Necesidad de cuidados continuos en personas con cáncer de pulmón avanzado / The Need for Continuous Care in People with Advanced Lung Cancer

Introducción: El cáncer de pulmón constituye un problema sanitario a nivel mundial, a pesar de los avances tecnológicos y terapéuticas en oncología, hay un alto porcentaje de personas que se diagnostican en estadios avanzados de la enfermedad, las cuales tienen una mayor demanda de cuidados continuos. Objetivo: Identificar la necesidad de cuidados continuos en personas con cáncer de pulmón avanzado. Métodos: Revisión sistemática realizada durante enero a julio del 2021. Se realizó análisis de contenido de documentos, que incluyó artículos originales y de revisión publicados desde 2010 hasta 2021 en las bases de datos SciELO, Google Scholar y Elsevier. Se elaboró la pregunta guía a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante los descriptores en Ciencias de la Salud (DeCS) "Personal de enfermería", "Neoplasia de pulmón" y "cuidados de enfermería" y el operador booleano AND. Se utilizó el diagrama de flujo (PRISMA) para la formulación de la estrategia de búsqueda, se identificaron y revisaron 77 artículos, de los que fueron útiles 12 de la evolución de la categoría. Conclusiones: El análisis realizado referido a la necesidad de los cuidados continuos en personas con cáncer de pulmón avanzado permitió definición operativa de esta categoría, a partir de las características de esta entidad y la demanda que enfrentan los servicios de hospitalización y los profesionales de enfermería en correspondencia con la satisfacción de necesidades de estas personas, y permitió establecer un acercamiento en los referentes teóricos que sustentan el tema(AU)

Introduction: Lung cancer is a worldwide health problem; despite technological and therapeutic advances in oncology, there is a high percentage of people diagnosed in advanced stages of the disease, which have a greater demand for continuous care. Objective: To identify the need for continuous care in people with advanced lung cancer. Methods: A systematic review was conducted from January to July 2021. Document content analysis was performed, including original and review articles published from 2010 to 2021 in the SciELO, Google Scholar and Elsevier databases. The guiding question was elaborated using the acronym PICo. The search strategy was performed using the Health Sciences Descriptors (DeCS) Personal de enfermería [nursing personnel], Neoplasia de pulmón [lung neoplasia], and cuidados de enfermería [nursing care], together with the Boolean operator AND. The PRISMA flowchart was used for the formulation of the search strategy; 77 articles were identified and reviewed, of which 12 from the category evolution. Conclusions: The carried out analysis regarding the need for continuous care in people with advanced lung cancer allowed the operational definition of this category, based on the characteristics of this entity or the demand faced by hospitalization services and nursing professionals in correspondence with the satisfaction of needs of these people, as well as it allowed establishing an approach within the theoretical references that support the topic(AU)

Estrés laboral y dinámica familiar en el personal de enfermería / Occupational Stress and Family Dynamics in the Nursing Personnel

Introducción: El profesional de enfermería se encuentra expuesto a situaciones emocionalmente fuertes, ya que a diario toman decisiones vitales para para salvar vidas y enfrentan la muerte. Estas tensiones pueden generar estrés, el cual no solo afecta la productividad o desempeño en su trabajo, sino que influyen en la salud física, mental y emocional, lo cual perturba incluso las relaciones con los miembros de su familia. Objetivo: Determinar la relación existente entre la dinámica familiar y el estrés laboral que presentan las enfermeras que laboran en del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique, Arequipa, Perú. Métodos: Estudio descriptivo, transversal y correlacional. Población de 72 enfermeras activas, del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique. La muestra estuvo conformada por 50 enfermeras, quienes consintieron participar en el estudio y no se encontraban de licencia. Fueron aplicados dos cuestionarios: uno para estimar el grado de estrés conocido como Escala de Estrés de la vida profesional de 22 ítems, y otro para valorar la Dinámica Familiar de 18 ítems. Los datos fueron procesados por estadística descriptiva y para el análisis inferencial se aplicó la prueba Chi cuadrado de Pearson (X 2) con un nivel de significancia del 5 por ciento. Resultados: Presentó nivel de estrés leve el 70 por ciento de las enfermeras y la dinámica familiar fue valorada como aceptable y satisfactoria en el 38 y 30 por ciento, respectivamente. Las enfermeras que presentaron niveles de estrés entre moderado y alto, reflejaron dinámicas familiares insatisfactorias. Conclusiones: El personal de enfermería del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique; presentó bajo nivel de estrés, el cual deriva de las actividades propias de la profesión. La asociación de estrés con la dinámica familiar no fue significativa, muy probablemente debida al número de muestra(AU)

Introduction: Nursing professionals are exposed to emotionally strong situations, since they make vital decisions day by day, in order to save lives and face death. These tensions can generate stress, which not only affects productivity or performance at work, but also affects their physical, mental and emotional health, which even disturbs their relationships with their family members. Objective: To determine the relationship between family dynamics and occupational stress presented by nurses who work at Julio Pinto Manrique Regional Hospital of the National Police of Peru, in Arequipa. Methods: Descriptive, cross-sectional and correlational study carried out with a population of 72 active nurses from Julio Pinto Manrique Regional Hospital of the National Police of Peru. The sample consisted of fifty nurses, who consented to participate in the study and were not out of work. Two questionnaires were applied: one for estimating the degree of stress, known as Professional Life Stress Scale and made up of 22 items; and another for assessing family dynamics, made up of eighteen items. The data were processed using descriptive statistics, while Pearson's chi-square test (X2) was applied for inferential analysis, with a significance level of 5 percent. Results: 70 percent of the nurses presented a mild stress level, while family dynamics was assessed as acceptable and satisfactory in 38 percent and 30 percent, respectively. The nurses who presented moderate-to-high stress levels showed unsatisfactory family dynamics. Conclusions: The nursing personnel of Julio Pinto Manrique Regional Hospital of the National Police of Peru presented a low level of stress, which derives from professional practice itself. The association of stress with family dynamics was not significant, most likely due to the number of samples(AU)

Manejo de medidas de bioseguridad en el personal de enfermería que labora en el área de emergencia del hospital general norte de Guayaquil IESS los ceibos / Management of biosecurity measures for nursing personnel working in the emergency area of the Hospital General Norte de Guayaquil IESS Los Ceibos

Las medidas de Bioseguridad son un conjunto de normas preventivas que debe aplicar el personal de salud y de enfermería para evitar el contagio por la exposición de agentes infecciosos, sean físicos, químicos o biológicos. Objetivo: Determinar el manejo de las medidas de bioseguridad del personal de enfermería del servicio de emergencia del Hospital General Norte de Guayaquil IESS Los Ceibos. Fundamentándose en la gran problemática del manejo de los riesgos biológicos en el personal sanitario, que con frecuencia omite aplicar normas de seguridad, lo que aumenta el riesgo de contraer una enfermedad infectocontagiosa de tipo laboral. Materiales y métodos: La metodología empleada fue diseño descriptivo, con corte transversal, Cuali-cuantitativo. La recolección de datos se la realizó mediante la aplicación de cuestionarios pre estructurado, los cuales ayudaron a establecer el nivel de conocimientos y manejo de las medidas de bioseguridad por parte del personal. La muestra la conformaron 90 enfermeras y enfermeros que laboran en el área de emergencia. Resultados: Los resultados revelaron que el nivel de conocimiento del personal de enfermería es alto o adecuado con un porcentaje promedio de 77,67%, por ende, el 22,33% del personal desconoce estas medidas preventivas o tiene conocimiento deficiente. Con respecto a la aplicación de las medidas de bioseguridad se obtuvo un porcentaje general de 47%, es decir se considera la aplicación de estas normas por parte del personal deficiente e insuficiente. Conclusión: Se menciona que hay riesgos en el área de emergencia, prevaleciendo entre ellos el biológico de acuerdo a la opinión del personal encuestado, por otra parte, se determinó un conocimiento eficiente de las medidas de bioseguridad, pero su aplicación en relación al conocimiento es deficiente, situación que incrementa el riesgo laboral(AU)

Biosafety measures are a set of preventive rules to be applied by health and nursing personnel to avoid contagion by exposure to infectious agents, whether physical, chemical or biological. Objective: To determine the management biosecurity measures of the nursing staff of the emergency service of the Hospital General Norte de Guayaquil IESS Los Ceibos. Based on the great problem of the management of biological risks in health personnel, who often fail to apply safety standards, which increases the risk of contracting an occupational infectious-contagious disease. Materials and methods: The methodology used was a descriptive, cross-sectional, qualitative-quantitative design. Data collection was carried out through the application of pre-structured questionnaires, which helped to establish the level of knowledge and management biosafety measures by the personnel. The sample consisted of 90 nurses working in the emergency area. The results: The results revealed that the level of knowledge of the nursing personnel is high or adequate with an average percentage of 77.67%; therefore, 22.33% of the personnel are unaware of these preventive measures or have deficient knowledge. With respect to the application biosecurity measures, an overall percentage of 47% was obtained, i.e. the application of these norms by of personnel is considered deficient and insufficient. Conclusion: It is mentioned that there are risks in the emergency area, prevailing among them the biological risk, according to the opinion of the personnel surveyed. On the other hand, an efficient knowledge of the biosecurity measures was determined, but their application in relation to the knowledge is deficient, a situation that increases the occupational risk(AU)

Fundamentos teóricos de la mecánica corporal en la movilización de pacientes en el ámbito de enfermería / Theoretical foundations of body mechanics in the mobilization of patients in the field of nursing

Existe un conglomerado importante de fundamento teórico que en su discurso sustenta la importancia de la mecánica corporal en la medicina, por ser una actividad completa; su correcta aplicación garantiza una buena salud. Objetivo: Describir los fundamentos teóricos de la mecánica corporal en la movilización de pacientes en el ámbito de la enfermería. Metodología: Documental, descriptiva. Resultados: Diversos estudios demuestran que las lesiones musculo-esqueléticas en el personal de enfermería, en un porcentaje alto se deben a la aplicación inadecuada de la mecánica corporal durante la movilización de pacientes. La bibliografía consultada revela: en el ámbito de la enfermería se refleja desconocimiento en el tema de la mecánica corporal en la movilización de pacientes, antes, durante o después de la ejecución de procedimientos, lo cual es causante de lesiones musculo-esqueléticas en el personal de enfermería. Recomendación: Es un deber para el personal de enfermería aplicar la mecánica corporal en todas las acciones que realiza en la práctica consigo mismo y también con el paciente, aprovechando al máximo la energía que brinda, el bienestar que ofrece a ambos y la prevención que trae consigo ante posibles lesiones músculo-esqueléticas(AU)

There is an important conglomerate of theoretical foundation, which in its speech supports the importance of body mechanics in medicine as a complete activity; because its correct application guarantees good health. Objective: Describe the theoretical foundations of body mechanics in the mobilization of patients in the field of Nursing. Methodology: Documentary, descriptive. Several studies show that musculoskeletal injuries in nursing staff, in a high percentage, are due to improper application of body mechanics during patient mobilization. Conclusion: The bibliography consulted reveals that in the nursing field the subject of body mechanics in the mobilization of patients, before, during or after the execution of procedures is unknown, which is the cause of musculoskeletal injuries in nursing staff. Recommendation: It is a duty for the nursing staff to apply body mechanics in all the actions they perform in practice with themselves and also with the patient, taking full advantage of the energy it provides, the well-being it offers to both and the prevention it brings before possible musculoskeletal injuries(AU)

Dinâmica de geração e dissipação do estresse na equipe de enfermagem num centro de oncologia / Dynamics of stress generation and reduction in the nursing team at an oncology center / Dinámica de generación y disipación del estrés en el equipo de enfermería en un centro de oncología

Objetivo: representar a dinâmica de geração, acumulação e dissipação do estresse na equipe de enfermagem em um centro de terapia oncológica. Método: um modelo de simulação matemático de dinâmica de sistemas foi desenvolvido com base na coleta de dados in loco. O modelo serviu para testar o impacto de três políticas direcionadas a reduzir o estresse na equipe: i) incremento na carga de atendimento; ii) incremento do tamanho das equipes de turno e iii) redução de horas de atendimento por leito. Resultados: o modelo demonstrou que a política de incremento de tamanho da equipe obteve os melhores resultados, sintetizados com o índice de absenteísmo, estabilizando-se em 8%; pessoal afastado também se estabilizando em 4-5 pessoas por mês, bem como o estresse acumulado reduzido aos níveis do cenário base. Conclusão: as medidas no sentido de acompanhamento das demandas físicas e emocionais, a contratação de pessoal, um melhor treinamento técnico para as atividades ditas estressantes e uma melhor distribuição de tarefas podem ser eficazes na redução dos índices de absenteísmo e melhorar a qualidade de vida desses trabalhadores.

Objective: to represent the dynamics of stress generation, accumulation and reduction in the nursing team at an oncology therapy center. Method: a mathematical simulation model of system dynamics was developed based on data collection in loco. The model served to test the impact of three policies aimed at reducing stress in the team, namely i) increase in the service load; ii) increase in the size of shift teams and iii) reduction of service hours per bed. Results: the model showed that the policy of increasing the size of the team obtained the best results, with the absenteeism index stabilizing at 8%; staff at leave also stabilizing at 4-5 people per month, as well as accumulated stress reduced to baseline levels. Conclusion: measures to monitor physical and emotional demands, hiring staff, better technical training for so-called stressful activities, and a better distribution of tasks can be effective in reducing absenteeism rates and improving the quality of life of these workers.

Objetivo: representar la dinámica de generación, acumulación y disipación del estrés en el equipo de enfermería en un centro de terapia oncológica. Método: un modelo de simulación matemático de dinámica de sistemas fue desarrollado basado en la recolección de datos in loco. El modelo sirvió para testar el impacto de tres políticas dirigidas a reducir el estrés en el equipo: i) incremento en la carga de atendimiento; ii) incremento del tamaño de los equipos de turno y iii) reducción de horas de atendimiento por lecho. Resultados: el modelo demostró que la política de incremento de tamaño del equipo obtuvo los mejores resultados, sintetizados con el índice de ausentismo estabilizándose en 8%; personal alejado también estabilizándose en 4-5 personas por mes, así como el estrés acumulado reducido a los niveles del escenario base. Conclusión: las medidas en el sentido de acompañamiento de las demandas físicas y emocionales, la contratación de personal, mejor entrenamiento técnico para actividades llamadas estresantes y una mejor distribución de tareas pueden ser eficaces en la reducción de los índices de ausentismo y mejorar la calidad de vida de esos trabajadores.

Symptoms of posttraumatic stress disorder after exposure to biological material / Síntomas de transtorno de estrés post-traumático después exposición a material biológico / Sintomas de transtorno de estresse pós-traumático após exposição a material biológico

Abstract Objective: To track symptoms of posttraumatic stress disorder (PTSD) according to scores of the Impact of Event Scale-Revised (IES-R) in nursing staff exposed to accidents with biological material, from October 2014 to May 2016, in a philanthropic hospital in the state of Minas Gerais. Methods: Retrospective, descriptive study with a quantitative approach. Inferential analysis was performed using a 95% confidence interval, p ≤ 0.05. The data were collected considering all the ethical aspects described in resolution 466/2012. Results: The majority of workers were nursing technicians (52.5%), female (91.8%), with a mean age of 31.4 years (SD 7.5), the majority of exposures being percutaneous (60.7%). Of all individuals, 19.6% presented scores above 5.6, showing signs of PTSD. Individuals who had suffered accidents more than six months previously (p = 0.025) had significantly higher scores than those who had been exposure for less than three months. Conclusion: The study highlights the need for the use of validated instruments for the evaluation of fear, anxiety, stress, and other psychological reactions that characterize PTSD, as well as the provision of psychological care for workers exposed to biological material.

Resumen Objetivo: Rastrear síntomas de trastorno de estrés postraumático según los escores de la escala de impacto del evento-revisado en trabajadores del equipo de enfermería, expuestos a accidentes con material biológico en el período de octubre de 2014 a mayo de 2016 en un hospital Filantrópico de Minas Gerais. Métodos: Estudio transversal, retrospectivo, descriptivo, con abordaje cuantitativo. El análisis inferencial fue realizado utilizando intervalo de confianza del 95%, p ≤ 0,05. Los datos fueron recolectados resguardándose todos los aspectos éticos descritos en la resolución 466/2012. Resultados: La mayoría de los trabajadores eran técnicos de enfermería (52,5%), del sexo femenino (91,8%), con una media de edad de 31,4 años (DP = 7,5). Las exposiciones se produjeron por vía percutánea (60,7%). Del total de individuos, el 19,6% presentó escores por encima de 5,6 evidenciando señales para TEPT y aquellos que se habían accidentado hace más de seis meses tuvieron puntuaciones significativamente superiores (p = 0,025) a los que sufrieron exposición hace menos de tres Los meses. Conclusión: Se evidenció la necesidad del uso de instrumentos validados para la evaluación del miedo, ansiedad, estrés entre otras reacciones psicológicas que caracterizan el trastorno de estrés postraumático y de la oferta de atención psicológica para los trabajadores expuestos a material biológico.

Resumo Objetivo: Rastrear sintomas de Transtorno de Estresse Pós-Traumático (TEPT) segundo os escores da Escala de Impacto do Evento-Revisado em trabalhadores da equipe de enfermagem, expostos a acidente com material biológico no período de outubro de 2014 a maio de 2016 em um hospital filantrópico de Minas Gerais. Métodos: Estudo transversal, retrospectivo, descritivo, com abordagem quantitativa. A análise inferencial foi realizada utilizando-se intervalo de confiança de 95%. Os dados foram coletados resguardando-se todos os aspectos éticos descritos na resolução 466/2012. Resultados: A maioria dos trabalhadores eram técnicos de enfermagem (52,5%), do sexo feminino (91,8%), com média de idade de 31,4 anos (DP = 7,5). As exposições ocorreram por via percutânea (60,7%). Do total de indivíduos, 19,6% apresentaram escores acima de 5,6 evidenciando sinais para TEPT e aqueles que haviam se acidentado há mais de seis meses tiveram escores significativamente superiores (p = 0,025) aos que sofreram exposição há menos de três meses. Conclusão: Um em cada cinco (19,6%) dos trabalhadores da equipe de enfermagem que sofreram exposição ocupacional com material biológico apresentaram TEPT. Isso evidenciou a necessidade do uso de instrumentos validados para avaliação do medo, ansiedade, estresse entre outras reações psicológicas que caracterizam o transtorno e da oferta de atendimento psicológico para os trabalhadores expostos a material biológico.

Comparative study of nursing group personnel number to active bed of hospitals affiliated to yasuj medical sciences university with existing standards and factors effective on it in 2015.

Introduction: Most problems of institutions providing treatment services in health systems (hospitals) are due to shortage of human force or its unsuitable distribution. Among the most important ways of increasing employing nurses as the major part of hospitals human forces is standardization of quantity and distribution of this valuable source. Methods: This study is applied descriptive and of cross sectional type. The research sample and society is nursing group personnel affiliated to Yasuj Medical Sciences University. Data collecting tool is some tables containing number, gender combination and type of employment of nursing personnel (library model) and effective factors like reducing working hours rate due to efficiency law, increasing the number of hospitalization days after health system evolution plan were studied. Information after collecting was analyzed using SPSS software and using descriptive statistical tests. Results: The obtained results indicate that the ratio of nurse to active bed number is not similar to standards and there is a difference. The rate of working hours´ reduction due to efficiency law and the number of hospitalization days results in need to more personnel after health system evolution. Conclusion: The obtained results show that the required nursing force in the hospitals affiliated to Yasuj Medical Sciences University in some wards is not according to the standard of Ministry of Health and systematic attitude standard.

A survey on the training needs on nursing personnel for the aged from the perspective of nursing targets and their relatives / 中国实用护理杂志

Objective To understand the training status and learning requirement of nursing personnel for the aged from the perspective of nursing targets and their relatives in the city of Nanjing.Methods The questionnaire involved six categories,80 questionnaires were sent out,57 of them were recollected.The effective recovery rate was 71.3％(57/80).All the data were input into Excel to do statistical analysis.Results The nursing personnel did not fully grasp the skills of transfusion nursing and muscle injection [45.6％(26/57) and 33.3％(19/57)] in the basic theory of basic care,knowledge and skills from the perspective of nursing targets and their relatives.The Chinese medicine nursing skills such as scrapping [needing very much 40.4％ (23/57)] and burying seeds [needing very much 40.4％ (23/57)] in the ear acupuncture point were also needed to be enhanced.A total of 75.4％ (43/57) of respondents chose online examination as the way of nursing personnel's evaluation.Conclusions Nursing personnel are in great need of on-job professional training.

Valoración de las Subescalas de Maslach Burnout Inventory en Personal de Enfermería

El objetivo de este estudio fue determinar la prevalencia del síndrome de Burnout y su relación con factores sociodemográficos y laborales en personal de enfermería del Servicio de Clínica Médica del Hospital Central del Instituto de Previsión Social (IPS) entre noviembre del 2010 a enero del 2011. Se realizó un estudio observacional descriptivo transversal y para la medición del síndrome de Burnout se utilizó el Maslach Burnout Inventory. Participaron 106 personas con una edad media ± DE de 31 ± 7 años. Los valores promedios ± desvío estándar obtenidos en las distintas subescalas del MBI fueron en cansancio emocional 25,9 ± 13,6; despersonalización 10,8 ± 7,4; y realización personal 34,0 ± 9,1. La prevalencia del síndrome de Burnout fue del 18,9%, que estuvo asociado a mayor edad y a mayor número de pacientes que atiende. Se recomienda implementar estrategias de prevención del Burnout para un mejor desempeño del personal de enfermería del IPS.

The aim of this study was to determine the prevalence of burnout syndrome and its relationship to work and socio-demographic factors in the nursing personnel of general medicine area at the Central Hospital of the Social Security Institute. A descriptive cross-sectional study was carried out using the Maslach Burnout Inventory to determine the presence of burnout. A total of 106 individuals participated in the study with a mean age ± SD of 31 ± 7 years. The mean values ± standard deviation for the MBI subscales were as follows: 25.9 ± 13.6 for emotional exhaustion, 10.8 ± 7.4 for depersonalization, and 34.0 ± 9.1 for personal accomplishment. The prevalence of burnout syndrome was 18.9%, which was associated with age older than 30 years and higher number of patients under their care. Implementation of burnout prevention strategies for better performance of nursing staff of IPS is recommended.

Knowledge and Attitude of 851 Nursing Personnel toward Depression in General Hospitals of Korea

Our study aimed to examine the knowledge and attitude of nursing personnel toward depression in general hospitals of Korea. A total of 851 nursing personnel enrolled at four university-affiliated general hospitals completed self-report questionnaires. Chi-square tests were used to compare the knowledge and attitude of registered or assistant nurses toward depression. In addition, binary logistic regression analysis was used to adjust for the following confounders: age-group and workplace. Registered and assistant nurses differed in their knowledge and attitude toward depression. The proportion of rational and/or correct responses were higher in registered nurses than assistant nurses for the following: constellation of depressive symptoms defined by DSM-IV (adjusted odds ratio [aOR], 3.876; P<0.001); suicide risk in depression recovery (aOR, 3.223; P=0.001) and psychological stress as a cause of depression (aOR, 4.370; P<0.001); the relationship between chronic physical disease and depression (aOR, 8.984; P<0.001); and other items. Our results suggest that in terms of the biological model of depression, the understanding of registered nurses is greater than that of assistant nurses. Moreover, specific psychiatric education programs for nursing personnel need to be developed in Korea. Our findings can contribute to the development of a general hospital-based model for early detection of depression in patients with chronic medical diseases.

Formación de médicos y enfermeras para la detección temprana del cáncer de mama en México / Doctors and nurses' training for the early detection of the breast cancer in Mexico

Objetivo Analizar la formación académica que reciben los estudiantes de medicina y enfermería sobre el cáncer de mama (CaMa) durante el trascurso de su carrera universitaria. Materiales y Métodos Estudio exploratorio realizado en 2009. Basado en entrevistas semi-estructuradas a actores clave y revisión documental. Población de estudio: 199 Facultades/Escuelas de medicina y 108 Escuelas/Institutos de enfermería. Unidad de análisis: plan de estudios. Resultados En 16,8 % de los planes de estudio de medicina y 6,3 % de enfermería se encontró información específica de contenidos sobre CaMa. La capacitación que reciben los médicos es predominantemente desarrollada por las áreas biomédica y clínica y en menor proporción en el área socio-médica. En enfermería los temas que más se desarrollan son en áreas comunitarias, abordando contenidos de promoción de la salud y prevención de la enfermedad (estilos de vida saludable e identificación de mujeres con alto riesgo de padecer CaMa). Discusión Se encontró escasa evidencia sobre entrenamiento específico para la detección y atención del cáncer de mama en los planes de estudio. Por los resultados encontrados es necesario fortalecer los currículos para formar a los futuros profesionales con capacidades para trabajar en la solución de los problemas y necesidades específicos de salud de la población particularmente en acciones de prevención primaria y secundaria.

Objective Analyzing formal knowledge about breast cancer (BC) issues that medical and nursing students receive from different syllabuses and courses during their undergraduate studies. Materials and Methods This exploratory study was conducted in 2009; it was based on semi-structured interviews applied to key stakeholders and complemented by an analysis of their undergraduate courses. The study population consisted of 199 Faculties and Schools of Medicine and 108 Schools and Colleges of Nursing and the unit of analysis consisted of the syllabuses for the undergraduate courses. Results 16.8 % of the medical courses and 6.3 % of the nursing courses had specific information about BC. Medical students predominantly received their training in biomedical and clinical areas and the socio-medical area to a lesser extent. The issues in nursing courses was mainly focused (in community areas) on promoting health and preventing disease (healthy lifestyles and recognition of women at high risk regarding BC). Discussion Little evidence was found that medicine and nursing syllabuses contain issues related to BC. Medical and nursing curricula should be strengthened to improve professional skills and abilities related to BC to solve the affected population's problems and health needs, particularly regarding primary and secondary prevention.

Fatores associados à capacidade para o trabalho e percepção de fadiga em trabalhadores de enfermagem da Amazônia ocidental / Factors associated with work ability and perception of fatigue among nursing personnel from Amazonia

OBJETIVO: Analisar os fatores associados à capacidade inadequada para o trabalho e à percepção de fadiga entre os profissionais de enfermagem. MÉTODO: Estudo transversal desenvolvido com 272 trabalhadores em um hospital de urgência e emergência de Rio Branco/Acre. A coleta de dados ocorreu por meio dos seguintes instrumentos: questionário sobre dados sociodemográficos, condições de trabalho e estilo de vida; Índice de Capacidade para o Trabalho - ICT; e Questionário de Percepção de Fadiga. Para análise dos fatores associados à capacidade inadequada para o trabalho e à percepção de fadiga elevada foi utilizada a regressão de Poisson bivariada e múltipla. RESULTADOS: A prevalência de capacidade inadequada para o trabalho foi de 40,8 por cento, tendo como fatores associados: sexo feminino (RP = 1,84; IC95 por cento 1,06 - 3,18); referir outro vínculo empregatício (RP = 1,71; 1,25 - 2,35); número de funcionários insuficiente (RP = 1,96; 1,10 - 3,47); tarefas repetitivas e monótonas (RP = 1,84; 1,24 - 2,72); três ou mais morbidades sem diagnóstico médico (RP = 1,48; 1,06 - 2,06); fadiga elevada (RP = 2,37; 1,81 - 3,12). A prevalência de fadiga elevada foi de 25,7 por cento e os fatores associados foram: tarefas repetitivas e monótonas (RP = 1,74; 1,00 - 3,03); referir de três a cinco morbidades com diagnóstico médico (RP = 1,98; 1,00 - 3,11) e seis ou mais morbidades (RP = 3,79; 2,04 - 7,03), segundo a auto-avaliação do profissional. CONCLUSÕES: O estudo evidencia que grande parte população estudada apresenta capacidade inadequada para o trabalho e níveis elevados de fadiga, apontando para a necessidade de intervenções no plano individual (condições de vida) e no ambiente de trabalho, principalmente no que tange aos aspectos organizacionais.

OBJECTIVE: To analyze factors associated with inadequate work ability and perceived fatigue among nursing professionals. METHODS: A cross-sectional study was conducted involving 272 nursing personnel at an emergency hospital in Rio Branco/State of Acre, Brazil. Data collection was performed using the following instruments: questionnaire on sociodemographic data, working conditions and life styles; the Work Ability Index - WAI, and a questionnaire on perceived fatigue. Bivariate and multiple Poisson regression was used in the analysis of factors associated with work ability and perceived fatigue. RESULTS: The prevalence of inadequate work ability was 40.8 percent and presented the following associated factors: female sex (RP = 1.84; 95 percent CI 1.06 - 3.18); refering: other job commitment (RP = 1.71; 1.25 - 2.35); understaffing (RP = 1.96; 1.10 - 3.47); repetitive and monotonous tasks (RP = 1.84; 1.24 - 2.72); reporting three or more clinically undiagnosed morbidities (RP = 1.48; 1.06 - 2.06); excessive reported fatigue (RP = 2.37; 1.81 - 3.12). The prevalence of severe fatigue was 25.7 percent and the associated factors were: repetitive and monotonous tasks (RP = 1.74; 1.00 - 3.03); reporting three to five clinically-diagnosed morbidities (RP = 1.98; 1.00 - 3.11) and six or more self-reported morbidities (RP = 3.79; 2.04 - 7.03). CONCLUSIONS: The study revealed that most of the studied population showed reduced work ability and high levels of fatigue. These results point toward the need for interventions on an individual level (such as life conditions) and workplace improvements, looking jointly at the organizational aspects and work environment, particularly organizational aspects.

Ética y bioética en la formación del profesional de enfermería, una necesidad para la vida / Ethics and bioethics in the training of nursing personnel, a lifelong need

Literalmente Bioética es un neologismo que significa ética de la vida y surge en la década del 70, en la enciclopedia se define como el estudio sistemático de la conducta humana en el campo de las ciencias biológicas y de la atención de salud. Se realizó un estudio prospectivo longitudinal y descriptivo para determinar el nivel de conocimiento que tienen los estudiantes de curso complementario en el curso 03-04 todos del municipio Pinar del Río; donde se les aplicó una encuesta antes y después de implementar el programa correspondiente a la asignatura de Ética y Bioética en Enfermería. Los principales indicadores a medir fueron conocimientos previos a través de cursos básicos y de especialización, vínculo de los conocimientos teóricos con la actividad práctica, así como criterios de los estudiantes respondiendo a diferentes indicadores se utilizó el método porcentual aritmético presentándose los resultados en tablas. Los contenidos y las diferentes formas satisfacen las necesidades de los patrones morales de la sociedad en el ejercicio de la profesión, se hace necesario brindar educación continuada en los aspectos éticos y reflexionar sobre la importancia del cumplimiento de los principios éticos y bioéticos con vistas a reforzar un marco de valores que deben regir la filosofía de la profesión.

Bioethics is a neologism that means ethics for life and it theory was founded during the 70's; in the Encyclopedia it is defined as the systematic study of the human behaviour in the field of Biological Sciences and Health Care. A longitudinal-prospective and descriptive study was carried out to determine level of knowledge developed by the students of the complementary course during the academic course 2003 _ 2004 in Pinar del Rio Municipality, conducting a survey before and after the implementation of the syllabus corresponding to Ethics and Bioethics subjects in Nursing School. The main indicators of the study were: previous knowledge through basic courses and courses of specializations, linking of theory and practical activity, as well as student's criteria according to different points. Arithmetical percentage method was used and results were charted. It is necessary to follow a continuous education in ethical practice and reinforce ethical and bioethical principles.

Ocorrências éticas na enfermagem / Negligence: a risk factor in caring / Negligencia: factor de riesgo del cuidar

Este estudo utiliza cento e catorze registros de ocorrências éticas levantadas por uma Comissão de Ética de Enfermagem de um hospital do Município de São Paulo, no período de 1995 a 2001. Os objetivos foram: caracterizar os profissionais de enfermagem envolvidos e identificar as causas das ocorrências. Utilizou-se como instrumento uma ficha previamente elaborada. Os resultados: a maioria das ocorrências foi praticada por pessoas do sexo feminino, da faixa etária de 30 a 39 anos. Os auxiliares de enfermagem foram responsáveis pelo índice mais expressivo de ocorrências éticas. Destacou-se a negligência como principal causa das ocorrências, seguida pelas imprudência e a imperícia. O tipo de falha mais freqüente foi o erro no preparo e administração de medicamentos.

Descriptive and exploratory study with a quantitative approach involving hundred fourteen causes of nursing ethical occurences (or infractions) between 1995 _ 2001. The objectives of the study were to: 1) characterize the nursing professionals involved in ethical occurences; 2) identify causes of mistakes made. Outcomes obtained showed that: a) nursing auxiliaries were responsible for the majority of ethical occurences; b) the main cause of occurrences were negligence, followed by imprudence; c) the more frequent technical mistake observed was in the preparation and/or administration of medicines. This study aims to contribute for a better understanding of the ethical issue involved in the daily nursing practice, as well as to alert profissionals in order to not be involved in similar ethical events.

Estúdio descriptivo y exploratório com abordaje cuantitativo envolviendo ciento y catorce causas de ocurrencias éticas (o infracciones) entre 1995-2001. Los objectivos del estúdio fueron: 1) caracterizar los profesionales de enfermería envolvidos em ocurrencias éticas; 2) identificar las causas prevalientes de errores cuanto a la categoria de profisional y su jornada de trabajo. Resultados obtenidos demostraron que: a) los auxiliares de enfermería eran responsables por la mayoria de lãs ocurrencias éticas; b) la causa principal de ocurrencias era la negligencia, seguida por imprudencia; c) los errores técnicos más observados eran em la preparación y/o administración de medicinas. Este estúdio visa contribuir para la mejor comprensión de las cuestiones éticas que envolven la prática diária de enfermería y alertar los profesionales para que no incurran em eventos de esta naturaleza.

Valores que privilegian los usuarios y el personal de Enfermería de cinco instituciones de salud de Manizales / Values that privilege the users and Nursing personnel in five health institutions in Manizales

La descripción de los valores que privilegian el personal de enfermería y los usuarios de cinco instituciones de salud de Manizales, muestra la estimación de una serie de valores planteada en una escala usuarios y otra para personal de enfermería, que destacan aspectos personales, familiares y profesionales. La investigación buscó un acercamiento al sector salud, afectado en el tema de los valores por los cambios en las instituciones de salud, originados en la aplicación de la Ley 100 que han generado en usuarios y trabajadores condiciones adversas que modifican la jerarquización de los valores y la calidad de vida, derivadas de la aplicación de las políticas estatales. Se hace necesario establecer espacios de reflexión capaces de propiciar en las personas la interiorización, los valores y la calidad en la prestación de los servicios de salud como un aporte a la construcción de un nuevo país. Este estudio es de tipo cuantitativo, descriptivo, realizado en 6 instituciones de salud de Manizales de II y III nivel de atención, con una muestra de 215 participantes entre personal de enfermería y usuarios.

Values that favor the customers the nursing personnel of five institutions from Manizales (Colombia). This is a descriptive study that aims at estimating the evalues as way to approach the health sector theme. A sector that has been affected by the transformations and changing policies derived from the implementation of new laws that restructure this sector. The social claim to rescue the needed values to reach a healthful living together standard in the health performance surrounding cannot be denied. Here, performers such as customers have the right to express their preferences some way as the nursing personnel, which is also in conditions to express their probabilities for valuing the necessary qualities to worthily survive in the midst of adverse conditions. This fact becomes an option to reflect, internalise, and own personal, family, professional and socia..

The Experience of Nursing Staff on the Dementia Patients' Aggressive Behavior / 간호학회지

Providing care to the dementia elderly with behavioral problem is a major issue in nursing homes today. This study was aimed to explore the nursing staffs' response to aggressive dementia patients, and the effect that the aggressive behavior had on Nsgstaff. The interviews used a semi-structured questionnaire are were carried out from May to July, 1999. The subjects were 23 nursing personnel working in the nursing homes for dementia elderly. The result are as follows; 1. The types of aggressive behavior cited by the subjects was "physical", "linguistic", and "sexual". 2. The factors that caused the behavior were "symptoms of disease", "under- conditioning", "context of nursing care", "unsatisfied need", "relationship to other patients", "change of outer environment", and "invasion of one's own privacy". 3. The response of the subjects were "unhappiness", "stress", "anger", "exaggeration", "anxiety", and "fear". 4. The management strategies listed by nursing personnel used to alleviate aggressive behavior were "ignorance" "patience" "leaving the area" "soothing sounds" "verbal punishment" "restriction and isolation" and "various management skill appliance" "adaptation". 5. The effect that aggressive behavior and were "disturbance of relationship to elderly" "decline in the amount and quality of nursing care" "interruption of task performance" "job exhaustion" "desire to leave the job" "physical impact" "stress on the cognition of others" "anxiety about health and one own future" "interference to family life'. The findings of this study will be useful in understanding the difficulties of nursing personnel when confronting the aggressive behavior of dementia partients. It also is useful as basic data in preparing efficient intervention program for these difficulties.

The Experience of Nursing Staff on the Dementia Patients' Aggressive Behavior / 간호학회지

Providing care to the dementia elderly with behavioral problem is a major issue in nursing homes today. This study was aimed to explore the nursing staffs' response to aggressive dementia patients, and the effect that the aggressive behavior had on Nsgstaff. The interviews used a semi-structured questionnaire are were carried out from May to July, 1999. The subjects were 23 nursing personnel working in the nursing homes for dementia elderly. The result are as follows; 1. The types of aggressive behavior cited by the subjects was "physical", "linguistic", and "sexual". 2. The factors that caused the behavior were "symptoms of disease", "under- conditioning", "context of nursing care", "unsatisfied need", "relationship to other patients", "change of outer environment", and "invasion of one's own privacy". 3. The response of the subjects were "unhappiness", "stress", "anger", "exaggeration", "anxiety", and "fear". 4. The management strategies listed by nursing personnel used to alleviate aggressive behavior were "ignorance" "patience" "leaving the area" "soothing sounds" "verbal punishment" "restriction and isolation" and "various management skill appliance" "adaptation". 5. The effect that aggressive behavior and were "disturbance of relationship to elderly" "decline in the amount and quality of nursing care" "interruption of task performance" "job exhaustion" "desire to leave the job" "physical impact" "stress on the cognition of others" "anxiety about health and one own future" "interference to family life'. The findings of this study will be useful in understanding the difficulties of nursing personnel when confronting the aggressive behavior of dementia partients. It also is useful as basic data in preparing efficient intervention program for these difficulties.

Factors responsible for nursing personnel's occupational injuries and maintenance of their health / 中华医院管理杂志

It is pointed out that nursing personnel at the clinical forefront are a high-risk group for occupational injuries. The risk factors include: lack of knowledge on occupational injuries and their prevention in elementary and continuing education; various factors affecting nursing personnel's physical health, such as drug-dissolving facilities for the special purpose of chemotherapy, imperfect clean work station or relatively hermetical drug-dissolving environment ; increase of diseases that could be easily contracted in the hospital, such as hepatitis B, with the stabbing of nursing personnel by sharp medical instruments infected by blood or saliva being the main route of their occupational infection. The disadvantageous impact of occupation on their health puts nursing personnel under great psychological pressure. In order to safeguard their physical and mental health, it is imperative to put knowledge on hospital infection, occupational injuries and health maintenance on the curriculum of medical colleges and universities, reinforce nursing personnel's training in occupational safety, and take measures to prevent occupational injuries, such as using disposable gloves when dispensing medicines in chemotherapeutic drug centers.