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Orientador: Izilda Esmenia Muglia Araujo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T20:04:18Z (GMT). No. of bitstreams: 1 Bellan_MargareteConsorti_M.pdf: 1469477 bytes, checksum: 6b246d40e4df19b1a0571c088ab4f183 (MD5) Previous issue date: 2006 / Resumo: A equipe de enfermagem freqüentemente é quem testemunha a parada cardiorrespiratória (PCR). Portanto, deve possuir conhecimentos suficientes para realizar os primeiros atendimentos. O sucesso da reanimação cardiorrespiratória (RCR) depende do tempo entre a ocorrência e o início do tratamento, da harmonia e sincronismo da equipe e da capacitação dos profissionais. Foram objetivos do estudo: elaborar um programa de capacitação para enfermeiros na RCR, capacitar o enfermeiro para o atendimento da PCR, avaliar o conhecimento dos enfermeiros antes e após sua participação no programa e comparar a atuação dos enfermeiros submetidos ao programa com os do grupo controle. O estudo foi desenvolvido em um hospital universitário e contemplou três etapas: etapa-I, capacitação teóricoprática; etapa-II, avaliação recente do conhecimento teórico-prático; e etapa-III, avaliação tardia. A amostra foi composta por 21 enfermeiros no grupo-A (controle ¿ não participou do programa de capacitação) e 38 no grupo-B (experimental ¿ participou do programa). Os instrumentos teórico e prático foram submetidos à validação de conteúdo e pré-teste. Na avaliação dos juízes não houve discordância significativa quanto à organização (p=0,368), objetividade (p=1,000), exceto quanto à clareza (p=0,042) para o instrumento-I (teórico). Em relação ao instrumento-II (prático), não houve discordância em nenhum dos itens (p=0,05). Na análise de desempenho dos enfermeiros verificou-se que a média das notas da avaliação teórica no grupo-A variou de forma progressiva nas três etapas: 6,45, 6,66 e 7,10; e no grupo-B de forma oscilante: 6,48, 8,36 e 8,0, respectivamente, com diferença estatisticamente significativa entre os grupos nas etapas II e III (p<0,001). Em relação às atividades práticas do suporte básico de vida (SBV) e suporte avançado (SAV), no grupo-A as médias de notas foram 3,90 e 3,49 na etapa-II e 4,32 e 3,72 na etapa-III, respectivamente, enquanto no grupo-B obtiveram as médias de notas 6,92 e 5,66 na etapa-II e 7,08 e 4,99 na etapa-III, espectivamente. As diferenças entre os grupos nas duas etapas das duas atividades foram significativas (p<0,001). Conclui-se que os conteúdos abordados e os instrumentos utilizados subsidiaram de forma favorável a execução e avaliação do programa de capacitação elaborado e implementado para os enfermeiros no atendimento da PCR. Observou-se melhora no desempenho tanto nas atividades teóricas quanto nas práticas. O grupo-B foi superior em ambos os desempenhos em relação ao grupo-A. No entanto, o desempenho na atividade teórica do grupo-B após uma semana foi superior ao de três meses; já na atividade prática do SBV, o desempenho na etapa-III foi superior à etapa-II, enquanto no SAV o desempenho da etapa-III foi inferior ao da etapa-II. O comportamento do desempenho dos sujeitos do grupo-A diferiu tanto nas atividades teórica como na prática em relação ao grupo-B. Na avaliação teórica observou-se uma melhora progressiva nas três etapas, assim como nas duas etapas das atividades práticas de SBV e SAV. Diante destes resultados, acreditase que o programa de capacitação elaborado poderá ser amplamente utilizado na instituição estudada e também adaptado para utilização em outras / Abstract: Nursing team members are frequently cardiac arrest witness, and therefore must acquire knowledge to perform basic (BLS) and advanced cardiac life support (ACLS). Successful cardiopulmonary resuscitation (CPR) depends on the treatment starting time, team¿s harmony/synchrony and involved professionals¿ capability. The study¿s main objectives were: to elaborate a nursing capacitation program in CPR; to train nurses in performing CPR; to evaluate nurses¿ CPR-knowledge before and after their participation in the program; and to analyse, comparatively, the CPR-performance of nurses that took part or not in the program. The study was developed in an university-hospital and faced three stages: stage-I, theorical-practical capacitation; stage-II, recent evaluation of theorical-practical knowledge; and stage-III, delayed evaluation of theorical-practical knowledge. The time interval between stages I and II was one week and between II and III, three months. Nurses were divided into two groups [A ¿ control (n=21), did not participate; and B ¿ experimental (n=38), did participate on the capacitation program]. Theorical and practical instruments were submitted to content validation and to a pre-test. There were no disagreements amongst judges concerning organization (p=0,368) and objectivity (p=1,000), except for clearness (p=0,042) of the instrument-I (theorical). In relation to instrument-II (practical), there were no disagreement in any items (p=0,05). On the analysis of nurses¿ performance, it was verified that group-A average punctuation in theorical evaluation varied in a progressive way on the three stages (6.45, 6.66 and 7.10, respectively), and in group-B in a non-steady way (6.48, 8.36 and 8.0, respectively) [group-B better than group-A on stages II and III (p<0,001; Tukey-test)]. In relation to practical activities on BLS and ACLS in group-A, the average punctuations were 3.90 and 3.49 on stage-II, and 4.32 and 3.72 on stage-III, respectively, while group-B has got average punctuations of 6.92 and 5.66 on stage-II, and 7.08 and 4.99 on stage-III, respectively [group-B better than group-A on the two stages of two activities (p<0,001; Tukey-test)]. Based on these results, it can be concluded that the approached contents and the used instruments helped in a most favorable way the execution and evaluation of the capacitation program elaborated and implemented to improve nurses¿ CPR-performance. It was observed an improvement not only on theorical activities but also in practical ones. Group-B has shown superior performances than group-A. However, it could be verified that theorical activity performance of group-B, within a week (stage-II), was superior in relation to stage-III (after three months); on the BLS practical activity, subjects¿ performance on stage-III was superior to stage-II, while on the SAV, performance of stage-III was inferior to stage-II. Group-A performance behavior differed not only on theorical activity but also on practical one in relation to group-B. On the theorical evaluation, it was observed a progressive improvement in all three stages, and also on both stages of BLS and ACLS practical activities. Facing these results, it is believed that this elaborated capacitation program can be largely utilized in our own institution and possibly could be adapted and extended to other ones / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

This study investigates the factors most likely to support effective communication in clinical placements for ESL nursing students in New Zealand. The experiences of ESL students as they complete a clinical placement are examined and compared with data from the students‟ clinical lecturers and preceptors. Data for the study was collected through interviews with individual students before, during and after their Transition to Practice placement. Interviews were also held with two of the students‟ preceptors, and a focus group was held with clinical lecturers who had experience of working with ESL students. Results from the study underline the importance of facilitating students‟ entry to the placement community of practice, and access to its interactions. A number of factors supported or inhibited students‟ participation and learning within the placement community. The study identified two critical factors intrinsic to the student, and two extrinsic to the student. Intrinsic factors included the student‟s proficiency with English language: in particular, the sophisticated sociopragmatic language skills used by nurses in their daily interactions. The student‟s use of learning strategies, including the proactive approach best suited to learning on placement, was also critical. Extrinsic factors likely to support the student‟s integration within the community of practice were the quality of the preceptor, in terms of attitude to and training for the preceptoring role, and the tone of the placement environment. The major outcomes of this study point to the importance of providing direct instruction for ESL students in the kinds of language and learning styles required for placement. There are also implications for the selection and training of preceptors and for the placing of students in appropriate clinical environments. The study concludes with suggestions for a specific communication programme for ESL students.

Master of Public Health - MPH / Men comprise about 10% of the nursing population globally and approximately 15% of the nursing workforce according to the South African Nursing Council. There has been an increase noted in the number of males entering the nursing profession. However, it is reported that male nurses experience discriminatory encounters related to gender bias, nursing culture, lack of equity in learning opportunities, and the stigmatisation of male nurses by the media. Although figures indicate that men remain a minority within this female dominated profession, a university in the Western Cape reported an increased enrolment of males in the nursing programme. However, little is known about what motivates them to enter this female-dominated profession and the challenges they face within the nursing profession. Therefore, the aim of this study was to compile a profile of the current male student nursing population at his school of nursing. The objectives were to identify factors motivating male students to choose nursing as a profession; identify the perceived challenges of male students in the nursing programme; and determine any associations. A quantitative, descriptive study design was used to collect data from the study population, 218 male students registered for the undergraduate nursing programmes in 2018. Stratified sampling was used to select male students for participation in the cross- sectional survey and 143 completed the self-administered questionnaire. The tool in this study was adapted from studies conducted by Bartfay et al (2010) and from O’Lynn (2003, 2013). The Cronbach’s Alpha coefficient for the Likert scale questions to determine the motivation for choosing nursing was 0.700 -and 0.905 for the perceived challenges. The Statistical Package for the Social Sciences (SPSS) version 25 was used to calculate descriptive and inferential statistics. Spearman’s correlations to calculate the strength of the relationship between the dependent variables. Mann-Whitney U test and the Kruskal- Wallis tests were used to determine the associations between the different variables. A response rate of 65.5% (143) was obtained. The majority of the male students, 84% (120) were aged between 18-25 years and 13% (18) between 26 and 33 years. The majority, 77% (110) were Blacks, 19% (27) Coloureds and 1% (2) White. Forty four percent (63) resides in the Eastern Cape, whilst 39% (56) is from the Western Cape. The spread across the different year levels from 1st to 4th year of the B. Nursing programme are 25% (35), 27(39), 21% (29) and 20% (28) respectively. The majority, 88% (126) had no previous nursing experience before commencing the nursing programme but 53% (76) were studying. The majority, 95% (137) were single and 79% (114) indicating no dependents. The desire to make a difference in society (97%, n=137) and always wanted to be a nurse (38%, n=54) were identified respectively as the most and least important intrinsic factor for entering the nursing profession. The highest rated extrinsic factors for choosing nursing ranging from 92% -76% included having a stable career; variety of career paths; travelling abroad; career mobility and using nursing as a steppingstone to other careers. However, 39% (56) were encouraged by family to do nursing. In terms of perceivedchallenges, the majority of male students indicated that media portrayed nursing as a female profession, 86% (122) and male nurses as gay or effeminate, 71% (102). Challenges in the clinical settings reveal that 71% (102) of the respondents fear being accused of inappropriate touching of female patients, 82% (118) indicated that female patients were reluctant to receive care from male nurses, and 78% (112) perceive that female colleagues utilize male nurses primarily to lift heavy objects or heavy patients. Finally, the results indicate that extrinsic motivations were significantly associated with the respondents’ race (p = 0.004) and province (p = 0.047). A significant association was found between intrinsic motivation and the age of those respondents who considered nursing as a profession (p = 0.000). There was a significant association between extrinsic motivations and the age when the respondents considered nursing (p = 0.016). The main recommendation that nurse educators and clinical staff be informed of the challenges and gender-based issues that male student nurses face and implement remedial actions in both the classroom and clinical areas.

The path to a career in nursing begins on the first day of nursing training and is not completed until the nurses have worked one year in their profession. During the training period, the student nurses have training elements in two different activitysystems: the higher education institution and the healthcare sector. The aim of this study is to examine and highlight the relationship between the different parts of the training as well as how the relationship is manifested during the newly qualified nurses’ initial period in the profession. The research’s overall question is what makes the newly qualified nurses’ learning and knowledge development easier or harder in relation to the different parts of the nursing training. Interviews have been used to create data which have been analysed based on activity theory, a social theory of learning and different ways of describing knowledge. The research findings show that the activity systems have different knowledge cultures, learning processes and patterns of action. The study participants describe the differences in terms of being in ‘different worlds’. The newly qualified nurses do not always have the practical skills that are sought after and, therefore, cannot always act as independent subjects, but become marginalized non-participants who observe the course of events. Supervision and the rounds are the two most demanding duties during the first year in the profession, since these duties have been practiced to a limited extent during the nurse training placement. The supervisory function appears different to newly qualified male and female nurses. The women in the study feel that it is problematic to be a supervisor for older experienced assistant nurses, in that the assistant nurses do not accept them as supervisors. The men do not indicate this as being a problem, rather emphasizing that the assistant nurses support them in the supervisory function. During the rounds, the nurses must inform the doctor of the state of the patients’ health and care needs. The participants feel that it is difficult to live up to the doctors’ demands ahead of the rounds. In summary, my findings show that the different knowledge cultures in the higher education institution and the healthcare sector make the newly qualified nurses’ learning and knowledge development more difficult. During the first year in the profession, the newly qualified nurses learn to be nurses, and they talk about themselves as nurses in a totally different way than at the start of that year. The changed way of talking about themselves indicates that they have recreated their identity from student nurses to nurses.

Cette recherche a été initiée à partir des constats suivants : les étudiants en soins infirmiers français réussissent en majorité à achever leurs scolarités en dépit d’un vécu de stress important durant celles-ci, les conduisant parfois au burnout. Grâce à une approche exploratoire avec en premier une revue de littérature puis une enquête auprès de 30 participants à l’aide d’entretiens semi-directifs analysés de manière thématique, nous avons étudié ces phénomènes sous l’angle de la vulnérabilité et de la résilience. D’une part, les principaux résultats nous permettent de confirmer que la formation infirmière place l’individu dans une situation de vulnérabilité conjoncturelle. Les facteurs personnels de vulnérabilité soulignés sont entre autres : le processus de transformation identitaire opérant lors de la scolarité, les enjeux dus à un apprentissage durant la jeunesse (alterner formation et premier travail d’étudiant, apprendre à s’autogérer dans un premier appartement, s’éloigner pour la première fois du cocon familial, etc.) ou plus tard dans la vie adulte (revenir à un statut financier plus précaire, se faire encadrer par des plus âgés que soi, assumer son rôle de parent en plus de celui de ses travaux d’étudiants, etc.). Les principaux facteurs de vulnérabilité liés à l’environnement sont : la mesure difficile de l’écart entre l’idéal et la réalité, le vécu émotionnel durant l’apprentissage en stage auprès des patients, des encadrants sur le terrain souvent en souffrance dans leur travail et dont la relation pédagogique avec l’apprenti est détériorée. Les symptômes qui en découlent vont d’un simple stress, à des angoisses, des insomnies, ou encore une perte d’espoir par exemple. Ces symptômes sont parfois l’expression d’un syndrome de stress post-traumatique ou d’un burnout. D’autre part, l’enquête a révélé que des processus résilients peuvent être observés pendant les études. D’un point de vue des facteurs de protection, l’apprentissage en lui-même et des pédagogues soutenants favorisent le processus de mentalisation. Des mécanismes de défense sont également activés durant la formation comme l’altruisme lors de la relation d’aide ou l’affiliation au cours des nombreux temps de partage entre pairs. Des tuteurs potentiels de résilience à la disposition des étudiants ont été identifiés : les apprenants entre eux, les formateurs, les directeurs, les cadres de santé/maître de stage, les infirmiers, les aides-soignants et des psychologues. Nous avons identifié leurs caractéristiques comme la bienveillance dont ils font preuve, le rôle de garant de la loi, de l’éthique et de la déontologie… Enfin, nous avons analysé les nouveaux éléments apportés par cette recherche et nous les avons éclairés par des investigations complémentaires dans la littérature. Nous avons notamment comparé les publications internationales sur les risques de burnout des étudiants en soins infirmiers. Nous avons approfondi la principale caractéristique de leurs tuteurs de résilience qui est ressortie de notre enquête : la compassion. Enfin, nous avons envisagé le suivi pédagogique et l’analyse de pratique professionnelle comme deux séquences d’apprentissage permettant d’accompagner la résilience. / The vast majority of French nursing students succeed in their studies despite having experienced stress factors, that can often be associated or, indeed, lead to burnout. We conducted a literature review followed by a semi-structured interview of 30 nursing students. The aim was to explore the concepts of vulnerability and resilience and how nursing students use these to succeed in their studies. Our main results confirm that nursing training places students in a situation of temporary vulnerability. Personal factors of vulnerability identified were: the stakes due to learning during the youth or later in adult life and the process of identity. The main factors of vulnerability relating to the environment were; the difficulty in measuring the gap between the ideal and reality, the emotional experience with the patient during their placement and establishment of difficult relationships with supervisors, who are often suffering in their work. The main consequences observed were stress, anxiety, insomnia, or loss of hope. These symptoms are sometimes the expression of post-traumatic stress disorder or of a professional burnout.On the other hand, the survey revealed that resilient processes can be observed during the studies. The main protective factors identified in the study that gave the students resilience were ; learning in oneself and supportive teachers, which allows the mentalization process. Defense mechanisms are also activated during training. Altruism in the supportive relationship both with mentors and the camaradery formed with fellow students were particularly evident amongst the interview responses. Potential sources of resilience identified were: student groups, trainers, directors, health managers / supervisors, nurses, nursing aides and psychologists. In summary, we have analyzed the new elements that this research has shown and compared to previous studies that have been conducted about the risk of among nursing students. We identified the main characteristic of their resilience tutors that emerged from our investigation: compassion. Finally, we considered the pedagogical follow-up and the analysis of professional practice as the two sequences of learning to promote resilience.

The purpose of this study was to explore and describe the experiences of Recognition of Prior Learning (RPL) nursing candidates related to the four-year comprehensive nursing training programme at a Nursing Education Institution in Gauteng. To this end an exploratory descriptive qualitative research design was undertaken. The research sample comprised of 13 purposefully selected participants. Face-to-face individual interviews, using open-ended questions (Grand tour), were used to collect data, which was analysed using Tesch’s approach. Findings from the study highlighted the challenges faced by nursing RPL candidates as adult students. These included challenges related to their theoretical learning as well as their clinical facility experiences. Based on the study results, recommendations were formulated in assisting them to successfully and timeously complete their nursing programme / Health Studies / M.A. (Nursing Science)

The purpose of this study was to explore and describe the experiences of Recognition of Prior Learning (RPL) nursing candidates related to the four-year comprehensive nursing training programme at a Nursing Education Institution in Gauteng. To this end an exploratory descriptive qualitative research design was undertaken. The research sample comprised of 13 purposefully selected participants. Face-to-face individual interviews, using open-ended questions (Grand tour), were used to collect data, which was analysed using Tesch’s approach. Findings from the study highlighted the challenges faced by nursing RPL candidates as adult students. These included challenges related to their theoretical learning as well as their clinical facility experiences. Based on the study results, recommendations were formulated in assisting them to successfully and timeously complete their nursing programme / Health Studies / M.A. (Nursing Science)

Made available in DSpace on 2011-05-04T12:36:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O objeto deste estudo foi o Curso de Formação Profissional de Auxiliar de Enfermagem realizado no município de Natividade, estado do Rio de Janeiro nos anos de 1995 a 1997, pela Escola de Formação Técnica em Saúde Enfª Izabel dos Santos ETIS SESDEC/RJ e teve como objetivo estudar os efeitos ocorridos na prática profissional das egressas da rede de saúde. Na implantação e no desenvolvimento deste curso foi utilizada a proposta do Projeto de Formação em Larga Escala de Pessoal de Nível Médio e Elementar para os Serviços de Saúde, mais conhecido como Projeto Larga Escala PLE, que objetivava a formação profissional de nível médio visando à qualidade da assistência à saúde da população, e que ainda hoje influencia a formação dos trabalhadores da saúde. O Projeto Larga Escala concebia que para transformar a realidade é preciso construir novas práticas de formação e de gestão na saúde, tornando necessário que a educação profissional se fundamente numa concepção que amplie os horizontes de interesses da sociedade, numa visão de mundo que posiciona e compreende o homem como centro das preocupações. Para atingir o objetivo proposto, foi realizada pesquisa em documentos na ETIS-SESDEC/RJ e aplicado um questionário com perguntas abertas e fechadas às egressas do curso. Os dados foram trabalhados dentro de uma abordagem quanti-qualitativa. Os resultados indicaram que: 100 por cento dos respondentes são do sexo feminino, a maioria (38,9 por cento) está na faixa etária entre 41 e 50 anos e 50 por cento são casadas. Quanto à escolaridade, 27,8 por cento possuem 3º grau, 11,1 por cento 3º grau incompleto, 44,4 por cento ensino médio, 11,1 por cento ensino médio incompleto e 5,5 por cento ensino fundamental. Destaca-se que 83,3 por cento das egressas encontram-se desenvolvendo atividades relacionadas à saúde e 16,7 por cento não atuam na saúde. O curso de formação profissional de auxiliar de enfermagem, em conformidade com as egressas, contribuiu para melhorar a prática, além de promover mudanças significativas nos aspectos humanístico, ético e no comprometimento com a sociedade. / The object of this study was the Nursing Assistant Professional Training Course held in the municipality of Natividade, in the State of Rio de Janeiro between the years 1995 and 1997, by the Nurse Izabel dos Santos Health Technical Training School – ETIS – SESDEC/RJ and aimed to study the effects in the professional practice of alumni of the health network. In the implementation and development of this course, the Project Proposal for the Large Scale Training of Mid- and Elementary-Personnel for Health Services, better known as the Large Scale Project – PLE, which sought the training of mid-level professionals aimed at quality health assistance of the population, and still today influences the training of health workers. The Large Scale Project understood that in order to transform reality it is necessary to construct new training practices and health management, thus making professional education necessarily base itself on an idea that broadens the horizons of the interests of society, into a worldview which places and understands humanity at the center of its worries. To meet this proposed objective, an ETIS-SESDEC/RJ documentary study was created and a questionnaire given to the graduate from the course consisting of open and closed responses. The data was elaborated within a quantitative-qualitative prism. The results indicated that: 100% of respondents were female, the majority (38.9%) is in the age group between 41 and 50 years old and 50% are married. As for schooling, 27.8% have a college education, 11.1% did not complete college, 44.4% have a high school education, 11.1 did not complete high school and 5.5% have an elementary education. It should be noted that 83.3% of alumni found them developing health related activities and 16.7% do not work in health. The nursing assistant professional training course, in confirmation with the alumni, contributed toward bettering the practice, in addition to provoking significant changes in the humanistic and ethical aspects and in the commitment to society.