Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2019-03-13T19:56:19Z No. of bitstreams: 1 VIANA_SUSY_ANE_RIBEIRO_DIS.pdf: 3189179 bytes, checksum: d1f3103752ccad4f16b0aa1e9a5b0437 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2019-03-21T13:45:47Z (GMT) No. of bitstreams: 1 VIANA_SUSY_ANE_RIBEIRO_DIS.pdf: 3189179 bytes, checksum: d1f3103752ccad4f16b0aa1e9a5b0437 (MD5) / Made available in DSpace on 2019-03-21T14:28:42Z (GMT). No. of bitstreams: 1 VIANA_SUSY_ANE_RIBEIRO_DIS.pdf: 3189179 bytes, checksum: d1f3103752ccad4f16b0aa1e9a5b0437 (MD5) Previous issue date: 2017-03-01 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The construction and adaptation of instruments are necessary to aggregate methods of psychological evaluation that aim to investigate aspects of health promotion and quality of life, it is particularly noticed the importance of new instruments that contemplate the elderly. The literature has shown gratitude as a protective factor and as a provider of subjective well-being for the elderly. Therefore, the central axis of this study is the cross-cultural translation and adaptation of the Cuestion?rio de Gratitud de 20 ?tems (G-20) prepared by Bernab?-Valero et al (2014) in Spain, directing the instrument to the elderly Brazilian population. It was chosen as the method of adaptation the ten-step process of Beaton et al. Al (2002): 1) Conceptual definitions and literature review; 2) Contact with the author; 3) Translation; 4) Synthesis of translations; 5) Backtranslation; 6) Analysis of Judges; 7) Modifications and readjustments; 8) Pilot Study; 9) Final version readjustments and application in a larger sample; And, 10) Psychometric Analyzes of the instrument. The Brazilian version will maintain the G-20 nomenclature, adding the name "G-20-IB Elderly Gratitude Scale" (Brazilian Elderly) in its final title. Six bilingual translators participated in the study, of which 3 were Brazilian and 3 were foreigners (stage 3); Seven judges, two specialists and five non-specialists (stage 6); 38 elderly (step 8); And 80 elderly (stage 9), from three Brazilian states. Descriptive statistical analyzes (average, standard deviation, percentages and percentiles) were performed for the analysis among judges. The concordance index will be evaluated using the Fagundes method and the Kappa index. Internal consistency was measured using Cronbach's Alpha. The G-20 IB presented suitability between judges concordance analyzes, where k = 1. As well as, presented Alpha of Cronbach equal to ? = 0.81 demonstrating optimal adequacy, suggesting that the instrument has a good level of convergence between the items. Further studies are still needed for the psychometric validation of the G-20 IB, however this study was able to present a premise of other studies that may still be performed with this new evaluation instrument. Gratitude is linked directly as we shape interpersonal relationships and personal existential senses. It has a motivating and pro-social factor, which intensifies emotions of subjective well-being towards healthy aging. The contribution of this study would be to help in the elaboration of new knowledge and intervention techniques for the elderly that prioritize the use of preventive and non-pharmacological tactics. / A constru??o e adapta??o de instrumentos s?o necess?rias para agregar m?todos de avalia??o psicol?gica que visem investigar aspectos de promo??o de sa?de e qualidade de vida, em particular percebe-se a import?ncia de novos instrumentos que contemplem o idoso. A literatura tem apresentado a gratid?o como fator protetivo e de promo??o de sa?de e bem-estar subjetivo para os idosos. Portanto, o eixo central desse estudo ? a tradu??o e adapta??o transcultural do Cuestion?rio de Gratitud de 20 ?tems (G-20) elaborado por Bernab?-Valero et al (2014) na Espanha, direcionando o instrumento para a popula??o brasileira idosa. Foi escolhido como m?todo de adapta??o de instrumento o processo dividido em dez etapas de Beaton e outros (2002): 1) Defini??es conceituais e revis?o da literatura; 2) Contato com a autora; 3) Tradu??o; 4) S?ntese das Tradu??es; 5) Retrotradu??o (backtraslation); 6) An?lise dos Ju?zes; 7) Modifica??es e reajustes; 8) Estudo Piloto; 9) Reajustes da vers?o Final e aplica??o em uma amostra maior; e, 10) An?lises Psicom?tricas do instrumento. A vers?o brasileira ir? manter a nomenclatura G-20, sendo acrescido o nome ?Escala de Gratid?o para Idosos G-20-IB? (Idosos Brasileiros) em seu t?tulo final. Participaram do estudo seis tradutores bil?ngues, sendo tr?s brasileiros e tr?s estrangeiros (etapa 3); Sete ju?zes, dois especialistas e cinco n?o especialistas (etapa 6); 38 idosos (etapa 8); e 80 idosos (etapa 9), provenientes de tr?s estados do Brasil. Foram realizadas an?lises estat?sticas descritivas (m?dia, desvio-padr?o, percentuais e percentis), para a an?lise entre ju?zes o ?ndice de concord?ncia foi avaliado atrav?s do m?todo de Fagundes e do ?ndice de Kappa, a consist?ncia interna foi medida atrav?s do Alpha de Cronbach. A G-20 IB apresentou adequabilidade nas an?lises de concord?ncia interju?zes, sendo k=1. Tamb?m apresentou Alpha de Cronbach igual a ?= 0.81 demonstrando ?tima adequa??o, sugerindo que o instrumento possui um bom n?vel de converg?ncia entre os itens. Ainda se fazem necess?rios mais estudos para a valida??o psicom?trica da G-20 IB, mas esse estudo p?de apresentar uma premissa de outros estudos que ainda poder?o ser realizados com esse novo instrumento de avalia??o. A gratid?o est? ligada diretamente com a maneira que moldamos as rela??es interpessoais e sentidos existenciais pessoais, ela possui um fator motivador e pr?-social, que intensifica emo??es de bem-estar subjetivo para um envelhecimento bem sucedido. O aporte desse estudo seria o de poder contribuir na elabora??o de novos conhecimentos e de t?cnicas de promo??o de sa?de e de interven??o para o idoso, que priorizem o uso de t?ticas preventivas e n?o farmacol?gicas.

Background: Sweden has developed to a country with great ethnic variation. Previous research shows that knowledge about the patient’s ethnicity is important for the quality and it’s the nurse’s responsibility to ensure that the patient gets god care regarded what ethnicity the patients belong to. Research shows that patients with different ethnicity then the majority has a larger ability to develop illness. Purpose: To describe nurse’s experiences of caring for patients with different ethnicity. Method: A systematic literature review with descriptive syntheses. Results: The result showed that communication barriers, ethnic collision and lack of recourses is the greatest challenge for nurses to provide transcultural care. But at the same time nurse’s experienced that they evolved in a professional level when they experienced that their awareness of the importance of ethnicity as a key too holistic acre. That knowledge got better when they cared for patients with another ethnicity. Conclusion: Nurse’s experienced that it’s challenging to provide god care to patients with different ethnicity. Knowledge of transcultural care is an important key to holistic care. The nurse’s experienced that more knowledge about transcultural care and more recuses in form of time, education and access to professional interpreter as important elements to reach the goal to provide good and individualized care.

Dentro da área da saúde, a maior parte dos instrumentos de avaliação e investigação clínica desenvolvidos até agora está organizada em idiomas mais predominantes como o inglês e o espanhol, e tem sua aplicação dirigida aos países falantes destes mesmos idiomas. No Brasil, a existência de instrumentos atualizados e padronizados em língua portuguesa, ou que tenham sido submetidos a uma tradução e adaptação transcultural, de modo a satisfazer as necessidades da realidade brasileira, é escassa. O uso de protocolos que tenham sido traduzidos e adaptados culturalmente para um público alvo definido é de singular importância nesta área. Deste modo, o objetivo deste estudo foi proceder a tradução e adaptação cultural do Teste de Sintaxe de Aguado (TSA), que se encontra em língua espanhola, para a língua portuguesa do Brasil. Para tanto, o processo de tradução e adaptação cultural seguiu as diretrizes propostas por Beaton et al. (2000). Posteriormente, um estudo piloto com 20 crianças com desenvolvimento típico de linguagem foi realizado de modo a verificar a aplicabilidade e eficácia da versão final do teste traduzido. O processo de adaptação cultural do instrumento para o português indicou que houve equivalência dos itens traduzidos, equivalência semântica quase que total entre as duas traduções e ausência de dificuldades na tradução. O procedimento mostrou-se aplicável em crianças brasileiras, em relação ao tempo, instruções e itens gramaticais verificados, mas levanta a possibilidade de eliminar alguns deles, como a compreensão e a expressão de frases interrogativas e de pronomes demonstrativos. Estudos posteriores devem ser conduzidos para avaliar a confiabilidade e validade do instrumento no Brasil. / The majority of instruments for clinical evaluation and investigation in the health area developed up to now focus primarily on more predominant languages such as English and Spanish, therefore limiting their application to the countries in which such languages are spoken. In Brazil, the existence of updated and standardized instruments in the Portuguese language, or that have been put through a process of translation and cross-cultural adaptation, in order to satisfy the Brazilian needs, is scarce. The use of protocols that have been properly translated and culturally adapted to a defined target public is of major importance in this area. Thus, the main aim of this study involved the translation and cross-cultural adaptation of the Aguados syntax test (TSA), from the Spanish to the Brazilian Portuguese language. For this purpose, the process of translation and cross-cultural adaptation followed the guidelines proposed by Beaton et al. (2000). Afterwards, a pilot study featuring 20 children with normal language development was carried out to verify the efficacy and applicability of the final translated version of the test. The process of cultural adaptation into the Brazilian Portuguese language confirmed there was equivalence and reconciliation of the translated items, an almost complete semantic equivalence and the absence of underlying translation difficulties. The test proved to be applicable to Brazilian children, in relation to time, instructions and verified grammatical items. However, it raises the possibility of eliminating certain items, such as those that deal with interrogative sentences and demonstrative pronouns. Further studies must be carried out in order to evaluate the validity and reliability of the instrument in Brazil.

Ungefär 14 procent av den svenska befolkningen utgörs av invandrare. Studier visar att många invandrare är utsatta i samhället då de kommer till ett nytt land. Denna utsatthet kan vara språksvårigheter, arbetslöshet, rasism och diskrimination. I samband med att invandringen ökar i Sverige ökar även sannolikheten att man som sjuksköterska kommer i kontakt med patienter med annan kulturell bakgrund. På så sätt kan det uppstå det kulturkrockar i mötet med invandrarpatienter. Sjuksköterskans roll är därmed väldig viktig i mötet med invandrarpatienter. För att mötet ska bli bra bör sjuksköterskan erhålla goda kunskaper om andra kulturer. Syftet med denna litteraturstudie är att beskriva sjuksköterskors upplevelser av att vårda patienter med annan kulturell bakgrund. I vår metod har vi använt oss av 15 kvalitativa studier där sjuksköterskors upplevelser har belysts genom intervjuer. Studierna har vi funnit genom diverse databaser. Sedan har vi analyserat studierna steg för steg utifrån Fribergs (2006) analysbeskrivning. I resultatet ledde de analyserade artiklarna fram till sex kategorier: (1) Språket är ett hinder, (2) Tolken kan vara både en tillgång och ett hinder, (3) Anhöriga på både gott och ont, (4) Olika kulturella föreställningar skapar utmaningar, (5) Kunskapen om andra kulturer är bristfällig, (6) Fördomar har betydelse. I diskussionen beskrivs olika strategier som sjuksköterskor kan tillämpa för att komma över språkliga hinder. Det framkommer även att kunskapen hos sjuksköterskor är något som bör förbättras, detta genom att införa transkulturell omvårdnad i sjuksköterskeutbildningens kursplan. Sjuksköterskor bör även ha förståelse för invandrarpatienters behov och önskan om att ha sina anhöriga närvarande under en sjukhusvistelse. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

Att Sverige idag är ett mångkulturellt samhälle återspeglas i dagens sjukvård. Sjuksköterskor möter idag patienter med invandrarbakgrund och kan därmed uppleva svårigheter att förstå dessa patienters behov på grund av språkhinder och/eller kulturella skillnader. Syftet med studien var att beskriva sjuksköterskans upplevelser i mötet med patienter med invandrarbakgrund. Vi använde oss av en litteraturstudie där 11 kvalitativa vetenskapliga artiklar granskats och analyserats enligt Evans (2003) modell. Analysen resulterade i följande fem teman; Språkbarriär – ett hinder för god omvårdnad, Tolkens för - och nackdelar, Anhöriga - på gott och ont, Att uppleva bristfällig kulturkompetens, Upplevelsen av både positiva och negativa fördomar och förutfattade meningar. I diskussionen lyfter författarna fram samtliga teman för att de är av betydelse för sjuksköterskan i mötet med patienter med invandrarbakgrund. Sjuksköterskorna i dem studerade artiklarna upplevde frustration och missnöje eftersom de inte kunde tillgodose en god omvårdnad till patienter med invandrarbakgrund. / Program: Sjuksköterskeutbildning

A epilepsia é uma das condições neurológicas mais prevalentes da infância afetando entre 5 a 10 crianças em cada 1.000. A epilepsia, enquanto condição crônica pode trazer riscos ao desenvolvimento físico, sócioemocional e cognitivo, aumentando a morbidade psicossocial. O desconhecimento sobre a doença, o estigma e os elementos de rotulação, podem interferir na autopercepção da criança e do adolescente com epilepsia levando a alterações no autoeficácia e autoconceito. O presente estudo teve como objetivos avaliar o impacto de um serious game no autoconceito, autoeficácia, percepção de estigma e conhecimento de crianças e adolescentes com epilepsia e comparar a autopercepção destas crianças ao utilizar outro serious game envolvendo a temática da fome mundial; realizar a adaptação transcultural do instrumento Seizure Self-Efficacy Scale for Children (SSES-C) e apresentar uma versão em Língua Portuguesa para uso no Brasil; desenvolver um serious game voltado à temática da epilepsia para crianças e adolescentes que apresentam esta condição; descrever e caracterizar a percepção de crianças e adolescentes com epilepsia em relação ao autoconceito, autoeficácia, estigma e conhecimento sobre epilepsia. Para alcançar os objetivos propostos, dividiu-se o estudo em três eixos investigativos sendo o primeiro relacionado à descrição da metodologia e dos resultados da adaptação transcultural do instrumento Seizure Self-Efficacy Scale for Children (SSES-C) realizado com base nos procedimentos propostos de traduções, síntese das traduções, retrotraduções, análise das Equivalências Conceitual, Semântica, Idiomática e Experimental ou Cultural feitas por um comitê de especialistas, além do Pré-teste e Avaliação da Versão Final. Os resultados indicaram Porcentagem de Concordância, das quatro equivalências, entre 90 e 100%, chegando-se a Versão Brasileira da SSES-C. O segundo eixo investigativo voltou-se a metodologia de desenvolvimento do serious game destinado a crianças e adolescentes com epilepsia nomeado pelas pesquisadoras como Game Epilepsia. O processo de construção do jogo envolveu uma equipe multiprofissional e baseou-se em uma história com características de aventura, resultando em um serious game com jogos do tipo point and clik. O jogador pode escolher com qual personagem deseja jogar e ao longo do jogo são abordados conceituais, clínicos e psicossociais da epilepsia. O terceiro eixo investigativo foi desenvolvido no Ambulatório de Epilepsia Infantil do Hospital de Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, convidando-se pacientes a comporem um grupo chamado de Grupo Controle (GC) e o outro de Grupo Experimental (GE), cada um formado por 40 crianças e adolescentes de ambos os sexos com idade entre 8 e 14 anos. Tanto o GC quanto o GE responderam ao Formulário de Caracterização Familiar e da Criança, à Escala de Estigma em Doenças Crônicas, à Versão Brasileira da Escala de Autoeficácia para Crianças com Crises Epilépticas e à Escala de Autoconceito de Piers-Harris. Apenas o GE respondeu a um Questionário de Conhecimento sobre Epilepsia desenvolvido pelas pesquisadoras. O GC foi submetido à intervenção com um serious game chamado Food Force, desenvolvido pelas Nações Unidas, cuja temática é a fome mundial, enquanto no GE utilizou-se o Game Epilepsia e ambos responderam aos instrumentos antes e após jogarem. Tanto o GC e o GE foram compostos por 23 meninos e 17 meninas cuja média de idade foi de 10,7 anos. As crianças e adolescentes do GC mostraram aumento significativo no escore da Escala de Autoconceito de Piers Harris antes e após jogaram os respectivos jogos (p 0.05). No instrumento que avaliava o estigma, os dois grupos mostraram preocupação frente ao medo das pessoas na possibilidade de ocorrência de uma crise. Na escala de autoeficácia, percebeu-se dificuldade em lidar com questões relativas a solucionar dúvidas com os profissionais da saúde. Especificamente em relação ao conhecimento sobre epilepsia avaliado no GE houve aumento percentual e estatisticamente significativo em todas as questões (p 0,01). No que tange a percepção do estigma, a autoeficácia e ao autoconceito, ao comparar-se as médias obtidas pelas 80 crianças e adolescentes do GC e do GE, as mudanças foram estatisticamente significativas com aumento nas médias pré e pós jogo (p 0,05). Quando comparada a diferença entre as médias do GC e do GE usando cada jogo, observou-se que o Game Epilepsia elevou mais os valores do autoconceito global quando comparado ao Food Force (p 0,001), mas não foram observadas modificações na percepção de estigma e autoeficácia. Adicionalmente ao se considerar a variável gênero, observou-se que percepção do autoconceito global, da autoeficácia e do estigma das meninas é estaticamente mais positiva que a dos meninos (p 0,05). De acordo com a Classificação de Cohen, a correlação entre autoconceito e autoeficácia mostrou-se moderada (r = 0,38), entre autoconceito e estigma mostrou-se forte (r = 0,59) e entre estigma e autoeficácia foi fraca com r = 0,20 (p 0,05). Destaca-se a importância de intervenções voltadas a crianças e adolescentes com epilepsia e o potencial dos serious games como ferramenta na construção do aprendizado, modificação de comportamentos e fortalecimento de sentimentos e atitudes mais positivas perante às doenças crônicas. Conclui-se que esta pesquisa permitiu a disponibilização de instrumento voltado a identificação e caracterização da autoeficácia em crianças e adolescentes com epilepsia, além de um serious game que poderá ser utilizado por crianças que não tenham a doença. / Epilepsy is one of the most prevalent neurological conditions of childhood affecting 5 to 10 children per 1,000. Epilepsy, as a chronic condition can pose risks to the physical, social-emotional and cognitive development, increasing psychosocial morbidity. Lack of knowledge about the disease, stigma and labeling elements can interfere in self-perception the children and adolescents with epilepsy leading to changes in self-efficacy and self-concept. This study aimed to evaluate the impact of a serious game in the self-concept, self-efficacy, perceived stigma and knowledge of children and adolescents with epilepsy and compare the perception of these children when using other serious game involving the issue of world hunger; perform the cross-cultural adaptation of the Seizure Self-Efficacy Scale for Children (SSES-C) and present a version in Portuguese for use in Brazil; develop a serious game aimed epilepsy theme for children and adolescents with this condition; describe and characterize the perception of children and adolescents with epilepsy as the self-concept, self-efficacy, stigma and knowledge about epilepsy. To achieve the proposed objectives, we divided the study into three investigative axes. The first is related to the description of the methodology and results of cross-cultural adaptation of the Seizure Self-Efficacy Scale for Children (SSES-C) carried out based on the steps of translation, synthesis of translations, back translations, analysis of Conceptual, Semantics, Idiomatic and Cultural or Experimental Equivalences made by a committee of experts, in addition to the pre-test and Final Version Evaluation. The results indicated Percentage of Agreement, the four equivalences between 90 and 100%, reaching to the Brazilian version of the SSES-C. The second investigative axis turned to the methodology for developing serious game aimed at children and adolescents with epilepsy appointed by the researchers as \"Game Epilepsy\". The game of the construction process involved a multidisciplinary team and was based on a story with adventure features, resulting in a serious game with type point and clik games. The player can choose which character you want to play and throughout the game are covered conceptual, clinical and psychosocial epilepsy. The third investigative hub was developed at the Clinic Epilepsy Children\'s Clinical Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo by inviting patients to be part of a group called the Control Group (CG) and the other experimental group (GE), each consisting of 40 children and adolescents of both sexes aged between 8 and 14 years. Both the GC as the GE responded to the Family Characterization Form and Child, the Stigma Scale for Chronic Diseases, the Brazilian version of the Self-efficacy Scale for Children with Epileptic Seizures and Self Scale Piers-Harris. Only GE responded to a Knowledge Questionnaire Epilepsy developed by the researchers. The GC was submitted to therapy with a serious game called \"Food Force\", developed by the United Nations, whose theme is world hunger, while in GE used the \"Game Epilepsy\" and both answered the instruments before and after play. Both GC and GE were composed of 23 boys and 17 girls whose average age was 10.7 years. GC´s children and adolescents showed a significant increase in the Self Scale score of Piers Harris before and after played games (p <= 0.05). On the instrument that measured the stigma, both groups showed concern facing the fear of the people in the possibility of a seizure. In the self-efficacy scale, it was perceived difficulty in dealing with issues to resolve doubts with healthcare professionals. Specifically in relation to information about epilepsy evaluated in GE percentage increase was statistically significant in all matters (p <= 0.01) Regarding the perception of stigma, self-efficacy and self-concept, when comparing the averages for 80 children and adolescents of GC and GE, the changes were statistically significant increase in mean pre and post game (p <= 0,05). When compared to the average difference between the CG and EG using each set, we observed that the \"game\" epilepsy elevated plus the overall self values when compared to the \"Food Force\" (p <= 0.001), but no changes were observed in the perception of stigma and self-efficacy. In addition to considering the gender variable, it was observed that perception of global self-concept, self-efficacy and stigma of girls is statically more positive than boys (p <= 0.05). According to Cohen\'s rating, the correlation between self-concept and self-efficacy was moderate (r = 0.38) between self and stigma proved to be strong (r = 0.59) and between stigma and self-efficacy was weak with r = 0.20 (p <= 0.05). We emphasize the importance of interventions aimed at children and adolescents with epilepsy and the potential of serious games as a tool for learning construction, behavior modification and strengthening of feelings and more positive attitudes to chronic diseases. We conclude that this research allowed the provision of instrument aimed at identification and characterization of self-efficacy in children and adolescents with epilepsy, and a serious game that can be used by children who do not have the disease

Os estudos internacionais sobre o hábito intestinal em populações aparentemente saudáveis, embora amplos e curiosos, revelam que aproximadamente 95% da população apresentam entre três evacuações por dia e três evacuações por semana. No Brasil, estudos semelhantes, considerando cultura, hábitos de vida e hábitos alimentares, entre outros, ainda são inexistentes. O objetivo deste estudo é realizar a adaptação transcultural do instrumento \"Bowel Function in the Community\" para a língua portuguesa e testar suas propriedades de medida, na versão traduzida para o português. Trata-se de um instrumento elaborado por Reilly e cols. (2000), composto de 70 questões agrupadas não em domínios mas em agrupamentos específicos: hábito intestinal geral; presença de incontinência anal: sintomas urinários; história de doenças anorretais e histórico cirúrgico; uso de serviços médicos e fatores de risco que podem contribuir para o desenvolvimento da incontinência anal. O processo de adaptação transcultural baseou-se preconizado por Beaton e cols (2002) e envolveu duas etapas: a tradução do instrumento para a língua portuguesa e a validação de suas propriedades de medida validade de conteúdo, confiabilidade inter-observadores e confiabilidade teste-reteste. A primeira etapa incluiu a tradução e a retro-tradução do instrumento - realizadas por profissionais de língua inglesa; a avaliação das versões original, traduzida e retro-traduzida por um comitê composto de cinco coloproctologistas fluentes na lingua inglesa; pré-teste (1), grupo focal, pré-teste (2), estes realizados com 30 sujeitos da população geral (10 em cada fase). Para testar as propriedades de medida da versão adaptada para a língua portuguesa, na segunda etapa, o instrumento foi aplicado, através da entrevista, em amostra aleatória de 356 indivíduos sadios, com idade acima de 18 anos, de ambos os sexos e diferentes níveis de escolaridade, que construíram duas sub-amostras para avaliação da confiabilidade inter-observadores (120 indivíduos) e da confiabilidade teste-reteste (120 indivíduos). Na primeira etapa após tradução, retrotradução e avaliação das mesmas pelo comitê de especialistas, obteve-se a versão traduzida, submetida ao pré-teste (1), grupo focal e pré-teste (2). A versão adaptada resultante da primeira etapa, avaliou alterações principalmente de ordem semântica e idiomática, tendo atestada a sua validade de conteúdo. A confiabilidade inter-observadores foi atestada, obtendo nível de concordância de 94% entre bom e excelente. A confiabilidade teste-reteste foi atestada, obtendo nível de concordância acima de 60% entre moderada e excelente. Conclui-se que o instrumento pode ser disponibilizado para novas aplicações visando aumentar o conhecimento do hábito intestinal de nossa população / International studies on the intestinal habits of apparently healthy populations, although broad and rigorous, have shown that approximately 95% of the people have between three bowel movements per day to three per month. In Brazil, similar studies which take into consideration culture, lifestyles and eating habits, are inexistent. The objective of this study was to make the transcultural adaptation of the \"Bowel Function in the Community\" instrument to the Portuguese language, and to test its adapted measuring properties. The original instrument, developed by Reilly et al. (2000), has 70 questions organized by a specific grouping criteria: general intestinal habit; anal incontinence; urinary symptoms; anorectal diseases and surgical history; use of medical services; ans risk factors, which could contribute to the development of anal incontinence. The transcultural adaptation was based on Beaton et al. (2002), and involved two phases: translation of the instrument to the Portuguese language, and the validation of the content valid measuring properties, inter-rater and test-retest reliability. The first phase of the study included the translation and the backtranslation of the instrument by English language professionals; the evaluation of the original versions, translated and backtranslated by a committee composed of 5 coloproctologists fluent in English; a pre-test (1); a focal group, and a pre-test (2), using 30 subjects from the general population (10 in each test). During the second phase of the study, a randomized sample of 356 healthy subjects, over 18, from both sexes, and from different levels of formal education were interviewed, to test the Portuguese adapted version of the measuring properties. They constituted two samples: one used for the inter-rather reliability (120 subjects), and the other used for the test-retest (120 subjects) reliability. The adapted version resulted from the first phase, evaluated mainly the semantics and idiomatic changes to test the instrument´s content vality. Inter-rater reliability was validated at a 94% level of agreement between good and excellent. Test-retest reability was validated at a 60% level of agreement between moderate and excellent. Results from the study have shown that the adapted instrument can be made available for new applications to get more information on the intestinal habits of our population

BACKGROUND Increasingly, it is recognised that the unique needs of people from culturally and linguistically diverse backgrounds (CaLDB) should be addressed within a framework of cultural competence. To date, there are limited data on the issues facing CaLDB patients in the Cardiac Rehabilitation (CR) setting. Appreciation of an individual???s values, attitudes and beliefs underpins negotiation of behaviour change in the CR setting. Therefore an understanding of patient and professional interactions is of key importance. OBJECTIVES The focus of this study has been to undertake an exploration of CR service delivery to people from culturally and linguistically diverse backgrounds, using Arabic speaking people as an exemplar of a CaLDB group. More broadly, this research project has sought to identify factors, which influence the practice of health professionals towards CaLDB patients, and to develop a model for evaluation of culturally competent health care in the CR setting. The study sought to achieve these aims by addressing the following research questions: 1. In what way do health practitioners in CR adjust their treatment and support to accommodate the perceived needs of CaLDB communities? 2. In what way do factors (such as individual and organisation perspectives) influence the adjustment of clinical practice and service delivery of CR practitioners; and what are practitioners??? and patients??? perception of barriers and facilitators to service delivery? 3. To what level are CaLDB patients satisfied with CR services? This study design is comprised of the following elements: (1) interviews with health practitioners and Arabic speaking background patients as an exemplar of CaLDB patients; (2) review of policy and procedure documents and medical records; and (3) field observation. METHOD This thesis embraces a qualitative approach as the primary method of investigation to align with the exploratory and descriptive nature of the study. The main methods used in the study were: in depth interviews with health professionals and patients; field observations; appraisal of relevant documents and consultation with expert panels. Study samples were selected through a purposive sampling strategy.Data were analysed using the method of content analysis, guided by the research questions. FINDINGS In total, 25 health professionals (20 female and 5 male) and 32 patients (21 male and 11 female) were interviewed. The method of qualitative content analysis was used for data analysis. Data analysis revealed four major themes: 1) The challenging context; 2) Tuning practices; 3) Influencing factors; and 4) Goodness of fit. The study demonstrated a challenging context for CR delivery, both from the perspective of patients and health professionals. Data reveal a process of reflection, negotiation, and navigation of care by CR health professionals in an effort to understand and meet the diverse needs of CALDB patients. CONCLUSION On the basis of the study findings, a process-oriented model of tuning practice to achieve cultural competence in CR delivery is proposed to inform policy, research and clinical practice.

<p>Då Sverige är ett mångkulturellt land med en expanderande population ställs vi inför många möten i vården med patienter av annan kulturell bakgrund. Syftet med studien var att beskriva vilka faktorer som kan påverka sjuksköterskans möte med patienter av annan etnisk bakgrund än den svenska. Studien genomfördes som en litteraturstudie där 14 vetenskapliga artiklar analyserades. Resultatet visar olika faktorer som påverkar mötet, vilka kan vara kommunikation, utbildning, attityder, miljö, etnicitet och religion, där kommunikationen som är både verbal och icke-verbal, kan ses som den viktigaste aspekten för ett bra patientmöte. Personalen behöver insikt i hur människor av annan etnicitet kan uttrycka sig för att kunna uppfatta deras behov. Kunskap och förståelse om andra etniciteter krävs för att kunna utöva adekvat omvårdnad. Sjuksköterskan bör därtill utveckla sin kulturella kompetens genom utbildning. Ämnet bör ingå i grundutbildningen för all vårdpersonal. Dessutom bör en evidensbaserad eller åtminstone forskningsförankrad handlingsplan för transkulturella möten finnas på varje vårdavdelning. <strong></strong></p> / <p>Since Sweden is a multicultural country with an expanding population we are faced with many meetings in the care of patients of different origin. The aim of the study was to describe the factors that may influence the nurse’s meeting whit patients of different ethnical background than the Swedish. The study was conducted as a literature review in which 14 scientific articles were analyzed. The result shows the different factors that affect the meeting, which may be communication, education, attitudes, environment, ethnicity and religion, were communication is seen as both verbal and non-verbal, and can be seen as the most important aspect of a high-quality patient meeting. The personnel need an understanding of how people of different ethnicity express themselves in order to understand their needs. Knowledge and understanding of other ethnicity is required to provide an adequate care with the best results. Nurses should develop their cultural competency through education. These skills should be learned in the basic education for health professionals. In addition, clinical practical guidelines for multicultural meetings should be found on each nursing ward.</p>

<p>I den här uppsatsen har jag undersökt internkommunikationen på ett multikulturellt företag för att se hur olika kulturer visar sig i olika förhandlingsstilar. Mitt material har bestått av sexton mejl mellan en tysk och en svensk affärsman från det multikulturella företaget Volkswagen. Mina frågeställningar var:</p><p>1. Skiljer sig Sch och Joh:s sätt att formulera sig och vilken betydelse får det i så fall för förhandlingen? 2. Vilka förhandlingsstilar används? Vad får de för konsekvenser? 3. Hade genomtänkta retoriska strategier kunnat effektivisera förhandlingens gång och i så fall vilka?</p><p>För att svara på frågorna har jag gjort en stilanalys kompletterad av en strukturell analys. Jag har även gjort en förhandlingsanalys och till sist undersökt de två kulturerna genom en jämförelse. Min uppsats lutar sig mot Hofstedes teori om kulturella dimensioner samt Ghauris teori om förhandlingens tre faser, för att nämna några.</p><p> </p><p>Viktiga slutsatser är att det finns större och mer betydelsefulla skillnader mellan tyskar och svenskar än väntat. Jag har också kommit fram till att kurser i förhandlingsteknik kan visa sig vara lönsamma för multikulturella företag och det är det jag vill förmedla med den här uppsatsen. </p><p> </p> / <p><p>In this essay I want to investigate the internal communication of an transcultural company to see how different cultures are shown in different styles of negotiation. I have been looking at sixteen emails between a German businessman and a Swedish businessman, both working at the transcultural company Volkswagen.</p><p>The essay’s research questions are: 1. Do the German and the Swede differ when it comes to manner of speaking, and if so, how does that effect the negotiation?  2. Which styles do they use in negotiation? What kind of consequences do the styles cause? 3. Would carefully prepared rhetorical strategies make the negotiation more effective, and in that case, which strategies would that be?</p><p>To answer these questions I have made a stylistic and a structural analysis, followed by an analysis of the negotiation style and strategies. At last I studied the two cultures and made a comparison between them. I have built my essay on the theory of cultural dimensions by Hofstede and Ghauri’s idea about the phases of negotiation, to mention a few.</p>Conclusions I’ve made are that there are bigger differences between Germans and Swedes then I expected. I’ve also seen that education in negotiation could be profitable for transcultural companies, which I with this essay would like to convey. </p>