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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
51

Implementing Systematic Sexual Orientation and Gender Identity (SOGI Data) Collection at an Inpatient Hospital Located in the Southern Region of the United States

Malugin, Shawn 14 April 2022 (has links)
Purpose LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge. Aims The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization. Processes To understand how to provide high-quality care to LGBTQ patients, providers receive instruction on the importance of collecting SOGI data and cultural competency training using the Gay and Lesbian Medical Association (GLMA) guideline. After IRB determined the project as not research involving human subjects, SOGI data questions (your current gender identity is and describe your sexual orientation) were added to the EHR demographic health history section. Provider adoption of collecting SOGI data is measured by extracting data from the EHR. Results Results will determine the providers’ responsiveness to implementing SOGI data questions into the EHR. Limitations Provider having a choice of collecting SOGI data, the small sample size of providers, and the project’s location are limitations. Conclusions LGBTQ individuals have more health inequities and face marginalization when accessing healthcare. SOGI data collection is essential for assessing health risk factors, improving health outcomes, and creating a safe and inclusive healthcare environment for LGBTQ patients.
52

The Effects Of Hormone Replacement Therapy (HRT) On Surgically Postmenopausal Women: A Review Of The Literature

Hertweck, Leslie M 01 January 2018 (has links)
The primary purpose of this research was to examine the effects of HRT in women with acute estrogen deficiency from surgically induced menopause. The secondary purpose was to evaluate how HRT improves symptoms of acute estrogen deficiency and quality of life (QOL) in women using hormone supplementation. Peer reviewed articles published from 2000 to 2017 that were written in the English language with a focus on the use of HRT in women with acute estrogen deficiency after surgical menopause were evaluated for relevance. Evidence suggests the primary reason for decreased use of HRT is the associated risks outweighing the benefits; however, this is not reflected in health care provider's (HCP's) clinical experience. HCP's were more likely to prescribe HRT for themselves or family members if they were experiencing the negative side effects of estrogen deficiency due to surgical menopause, but not to women in their care with similar clinical manifestations of menopause. Additionally, serious risks associated with HRT for acute estrogen deficiency remain incongruent with HRT for women experiencing natural menopause; although risk for breast cancer due to HRT was a universal concern. Risks of HRT related to thromboembolism, stroke and heart disease, were discussed with comparison to the undesirable clinical manifestations of menopause. Results indicate further education and research is needed that explores the risks and benefits for HRT in women with sudden onset of estrogen deficiency from surgical menopause.
53

Desenvolvimento profissional docente: um estudo com professores enfermeiros universitários / Teacher professional development: a study with university nurse professor

Borba, Kátia Pereira de 19 December 2017 (has links)
Introdução: O professor enfermeiro é um profissional que tem um importante trabalho transversal na área do ensino de enfermagem. Exercendo a docência universitária, seu trabalho não se reduz ao campo didático-pedagógico, mas pressupõem ofícios com distintos ramos do saber, o que exige instrumentalização diversificada, com o objetivo de formar o profissional enfermeiro para o mundo do trabalho. Todavia, sob a hegemonia contemporânea da lógica neoliberalista, a formação do enfermeiro pode estar mais articulada ao mercado de trabalho, o que concebe um profissional proativo e flexível para a realização de multitarefas. Com o advento do neoliberalismo, a universidade pública tornou-se uma instituição de altíssimo grau de complexidade, um tipo sofisticado e diversificado de organização social, sendo a carreira docente compelida ao paradigma do produtivismo acadêmico. Mediante o interesse de estudar a formação docente e o exercício da docência no ensino de enfermagem de professores enfermeiros universitários atuantes em uma universidade pública e debruçando-se sobre as leituras científicas, compreendeu-se o termo formação docente sob uma visão ampliada, denominado nessa perspectiva desenvolvimento profissional docente (DPD). O DPD se constrói ao longo da carreira docente e pode ser influenciado pela instituição de ensino e contextos políticos. Considerando-se a influência da política neoliberalista sobre a universidade pública brasileira, partiu-se da premissa que o DPD de professores enfermeiros universitários tem profunda relação com o exercício da docência no ensino de enfermagem. Assim, essa pesquisa respondeu a seguinte questão: Como acontece o DPD de professores enfermeiros universitários atuantes em uma universidade pública? Objetivo: Analisar o desenvolvimento profissional docente de professores enfermeiros universitários atuantes em uma universidade pública. Percurso metodológico: Estudo de caso naturalístico, descritivo e exploratório de abordagem qualitativa, realizado junto à Universidade de São Paulo (USP), no curso de Bacharelado e Licenciatura em Enfermagem da Escola de Enfermagem de Ribeirão Preto (EERP). Obtiveram-se dados de fontes primária e secundária. Para a fonte primária utilizou-se como instrumento de coleta de dados uma entrevista semiestruturada, e para a secundária a observação do trabalho docente e a consulta em documentos, os quais, o Curriculum lattes dos professores entrevistados, os planos de ensino das disciplinas ministradas por estes, e o projeto pedagógico do curso. As entrevistas e as observações do trabalho docente foram realizadas pela própria pesquisadora, entre os meses de setembro a dezembro de 2016. As observações aconteceram posteriormente à realização das entrevistas, mediante a técnica observação do tipo observador como participante, sendo descritas em um diário de campo, o que totalizou 200 horas de práticas pedagógicas observadas. A inclusão dos participantes no estudo caracterizou-se por amostragem intencional, obedecendo aos seguintes critérios: ser professor enfermeiro em Regime de Dedicação Integral a Docência e à Pesquisa; ter atuado ou estar atuando em alguma (s) das 23 disciplinas anuais ou semestrais que estavam sendo ofertadas para os graduandos do primeiro ao quinto ano do curso, no segundo semestre letivo do ano de 2016; e ter experiência na docência de no mínimo três anos. Os dados da entrevista semiestruturada foram organizados em quatro categorias temáticas, e analisados através da análise de conteúdo, na modalidade de análise temática. Na análise utilizou-se o referencial teórico de Carlos Marcelo García. A pesquisa somente aconteceu após aprovação por Comitê de Ética. A participação dos professores enfermeiros foi voluntária após aceitação e assinatura do termo de consentimento livre e esclarecido. Foi mantido o sigilo dos participantes e a garantia do anonimato quanto às informações adquiridas. Resultados, análise e discussão: A compreensão sobre as relações que envolvem o professor enfermeiro, e a universidade pública, o currículo, o ensino de enfermagem e a profissionalidade, possibilitaram analisar o desenvolvimento profissional docente desse grupo específico. Participaram da pesquisa 30 professores enfermeiros, com o predomínio de mulheres adultas, com tempo de formação acadêmica superior a 10 anos e experiência profissional na docência e na assistência de enfermagem há mais de cinco anos. A análise e discussão foram construídas em quatro categorias temáticas: A organização da universidade pública como elemento inerente ao desenvolvimento profissional docente; O currículo como elemento intrínseco ao desenvolvimento profissional docente; O desenvolvimento profissional docente de professores enfermeiros universitários, e as expectativas da profissão quanto as oportunidades de cursos de formação e carreira docente; e o desenvolvimento profissional docente de professores enfermeiros universitários, e as atividades acadêmicas e didáticas que envolvem o ensino de enfermagem. Compreendeu-se que os professores enfermeiros universitários entendem a função primordial da universidade pública como instituição social, contudo consentem com a sua função hegemônica contemporânea enquanto organização social, e percebem a sua estrutura física como elemento contribuinte para o DPD. Evidenciou-se o currículo do curso como elemento de instigação e divergências entre os professores, assim como, a necessidade de haver formação e o compartilhamento de discussões sobre o desenvolvimento do mesmo. Os professores enfermeiros envolvem-se com o processo de ensinar; exercem docência no ensino de enfermagem desempenhando suas práticas pedagógicas em instalações apropriadas; e têm dificuldades quanto à disponibilidade de tempo para preparar antecipadamente suas atividades de ensino. Apresentam discordância em relação à articulação entre projeto pedagógico, planos de ensino e o desenvolvimento de práticas pedagógicas; articulam o ensino, a pesquisa e a extensão; e demonstraram discrepâncias quanto ao uso de estratégias de ensino e de referenciais teóricos para fundamentar o preparo de suas práticas pedagógicas. Por fim, os professores enfermeiros compreendem o DPD como elemento que abarca a carreira docente e que influencia positivamente e negativamente sobre o exercício da docência no ensino de graduação em enfermagem, e apontam a necessidade de ter na universidade indicadores de avaliação, que incentivem a capacitação do professor na área do ensino. Considerações Finais: O desenvolvimento profissional docente de professores enfermeiros universitários pode exercer influência sobre o exercício da docência, beneficiando ou não o ensino de enfermagem. Espera-se com este estudo ter possibilitado reflexões sobre o exercício da docência de professores enfermeiros universitários mediante a perspectiva da visão ampliada da formação docente, assim como ter contribuído para modificações junto ao contexto do ensino de enfermagem. Em tempos de neoliberalismo recomenda-se ampliar o campo de discussão e pesquisa sobre o DPD, envolvendo a educação em enfermagem em universidades públicas / Introduction: The nurse professor is a professional with an important transversal job in nursing teaching. Besides being university professors, their work is not only didactic-pedagogical, but also in distinct positions in the realm of knowledge, what demands diversified instrumentation aiming to enable the professional nurse to work in the job market. Nevertheless, under the contemporaneous hegemony of neoliberal logic, the nurse formation is found more articulated to the job market, what conceives a proactive professional to multitask. With the advent of neo-liberalism, the public university became an extremely complex institution; a sophisticated and diversified social organization where the career in teaching is compelled to the paradigm of academic productivity. Owing to the interest in studying the teacher formation and teaching practice in nursing by university nurse professors working in a public university, and based on extensive scientific reading, the term teacher formation was better understood within a broader perspective as teacher professional development. The teacher professional development is built along with a career in teaching which can be influenced by the educational institution and political contexts. Considering the influence of neo-liberalist politics on the Brazilian public university, it was noted that the teacher professional development of university nurse professors has a deep relation with the teaching practice in nursing. Hence, this research answered the following question: How is the teacher professional development of university nurse professors working in a public university? Objective: Analyze the teacher professional development of university nurse professors working in a public university. Methodology: Study of a naturalistic case, descriptive and exploratory with a qualitative approach carried out along with São Paulo University (USP), in a nursing college course leading to a Bachelor of Education degree from Ribeirão Preto nursing school (EERP). Therefore, primary and secondary source data was obtained. For the primary source data collection a semi-structured interview was carried out, and for the secondary source data collection, teacher practice observation and documentation verification were chosen, which comprises the analysis of the Curriculum Lattes of the interviewed teachers, teaching practice plans of the ministered subjects and the pedagogical project of the course. The interviews and teacher practice observations were performed by the researcher between September and December 2016. The observations were posterior to the interviews by means of participant observer technique being depicted in a field diary, what totaled 200 hours of observed pedagogical practice. The participants\' inclusion in the study characterized by intentional sampling complied with the following criteria: being a nurse professor in Full Time Dedication Regime to the Teaching and Research; having worked or been working in one or some of the 23 annual or semi-annual disciplines which were being offered to the graduate students of the first and fifth year of the course in the second semester of the school year of 2016; having experience in teaching of at least three years. The semi-structured interview data was organized in four thematic categories and verified through content analysis in the thematic analysis modality. In the analysis, Carlos Marcelo Garcia\'s theoretical reference was used. The research was put into execution after the approval of the Ethics Committee. The nurse professors had a voluntary participation after acceptance and signature of the agreement term free and elucidated. Moreover, the secrecy of the applicants was maintained and the anonymity of the information gathered guaranteed. Result, analysis and discussion: The understanding about the relationship between the nurse professor and the public university, the curriculum, the teaching in nursing and professionalism permitted the analysis of the teacher professional development of this specific group. Thus, 30 nurse professors participated in the research with the preponderance of adult women, college graduated for over 10 years with professional experience in teaching and nursing assistance for over 5 years. The analysis and discussion were built in four thematic categories: - The organization of the public university as an inherent element to the teacher professional development; - The curriculum as an intrinsic element to the teacher professional development; - The teacher professional development of university nurse professors and the profession\'s expectations regarding graduation course opportunities and career in teaching; - The teacher professional development of university nurse professors and the didactic-academic activities that involve the teaching in nursing. It was inferred that the university nurse professors comprehend the primordial function of the public university as a social institution. Nonetheless, they consent with their contemporaneous hegemonic position while social organization, and perceive the university material structure as a contributing factor to the teacher professional development. In addition, the curriculum was noted as an instigating and diverging element among the professors, they felt the necessity of educating themselves and sharing ideas about its development. The nurse professors get involved in the teaching process, teach nursing executing their pedagogical practices in appropriate environments, but they have difficulty as for time availability to prepare their teaching activities beforehand. The group presents disagreement regarding articulation between pedagogical project, teaching plans and pedagogical practice development. Furthermore, they coordinate teaching, the research and extension, but demonstrate discrepancies concerning teaching strategy use and theoretical references to fundament their pedagogical practices. Lastly, the nurse professors understand the teacher professional development as an element that encompasses the teaching career and that influences positively or negatively the teacher practice in the nursing graduation. The group also utters the need of assessment indicators at the university which motivates the empowerment of the professor in the teaching area. Final Considerations: The teacher professional development of university nurse professors can influence the teaching practice, benefitting or not the nursing education. It is expected that this study has fomented reflections about the teaching practice of university nurse professors under a broader perspective of the teacher formation, as well as having contributed to modifications in the field of nursing teaching. In neo-liberalism times, it is recommended that the discussion field and the teacher professional development research be expanded involving nursing education in public universities
54

Žinių apie šiuolaikinę kontracepciją poreikio slaugytojoms ir akušerėms tyrimas / The need of information of modern contraception for the nurses and midwives

Sužiedelytė, Rūta 14 July 2014 (has links)
Darbo tikslas - ištirti žinių apie šiuolaikinę kontracepciją poreikį slaugytojams ir akušeriams. Tyrimo metu siekta: įvertinti slaugytojų ir akušerių nuomonės apie kontracepciją ir įrodymais pagrįstos medicinos duomenų skirtumus; išsiaiškinti ir palyginti slaugytojų ir akušerių žinių apie šiuolaikinę kontracepciją panaudojimą praktinėje veikloje; išsiaiškinti slaugytojų ir akušerių nuomonę apie jų svarbą, lytinio švietimo ir informavimo kontracepcijos klausimais, veikloje. Tyrimo hipotezė - akušerių žinios apie šiuolaikines kontraceptines priemones yra geresnės negu slaugytojų. Atliktas vienmomentis kiekybinis tyrimas, taikant apklausos metodą, kurio metu naudota autorės sudaryta nestandartizuota anketa. Apklausoje dalyvavo 220 respondentų (107 akušeriai, 111 slaugytojai ir 2 asmenys nurodė kitą profesiją) dirbančių Kauno miesto sveikatos priežiūros įstaigose ir jų skyriuose, kurie dirba su moterimis ir kuriems gali tekti konsultuoti kontracepcijos klausimu. Duomenims analizuoti naudota statistinė analizė. Atliekant statistinę duomenų analizę analizuoti tik slaugytojų ir akušerių duomenys. Tyrimo rezultatai: vertinant teiginius apie kontracepcijos poveikį slaugytojos įvertino teisingai 3 iš aštuonių, o akušerės 5 iš aštuonių teiginių. 76,4 proc. respondentų atsakė, jog domisi naujovėmis apie kontracepciją. 60,5 proc. respondentų jų nuomone žino kas yra įrodymais pagrįsta medicina/praktika. 69,5 proc. apklaustųjų jaučia poreikį įgyti daugiau žinių kontracepcijos tema... [toliau žr. visą tekstą] / Research goal – to analyse the need of information about modern contraceptics for nurses and midwives. Study aims were: assess the differences between the opinions of nurses and midwives and the evidence-based actual data about contraceptics; to find and compare the application of information about contraception by the nurses and midwives in working environment; to gauge the significance placed upon them by the nurses and midwives in sex education concerning contraception. Hypothesis – midwives have a higher knowledge base concerning modern contraception than nurses. Public quantitative research has been conducted using a survey method, in which authors’ non-standardised questionnaire has been used. In total, 220 respondents have participated (107 midwives, 111 nurses and 2 people of other profession) from Kaunas city’s health care establishments and their subsidiaries, in which female patients are present or come to and in which some sort of consultation regarding contraception could be done. The data has been analysed with statistical tools. In the data analysis, only the data concerning nurses and midwives has been analysed. Research results: in the evaluation task of presented statements upon contraception, nurses have answered 3 out of 8 correctly; midwives have answered 5 out of 8 correctly. 76,4 per cent of respondents have stated that they show interest into the new modern contraception methods. 60,5 per cent of respondents claim to know what is evidence-based... [to full text]
55

A clínica como instrumento do trabalho em enfermagem na produção na produção de cuidados / Clinical practice as the nurse's working tool for producing health care / La clínica como instrumento del trabajo de enfermeros en la producción de asistencias

Sousa, Lenice Dutra de January 2013 (has links)
Submitted by Raquel Vergara Gondran (raquelvergara38@yahoo.com.br) on 2016-03-09T22:14:56Z No. of bitstreams: 1 dlenice.pdf: 1516345 bytes, checksum: 930c729b0216458e24773e1f6778bc27 (MD5) / Approved for entry into archive by Lilian M. Silva (lilianmadeirasilva@hotmail.com) on 2016-03-13T15:54:53Z (GMT) No. of bitstreams: 1 dlenice.pdf: 1516345 bytes, checksum: 930c729b0216458e24773e1f6778bc27 (MD5) / Made available in DSpace on 2016-03-13T15:54:53Z (GMT). No. of bitstreams: 1 dlenice.pdf: 1516345 bytes, checksum: 930c729b0216458e24773e1f6778bc27 (MD5) Previous issue date: 2013 / Este estudo teve por objetivo analisar o trabalho do enfermeiro sob a ótica da produção de cuidados em saúde e do exercício da clínica. Para sua realização, optou-se pela utilização do referencial filosófico de Deleuze e Guattari devido às suas convicções acerca de um modo de pensar interconectado. Para tanto, foi realizada uma pesquisa qualitativa e exploratória, na forma de Estudo de Caso, em uma unidade de internação cirúrgica de um hospital universitário, tendo como unidade de análise um grupo de seis enfermeiros dessa mesma unidade de internação. Utilizou-se a observação não participante, a pesquisa documental e a entrevista em profundidade como métodos de coleta de dados. Os dados foram analisados, de acordo com a análise textual discursiva. O projeto dessa pesquisa, elaborado consoante às diretrizes da Resolução196/96 do Conselho Nacional de Saúde, foi aprovado sob parecer n° 87/2012. Obteve-se como um dos principais resultados que o resgate da clínica como saber pode ser um mecanismo de fortalecimento da Enfermagem capaz de propiciar um cuidar que, concomitantemente, legitima a autonomia e a visibilidade das ações de enfermagem. Verificou-se que o modelo clínico/biomédico de assistência traz em suas raízes conhecimentos advindos da clínica como ciência arborífica que, quando incorporados ao trabalho do enfermeiro, possibilitam cuidados resolutivos e coerentes às necessidades de saúde da clientela assistida e ao contexto de trabalho. Os cuidados de enfermagem são instituídos pelo enfermeiro de maneiras distintas e dependentes de conhecimento clínico: seja a partir de conexões diretas com o paciente, assim como, com a criação de linhas de fuga com outros membros da equipe de saúde multiprofissional. Atua como base para a conexão de outros saberes e práticas que expandem o fazer do enfermeiro, por meio de interligações com o ambiente. Deste modo, existe a formação de rizomas, por meio de linhas de fuga que partem da própria estrutura arborífica. Os rizomas são fundamentados e transformados, com base nas necessidades que emergem da prática clínica do enfermeiro e demonstram a capacidade desse profissional de superar o modelo clínico/biomédico hegemônico de assistência, confirmando a tese de que: o trabalho da enfermagem é organizado segundo duas perspectivas interconectadas e interdependentes: a perspectiva do modelo clínico, que compõe a estrutura-mestre da sua prática e equipara-se à estrutura arborescente do referencial de Deleuze e Guattari, que é representada pelos saberes biológico, fisiológico, patológico e farmacológico; e a perspectiva caracterizada por uma estrutura rizomática, composta por elementos múltiplos e heterogêneos, que pode ser representada por aspectos que interferem no ambiente em que o paciente está inserido, seja no âmbito social, familiar, de trabalho, entre outros. Deste modo, o modelo clínico de assistência organiza-se como uma estrutura centrada que possibilita a resolutividade das necessidades biológicas e atua como base para a conexão de outros saberes e práticas que expandem o fazer do enfermeiro, por meio de interligações com o ambiente, resultando em uma prática clínica mais próxima do que se considera/denomina integralidade. / This study aimed at analyzing the nurse's work in the perspective of health care production and clinical practice. For carrying out this study, Deleuze and Guattari's philosophical reference was chosen for their convictions about an interconnected way of thinking. Therefore, a qualitative and exploratory case study was performed in a surgery unit of a university hospital, and a group of six nurses from this unit were taken as unit of analysis. Data were collected through non-participant observation, documentary research and depth interview. They were analyzed according to the discursive textual analysis. The project of this research was set up in accordance with Resolution n. 196/96 of the National Health Council and approved by the opinion n. 87/2012. One of the main results indicated that the revival of clinical practice as knowledge might be a strengthening mechanism in Nursing which would provide a sort of health care which concurrently legitimates autonomy and visibility of nursing actions. It was determined that the clinical/biomedical model of health care has in its roots knowledges based on clinical practice as an arborescent science. When such knowledges are incorporated in the nurse's work, they enable resolutive health care which is coherent to clientele's health needs and to the work context. Nursing cares are distinctively instituted by the nurse and depend on clinical knowledge from direct connections with patients as well as by creating lines of flight with other members of the multi professional health team. The clinical model of health care acts as a basis for the connection of other knowledges and practices which expand the nurse's practices through interconnections with the working environment. This way, the creation of rhizomes occurs through lines of flight which comes from the very arborescent structure. The rhizomes are founded and transformed according to the needs which arise from the nurse's clinical practice and show the professional's capacity to overcome the hegemonic clinical/biomedical model of health care. This confirms the thesis that the nursing work is organized according to two interconnected and interdependent perspectives. First, the perspective of clinical model, which forms the main structure of the nursing practice and is on the level with the arborescent structure of Deleuze and Guattari's referential, which on its turn is represented by biological, physiological, pathological and pharmacological knowledges. Second, the perspective characterized by a rhizomatic structure, formed by multiple and heterogeneous elements, which can be represented by the aspects that interfere in patient's environment - be it social, family, work or other. This way, the clinical model of health care is organized as a centralized structure that enables resolutivity of biological needs and acts as a basis for connecting other knowledges and practices that expand the nurse's practice through interconnections with the work environment. As a result, clinical practice gets closer to what is considered as or called integrality. / Este estudio tuvo como objetivo analizar el trabajo de enfermeros bajo la óptica de la producción de asistencias en la salud y del ejercicio de la clínica. Para su realización se optó por el uso del referencial filosófico de Deleuze y Guattari debido a sus convicciones acerca de un modo de pensar interconectado. Para eso fue realizada una investigación cualitativa y exploratoria con la forma de estudio de caso en una unidad de internación quirúrgica de un hospital universitario, teniendo como unidad de análisis un grupo de seis enfermeros de esa unidad de internación. Se usó observación no participativa, investigación documental y entrevista en profundidad como métodos de recopilación de datos. Los mismos fueron analizados de acuerdo con el análisis textual discursivo. El proyecto de esta investigación, elaborado de acuerdo con las directrices de la Resolución 196/96 del Consejo Nacional de Salud, fue aprobado por el Dictamen N° 87/2012. Uno de los principales resultados obtenidos fue que el rescate de la clínica como un saber puede ser un mecanismo de fortalecimiento de la enfermería, capaz de proporcionar una asistencia que, concomitantemente, legitima la autonomía y la visibilidad de las acciones de enfermería. Se verificó que el modelo clínico/biomédico de asistencia posee en sus raíces conocimientos provenientes de la clínica como ciencia arborífica que al ser incorporados al trabajo de los enfermeros hacen posibles asistencias resolutivas y coherentes con las necesidades de salud de la clientela asistida y con el contexto de trabajo. Las asistencias de enfermería son proporcionadas por los enfermeros de modos distintos y dependientes del conocimiento clínico: sea a partir de conexiones directas con los pacientes como con la creación de líneas de fuga con otros miembros del equipo de salud multiprofesional. Por lo tanto, existe la formación de rizomas por medio de líneas de fuga que parten de la propia estructura arborífica. Los rizomas son fundamentados y transformados con base en las necesidades que surgen de la práctica clínica de los enfermeros y demuestran la capacidad de esos profesionales para superar el modelo clínico/biomédico hegemónico de asistencia, confirmando la tesis de que el trabajo de la enfermería se organiza de acuerdo con dos perspectivas interconectadas e interdependientes: la perspectiva del modelo clínico, que compone la estructura maestra de su práctica y se equipara a la estructura arborescente del referencial de Deleuze y Guattari que es representada por los saberes biológico, fisiológico, patológico y farmacológico; y la perspectiva caracterizada por una estructura rizomática, compuesta por elementos múltiples y heterogéneos, que puede ser representada por aspectos que interfieren en el ambiente en que el paciente está inserido, sea en el ámbito social, familiar o de trabajo, entre otros. De ese modo, el modelo clínico de asistencia se organiza como una estructura centrada que hace posible la resolutividad de las necesidades biológicas y actúa como base para la conexión de otros saberes y prácticas que expanden el hacer de los enfermeros por medio de interligaciones con el ambiente, resultando en una práctica clínica más próxima de lo que se considera/denomina integralidad.
56

Desenvolvimento profissional docente: um estudo com professores enfermeiros universitários / Teacher professional development: a study with university nurse professor

Kátia Pereira de Borba 19 December 2017 (has links)
Introdução: O professor enfermeiro é um profissional que tem um importante trabalho transversal na área do ensino de enfermagem. Exercendo a docência universitária, seu trabalho não se reduz ao campo didático-pedagógico, mas pressupõem ofícios com distintos ramos do saber, o que exige instrumentalização diversificada, com o objetivo de formar o profissional enfermeiro para o mundo do trabalho. Todavia, sob a hegemonia contemporânea da lógica neoliberalista, a formação do enfermeiro pode estar mais articulada ao mercado de trabalho, o que concebe um profissional proativo e flexível para a realização de multitarefas. Com o advento do neoliberalismo, a universidade pública tornou-se uma instituição de altíssimo grau de complexidade, um tipo sofisticado e diversificado de organização social, sendo a carreira docente compelida ao paradigma do produtivismo acadêmico. Mediante o interesse de estudar a formação docente e o exercício da docência no ensino de enfermagem de professores enfermeiros universitários atuantes em uma universidade pública e debruçando-se sobre as leituras científicas, compreendeu-se o termo formação docente sob uma visão ampliada, denominado nessa perspectiva desenvolvimento profissional docente (DPD). O DPD se constrói ao longo da carreira docente e pode ser influenciado pela instituição de ensino e contextos políticos. Considerando-se a influência da política neoliberalista sobre a universidade pública brasileira, partiu-se da premissa que o DPD de professores enfermeiros universitários tem profunda relação com o exercício da docência no ensino de enfermagem. Assim, essa pesquisa respondeu a seguinte questão: Como acontece o DPD de professores enfermeiros universitários atuantes em uma universidade pública? Objetivo: Analisar o desenvolvimento profissional docente de professores enfermeiros universitários atuantes em uma universidade pública. Percurso metodológico: Estudo de caso naturalístico, descritivo e exploratório de abordagem qualitativa, realizado junto à Universidade de São Paulo (USP), no curso de Bacharelado e Licenciatura em Enfermagem da Escola de Enfermagem de Ribeirão Preto (EERP). Obtiveram-se dados de fontes primária e secundária. Para a fonte primária utilizou-se como instrumento de coleta de dados uma entrevista semiestruturada, e para a secundária a observação do trabalho docente e a consulta em documentos, os quais, o Curriculum lattes dos professores entrevistados, os planos de ensino das disciplinas ministradas por estes, e o projeto pedagógico do curso. As entrevistas e as observações do trabalho docente foram realizadas pela própria pesquisadora, entre os meses de setembro a dezembro de 2016. As observações aconteceram posteriormente à realização das entrevistas, mediante a técnica observação do tipo observador como participante, sendo descritas em um diário de campo, o que totalizou 200 horas de práticas pedagógicas observadas. A inclusão dos participantes no estudo caracterizou-se por amostragem intencional, obedecendo aos seguintes critérios: ser professor enfermeiro em Regime de Dedicação Integral a Docência e à Pesquisa; ter atuado ou estar atuando em alguma (s) das 23 disciplinas anuais ou semestrais que estavam sendo ofertadas para os graduandos do primeiro ao quinto ano do curso, no segundo semestre letivo do ano de 2016; e ter experiência na docência de no mínimo três anos. Os dados da entrevista semiestruturada foram organizados em quatro categorias temáticas, e analisados através da análise de conteúdo, na modalidade de análise temática. Na análise utilizou-se o referencial teórico de Carlos Marcelo García. A pesquisa somente aconteceu após aprovação por Comitê de Ética. A participação dos professores enfermeiros foi voluntária após aceitação e assinatura do termo de consentimento livre e esclarecido. Foi mantido o sigilo dos participantes e a garantia do anonimato quanto às informações adquiridas. Resultados, análise e discussão: A compreensão sobre as relações que envolvem o professor enfermeiro, e a universidade pública, o currículo, o ensino de enfermagem e a profissionalidade, possibilitaram analisar o desenvolvimento profissional docente desse grupo específico. Participaram da pesquisa 30 professores enfermeiros, com o predomínio de mulheres adultas, com tempo de formação acadêmica superior a 10 anos e experiência profissional na docência e na assistência de enfermagem há mais de cinco anos. A análise e discussão foram construídas em quatro categorias temáticas: A organização da universidade pública como elemento inerente ao desenvolvimento profissional docente; O currículo como elemento intrínseco ao desenvolvimento profissional docente; O desenvolvimento profissional docente de professores enfermeiros universitários, e as expectativas da profissão quanto as oportunidades de cursos de formação e carreira docente; e o desenvolvimento profissional docente de professores enfermeiros universitários, e as atividades acadêmicas e didáticas que envolvem o ensino de enfermagem. Compreendeu-se que os professores enfermeiros universitários entendem a função primordial da universidade pública como instituição social, contudo consentem com a sua função hegemônica contemporânea enquanto organização social, e percebem a sua estrutura física como elemento contribuinte para o DPD. Evidenciou-se o currículo do curso como elemento de instigação e divergências entre os professores, assim como, a necessidade de haver formação e o compartilhamento de discussões sobre o desenvolvimento do mesmo. Os professores enfermeiros envolvem-se com o processo de ensinar; exercem docência no ensino de enfermagem desempenhando suas práticas pedagógicas em instalações apropriadas; e têm dificuldades quanto à disponibilidade de tempo para preparar antecipadamente suas atividades de ensino. Apresentam discordância em relação à articulação entre projeto pedagógico, planos de ensino e o desenvolvimento de práticas pedagógicas; articulam o ensino, a pesquisa e a extensão; e demonstraram discrepâncias quanto ao uso de estratégias de ensino e de referenciais teóricos para fundamentar o preparo de suas práticas pedagógicas. Por fim, os professores enfermeiros compreendem o DPD como elemento que abarca a carreira docente e que influencia positivamente e negativamente sobre o exercício da docência no ensino de graduação em enfermagem, e apontam a necessidade de ter na universidade indicadores de avaliação, que incentivem a capacitação do professor na área do ensino. Considerações Finais: O desenvolvimento profissional docente de professores enfermeiros universitários pode exercer influência sobre o exercício da docência, beneficiando ou não o ensino de enfermagem. Espera-se com este estudo ter possibilitado reflexões sobre o exercício da docência de professores enfermeiros universitários mediante a perspectiva da visão ampliada da formação docente, assim como ter contribuído para modificações junto ao contexto do ensino de enfermagem. Em tempos de neoliberalismo recomenda-se ampliar o campo de discussão e pesquisa sobre o DPD, envolvendo a educação em enfermagem em universidades públicas / Introduction: The nurse professor is a professional with an important transversal job in nursing teaching. Besides being university professors, their work is not only didactic-pedagogical, but also in distinct positions in the realm of knowledge, what demands diversified instrumentation aiming to enable the professional nurse to work in the job market. Nevertheless, under the contemporaneous hegemony of neoliberal logic, the nurse formation is found more articulated to the job market, what conceives a proactive professional to multitask. With the advent of neo-liberalism, the public university became an extremely complex institution; a sophisticated and diversified social organization where the career in teaching is compelled to the paradigm of academic productivity. Owing to the interest in studying the teacher formation and teaching practice in nursing by university nurse professors working in a public university, and based on extensive scientific reading, the term teacher formation was better understood within a broader perspective as teacher professional development. The teacher professional development is built along with a career in teaching which can be influenced by the educational institution and political contexts. Considering the influence of neo-liberalist politics on the Brazilian public university, it was noted that the teacher professional development of university nurse professors has a deep relation with the teaching practice in nursing. Hence, this research answered the following question: How is the teacher professional development of university nurse professors working in a public university? Objective: Analyze the teacher professional development of university nurse professors working in a public university. Methodology: Study of a naturalistic case, descriptive and exploratory with a qualitative approach carried out along with São Paulo University (USP), in a nursing college course leading to a Bachelor of Education degree from Ribeirão Preto nursing school (EERP). Therefore, primary and secondary source data was obtained. For the primary source data collection a semi-structured interview was carried out, and for the secondary source data collection, teacher practice observation and documentation verification were chosen, which comprises the analysis of the Curriculum Lattes of the interviewed teachers, teaching practice plans of the ministered subjects and the pedagogical project of the course. The interviews and teacher practice observations were performed by the researcher between September and December 2016. The observations were posterior to the interviews by means of participant observer technique being depicted in a field diary, what totaled 200 hours of observed pedagogical practice. The participants\' inclusion in the study characterized by intentional sampling complied with the following criteria: being a nurse professor in Full Time Dedication Regime to the Teaching and Research; having worked or been working in one or some of the 23 annual or semi-annual disciplines which were being offered to the graduate students of the first and fifth year of the course in the second semester of the school year of 2016; having experience in teaching of at least three years. The semi-structured interview data was organized in four thematic categories and verified through content analysis in the thematic analysis modality. In the analysis, Carlos Marcelo Garcia\'s theoretical reference was used. The research was put into execution after the approval of the Ethics Committee. The nurse professors had a voluntary participation after acceptance and signature of the agreement term free and elucidated. Moreover, the secrecy of the applicants was maintained and the anonymity of the information gathered guaranteed. Result, analysis and discussion: The understanding about the relationship between the nurse professor and the public university, the curriculum, the teaching in nursing and professionalism permitted the analysis of the teacher professional development of this specific group. Thus, 30 nurse professors participated in the research with the preponderance of adult women, college graduated for over 10 years with professional experience in teaching and nursing assistance for over 5 years. The analysis and discussion were built in four thematic categories: - The organization of the public university as an inherent element to the teacher professional development; - The curriculum as an intrinsic element to the teacher professional development; - The teacher professional development of university nurse professors and the profession\'s expectations regarding graduation course opportunities and career in teaching; - The teacher professional development of university nurse professors and the didactic-academic activities that involve the teaching in nursing. It was inferred that the university nurse professors comprehend the primordial function of the public university as a social institution. Nonetheless, they consent with their contemporaneous hegemonic position while social organization, and perceive the university material structure as a contributing factor to the teacher professional development. In addition, the curriculum was noted as an instigating and diverging element among the professors, they felt the necessity of educating themselves and sharing ideas about its development. The nurse professors get involved in the teaching process, teach nursing executing their pedagogical practices in appropriate environments, but they have difficulty as for time availability to prepare their teaching activities beforehand. The group presents disagreement regarding articulation between pedagogical project, teaching plans and pedagogical practice development. Furthermore, they coordinate teaching, the research and extension, but demonstrate discrepancies concerning teaching strategy use and theoretical references to fundament their pedagogical practices. Lastly, the nurse professors understand the teacher professional development as an element that encompasses the teaching career and that influences positively or negatively the teacher practice in the nursing graduation. The group also utters the need of assessment indicators at the university which motivates the empowerment of the professor in the teaching area. Final Considerations: The teacher professional development of university nurse professors can influence the teaching practice, benefitting or not the nursing education. It is expected that this study has fomented reflections about the teaching practice of university nurse professors under a broader perspective of the teacher formation, as well as having contributed to modifications in the field of nursing teaching. In neo-liberalism times, it is recommended that the discussion field and the teacher professional development research be expanded involving nursing education in public universities
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Quality Improvement Measures for Cervical Screening Guidelines in a Clinic for Uninsured Adults

Baker-Townsend, Julie Ann 01 January 2014 (has links)
Cervical cancer, a completely curable disease with early detection and management, is an international concern. Early identification allows for treatment of the disease, which prevents or slows progression, ultimately reducing morbidity and mortality. Due to the regressive nature of most cervical lesions, the duration between cervical cytology has been lengthened to prevent over diagnosis and treatment. This was reflected in the 2012 United States Preventative Services Task Force (USPSTF) clinical practice guideline for cervical cancer screening. The purpose of this project was to determine the effectiveness of a quality improvement initiative to increase adherence to the 2012 USPSTF guideline at a volunteer medical clinic for the working uninsured. In this retrospective, time series observational evaluation, data were collected via chart review regarding adherence to the guideline. The intervention consisted of the placement of a visual algorithm educational tool for clinical decision-making for cervical cytology screening in each exam room. Data were collected during three time periods: (1) the 3 months prior to initial education of clinic staff regarding the guideline; (2) the 3months between initial education and introduction of the algorithm; and (3) the 3 months post introduction of the algorithm. A total of 335 charts were reviewed. There was a significant difference in the proportion of appropriate screening among the three groups (Χ2= 6.83 p=.03). There was also a significant difference in appropriate screening rates between the new and established patients’ group, controlling for group (p<.0001). The use of the interventional algorithm is recommended to improve adherence to evidence-based practice guideline related to cervical screening as it decreases harm(s) to the patient by reduction of fear, cost to the patient, and overtreatment of benign regressive lesions.
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Perceptions and Experiences of Intimate Partner Violence Among Hispanic College Students

Vera, Racquel 18 December 2013 (has links)
Intimate partner violence (IPV) is recognized as a serious, growing problem on college campuses. IPV rates among college students exceed estimates reported for the general population. Few studies have examined the impact of IPV among the Hispanic college student (HCS) population or explored how HCSs perceive and experience IPV. Focusing on young adults (ages 18 to 25 years), this mixed methods study was designed to explore the perceptions and experiences of IPV focusing on levels of victimization and perpetration in relation to gender role attitudes and beliefs, exposure to parental IPV, acculturation, and religiosity. A sample of 120 HCSs was recruited from two south Florida universities. A subsample of 20 participants was randomly selected to provide qualitative responses. All participants completed a series of questionnaires including a demographic survey, the FPB, CTS2-CA, SASH, ERS and CTS2. Bivariate correlational techniques and multiple regressions were used to analyze data. Marked discrepancy between participants’ perceived experience of IPV (N = 120) and their CTS2 responses (n = 116, 96.7%). Only 5% of the participants saw themselves as victims or perpetrators of IPV, yet 66% were victims or 67% were perpetrators of verbal aggression; and 31% were victims or 32.5% were perpetrators of sexual coercion based on their CTS2 scores. Qualitative responses elicited from the subsample of 20 students provided some insight regarding this disparity. There was rejection of traditional stratified gender roles. Few participants indicated that they were religious (20.8%, n = 25). Evidence for the theory of intergenerational transmission of violence was noted. Recall of parental IPV was a significant predictor of level of IPV victimization (β = 0.177, SE = 0.85, p = 0.041). Nursing and social service providers must be cognizant that contributing factors to either victimization and/or perpetration of IPV among college students must be addressed first (i.e., perceptions of IPV), both in acute (i.e., emergency department) and community (i.e., college and university) settings for optimum intervention outcome.
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Effect of a Self-Care and Self-Awareness Education Program on Resilience to Burnout and Depression in Clinically Experienced Nursing Students

Taylor, Andrew 01 December 2020 (has links) (PDF)
The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these hazards. The educational intervention had a strong positive effect on resilience scores (effect size of r=72%; p < 0.05). Eighty-six percent of the participants believed that the intervention increased their capabilities for self-care, especially in sleep, spending time outside, hydration, nutrition, and physical stretching exercises but not in journaling. Eighty-one percent stated that they would be likely to seek professional help if needed. Although this study must be repeated in other samples before it be implemented with full confidence, the standardized, high intensity, short duration, resilience training session can be recommended to nursing programs just prior to graduation and to hospitals for nurse orientation programs.
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Therapy Options for Winged Scapula Patients: A Literature Review

Normand, Samantha L 01 January 2016 (has links)
Winged scapula is a condition characterized by lateral or medial protrusion of the scapula caused by nerve damage leading to muscular paralysis. The purpose of this systematic review of literature is to evaluate the current research literature related to the effectiveness of therapy options for winged scapula. Eleven peer reviewed English language research articles published from 1998 to present were included for evaluation. Study results revealed positive therapeutic outcomes for physical therapy and scapular bracing. Results also showed positive outcomes for the use of transcutaneous electrical nerve stimulation and acupuncture for the treatment of nerve related conditions similar to winged scapula. Additional research is needed to evaluate the effectiveness of transcutaneous electrical nerve stimulation and acupuncture for winged scapula patients specifically.

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