Ascertainment of Nutrition Care Process (NCP)Implementation and Use of NCP Terminologies (NCPT) among Hospital Dietitians in the Philippines

Background and Objective@#The Nutrition Care Process (NCP) is a systematic method used by dietitians to provide high-quality nutrition care resulting in good patient outcomes. This study aimed to assess the NCP implementation and use of NCP Terminologies (NCPT) among hospital dietitians in the Philippines. Specifically, the study aimed at assessing the knowledge, perception, and practices on NCP and use of NCPT and correlate them with the dietitians' education, and professional and employment profile; and explain the barriers and facilitators of the practice of NCP and use of NCPT among hospital dietitians in the Philippines. @*Methods@#The knowledge, perception, and practices (KPP) on NCP and NCPT of the dietitians employed in the Philippine Department of Health’s licensed level 3 hospitals were determined using a validated questionnaire. Significant factors associated with the KPP were also determined. The barriers and facilitators of the practice of NCP and NCPT were determined using focus group discussion and key informant interviews of chief clinical dietitians and hospital administrators, respectively. @*Results@#The study revealed that majority of the participants had a high level of knowledge on NCP and NCPT, positively perceived its implementation, and more than half of them implement NCP and NCPT in the hospitals. The participants’ knowledge on NCP and NCPT was significantly associated with research involvement and active membership in a professional organization. While the practice of NCP and NCPT was significantly associated with having NCP-related trainings, frequency of trainings, and active membership in a professional organization. The barriers to NCP implementation were insufficient resources; lack of orientation, trainings, and support; organizational and administrative constraints; pandemic constraints; insufficient time; and lack of confidence to conduct NCP. While the facilitators of implementation were collaboration, dedication, and commitment of the healthcare team; institutionalization of NCP laws and policies; budget allocation for NCP-related activities; monitoring and consistency of NCP implementation; and work schedule. @*Conclusion@#The findings suggest that the implementation of NCP and NCPT in the Philippines needs further support from the institution, professional organizations, and policy makers by developing strategies to cope with the barriers, and strengthen the facilitators and factors associated with practice.

Repercussions of moving patients on the context of practice: perspectives of the nursing team / Repercusiones de la movilización de pacientes sobre el contexto de práctica: perspectivas del equipo de enfermería / Repercussões da movimentação de pacientes sobre o contexto de prática: perspectivas da equipe de enfermagem

Objective: to examine the nursing team's view of the repercussions of moving patients (admissions, transfers and discharges) on the organization of work and the delivery of care. Method: this is a qualitative study using the focus group technique, conducted with 23 professionals - 12 nurses, eight nurse technicians and three nurse assistants working in three inpatient units at a teaching hospital in the countryside of Sao Paulo. Four meetings took place between November 2021 and March 2022. The reports were analyzed thematically using MAXQDA software. Results: two thematic categories emerged: the influence of structural factors and work organization on the intra-hospital moving of patients; it demands time, generates work overload and interferes with the delivery of care. Conclusion: the volume of moving patient associated with unforeseen demands, care complexity and insufficient staff and resources have a negative impact on the delivery of care, with clinical risks and work overload. The findings make it possible to improve the regulation of patients entering and leaving the units, work organization and care management, avoiding clinical risks, delays, omissions and work overload.

Objetivo: examinar la perspectiva del equipo de enfermería sobre las repercusiones del movimiento de pacientes (admisiones, traslados y altas) en la organización del trabajo y en la prestación de cuidados. Método: estudio cualitativo utilizando la técnica de grupo focal llevado a cabo con 23 profesionales, incluyendo 12 enfermeros, ocho técnicos y tres auxiliares de enfermería de tres unidades de internación de un hospital universitario del interior de São Paulo. Se realizaron cuatro encuentros entre noviembre de 2021 y marzo de 2022. Los relatos fueron analizados en la modalidad temática con la ayuda del software MAXQDA. Resultados: surgieron dos categorías temáticas: la influencia de factores estructurales y de la organización del trabajo en el movimiento intrahospitalario de pacientes; y, el movimiento de pacientes demanda tiempo, genera sobrecarga de trabajo e interfiere en la prestación de cuidados. Conclusión: el volumen de movimientos de pacientes asociado a demandas imprevistas, complejidad asistencial e insuficiencia de personal y de recursos repercute negativamente en la prestación del cuidado con riesgos clínicos y sobrecarga laboral. Los hallazgos permiten mejorar la regulación de las entradas y salidas de pacientes en las unidades, la organización del trabajo y la gestión del cuidado, evitando riesgos clínicos, retrasos, omisiones y sobrecarga laboral.

Objetivo: examinar o olhar da equipe de enfermagem quanto às repercussões da movimentação de pacientes (admissões, transferências e altas) na organização do trabalho e na entrega do cuidado. Método: estudo qualitativo utilizando técnica de grupo focal conduzido junto a vinte e três profissionais sendo doze enfermeiros, oito técnicos e três auxiliares de enfermagem lotados em três unidades de internação de um hospital de ensino do interior de São Paulo. Ocorreram quatro encontros, entre novembro de 2021 e março de 2022. Os relatos foram analisados na modalidade temática com o auxílio do software MAXQDA. Resultados: emergiram duas categorias temáticas: a influência de fatores estruturais e da organização do trabalho na movimentação intra-hospitalar de pacientes; e a movimentação de pacientes demanda tempo, gera sobrecarga de trabalho e interfere na entrega do cuidado. Conclusão: o volume de movimentações de pacientes associado às demandas imprevistas, complexidade assistencial e insuficiência de pessoal e de recursos repercutem negativamente na entrega do cuidar com riscos clínicos e sobrecarga laboral. Os achados possibilitam aprimorar a regulação das entradas e saídas de pacientes nas unidades, organização do trabalho e gestão do cuidado evitando-se riscos clínicos, atrasos, omissões e sobrecarga laboral.

Proceso de atención de enfermería para un retorno seguro a las escuelas posterior al covid-19 -análisis de caso comunitario / Nursing care process for a safe return to schools post-covid-19

La COVID-19 provocó el cierre de las escuelas, y trasladó las actividades a los entornos virtuales por casi dos años. Posteriormente, los gobiernos otorgaron a las instituciones educativas, planes de retorno seguro a las actividades escolares para mejorar una transición a la presencialidad de la comunidad escolar y mantener a un mínimo los casos nuevos de la COVID-19. El profesional de enfermería, a través del Proceso de Atención de Enfermería (PAE), posee las herramientas y conocimientos necesarios para operativizar estos lineamientos e implementarlos de forma efectiva en las comunidades escolares. Objetivo: Implementar el PAE para facilitar el retorno seguro a las actividades escolares en una escuela primaria de México. Metodología: Estudio de caso comunitario con PAE, implementado en una escuela primaria pública de México. Para la valoración se utilizaron técnicas cualitativas y de participación comunitaria (entrevistas, cartografía social, etc) y para el proceso diagnóstico, resultados e intervenciones se utilizó la taxonomía NANDA 2021-2023, Clasificación de Resultados NOC y Clasificación de Intervenciones NIC. Resultados: Se trabajó en torno a un diagnóstico, un resultado y dos intervenciones sobre la participación comunitaria en programas educativos y de comunicación en salud, así como la disminución de las conductas de riesgo para la salud en la comunidad. Conclusiones: El PAE permitió mejorar las conductas promotoras de la salud en torno al uso de cubrebocas, sana distancia y lavado de manos en la comunidad. Se elaboraron materiales de comunicación en salud como técnica de refuerzo de los hábitos aprendidos[AU]

COVID-19 caused the closure of schools, moving activities to virtual environments for almost two years. Subsequently, governments give educational institutions plans for the safe return to school activities to improve a transition to face-to-face attendance for the school community and keep new cases of COVID-19 to a minimum. Te nursing professional, through the Nursing Care Process (NCP), has the necessary tools and knowledge to operationalize these guidelines and implement them effectively in school communities. Objective: To facilitate a safe return to school activities in a primary school in Mexico. Methodology: A community case study with NCP, establishing the community of a primary school as a patient, for the assessment qualitative techniques and community participation were used and for the diagnostic process, results, and interventions the NANDA 2021-2023 taxonomy was used, Classifcation of NOC Results and classifcation of NIC Interventions. Results: Work was carried out around a diagnosis, a result, and two interventions on community participation in educational and health communication programs, as well as the reduction of risk behaviors for health in the community. Conclusions: Te NCP made it possible to improve health-promoting behaviors around the use of face masks, healthy distance, and hand washing in the community. By considering the assessment of different actors, health communication materials were made as a technique to reinforce learned habits[AU]

A COVID-19 provocou o fechamento de escolas, deslocando as atividades para ambientes virtuais por quase dois anos. Posteriormente, os governos concedem às instituições de ensino planos para o retorno seguro às atividades escolares para melhorar a transição para o atendimento presencial para a comunidade escolar e reduzir ao mínimo os novos casos de COVID-19. O profssional de enfermagem, por meio do Processo de Cuidar de Enfermagem (PCE), possui as ferramentas e conhecimentos necessários para operacionalizar essas diretrizes e implementá- las efetivamente nas comunidades escolares. Objetivo: Facilitar o retorno seguro às atividades escolares em uma escola primária no México. Metodologia: Estudo de caso comunitário com PCE, estabelecendo a comunidade de uma escola primária como paciente, para a avaliação foram utilizadas técnicas qualitativas e participação da comunidade e para o processo diagnóstico, resultados e intervenções foi utilizada a taxonomia NANDA 2021-2023, Classifcação da NOC Resultados e classifcação das intervenções NIC. Resultados: Trabalhou-se em torno de um diagnóstico, um resultado e duas intervenções sobre a participação da comunidade em programas educativos e de comunicação em saúde, bem como a redução de comportamentos de risco para a saúde na comunidade. Conclusões: O PCE possibilitou melhorar os comportamentos de promoção da saúde em torno do uso de máscaras faciais, distanciamento saudável e lavagem das mãos na comunidade. Tendo em conta a avaliação dos diferentes atores, foram elaborados materiais de comunicação em saúde como técnica para reforçar os hábitos aprendidos[AU]

Intervención de enfermería durante la circulación extracorpórea en cirugía cardiovascular / Nursing intervention during extracorporeal circulation in cardiovascular surgery

Introducción: Una intervención de enfermería durante la circulación extracorpórea en cirugía cardiovascular puede reducir la aparición de complicaciones, la estadía en unidad de cuidados intensivos, hospitalaria y la mortalidad. Se ofrecen cuidados articulando los dominios de atención a personas en estado crítico establecidos por Patricia Benner, el Proceso de Atención de Enfermería y las taxonomías. Objetivo: Exponer el desarrollo de una intervención de enfermería durante la circulación extracorpórea. Métodos: Se realizó un estudio experimental, que incluyó 159 personas, distribuidas en dos grupos, que acudieron al Servicio de Cardiología, del Centro de Investigaciones Médico Quirúrgicas desde enero de 2018 hasta enero de 2021. Los grupos fueron escogidos mediante la aleatorización simple (1:1). El primero se conformó por 79 personas, abordadas con el procedimiento convencional; y el segundo, por 80, atendidas con la intervención de enfermería diseñada por el equipo de investigación. Se compararon y expresaron los resultados en números absolutos, porcentajes y media. Resultados: Predominaron los hombres (79,7 por ciento). La edad media fue 60 años. En el grupo al que se le aplicó la intervención de enfermería se redujeron la aparición de complicaciones, la estadía en Unidades de Cuidados Intensivos, hospitalaria, y la mortalidad (p = 0,04). Conclusiones: La implementación de la Intervención de Enfermería por el enfermero perfusionista ayudó a mejorar las respuestas humanas de esas personas. Los resultados finales obtenidos mostraron su validez, al evidenciar la disminución en la aparición de complicaciones y, por ende, la reducción de la estadía en UCI, hospitalaria y la mortalidad(AU)

Introduction: A nursing intervention during extracorporeal circulation in cardiovascular surgery can reduce the occurrence of complications, the stay in intensive care units, in hospitals, and mortality. Care is offered by articulating the domains of care for people in critical condition established by Patricia Benner, the Nursing Care Process and taxonomies. Objective: To present the development of a nursing intervention during extracorporeal circulation. Methods: An experimental study was conducted, which included 159 people, divided into two groups, who attended the Cardiology Service of the Center for Medical and Surgical Research from January 2018 to January 2021. Groups were chosen using simple randomization (1:1). The first group was made up of 79 people, approached with the conventional procedure; and the second, by 80 people, attended with the nursing intervention designed by the research team. The results were compared and expressed in absolute numbers, percentages and mean. Results: Men predominated (79.7 percent). The median age was 60 years. In the group to which the nursing intervention was applied, the occurrence of complications, the stay in Intensive Care Units, in hospitals, and mortality were reduced (p = 0.04). Conclusions: The implementation of the Nursing Intervention by the perfusionist nurse helped to improve the human responses of these people. The final results obtained showed their validity, as they showed the decrease in the onset of complications and, therefore, the reduction of ICU and hospital stay and mortality(AU)

Efectividad del proceso de atención de enfermería en la supervivencia del recién nacido menor de 1500 gramos

Introducción: el parto pretérmino es el principal problema obstétrico en la actualidad. Uno de los desafíos más importantes de la neonatología es el manejo integral del recién nacido de muy bajo peso. Objetivo: evaluar cuidados de enfermería mediante la aplicación del Proceso de Atención de Enfermería en recién nacidos menor de 1500 g. Métodos: estudio descriptivo, retrospectivo y observacional de 53 neonatos menor de 1500 g, para describir la muestra se utilizaron los números absolutos y porcientos, la asociación entre variables y la significación estadística mediante el estadígrafo Ji cuadrado. Resultados: la morbilidad fue más frecuente en el grupo menor de 30 semanas 23 (43,4 %), aportando este grupo la mayor supervivencia, 20 (37,7 %) vivos y la mayor mortalidad, 3 (5.7 %); recién nacidos con un peso entre 1250 g -1499 g 25 (42,2 %) y estadía entre 15-28 días 25 (47,2 %) también aportaron el mayor índice de sobrevida. Las complicaciones respiratorias 3 (58,5%) y la mayor mortalidad 2 (3,8%), ocurrió en pacientes con tiempo de ventilación mecánica mayor de 72 horas con 2 (3,8%); las expectativas fueron alcanzadas en 48 (90,6 %) y las acciones se evaluaron de bien en 47 80,7 %). Conclusiones: la supervivencia se relacionó de forma significativa a las acciones definidas en el proceso de atención de enfermería (p=0,003).

Introduction: preterm delivery is the main obstetric problem today. One of the most important challenges in neonatology is the comprehensive management of the very low birth weight newborn. Objective: to evaluate nursing care by applying the Nursing Care Process in newborns under 1500 g. Methods: a descriptive, retrospective and observational study of 53 neonates under 1500 g, absolute numbers and percentages, the association between variables and statistical significance were used to describe the sample using the Ji-square statistic. Results: morbidity was more frequent in the group less than 30 weeks 23 (43.4%), this group having the longest survival, 20 (37.7%) alive, and the highest mortality, 3 (5.7%); Newborns weighing between 1250 g -1499 g 25 (42.2%) and staying between 15-28 days 25 (47.2%) also contributed the highest survival rate. Respiratory complications 3 (58.5%) and the highest mortality 2 (3.8%) occurred in patients with mechanical ventilation time greater than 72 hours with 2 (3.8%); expectations were met in 48 (90.6%) and actions were evaluated as good in 47 (80.7%). Conclusions: survival was significantly related to the actions defined in the nursing care process (p = 0.003).

Introdução: o parto prematuro é o principal problema obstétrico na atualidade. Um dos desafios mais importantes da neonatologia é o manejo abrangente do recém-nascido de muito baixo peso. Objetivo: avaliar a assistência de enfermagem por meio da aplicação do Processo de Cuidado de Enfermagem em recém-nascidos menores de 1500 g. Métodos: estudo descritivo, retrospectivo e observacional de 53 neonatos abaixo de 1500 g, para descrever a amostra foram utilizados números absolutos e percentuais, a associação entre as variáveis e significância estatística utilizando o estatístico Qui-quadrado. Resultados: a morbidade foi mais frequente no grupo com menos de 30 semanas 23 (43,4%), este grupo contribuindo com a maior sobrevida, 20 (37,7%) vivos e a maior mortalidade, 3 (5,7%); Recém-nascidos com peso entre 1250 g -1499 g 25 (42,2%) e permanência entre 15-28 dias 25 (47,2%) também contribuíram com a maior taxa de sobrevida. As complicações respiratórias 3 (58,5%) e a maior mortalidade 2 (3,8%), ocorreram em pacientes com tempo de ventilação mecânica superior a 72 horas com 2 (3,8%); As expectativas foram atendidas em 48 (90,6%) e as ações foram bem avaliadas em 47 80,7%). Conclusões: a sobrevida foi significativamente relacionada às ações definidas no processo de cuidado de enfermagem (p=0,003).

Enfermedades desmielinizantes: leucodistrofia metacromática y esclerosis múltiple, a propósito de un caso / Demyelinating diseases: metachromatic leukodystrophy and multiple sclerosis, a case study

RESUMEN Las enfermedades desmielinizantes son entidades poco frecuentes en la edad pediátrica; tal es el caso de la esclerosis múltiple y la leucodistrofia metacromática, en las cuales intervienen factores genéticos y ambientales, y ambas afectan diferentes estructuras del sistema nervioso central, los nervios, los músculos, otros órganos y el comportamiento del individuo. Son afecciones que tiene una evolución progresiva al deterioro neuromuscular: en poco tiempo el paciente entra en un estado neurovegetativo con pérdida de la conciencia, por lo que requieren de atención médica y de enfermería especializada. El propósito de este estudio es presentar un caso de leucodistrofia metacromática, haciendo referencia a su complejo diagnóstico diferencial con la esclerosis múltiple y la aplicación del proceso de enfermería. Paciente masculino de 6 años de edad con antecedentes con antecedentes de diversos episodios de infecciones respiratorias y atelectasias, así como estadía prolongada en unidades de cuidados intensivos. Otros síntomas fueron hipotonía muscular, ausencia de reflejos tendinosos y trastornos audiovisuales. A la edad de 6 años el paciente había perdido todo contacto con el medio, sufrió tetraparesia y frecuentes episodios de convulsiones tónicas. A pesar de los intensos tratamientos y seguimientos en diferentes consultas, falleció a los 6 años de edad por complicaciones respiratorias.

ABSTRACT Demyelinating diseases are infrequent entities in pediatric age; such is the case of metachromatic leukodystrophy and multiple sclerosis, in which genetic and environmental factors take action. both of them affect different structures of the central nervous system, nerves, muscles, organs and individual behavior. These affections have a progressive evolution of the neuromuscular deterioration: soon the patient enters a neurovegetative state with loss of consciousness. Therefore, medical attention and specialized nursing is required. The purpose of this study is to present a case of metachromatic leukodystrophy referring to its complex differential diagnosis with multiple sclerosis and nursing process application. A 6-year-old male patient with record of several respiratory infections and atelectasis, such as extended stay at the intensive care unit. Some other symptoms were muscle hypotonia, lack of tendinous reflexes, and audiovisual disorder. At the age of 6 the patient had lost all contact with the environment, suffered from tetra paresis and frequent tonic seizure episodes. Despite the intense treatments and the follow-ups in several medical consultations, the patient passed away at the age of 6 due to respiratory complications.

Seguridad del paciente como fenómeno fundamental para el cuidado en la neuronavegación por imágenes / Patient safety as an essential phenomenon for care in imaging neuronavigation / Segurança do paciente como fenômeno essencial para o cuidado na neuronavegação por imagens

RESUMEN Objetivo:analizar el significado holístico de la seguridad del paciente como fenómeno esencial para el cuidado en la neuronavegación por imágenes. Método:este estudio se realizó entre los meses de julio a diciembre del 2020, en el Centro de Investigaciones Medico Quirurgicas, ubicado en el municipio Playa, en la Habana, Cuba. Las autoras se apoyaron en un enfoque cualitativo propiamente inductivo. Se realizó una triangulación teórica en primer lugar y en segundo lugar; hubo que recurrir a la entrevista en profundidad desde la teoria fundamentada. Resultados:la triangulación -la relación enfermera paciente como proceso interpersonal y terapéutico, otro resultado lo es el vínculo entre los valores éticos y espirituales de la enfermera y del paciente. Las debilidades que se identificaron en la triangulación: La débil explicación por parte de los profesionales de enfermería del proceder que se le va a realizar a los pacientes. Las entrevista a profundidad se ha comportado como elemento enriquecedor del estudio, al propiciar que las autoras asumieran el nombre de tratamiento quirurgicode tumores cerebrales con el uso del planificador. Conclusión:el cambio de la cultura de seguridad del paciente es un proceso en el cual los profesionales de enfermería juegan un papel protagónico.

ABSTRACTObjective: to analyze the holistic meaning of the patient's security as essential phenomenon for the care in the neuronavegación for images. Method:this study was carried out among the months of July to December of the 2020. In the Center of Investigations I Prescribe Surgical, located in the municipality Beach, in the Havana, Cuba. The authors leaned on in a properly inductive qualitative focus. He/she was carried out a theoretical triangulation in the first place, in second place; it was necessary to appeal to the interview in depth from the based theory. Results: the triangulation -the relationship patient nurse as interpersonal and therapeutic process, another result is it the bond among the nurse's ethical and spiritual values and of the patient. The weaknesses that were identified in the triangulation: The weak explanation on the part of the infirmary professionals of proceeding that he will carry out the patients. The interview to depth has behaved as enriching element of the study, when propitiating that the authors assumed the name of surgical treatment of cerebral tumors with the use of the planner. Conclusion:the change of the culture of the patient's security is a process in which the infirmary professionals play a protagonistic paper.

RESUMO Objetivo: analisar o significado holístico da segurança do paciente como fenômeno essencial para o cuidado na neuronavegação por imagens. Método: este estudio foi realizado entre os meses de julho a dezembro de 2020, no Centro de Investigações Médico Cirúrgicas, localizado no município de Playa, em Havana, Cuba. As autoras se apoiaram em um enfoque qualitativo propriamente indutivo. Realizou-se uma triangulação teórica em primeiro e segundo lugar. Recorreu-se a entrevista em profundidade a partir da teoria fundamentada. Resultados: a triangulação -a relação enfermeira paciente como processo interpessoal e terapêutico, outro resultado é isto o laço entre os valores éticos e espirituais do enfermeira e do paciente. As fraquezas que foram identificadas na triangulação: A explicação fraca por parte dos profissionais de enfermaria de proceder que ele levará a cabo os pacientes. A entrevista para profundidade se comportou como enriquecendo elemento do estudo, ao propiciar que os autores assumiram o nome de tratamento cirúrgico de tumores cerebrais com o uso do planejador.Conclusão:a mudança da cultura da segurança do paciente é um processo no qual os profissionais de enfermaria jogam um papel de protagonistic.

Nutrition Counseling in an Academic Medical Center According to Socioeconomic Status and Grocery Shopping Consumer Behavior Decreased Relative Fat Mass in Breast Cancer Survivors

ABSTRACT Background: Body composition assessment in breast cancer survivors (BCSs) is essential to plan feasible dietary strategies for sarcopenic obesity prevention. Objective: Studying the effect of an individualized nutrition intervention according to socioeconomic status and grocery shopping behavior on BCSs relative fat mass (RFM). Methods: BCSs attending an academic medical center were studied; participants saved all 1-week supermarket tickets and answered a grocery shopping consumer preference survey. RFM was assessed at baseline and after the 3-month nutrition intervention. Nutrition plans were based on the dynamic macronutrient meal-equivalent menu method (MEM) and dietary guidelines for BCSs. Results: Thirty-three BCSs completed the study and 91% of them presented obesity or overweight at baseline. After the intervention, BCSs lost 1.6 kg (p < 0.01) of body weight, 1.8 kg (p < 0.01) of RFM, 3 cm (p < 0.01) of waist circumference, and 2.4 cm (p < 0.01) of hip circumference, while no changes were observed in fat-free mass (p = 0.6) and arm bone-free muscle area (p = 0.7). Conclusions: RFM and body weight in breast cancer survivors decreased after an individualized nutrition intervention according to socioeconomic status and grocery shopping consumer behavior. Based on the participants’ food preferences and consumer behavior, plant-based protein diet plans cost less than the animal-based protein diet plans.

Inestabilidad hemodinámica durante el proceso intradialítica en usuarios con insuficiencia renal crónica / Hemodynamic instability during the intradialytic process in users with chronic renal failure / Instabilidade hemodinâmica durante o processo intradialítico em usuários com insuficiência renal crônica

La insuficiencia renal crónica es una complicación de varias enfermedades, uno de los tratamientos sustitutivos es la hemodiálisis, tratamiento donde el paciente puede presentar algunas complicaciones durante la realización de este proceso, por ende existe una gran preocupación en la alta tasa de incidencia de usuarios con enfermedades renales crónica y el cuidado que estos requieren en las unidades de hemodiálisis durante la sesión. OBJETIVO: determinar la inestabilidad hemodinámica durante el proceso intradialítica en usuarios con insuficiencia renal crónica sometidos a hemodiálisis. MÉTODO: fue un estudio descriptivo, se utilizó como técnica la observación directa y encuesta, el instrumento utilizado fue la hoja de recolección de datos sobre complicaciones en usuarios con hemodiálisis, guía de observación aplicada y el cuestionario. RESULTADOS: un 56% del sexo masculino, el 48% eran mayores de 61 años de edad, un 88% con catéter vascular; el 36% por causa glomerulonefritis, 41% con comorbilidad de hipertensión, 33% con diabetes mellitus, 67% con hipotensión intradialítica e hipertensión 33%. CONCLUSIONES: utilizando la metodología disciplinar y el lenguajes estandarizados de la taxonomía NANDA, NIC, NOC, esto facilitara la recolección sistemática de información, la toma de decisiones sobre la efectividad del cuidado enfermero, para elevar la calidad de atención y disminuir las complicaciones como la hipotensión en usuarios sometidos a hemodiálisis, para garantizar la seguridad del usuario. (AU)

Chronic kidney failure is a complication of several diseases, one of the substitute treatments is hemodialysis, a treatment where the patient may present some complications during this process, and therefore there is great concern in the high incidence rate of users with chronic kidney diseases and the care they require in the hemodialysis units during the session. OBJECTIVE: to determine the hemodynamic instability during the intradialytic process in users with chronic renal failure undergoing hemodialysis. METHOD: it was a descriptive study, direct observation and survey were used as a technique, and the instrument used was the data collection sheet on complications in users with hemodialysis, the observation guide applied and the questionnaire. RESULTS: 56% were males, 48% were older than 61 years of age, and 88% had a vascular catheter; 36% due to glomerulonephritis, 41% with comorbidity of hypertension, 33% with diabetes mellitus, 67% with intradialytic hypotension and 33% hypertension. CONCLUSIONS: using the disciplinary methodology and the standardized languages of the NANDA, NIC, NOC taxonomy, this will facilitate the systematic collection of information, decision-making on the effectiveness of nursing care, to increase the quality of care and reduce complications such as hypotension in patients. Users undergoing hemodialysis, to ensure user safety.(AU)

A insuficiência renal crônica é uma complicação de várias doenças, um dos tratamentos substitutos é a hemodiálise, um tratamento onde o paciente pode apresentar algumas complicações durante este processo, portanto existe grande preocupação na alta incidência de usuários com doenças renais crônicas e os cuidados eles exigem nas unidades de hemodiálise durante a sessão. OBJETIVO: determinar a instabilidade hemodinâmica durante o processo intradialítico em usuários com insuficiência renal crônica em hemodiálise. MÉTODO: foi um estudo descritivo, utilizou-se como técnica a observação direta e o survey, o instrumento utilizado foi a ficha de coleta de dados sobre complicações em usuários em hemodiálise, o guia de observação aplicado e o questionário. RESULTADOS: 56% eram homens, 48% tinham mais de 61 anos de idade, 88% possuíam cateter vascular; 36% devido a glomerulonefrite, 41% com comorbidade de hipertensão, 33% com diabetes mellitus, 67% com hipotensão intradialítica e 33% com hipertensão. CONCLUSÕES: usando a metodologia disciplinar e as linguagens padronizadas da taxonomia NANDA, NIC, NOC, isso facilitará a coleta sistemática de informações, a tomada de decisão sobre a eficácia da assistência de enfermagem, para aumentar a qualidade da assistência e reduzir complicações como hipotensão em pacientes usuários em hemodiálise, para garantir a segurança do usuário.(AU)

Proceso de atención de Enfermería en un paciente con gastroquisis. A propósito de un caso / Nursing care process in a patient with gastrochisis. Aproposs of a case

RESUMEN La gastroquisis, es un defecto congénito de cierre de la pared abdominal, en general justa a la derecha de la insertación normal del cordón umbilical en la pared del abdomen. Rara vez ocupa una posición especular a la izquierda del cordón umbilical; una cantidad variable de intestinos, y en ocasiones otros órganos abdominales se hernian, fuera de la pared abdominal, sin saco ni cobertura membranosa a diferencia del onfalocele. El Proceso de Atención de Enfermería, es el método científico de actuación de los profesionales de la Enfermería, vinculados a una base teórica que desarrollan habilidades analíticas que aplicadas en la práctica, repercuten en la mejoría de los pacientes. El objetivo de este trabajo es describir un caso poco frecuente de gastroquisis, y vincularlo al proceso de atención de Enfermería. Se trató de una recién nacida, sexo femenino, raza mestiza. Ingresó en la Sala de Terapia Intensiva del Hospital Pediátrico Provincial Eliseo Noel Caamaño de Matanzas con 5 horas de nacida. La vinculación de este caso con el Proceso de Atención de Enfermería permitió una atención integral al individuo enfermo, y desarrolló las habilidades prácticas de la asistencia de enfermería (AU).

ABSTRACT Gastrochisis is a congenital defect of the abdominal wall closure, generally just on the right of the umbilical cord normal insertion in the abdominal wall. It rarely occupies a specular position to the right of the umbilical cord; a variable amount of intestines, and sometimes other abdominal organs, are herniated outside the abdominal wall, without a sac or a membranous covering unlike the omphalocele. The nursing care process is a scientific method of nursing professionals behavior, on a theoretical basis, developing analytical skills that, applied in the practice, have repercussion on the patients´ improvement. Describing an infrequent case of gastrochisis, and linking it to the Nursing care process is the aim of this article. The patient was a mestizo female newborn who entered the Intensive Care Ward of the Pediatric Provincial Hospital "Eliseo Noel Caamaño" of Matanzas five hours after birth. Linking this case to the Nursing care process allowed the integral care of the sick person, and developed the nursing care practical skills (AU).

Evidence-based Nutritional Intervention Protocol for Korean Moderate-Severe Obese Children and Adolescents

Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as “inadequate energy intake,” “overweight/obesity,” or “food and nutrition-related knowledge deficit.” All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002111

The interplay of C.P.A. in elderly care towards client care satisfaction

@#<p style="text-align: justify;">This study explored the interplay of the care culture (C), caring process (P) and care agent (A) in the care of older adults towards care satisfaction and quality of life. Two elderly care facilities (public and private) were considered as cases of this study. Using case study design, four elderly clients were asked to answer the Modified Patient Satisfaction Questionnaire, and five care facility personnel were interviewed and observed. The cross-case analysis derived the themes: a) a caring governance is a felt privilege for the elderly; b) housing arrangement: security or vulnerability?; c) How did you take care of me?: Its influence on patient care outcomes; and d) Elderly care provider: What am I?. The landscape of elderly care is a combination of the environment, culture, process and the agent who made the care more effective through patient outcomes and satisfaction. These factors have interacting relationship which one to the other but ultimately leads to a question of the elderly clients' present disposition and conditions.</p>

Características humanas e institucionales que influyen en la aplicación del proceso de atención de enfermería en un hospital de la ciudad de medellín

Objetivo. Describir las características humanas e institucionales que influyen en los enfermeros para la aplicación del Proceso de Atención de Enfermería (PAE) en un hospital de la ciudad de Medellín. Métodos. Estudio descriptivo, transversal, muestra constituida por 44 enfermeros profesionales del área asistencial. Se utilizó un instrumento ad hoc que permitió el análisis de variables sociodemográficas y características humanas e institucionales que influyen en los enfermeros para la aplicación del PAE. Resultados. El 96% de la población es del sexo femenino, con rango de edades entre 21 y 61 años. En cuanto a las características que influyen desfavorablemente en la aplicación del PAE, el 73% consideró como principal la realización de procedimientos de enfermería y la actualización del kárdex, el 70%, el número de pacientes asignados, un 66% consideró influyente el servicio donde labora, seguido del acompañamiento en rondas médicas y administración de medicamentos con un 57% y un 52%, respectivamente. El 81,8% consideró que la aplicación del PAE mejora la calidad de atención de los pacientes. Conclusion. Los enfermeros identifican el PAE como un instrumento óptimo y necesario para guiar el cuidado de enfermería, y lograr identidad profesional. No obstante, su aplicación es parcial y discontinua, por lo que influye en la atención brindada a los sujetos de cuidado.

Objective. To describe the human and institutional characteristics that influence the nurses in the application of the Nursing Care Process (PAE in Spanish) in a Hospital of the city of Medellin. Methods. Descriptive, cross-sectional study, sample constituted by 44 professional nurses of the healthcare field. An Ad Hoc instrument was applied, it allowed the analysis of sociodemographic variables and human and institutional characteristics that influence nurses in the application of PAE. Results. 96% of the population is female, with a range of ages between 21 and 61 years old. As for the characteristics that have an unfavorable influence on the application of the PAE, 73% consider relevant carrying out nursing procedures and updating the Kardex, 70%, the amount of patients assigned, a 66% considered that the service performed has an impact, followed by medical assistance shifts and drug administration with 57% and 52%, respectively. 81.8% consider that the application of the PAE improves the quality care of patients. Conclusion. The nurses identify the PAE as an optimal and necessary instrument to guide nursing care, and achieve professional identity. However, its application is partial and not continuous, which is why it influences the patients care.

Objetivo. Descrever as características humanas e institucionais que influenciam os enfermeiros para a aplicação do Processo de Cuidados de Enfermagem (Proceso de Atención de Enfermería, PAE) em um hospital da cidade de Medellín. Métodos. Estudo descritivo, transversal; amostra constituída por 44 enfermeiros profissionais da área da saúde. Foi utilizado um instrumento ad hoc que permitiu análise de variáveis sociodemográficas e características humanas e institucionais que influenciam aso enfermeiros para a aplicação do PAE. Resultados. 96% da população é do sexo feminino, com um intervalo de idades entre 21 e 61 anos. Quanto às características que têm influência desfavorável na aplicação do PAE, 73% consideram como principal a realização de procedimentos de enfermagem e a atualização do kardex; 70%, o número de pacientes designados; 66% consideram o serviço onde eles trabalham influente, seguido do acompanhamento em rodadas médicas e administração de medicamentos com 57% e 52%, respectivamente. 81,8% consideram que a aplicação do PAE melhora a qualidade do atendimento os pacientes. Conclusão. Os enfermeiros identificam o PAE como um instrumento ideal e necessário para orientar os cuidados de enfermagem e alcançar a identidade profissional. Contudo, sua aplicação é parcial e descontínua, razão pela qual influencia a atenção dada a sujeitos de cuidados.

Evaluación de la calidad de la atención en salud y enfermería en un Hogar de Ancianos / Evaluation of the quality of health care and nursing in a Nursing home

RESUMEN Introducción: El envejecimiento poblacional es un fenómeno demográfico de trascendencia mundial. Objetivo: Evaluar la calidad de la atención en salud y de enfermería que se brinda a los adultos mayores. Métodos: Investigación descriptiva longitudinal en el Hogar de Ancianos de Pinar del Río, durante 2013. Universo de 80 ancianos y 17 enfermeras relacionadas con la atención a los ancianos. Se evaluó la estructura, proceso y resultados. Para obtener la información se aplicó un instrumento diseñado por los autores y validado por expertos. El procesamiento de los datos se efectuó con frecuencias absolutas y porcentajes. Resultados: Existe buena cobertura de recursos humanos, siendo las asistentes para la atención de servicios de enfermería el más bajo porcentaje. El equipamiento técnico representó el 93,10 por ciento ocasionado por roturas, están los recursos materiales suficientes para atender a los adultos mayores. Existen procesos aplicados según morbilidad que aunque evaluados de aceptable se encuentran por debajo del 100 por ciento. Conclusión: La estructura no presenta insuficiencias en lo relativo a recursos humanos y materiales, lo que unido a la no presencia de problemas organizativos y de calidad de las historias clínicas, y en la instrumentación y aplicación del PAE, influyen positivamente en la calidad del proceso de atención; existe satisfacción con la calidad de la atención al adulto mayor(AU)

ABSTRACT Introduction: Population aging is a demographic phenomenon of global significance. Objective: To evaluate the quality of health care and nursing the elderly is provided. Methods: A longitudinal descriptive research in the Nursing Home of Pinar del Rio, in 2013. Universe 80 elderly and 17 nurses related to elderly care. the structure, process and results were evaluated. For information an instrument designed by the authors and validated by experts applied. The data processing was carried out with absolute frequencies and percentages. Results: There is good coverage of human resources, with the care assistants nursing the lowest percentage. The technical equipment accounted for 93.10 percent caused by breakage, material resources are sufficient to meet the elderly. There are processes applied according morbidity but acceptable are evaluated below 100 percent. Conclusion: the structure has no shortcomings in terms of human and material resources, which together with the non-presence of organizational problems and quality of medical records, and in the implementation and application of SAP positively influence the quality of the process of attention; There is satisfaction with the quality of care for the elderly(AU)

Evaluación de la calidad de la atención al adulto mayor en el primer nivel de salud / Evaluation of quality of care for the elderly in primary health care

Introducción: El envejecimiento poblacional constituye un problema demográfico y social a nivel mundial, del que Cuba no está exenta. El sistema de salud cubano tiene como objetivo incrementar los niveles de salud, la calidad de los servicios y la satisfacción de la población y sus prestadores. Cuba posee el 19,8 por ciento de la población de 60 y más años, cifra con tendencia al aumento en los años futuros, la que demanda incremento en los servicios de salud de calidad, por lo que evaluar la atención que se presta constituye una necesidad en el nivel primario. Objetivo: Evaluar la calidad del proceso de atención que se brinda a las personas mayores en unidades del primer nivel de salud. Métodos: Se realizó una investigación en sistemas y servicios de salud, cuya información se obtuvo mediante formularios validados en Consultorios de Médicos de la Familia y Grupos Básicos de Trabajo, como fuente de información se empleó la historia clínica de cada paciente. Resultados: La calidad de la atención en los Consultorios de Médicos de la Familia y Grupos Básicos de Trabajo mostró insuficiencias de acuerdo con los estándares establecidos, lo que evidencia la poca prioridad que se le presta a la atención del adulto mayor en el primer nivel de salud. Conclusiones: La calidad de la atención al adulto mayor en los Consultorios de Médicos de la Familia y Grupos Básicos de Trabajo evaluados mostró incumplimientos de acuerdo a lo establecido(AU)

Introduction: Population aging is a demographic and social problem worldwide, and Cuba is not an exception. The objective of the Cuban health system is to increase health levels, the quality of services and the satisfaction of the population and its providers. Cuba has 19.8 por ciento of its population at age 60 and over, a figure with a tendency to increase in future years, which demands an increase in quality health services, a reason why evaluating the care provided is a necessity at the primary level. Objective: To evaluate the quality of the care process provided to the elderly in units of the first level of health. Methods: An investigation was carried out in health systems and services, whose information was obtained through forms validated in family doctor's offices and basic work groups, as a source of information the clinical history of each patient was used. Results: The quality of care in family doctor's offices and basic work groups showed insufficiencies according to the established standards, which shows the low priority that is given to the care of the elderly in the first level of healthcare. Conclusions: The quality of care for the elderly in the family doctor's offices and basic work groups evaluated showed non-compliance according to what was established(AU)

Evaluación del proceso de atención al adulto mayor con afecciones respiratorias tratado con fitofármacos. Municipio Colón / Evaluation of the health care process of elder people with respiratory diseases treated with herbal medical products. Municipality of Colon

Introducción: actualmente muchas personas sobrepasan las barreras cronológicas situadas como etapa de vejez, y esto puede transformarse en un problema si no se es capaz de brindar soluciones adecuadas a las consecuencias que del mismo se derivan. Objetivo: evaluar el proceso de atención a los adultos mayores con afecciones respiratorias tratados con fitofármacos. Materiales y métodos: se realizó un estudio observacional descriptivo de corte transversal en los 861 adultos mayores con diagnóstico de infección respiratoria aguda tratados con fitofármacos en los consultorios pertenecientes al Policlínico Dr. "Francisco Figueroa Véliz", del municipio Colón, provincia Matanzas, en el período comprendido entre julio y diciembre del 2015. Se analizaron los indicadores: adultos mayores con infección respiratoria aguda tratados con fitofármacos registrados en el consultorio, seguimiento médico a dichos pacientes, indicaciones correctas de fitofármacos, indicación de complementarios, inter-consultas realizadas y comportamiento de la certificación de calidad emitida a las producciones realizadas. Para la recolección de información se utilizó un instrumento que fue validado en su funcionamiento. Resultados: de los seis indicadores evaluados no alcanzaron los estándares establecidos el seguimiento médico a los adultos mayores con infección respiratoria aguda tratados con fitofármacos pues solo en el 95 % de las historias clínicas había constancia y la certificación de calidad ya que de los 220 lotes elaborados solo fueron analizados por control de la calidad el 81 % de ellos, por lo tanto el componente Proceso no es adecuado. Conclusiones: todas las unidades organizativas del área de salud presentan problemas con el proceso que se desarrolla (AU).

Background: currently many people surpass the chronological barriers limiting the old age stage, and this can become a problem if adequate solutions are not given to the consequences derived from it. Objective: to evaluate the health care processes of elder people treated with herbal medical products. Materials and methods: a cross-sectional, observational, descriptive study was carried out in 861 elder people with acute respiratory infection (ARI) treated with herbal medical products in the medical consultations belonging to the Policlinic "Dr. Francisco Figueroa Véliz" of the municipality of Colon, province of Matanzas, in the period July-December 2015. The indicators analyzed were elder people with acute respiratory infection treated with herbal medical products registered in the consultations, their medical follow-up, correct indication of herbal medical products, indication of complementary tests, inter- consultations and behavior of the quality certifications emitted for the elaborated production. For collecting information, it was used an instrument validated in its functioning. Results: of the six indicators evaluated, the follow-up to elder people with ARI treated with herbal medical products did not reach the average standards because in only 95 % of the clinical records it was registered; the quality certification was also deficient, because only the 81 % of the 220 lots elaborated was analyzed by quality control, therefore the component Process is not suitable. Conclusions: all the organizational units of the health area have problems with the developed process (AU).

Exploration of Pharmaceutical Care Process for Pregnancy Combined with Hypothyroidism or Hyperthyroidism / 中国药学杂志

OBJECTIVE: To explore standardized pharmaceutical care service mode from establishment of process for pregnancy combined with hypothyroidism or hyperthyroidism. METHODS: According to evidence-based medicine, relevant regulations and clinical practice, the pharmaceutical care process was established and tried out based on the clinical pharmacists' daily work. We used methods of pharmaceutical care classification and standard record forms to carry out the systematic, real-time and continuous medical supervision work for patients. RESULTS: Pharmaceutical care was performed on forty-two patients with hypothyroidism or hyperthyroidism in accordance with this procedure. Clinical pharmacists participated in the optimization of drug treatment regimens, intervened with irrational use of drugs, and advised on drug adverse reactions. CONCLUSION: The practice of pharmaceutical care process is beneficial for clinical pharmacists to carry out pharmaceutical service in depth and ensure the safety of drug use. Standardization can promote this procedure in the industry field, as well as promote the improvement and homogenization of professional skill level and pharmacy service ability of clinical pharmacists in gynecology and obstetrics.

A study on application of systematic emergency nursing process in neonatal hypoxic ischemic encephalopathy / 中国中西医结合急救杂志

Objective To study the application effect of systematic emergency nursing process in treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods One hundred and four neonates with HIE who were treated in the First Hospital of Hebei Medical University from January 2016 to January 2018 were selected as the subjects of this study, and they were divided into a control group and a study group according to different nursing care process, with 52 cases in each group. The infants in the control group were resuscitated according to conventional traditional first aid measures, while the infants in the study group received systematic emergency nursing care process on the basis of routine first aid (including the preparation of early rescue drugs and equipment; warmth kept in the whole course, the room temperature controlled in 30 - 32 ℃; rapid assessment of maternal delivery methods and procedures, delivery of the newborn and assessment of babies general conditions; performance of preliminary resuscitation for neonate, tracheal intubation for mechanical ventilation, and external chest compression if necessary; close monitor of the vital signs of newborn; symptomatic treatment; reassessment of the baby's disease condition). The successful rescue rate, total rescue time, hospitalization time, neonatal Apgar score and quality of nursing care before and after resuscitation were compared between the two groups. Results The successful rescue rate of the study group was higher than that of the control group [96.2% (50/52) vs. 82.7% (43/52), P < 0.05], and the total rescue time (minutes: 8.9±2.1 vs. 12.4±3.2) and hospitalization time (days: 8.1±2.2 vs. 11.4±2.9) in study group were shorter than those in control group, all the differences being statistically significant (all P < 0.05). After resuscitation for 5 minutes, the Apgar scores of the newborns in the two groups were higher than those before the resuscitation (study group: 8.3±1.1 vs. 2.2±0.7, control group: 6.7±2.0 vs. 2.1±0.9), and after resuscitation for 5 minutes, the Apgar score of the study group was higher than that of the control group (8.3±1.1 vs. 6.7±2.0), the difference being statistical significant (P < 0.05). The scores of rescue technique (5.0±2.9 vs. 2.7±0.6), humanistic care (5.6±2.1 vs. 2.8±0.9), rescue efficiency (5.3±1.2 vs. 3.0±0.6), and rescue effect (5.7±1.3 vs. 2.9±0.8) in the study group were all higher than those in the control group (all P < 0.05). Conclusion The systematic emergency nursing care process can effectively elevate the successful rescue rate of neonates with HIE, shorten the total rescue time and hospitalization time, enhance the rescue effect, and improve the quality of nursing care, thus it is worthy to be widely applied clinically.

Psychoéducation des parents de patients souffrant de schizophrénie suivis au CNHUP de Cotonou (Bénin) / NA

La prise en charge des malades mentaux nécessite d'intégrer leur famille dans l'équipe soignante. Ce travail montre l'intérêt de la psychoéducation dans la prise en charge des patients souffrant de schizophrénie. 40 parents de patients souffrant de schizophrénie ont bénéficié par groupes fermés de 10 du programme Profamille dans le but d'accroitre l'efficacité de la prise en charge. Des modules psychoéducatifs leur ont été proposés. 72,5% des participants étaient de sexe féminin. Pour tous les groupes réunis 45% ont débuté et terminé les séances. Pour 49,12% des participants les causes de la schizophrénie sont d'ordre culturel. Leurs premières réactions face à la maladie sont tardives et les troubles anxiodépressifs représentent les principales répercussions de la maladie. L'application de ce programme a permis de discuter des croyances sur la maladie, d'accroitre le niveau de connaissance des parents sur la schizophrénie, de leur faire acquérir des compétences pour y faire face. Le programme profamille permet d'accroitre l'efficacité thérapeutique.

The care of the mental sick requires to integrate their family into the medical team. This work shows the interest of psychoeducation in the management of schizophrenics. 40 parents of schizophrenics benefited by groups closed by 10 of the program profamille in order to increase the efficiency of care. The various psychoeducatif modules have been proposed to them. 72.5% of the participants were female. For all the gathered groups, 45% began and ended the sessions. For 49.12% of the participants the causes of schizophrenia are of cultural order. Their first reactions in front of the disease are late and the anxiodepressifs disorders represent the main repercussions of the disease. The application of this program allowed to discuss beliefs about the disease, to increase parents' knowledge of the schizophrenia, and to make them acquire skills to face it. The profamily program allows to increase the therapeutic efficiency.

Experiencia de los alumnos de la licenciatura en enfermería en el aprendizaje y aplicación del proceso de atención de enfermería / The experience of Bachelor's Nursing degree students in the learning and implementation process of Nursing care

Introducción: El cuidado de la salud es el objeto de estudio de la disciplina, práctica propia para atender a la persona, familia y comunidad. Mientras el Proceso de Atención de Enfermería (PAE) es el método de intervención distintivo de la profesión, el cual aprenden los estudiantes durante su formación, sin embargo, la esencia de este proceso no se manifiesta durante la teoría y el desarrollo de su práctica clínica, esta investigación se enfoca en la experiencia del alumno en el aprendizaje y aplicación del PAE. Objetivos: a) Describir cómo es la experiencia de los alumnos de la Licenciatura en Enfermería en el aprendizaje y aplicación del proceso de atención de enfermería durante su formación académica. b) Identificar si el estudiante reconoce al PAE como la metodología propia de la disciplina para otorgar el cuidado. Metodología: Estudio cualitativo descriptivo, con enfoque fenomenológico, utilizando entrevista en profundidad y grupo focal, participando previo consentimiento informado alumnos del 3ro al 7mo semestre, de los períodos 2016-2 y 2017-1 de la Licenciatura en Enfermería ENEO-UNAM, el análisis del discurso se realizó por saturación, codificando y descodificando, transcribiendo las entrevistas del lenguaje emic al etic, construyendo 3 categorías. Resultados: La primera: "Mundos diferentes" tuvo tres subcategorías, darse cuenta, vinculación teoría-práctica e influencia del profesional de enfermería. La segunda: "Formación teórica" tuvo dos subcategorías, aprendizaje complejo y, salud y enfermedad. La tercera categoría: Ambivalencia en la enseñanza del PAE por el docente" contó con dos subcategorías, heterogeneidad y desavenencia docente, y acompañamiento del profesor. Conclusiones: Los estudiantes de la Licenciatura en Enfermería ENEO-UNAM reconocen al PAE como una metodología necesaria para otorgar el cuidado, pero no han logrado construir una intencionalidad hacia esta herramienta de trabajo del cuidado que les permita abordarla de forma natural y razonada, creando un puente entre el ser y hacer de enfermería.

Introduction: Health care is the subject matter of Nursing care that in practice caters to the individual, family and community assistance. Considering that Nursing care process (PAE) is the distinctive method of intervention of this discipline which students learn during their training, however, the essence of this process does not manifest itself during the development of their clinical and theoretical practice. Specifically, the present research focuses on the experience of students along their learning and implementation PAE process. Objectives a) To describe the experience of the Bachelor's Nursing degree students regarding nursing care learning and its implementation process during their academic training. b) To identify if students recognize the PAE as the cornerstone methodology to provide care. Methodology The Descriptive qualitative, phenomenological approach is used to generate interview in depth and focal group. The participants in this research, with prior informed consent, are students from the 3rd to the 7th semester rom the periods 2016-2, and 2017-1 ENEO-UNAM Bachelor's nursing degree. The analysis of the discourse was made by saturation, encoding and decoding, transcribing the emic language interviews to the etic language into three categories. Results The first category called ""Different worlds"" had three subcategories to become aware, bonding and influence of the nursing professional. The second category denominated ""Theoretical training"" had two subcategories: complex learning, health and disease. The third category entitled ""Teacher's ambivalence in the teaching PAE"" had two subcategories, on one hand, heterogeneity and teaching disagreement, and, on the other hand, professor's monitoring. Conclusions The ENEO-UNAM Bachelor's nursing degree students recognize the PAE as an essential methodology to provide care, but have failed to build a purpose to address this work tool of care in such way that allows them to deal with it naturally and satisfactorily by building a bridge to fill the gap between being and doing nursing.