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Autonomie dans les pratiques infirmières hospitalières : contribution à une théorie agentique du développement professionnelPiguet, Catherine 09 June 2008 (has links)
La redéfinition de la profession infirmière, intervenue en Europe depuis 1990 afin de répondre aux nouveaux besoins en santé de la population, appelle les professionnelles à se centrer sur la prévention, le maintien et la promotion de la santé dans toutes les situations de soins (OMS, 1986). Cette réorientation, développée dans la formation initiale, touche le développement d’un rôle présenté dans les textes de lois et professionnels comme « autonome » et « indépendant » et pose problème quant à son intégration dans les pratiques de soins infirmiers. En effet, celles-ci, principalement déléguées par le corps médical et par l’institution, font apparaître l’injonction paradoxale au sein de laquelle les infirmières se situent : celle du développement d’une pratique autonome selon des objectifs donnés.
A partir d’un échantillon (n=841) issu d’une enquête réalisée auprès de l’ensemble des infirmières d’un CHU en Suisse (n=1951), au travers d’une approche sociocognitive (BANDURA, 2003), la recherche des principaux facteurs favorisant le développement d’une « pratique de santé », identifiée comme la centration sur le malade et sa santé selon sa propre définition de la santé, amène à mettre en évidence une double dimension de l’agentivité: autonome et hétéronome.
Ainsi, les résultats montrent que la valeur attribuée par l’infirmière à sa « pratique de santé » détermine son orientation au sein d’un contexte qui reste prioritairement dirigé vers une « pratique de soins », centrée sur la gestion de l’ensemble des soins auprès du patient selon la définition de l’institution. Dès lors, l’autonomie dans les pratiques infirmières se présente comme l’exercice de l’agentivité, soit la puissance personnelle d’agir de l’infirmière, selon sa propre orientation : santé ou soins. Elle se développe significativement chez les professionnelles ayant un haut niveau de formation, santé ou soins, par une approche centrée sur l’apprentissage tout au long de la vie.
Cette thèse permet de tracer des perspectives relatives à la clarification des rôles et des missions des infirmières et de leurs développements, au sein des établissements hospitaliers universitaires en particulier. Elle pose la question de la construction d’un sentiment d’efficacité personnelle (SEP) qui ne correspondrait pas à l’attente prioritaire et explicite du contexte. Enfin, en distinguant l’agentivité de l’autonomie, elle contribue à la construction conceptuelle des questions liées à l’autoformation (CARRE, 2005). / The redefinition of the nursing profession, in effect in Europe since 1990 in order to meet the new health needs of the population, requires professionals to focus on the prevention, the maintenance and the promotion of health in all care situations (OMS, 1986). This reorientation, developed in initial training, concerns the development of a role depicted in the professional legal texts as "autonomous" and "independent", while raising the issue of its integration into nurses' care-giving practices. Indeed, these practices, which are mainly delegated by the medical corps and the institution, highlight the paradoxical injunction in which nurses find themselves: developing their autonomous practice in accordance with heteronomously-set objectives.
Based on a sample (n=841) taken from a study which surveyed the nursing population of a Swiss university hospital (n=1951), via a social cognitive approach (BANDURA, 2003), the search for main factors that foster the development of "health practices", identified as a focus on the patient and the patient's health according to one's own definition of health, brings to the fore a double dimension of agency : autonomous and heteronomous.
Thus, the results show that the value attributed by the nurse to her "health practices" determines their orientation within a context that remains first and foremost directed toward "treatment practices" centered on the management of patient care in all its forms as defined by the institution. Consequently, autonomy in nursing practices appears to be the exercise of agency or of the nurse's personal power to act, according to her own orientation, health or treatment. It develops significantly in highly-qualified professionals, according to an approach centered on lifelong learning.
This thesis allows for a marking out of perspectives pertaining to the clarification of nurses' roles and missions as well as the development of these roles within the university hospital structure. It raises the question of the construction of a self-efficacy which would not correspond to the explicit, nor priority expectation of the context. Lastly, by distinguishing agency and autonomy, this thesis contributes to the conceptual construction of questions linked to self-directed learning (CARRE, 2005).
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Enfermeiros na Atenção Primária à Saúde no município de Itaboraí-RJ: reflexões sobre a prática / Nurses in Primary Health Care in the municipality of Itaboraí-RJ: reflections about the practiceJovana Lucia Schettini Mendonça Toniato 22 January 2014 (has links)
Este estudo é fruto da pesquisa de mestrado do Programa de Pós-Graduação em Enfermagem da Universidade do Estado do Rio de Janeiro (ENF/UERJ). Teve por objetivo identificar e analisar as práticas realizadas pelos enfermeiros na equipe da ESF do município de Itaboraí, correlacionando-as com a Política Nacional de Atenção Básica, (PNAB, 2012). A escolha pelo estudo das práticas de enfermagem na equipe da ESF iniciou-se a partir de reflexões em torno do projeto de pesquisa denominado Saberes e Práticas na Atenção Primária a saúde: diálogos entre usuários e profissionais de saúde no Estado do Rio de Janeiro. Estas reflexões levaram ao entendimento de que as práticas de saúde dos enfermeiros influenciam e são influenciadas por constructos socias tais como a cultura, política, economia e pelas relações de poder existentes no interior das equipes de saúde; o que pode potencializar ou minimizar a realização de práticas integrais que atendam as necessidades de saúde dos usuários, a consolidação no novo modelo de assistência à saúde e o fortalecimento da identidade profissional do enfermeiro. Trata-se de um estudo descritivo, de natureza qualitativa. A pesquisa foi desenvolvida no período de 2012 a 2013, sendo utilizada a entrevista semiestruturada e a observação semiestruturada como instrumentos de coleta de dados. Foi utilizado como critério de inclusão as USFs com equipe mínima de saúde completa e cujos enfermeiros possuíssem, pelo menos, dois anos de atuação na estratégia. Os critérios de exclusão foram: USFs que não possuíssem equipe mínima completa e cujos enfermeiros tivessem menos de dois anos de atuação na ESF. Foram entrevistados 10 enfermeiros. A técnica de análise utilizada foi a análise temática proposta por Bardin associada a análise do diário de campo chegando as seguintes categorias: A práticas dos enfermeiros na ESF de Itaboraí frente a PNAB, (2012); elementos orientadores das práticas dos enfermeiros: o normativo e o social e as práticas do enfermeiro na ESF e o trabalho em equipe. Concluiu-se que os enfermeiros realizam práticas assistências, de educação em saúde e de gerência, sendo as mesmas embasadas pelos manuais do MS e pelas necessidades de saúde da população adscrita. No entanto, estas práticas encontram alguns entraves para serem realizadas dentro da equipe causando desânimo para o enfermeiro e reduzindo suas potencialidades. Acredita-se que este estudo aponta para a necessidade de uma reavaliação no âmbito organizacional da assistência da ESF neste município, assim como parece imprescindível o diálogo entre as experiências práticas e os conhecimentos teórico de forma a orientar a construção de saberes e a formulação de uma visão crítica sobre as práticas. / This Study comes from a research about Pos-Graduation Program in Nursing from the University State in Rio de Janeiro (ENF/UERJ). The objectives are identified and analyze health practices carried out by nurses in the ESF team of the municipality of Itaboraí, correlating them with the National Policy of Primary Health Care, (PNAB, 2012). The choice by the study of nursing practices in ESF team began from reflections around the research project called knowledge and practices in Primary Health Care: dialogues between users and health professionals in the State of Rio de Janeiro. Such reflections led to the understanding that the health practices of nurses influence and are influenced by social constructs such as culture, politics, economics and the power relations within the health teams; What can maximize or minimize the possibilities for realization of integral practices that contemplate the real needs of users' health, the consolidation in the new model of health care and strengthening the professional identity of the nurse. This is a descriptive study of qualitative nature. The survey was developed in the period of 2012 until 2013, being used the semi structured interview and semi-structured observations as data collection instruments. It was used as a criterion for inclusion the USFs with minimum full health team and whose own nurses, at least two years of experience in the strategy. Exclusion criteria were: USFs own minimal team not complete and whose nurses had less than two years of experience on ESF. 10 nurses were interviewed. The analysis technique used was the thematic analysis proposed by Bardin associated with analysis of the field journal arriving the following categories: nurses' practices in the ESF of Itaboraí front of PNAB, (2012); I guiding elements: the nurses' practices and the social and legal practices of nurses on ESF and teamwork. It was concluded that nurses perform practice assists, health education and management, being informed by the MS manuals and the registered population health needs. However, these practices are some obstacles to be performed within the team causing dismay to the nurse and reducing their potential. It is believed that this study points to the need for a reassessment within the organizational assistance from the ESF in this municipality, as well as seems essential dialogue between the practical experiences and theoretical knowledge in order to guide the construction of knowledge and the formulation of a critical view on the practices.
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Ošetřovatelské postupy v interních oborech v kontextu s vývojem / Nursing practices internal medicine in context with the development.POSPÍŠILOVÁ, Eva January 2013 (has links)
Nursing methods are understood as a collection of knowledge and instructions about how to perform nursing in order to achieve the most effective nursing care. It's not a set of fixed rules. Their development relies on the development of medicine and technology. They are in accordance with medicinal and technological knowledge. The goal of this thesis is to map the development of certain nursing methods in internal departments from the second half of the 19th century to the present day. It has been a qualitative research carried out by studying and analyzing written documents. This thesis was based on searching, sorting and consequent processing of historical archived publications and contemporary professional sources related to this topic. The thesis is divided into two parts. The first part deals with the history of nursing. It contains a brief description of the beginning of nursing along with the factors which have influenced nursing. Foundations of modern nursing have formed thanks to Florence Nightingale, who also influenced the development of nursing in the Czech lands. The history of Czech nursing is mostly concentrated around the period of the world wars. The second part is dedicated to specific nursing activities concerning healthy living spaces, rooms for patients, patients? beds and their modifications, care of patients? hygiene and monitoring the vital functions. The timeframe begins at the first half of the 19th century due to the establishment of real nursing professions at that time. Individual stages are ten years long. They indicate complex development of specific nursing methods from their beginnings to the present day. Mapping the historical development of certain nursing methods can contribute to the modern nurse's work. Past knowledge can help them to avoid mistakes and use of outdated methods. My thesis may also lead to a reflection of current methods, which may be replaced by more advanced ones.
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Enfermeiros na Atenção Primária à Saúde no município de Itaboraí-RJ: reflexões sobre a prática / Nurses in Primary Health Care in the municipality of Itaboraí-RJ: reflections about the practiceJovana Lucia Schettini Mendonça Toniato 22 January 2014 (has links)
Este estudo é fruto da pesquisa de mestrado do Programa de Pós-Graduação em Enfermagem da Universidade do Estado do Rio de Janeiro (ENF/UERJ). Teve por objetivo identificar e analisar as práticas realizadas pelos enfermeiros na equipe da ESF do município de Itaboraí, correlacionando-as com a Política Nacional de Atenção Básica, (PNAB, 2012). A escolha pelo estudo das práticas de enfermagem na equipe da ESF iniciou-se a partir de reflexões em torno do projeto de pesquisa denominado Saberes e Práticas na Atenção Primária a saúde: diálogos entre usuários e profissionais de saúde no Estado do Rio de Janeiro. Estas reflexões levaram ao entendimento de que as práticas de saúde dos enfermeiros influenciam e são influenciadas por constructos socias tais como a cultura, política, economia e pelas relações de poder existentes no interior das equipes de saúde; o que pode potencializar ou minimizar a realização de práticas integrais que atendam as necessidades de saúde dos usuários, a consolidação no novo modelo de assistência à saúde e o fortalecimento da identidade profissional do enfermeiro. Trata-se de um estudo descritivo, de natureza qualitativa. A pesquisa foi desenvolvida no período de 2012 a 2013, sendo utilizada a entrevista semiestruturada e a observação semiestruturada como instrumentos de coleta de dados. Foi utilizado como critério de inclusão as USFs com equipe mínima de saúde completa e cujos enfermeiros possuíssem, pelo menos, dois anos de atuação na estratégia. Os critérios de exclusão foram: USFs que não possuíssem equipe mínima completa e cujos enfermeiros tivessem menos de dois anos de atuação na ESF. Foram entrevistados 10 enfermeiros. A técnica de análise utilizada foi a análise temática proposta por Bardin associada a análise do diário de campo chegando as seguintes categorias: A práticas dos enfermeiros na ESF de Itaboraí frente a PNAB, (2012); elementos orientadores das práticas dos enfermeiros: o normativo e o social e as práticas do enfermeiro na ESF e o trabalho em equipe. Concluiu-se que os enfermeiros realizam práticas assistências, de educação em saúde e de gerência, sendo as mesmas embasadas pelos manuais do MS e pelas necessidades de saúde da população adscrita. No entanto, estas práticas encontram alguns entraves para serem realizadas dentro da equipe causando desânimo para o enfermeiro e reduzindo suas potencialidades. Acredita-se que este estudo aponta para a necessidade de uma reavaliação no âmbito organizacional da assistência da ESF neste município, assim como parece imprescindível o diálogo entre as experiências práticas e os conhecimentos teórico de forma a orientar a construção de saberes e a formulação de uma visão crítica sobre as práticas. / This Study comes from a research about Pos-Graduation Program in Nursing from the University State in Rio de Janeiro (ENF/UERJ). The objectives are identified and analyze health practices carried out by nurses in the ESF team of the municipality of Itaboraí, correlating them with the National Policy of Primary Health Care, (PNAB, 2012). The choice by the study of nursing practices in ESF team began from reflections around the research project called knowledge and practices in Primary Health Care: dialogues between users and health professionals in the State of Rio de Janeiro. Such reflections led to the understanding that the health practices of nurses influence and are influenced by social constructs such as culture, politics, economics and the power relations within the health teams; What can maximize or minimize the possibilities for realization of integral practices that contemplate the real needs of users' health, the consolidation in the new model of health care and strengthening the professional identity of the nurse. This is a descriptive study of qualitative nature. The survey was developed in the period of 2012 until 2013, being used the semi structured interview and semi-structured observations as data collection instruments. It was used as a criterion for inclusion the USFs with minimum full health team and whose own nurses, at least two years of experience in the strategy. Exclusion criteria were: USFs own minimal team not complete and whose nurses had less than two years of experience on ESF. 10 nurses were interviewed. The analysis technique used was the thematic analysis proposed by Bardin associated with analysis of the field journal arriving the following categories: nurses' practices in the ESF of Itaboraí front of PNAB, (2012); I guiding elements: the nurses' practices and the social and legal practices of nurses on ESF and teamwork. It was concluded that nurses perform practice assists, health education and management, being informed by the MS manuals and the registered population health needs. However, these practices are some obstacles to be performed within the team causing dismay to the nurse and reducing their potential. It is believed that this study points to the need for a reassessment within the organizational assistance from the ESF in this municipality, as well as seems essential dialogue between the practical experiences and theoretical knowledge in order to guide the construction of knowledge and the formulation of a critical view on the practices.
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A study of nursing practices used in the management of infection in hospitals, 1929-1948Justham, David January 2014 (has links)
Before the availability of antibiotics minor infections could become life threatening. Nurses working in voluntary and public hospitals in Britain were exposed to such risks. This thesis uses both oral testimonies and published sources in order to examine their practices concerning the management of infection risks. The detail of nursing work in this period has been generally hidden in nursing histories of the 1930s and 1940s which have addressed mainly political, recruitment, educational, registration and status issues. Whilst these histories may comment about menial duties, and the culture and discipline in clinical areas, they lack detailed exploration of the day-to-day work of the nurse. This novel study contributes to redressing the balance by examining nursing practice between the discovery of penicillin in 1929 and its widespread availability in Britain in 1948. Data analysis, including the oral testimonies of nineteen former nurses who worked between 1929 and 1948, suggests that nursing practice during this period placed enormous emphasis on cleanliness and hygiene. It is argued that this was linked to sanitarianism which influenced nursing practice before its replacement by germ theory. Probationer nurses learnt their skills in managing infection risks to themselves and their patients in a disciplined and safe way. This was achieved through the exercise of strict routines and a hierarchy of tasks that provided a graduated exposure to the patient and infection risks. This thesis draws on debates in the literature about purity, vocation and status to explore, and add weight to this argument. The analysis also identifies that the introduction of sulphonamide drugs and antibiotics altered nursing practices in the management of both infection risks and patients with infection. Whilst the full effects of these changes are not examined in this thesis, it is argued that the significant impact of these drugs was such that the emphasis on cleaning and hygiene became diminished in importance and nursing had to redefine its role. It suggests that more prominence needs to be given to changes in clinical practice in the history of nursing. This study breaks new ground by suggesting the rigorous training of nurses in cleaning and hygiene tasks was needed in order to manage the infection risks faced by nurses before the availability of antibiotics.
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Etude de l'effet centre en dialyse péritonéale / Center effect in peritoneal dialysis patientsFourre Guillouet, Sonia 12 December 2019 (has links)
Les études regroupées dans cette thèse montrent qu'il existe une hétérogénéité entre les centres de dialyse péritonéale dans la survenue des infections péritonéales et l’échec précoce de la méthode. Nous avons aussi montré que certaines organisations peuvent être modifiées dans l’objectif d’améliorer le devenir du patient en optimisant la ressource.Nos travaux soulignent le rôle des équipes infirmières et l’importance des visites infirmières à domicile dans la prévention des infections du liquide de dialyse péritonéale. La mise à disposition de moyens humains minimum pourrait constituer un des critères d’attribution des autorisations de traitement par dialyse donnés aux établissements de santé.Augmenter la taille des centres pourrait avoir un effet bénéfique sur la survie de la méthode en améliorant l’expérience des centres. Dans ce contexte, le regroupement d’activité entre plusieurs établissements pourrait avoir un effet positif sur la survie de la méthode.Nous avons aussi pu observer qu’il existait une disparité entre les centres dans l’utilisation de l’assistance à domicile par une infirmière pour la réalisation de la dialyse. L’attribution de l’assistance repose principalement sur l’évaluation de l’infirmière de dialyse péritonéale ce qui laisse entrevoir des possibilités de rationalisation dans son utilisation. L’utilisation et la validation d’outils permettant d’estimer la capacité d’autonomisation du patient est une recherche qui devra être conduite. / The studies grouped in this thesis show that there is a heterogeneity between the peritoneal dialysis centers in the occurrence of peritoneal infections and the early failure of the method. We have also shown that some organizations can be modified in order to improve the patient's future by optimizing the resource.Our work highlights the role of nursing teams and the importance of home nursing visits in the prevention of peritoneal dialysis fluid infections. The provision of minimum human resources could be one of the criteria for granting dialysis treatment authorizations given to health facilities.Increasing the size of the centers could have a beneficial effect on the survival of the method by improving the centers experience. In this context, group activities between several establishments could have a positive effect on the survival of the method.We also observed that there is a disparity between centers in the use of home assistance by a nurse for dialysis. The allocation of assistance is mainly based on the evaluation of the peritoneal dialysis nurse, which suggests possibilities of rationalization in its use.The use and validation of tools to estimate the patient's capacity to be treated by self-care peritoneal dialysis is a research that will need to be conducted.
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Mulher e Saúde: dialetizando o trabalho da enfermagem ambulatorial / Woman and Health: Dialectical approach on nursing practices ambulatory service.Barrientos, Dora Mariela Salcedo 14 June 2002 (has links)
O presente trabalho teve como objetivos: identificar as percepções e as contradições das mulheres enfermeiras acerca das práticas sociais da enfermagem, analisar a prática das enfermeiras enquanto prática social na perspectiva de gênero materializada em seu cotidiano de trabalho; compreender os significados atribuídos pelas enfermeiras ao seu fazer profissional para subsidiar a transformação da prática junto às usuárias através da enfermagem generificada. Foi realizada uma pesquisa com perspectiva de intervenção junto às enfermeiras que trabalham no ambulatório do Hospital Universitário da Universidade de São Paulo em 3 períodos, abrangendo um total de 7hr 30´ durante o mês de junho de 2000, através de oficinas de trabalho estruturadas em vários momentos: motivação, reflexão individual, reflexão grupal, síntese e avaliação. Foi realizada uma análise imediata dos discursos para efeito de intervenção durante a própria oficina e, posteriormente, através do aprofundamento dessa análise foram encontradas as seguintes categorias empíricas: ambigüidades e/ou multiplicidade de se viver e ser mulher enfermeira: um caminho para a superação das contradições; a mulher e a prática na enfermagem versus a mulher nos papéis tradicionais (des) generificando o trabalho feminino. Os resultados mostram que estas oficinas representam um avanço epistemológico, ficando evidente que esta metodologia gerou um locus de intervenção concomitantemente à coleta de dados que, permeado por um clima de confiança, levou ao aprofundamento das informações, em razão da construção de empatia entre investigadoras e investigadas, apontando novas saídas para uma verdadeira transformação do exercício profissional junto à população feminina. / This work had as objectives: identify women nurses perceptions and contradictions about nursing social practices, to analyze nurses practice as social practice in the gender perspective materialized in their usual work; to understand meanings given to their professional work by the nurses to give support to the practices transformation together with the clients through a nursing under gender point of view. It was made an intervention research with nurses that work in the ambulatory center, at the University Hospital of the Sao Paulos University in six stages, including 7 hours 30´ during June, 2000, using Workshops, divided in many moments: motivation, group reflection, synthesis and evaluation. It was made a quick speech analysis for intervention during the workshop and afterwards with a deeper analysis there were found the next empiric categories: Ambiguities and/or multiplicities of living and being a nurse woman: A way to get over contradictions; Woman and the nursing practice vs. woman in traditional roles. (Mis) gendering feminine work. The results show that these workshops represent an epistemological advance, being clear that this methodology let us an advanced compared the focal groups method, or the group interviews method, and other methodological options, because it created a way of intervention at the same time of data collection that helped by reliable environment, let us to go inside the information, as a result of researchers and researched empathy, showing new ways for a real change of the professional work with women.
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How healthcare workers experience violence against women and how it influences the care : A qualitative studyVingård Frank, Linda January 2010 (has links)
Violence against women (VAW) is a global problem existing in all cultures. This study is performed because there is a lack of knowledge about how healthcare personnel treat VAW to promote health and to alleviate suffering. The aim is to describe how healthcare workers experience violence against women and how it influences the care. Qualitative semi structured individual interviews were made with three nurses and one medical student in Egypt. The interviews were taped and transcribed before the text was analyzed by qualitative content analysis. The result showed that women were subordinated and discriminated in Egypt and in the healthcare. The care for the abused women was focused on first aid, and the respondents expressed that it was the woman’s own decision and responsibility to report or do any further actions. Often the violence was ignored or silenced. Violence and threats was accepted by the society and individuals as a mean for handling conflicts and was used in the healthcare settings as well. The respondents expressed a need for change and a wish for decreasing the violence, work for equality and stressed the importance of education in society. They also emphasised the need for women to gain more economic independence. Attitudes of healthcare workers need to be addressed and further investigation is necessary to prevent VAW. / Program: Sjuksköterskeutbildning
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Mulher e Saúde: dialetizando o trabalho da enfermagem ambulatorial / Woman and Health: Dialectical approach on nursing practices ambulatory service.Dora Mariela Salcedo Barrientos 14 June 2002 (has links)
O presente trabalho teve como objetivos: identificar as percepções e as contradições das mulheres enfermeiras acerca das práticas sociais da enfermagem, analisar a prática das enfermeiras enquanto prática social na perspectiva de gênero materializada em seu cotidiano de trabalho; compreender os significados atribuídos pelas enfermeiras ao seu fazer profissional para subsidiar a transformação da prática junto às usuárias através da enfermagem generificada. Foi realizada uma pesquisa com perspectiva de intervenção junto às enfermeiras que trabalham no ambulatório do Hospital Universitário da Universidade de São Paulo em 3 períodos, abrangendo um total de 7hr 30´ durante o mês de junho de 2000, através de oficinas de trabalho estruturadas em vários momentos: motivação, reflexão individual, reflexão grupal, síntese e avaliação. Foi realizada uma análise imediata dos discursos para efeito de intervenção durante a própria oficina e, posteriormente, através do aprofundamento dessa análise foram encontradas as seguintes categorias empíricas: ambigüidades e/ou multiplicidade de se viver e ser mulher enfermeira: um caminho para a superação das contradições; a mulher e a prática na enfermagem versus a mulher nos papéis tradicionais (des) generificando o trabalho feminino. Os resultados mostram que estas oficinas representam um avanço epistemológico, ficando evidente que esta metodologia gerou um locus de intervenção concomitantemente à coleta de dados que, permeado por um clima de confiança, levou ao aprofundamento das informações, em razão da construção de empatia entre investigadoras e investigadas, apontando novas saídas para uma verdadeira transformação do exercício profissional junto à população feminina. / This work had as objectives: identify women nurses perceptions and contradictions about nursing social practices, to analyze nurses practice as social practice in the gender perspective materialized in their usual work; to understand meanings given to their professional work by the nurses to give support to the practices transformation together with the clients through a nursing under gender point of view. It was made an intervention research with nurses that work in the ambulatory center, at the University Hospital of the Sao Paulos University in six stages, including 7 hours 30´ during June, 2000, using Workshops, divided in many moments: motivation, group reflection, synthesis and evaluation. It was made a quick speech analysis for intervention during the workshop and afterwards with a deeper analysis there were found the next empiric categories: Ambiguities and/or multiplicities of living and being a nurse woman: A way to get over contradictions; Woman and the nursing practice vs. woman in traditional roles. (Mis) gendering feminine work. The results show that these workshops represent an epistemological advance, being clear that this methodology let us an advanced compared the focal groups method, or the group interviews method, and other methodological options, because it created a way of intervention at the same time of data collection that helped by reliable environment, let us to go inside the information, as a result of researchers and researched empathy, showing new ways for a real change of the professional work with women.
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La pratique de soins infirmiers en pédopsychiatrie dans un contexte clinique interculturelLavallée, Dominique 06 1900 (has links)
Les défis rencontrés dans les soins en santé mentale dans un contexte clinique interculturel sont nombreux, en raison, notamment, des différences de perceptions et de
la stigmatisation culturelle de la maladie mentale (Hwang, Myers, Abe-Kim, & Ting,
2008; Alegria, Atkins, Farmer, Slaton, & Stelk, 2010). Les soins infirmiers en santé mentale ne semblent pas toujours adaptés aux besoins particuliers des adolescents et leur famille issus d’origines culturelles diverses (Alegria, Vallas, & Pumariega, 2010; Dogra & Vostanis, 2007; McKenzie et al., 2009). La pratique de soins infirmiers dans ce contexte est très peu documentée dans les écrits scientifiques pour nous permettre d’adresser en profondeur cette problématique. Le but de cette étude de cas multiples, tel que préconisée par Stake (2005), est de décrire la pratique de soins infirmiers en pédopsychiatrie dans un contexte clinique interculturel. Le cadre de référence de cette étude est celui des six volets de compétences requises pour l’infirmière en santé mentale et en soins psychiatriques émis par l’Ordre des infirmières et des infirmiers du Québec (2009). Les résultats de cette étude qualitative proviennent de l’analyse descriptive d’entretiens individuels (n=7) auprès d’infirmières en pédopsychiatrie qui ont accompagné au moins un adolescent et sa famille dans un contexte clinique interculturel. Les données issues de ces entretiens ont été validées lors de deux entretiens de groupe où un cas prototype, composé à partir des données issues des entretiens individuels, a été soumis à la discussion. Les résultats de cette étude révèlent des perceptions de la pratique de soins infirmiers dans un contexte clinique interculturel et des interventions privilégiées par des infirmières. Des recommandations pour la pratique, la formation et la recherche en sciences infirmières ont été formulées. / The challenges in mental health care in an intercultural clinical context are numerous, notably, because of the differences in perceptions and cultural stigma of mental illness (Hwang, Myers, Abe-Kim, & Ting, 2008; Alegria, Atkins, Farmer, Slaton, & Stelk, 2010). Nursing practices in mental health don’t always seem suited to the specific needs of the adolescents and their families from culturally diverse backgrounds (Alegria, Vallas, & Pumariega, 2010; Dogra & Vostanis, 2007; McKenzie et al., 2009). The practice of nursing in this context is poorly documented to address this issue in depth. The purpose of this multiple case study (Stake, 2005), is to describe the practice of nursing in child and adolescent psychiatry in an intercultural clinical context. The six areas of expertise required for the mental health nurses and psychiatric nurses describe by the Quebec Order of nurses (2009) were used as framework. The results of this qualitative study were obtained from descriptive analysis of individual interviews (n=7) with child and adolescent psychiatric nurses who accompanied at least one teenager and his family in an intercultural clinical context. The data from these interviews were validated in two group interviews, where a prototype case, made from data from the individual interviews, was submitted to discussion. The results of this study indicate perceptions of nursing practice in an intercultural clinical context and preferred nursing practices. Recommendations for practice, education and nursing research were made.
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