyser skolsköterskornas uppfattning om vikt som något komplicerat och känsligt att samtala om samt betydelsen av att ge eleven och vårdnadshavarna adekvat bemötande och råd. Att se barnet, som beskriver hur betydelsefull omgivningen är för barn med övervikt och hur skolsköterskor ämnar bygga goda relationer.  Slutsats: Viljan att värna om barnets välbefinnande överskuggar negativa attityder.  Skolsköterskorna vinnlägger sig om att bemöta barnen med öppenhet och respekt. / Background: According to the WHO, children's health is a fundamental right and is related to both external and internal conditions and attitudes. Overweight and obesity among children is widespread and can lead to health problems. School nurses have a unique role in promoting health and preventing poor health among children in schools but encounter challenges in meeting the needs of children with overweight and obesity. Children's rights, according to UN:s Convention on the Rights of the Child and Sustainable Development Goals, are central to the school nurse's profession and guide their work in student health. Attitudes are crucial in the school nurse's interaction with the children and their health development.    Aim: The aim was to explore school nurses' attitudes and experiences in working with children and obesity.     Method: 12 semi-structured interviews were conducted via video calls with school nurses from southern Sweden. The manifest content was then analysed.    Results: The analysis resulted in three main categories; The school nurse’s view of obesity, which describes the importance of parents’ responsibility and how overweight can be interpreted as symptoms of something else. To navigate a mined area, the school nurses’ perception of weight as something complicated and sensitive to talk about is highlighted as well as the importance of giving the pupil and guardian adequate support and advice.  To see the child, describes the importance of the environment for the children with overweight and how school nurses intend to build good relationships.   Conclusion: The desire to take care of the child's well-being overshadows the school nurses’ negative attitudes. The school nurses strive to treat the children with openness and respect.

Bakgrund: Övervikt är ett angeläget folkhälsoproblem som globalt ökar bland barn och ungdomar vilket betraktas som största hälsoutmaningen. Barn med övervikt har en ökad risk att bevara övervikt även i vuxen ålder vilket i sin tur kan medföra till olika folksjukdomar. Barnhälsovårdssjuksköterskor innehar en betydande nyckelroll i att tidigt identifiera övervikt hos barn mellan 0–6 år för att vägleda dessa familjer. Syfte: Syftet med studien var att undersöka barnhälsovårdsjuksköterskors erfarenheter av att stödja överviktiga barn och deras föräldrar. Metod: Studien genomfördes utifrån kvalitativ metod med induktiv ansats. Semistrukturerade intervjuer med 12 barnhälsovårdssjuksköterskor från sydöstra och sydvästra delen av Sverige utgjorde datainsamlingen. Dataanalysen genomfördes med manifest innehållsanalys enligt Graneheim och Lundman. Resultat: Analysen av intervjumaterialet resulterade i tre kategorier och sju underkategorier. Huvudkategorierna som framkom var: Vikten av det hälsofrämjande förhållningssättet, Vikten av delaktighet och bemötande i mötet med familjen och Vikten av att samverka med andra professioner. Slutsatser: Det är av stor betydelse att barnhälsovårdsjuksköterskorna tidigt kan identifiera övervikt för att tidigt kunna stödja barn och familjer. Viktigt att utifrån detta arbeta hälsofrämjande i beaktande till helheten och utifrån Swansons omvårdnadsteori stödja barnet och familjen till att uppnå välbefinnande. / Background: Overweight is an urgent health problem that is increasing globally among children, which is considered the biggest health challenge. Overweight children have increased risk of maintaining overweighted in adulthood and can lead to various diseases. Child health nurses have a significant role in early identification of overweight to guide these families. Aim: The aim of the study was to investigate child health care nurses' experiences of supporting overweight children and their parents. Method: A qualitative method with an inductive approach was used. Semi-structured interviews with 12 child health care nurses in Sweden constituted the data. The data analysis was carried out with manifest content analysis according to Graneheim and Lundman. Results: The analysis of the interview material emerged in three categories: The importance of the health-promoting approach, The importance of participation and treatment in the meeting with the family and The importance of collaborating with other professions. Conclusions: It is important that the child health care nurses’ can identify overweight early in order to be able to respond to children and families. It is important to work on health promotion and based on Swanson's nursing theory to support the child and the family in achieving well-being

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2017-08-28T18:23:41Z No. of bitstreams: 1 Gabriela Silva dos Santos.pdf: 3809016 bytes, checksum: 203c779440c0dcb826d250be0b99131d (MD5) / Made available in DSpace on 2017-08-28T18:23:41Z (GMT). No. of bitstreams: 1 Gabriela Silva dos Santos.pdf: 3809016 bytes, checksum: 203c779440c0dcb826d250be0b99131d (MD5) Previous issue date: 2014 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / O presente estudo tem como objeto de pesquisa a influência das redes sociais virtuais sobre os adolescentes que convivem com Doença Crônica na busca de informação em saúde. Como objetivo geral: Compreender a influência dessas redes sobre os adolescentes que convivem com a Doença Crônica na busca por informação em saúde. Trata-se de um estudo descritivo-exploratório, de abordagem qualitativa. Realizado no ano de 2014 com adolescentes de 12 a 20 anos que se tratam no ambulatório de especialidades do Núcleo de Estudos da Saúde do Adolescente (NESA), localizado no Hospital Universitário Pedro Ernesto (HUPE), Rio de Janeiro. Os aspectos éticos foram respeitados, sendo o projeto de pesquisa aprovado pelo Comitê de Ética em Pesquisa (CEP), sob o nº 692.112. A coleta de dados se deu através de entrevistas semiestruturadas, individuais, com perguntas abertas e a criação de desenhos por cada um dos adolescentes. O estudo tem como base teórica a Teoria Humanística de Paterson e Zderad. Para análise dos dados, utilizou-se a análise de conteúdo de Bardin. Nos resultados temos as seguintes categorias: Demandas de informação dos adolescentes que convivem com doença crônica; Aspectos positivos da informação obtida na mídia virtual- perspectivas dos adolescentes com doença crônica; Aspectos negativos da informação obtida na internet pelo adolescente com doença crônica. Os adolescentes com doença crônica que utilizaram a internet para obtenção de informação buscaram: compreender a sintomatologia da sua condição, conteúdos sobre estética e sobre o futuro. Entre os aspectos positivos temos a influência da mídia no tratamento, como um incentivo a prosseguir com o cuidado da saúde, a compreensão da doença e saberes adquirido pelo meio virtual. Por outro lado, temos aspectos negativos, tais como a ausência de conteúdos de fácil compreensão, pois a linguagem técnica dificulta o processo de informação e os adolescentes têm dificuldades para identificar a veracidade das informações e segurança do site. Compreender a doença é uma atividade inerente à condição humana: o ser humano vive em busca de conhecimento, vive em busca da evolução, e hoje temos a internet e as redes virtuais como aliadas. A compreensão da doença crônica e suas consequências requer muito mais que o conhecimento da patologia. É preciso inserir-se, como profissional da enfermagem, no contexto, na vivência, na dimensão que a patologia representa, e isso transcende o desejo de obter a cura, envolvendo o sentir-se bem ante a sociedade e consigo mesmo / The subject of research for the present study was the influence of virtual social networks on adolescents living with Chronic Disease in the search for health information. As a general goal: to understand the influence of these networks on adolescents that live with chronic illness and their search for health information. This is a descriptive-exploratory study with a qualitative approach. The work was carried out in 2014 with adolescents between the ages of 12 and 20 that sought treatment with the ambulatory specialty clinic at the Nucleus of Teenage Health Studies (Núcleo de Estudos da Saúde do adolescente or NESA), located at Pedro Ernesto University Hospital (Hospital Universitário Pedro Ernesto or HUPE) in Rio de Janeiro. Ethical issues were respected, having the research project approved by the Ethical Research Committee (CEP), under process number 692.112. Data collection was carried out through semi-structured, individual interviews that contained open questions and through drawings made by each one of the adolescents. The theory this study is based on is the Humanistic Theory of Paterson and Zderad. For data analysis, Bardin's content analysis was used. The results were sectioned into the following categories: Demands for information of adolescents that live with chronic illness; Positive aspects of the information obtained through virtual media – the adolescents who live with chronic disease perspective; Negative aspects of the information obtained on the internet by the adolescent with chronic disease. The adolescents with a chronic illness that used the internet to obtain information sought: to understand the symptomatology of their condition, content about aesthetics and about the future. Among the positive aspects is the media´s influence on treatment, as an incentive to continue with health care, the understanding of the illness and knowledge acquired in the virtual envirnment. On the other hand, there are negative aspects, such as the absence of content that is easy to understand, because the technical language hinders the process of information difficult and adolescents find it difficult to verify the information and website security. Understanding the illness is an activity inherent to the human condition: human beings are constantly searching for knowledge, for evolution, and nowadays we have the internet and virtual networks as allies. The understanding of chronic disease and its consequences demands a lot more than just knowledge of the pathology. It is necessary to insert oneself, as a professional in nursing, into the context, into the experience, into the dimension that the pathology represents, and that goes beyond the desire of obtaining the cure, involving one's well-being within society and with oneself / El presente estudio tiene como objeto el estudio la influencia de las redes sociales virtuales en adolescentes que viven con enfermedades crónicas en la búsqueda de información de salud. Como objetivo general: Comprender la influencia de estas redes en los adolescentes que viven con una enfermedad crónica en la búsqueda de información en salud. Este es un estudio descriptivo de tipo cualitativo. Llevado a cabo en el año de 2014 con la participación de adolescentes de 12 a 20 años que se ven en pacientes ambulatorios clínica en el Núcleo de Estudios sobre la Salud de los Adolescentes (NESA) Situado en el Hospital Universitario Pedro Ernesto ( HUPE), Rio de Janeiro. Los aspectos éticos se han respetado, y el proyecto de investigación fue aprobado por el Comité de Ética en Investigación (CEP), sob o nº 692.112. La recogida de datos se recogen por medio de entrevistas semi-estructuradas, individuales, con preguntas abiertas y la creación de dibujos de cada uno de los adolescentes. El estudio tiene como base teórica la teoría humanística de Paterson y Zderad. Para el análisis de los datos, se utilizó el análisis de contenido de Bardin. En cuanto a los resultados que tienen las siguientes categorías: Las demandas de información de los adolescentes que viven con enfermedades crónicas; aspectos positivos de la información obtenida en los medios virtuales de las perspectivas de los adolescentes con enfermedades crónicas; aspectos negativos de la información obtenida en la internet por los adolescentes con enfermedades crónicas. Los adolescentes con enfermedades crónicas que utiliza la internet para obtener la información: para entender los síntomas de su enfermedad, los contenidos sobre estética y en el futuro. Entre los aspectos positivos que tiene la influencia de los medios de comunicación en el tratamiento, como un incentivo para continuar con la atención de la salud, el conocimiento de la enfermedad y los conocimientos adquiridos por medios virtuales. Por otro lado, hay aspectos negativos, tales como la ausencia de contenido fácil de entender, porque el lenguaje técnico obstaculiza el proceso de información y los adolescentes tienen dificultades para identificar la exactitud de la información y la seguridad del sitio. Entender la enfermedad es una actividad inherente a la condición humana: el ser humano vive en la búsqueda del conocimiento, la vida en la búsqueda de la evolución, y ahora tenemos el internet y las redes virtuales como un aliado. La comprensión de las enfermedades crónicas y sus consecuencias requiere mucho más que el conocimiento de la patología. Necesita introducir, como el profesional de enfermería, en el contexto de la experiencia, la dimensión que representa la patología, y esto va más allá del deseo de obtener una cura, en el que participan el sentirse bien a los ojos de la sociedad y de sí mismo

<p>The overall aim of the present thesis was to gain further knowledge about the nursing theoretical basis of care of older people, to translate the theory of gerotranscendence into practical guidelines<b>,</b> and to implement the theory and guidelines in practical settings. </p><p>Study I comprised a literature search and a review with qualitative analysis of nursing theories. The conclusion drawn was that nursing theories do not provide guidance on how to care for older people or on how to support them in the developmental process of ageing. Thus, there is a need to develop a nursing care model that, more than contemporary theories, takes human ageing into consideration. </p><p>Study II was a qualitative interview study involving staff working in care of older people. The interviews were qualitatively analysed. The conclusion was that staff members need an interpretative framework that allows them to understand the signs they sometimes observe in older people. Such a framework would enable staff to develop a broader approach to their care for older people. Parts of this framework can be found in the theory of gerotranscendence. </p><p>In Study III, guidelines for practical care of older people<b> </b>were derived from the theory of gerotranscendence. Focus group interviews were used and other sources supporting the guidelines were given. A qualitative analysis of the interviews was carried out, and the theory of gerotranscendence was used as the theoretical framework. The guidelines could be used to promote a development toward gerotranscendence and could also be of value for people who have already attained a state of gerotranscendence. The guidelines focus on the individual, activities and the organisation.</p><p>In Study IV, the theory of gerotranscendence and practical guidelines were introduced in a nursing home. Data were collected via qualitative interviews with staff and residents, and observations were made. Qualitative analysis and triangulation were performed. As theoretical frameworks, both the theory of gerotranscendence and innovation theory were used. The result showed that the most used guidelines were those focusing on the individual; these concern what each staff member could do in his/her relation to the resident and care. The findings showed further that those staff members who interpreted signs in line with the theory of gerotranscendence also used the guidelines. The staff who were early to adopt and promote the guidelines were those individuals who described a feeling of harmony with essential parts of the gerotranscendence theory. </p><p>The most important finding of this thesis was that it was possible to translate a theory such that it could generate practical guidelines that could be used by the staff. There are probably many theories that could be translated in order to be implemented in practical care, e.g. to build a bridge between theory and practice, thereby helping staff. Innovation theory could be of general interest in all contexts in which work towards change is being conducted.</p> / <p>Det övergripande syftet med denna avhandling var att få kunskap om den omvårdnads teoretiska basen för vård av äldre, och att översätta teorin om gerotransendens till praktiska guidelines, och att införa teorin om gerotranscendens och guidelines i praktiken</p><p>Studie I, var en litteratursökning med en kvalitativ analys av omvårdnadsteorier. Den visade att dessa teorier inte ger någon vägledning om hur omvårdnad av äldre ska ske eller hur man kan stödja äldre i deras utvecklingsprocess. Därför finns det ett behov att utveckla en omvårdnadsmodell som mer än nuvarande teorier beaktar människans åldrande.</p><p>Studie II, var en kvalitativ intervjustudie med personal i äldrevård. Intervjuerna analyserades kvalitativt. Studien påvisade att personal behöver mer kunskaper om åldrandeprocessen så att de kan förstå tecken och beteenden de ibland observerar hos de äldre. Detta skulle göra det möjligt för personal att utveckla ett vidare perspektiv för hur de kan stödja äldre personer. </p><p>I studie III, utarbetades guidelines från teorin om gerotranscendens. Fokus grupps intervjuer användes. Intervjuerna analyserades kvalitativt och teorin om gerotranscendens användes som teoretisk grund. Dessutom ges i studien hänvisning till andra källor som stödjer guidelines. Guidelines kan användas för att stödja en utveckling mot gerotranscendens och kan också vara av värde för personer som redan uppnått gerotranscendens. Guidelines innehåller åtgärder som vårdare kan göra enskild, ger förslag till aktiviteter och organisatoriska åtgärder. </p><p>I studie IV, introducerades teorin om gerotranscendens och de utarbetade guidelines på ett äldreboende. Kvalitativa intervjuer gjordes med personal och boende och observationer genomfördes. Detta analyserades kvalitativt och triangulering användes, både teorin om gerotranscendens och innovations teori användes som teoretisk grund. Resultatet visade att de mest använda guidelines var de som enskilda vårdare kunde utföra självständigt. Vidare att den personal som förklarade tecken de såg hos äldre i linje med teorin om gerotranscendens, använde också guidelines. Den personal som tidigt tog till sig och stödde användandet av guidelines var de som själva beskrev att de kände igen sig själva i delar av teorin,</p><p>Det viktigaste resultatet in denna avhandling är att det var möjligt att översätta en teori till praktiskt användbara guidelines. Förmodligen finns det fler teorier som skulle kunna översättas och implementeras i praktisk verksamhet, vilket skulle vara att bygga en bro mellan teori och praktik, och hjälpa personal att kunna omsätta teorier praktiskt. Innovationsteori kan vara av generellt intresse i alla sammanhang när förändringsarbete bedrivs. </p>

The overall aim of the present thesis was to gain further knowledge about the nursing theoretical basis of care of older people, to translate the theory of gerotranscendence into practical guidelines, and to implement the theory and guidelines in practical settings. Study I comprised a literature search and a review with qualitative analysis of nursing theories. The conclusion drawn was that nursing theories do not provide guidance on how to care for older people or on how to support them in the developmental process of ageing. Thus, there is a need to develop a nursing care model that, more than contemporary theories, takes human ageing into consideration. Study II was a qualitative interview study involving staff working in care of older people. The interviews were qualitatively analysed. The conclusion was that staff members need an interpretative framework that allows them to understand the signs they sometimes observe in older people. Such a framework would enable staff to develop a broader approach to their care for older people. Parts of this framework can be found in the theory of gerotranscendence. In Study III, guidelines for practical care of older people were derived from the theory of gerotranscendence. Focus group interviews were used and other sources supporting the guidelines were given. A qualitative analysis of the interviews was carried out, and the theory of gerotranscendence was used as the theoretical framework. The guidelines could be used to promote a development toward gerotranscendence and could also be of value for people who have already attained a state of gerotranscendence. The guidelines focus on the individual, activities and the organisation. In Study IV, the theory of gerotranscendence and practical guidelines were introduced in a nursing home. Data were collected via qualitative interviews with staff and residents, and observations were made. Qualitative analysis and triangulation were performed. As theoretical frameworks, both the theory of gerotranscendence and innovation theory were used. The result showed that the most used guidelines were those focusing on the individual; these concern what each staff member could do in his/her relation to the resident and care. The findings showed further that those staff members who interpreted signs in line with the theory of gerotranscendence also used the guidelines. The staff who were early to adopt and promote the guidelines were those individuals who described a feeling of harmony with essential parts of the gerotranscendence theory. The most important finding of this thesis was that it was possible to translate a theory such that it could generate practical guidelines that could be used by the staff. There are probably many theories that could be translated in order to be implemented in practical care, e.g. to build a bridge between theory and practice, thereby helping staff. Innovation theory could be of general interest in all contexts in which work towards change is being conducted. / Det övergripande syftet med denna avhandling var att få kunskap om den omvårdnads teoretiska basen för vård av äldre, och att översätta teorin om gerotransendens till praktiska guidelines, och att införa teorin om gerotranscendens och guidelines i praktiken Studie I, var en litteratursökning med en kvalitativ analys av omvårdnadsteorier. Den visade att dessa teorier inte ger någon vägledning om hur omvårdnad av äldre ska ske eller hur man kan stödja äldre i deras utvecklingsprocess. Därför finns det ett behov att utveckla en omvårdnadsmodell som mer än nuvarande teorier beaktar människans åldrande. Studie II, var en kvalitativ intervjustudie med personal i äldrevård. Intervjuerna analyserades kvalitativt. Studien påvisade att personal behöver mer kunskaper om åldrandeprocessen så att de kan förstå tecken och beteenden de ibland observerar hos de äldre. Detta skulle göra det möjligt för personal att utveckla ett vidare perspektiv för hur de kan stödja äldre personer. I studie III, utarbetades guidelines från teorin om gerotranscendens. Fokus grupps intervjuer användes. Intervjuerna analyserades kvalitativt och teorin om gerotranscendens användes som teoretisk grund. Dessutom ges i studien hänvisning till andra källor som stödjer guidelines. Guidelines kan användas för att stödja en utveckling mot gerotranscendens och kan också vara av värde för personer som redan uppnått gerotranscendens. Guidelines innehåller åtgärder som vårdare kan göra enskild, ger förslag till aktiviteter och organisatoriska åtgärder. I studie IV, introducerades teorin om gerotranscendens och de utarbetade guidelines på ett äldreboende. Kvalitativa intervjuer gjordes med personal och boende och observationer genomfördes. Detta analyserades kvalitativt och triangulering användes, både teorin om gerotranscendens och innovations teori användes som teoretisk grund. Resultatet visade att de mest använda guidelines var de som enskilda vårdare kunde utföra självständigt. Vidare att den personal som förklarade tecken de såg hos äldre i linje med teorin om gerotranscendens, använde också guidelines. Den personal som tidigt tog till sig och stödde användandet av guidelines var de som själva beskrev att de kände igen sig själva i delar av teorin, Det viktigaste resultatet in denna avhandling är att det var möjligt att översätta en teori till praktiskt användbara guidelines. Förmodligen finns det fler teorier som skulle kunna översättas och implementeras i praktisk verksamhet, vilket skulle vara att bygga en bro mellan teori och praktik, och hjälpa personal att kunna omsätta teorier praktiskt. Innovationsteori kan vara av generellt intresse i alla sammanhang när förändringsarbete bedrivs.