121 |
The relationship of nursing personnel and nursing home care quality /Bostick, Jane E. January 2002 (has links)
Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / "May 2002." Typescript. Vita. Includes bibliographical references (leaves 90-96).
|
122 |
The relationship of nursing personnel and nursing home care qualityBostick, Jane E. January 2002 (has links)
Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 90-96). Also available on the Internet.
|
123 |
Coping, Psychiatric Morbidity and Perceived Care in Patients with Aneurysmal Subarachnoid HaemorrhageHedlund, Mathilde, January 2009 (has links)
Diss. (sammanfattning) Uppsala : Uppsala universitet, 2009.
|
124 |
Vårdpersonalens erfarenheter i mötet med patienter med psykisk ohälsa inom den somatiska vården / Nursing staffs’ experiences in the encounter with patients with mental illness in somatic careWidell, Cecilia, Sjöholm, Julia January 2013 (has links)
Bakgrund: Historiskt har personer med psykisk ohälsa setts som annorlunda och varit utstötta av samhället. Dagens samhälle porträtterar ofta personer med psykisk ohälsa som galna och farliga. Psykisk ohälsa är idag vanligt förekommande, och för att kunna ge högkvalitativ vård måste en holistisk syn vara grundläggande. Syfte: Syftet är att belysa vårdpersonalens erfarenheter i mötet med patienter med psykiska ohälsa inom den somatiska vården. Metod: En litteraturstudie baserad på åtta vetenskapliga artiklar har gjorts, varav sex artiklar är kvantitativa och två kvalitativa. Vikt lades på att belysa vårdpersonalens erfarenheter i mötet med patienter med psykisk ohälsa. Teoretisk förankring har skett till Katie Erikssons teori om vårdande. Resultat: Resultatet visar att det förekommer negativa attityder gentemot dessa patienter inom den somatiska vården. Bristen av kunskap, erfarenhet, interaktion med patienter med psykisk ohälsa och stöd ses som bidragande faktorer till dessa attityder. Detta leder många gånger till att vårdpersonalen undviker att ge vård till dessa patienter. En liten del av vårdpersonalen hade en positiv syn, vilket då grundade sig i att de hade mer erfarenhet av och kunskap om personer med psykisk ohälsa. Diskussion: Resultatet belyser en vilja att få mer utbildning och kunskap om psykisk ohälsa bland vårdpersonalen, dock framkom det att endast utbildning inte var tillräckligt för att förändra de negativa attityderna som framkom. Då dessa patienter många gånger befinner sig på en somatisk avdelning är det viktigt att reflektera över de attityder som finns mot dessa patienter, och hur det påverkar omvårdnaden. / Background: Historically, people with mental illness have been seen as different and been excluded by society. Todays’ society often portrays people with mental illness as crazy and dangerous. Mental illness is now widespread, and to provide high quality care, a holistic approach is essential. Aim: The aim is to highlight nursing staffs’ experiences in the encounter with patients with mental illness in somatic care. Methods: A literature review based on eight scientific papers has been carried out, including six quantitative and two qualitative articles. With emphasis on illuminating nursing staff s’ experience in the encounter with patients with mental illness. Theoretical framework has been anchored to Katie Erikson's theory of caring. Results: The results indicate that there are negative attitudes towards patients in somatic care. Lack of knowledge, experience, interaction with patients with mental illness and support are seen as contributing factors to these attitudes. This often leads to nursing staff avoiding providing care to these patients. A small part of the nursing staff had a positive outlook, which then was based on the nursing staff having more experience and knowledge of people with mental illness. Discussions: There was a desire to get more education and knowledge of mental health among nurses. However, the results showed that only education was not enough to change the negative attitudes that emerged. Because these patients often find themselves on a somatic ward, it is important to reflect on the attitudes towards these patients, and how it affects the nursing care.
|
125 |
"Där vi inte kan nå fram, där kan faktiskt vårdhunden" : Omvårdnadspersonalens erfarenhet av vårdhund för äldre med demens / "Where we can´t reach all the way, the dog can" : Experience of nursing staff of dog-assisted therapy for elderly people with dementiaSchär, Emma January 2015 (has links)
Bakgrund: De allra flesta äldre personer med demens drabbas någon gång under sin sjukdomstid av beteendemässiga eller psykiska symtom vilket kan innebära ett stort lidande för personen i fråga. Studier har visat att kontakt med hundar kan minska dessa symtom. Idag utbildas vårdhundar i Sverige för att exempelvis arbeta med personer med demenssjukdom. Syfte: Syftet är att belysa omvårdnadspersonalens erfarenhet av insatser med vårdhund för äldre personer med demens. Metod: Studien hade en kvalitativ ansats. Tretton individuella och semistrukturerade intervjuer genomfördes med omvårdnadspersonal på fyra särskilda boenden i södra Sverige. En av dessa intervjuer exkluderades och ingick inte i resultatet. Kvalitativ innehållsanalys användes för att analysera materialet. Resultat: I analysen framkom fyra kategorier, att vårdhunden skapar glädje och harmoni, framkallar en positiv stämning som varar, väcker positiva minnen och färdigheter till liv samt skapar kontakt och närhet. Slutsats: Studien indikerar att då äldre personer med demens drabbas av beteendemässiga eller psykiska symtom kan vårdhunden öka välbefinnandet genom att skapa glädje, harmoni och närhet samt genom att få personen att minnas. Mer forskning behövs för att nå en ökad kunskap om vårdhundens betydelse för äldre personer med demens. / Background: Most elderly people who lives with dementia, suffer in some point during the time of their disease from behavioural and psychological symptoms, which could mean much suffering for the person in question. Studies have shown that contact with dogs can decrease these symptoms. In Sweden today, dogs are trained to work with persons who suffers from dementia. Purpose: The purpose of the study is to illuminate nursing staff´s experience of working with dog- assisted therapy and elderly persons who suffer from dementia. Method: The study had a qualitative approach. Thirteen individual semistructured interviews with nursing staff were performed at four nursing homes in southern Sweden. Qualitative content analysis was used to analyse the material. Result: In the analysis four categories emerged, dog-assisted therapy creates joy and harmony, evokes a positive lasting atmosphere, bring back positive memories and skills and also creates contact and closeness. Conclusion: The study indicates that, when elderly people with dementia suffers from behavioural and psychological symptoms, dog- assisted therapy can increase their well- being, by creating joy, harmony and closeness and by making the person remember. More research is needed to reach an increased knowledge about the meaning of dog-assisted therapy for elderly people with dementia.
|
126 |
Zátěžové situace a ošetřovatelský personál / Stress situations and nursing personnelMAREŠOVÁ, Lucie January 2016 (has links)
This thesis deals with the stressful situations in the profession of the nursing staff. The occupation of the nurse belongs to the most demanding ones. In this occupation, the nurse is permanently affected by many stressors of different types. She faces death, the suffering, dying and incurably ill people very often. She is there in times of pain, agony and suffering. Personal encounters with these difficult situations require highly professional approach but most of all, they present immense work stress for the nurse. The theory section describes mainly the stressful situations that are the most common and most difficult in the work of the nursing staff. The next part of the theory section describes possible consequences of the stressful situations and methods of managing them including the support by the management. This thesis has two objectives. The first objective was to map the manners used by the nursing personnel to cope with the stressful situations brought by their profession. The second objective was to find out the difference in the coping with the stressful situations between the hospital staff and hospice staff. The research section of this thesis contains the quantitative research done using the technique of an anonymous questionnaire with 20 question prepared by ourselves. The questionnaire was distributed to the nursing staff of all categories in the hospital and hospice care. It was completed by 269 respondents in total. The data was statistically processed using systems Microsoft Excel 2010 and Software R, version 3.0.2 (Chi-squared test, Fisher´s exact test, and Wilcoxon test). We determined four hypotheses. H1: Manners of coping with the stressful situations depend on the qualification of the nursing staff reached; not confirmed. H2: Manners of coping with the stressful situations are influenced by the length of practice of the staff; not confirmed. H3: Manners of coping with the stressful situations differ between the hospital staff and hospice staff; confirmed. H4: The nursing staff views their own mental hygiene as more efficient than the support from the management concerning the coping with the stressful situations; confirmed. The research results show that the nursing staff faces the stressful situations very often. They see as the heaviest stress the care of the suffering and aggressive patient, conflicts with the patient´s family, conflicts at work and workload. The manners of coping with the work burden which proved as the best for them are relax, rest and sleep. There were no differences proved in the manners of coping with the stress among respective members of the nursing team. Nevertheless, the coping with the work burden of the nursing staff in the hospital and hospice care is different. A minimum of the respondents notices any support during the stressful situations from the employer. On the other hand, certain support by the management could be viewed in the form of trainings, supervision or contribution to a "recovery" which are granted to the respondents from the employer according to their answers. However, the respondents would prefer, as the support by the management, the increase in pay or more days off. The respondents view as insufficient the preparation of the graduates for the future stressful situations in their profession, as well. They would recommend mainly various trainings dealing with the stress and its management. A good solution to alleviate the work burden of the nursing staff and quality enhancement of the services provided could be investments into better work conditions, both in terms of sufficient human and material resources and the very organization of the work processes.
|
127 |
Se mig som den individ jag är, inte som den smitta jag bär. : Upplevelsen av bemötande som MRSA-bärande person.Bernhardsson, Jonna, Lundgren, Therese January 2018 (has links)
Bakgrund:Redan på 1960-talet rapporterades det om antibiotikaresistens i form av meticillinresistenta staphylococcus aureus, MRSA. Denna grupp av bakterie är anmälningspliktig enligt Smittskyddslagen (SFS 2004:168) sedan år 2000. Att MRSA är ett stort problem på sjukhus över hela världen beror på överdriven antibiotikaanvändning. Som bärare av MRSA finns det restriktioner kring hygien som patienter ska förhålla sig till i sjukvårdsmiljö samt i hemmet. Syfte:Att studera hur personer med MRSA upplever sin situation i vården och i samhället. Metod:Litteraturöversikt med 10 artiklar. Sökningarna är utförda i PubMed samt förekomst av sekundära sökningar. Resultat:Det framkom att patienter inte får tillräcklig information om vad bärarskap av MRSA innebär, ofta på grund av att vårdpersonalen har bristande kunskap då nationella riktlinjer saknas. Patienter upplever stigmatisering, utanförskap och en känsla av att vara pestsmittad på grund av bemötandet från vårdpersonal samt uppfattningar från närstående och arbetskollegor.Resultatet presenteras i form av kategorierna stigmatisering, bristande kunskap hos vårdpersonal, bristande kunskap hos patienter, upplevelsen av vårdpersonalens bemötande, att diagnostiseras med MRSA ochupplevelsen av att bära på MRSA i det vardagliga livet. Slutsats:Personer som bär på MRSA känner sig stigmatiserade, nedprioriterade i vårdsammanhang samt att informationen som finns att tillgå är bristfällig och kan skilja sig från län till län. / Background: As early as in the 1960s antibiotic resistance was reported in the form of methicillin resistant staphylococcus aureus, MRSA. According to the diseases act this group of bacteria has been mandatory to report since the year 2000. The worldwide problem of MRSA in hospitals derives from excessive use of antibiotics. Patients that are carriers of MRSA have to relate to restrictions on hygiene both in the healthcare environment and in their own homes. Aim: To study how people with MRSA experience their situation in healthcare and in society. Method:Literature review with 10 articles. The searches are executed in PubMed and the occurrence of secondary searches. Result: The study shows a lack of information given to the MRSA carrying patients. This lack of information is related to the fact that national guidelines are missing which in turn has led to the health personnels lack of knowledge. Patients experience stigma, alienation and a feeling of being infected with plague because of the treatment from health personnel and the perception from relatives and colleagues.The result is presented with the categories stigma, insufficient knowledge of health professionals, insufficient knowledge of patients, the experience of treatment from health professionals, to be diagnosed with MRSA and the experience of being an MRSA-carrier in the everyday life. Conclusion:MRSA carriers feel stigmatized, that they have a lower priority in care context and also that the information available is inadequate and may differ from county to county
|
128 |
Processo de trabalho e atividades educativas de trabalhadores de enfermagem em hospitais públicos / Work process and educational activities for nursing personnel in public hospitalsAdriana Marques da Silva 16 April 2010 (has links)
O estudo tem como tema central a educação dos trabalhadores de enfermagem e a sua articulação com o cotidiano de trabalho. Foi desenvolvido com os objetivos de analisar as concepções dos enfermeiros sobre as relações existentes entre atividades educativas de trabalhadores e processo de trabalho de enfermagem, e as possibilidades de mudança nessa relação na perspectiva da integralidade da saúde, da educação permanente em saúde e do trabalho em equipe, conceitos que compõem o referencial teórico. Na pesquisa de campo foram realizadas 22 entrevistas semi-estruturadas com enfermeiros de dois hospitais públicos, 14 em hospital de ensino e 8 em hospital municipal. Os sujeitos foram selecionados com a utilização da técnica de bola-de-neve, iniciando com a gerente da área de enfermagem de cada hospital estudado. Os resultados mostraram que nos dois hospitais o processo de trabalho dos enfermeiros se compõe de duas dimensões complementares: gerencial e assistencial. Na primeira predominam atividades de gerenciamento de recursos humanos e, na segunda, a sistematização da assistência de enfermagem. Contudo, no hospital de ensino a atuação dos enfermeiros na sistematização da assistência de enfermagem refere-se à execução do cuidado e ao gerenciamento do cuidado e, no hospital municipal, apenas ao gerenciamento do cuidado. Há, em ambos os serviços, uma estreita relação entre processo de trabalho e atividades educativas de trabalhadores de enfermagem, porém, de caráter instrumental, técnico; e os enfermeiros têm a expectativa que as atividades educativas sejam realizadas pela área de educação continuada. Foram identificadas possibilidades de mudanças nas relações entre o processo de trabalho e a atividade educativa, em experiências voltadas a gestão participativa e ao trabalho em equipe, porém uma frágil presença de tematização da integralidade e da educação permanente em saúde. Conclui-se pela necessidade de construção de mudanças do modelo assistencial e das atividades educativas de trabalhadores nos hospitais, na perspectiva da atenção integral à saúde contemplando para além do biológico, também as dimensões da vida social, cultural e emocional. / The study is focused on nursing workers education and the relationship with the daily work. It was developed with the purpose of analyzing the nursess views on the relationship between educational activities for workers and work processes of nurses, and the possibilities for change in this relationship in perspective for integration of health, of continuing health education and teamwork concepts which constitute the theoretical framework. In the field research were carried out as follows: 22 semi-structured interviews with nurses from two hospitals, 14 in educational hospital and 8 in the public hospital. The subjects were selected using the snowball technic, starting with the nurse area manager at each hospital. The results showed that both hospitals nurses work processes is composed by two complementary dimensions: management and care. The first activities are mostly of human resource management and, second, the nursing care systematization. However, in educational hospital the nurses work in nursing care systematization refers to the care implementation and care management and in public hospital, just care management. In both services, we found a close relationship between work processes and educational activities nursing workers, however of instrumental character, technical; though nurses have the expectation that the educational activities be done by the educational area. We identified opportunities for change in relations between the work processes and educational activities, in experiments aimed at participatory management and teamwork, but a weak presence of thematizing completeness and continuing health education. It is needed to change the assistencial model and educational activities for workers in hospitals, in view of the comprehensive health care in addition to addressing the biological, also the dimensions of social, cultural and emotional.
|
129 |
Sistematização da assistência de enfermagem: um estudo com auxiliares e técnicos de enfermagem / Nursing Assistance of Systhematization: a study with auxiliaries and nursing thecniciansLuciana Aparecida Ribeiro Ramos 25 July 2007 (has links)
Trata-se de um estudo de natureza descritiva, com o objetivo de caracterizar o processo de trabalho dos auxiliares e técnicos de enfermagem quanto aos seguintes aspectos da Sistematização da Assistência de Enfermagem (SAE): informação sobre essa metodologia durante sua formação profissional; informação sobre a SAE no setor de trabalho; informação quanto à aprovação legal para participar da SAE; a percepção desses profissionais sobre a sua participação nas fases da SAE; a contribuição da SAE na organização do seu serviço, conhecer as atividades realizadas por estes profissionais vinculadas às fases da SAE e a freqüência das mesmas. A população foi composta de 70 auxiliares e 07 técnicos de enfermagem. Um questionário com perguntas estruturadas e uma escala do tipo Likert foram utilizados como intrumento de coleta de dados. Os principais resultados revelaram: a) 93,5% dos sujeitos reconhecem autilização dessa metodologia no setor onde trabalha. b) 74,0% receberam treinamento para seu uso, destes, 67,7% afirmaram ter sido após a formação profissional. c) 46,8% referiram saber quais são as fases da SAE, destes, 33,3% citaram a coleta de dados, 33,3% a avaliação, 25,0% o diagnóstico de enfermagem, 25,0% a implementação, 27,7% o planejamento de enfermagem, 52,7% responderam de forma incorreta. d) 67,5% consideram que participam da SAE. e) 75,0% não identificam em quais fases participam da SAE. f) 33,8% acreditam ter respaldo legal para participar, 3,9% que não tem autorização, 13,0% referiram não saber e 44,2% não responderam. g) 94,8% consideram que a SAE melhora a qualidade de sua assistência. Quanto às atividades desenvolvidas: a) 81,8% referem que fazem a admissão do paciente. b) 77,9% dos sujeitos solicitam informações sobre o problema de saúde atual; 70,0% sobre antecedentes pessoais; 66,2% sobre antecendentes alérgicos; 87,7% sobre o uso diário de medicamentos. b) quanto a coleta de dados, 93,5% observam a freqüência respiratória; 93,5% a presença de dispnéia; 92,2% a presença de tosse; 77,9% alterações na oxigenoterapia; 67,5% nunca realizam a ausculta pulmonar; 89,6% verificam a pressão arterial; 81,8% alterações na infusão venosa, 81,8% verificam freqüência de pulsos periféricos; 76,6% avaliam a presença de edema; 76,6% a perfusão periférica; 87,0% referem avaliar aterações no nivel de consciência e 81,8% a orientação no tempo e espaço; 98,7% verificam a temperatura; 90,9% observam a presença de lesões; 85,5% a freqüência e características da urina, 83,1% o tipo e aceitação da dieta; 80,5% o débito urinário; 76,6% a freqüência e características das fezes; 85,7% não auscultam o abdome. c) quanto ao diagnóstico de enfermagem, 85,7% referem nunca realizar esta atividade. d) quanto ao planejamento 87,0% referem nunca participar da prescrição; e) quanto a implementação: 97,4% executam a prescrição e 98,7% checam a prescrição; 98,8% informam alterações observadas durante o cuidado. e) quanto à alta hospitalar, 75,3% anotam condições de deambulação do paciente; 97,4% as condições de dreno. Concluimos que estes profissionais, embora sem saberem, têm uma importante participação nas fases do processo, executando atividades assistenciais previstas em lei, como admissão, observação, descrição e anotação de sinais e sintomas, execução do plano de cuidados e relatório de enfermagem. / It is a descriptive study, that has had as goal to characterize the nursing auxiliaries and nursing technicians working process related to the following aspects of the Nursing Assistance of Systhematization (NAS): information acquired during their professional formation; the use of the method at the working field; the knowledge of legal aspects and their perception on the participation at the phases of NAS; the contribution of it in the organization of their assistance service and the activities done by these professionals. The sample of population was composed by 70 nursing auxiliaries and 07 nursing technicians. A questionnaire with structured questions and a Likert scale were used as collecting data tool. The main results have revealed: a) 93,5% of the subjects recognize the use of this methodology at the working field; b) 74,0% received training to use it, and 67,7% of these have said that it happened after their professional formation; c) 46,8% have said that they knew what the phases of the NAS are, and 33,3% of them have mentioned the collecting data, 33,3% the test, 25,0% the nursing diagnostic, 25,0% the implementation, 27,7% the nursing planning, 52,7% have answered incorrectly and 5,5% haven?t answered; d) 67,5% considered that participate of NAS; e) 75,0% of the subjects can?t identify in which phases they participate of NAS; f) 33,8% of them believe to have a legal protection (approval from Coren ? Regional Nursing Council) in order to participate, 3,9% believe that they don?t have authorization, 13% have said that they don?t know and 44,2% of them haven?t answered the question; G) 94,8% have considered that NAS improves the quality of their nursing assistance. In relation to the developed activities: a) 81,8% have said that they do the patient?s admission; b) 77,9% of the subjects have solicited information on the current health problem; 70,0% on personal antecedents; 66,2% on the allergic antecedents; 87% on the medicine daily use; c) related to the data collection, 93,5% have observed the respiratory frequency; 93,5% the presence of dyspnea; 92,2% the cough presence; 77,9% alterations at the oxygen therapy; 67,5% have never done the pulmonary ausculation; 89,6% have verified the arterial pressure; 81,8% alterations in the venous infusion; 81,8% have verified frequency of peripherical pulses, 76,6% have evaluated the presence of edema; 76,6% the peripherical perfusion, 87,0% have evaluated alterations at the consciousness level and 81,8% the orientation at time and space; 98,7% have verified the temperature; 90,9% have noted the lesion presence; 85,5% the frequency and characteristics of urine, 83,1% the type and acceptance of the diet; 80,5% the urinary debit, 76,6% the frequency and characteristics of excrement; 85,7% haven?t done the abdomen ausculation; d) in relation to the planning 87,0% have said that they have never participated of institutional protocol prescription; e) in relation to the implementation 97,4% have done the nursing prescription and 98,7% have checked the prescription after putting in practice the care proceeding; 98,8% have said they inform alterations noted during the care; e) in relation to the hospital release 75,3% have noted conditions of digression; 97,4% the conditions of drain; 72,7% have oriented on the prescribed medicines. By this way we can conclude that these professionals, although without knowing that, have had an important participation at the phases of the process. Mainly at those phases that mirrors their attributions foreseen by law, as admission, observation, description and taking notes of signals and symptoms, execution of care plans and nursing report.
|
130 |
A suspeita de uso de drogas influi na administração de analgésico opióide? / Does the suspicion of drugs use influence the administration of opioid analgesic?Maria Clara Giorio Dutra Kreling 02 October 2012 (has links)
Introdução: A literatura sugere que o medo da dependência de opióides é uma barreira para o alívio da dor, especialmente quando há suspeita de uso desses fármacos. No entanto, essa hipótese carece de testes empíricos. Objetivos: Comparar a conduta de profissionais de enfermagem na administração de analgésicos opióides e não opióides, quando há ou não suspeita de que o paciente seja usuário de drogas; identificar a prevalência de pacientes com suspeita de uso de drogas e conhecer as características dos pacientes que os profissionais de enfermagem consideram como sugestivas de uso de drogas. Método Estudo transversal com pacientes e profissionais de enfermagem (auxiliares e técnicos). Foram incluídos 507 pacientes com trauma ortopédico e prescrição de analgésico opióide, internados em quatro hospitais de Londrina, Paraná, entre fevereiro de 2011 a março de 2012, e 199 profissionais responsáveis pela administração de medicamentos a esses pacientes. Cada paciente recebeu a avaliação de três profissionais e considerou-se paciente suspeito aquele indicado por pelo menos um profissional. O desfechos principais foram a 1) quantidade administrada de analgésicos opióides e não opióides prescritos em regime se necessário e em horário fixo nas últimas 24 horas; 2) prevalência de pacientes suspeitos de uso de drogas; 3) condutas dos profissionais frente à solicitação do opióide; 4) Características dos pacientes que os profissionais consideram sugestivas de uso de drogas. Nas análises utilizaram-se os testes de Qui quadrado, Fisher e Mann-Whitney, e nível de significância de 5%. Resultados: A prevalência de pacientes suspeitos foi de 6,86%, maior em homens (p<0.036) e jovens (p<0,001). Os pacientes suspeitos receberam mais opióides se necessário (p=0,037) e até 30% da dose máxima possível, contra até 20% para os não suspeitos. A administração entre suspeitos e não suspeitos não diferiu quanto aos opióides prescritos em horário fixo, no entanto, deixou-se de administrar 10% da dose para ambos os grupos. Entre os profissionais entrevistados, 75,6% relataram que mantêm a analgesia com opióide, mesmo quando há suspeita de o paciente ser usuário de droga, mas 28,9% deles disseram tentar reduzir a dose nesses casos. As características dos pacientes mais frequentemente consideradas pelos profissionais como sugestivas de uso de drogas pertenciam à categoria consequências emocionais/físicas/sociais e sinais de abstinência (70,6%) e insistência pelo opióide (55,9%), mais do que a aparência pessoal (0,0%). Conclusão: A prevalência de suspeitos foi semelhante a estudos realizados em departamentos de emergência, sugerindo que os auxiliares e técnicos de enfermagem foram cuidadosos na estimativa de suspeição. Os resultados obtidos contrariam a literatura, pois indicaram que os suspeitos de serem usuários de droga receberam mais analgésicos opióides. Assumindo-se a premissa de que os profissionais identificaram corretamente os usuários de drogas, pode-se explicar o maior recebimento de opióide pelos suspeitos, pelas características comportamentais e emocionais: maior inquietude, insistência verbal e talvez menor alívio da dor, pois usuários de droga podem desenvolver tolerância. A administração de analgésicos, especialmente em esquema se necessário, é uma decisão importante da enfermagem que pode contribuir para o alívio da dor, daí a importância de entender as motivações que influenciam os profissionais nessa decisão. / Introduction: The literature suggests that the fear of getting addicted to opiods can be a barrier to adequate pain relief, especially when there is a suspicious of drug use. However, this hypothesis needs to be tested empirically. Objectives: Compare the conduct of nursing professionals in administering analgesics when there is the suspicion that the patient is a drug user; identify the prevalence of patients with the suspicious of drugs use and knowing the characteristics of patients that nursing professionals consider as indicators of drug use. Method: Transversal study with patients and nursing professionals (aides and technicians). The study included 507 patients with orthopedics trauma to whom opiod analgesics were prescribed. They were admitted to four hospitals in Londrina, Paraná, Brazil, between February 2011 and 2012. Patients were seen by 199 professionals responsible for administering the medications. Each patient was evaluated by three professionals regarding drug use suspicion. The patient was classified as suspect when indicated by at least one of these professionals. The evaluation included 1) amount of opioid analgesics prescribed under the if necessary regime and at fixed times; 2) prevalence of patients being suspected of drug use and 3) professionals conduct when dealing with opioid prescriptions in the last 24 hours. The analysis used Chi Square, Fisher and Mann- Whitney tests at 5% of level of significance. Results: The prevalence of suspect patients was 6.86%, greater in men (p<0.036) and young people (p<0,001). When comparing the group of suspects with the group of non-suspects, the suspect patients received more opioids under the if needed regime (p=0.037) and up to 30% of the possible maximum dosage against 20% for the non suspects. There was no difference between suspects and non suspects regarding the administration of opioid analgesics prescribed as if necessary; however, 10% of the dosage was not administered to both groups. Among the interviewed nursing aides and technicians, 75,6% reported that they maintain analgesia with opioid even when there was a suspicion that the patient is a drug user; however, 28,9% said they tried to reduce the dosage in these cases. The patients characteristics most often considered by professionals as suggestive of drug use belonged to the emotional/physical/social consequences and withdrawal signs category (70,6%) and insistence by the opioid (55,9%), more than personal appearance (0,0%). Conclusion: The prevalence of suspects was similar to studies performed in emergency departments, suggesting that nursing aides and technicians were careful in estimating suspicion. The results contradict those mentioned in the literature, since they indicate that drug users suspects received more opioid analgesics. By accepting the assumption that nursing aides and technicians have identified illicit drug users correctly, the greater number of opioid administration by the suspects can be explained based on the behavioral and emotional characteristics of this group: greater restlessness, verbal insistence and perhaps less pain relief, since drug users may develop tolerance to certain drugs. Whether or not to administer analgesics, especially those with the if necessary regime, is an important decision for the nursing staff, since they can contribute to an adequate pain relief, thus the importance of understanding the motivations that lead professionals to take this decision.
|
Page generated in 0.0663 seconds