Text in English / A survey by means of mailed questionnaires was conducted to compile a career profile of persons who completed the B.Cur programme at Medunsa. The sample consisted of all the nurses who had completed the B.Cur. programme over a decade from 1985 to 1994. Forty-one percent of the questionnaires were returned and the findings indicated that the nurse graduates were committed to nursing and were contributing to the nursing services in south Africa. The public service was the largest employer of the graduate nurses. Their commitment to nursing is shown by their long service as well as post-registration qualifications sought in nursing. The B.Cur programme at Medunsa had adequately prepared them to practice nursing. There appears to be a need, however, to review the curriculum in some areas. It was concluded that Medunsa has contributed to the provision of well qualified nurses. / Health Studies / M.A. (Nursing Science)

A Enfermagem como profissão se ocupa com o alívio do sofrimento, com a minimização da dor, com a dignidade diante da morte, com aspectos envolvidos com a condição humana, com o percurso da vida, com o cuidado do outro e de si. Falar sobre o final da vida, sobre como lidar com o luto são permanentes temáticas na mídia, nas redes sociais, nos grupos de conversas, o que o torna tema para a problematização de pesquisas. As tentativas de minimizar as angústias, as frustrações e os medos dos profissionais e estudantes que cuidam de pessoas que estão morrendo são inúmeras, assim, fui instigada a repensar minha maneira de ensinar e meus modos de agir em relação a pessoas que estão no final da vida. Neste contexto, considerando as vivências dos alunos durante a formação em Enfermagem, organizei a seguinte questão de pesquisa: como é iniciar as práticas hospitalares cuidando de pacientes no final da vida? Deste modo, tracei como objetivo conhecer as vivências de estudantes de graduação em enfermagem que iniciaram suas práticas hospitalares cuidando de pacientes no final da vida. Trata-se de uma pesquisa qualitativa, descritiva, que utilizou a técnica de grupo focal para produção de dados. Participaram do grupo estudantes do Curso de Enfermagem da Universidade Federal do Rio Grande do Sul (UFRGS) que vivenciaram a primeira prática hospitalar no Núcleo de Cuidados Paliativos do Hospital de Clínicas de Porto Alegre (HCPA). Para análise dos dados foi utilizada a análise do discurso proposta por Michel Foucault que explicita a íntima relação entre discurso e poder. Os discursos foram organizados de modo a destacar o domínio, a descrição dos acontecimentos, a língua e o acontecimento discursivo. A partir deste percurso, procurei signos que designam coisas e essas coisas é que foram descritas. Da análise das falas emergiu a categoria Aprendendo a ser trabalhador que é apresentada com dois marcadores discursivos denominados: Mesmo estando ali, parece que eu não faço nada e Caiu a ficha, que caracterizam o processo vivenciado pelos estudantes. A partir das falas dos estudantes e com a contribuição teórica de Jorge Larrosa (1994) foi possível modificar a palavra vivência, presente na pergunta e objetivo da pesquisa, por experiência. Assim, refletiu-se sobre experiência, experiência de si, tecnologias do eu entre outros conceitos sustentadores para procurar entender o processo de aprender a ser trabalhador. Os estudantes têm a impressão de que não fazem nada, considerando que historicamente a enfermagem empreende ações para “salvar vidas” e não para ajudar a morrer. É possível pensar que a morte do paciente desencadeia uma ausência de autoconfiança, uma debilidade, vergonha, culpa, e até abala a identidade com a profissão. Depois, cai a ficha, quando percebem que podem fazer muito pelos pacientes, seja um banho, uma troca de bolsa de colostomia, um conforto. Tais experiências representam o processo de ser trabalhador, que passa por domínios de saber, tipos de normatividade e subjetivação. Ao problematizar como estudantes experenciam o cuidado de enfermagem diante do final da vida pretendi demonstrar que mesmo que alunos e alunas tenham conhecimento sobre o final da vida, sobre o corpo, cada morte de paciente será evento novo, diferente do outro, pois cada pessoa, cada circunstância tem singularidades que necessitam ser consideradas. Cabe aos profissionais, estudantes e professores/as (re)conhecerem que a experiência é evento único, que se desenvolve a partir de determinadas tecnologias do eu. / Nursing, as a profession, is concerned about the relief of suffering, the minimization of pain, the dignity before death, about aspects related to the human condition, way of life and taking care of each other and of themselves. Talking about the end of life and dealing with mourning are permanent themes in the media, social networks, groups of conversations among other social forums, which makes this subject relevant to a research issue. Attempts to minimize the anxieties, frustrations and fears of professionals and students taking care of people who are dying are numerous. Since life is permeated by discourses and knowledge, I was instigated to rethink the way I teach, as well as the way I face what causes discomfort for the students, regarding this issue. On the context of the end of life and the experiences of the students through education in nursing, I performed the following research question: How to start hospital practices taking care of patients at the end of their lives? Thereby, traced as an objective to know the experiences of undergraduate nursing students who started their hospital practices caring for patients at the end of their lives. The present research is qualitative and descriptive and, through the focus group technique, analyzed discourses of students of the Nursing Course who experienced the first hospital practice in the Center of Palliative Care of the Hospital of Clinics of Porto Alegre (HCPA). As a result from the analysis emerged the category named as “Learning to be a worker”, presented with two markers denominated: “even being there, it seems that I do not do anything” and “I realized” that characterize the process experienced by the students. From these markers, it was possible to reflect on the experience, self-experience, technologies, among other supportive concepts for the possibility of understanding the process of learning how to be a worker. Students have the impression that they do nothing, considering that historically nursing undertakes actions to "save lives" and not to help to die. It is possible to think that death triggers an absence of self-confidence, weakness, shame, guilt, and even loss of identity with the profession. To discuss how students experience nursing care facing the end of life was not to confirm what is already said and written about the lack of preparation of the students. The aim was to demonstrate that independent of the knowledge about the end of life, each event of death will be different from the other, each person; each circumstance has singularity, individuality, both of himself and of the other. It is up to the professionals, students and teachers to know that the experience is a single event, that develops the self-technologies, that makes possible the theory of practice, allows the reflection on the technicality on the fragmentation of the care. Thus, caring will not be purely prescriptive, automatic/mechanical, aiming at the object, it will enable the subjectivity of human conditions and the uniqueness of oneself and the other.

Bakgrund: Vård i livets slutskede strävar efter att förbättra livskvaliteten hos patienter med livshotande sjukdom och för deras anhöriga. En av sjuksköterskans viktigaste uppgifter är att vårda patienter i livets slutskede samt möta deras anhöriga. Sjuksköterskestudenter är morgondagens sjuksköterskor och därmed bör de besitta kunskap om vårdande i livets slutskede. Syfte: Syftet var att beskriva sjuksköterskestudenters erfarenheter av vårdande i livets slutskede. Metod: En allmän litteraturstudie utfördes som grundades på 11 vetenskapliga artiklar. Databearbetningen resulterade i fyra kategorier: otillräcklighet vid vårdande i livets slutskede, hantering av svåra situationer vid vårdande i livets slutskede, samverkan vid vårdande i livets slutskede och okunskap om vårdande i livets slutskede. Resultat: Sjuksköterskestudenter blev känslomässigt engagerade i mötet med patienter i livets slutskede och deras anhöriga. De erfor att det fanns olika sätt att hantera de svåra situationerna som uppkom vid vårdande i livets slutskede. Det var också viktigt att skapa relationer med patienter samt inkludera anhöriga i vården. De beskrev dock kommunikationen med patienter och anhöriga som en utmaning. Sjuksköterskestudenter erfor även okunskap och att de inte hade tillräckligt med kompetens om vårdande i livets slutskede. Slutsats: Vårdande i livets slutskede väckte känslor av otillräcklighet, ensamhet och ångest hos sjuksköterskestudenter. Händelserna som uppkom vid vårdande i livet slutskede hanterades genom att vara närvarande eller genom att hålla sig på avstånd under vårdförloppet. Samverkan genom kommunikation med både patienter och anhöriga erfors av sjuksköterskestudenter som betydelsefullt. Dock erfor sjuksköterskestudenter att utbildningen inom vårdande i livets slutskede var otillräcklig. / Background: End-of-life care strives to improve the quality of life for patients with a life-threatening illness and their relatives. One of the nurses’ most important tasks are to provide care for patients at the end of their lives and for their relatives. Nursing students are tomorrows nurses, therefore they need to have knowledge about caring in end-of-life. Purpose: The purpose was to describe nursing student’s experiences of caring in end-of-life. Method: A general literature study based on 11 scientific articles. The data process resulted in four categories: insufficiency about caring in end-of-life, handling difficult situations in end-of-life, cooperation in caring in end-of- life and lack of knowledge about caring in end-of-life. Results: Nursing students became emotionally engaged when they met patients in end-of-life and their relatives. They experienced different ways to cope with the difficult situations that arose when caring in end-of-life. Nursing students also felt that it was important to establish relationships with patients as well as include the relatives in the care, they also described that communication with patients and their relatives could be challenging. However, it was also found that nursing students experienced insufficient skills and knowledge about caring in end-of-life. Conclusion: Caring in end-of-life caused feelings of insufficiency, loneliness and anxiety for the nursing students. Coping strategies included both total involvement in the care, and distancing one’s self from it. Nursing students experienced cooperation with both patients and relatives through communication as meaningful. However, nursing students experienced that the education in end-of-life care are inadequate.

Background. In Canadian baccalaureate nursing education, many schools pair their nursing students with a nurse preceptor to complete a consolidation placement in their final year of studies. The preceptor plays an important role in students’ learning and their success in the program. Although there are many factors that may influence preceptors’ ability to be successful in the role, the literature suggests that self-efficacy may affect their performance as a preceptors and may have an impact on students’ learning and their preceptorship experience. Self-efficacy is defined as a person’s confidence in their abilities to complete a task or goal. As such, preceptors with greater self-efficacy may be more effective in their role and may have a positive impact on students’ learning. Therefore, it is important to assess factors that influence preceptors’ self-efficacy as this knowledge could help inform and target the development of preceptor training programs, preceptor selection criteria and preceptor supports. Objectives. The purpose of this thesis is to explore the factors that affect the self-efficacy of preceptors. Five factors were investigated, including: (1) nursing experience, (2) preceptor experience, (3) vicarious preceptor experience, (4) preceptor training, and (5) the personality trait neuroticism. These variables are derived from Bandura’s (1986) theory of self-efficacy. Design. This study was conducted using a cross-sectional, non-experimental study design. Methods. A total of 95 nurse preceptors participated in the study by completing an online survey and were recruited using multiple strategies, including social media. The survey was comprised of demographic questions, a measure of the Big-Five personality traits, and a measure of clinical teaching self-efficacy. Correlation, independent t-tests and ANOVAs were done to analyze the data. Results. A statistically significant correlation was found between self-efficacy and two independent variables: nursing experience (r = 0.33, p < 0.01) and the personality trait of neuroticism (r = -0.21, p = .05). Additionally, self-efficacy was correlated with agreeableness (r = 0.22, p = .03) and age (r = 0.41, p < 0.01). A statistically significant difference in self-efficacy was found between diploma and bachelor degree nurses (mean difference = 0.37, p = .02), and bachelor degree and graduate degree nurses (mean difference = -0.45, p = .02). Conclusion. Three key results were found to influence the self-efficacy of nurse preceptors. This knowledge can be incorporated into preceptor training, preceptor support and the preceptor selection process.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In professional training of the nursing degree courses, there are situations which may be evaluated as stressful by students. If effective strategies are not used for coping with these situations, the stress remains and can lead to Burnout. However, Hardiness Personality is a set of features that allow resistance to stress, what is opposed to Burnout occurrence. In this process, some sociodemographic and academic characteristics can contribute to Hardiness and, thus, reduce the possibility of Burnout occurrence. In this sense, we verified the relationships among sociodemographic and academic characteristics, Burnout Syndrome and Personality Hardiness in nursing students of three Brazilian universities. This research is part of an ongoing project whose collection and partial data analysis were performed between 2011 and 2012. It is an analytical, cross-sectional and quantitative research. For data collection, we used the following instruments: Form to sociodemographic and academic characterization of students, Maslach Burnout Inventory-Student Survey (MBI-SS) and Hardiness Scale (EH). For analysis and organization of information, we built a database in an electronic spreadsheet in Excel (Office 2007) and used the Statistical Analysis System and Statistica. The qualitative variables were presented through absolute (n) and percentile(%) values and quantitative variables through descriptive measures: minimum and maximum values, mean and standard deviation. Cronbach alpha was used to analyze instruments internal consistency. We applied groups comparison tests to analyze the associations and comparisons among interest variables and tests were selected according to type of each variable involved. p values <0,05 were considered statistically significant, with a confidence interval of 95%. There was predominance of students who are female (84.21%), with age between 20 and 24 years (47.37%), single (74.39%), without children (81.05%) and who live with family (75.57%). Concerning to MBI-SS subscales, we verified that 64.04% of students showed a high level of Emotional Exhaustion, 35.79% high level of Cynicism and 87.72% low level of Professional Efficacy. Associating these subscales, 24.74% (n = 141) of participants presented Burnout. Regarding to HS domains, we observed 48.77% of population with high level of Control, 61.40% high level of Commitment and 35.44% high level of Challenge. In these domains association, we evidenced 21.93% (n = 125) of students with Hardiness Personality. There was a statistically significant difference between Hardiness Personality and Burnout (p = 0.033) occurrence among nursing students, being that 68.00% (n = 85) of Hardy students were not in Burnout. The occurrence, both of Burnout, as of Hardiness, was higher among students who are female, unmarried, without children, aged between 20 and 24 years, do not perform sports, without academic scholarship, enrolled in first semester, attending 10 disciplines, as well as among those who are satisfied to the course and did not think about drop it. We confirmed Hardiness as a set of features that allow stress resistance and, therefore, it is opposed to Burnout occurrence among nursing students. The sociodemographic and academic context contributes both to negative stress outcomes, like Burnout, as for strengthening of hardiness personality characteristics. Therefore, the manner in which student interprets the academic context may be define the outcomes related to stress. / Na formação profissional dos cursos de graduação em enfermagem, há situações que podem ser avaliadas como desgastantes pelos estudantes. Se não forem utilizadas estratégias efetivas para o seu enfrentamento, o estresse mantém-se e pode levar ao Burnout. Contudo, a Personalidade Hardiness consiste em um conjunto de características que permitem resistência ao estresse, o que se opõem a ocorrência do Burnout. Ainda, algumas características sociodemográficas e acadêmicas podem contribuir para o Hardiness e, assim, reduzir a possibilidade de ocorrência do Burnout. Nesse sentido, verificou-se as relações entre as características sociodemográficas e acadêmicas, a Síndrome de Burnout e a Personalidade Hardiness nos discentes de enfermagem de três universidades brasileiras. Essa pesquisa faz parte de um projeto em andamento, cuja coleta e análise parcial dos dados foram realizadas em 2011 e 2012. Trata-se de uma investigação analítica, transversal e quantitativa. Para coleta dos dados, foram utilizados um Formulário para caracterização sociodemográfica e acadêmica dos discentes, o Maslach Burnout Inventory- Student Survey (MBI-SS) e a Escala de Hardiness (EH). Para organização e análise dos dados, criou-se um banco de dados no programa Excel (Office 2007) e utilizado o programa Statistical Analisys System e Statistica. As variáveis qualitativas foram apresentadas em valores absolutos(n) e percentuais (%) e as quantitativas em medidas descritivas (valores mínimos e máximos, média e desvio padrão). Para análise da consistência interna dos instrumentos, utilizou-se o Coeficiente Alfa de Cronbach. Aplicou-se testes de comparação de grupos para análise das associações e comparações entre as variáveis de interesse e os testes foram selecionados segundo o tipo de variável envolvida. Valores de p<0,05 foram considerados estatisticamente significantes, com intervalo de confiança de 95%. Observou-se o predomínio de discentes do sexo feminino (84,21%), na faixa etária entre 20 e 24 anos (47,37%), solteiros (74,39%), sem filhos (81,05%) e que residem com a família (75,57%). Quanto às subescalas do MBI-SS, verificou-se que 64,04% dos discentes apresentaram alto nível de Exaustão Emocional, 35,79% alto nível de Despersonalização e 87,72% baixo nível de Eficácia Profissional. Na associação dessas subescalas, 24,74% apresentaram Burnout. Sobre os domínios da EH, observou-se 48,77% da população com alto nível de Controle, 61,40% com alto nível de Compromisso e 35,44% com alto nível de Desafio. Ao associar esses domínios, evidenciou-se 21,93% dos estudantes com Personalidade Hardiness. Houve diferença estatisticamente significativa (p=0,033) entre a ocorrência do Burnout e da Personalidade Hardiness nos discentes de enfermagem, sendo que dos 125 (100%) estudantes com Personalidade Hardiness, 68% (n=85) não estavam em Burnout. A ocorrência, tanto do Burnout, quanto do Hardiness, foi maior entre discentes do sexo feminino, solteiros, sem filhos, na faixa etária entre 20 e 24 anos, que não praticam Esportes, não possuem bolsa Acadêmica, estão matriculados no primeiro semestre, cursam 10 disciplinas, estão Satisfeitos com o curso e não pensaram em desistir do curso. Confirma-se o Hardiness como um conjunto de características que permite resistência ao estresse, e, portanto, opõe-se a ocorrência do Burnout entre os discentes de enfermagem. O contexto acadêmico contribui, tanto para desfechos negativos do estresse, como o Burnout, quanto para fortalecer as características da Personalidade Hardiness. Portanto, a forma com que o estudante interpreta o contexto acadêmico poderá definir os desfechos relacionados ao estresse.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study investigated the cultural perceptions of nursing undergraduate students regarding sexuality. The research had as loco the Federal University of Santa Maria, and the subjects were nursing undergraduate students of this institution. The main purpose was to comprehend to what extent sexuality, which is culturally conditioned, is understood and experienced by the nursing students with the aim of contributing to the construction of singular meanings concerning this human dimension on nursing care. This study aimed to recognize how the cultural construction of sexuality on the part of nursing students is built; unveil the feelings that emerge in relation to this issue, and identify the coping attitudes of these subjects in the situations that involve the theme in providing nursing care. This field research is a descriptive research with a qualitative approach. Data collection was done by means of focus group technique between May and June 2009 involving the participation of 14 students. The thematic analysis of Minayo (2008) was used. The interpretation of data established five categories: Sexuality as a Cultural Construction; Revealing Meanings; The Removal of Veils: Sexuality on Nursing Care; The Construction of Sexuality in Nurse s Academic Education; and Glimmering Perspectives. The results indicated that the construction of sexuality is related to the context in which the subject was socialized; questions related to the theme of sexuality started being discussed from adolescence; there was the distinction of gender on the education of children with regards to these questions and, in a minor proportion, it was discussed through clear and elucidative dialogical relations with the maternal figure. Sexuality was seen as a broad and dynamic concept; associated to gender roles; to the dimension of genitality and of sexual act, and to self-knowledge. The feelings that emerged concerning the theme of sexuality on the nursing care span nervousness, insecurity, distress and embarassment. Some students keep this human event veiled and change the subject when providing care, others seek to establish a dialogical relation, however, they concentrate on merely technical explanations. Some take the use of the technique mainly as a support to provide nursing care. On the students view, the theme has been neutralized and banalized on the nursing care and being treated as a mockery. With regards to the nurse s academic education concerning the theme of sexuality, the subject is treated through an eventually and informally character. The approach of the theme consists of a focus on neutrality, prohibitions and assexualization. It is recommended that sexuality should be approached as a subject of study in nursing and as a phenomenon inherent to every human being. It is believed that there is a need of promoting spaces for discussion and reflection which approach not only the sexuality of the subject receiving care, but also the student s. Finally, the possibility that the theme of sexuality should be worked on a transversal way is pondered, starting with the reality experienced by these subjects. / Este estudo investigou as percepções culturais de estudantes de graduação de enfermagem acerca da sexualidade. A pesquisa teve como loco a Universidade Federal de Santa Maria, e como sujeitos estudantes do Curso de Enfermagem dessa instituição. O principal objetivo foi o de compreender de que forma a sexualidade, condicionada culturalmente, é entendida e vivenciada pelos estudantes de Enfermagem, no intuito de contribuir para a construção de significados singulares acerca desta dimensão humana no cuidado de enfermagem. Buscou-se reconhecer como se deu a construção cultural da sexualidade dos estudantes de Enfermagem; desvelar os sentimentos que emergem em relação a essa temática e identificar as atitudes de enfrentamento desses sujeitos nas situações que envolvem o assunto, no cuidado de enfermagem. A metodologia norteadora da pesquisa está pautada em um estudo de campo, descritivo, com abordagem qualitativa. A coleta de dados ocorreu por meio da técnica do grupo focal, no período de maio a junho de 2009, contando com a participação de 14 estudantes. Foi utilizada a análise temática de Minayo (2008). A interpretação dos dados estabeleceu cinco categorias: A Sexualidade como uma Construção Cultural; Revelando Significados; A Retirada de Véus: A Sexualidade no Cuidado de Enfermagem; A Construção da Sexualidade na Formação Acadêmica do Enfermeiro; e Vislumbrando Perspectivas. Os resultados indicaram que a construção da sexualidade relaciona-se ao contexto em que o sujeito foi socializado; as questões relativas à temática começaram a ser discutidas a partir da adolescência; houve a distinção de gênero na educação dos filhos e filhas quanto a essas questões e, em menor proporção, foi discutida a partir de relações dialógicas claras e elucidativas com a figura materna. A sexualidade foi entendida como um conceito extenso e dinâmico; associada a papéis de gênero; à dimensão de genitalidade e de ato sexual e a autoconhecimento. Os sentimentos que emergiram em relação à temática, no cuidado de enfermagem, perpassam o nervosismo, a insegurança, a angústia e o constrangimento. Alguns estudantes mantêm este evento humano velado e mudam o foco do assunto no momento do cuidado, outros buscam estabelecer uma relação dialógica, porém concentram-se em explicações meramente técnicas. Alguns, ainda, se investem da realização da técnica como principal apoio para realizarem os cuidados de enfermagem. Sob o olhar dos estudantes, a temática tem sido neutralizada e banalizada no cuidado de enfermagem, sendo tratada como assunto de deboche. No que tange à formação acadêmica do enfermeiro em relação ao tema, esse assunto é tratado a partir de um caráter de eventualidade e informalidade. A abordagem da temática ocorre a partir de um enfoque de neutralidade, de proibições e de assexualização. Recomenda-se que a sexualidade seja tratada como assunto de estudo na enfermagem e como fenômeno inerente a todo o ser humano. Acredita-se na necessidade de gerar espaços de discussão e reflexão que tratem não apenas da sexualidade do sujeito cuidado, mas, também, dos estudantes. Enfim, pondera-se sobre a possibilidade de que seja trabalhada de modo transversal, partindo da realidade vivenciada por esses sujeitos.

Studier visar att många sjuksköterskestudenter upplever sig oförberedda inför ansvaret och stressen som sjuksköterskeyrket innebär och därmed överväger att lämna yrket inom fem år. Redan under studietiden är det många sjuksköterskestudenter som upplever stress- och utmattningssymtom, vilket påverkar det psykiska välbefinnandet samt engagemang och ambition till att leverera en säker och kvalitativ vård i kommande yrkesliv. Stresshantering innebär att individen hanterar en situation på ett adaptivt sätt och inte påverkas psykiskt av den. Syftet med föreliggande studie är att undersöka vilka effekter en KBT (Kognitiv beteendeterapi)- baserad stresshanteringsintervention i storgrupp har på sjuksköterskestudenters resiliens, användning av copingstrategier samt livstillfredsställelse. Studien undersöker även om individens resiliens kan prediceras av livstillfredsställelse och coping. Urvalet bestod av 28 sjuksköterskestudenter på termin 2 vid Karlstad universitet. Deltagarna besvarade frågeformulär för CD-Risc som mäter individens upplevda resiliens, Brief COPE som mäter individens användning av copingstrategier samt SWLS som mäter individens livstillfredsställelse. Frågeformulären besvarades innan stresshanteringsinterventionen startade, 10 veckor senare då interventionen var slut samt tre månader senare vid ett uppföljningsmöte. Studien är ett experiment med inomgruppsdesign för att mäta både kort- och långsiktiga effekter med stresshanteringsinterventionen. Med ANOVA för beroende mätningar visades att deltagarnas resiliens, problemfokuserade coping samt livstillfredsställelse ökade under interventionen, medan den dysfunktionella minskade. Vid uppföljningen var den problemfokuserade copingen, dysfunktionella copingen och livstillfredsställelsen stabil, medan resiliensen hade minskat. Den emotionsfokuserade copingen var oförändrad under både interventionen och fram till uppföljningen. Resiliens ses som individens förmåga att anpassa sig till och övervinna motgångar och att inte påverkas psykiskt. En multipel regression med resiliens som beroende variabel och livstillfredsställelse och copingstrategi som prediktorer beräknades. Regressionen visade att livstillfredsställelsen är en prediktor för resiliensen, medan copingen inte visades vara prediktorer för deltagarens resiliens. Studiens resultat visar att en KBT-baserad stresshanteringsintervention i grupp har effekt på sjuksköterskestudenters stresshanteringsförmåga. / Studies show that many nursing students feel unprepared for the responsibility and stress that the nursing profession implies and thus consider leaving the profession within five years. During the study period, there are many nursing students experiencing stress and fatigue symptoms, affecting mental well-being as well as commitment and ambition to deliver safe and qualitative care in the forthcoming professional life. Stress management means that the individual manages a situation in an adaptive manner and is not psychologically affected by it. The aim of the present study is to investigate the effects of a CBT (Cognitive Behavioral Therapy) - based stress management intervention in group on the resilience of nursing students, the use of coping strategies and the satisfaction of life. The study also investigates whether the resilience can be predicted by life satisfaction and coping. The selection consisted of 28 nursing students at Term 2 at Karlstad University. Participants responded questionnaires for CD-Risc, which measure the individual's experienced resilience, Brief COPE, which measures the individual's use of coping strategies and SWLS that measure the individual's life satisfaction. The questionnaires were responded before the stress management intervention started, 10 weeks later when the intervention was over and three months later at a follow-up meeting. The study is an experiment and within-group design to measure both short and long term effects with the stress management intervention. ANOVA for dependent measurements showed that participants' resilience, problem-focused coping and life satisfaction increased during intervention while dysfunctional decreased. In the follow-up, problem-focused coping, dysfunctional coping and life satisfaction were stable, while resilience had diminished. The emotion-focused coping was unchanged during both the intervention and the follow-up. Resilience is seen as the individual's ability to adapt to and overcome adversities and not to be psychologically affected. Multiple regression with resilience as dependent variable and life satisfaction and coping strategy as predictors were calculated. The regression showed that life satisfaction is a predictor of resilience, while coping was not shown to be predictors for the participant's resilience. The study's results show that a KBT-based stress management intervention in a group has an impact on nursing students' stress management ability.

A Enfermagem como profissão se ocupa com o alívio do sofrimento, com a minimização da dor, com a dignidade diante da morte, com aspectos envolvidos com a condição humana, com o percurso da vida, com o cuidado do outro e de si. Falar sobre o final da vida, sobre como lidar com o luto são permanentes temáticas na mídia, nas redes sociais, nos grupos de conversas, o que o torna tema para a problematização de pesquisas. As tentativas de minimizar as angústias, as frustrações e os medos dos profissionais e estudantes que cuidam de pessoas que estão morrendo são inúmeras, assim, fui instigada a repensar minha maneira de ensinar e meus modos de agir em relação a pessoas que estão no final da vida. Neste contexto, considerando as vivências dos alunos durante a formação em Enfermagem, organizei a seguinte questão de pesquisa: como é iniciar as práticas hospitalares cuidando de pacientes no final da vida? Deste modo, tracei como objetivo conhecer as vivências de estudantes de graduação em enfermagem que iniciaram suas práticas hospitalares cuidando de pacientes no final da vida. Trata-se de uma pesquisa qualitativa, descritiva, que utilizou a técnica de grupo focal para produção de dados. Participaram do grupo estudantes do Curso de Enfermagem da Universidade Federal do Rio Grande do Sul (UFRGS) que vivenciaram a primeira prática hospitalar no Núcleo de Cuidados Paliativos do Hospital de Clínicas de Porto Alegre (HCPA). Para análise dos dados foi utilizada a análise do discurso proposta por Michel Foucault que explicita a íntima relação entre discurso e poder. Os discursos foram organizados de modo a destacar o domínio, a descrição dos acontecimentos, a língua e o acontecimento discursivo. A partir deste percurso, procurei signos que designam coisas e essas coisas é que foram descritas. Da análise das falas emergiu a categoria Aprendendo a ser trabalhador que é apresentada com dois marcadores discursivos denominados: Mesmo estando ali, parece que eu não faço nada e Caiu a ficha, que caracterizam o processo vivenciado pelos estudantes. A partir das falas dos estudantes e com a contribuição teórica de Jorge Larrosa (1994) foi possível modificar a palavra vivência, presente na pergunta e objetivo da pesquisa, por experiência. Assim, refletiu-se sobre experiência, experiência de si, tecnologias do eu entre outros conceitos sustentadores para procurar entender o processo de aprender a ser trabalhador. Os estudantes têm a impressão de que não fazem nada, considerando que historicamente a enfermagem empreende ações para “salvar vidas” e não para ajudar a morrer. É possível pensar que a morte do paciente desencadeia uma ausência de autoconfiança, uma debilidade, vergonha, culpa, e até abala a identidade com a profissão. Depois, cai a ficha, quando percebem que podem fazer muito pelos pacientes, seja um banho, uma troca de bolsa de colostomia, um conforto. Tais experiências representam o processo de ser trabalhador, que passa por domínios de saber, tipos de normatividade e subjetivação. Ao problematizar como estudantes experenciam o cuidado de enfermagem diante do final da vida pretendi demonstrar que mesmo que alunos e alunas tenham conhecimento sobre o final da vida, sobre o corpo, cada morte de paciente será evento novo, diferente do outro, pois cada pessoa, cada circunstância tem singularidades que necessitam ser consideradas. Cabe aos profissionais, estudantes e professores/as (re)conhecerem que a experiência é evento único, que se desenvolve a partir de determinadas tecnologias do eu. / Nursing, as a profession, is concerned about the relief of suffering, the minimization of pain, the dignity before death, about aspects related to the human condition, way of life and taking care of each other and of themselves. Talking about the end of life and dealing with mourning are permanent themes in the media, social networks, groups of conversations among other social forums, which makes this subject relevant to a research issue. Attempts to minimize the anxieties, frustrations and fears of professionals and students taking care of people who are dying are numerous. Since life is permeated by discourses and knowledge, I was instigated to rethink the way I teach, as well as the way I face what causes discomfort for the students, regarding this issue. On the context of the end of life and the experiences of the students through education in nursing, I performed the following research question: How to start hospital practices taking care of patients at the end of their lives? Thereby, traced as an objective to know the experiences of undergraduate nursing students who started their hospital practices caring for patients at the end of their lives. The present research is qualitative and descriptive and, through the focus group technique, analyzed discourses of students of the Nursing Course who experienced the first hospital practice in the Center of Palliative Care of the Hospital of Clinics of Porto Alegre (HCPA). As a result from the analysis emerged the category named as “Learning to be a worker”, presented with two markers denominated: “even being there, it seems that I do not do anything” and “I realized” that characterize the process experienced by the students. From these markers, it was possible to reflect on the experience, self-experience, technologies, among other supportive concepts for the possibility of understanding the process of learning how to be a worker. Students have the impression that they do nothing, considering that historically nursing undertakes actions to "save lives" and not to help to die. It is possible to think that death triggers an absence of self-confidence, weakness, shame, guilt, and even loss of identity with the profession. To discuss how students experience nursing care facing the end of life was not to confirm what is already said and written about the lack of preparation of the students. The aim was to demonstrate that independent of the knowledge about the end of life, each event of death will be different from the other, each person; each circumstance has singularity, individuality, both of himself and of the other. It is up to the professionals, students and teachers to know that the experience is a single event, that develops the self-technologies, that makes possible the theory of practice, allows the reflection on the technicality on the fragmentation of the care. Thus, caring will not be purely prescriptive, automatic/mechanical, aiming at the object, it will enable the subjectivity of human conditions and the uniqueness of oneself and the other.

As has been reported in Canadian research on the experiences of Francophone patients and Francophone health professionals, active offer is not common or well performed in the Ontario healthcare system (Bernier, 2009; Boileau, 2016; Bouchard & Desmeules, 2013; Drolet et al., 2014; Hien & Lafontant, 2013). This descriptive quantitative research explored the self-reported awareness and implementation of the active offer concept during clinical placements by English language program 4th year undergraduate nursing students. A total of 69 participants were recruited in April 2017 to complete a paper or online-based survey. The survey consisted of questions on French language abilities, awareness of the patient safety risk of language discordance, communication experiences with Francophone patients and opinions of the role of the nurse, healthcare organizations and universities in the implementation of active offer. The participating nursing students reported little knowledge and training for implementing active offer during clinical settings. Despite the lack of preparation, the majority of them (92%) reported caring for a Francophone patient at least once with 25% doing that eight times or more during their clinical placements. More than 84% reported finding a way to communicate with Francophone patients in French, by speaking to them in French themselves or by asking Francophone colleagues, a professional interpreter or the patients’ family to interpret for them. Study recommendations include training nursing students during their undergraduate studies about the patient safety risks of language discordance, active offer and how to implement it. All English program nursing students should also be taught how to access and work with a professional interpreter. Those with French language skills should be encouraged to take healthcare specific language training. New research should be done to explore communication between English language program nursing students and Francophone patients to identify if it is safe and adequate from both the student and the patient’s point of view.

O presente estudo tem como objetivo identificar o padrão de uso de álcool e a relação com os aspectos da religiosidade em estudantes de enfermagem de uma Faculdade do Interior Paulista. O desenho metodológico trata-se de um estudo descritivo exploratório de abordagem quantitativa. Para a coleta de dados foi utilizado um questionário contendo informações sociodemográficas (sexo, idade, estado civil, religião) e os aspectos da prática religiosa. Foi aplicado o Teste de identificação dos problemas relacionados com o uso do álcool (AUDIT) e a Escala de Espiritualidade/Religiosidade (SSRS). A amostra foi composta por 78,2% dos estudantes de primeiro a quarto ano do curso de enfermagem matriculados no ano de 2008, caracterizados por 92,6% mulheres; com média de idade de 20,9 anos; 96,7% solteiros; 64,8% católicos; 60,7% frequentam reuniões religiosas uma vez/semana; 87,7% dos familiares praticam alguma religião; e 73,8% dos estudantes não consideraram religiosidade sinônimo de espiritualidade. Quanto ao padrão de consumo de álcool, 83,6% dos estudantes já fizeram uso de bebida alcoólica na vida, na classificação do AUDIT identificou-se que 79,5% eram abstêmios ou usuários de baixo risco, 20,5% faziam uso problemático do álcool, 45,9% bebiam na frequência de duas a quatro vezes por mês, 38,5% consumiam a quantidade quatro ou cinco doses e 36,9% se embriagavam menos uma vez por mês. A confiabilidade da escala SSRS apresentou um bom resultado com Alfa de Cronbach 0,83. A média da pontuação na escala SSRS foi de 14,94 pontos, sendo que 75,4% não consideram ser importante passar algum tempo do dia com pensamentos particulares e meditações religiosas; 72,1% discordam sobre a importância das orações ou pensamentos religiosos individuais sendo tão importantes quanto os que teriam durante cerimônias religiosas e cultos e 49,2% afirmam que suas vidas são baseadas em sua religião. Não houve associação entre a pontuação do AUDIT e as demais variáveis, no entanto identificou-se que quanto menor a soma na escala SSRS maior foi a pontuação no AUDIT. A religiosidade para essa amostra não foi identificada como fator de proteção para o uso de álcool entre os estudantes, 7 observou-se apenas que entre os estudantes afiliados às religiões, como a Católica, Espírita e Evangélica, houve diferenças no padrão de uso da substância investigada. Assim, o uso do álcool e a religiosidade/espiritualidade entre estudantes são temas complexos que precisam ser explorados e abordados nos currículos dos cursos de enfermagem, além de serem utilizados em estratégias preventivas no âmbito universitário. / The present paper aims to identify the pattern of alcohol use and related aspects of religiosity among nursing students from an inner paulista College. It is an exploratory descriptive study with a quantitative approach. To collect data it was used a questionnaire containing sociodemographic information (sex, age, marital status, religion) and religious practices. The Alcohol Use Disorder Identification Test (AUDIT) and the Scale of Spirituality/Religiousness (SSRS) were employed. The sample comprised 78.2% of students from first to fourth year of the nursing course enrolled in 2008: 92.6% women; mean age 20.9 years old; 96.7% single; 64.8% Roman Catholic; 60.7% attend religious meetings weekly; 87.7% of the family members practice some religion; 73.8% of the students did not consider religiosity synonymous with spirituality. Patterns of alcohol consumption: 83.6% of students have already made use of alcoholic beverages; according to AUDIT 79.5% were abstainers or low risk users; 20.5% presented hazardous alcohol use; 45.9% drank two to four times per month; 38.5% consumed four or five doses and 36.9% got drunk at least once a month. The SSRS scale reliability was good with 0.83 Cronbach\'s Alpha. The average score on the SSRS scale was 14.94 points; 75.4% did not consider it important to spend time with religious thoughts or meditations; 72.1% disagree on the importance of prays or religious thoughts (as it would happen during religious ceremonies and worships) and 49.2% say their lives are based on their religion. There was no association between AUDIT scores and other variables; however, the smaller the sums of the SSRS scale, the higher the AUDIT scores. Religiosity in this sample was not identified as a protective factor against alcohol use among students; it was observed that among the students, followers of different religions, especially Roman Catholic, Evangelical and Spirit Doctrine, there are differences regarding the alcohol use. Thus, alcohol use and religiousness/spirituality among students are complex issues that need to be explored and addressed in the curricula of nursing schools besides being used in preventive strategies in university scope.