Percepción de los pacientes hospitalizados respecto del cuidado de enfermería

Resumen: Introducción: La atención humanizada requiere la interacción entre los conocimientos científicos y los valores, generando la necesidad de particularizar los cuidados, siendo esta una actividad esencial en enfermería. Objetivo: Analizar la percepción que tienen los usuarios hospitalizados respecto del cuidado humanizado que reciben por parte de las profesionales de enfermería. Metodología: Se desarrolló una investigación de tipo cuantitativa, descriptiva, correlacional y de corte transversal, que incluyó a los usuarios hospitalizados en los Servicios Clínicos de Medicina, Cirugía, Pensionado y representantes legales de pacientes menores de 18 años en Pediatría, de un hospital público ubicado en el sur de Chile, con una muestra de 377 participantes. Posterior a aplicación de consentimiento informado, se aplicó una caracterización sociodemográfica y el instrumento Percepción de Comportamientos de Cuidado Humanizado de Enfermería - versión 3, con adaptación transcultural para la población chilena, el cual fue complementado con otros datos pertinentes a los objetivos de la investigación. Resultados: Se encontró que las personas participantes en su mayoría reconocieron al profesional de enfermería por el uniforme, y pese a existir algunas diferencias en cada servicio, refirieron satisfacción con el cuidado recibido (84,6 %). Aspectos como la edad, el tiempo de hospitalización y el reconocimiento del personal de enfermería, evidenciaron relación estadística con la satisfacción. Conclusiones: Se requiere implementar estrategias para fortalecer la percepción del cuidado humanizado de enfermería, siendo estos aspectos una contribución para la construcción de un clima y cultura organizacional que evidencien esta perspectiva de cuidado.

Resumo: Introdução: Uma atenção humanizada requer a interação entre saberes científicos e valores, gerando a necessidade de particularização ou cuidado, sendo essa uma atividade essencial na enfermagem. Objetivo: Analisar a percepção que os usuários hospitalizados têm sobre o atendimento humanizado que recebem dos profissionais de enfermagem. Método: Es uma investigação quantitativa, descritiva, correlacional e transversal, que incluiu os usuários hospitalizados nos Serviços de Medicina, Cirurgia, Pensionista e representantes legais de pacientes menores de 18 anos em Pediatria, de um hospital público localizado no sul do Chile, com uma amostra de 377 participantes, Após a aplicação do consentimento informado, foi aplicada uma caracterização sociodemográfica e foi aplicado o instrumento Percepção de Comportamentos de Assistência Humanizada de Enfermagem - versão 3, com adaptação transcultural para a população chilena, ou que foi complementado com outros dados pertinentes aos objetivos da pesquisa. Resultados: Verificou-se que os participantes, em sua maioria, reconheciam ou profissionais de enfermagem pelo uniforme e, apesar da existência de algumas diferenças em cada Serviço, relatam sentir-se satisfeitos com o atendimento recebido (84,6 %). Aspectos como a idade, tempo de internação e reconhecimento da equipe de enfermagem apresentam relação estatística com a satisfação. Conclusões: É necessário implementar estratégias que fortaleçam a percepção do cuidado humanizado de enfermagem, sendo esses aspectos uma contribuição para a construção de um clima e cultura organizacional que demonstrem essa perspectiva de cuidado.

Abstract: Introduction: Humanized care requires the interaction between scientific knowledge and values, generating the need to particularize care, which is an essential activity in nursing. Objective: To analyze the perception of hospitalized users regarding the humanized care they receive from nursing professionals. Methodology: A quantitative, descriptive, correlational, and cross-sectional research was carried out, which included hospitalized users in the Clinical Services of Medicine, Surgery, Private, and legal representatives of patients under 18 years of age in Pediatrics, of a public hospital located in the south of Chile, with a sample of 377 participants. After the application of informed consent, it was applied a sociodemographic characterization as well as the instrument Perception of Humanized Nursing Care Behaviors - Version 3, with transcultural adaptation for the Chilean population, which was complemented with other data pertinent to the objectives of the research. Results: It was found that most of the participants recognized the nursing professional by the uniform, and despite some differences in each service, they reported satisfaction with the care received (84.6%). Aspects such as age, length of hospitalization and recognition of the nursing staff showed a statistical relation with satisfaction. Conclusions: It is necessary to implement strategies to strengthen the perception of humanized nursing care, being these aspects a contribution to the construction of an organizational climate and culture that evidences this perspective of care.

Atención de Enfermería durante el postoperatorio a paciente sometido a clipaje de aneurisma por ruptura / Postsurgical Nursing Attention on a patient who underwent aneurysm clipping / Assistência de enfermagem no pós-operatório ao paciente submetido a ruptura de aneurisma

Introducción Es reconocido que el personal de enfermería es quien tiene mayor interacción con el paciente, por lo que se ve obligado a contar con conocimientos y experiencia suficiente que permita identificar y atender las necesidades de individuos que sufren de enfermedad cerebrovascular. Esta condición de salud puede ser secundaria a la ruptura de un aneurisma, lo que conduce al paciente a un estado crítico; además, puede traducirse en riesgo para el equilibrio financiero de la familia y el Sistema Sanitario. Métodos: Se desarrollaron las etapas del proceso de cuidado de enfermería centradas en una situación real de la práctica clínica durante el periodo postoperatorio de una paciente sometida a clipaje de aneurisma. Se utilizó el modelo de patrones funcionales de Marjory Gordon para la recolección de los datos; además de la taxonomía NANDA-NIC-NOC. Resultados: Se presentan los planes de cuidado en los que se centró la intervención de enfermería en la paciente valorada. Así como la evaluación del proceso en las dimensiones de estructura, proceso y resultado. Discusión/conclusiones: El EVC secundario a ruptura de aneurisma cerebral es una situación grave y devastadora para la familia y el sistema sanitario. Por tanto, una adecuada atención de enfermería a este problema es de la mayor importancia.

Introduction: It is well acknowledged that nursing staff have the greatest interaction with patients and thus, nurses need to have sufficient knowledge and experience to identify the diverse needs, for example of those patients suffering from cerebrovascular disease. This condition can be a consequence of a ruptured aneurysm, which can in turn lead the patient to a critical status jeopardizing the financial equilibrium of his/her family and the health system. Methods: The nursing process stages were developed during the postsurgical period of a patient who underwent an aneurysm clipping. The Gordon's functional health patterns model was used to collect data, in addition to the NANDA/NIC/NOC taxonomy. Results: Care plans derived from the nursing intervention were presented, as well as the related assessment in terms of the structure, process, and results dimensions. Discussion/Conclusion: The CVE secondary to the rupture of an aneurysm is a serious and devastating situation for the patient, his/her family, and the health system, therefore, an adequate related nursing attention becomes of the most importance.

Introdução: Reconhece-se que os enfermeiros têm maior interação com o paciente, sendo obrigados a ter conhecimento e experiência suficientes para identificar e atender às necessidades dos indivíduos portadores de doença cerebrovascular. Essa condição de saúde pode ser secundária à ruptura de um aneurisma, que leva o paciente a um estado crítico; além disso, pode ser traduzido em risco para o equilíbrio financeiro da família e do Sistema de Saúde. Métodos: Desenvolveram-se as etapas do processo de cuidar em enfermagem, enfocando uma situação real da prática clínica no pós-operatório de um paciente submetido a clipagem de aneurisma. O modelo de padrões funcionais de Marjory Gordon foi utilizado para coleta de dados; além da taxonomia NANDA-NIC-NOC. Resultados: São apresentados planos de cuidados em que a intervenção de enfermagem foi focada no paciente valorizado. Assim como a avaliação do processo nas dimensões de estrutura, processo e resultado. Discussão / conclusões: A EVC secundária a um aneurisma cerebral roto é uma situação grave e devastadora para a família e o sistema de saúde. Portanto, cuidados de enfermagem adequados para este problema são de extrema importância.

Patient Safety Management Activities of Clinical Nurse: A Modified Theory of Planned Behavior / 간호행정학회지

PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.

Satisfacción laboral de enfermería. Diferencias de ámbitos en atención primaria en salud y cuidado intensivo / Nursing job satisfaction. Differences of areas in primary health care and intensive care

La satisfacción laboral en la enfermería establece la calidad de los servicios prestados. Al determinar esta en ámbitos hospitalarios como unidades de cuidado intensivo y en la Atención Primaria en Salud en ámbito comunitario, a través del autoreporte de 280 enfermeros con la aplicación del cuestionario Font roja de 24 ítems, se encuentra que el 39,6% de la población está entre los 20 y 30 años, donde el ámbito comunitario posee medias más elevadas y estadísticamente significativas (p=0,00) en la relación interpersonal con sus jefes y compañeros, percepciones que favorecen a la autonomía del profesional de enfermería. El ámbito hospitalario goza de mayor satisfacción por el trabajo, de igual forma se satisface mejor con la competencia profesional. La monotonía laboral que manifiesta la escasa variedad del trabajo es autodeclarada con una media mayor en el ámbito comunitario, y afirmada con un OR de 2,36 (p=0,00) considerándose un factor de riesgo para este. Para concluir, la satisfacción laboral comparada en dos ámbitos laborales ratifica una realidad ante la insatisfacción de las relaciones interpersonales con los compañeros y jefes del ámbito hospitalario y la monotonía como factor de riesgo en ambientes comunitarios.

Nursing job satisfaction establishes the quality of the services provided. When determining this in hospital settings as intensive care units and Primary Health Care in the community, through the self-report of 280 nurses with the application of Font Roja questionnaire of 24 items, it is found that 39.6% of the population is between 20 and 30 years old, where the community environment has higher and statistically significant averages (p=0.00) in the interpersonal relationship with their heads and colleagues, perceptions that favor the autonomy of the nursing professional. The hospital environment enjoys greater satisfaction with work, in the same way, it is better satisfied with professional competence. The labor monotony that manifests the scarce variety of work is self-reported with a higher average in the community environment, and affirmed with an OR of 2.36 (p = 0.00), considering it a risk factor for this. To conclude, comparative job satisfaction in two work environments ratifies a reality of the dissatisfaction of interpersonal relationships with colleagues and heads of the hospital environment and monotony as a risk factor in community environments.

The Current Status of Professional Medical Support Staffs in General Hospitals less than 500 Beds / 임상간호연구

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.

The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds / 중환자간호학회지

PURPOSE: This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS).METHOD: The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others.RESULTS: Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics.CONCLUSION: To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

The Current Status of Professional Medical Support Staffs in Medical Institutions with over 500 Beds / 임상간호연구

PURPOSE: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. METHODS: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. RESULTS: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. CONCLUSION: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.

Factors Affecting Nurse Clinicians' Knowledge and Attitude of Organs Procurement from Brain Dead Patients / 중환자간호학회지

PURPOSE: This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians.METHODS: A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis were used.RESULTS: The mean score for knowledge of organ procurement from brain dead patients was 12.41 ± 2.16 (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (β = .454, p < .001), a recent family death (β = .187, p = .014), experience recognizing potential brain dead patients (β = .182, p = .033), and experience referring to potential brain dead patients (β = -.192, p = .048).CONCLUSION: To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.

Aspectos que facilitan o interfieren el proceso comunicativo entre el profesional de enfermería y el paciente en estado crítico / Aspectos que facilitam ou interferem o processo comunicativo entre o profissional de enfermagem e o paciente em estado crítico / Aspects that facilitate or interfere in the communication process between nursing professionals and patients in critical state

Objetivo. Describir los aspectos que facilitan o interfieren en el proceso comunicativo entre el profesional de enfermería y el paciente en estado crítico. Metodología. Estudio descriptivo realizado durante el segundo semestre del 2013, en el cual participaron 112 enfermeras que laboraran en unidades de cuidado intensivo de Bogotá (Colombia). Para la recolección de la información las investigadoras diseñaron una encuesta. Resultados. El 91.6% de los profesionales de enfermería considera importante la comunicación con el paciente y su familia; el 75.9% intenta proporcionar, durante la intervenciones de cuidado, cuidado físico y comunicarse por turno de 2 a 4 veces con el paciente y de 1 a 2 veces con la familia; el 50% refiere sentir temor para comunicarse; tan solo el 53.7% integra las emociones en el cuidado físico del paciente. Con respecto a los elementos de comunicación desarrollados en su formación posgraduada, el 42.8% recibió herramientas sobre comunicación terapéutica en su pregrado y solo un 33.0% en el posgrado. Cabe señalar que el 80.36% de las unidades de cuidado intensivo, en donde laboran los profesionales de enfermería, privilegia las intervenciones orientadas a satisfacer necesidades fisiológicas. Conclusión. El proceso comunicativo entre la enfermera y el paciente en estado crítico está limitado por las políticas restrictivas institucionales y por la escasa formación académica de las enfermeras. Hay necesidad de iniciar un proceso de cambio en relación con los modelos de práctica profesional profundamente arraigados en el cuidado físico del paciente crítico con el fin de establecer modelos que, durante el cuidado físico, estén centrados en la comunicación y relación paciente-familia-profesional...

Objective. To describe aspects facilitating or interfering in the communication process between nursing professionals and patients in critical state. Methodology. Descriptive study conducted during the second semester of 2013, with the participation of 112 nurses who work in Intensive Care Units of Bogotá (Colombia). To gather the information, the researchers designed a survey. Results. A total of 91.6% of the nursing professionals considers communication important with patients and their families; 75.9% seeks to provide, during the care interventions, physical care and communicate per shift from two to four times with the patient and from one to two times with the family; 50% states feeling afraid to communicate; only 53.7% integrate their emotions in the patient’s physical care. Regarding the elements of communication developed during their graduate formation, 42.8% received tools of therapeutic communication during their undergraduate studies and only 33.0% during graduate studies. It is worth to indicate that 80.36% of the Intensive Care Units, where the nursing professionals work, privilege interventions aimed at satisfying physiological needs. Conclusion. The communication process between nurses and patients in critical state is limited by restrictive institutional policies and by the nurses’ scarce academic formation. The need exists to start a process of change in relation to models of professional practice deeply rooted in physical care of critical patients to establish models that, during physical care, are centered on communication and the patient-family-professional relationship...

Objetivo. Descrever os aspectos que facilitam ou interferem no processo comunicativo entre o profissional de enfermagem e o paciente em estado crítico. Metodologia. Estudo descritivo realizado durante o segundo semestre do 2013, no qual participaram 112 enfermeiras que trabalharam em unidades de cuidado intensivo de Bogotá (Colômbia). Para a recolha da informação as pesquisadoras desenharam uma enquete. Resultados. 91.6% dos profissionais de enfermagem considera importante a comunicação com o paciente e sua família; 75.9% tenta proporcionar, durante a intervenções de cuidado, cuidado físico e comunicar-se por turno de 2 a 4 vezes com o paciente e de 1 a 2 vezes com a família; 50% refere sentir temor para comunicar-se; tão só 53.7% integra as emoções no cuidado físico do paciente. Com respeito aos elementos de comunicação desenvolvidos em sua formação pós-graduada, 42.8% recebeu ferramentas sobre comunicação terapêutica em sua graduação e só um 33.0% na pós-graduação. Cabe assinalar que 80.36% das unidades de cuidado intensivo, em onde trabalham os profissionais de enfermagem, privilegia as intervenções orientadas a satisfazer necessidades fisiológicas. Conclusão. O processo comunicativo entre a enfermeira e o paciente em estado crítico está limitado pelas políticas restritivas institucionais e pela escassa formação acadêmica das enfermeiras. Há necessidade de iniciar um processo de mudança em relação com os modelos de prática profissional profundamente arraigados no cuidado físico do paciente crítico com o fim de estabelecer modelos que, durante o cuidado físico, estejam centrados na comunicação e relação paciente-família-profissional...

Application of error-correction education mode for diabetic dietary education in the nursing specialist outpatient service / 中国实用护理杂志

Objective To explore the best mode of diabetic dietary education in the nursing specialist outpatient service,which is suit for China's national situation.Methods A total of 100 diabetic patients consulting diabetes diet in the nursing specialist outpatient service were divided into observation group and control group with 50 cases each by random digits table method.The routine sermonic education mode was used in control group,while the error-correction education mode was used in observation group.The question-real-time evaluation was performed at the end of the education and a follow-up evaluation after 6 months of intervention was evaluated.Results Grasp of the knowledge of diabetes diet in observation group immediately after education and 6 months after education were better than those in control group,t=3.07,3.06,P＜0.01.In the follow-up evaluation after 6 months of intervention,fasting blood glucose and glycosylated hemoglobin were (6.84±0.79) mmol/L,(6.83±0.36) ％ in observation group and (7.56±0.93) mmol/L,(7.67±0.87) ％ in control group.The indices in observation group were significantly better than those in control group,t=-4.17,-6.32,P＜0.01.Conclusions Using the error-correction education mode can correct the false dietary behavior of patients and improve the effect of the diabetic dietary education more effectively.

The Job Experience of Oncology Nurse Specialists

PURPOSE: The purpose of the study was to explore and describe the job experiences of oncology nurse specialists. METHODS: Nine oncology nurse specialists participated in the study. Data were collected through in-depth unstructured interviews with individual participants from February to June, 2014. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Corbin and Strauss's grounded theory method. RESULTS: From open coding, 98 concepts, 24 sub-categories, and 11 categories were identified. Analysis revealed that the core category of the job experiences of oncology nurse specialists was 'tightrope walking of professionalism without safeguards', consisting of four phases: Enthusiastic beginning, conflict, exertion, and internalization. To manage the 'tightrope walking of professionalism without safeguards', participants utilized various action/interactional strategies such as 'keeping the balance point' and 'taking a step forward.' As a result, participants experienced falling into a habitual routine and professional self-actualization. CONCLUSION: In-depth understanding of the job experiences of oncology nurse specialists will guide hospital administrators to promote effective interventions and policies to better support Korean oncology nurse specialists.

Clinical Nurses' HPV-related Knowledge and Perception of Cancer Causes: HPV Vaccinated vs. Not Vaccinated / 여성건강간호학회지

PURPOSE: The purpose of this study was to compare knowledge level of those clinical nurses who received HPV vaccine and those who did not and their perception of the relatedness of HPV vaccine to causes of cervical cancer. METHODS: A total of 249 clinical nurses were surveyed from June to July, 2009. The questionnaire originally developed by Kim & Ahn (2007) examined HPV-related knowledge originally and the tool for perception of the causes of cervical cancer was originally developed by Kim (1993). The total number of subjects equaled to: vaccination group of 52 (20.9%) and non-vaccination group of 197 (79.1%). RESULTS: Vaccination group showed significantly higher score of both knowledge of HPV vaccination and the perception of the cause of cervical cancer in comparison to the nonvaccination group at (p<.05). Among 4 subscales of the perception of causes of cervical cancer, destiny and constitution subscale scores were significantly different between the two groups at (p<.05). CONCLUSION: Clinical nurses need to constantly update with current knowledge of HPV and be prepared with currently changing cancer prevention strategies, especially in cervical cancer.

Sentidos da pesquisa na prática profissional de enfermeiras assistenciais / Meanings of research in the professional practice of clinical nurses / Sentidos de la investigación en la práctica professional de enfermeras asistenciales

O objetivo do estudo foi analisar os sentidos dados a atividade investigativa atribuídos pelas enfermeiras assistenciais participantes de um núcleo de apoio a pesquisa. Foi utilizado o referencial teórico da antropologia interpretativa e o estudo de caso etnográfico. Para a coleta de dados empregamos a entrevista semi-estruturada individual e grupal, análise de documentos e de depoimentos e o diário de campo. Pela análise interpretativa do discurso de 36 participantes identificamos quatro núcleos de sentidos: valoração da atividade, pesquisar é aprender, movimentos da atividade, a atividade é trabalho árduo que demanda esforço pessoal. Compreendemos que capacitação em pesquisa, apoiada pela organização e desejada pela enfermeira, consubstancia-se como estratégia científico-pedagógica na formação de enfermeiras, com repercussões positivas para a assistência prestada.

The aim of this study was to analyze the meanings given to investigative research by nurse clinicians enrolled in a research support group. The interpretive anthropology theoretical frame was used along with an ethnographic case study. Data was collected through semi-structured individual and group interviews, document and statement analysis as well as field diary notes. The statements of 36 participants were analyzed interpretively identifying four categories: activity's value, researching is learning, the movements about the activity, the activity is hard work that demands personal effort. We understand that once research training initiative is supported by the organization and desired by the nurse, it becomes a scientific-pedagogical strategy for academic nursing formation with positive repercussions to care assistance.

El objetivo del estudio ha sido analizar el sentido dado a la actividad investigativa atribuido por las enfermeras asistenciales participantes de un núcleo de apoyo a la investigación. Fue utilizada la referencia teórica de la antropología interpretativa y el estudio del caso etnográfico. Para la colecta de datos se ha empleado la entrevista semi-estructurada individual y grupal, el análisis de documentos y de declaraciones, y el diario de campo. Por el análisis interpretativo del discurso de 36 participantes se han podido identificar cuatro núcleos de sentidos: valoración de la actividad, investigación como aprendizaje, movimientos de la actividad, la actividad como trabajo arduo que demanda esfuerzo personal. Se entiende que la capacitación en investigación, apoyada por la organización, y deseada por la enfermera, se afianza como estrategia científico-pedagógica en la formación de enfermeras, con repercusiones positivas para la asistencia prestada.

O processo de trabalho e a clínica na enfermagem: pensando novas possibilidades / Proceso de trabajo y la clínica en la enfermería: pensando nuevas posibilidades / Work process and clinic in nursing: considering new possibilities

Este estudo teórico objetiva refletir acerca da construção histórica do processo de trabalho em enfermagem e sua articulação com a clínica. Ao longo dos anos, o processo de trabalho em enfermagem assumiu vários paradigmas permeados por transformações políticas, econômicas e tecnológicas. Essas transformações engendraram diferentes concepções e ferramentas de intervenção. A construção do conceito de clínica em enfermagem se deu no encontro com a medicina na institucionalização do dispositivo hospitalar inserindo a enfermagem num modelo de clínica anatomo-patológica. Atualmente autores têm discutido a importância de considerar a autonomia do trabalhador com relação ao seu modo de produção do trabalho, refletindo criticamente acerca de suas ferramentas de intervenção. Neste estudo questionamos as possibilidades de reinvenção da clínica na enfermagem partindo da contribuição de autores que pensam este fenômeno como uma ética da intervenção que valoriza a autonomia dos que buscam nossa assistência.

This theoretical study reflects on the historical construction of the nursing work process in its interrelationship with the clinic. Over the years, the nursing work process has been framed by various paradigms permeated by the influence of political, economic and technological changes. These changes have given rise to a variety of concepts and tools for intervention. The construction of the concept of clinic in nursing derived from the encounter with medicine during institutionalization of the hospital establishment, which brought nursing into an anatomical-pathological model of clinic. Currently, authors have been discussing the importance of considering workers’ autonomy as regards their way of producing their work and their reflecting critically on their tools for intervention. This study inquires into the possibilities for reinventing the concept of clinic in nursing, based on the contributions of authors who think of this phenomenon in terms of an ethics of intervention that values the autonomy of those who seek our assistance.

Estudio teórico tiene como objetivo reflexionar sobre la construcción histórica del proceso de trabajo en enfermería y su articulación con la clínica. A lo largo de los años, el proceso de trabajo en enfermería asumió varios paradigmas influenciados por transformaciones políticas, económicas y tecnológicas. Esas transformaciones fueron engendrando diferentes concepciones y herramientas de intervención. La construcción del concepto de clínica en enfermería se dio en el encuentro con la medicina en la institucionalización del dispositivo hospitalario insertando la enfermería en un modelo de clínica anatomo-patológica. Actualmente los autores han discutido la importancia de considerar la autonomía del trabajador en relación con su modo de producción del trabajo, reflexionando críticamente sobre sus herramientas de intervención. En este estudio cuestionamos las posibilidades de reinvención de la clínica en enfermería partiendo de la contribución de autores que piensan este fenómeno como una ética de la intervención que valoriza la autonomía de aquellos que buscan nuestra asistencia.

Síndrome de Burnout en el profesional de enfermería que labora en áreas críticas / Burnout's syndrome in nursing professionals working at critical areas

El síndrome de Burnout constituye un estado de fatiga o frustración, ocasionado por una falta de recompensa esperada, tras un esfuerzo dedicado a un proyecto de vida, precedido de una fase de falta de motivación, producción e ineficacia, constituyendo una de las principales causas de deterioro de las condiciones laborales, mayores accidentes y ausentismo. Objetivo: determinar la existencia del síndrome de Burnout entre las enfermeras de unidades críticas de una institución de salud infantil. Material y métodos: el estudio fue cuantitativo-descriptivo de corte transversal, realizado en cinco servicios de áreas críticas de una institución de salud de nivel III; la población estuvo constituida por 132 profesionales de enfermería, participando 105 conforme criterios de inclusión y exclusión. Para recolectar los datos se utilizó el cuestionario auto-administrado de Maslach Burnout Inventory/MBI en versión traducida y validada en el Perú, mediante entrevistas personales y entrega del instrumento en sobre cerrado. El análisis de los datos fue realizado mediante estadística descriptiva con análisis univariado y bivariado con auxilio del SPSS v.13. Resultados: el 78,1% presentó tendencia a síndrome de Burnout predominando el nivel bajo en todas las dimensiones: despersonalización 80,0%, cansancio emocional 66,7% y realización personal 65,7%. Todas las enfermeras presentaron baja realización personal, sin embargo, las de Sala de operación y Emergencia presentaron también cansancio emocional en nivel medio (30,4% y 33,9% respectivamente). Conclusión: elevada tendencia a presentar síndrome de Burnout con una baja realización personal en todas las áreas críticas, especialmente en Sala de operación.

The Burnou's síndrome, is a state of tiredness or frustation made by the lack of recompense expected, after an effort dedicated, preceded by an stage of lack of motivation, production and inefficacy; these situation is one of the main causes of deterioration of job conditions, increase of accidents and labour absenteeism. Objetive: to determinate the existence of Burnout's syndrome among nurses of critical units from a children health institution. Material and methods: the study was quantitative descriptive and cross-sectional, made in five services of critical areas of a health institution level III; population was formed by 132 professional nurses with a participation of 105 following inclusion and exclusion criteria; to data collect it was self-applied questionnaire of maslach Burnout Inventory (MBI) in translated and validated version in Peru; through personal interviews and deliver of instrument in close envelop; data analysis was made through descriptive statistics with univariated and bivariated analysis with the help of SPSS v. 13. Results: 78.1% had Burnout's syndrome trend, mainly low level in all dimensions: despersonalizations, emotional tiredness 66.7% and personal performance 65.7% al nurses showed low personal performance; however, at surgical room and emergency they showed emotional tiredness in a medium level as well (30.4% and 33.9% respectively). Conclusion: high Burnout's syndrome trend with low personal performance in all critical areas, especially surgical room.

Risk Factors of Blood and Body Fluid Exposure in Clinical Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the risk factors of exposure to blood and body fluid by clinical nurses. METHOD: The participants in this descriptive study were 276 clinical nurses involved in nursing care in a general hospital located in Seoul. The collected data were analyzed using a logistic regression model. RESULTS: The annual exposure rate to blood and body fluid by clinical nurses was 66.3%, and the ratio was higher in the exposed group than in the non-exposed group for nurses under the age of 25, nurses who were unmarried, nurses with low clinical experience, and nurses who work night shifts more than six days a week. Clinical nurses who were unmarried were 1.9 times more likely to have been exposed compared to married nurses. Nurses whose work experience was less than 18 months were 2.7 times more at risk than nurses with more than 18 months of experience. Also, nurses whose fatigue scores were high had an increased chance of exposure (1.9 times). CONCLUSION: It is necessary to provide intensive training programs for clinical nurses who are in the early months of their career and are likely to be young and unmarried, in order to prevent exposure to blood and body fluid. Administrative supports to self-control and hospital ward operation measures to relieve nurses' fatigue should be provided.

Sistema de classificação de pacientes: aplicação de um instrumento validado / Sistema de clasificación de pacientes: aplicación de un instrumento evaluado / Classification system of patients: application of a validated tool

As autoras aplicaram um instrumento de classificação de pacientes na Ala B2 do Hospital de Clínicas de Marília, em doisperíodos distintos, no ano de 1999, com o intuito de conhecer o grau de dependência dos pacientes em relaçãoàequipe de enfermagem. A amostra foi constituída de 31 pacientes no primeiro período e 35 pacientes no segundo período. Osresultados mostraram que a maioria dos pacientes foi classificada como cuidados mínimos ou intermediários, sendopreocupante o número de pacientes classificados como cuidados semi-intensivos e intensivos nas unidades de internação.São sugeridas algumas modificações no instrumento utilizado.

The authors applied an instrument of patient classification to the patients of Hall B2 of the Hospital das Clínicas deMarilia, intwo distinct periods of 1999, seeking to discover the degree of dependency of the patients in relation tonursing staff. The sample consisted of 31 patients in the first period and 35 in the second. The results showed that mostof the patients had been classified as needing minimum or intermediary care in their units of admission. Some modifications of the procedures were suggested.

Las autoras aplicaron un instrumento de clasificación en pacientes del Ala B2 del Hospital de Clínicas de Marília, en dosperiodos distintos durante 1999, con el objetivo de conocer el grado de dependencia de dichos pacientes con relación a los enfermeros. La muestra estuvo constituída de 31 pacientes en el primer periodo y de 35 pacientes en el segundo periodo. Los resultados mostraron que la mayoría de los pacientes fue clasificada como de cuidados mínimos o intermedios, siendopreocupante el número de pacientes clasificados como de cuidados semi-intensivos e intensivos en las unidades de internación. Se sugieren algunas modificaciones en el instrumento utilizado.