Critical Care Nurses’s Knowledge and Attitude Towards Sleep Promoting Interventions Among Critically Ill Patients in Intensive Care Unit

@#Introduction: Sleep promotion in the Intensive Care Unit (ICU) should be a priority because interruptions may prevent patients from getting enough sleep. Inadequate sleep might lead to delirium, anxiety, increased hospital stays, and higher mortalities. Critical care nurses with good knowledge and attitude towards sleep promotion interventions benefit critically ill patients’ quality of care and life. Critical illness, pain, mechanical ventilation, surroundings, and nurses’ activity at night contribute to sleep disturbances in ICU patients. The aim of this study was to determine critical care nurses’ knowledge regarding the physiology of sleep, interventions to promote sleep,attitude towards sleep, and sleep promotion. Methods: A cross-sectional study with a self-administered questionnaire and purposive sampling method was conducted among 109 critical care nurses at the ICU of a teaching hospital. Results: The mean score knowledge of critical care nurses was 4.72 (± 1.92), attitude towards sleep was 18.57 (± 3.56), and intervention towards sleep promotion was 70.00 (± 12.00). A significant correlation was observed between knowledge and attitude (p < 0.05, r = 0.22) and between attitude and intervention (p < 0.05, r = 0.32), indicating a modest correlation. Moreover, a significant association was noted between years of experience and attitude and intervention (p < 0.05). Conclusion: Critical care nurses’ knowledge, attitudes, and interventions were poor; hence, they need to improve their knowledge, attitude, and interventions. The significance of sleep promotion and factors leading to critical care nurses in Malaysia not promoting sleep among ICU patients needs to be rectified.

Atribuição do enfermeiro no processo de hemotransfusao: uma revisão integrativa dos últimos 4 anos / Attribution of the nurse in the blood transfusion process: an integrative review of the last 4 years / Atribución de la enfermera en el proceso de transfusión sanguínea: una revisión integradora de los últimos 4 años

A transfusão de sangue é considerada uma tecnologia de grande importância na terapia moderna. Quando usada corretamente, pode salvar vidas e melhorar o quadro clínico dos pacientes. Todavia, esse procedimento pode apresentar riscos tanto aguda quanto tardia. Para tanto, o conhecimento da enfermagem é de grande relevância a fim de evitar complicações e fornecer um procedimento assertivo ao paciente. Objetivo: Demonstrar, a partir de uma revisão integrativa dos últimos quatro anos, a atribuição do enfermeiro no processo de hemotransfusão, descrevendo seu papel desde o acolhimento até a infusão dos hemoderivados. Métodos: Trata-se de uma revisão integrativa da literatura. Resultados e discussão: Para a seleção, 10 artigos científicos foram inclusos na revisão. As análises em nível de grupo mostraram que é de suma importância do conhecimento técnico e científico para a segurança do paciente. Considerações finais: O processo de hemotransfusão é de responsabilidade da enfermagem, incluindo cuidados minuciosos e atenção clínica por parte do enfermeiro, devendo ser amplamente divulgado e discutido para garantir atualização de conhecimento entre os profissionais que atuam em hemoterapia, para que possam realizar as práticas com segurança e prevenir a ocorrência de eventos adversos.

Blood transfusion is considered a technology of great importance in modern therapy. When used correctly, it can save lives and improve the condition of patients. However, this procedure may present both acute and late requirements. Therefore, nursing knowledge is of great encouragement in order to avoid complications and provide an assertive procedure to the patient. Objective: To demonstrate, based on an integrative review of the last four years, the attribution of nurses in the blood transfusion process, describing their role from reception to the infusion of blood products. Methods: This is an integrative literature review. Results and discussion: For the selection, 10 scientific articles were included in the review. The group-level analyzes appreciated that technical and scientific knowledge is of paramount importance for patient safety. Final considerations: The blood transfusion process is the responsibility of nursing, including meticulous care and clinical attention by the nurse, and should be widely publicized and discussed to ensure updating of knowledge among professionals who perform hemotherapy, so that they can carry out the practices safely and preventing the occurrence of adverse events.

La transfusión de sangre se considera una tecnología de gran importancia en la terapia moderna. Cuando se utiliza correctamente, puede salvar vidas y mejorar el estado de los pacientes. Sin embargo, este procedimiento puede presentar requisitos agudos y tardíos. Por lo tanto, los conocimientos de enfermería son de gran estímulo para evitar complicaciones y proporcionar un procedimiento asertivo al paciente. Objetivo: Demostrar, a partir de una revisión integradora de los últimos cuatro años, la atribución de enfermería en el proceso de transfusión sanguínea, describiendo su papel desde la recepción hasta la infusión de hemoderivados. Métodos: Se trata de una revisión bibliográfica integradora. Resultados y discusión: Para la selección se incluyeron en la revisión 10 artículos científicos. Los análisis a nivel de grupo apreciaron que el conocimiento técnico y científico es de suma importancia para la seguridad del paciente. Consideraciones finales: El proceso de transfusión sanguínea es responsabilidad de enfermería, incluyendo el cuidado meticuloso y la atención clínica por parte de la enfermera, y debe ser ampliamente divulgado y discutido para garantizar la actualización de conocimientos entre los profesionales que realizan hemoterapia, para que puedan llevar a cabo las prácticas con seguridad y previniendo la ocurrencia de eventos adversos. PALABRAS CLAVE: Hemoterapia; Transfusión Sanguínea; Infusión de Hemoderivados; Cuidados de Enfermería; Asignación de Enfermería.

Fadiga por compaixão em enfermeiros intensivistas: revisão integrativa / Compassion fatigue in intensive care nurses: integrative review / Fatiga por compasión en enfermeras de cuidados intensivos: revisión integradora

Introdução: A fadiga por compaixão é caracterizada pelo desenvolvimento de exaustão emocional, física e/ou espiritual como resultado do trabalho com indivíduos em estado crítico. Objetivos: analisar as evidências empíricas atuais relacionadas à prevalência, causas e resultados da fadiga por compaixão entre enfermeiros de cuidados intensivos. Método: Trata-se de uma revisão integrativa por meio de uma pesquisa avançada em bancos de dados: Pubmed, Scielo e Medline. A amostra foi composta por dez artigos que atenderam aos critérios de inclusão. A busca limitou-se a pesquisas realizadas de 2017 a 2022. Resultados: Os principais achados desta revisão integrativa foram que a prevalência de fadiga por compaixão entre os enfermeiros variou entre os diversos ambientes de cuidados intensivos. Em relação às causas e consequências da fadiga por compaixão, esta revisão descobriu que o ambiente de trabalho e a demografia dos enfermeiros, como idade e anos de experiência, foram preditores de fadiga por compaixão, e os fatores que atenuam os efeitos da fadiga por compaixão entre enfermeiros intensivista incluíram líder e suporte administrativo dentro do cenário clínico e as estratégias de enfrentamento empregadas pelos enfermeiros. Há evidências inconclusivas para identificar preditores explícitos de fadiga por compaixão entre enfermeiros intensivistas. Conclusão: É provável que o início da fadiga por compaixão entre os enfermeiros de cuidados intensivos possa ser reduzido com uma monitorização cuidadosa do bem-estar físico e emocional no ambiente de cuidados intensivos, bem como através da oferta de educação em saúde aos enfermeiros para ajudar no desenvolvimento de estratégias de enfrentamento para evitar fadiga da compaixão.

Introduction: Compassion fatigue is characterized by the development of emotional, physical, and/or spiritual exhaustion as a result of working with critically ill individuals. Aims: To analyze the current empirical evidence related to the prevalence, causes, and outcomes of compassion fatigue among critical care nurses. Method: This is an integrative review by means of an advanced search in databases: Pubmed, Scielo and Medline. The sample was composed of ten articles that met the inclusion criteria. The search was limited to research conducted from 2017 to 2022. Results: The main findings of this integrative review were that the prevalence of compassion fatigue among nurses varied across different acute care settings. Regarding the causes and consequences of compassion fatigue, this review found that work environment and nurse demographics, such as age and years of experience, were predictors of compassion fatigue, and factors that mitigate the effects of compassion fatigue among intensivist nurses included leader and administrative support within the clinical setting and the coping strategies employed by nurses. There is inconclusive evidence to identify explicit predictors of compassion fatigue among intensivist nurses. Conclusion: It is likely that the onset of compassion fatigue among intensive care nurses can be reduced with careful monitoring of physical and emotional well-being in the intensive care setting, as well as through the provision of health education to nurses to assist in the development of coping strategies to avoid compassion fatigue.

Introducción: La fatiga por compasión se caracteriza por el desarrollo de agotamiento emocional, físico y/o espiritual como resultado del trabajo con enfermos críticos. Objetivos: Analizar la evidencia empírica actual relacionada con la prevalencia, las causas y los resultados de la fatiga por compasión entre las enfermeras de cuidados intensivos. Método: Se trata de una revisión integradora a través de una búsqueda avanzada en las bases de datos: Pubmed, Scielo y Medline. La muestra se compuso de diez artículos que cumplían los criterios de inclusión. La búsqueda se limitó a investigaciones realizadas entre 2017 y 2022. Resultados: Los principales hallazgos de esta revisión integradora fueron que la prevalencia de la fatiga por compasión entre las enfermeras varió en los diferentes entornos de cuidados agudos. En relación con las causas y consecuencias de la fatiga por compasión, esta revisión encontró que el entorno de trabajo y los datos demográficos de las enfermeras, como la edad y los años de experiencia, fueron predictores de la fatiga por compasión, y los factores que mitigan los efectos de la fatiga por compasión entre las enfermeras de cuidados intensivos incluyeron el apoyo del líder y administrativo dentro del entorno clínico y las estrategias de afrontamiento empleadas por las enfermeras. No hay pruebas concluyentes para identificar predictores explícitos de la fatiga por compasión entre las enfermeras de cuidados intensivos. Conclusión: Es probable que la aparición de la fatiga por compasión entre las enfermeras de cuidados intensivos pueda reducirse con una cuidadosa monitorización del bienestar físico y emocional en el entorno de los cuidados intensivos, así como mediante la provisión de educación sanitaria a las enfermeras para ayudar en el desarrollo de estrategias de afrontamiento para evitar la fatiga por compasión.

Percepción de enfermeras intensivistas sobre las condiciones de trabajo durante la COVID-19 / Intensive Care Nurses' Perception about Working Conditions during COVID-19

Introducción: La pandemia por SARS-CoV-2 develó la precaria infraestructura sanitaria y de recursos humanos a nivel mundial, lo cual se evidencia más en la Unidad de Cuidados Intensivos, por la alta demanda de pacientes críticos, las pocas camas disponibles y el déficit de trabajadores por confinamiento; esto generó mayor carga laboral, incremento de responsabilidades y riesgos para enfermeras intensivistas, requiriéndose respuestas institucionales rápidas, para el cuidado del recurso de primera línea. Objetivo: Identificar la percepción de enfermeras intensivistas sobre condiciones de trabajo durante la pandemia de COVID-19. Métodos: Se realizó un estudio cuantitativo, descriptivo-correlacional y retrospectivo en 80 enfermeras intensivistas de un hospital de IV nivel-EsSalud-Perú. Se aplicó un cuestionario (validez Aiken = 0,93, confiabilidad α Cronbach = 0,73). Los datos fueron procesados mediante IBM-SPSS-V27, presentados en tablas estadísticas (mediana / frecuencia / porcentaje) y análisis descriptivo. Según prueba de Kolmogorov-Smirnov, se alejan de la curva normal, decidiéndose por la correlación Rho de Spearman para asociar edad y condiciones de trabajo. Resultados: La mediana de edad de enfermeras intensivistas fue 41 a 50 años. Las condiciones de trabajo fueron percibidas como desfavorables por el 60 por ciento y según edad: un 33,75 por ciento entre 26-40, un 21,25 por ciento entre 41-50 y un 5 por ciento entre 51-64. En ergonomía (91,25 por ciento), organizacional (78,75 por ciento), ambiente psicosocial (68,75 por ciento) y físico (65 por ciento) fueron percibidas como desfavorables; en bioseguridad fue favorable (70 por ciento). Se halló correlación moderada entre edad y lo organizacional p = 0,431 y baja en bioseguridad p = 0,226 y ergonómicas p= 0,249. Conclusiones: Las condiciones de trabajo de enfermeras intensivistas durante la pandemia de la COVID-19 fueron percibidas como desfavorables para menores de 50 años y favorables para mayores de 51 años(AU)

Introduction: The SARS-CoV-2 pandemic revealed the precarious infrastructure of healthcare and human resources worldwide, more evident in the intensive care unit due to the high demand of critical patients, the few available beds and the deficit of workers caused by the lockdown. All this produced a greater workload, increased responsibilities and risks for intensive care nurses, circumstances that required rapid institutional responses for caring first-line resources. Objective: To identify intensive care nurses' perception about working conditions during the COVID-19 pandemic. Methods: A quantitative, descriptive-correlational and retrospective study was conducted with 80 intensive care nurses from a fourth-level EsSalud hospital in Peru. A questionnaire was applied (Aiken's validity = 0.93; Cronbach's alpha reliability = 0.73). The data were processed using IBM-SPSS-V27, presented in statistical tables (median/frequency/percentage), and by means of descriptive analysis. According to the Kolmogorov-Smirnov test, they deviate from the normal curve, deciding on Spearman's rho correlation to associate age and working conditions. Results: The age median of the intensive care nurses was 41-50 years. The working conditions were perceived as unfavorable by 60 percent and, according to age, 33.75 percent were 26-40 years, 21.25 percent were 41-50 years, and 5 percent were 51-64 years. The perceptions were perceived as unfavorable with respect to ergonomic (91.25 percent), organizational (78.75 percent), psychosocial (68.75 percent) and physical (65 percent) conditions; biosafety was favorable (70 percent). A moderate correlation was found between age and organizational conditions (p = 0.431), while there was a low correlation with respect to biosafety (p = 0.226) and ergonomic conditions (p = 0.249). Conclusions: The working conditions of intensive care nurses during the COVID-19 pandemic were perceived as unfavorable by those younger than 50 years and favorable by those older than 51 years(AU)

Percepções de enfermeiros sobre a assistência ao paciente em cuidados paliativos / Nurses' perceptions of patient care in palliative care / Percepciones de las enfermeras sobre la atención al paciente en cuidados paliativos

Introdução: baseada em uma visão holística do ser humano, os cuidados paliativos, tem como filosofia valorizar a vida e encarar a morte como um processo natural. Objetivo: compreender as percepções de Enfermeiros no estar com o paciente em cuidados paliativos. Materiais e Método: É um estudo transversal, exploratório descritivo, com abordagem qualitativa que procurou compreender o fenômeno do cuidado paliativo na percepção dos profissionais envolvidos. Resultados: Após várias leituras dos discursos, com base no objetivo e na semelhança das respostas, emergiram seis categorias temáticas: Cuidado Humanizado, Liderança, Sentimentos, Família, Cuidado Paliativo e Conforto. Conclusão: Os profissionais apontaram como fundamental, a participação familiar no processo e que as habilidades adquiridas por aprender a se ressignificar a cada dia, bem como entender suas limitações, contribuíram para entender melhor o processo de cuidar e minimizar o sofrimento durante a doença terminal.

Introduction: Based on a holistic view of the human being, palliative care's philosophy involves valuing life and facing death as a natural process. Objective: To understand the perceptions of nurses who care for palliative care patients. Materials and methods. A descriptive, exploratory, cross-sectional study with a qualitative approach that sought to understand the phenomenon of palliative care by exploring the professionals' perceptions was conducted. Results: After several readings of the speeches and based on the study's objective and similarity of responses, six thematic categories emerged: human care, leadership, feelings, family, palliative care, and comfort. Discussion: One of palliative care nurses' main concerns is promoting quality of life and comfort in these patients. Pain becomes the most important vital sign, and all the organic needs of these patients are essential. In that direction, human and holistic care is highlighted. Professionals must act to understand the importance of human and holistic care for the terminal patient, considering the physical, social, emotional, and spiritual dimensions. Conclusions: The professionals pointed out that family participation in the process was fundamental; the skills acquired by learning to re-signify each day, as well as understanding their limitations, contributed to a better understanding of the care process and minimizing suffering during terminal illnesses.

Introducción: basado en una visión holística del ser humano, los cuidados paliativos, su filosofía es valorar la vida y afrontar la muerte como un proceso natural. Objetivo: comprender la percepción de la enfermera de estar con el paciente en cuidados paliativos. Materiales y métodos: Es un estudio descriptivo, exploratorio, transversal con abordaje cualitativo que buscó comprender el fenómeno de los cuidados paliativos en la percepción de los profesionales involucrados. Resultados: Luego de varias lecturas de los discursos, a partir del objetivo y similitud de las respuestas, surgieron seis categorías temáticas: Cuidado Humanizado, Liderazgo, Sentimientos, Familia, Cuidados Paliativos y Confort. Conclusión: Los profesionales señalaron como fundamental la participación familiar en el proceso y que las habilidades adquiridas al aprender a resignificar cada día, así como comprender sus limitaciones, contribuyeron a comprender mejor el proceso de cuidar y minimizar el sufrimiento durante la enfermedad terminal.

The dynamic care nurse

@#Virginia Henderson defined that the primary role of nurses for individuals, whether sick or well, is to assist them in regaining their health and promoting their independence in activities of daily living (Halloran, 2018). The gap that is noted in the definition of Henderson’s role of nurses is the lack of direction as to how will a nurse render care that is unique and satisfying to an individual, knowing that the demand of expectation rises. Thus, it motivated this paper to study the concept of the dynamic care nurse. This concept paper utilized Walker and Avant (2005) method of analysis. The attributes associated with the dynamic care nurse are (1) continuous learning; and (2) the utilization of best practices. The antecedents identified include (1) initiative, and (2) compassion (ICN, 2012, Hemberg et al., 2020, Kroning, et al., 2019). Dynamic care nurse exemplifies the attributes of continuous learning and the utilization of best practices. Nurses can bridge the gaps in the practice through these attributes and by possessing initiative and compassion, it is not by afar to achieve a better health care service and positive health outcomes.

Relationships between Sedation Knowledge and Nurse Practice Competences in Intensive Care Unit / 임상간호연구

PURPOSE: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. METHODS: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 RESULTS: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. CONCLUSION: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.

O enfermeiro educador no puerpério imediato em alojamento conjunto na perspectiva de Peplau / The educator nurse in the immediate puerperium in joint accommodation from the Peplau's perspective

Estudo com abordagem qualitativa objetivando compreender as orientações apreendidas de puérperas em alojamento conjunto e discutir as ações do enfermeiro educador na perspectiva da Teoria de Peplau. A amostra constou de 27 mulheres enquadradas nos seguintes critérios: idade igual ou maior que 18 anos; estar no puerpério; ter ficado com o bebê em alojamento conjunto durante sua estadia na maternidade. A coleta de dados decorreu de junho a julho de 2014. Após análise das entrevistas emergiram três categorias e suas subcategorias: orientações fornecidas pelo enfermeiro acerca dos cuidados com o recém-nascido; orientações relativas aos cuidados com as puérperas; memória das puérperas acerca das orientações recebidas. A evidência dos resultados demonstrou que a escuta foi instrumento identificado como ação terapêutica mais empregada pelas enfermeiras e os papéis desenvolvidos exercidos de acordo com as necessidades das puérperas, atendendo à dinâmica do relacionamento interpessoal tornando-as mais autônomas e satisfeitas nos seus cuidados.

A study with a qualitative approach aimed to comprehend the learned orientations of puerperium women in joint accommodation and to discuss the actions of the educator nurse from the perspective of Peplau's Theory. Twenty- seven women composed the sample according to the following criteria: to be 18 years or older; to be in puerperium; to have stayed with the baby in a joint accommodation during her stay in the maternity. The data collection occurred from June to July 2014. After analyzing the interviews, three categories emerged and its subcategories: orientations provided by the nurse about newborn care; orientations related to puerperal women care; the memory of puerperal women about received orientations. Results evidence demonstrated listening being the instrument identified as the most used therapeutic action by nurses and the roles developed by the puerperal women needs, attending to the dynamic of the interpersonal relationship, making them more autonomous and satisfied in their care.

Critical Care Nurses' Perception of Life-sustaining Treatment at End of Life: A Content Analysis / 중환자간호학회지

PURPOSE: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life.METHODS: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital.RESULTS: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members.CONCLUSIONS: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

Clínica de lactancia materna en domicilio, intervención integral de apoyo para el éxito del proceso de lactancia / Clinic breastfeeding in home, integral intervention of support for the success of the breastfeeding process

En este artículo se relatará la experiencia profesional en torno a la Clínica de Lactancia en modalidad visita domiciliaria, cuyo propósito es brindar apoyo y acompañamiento a la familia para el inicio, mantención y recuperación de la lactancia, como una estrategia de intervención integral de enfermería. La lactancia materna es una de las mejores inversiones en salud para las personas, sus beneficios y duración en manera exclusiva hasta los 6 meses y luego complementada hasta los 24 meses o hasta que lo deseen, ha sido respaldado por múltiples asociaciones científicas nacionales e internacionales. La clínica de lactancia domiciliaria permite realizar intervenciones de salud en el contexto de la vida cotidiana de las personas, realizar una valoración individual, del binomio y de la familia, considerando aspectos de la salud física, psicológica, afectiva, social y contextual que pudieran estar influyendo en el fenómeno de la lactancia. Parte del éxito de una clínica de lactancia domiciliaria, está en el lazo terapéutico de confianza que se pueda formar entre la enfermera(o) consultora en lactancia y la familia, pero especialmente con la madre, quien que se encuentra en un proceso de adaptación a su nuevo rol. Desde nuestra experiencia profesional como enfermeras, podemos contribuir al cuerpo de conocimientos propios de la disciplina en lo relacionado a los cuidados de la madre y su hijo(a) en periodo de amamantamiento.

This article describes the experience of nurses delivering Nursing Clinics within a home visit modality. The purpose of this service is to provide support and company to the newborn's family for the initiation, maintenance and recovery of breastfeeding, as a comprehensive nursing intervention. Breastfeeding is one of the best investmentsin health for people. Its benefits for the newborn and the mother have been supported by multiple national and international scientific associations, which have highlighted its exclusivity up to six months of age and then its continuation as complementary of solids up to 24 months of age. Nursing clinics at home allow for situated health interventions according to people's everyday lives; for carrying out individual, binomial and family assessments, considering aspects of physical, psychological, emotional, social and contextual health that may impact upon the experience of breastfeeding. Part of the success of a nursing clinicat home, relies upon the therapeutic relationship of trust and rapport that can be developed between the nurse (or consultant in breastfeeding) and the family, but especially upon the one developed with the mother, who is in a process of adaptation to her new role. From our professional experience as nurses, we can contribute to the body of knowledge of the discipline in relation to the care of the mother and her child during breastfeeding.

Critical care nurses' attitude towards life-sustaining treatments in South East Iran / 世界急诊医学杂志（英文）

@#BACKGROUND:Life-sustaining treatments (LSTs) may prolong life but greatly decrease the quality of death. One factor influencing decision-making about withholding and withdrawing these treatments is the attitude of nurses. This study aimed to evaluate the attitude of critical care nurses towards life-sustaining treatments in South East Iran. METHODS:In this cross-sectional study, "Ethnicity and Attitudes towards Advance Care Directives Questionnaire" was used to investigate the attitude of 104 critical care nurses towards life-sustaining treatments in three hospitals affiliated to Kerman University of Medical Sciences. RESULTS:The findings of this study indicated that although a majority of critical care nurses (77％) did not have personal desire for use of LSTs including CPR and mechanical ventilation, they had moderately negative to neutral attitude towards general use of LSTs (2.95 of 5). CONCLUSIONS:These findings suggest that nurses' attitude towards LSTs can be changed by inclusion of specific courses about death, palliative care and life-sustaining treatments in undergraduate and postgraduate nursing curricula. Educating Muslim nurses about religious aspects of LSTs may also improve their attitudes.

La mujer en posparto: un fenómeno de interés e intervención para la disciplina de enfermería / The woman in postpartum: a phenomenon of interest and intervention for the discipline of nursing

Introducción: El posparto constituye un fenómeno de interés para la disciplina de enfermería, y ostenta una trayectoria histórica desde el inicio de las prácticas de cuidado; es una etapa determinante para la mujer por la complejidad que deriva el proceso de convertirse en madre. El objetivo del artículo es reconocer y analizar las necesidades de la mujer en pos parto, como base para la construcción de herramientas para la planeación del cuidado y auto cuidado de la diada, que fomenten la activación del rol maternal y la disminuyan de la morbi-mortalidad materno- perinatal; a parir de la revisión sistemática e integrativa de literatura científica. Materiales y Métodos: Revisión de bases de datos LILACS, PUBMED, SciELO, SCOPUS, SCIENCE DIRECT, EBSCO; Para guiar la revisión de artículos se formuló la siguiente pregunta ¿Cuáles son los productos científicos relacionados con las necesidades de la mujer en pos parto, que lleven a la construcción de intervenciones de enfermería? Resultados: Se seleccionaron 70 artículos y se realizó la lectura exploratoria para la selección de textos para el análisis; La muestra final de esta revisión fueron 50 artículos citados en el estudio. Discusión y Conclusiones: Enfermería como profesión, debe estructurar intervenciones sustentadas en teoría disciplinar que permitan actuar sobre las necesidades de la mujer en pos parto a partir del apoyo social que hace referencia a la cantidad de ayuda que recibe realmente, la satisfacción que produce esa ayuda y las personas (enfermería) que la proporcionan, el cual permitirá brindar cuidado humanizado, individual, personalizado de reciprocidad a la mujer ,recién nacido, pareja y/o familia como medio para disminuir la morbi-mortalidad al mejorar su calidad de vida.

Introduction: Postpartum is a phenomenon of interest to the discipline of nursing, and boasts a historical trajectory from the start of care practices; is a crucial step for women because of the complexity derives the process of becoming a mother. The article aims to recognize and analyze the needs of women in childbirth post as a basis for building tools for the planning of care and self-care dyad, which promote activation of the maternal role and decrease in morbidity - maternal mortality - perinatal; calving and integrative systematic review of scientific literature. Materials and Methods: Review of databases LILACS, PUBMED, SciELO, SCOPUS, SCIENCE DIRECT, EBSCO; to guide articles reviewing the following question was asked ¿What are the scientific products related to the needs of women in postpartum, leading to the construction of nursing interventions? Results: 70 articles were selected and exploratory reading for selecting texts for the analysis was performed; the final sample of this review were 50 articles cited in the study. Discussion and Conclusions: Nursing as a profession, should be structured discipline grounded in theory capable of influencing the needs of postpartum women from social support refers to the amount of aid actually received, the satisfaction that interventions that help people and (nursing) who provide, which will provide humanized, single, personalized care to women reciprocity, newborn, couples and/or families as a way to decrease the mortality and morbidity by improving their quality of life.

Development of a Nursing Competency Scale according to a Clinical Ladder System for Intensive Care Nurses / 간호행정학회지

PURPOSE: This study was done to develop a nursing competency scale according to a clinical ladder system for intensive care nurses. METHODS: Index of content validation was done by 20 clinical experts and 80 nurses in Intensive Care Units (ICU). RESULTS: The process and results of study are as follows. First, 12 nursing competencies were used in the establishment of the clinical ladder system (Jang, 2000). Second, the first draft of the competency lists was developed. It was based on the clinical nurses' behavioral indicators of nursing competency by Jang (2000), and was modified and supplemented through various literature reviews including competency standards for specialist intensive care nurses in Australia and consultation with 2 clinical nurses with over 10 years experience in the ICU. Third, the draft was examined by 20 clinical experts for content validity. Finally, the final draft was analysed using clinical validity where 20 nurses in each ladder participated. The final number of items was fixed at 309. CONCLUSION: The tool represents expected nursing competency of nurses working in ICU. Intensive care nurses can recognize their strengths and weaknesses, and identify directions for their professional growth by analysing results of their competency evaluation using this tool.

Experiencia de cuidadores familiares sobre el cuidado de transición en mujeres mastectomizadas / Experience of family caregivers on transition care in mastectomized women / Experiência de cuidadores familiares no cuidado de transição em mulheres mastectomizadas

En la actualidad presenciamos cambios en la presentación de servicios de salud e implementación de políticas públicas cada vez más eficientes, sin embargo gran parte de los cuidados a mujeres con cáncer sometidas a tratamiento quirúrgico como la mastectomía se administran en el hogar. Esta situación establece un compromiso para la paciente y su familia. Con frecuencia, algún familiar se encarga del cuidado de la paciente que en muchos casos podría considerarse altamente especializado. En nuestra sociedad se desconoce el nivel de la experiencia o la calidad de la misma que tienen los cuidadores familiares posteriormente al alta hospitalaria y previa a la siguiente consulta. Este espacio de tiempo podría definirse como de transición. Los cuidados de transición se refieren al periodo durante el cual los pacientes pasan de una fase a otra de la enfermedad o del tratamiento, o bien, cuando cambian de un entorno de atención a otro. Los cuidados de transición tienen repercusiones importantes en la salud de la paciente. Estos periodos de cambio se ubican generalmente en el hogar. El presente estudio expone y analiza el factor de la experiencia durante el cuidado de transición por los cuidadores familiares de mujeres mastectomizadas. Se realizó una investigación cualitativa, con entrevistas semiestructuradas realizadas a tres familiares responsables del cuidado así como un análisis de contenido. Después de validad los resultados, situamos como la principal preocupación la curación de herida quirúrgica sin lastimar a la paciente. Se identifican momentos clave perfectamente determinados durante la transición. La falta de conocimientos por el cuidador se sustituye por buena voluntad y utilizando su propio criterio. Está presente la fe en el cuidador como su principal sostén, así como una necesidad de información orientada hacia la técnica de curación. Los cuidados de transición encauzados hacia la curación de herida quirúrgica cuentan con elementos que están más en función de una lógica primaria que de una capacitación sobre el tema. Esto contrasta con la literatura que se hace re4ferencia en el cuidador, donde frecuentemente se ocupa de aspectos puntuales como: la dieta, medicación, el estado general y anímico de la paciente. Finalmente se elaboran propuestas para conformar un puente de cuidados de transición hospital-hogar-hospital, considerando una consultoría de enfermería durante el proceso para favorecer el bienestar de la mujer mastectomizada, al disminuir complicaciones, disminuyendo costos previsibles para la institución y evitando una atención biomédica fragmentada.

Nowadays, we witness changes in health services presentation and public policies implementation more4 and more efficient. Nevertheless, most care for women with cáncer, subjected to surgical treatment, such as mastectomy, is provided at home. The aforementioned situation establishes an engagement for the patient and her family. Frequently some family members take charge of the care of the patients. In many cases, this care could be regarded as specialized. In our society, the level of experience and the care quality of the care givers, afte4r the hospital discharge and before the following medical consultation, are unknown. This mentioned period could be named as the transitional period. Transitional cares are referred to the period during qhich patients go from one phase to another in the disease or in the treatment; or when the patients move from one attention background to another fifferent ambience. Transitional cares present an important impacto n patients´ health. Those change periods are usually located at home. The present study exposes and analyzes the experience factor during transitional cares for the mastectomized women by part of family care providers. The study performed a qualitative reserch, with semi-structured interviews carried out on family members responsible for the care, as well as an analysis of contets. After validating the results, our first concern was the surgical wound healing, without causing the patient any harm. Several completely well-determined key moments were identified during the transitional period. The lack of care knowledge by part of the care providers may be substituted by good willin and the use of their own criterion. The reliance on the caregiver is always present, as well the need for information oriented to the healing technique. The transitional cares guided to healing the surgical wound count on some elements that are more in terms of a prmary logic tan guided by training on the matter. This is opposed to the concept found in the literatura that makes reference to the caregiver, where the main points refer to certain punctual aspects, such as diet, medication, and the patient´s physical and psychic condition. Finally, the study gives some propositions in order to establish some kind of hospital-home-hospital brindging transitional care, considering a nursing consulting during the process so as to improve mastectomized women´s welfare, diminishing complications for the patients, decreasing predictable costs, and avoiding a fragmented biomedical attention.

Atualmente testemunhando mudanças na apresentação dos serviços de saúde e implementar políticas públicas cada vez mais eficientes, por mais cuidados para mulheres com submetidos a cirurgia de câncer, como a mastectomia são administradas em casa. Essa situação estabelece um compromisso para o paciente e sua família. Freqüentemente, um membro da família cuida do paciente, que em muitos casos pode ser considerado altamente especializado. Em nossa sociedade o nível de experiência ou a qualidade do que tem posteriormente parentes para alta hospitalar e antes de as seguintes cuidadores de consulta é desconhecida. Esse espaço de tempo poderia ser definido como transitório. tratamento de transição são relativos ao período durante o qual os pacientes se mover a partir de uma fase para outra doença ou tratamento, ou quando alterar o ambiente cuidado para outro. O cuidado de transição tem importantes repercussões na saúde do paciente. Esses períodos de mudança geralmente estão localizados em casa. Este estudo descreve e analisa o fator experiência para cuidar de transição para cuidadores familiares de mulheres mastectomizadas. A pesquisa qualitativa foi realizada por meio de entrevistas semi-estruturadas com três cuidadores familiares, bem como uma análise de conteúdo. Após validar os resultados, colocamos como principal preocupação a cicatrização da ferida cirúrgica sem prejudicar o paciente. Momentos chave perfeitamente identificados durante a transição são identificados. A falta de conhecimento do cuidador é substituída por boa vontade e usando seus próprios critérios. A fé está presente no cuidador como seu esteio, assim como a necessidade de uma técnica de cura orientado a informações. cuidados de Transição introduzido a cicatrização da ferida cirúrgica tem elementos que são mais em termos de uma lógica primária de formação sobre o assunto. Isto contrasta com a re4ferencia literatura no cuidador, que muitas vezes lida com aspectos específicos, tais como dieta, medicação e o humor geral do paciente. Finalmente, as propostas são feitas para formar um cuidado transicional ponte do hospital-home-hospitalar, considerando-se uma enfermeira de consultoria durante o processo para promover o bem-estar das mulheres com mastectomias, diminuindo complicações, diminuindo custos previsíveis para a instituição e evitando cuidados biomédica fragmentado

O impacto da doença de Alzheimer no cuidador / El impacto de la enfermedad de Alzheimer en el cuidador / Alzheimer disease: its impact on the health care nurse

O crescimento da população idosa é um fenômeno mundial. Em 2025 o Brasil será o 6º país do mundo quanto ao contingente de idosos. Concomitantemente com o aumento da população idosa ocorre o aumento das doenças crônico-degenerativas, como a Doença de Alzheimer (DA). A DA é caracterizada por um declínio progressivo nas áreas de cognição, função e comportamento. À medida que a doença progride surge a demanda por cuidados especiais, função importante desempenhada pelos cuidadores. Pesquisas têm evidenciado que o declínio do paciente e suas demandas específicas são fatores importantes de estresse para o cuidador. Estes apresentam altos índices de sintomas psiquiátricos - especialmente a depressão -, prejuízos no sistema imunológico, assim como altos índices de conflitos familiares. Outros estudos sugerem que altos índices de sobrecarga e impacto no cuidador estão associados à institucionalização do paciente. O presente estudo de revisão tem por objetivo levantar os principais aspectos determinantes do impacto no cuidador de pacientes com DA.

Increase in the elderly population is a worldwide phenomenon. In 2025 Brazil will be the sixth country in the world in the number of elderly people. Consequently, there will also be an increase in chronic-degenerative diseases, such as Alzheimer Disease (AD.). AD is described as a progressive decline in cognition areas, function and behavior. During its progressive development, the AD person requires special care which is administered by health care nurses. Researches evidenced that the patient's deterioration stage and his/her requirements are important stress factors to the care nurses. These manifest high indexes of psychiatric symptoms, mainly depression, damage at the immunological system and also high familiar disagreement indexes. Other studies suggest that these high indexes and burden on the care nurses are associated with the patient's institutionalization. Current revision study shows the main determinant aspects on the impact on care nurses with AD patients.

El crecimiento de la población anciana es un fenómeno mundial. En 2025 Brasil será el 6º país del mundo cuanto al contingente de ancianos. Concomitantemente con el aumento de la población anciana ocurre el aumento de las enfermedades crónico-degenerativas, como la Enfermedad de Alzheimer (DA). La EA es caracterizada por un declino progresivo en las áreas de cognición, función y comportamiento. A la medida que la enfermedad avanza surge la demanda por cuidados especiales, función importante desempeñada por los cuidadores. Pesquisas han evidenciado que el declino del paciente y sus demandas específicas son factores importantes de estrese para el cuidador. Estos presentan altos índices de síntomas psiquiátricos - especialmente la depresión -, perjuicio en el sistema inmunológico, así como altos índices de conflictos familiares. Otros estudios sugieren que altos índices de sobrecarga e impacto en el cuidador están asociados a la institucionalización del paciente. El presente estudio de revisión tiene por objetivo levantar los principales aspectos determinantes del impacto en el cuidador de pacientes con EA.

Direct Care Stress and Job Satisfaction in Home Care Nurses* / 여성건강간호학회지

PURPOSE: This study was aimed to investigate direct care stress and job satisfaction in home care nurses. METHOD: Subjects were 139 home care nurses of hospitals in urban cities. Data was collected by a self report questionnaire. Direct care stress was measured by Community Health Nurses Perceptions of Work-Related Stressors Questionnaire. Job satisfaction was measured by a visual analogue scale. RESULTS: The average score of direct care stress was 60.4. There were significantly high direct care stress in those who had less than that 3 years experience than in their counterparts. The average score of job satisfaction was 79.5. There were significant high job satisfaction in those who willingly chose to work. Direct care stress negatively correlated with the length of office experience of the home care nurse. CONCLUSION: A direct care educational program should be developed for those who have less than 3 years experience to decrease their stress level.

Scale Development of Job Stress for Home Care Nurses / 간호학회지

The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted. The final item count was 50. Categories were as follows: overload work(8 items), lack of specialized knowledge and technique(5 items), ethical dilemma(4 items), role conflict(5 items), interpersonal relationships(6 items), visiting home environment(9 items), driving conditions(4 items) and lack of administrative support(9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.