Intervenciones de enfermería en Medicina Natural y Tradicional para la rehabilitación de pacientes operados de cardiopatías congénitas

Introducción: El sistema de salud cubano insiste en la necesidad de adiestrar profesionales en modalidades de Medicina Natural y Tradicional. Su integración aumenta los recursos diagnósticos terapéuticos en la prevención, promoción y rehabilitación de individuos, familias y comunidades. La Medicina Natural y Tradicional es promovida por la Organización Mundial de la Salud, y está incluida en la Clasificación de Intervenciones de Enfermería. El término "intervención de enfermería" se asume para integrar estas modalidades a la rehabilitación de personas operadas de cardiopatías congénitas. Objetivo: Diseñar la integración de la Medicina Natural y Tradicional en las intervenciones de enfermería para la rehabilitación de personas operadas de cardiopatía congénita. Materiales y métodos: Estudio descriptivo y transversal realizado en el Cardiocentro Pediátrico William Soler, de La Habana, en el período 2016-2018. El universo estuvo conformado por 100 enfermeras/os, de las/os cuales 60 fueron seleccionadas/os mediante muestreo aleatorio simple. Se diseñó un instrumento que se validó por criterio de expertos. La información se procesó con frecuencias absolutas y porcentajes. Resultados: El criterio de expertos determinó la viabilidad de la propuesta, su consolidación para desarrollar cuidados holísticos, naturales e integrales, y el diseño de la integración de la Medicina Natural y Tradicional en intervenciones de enfermería para la rehabilitación de personas operadas de cardiopatías congénitas. Asimismo, complementar protocolos utilizados en el Departamento de Rehabilitación del Cardiocentro Pediátrico William Soler, además de la superación profesional. Conclusiones: Se seleccionaron diagnósticos e intervenciones reconocidas por la Clasificación de Intervenciones de Enfermería, aplicables para solucionar problemas detectados en la rehabilitación de personas operadas de cardiopatías congénitas, lo que contribuyó como aporte teórico desde la ciencia a la práctica enfermera.

Introduction: The Cuban health system insists on the need of training professionals on modalities on Natural and Traditional Medicine. Their integration increases the diagnostic nd therapeutic resources in the promotion, prevention and rehabilitation of individuals,familiesand communities. Natural and Traditional Medicine is promoted by the World Health Organization, and is included in the Classification of Nursing Interventions. The term "nursing intervention" is assumed to integrate these modalities into the rehabilitation of persons operated on for congenital heart diseases. Objective: To design the integration of the Natural and Traditional Medicine into nursing interventions for the rehabilitation of persons operated on for congenital heart diseases. Materials and methods: Descriptive, cross-sectional study carried out in the Pediatric Heart center William Soler, of Havana, in the period 2016-2018. The universe was made up by 100 male and female nurses, 60 of whom were selected through simple randomly sampling. An instrument was, designed that was validated by expert criteria. The information was processed with absolute frequencies and percentages. Results: The expert criteria determined the proposal's viability, its consolidation to develop holistic, natural and comprehensive care, and the design of the integration of Natural and Traditional Medicine into nursing interventions for the rehabilitation of persons operated on for congenital heart diseases. Likewise, complement protocols used in the Rehabilitation Department of the Pediatric Heart center William Soler, in addition to professional upgrading. Conclusions: Diagnoses and interventions recognized by the Classification of Nursing Interventions were selected, applicable to solve problems detected in the rehabilitation of persons operated on for congenital heart diseases, which contributed to the nursing practice as a theoretical scientific contribution.

Nivel de conocimientos de enfermeros sobre medicina natural y tradicional para la rehabilitación de operados de cardiopatías congénitas

Introducción: la medicina natural y tradicional puede integrarse a la rehabilitación de los pacientes operados de cardiopatías congénitas, por lo que se requieren profesionales de enfermería con preparación para realizar las intervenciones específicas útiles en estos pacientes. Objetivo: identificar el nivel de conocimientos que posee el personal de enfermería sobre medicina natural y tradicional para la rehabilitación de las personas operadas de cardiopatía congénita. Materiales y métodos: se realizó un estudio descriptivo, transversal, en el Cardiocentro Pediátrico William Soler, de La Habana, durante el período junio-noviembre de 2019. Se aplicó una encuesta diseñada por los investigadores y validada por criterio de expertos. El universo lo constituyeron 100 enfermeras involucradas en el proceso de rehabilitación en práctica diaria, de las cuales se seleccionaron 60 mediante muestreo aleatorio simple. Para procesar la información se utilizó el software estadístico IMB SPSS Statistics. Resultados: se identificó el bajo nivel de conocimientos sobre las intervenciones de enfermería en medicina natural y tradicional para la rehabilitación de personas operadas de cardiopatías congénitas, resultado esperado por la insuficiente investigación en ese campo. Conclusiones: el estudio posibilitó identificar las debilidades relacionadas con el objeto de estudio, y propuso el diseño de un programa para la integración de la medicina natural y tradicional en las intervenciones de enfermería para la rehabilitación de personas operadas de cardiopatías congénitas.

Introduction: natural and traditional medicine can be integrated into the rehabilitation of patients operated of congenital heart diseases, so nursing professionals are required with training to perform the specific interventions that are useful in these patients. Objective: to identify the level of knowledge that the nursing staff have on natural and traditional medicine for the rehabilitation of patients operated of congenital heart disease. Materials and methods: across-sectional, descriptive study was carried out in the Pediatric Cardio Center William Soler, in Havana, during the period from June to November 2019. A survey, designed by the researchers and validated by expert criteria, was applied. The universe were 100 nurses involved in the rehabilitation process in their daily practice, of whom 60 were selected by simple random sampling. IMB SPSS Statistics software was used to process the information. Results: the low level of knowledge on nursing interventions in natural and traditional medicine for the rehabilitation of patients operated of congenital heart diseases was identified, an expected result due to insufficient research in this field. Conclusions: the study made it possible to identify weaknesses related to the object of study, and proposed the design of a program to integrate natural and traditional medicine into nursing interventions for the rehabilitation of patients operated of congenital heart diseases.

Pandemia COVID-19: Necessidades humanas de cuidado ao paciente com traqueostomia e as intervenções de enfermagem / Pandemia de COVID-19: Necesidades de cuidado humano de pacientes con traqueostomía e intervenciones de enfermería / COVID-19 pandemic: Human care needs of patients with tracheostomy and nursing interventions

Objetivo: refletir as necessidades básicas de saúde ao paciente com traqueostomia por câncer de cabeça e pescoço no contexto da pandemia pelo coronavírus, utilizando a Teoria das Necessidades Básicas. Método: estudo teórico-reflexivo. Foram utilizados documentos do Ministério da Saúde e da Organização Pan-Americana de Saúde, assim como uma revisão da literatura na base de dados da PUBMED para que a literatura científica associasse com os documentos consultados. Resultados: as necessidades básicas de saúde afetadas foram: Psicobiológicas de oxigenação e ambiente; Psicossociais de segurança e comunicação e Psicoespirituais de religião, seguidas dos enunciados das Intervenções de Enfermagem (NIC) como oxigenoterapia, aumento da segurança do paciente, estímulo a rituais religiosos. Conclusão: a construção do saber científico na Enfermagem torna-se imperioso, para que as necessidades de saúde afetadas ao paciente com traqueostomia na pandemia da COVID-19 sejam atendidas, para promoção da saúde e da vida.(AU)

Objective: to reflect the basic health needs of patients with tracheostomy for head and neck cancer in the context of the coronavirus pandemic, using the Theory of Basic Needs. Method: This is a reflective study, carried out through a critical reading of official documents from national and international health agencies and other conceptual sources on the subject.Results: the basic health needs affected were: Psychobiological oxygenation and environment; Psychosocial security; communication and health education and Psychospirituals of religion, followed by nursing interventions of NIC activities, oxygen therapy, environmental control, increased safety, improved communication in speech deficits; encouraging religious rituals and facilitating an efficient decision-making process. Conclusion: the construction of scientific knowledge in Nursing becomes imperative, so that the health needs affected by the patient with tracheostomy in the COVID-19 Pandemic are met, to promote health and life.(AU)

Objetivo: reflejar las necesidades básicas de salud de los pacientes traqueostomizados por cáncer de cabeza y cuello en el contexto de la pandemia del coronavirus, utilizando la Teoría de las Necesidades Básicas. Método: Se trata de un estudio reflexivo, realizado a través de una lectura crítica de documentos oficiales de organismos de salud nacionales e internacionales y otras fuentes conceptuales sobre el tema. Resultados: las necesidades básicas de salud afectadas fueron: Oxigenación psicobiológica y medio ambiente; seguridad psicosocial; comunicación y educación para la salud y Psicoespirituales de la religión, seguidas de las intervenciones de enfermería de las actividades NIC, oxigenoterapia, control ambiental, aumento de la seguridad, mejora de la comunicación en los déficits del habla; fomentar los rituales religiosos y facilitar un proceso eficiente de toma de decisiones. Conclusión: la construcción del conocimiento científico en Enfermería se torna imperativa, para que sean atendidas las necesidades de salud afectadas por el paciente con traqueotomía en la Pandemia del COVID-19, para promover la salud y la vida.(AU)

Sistematização da assistência de enfermagem em obstetrícia: estruturação de um banco de dados / Sistematización de la atención de enfermería en obstetría: estructurando una base de datos / Systematization of nursing care in obstetrics: structuring a database

Objetivo: estruturar um banco de dados com diagnósticos e intervenções/atividades de enfermagem para asmulheres no ciclo gravídico-puerperal. Método: pesquisa metodológica, realizada numa maternidade pública, em João Pessoa, Paraíba, Brasil, entre 2015 a 2016, em três etapas: mapeamento cruzado dos diagnósticos de enfermagem com os conceitos da Taxonomia li da North American Nursing Diagnosis Association lnternational, identificação das intervenções/atividades de enfermagem e comparação com as propostas pela Classificação das Intervenções de Enfermagem; e, validação dos diagnósticos e intervenções/atividades de enfermagem. Resultados: foram validados 93 diagnósticos, sendo 36 para as gestantes patológicas, 27 para as parturientes e 31 para as puérperas; e 996 intervenções/atividades de enfermagem para os diagnósticos validados no ciclo gravídico puerperal. Conclusão: a utilização de um banco de dados compatível com a prática de enfermagem desenvolvida na área obstétrica facilita o desenvolvimento das etapas do Processo de Enfermagem e reduz a lacuna entre teoria e prática.(AU)

Objective: to structure a database with diagnoses and nursing interventions/activities for women in the pregnancy­puerperal cycle. Method: methodological research, carried out in a public maternity hospital, in João Pessoa, Paraíba, Brazil, from 2015 to 2016, in three stages: cross-mapping of nursing diagnoses with the concepts of North American Nursing Diagnosis Association lnternational Taxonomy li, identification of nursing interventions/activities and comparison with the proposed by the Classification of Nursing lnterventions; and, validation of nursing diagnoses and interventions/activities. Results: 93 diagnoses were validated, 36 for pathological pregnant women, 27 for pregnant women and 31 for puerperal women; and 996 nursing interventions/activities for diagnoses validated in the puerperal pregnancy cycle. Conclusion: the use of a database compatible with the nursing practice developed in the obstetric area facilitates the development of the stages of the Nursing Process and reduces the gap between theory and practice. (AU)

Objetivo: estructurar una base de datas con diagnósticos e intervenciones/actividades de enfermería para mujeres enel ciclo embarazo-puerperal. Método: investigación metodológica, realizada en una maternidad pública, en João Pessoa, Paraíba, Brasil, de 2015 a 2016, en tres etapas: mapeo cruzado de diagnósticos de enfermería con los conceptos de la Taxonomía li de Asociación Internacional de Diagnóstico de Enfermería de América dei Norte, identificación de intervenciones/actividades de enfermería y comparación con las propuestas por la Clasificación de lntervenciones de Enfermería; y validación de diagnósticos e intervenciones/actividades de enfermería. Resultados: se validaron 93 diagnósticos, 36 para gestantes patológicas, 27 para gestantes y 31 para puérperas; y 996 intervenciones/actividades de enfermería para diagnósticos validados en el ciclo dei embarazo puerperal. Conclusión: el uso de una base de datas compatible con la práctica de enfermería desarrollada en el área obstétrica facilita el desarrollo de las etapas dei Proceso de Enfermería y reduce la brecha entre teoría y práctica.(AU)

A Prospective Study of Da Vinci Surgical Robotic System with Chest Wall External Nursing Interventions / 中国肺癌杂志

BACKGROUND@#Minimally invasive and rapid recovery are trends in surgical treatment of lung cancer, and Da Vinci Surgical Robotic System plays an important role in them. This study was planned to explore the effect of chest wall external nursing interventions on reducing postoperative thoracic drainage and promoting rapid recovery of patients.@*METHODS@#The patients who underwent robotic radical lung cancer resection in our hospital from November 2017 to April 2018were randomly divided into two groups. The control group received robotic radical lung cancer resection with abdominal bands wrapped around the chest. The experimental group underwent Da Vinci robotic radical lung cancer surgery and assisted chest wall external nursing interventions after surgery.@*RESULTS@#The total and average daily drainage of the experimental group were less than those of the control group. Both the extubation time and the hospitalization time were shorter than those of the control group, but there was no significant difference. The pain score in the second days after operation of the experimental group was slightly higher than that of the control group, with no significant statistical difference. For patients whose chest wall thickness is less than 4 cm, mirabilite external application can significantly reduce the average daily and total drainage volume, but there is no significant difference in extubation time and hospitalization time.@*CONCLUSIONS@#Chest wall external nursing interventions are beneficial to the recovery of patients undergoing Vinci robotic lung cancer surgery. Especially for patients with thinner chest wall. It can reduce postoperative drainage, shorten tube retention time and accelerate discharge. Further improvement is expected to achieve better clinical results.

Pós-operatório de revascularização do miocárdio: possíveis diagnósticos e intervenções de enfermagem / Postoperative myocardial revascularization: possible diagnosis and nursing interventions / La revascularización miocárdica postoperatoria: posibles diagnósticos e intervenciones de enfermeira

Objective: The research's main focus was to describe both the diagnosis and nursing interventions most common in the postoperative period of myocardial revascularization. Methods: It is an integrative literature review that was performed an analysis of publications on the subject. In order to guide the literature search, it was used the Patient, Intervention, Comparison and Outcomes (PICO) strategy, and with the purpose of complement the review, 13 articles on the topic were selected. Results: The research data made possible to identify 25 nursing diagnosis, according to the North American Nursing Diagnosis Association (NANDA) Taxonomy II, among them are Risk for infection; Acute pain; Decreased cardiac output; Impaired gas exchange; Risk for unstable blood glucose level among others. Conclusion: The research proved to be crucial to developing studies regarding nursing diagnosis in the postoperative period of myocardial revascularization, directing the nursing patient-specific actions, and then facilitating their decision-making process

Objetivo: Descrever os diagnósticos e intervenções de enfermagem mais comuns no período de pós-operatório de revascularização do miocárdio. Métodos: Trata-se de uma revisão integrativa da literatura, com analise de publicação sobre a temática. Para norteamento a busca da literatura foi utilizada como estratégia PICO. Para complementar a pesquisa selecionou-se 13 artigos sobre o tema. Resultados: As informações possibilitaram identificar 25 diagnósticos de enfermagem, segundo a Taxonomia II NANDA, dentre eles destacam-se: Risco para infecção; Dor aguda; Debito cardíaco diminuído; troca de gases prejudicada; Risco de Glicemia instável dentre outros. Conclusão: O estudo revelou ser fundamental desenvolver estudos sobre diagnósticos de enfermagem no pós-operatório de Revascularização do miocárdio, direcionando a enfermagem em ações específicas de cada paciente, facilitando sua tomada de decisão

Objetivo: Describir los diagnósticos de enfermería y las intervenciones son más comunes en el postoperatorio de cirugía de revascularización miocárdica. Metodos: Se trata de un examen integrador de la literatura, con el análisis de la publicación sobre el tema. A norteamento la búsqueda en la literatura se usa como estrategia de pico. Para complementar la investigación hemos seleccionado 13 artículos sobre el tema. Resultados: La información nos permitió identificar 25 diagnósticos de enfermería, según la taxonomía de la NANDA II, entre ellos son: riesgo de infección; Dolor agudo; Insuficiencia cardiaca; intercambio gaseoso disminuidos visuales; Riesgo de glucemia inestable entre otros. Conclusión: El estudio demostró ser crucial para desarrollar estudios sobre diagnósticos de enfermería en el postoperatorio de cirugía de revascularización miocárdica, dirigiendo las acciones de enfermería específicos para cada paciente, facilitando su toma de decisiones

Effect of the cluster nursing interventions to ICU mechanical ventilation patients: a Meta analysis in China / 中国实用护理杂志

Objective@#To evaluate the effect of ICU mechanical ventilation patients with cluster nursing and conventional nursing, and provide the basis for the clinical work.@*Methods@#Randomized controlled trials (RCTs) related to the ICU mechanical ventilation patients with cluster nursing and conventional nursing were collected through the databases such as CBM、CNKI, Wanfang Data, VIP Data. Meta-analyses were conducted for the included studies by the RevMan 5.3 software.@*Results@#A total of 12 qualified research literatures were included, with a total sample size of 1478 cases, the test group 742 cases, the control group 736 cases. Meta-analysis showed that cluster nursing intervention can reduce the time of ICU patients with mechanical ventilation (Z=14.00, P<0.01), reduce the time at ICU (Z=41.89, P<0.01), reduce the incidence of ventilator associated pneumonia (Z=8.33, P<0.01) and reduce the patient mortality (Z=2.79, P<0.01).@*Conclusions@#The results of this meta-analysis showed that cluster nursing measures were statistically significant in reducing mechanical ventilation complications in ICU patients compared with conventional nursing measures. However, in view of the methodological quality and limitations of this study included in the literature. Suggestions for future research to carry out large sample, high quality, multicenter randomized controlled study, make the ICU mechanical ventilation in patients with cluster nursing measures to constantly update and perfect, as well as to seek more evidence-based nursing support evidence.

Research on the influence of high quality nursing interventions in patients with pernicious placenta previa and the neonate's prognosis / 中国实用护理杂志

Objective To explore the influence of high quality nursing interventions in patients with pernicious placenta previa and the neonate's prognosis. Methods The clinical data about 28 patients with pernicious placenta previa treated from January 2016 to January 2017 were reviewed;the high quality nursing interventions were applied(study group). 30 patients with pernicious placenta previa treated from December 2014 to December 2015 were selected;the conventional nursing cares were applied (control group). After intervention, the clinical prognosis for the infants and mom was analyzed. Results At the time of admission, the research group of state anxiety and trait anxiety and depression scale scores were 58.42±3.61,55.57±2.69,55.06±2.67,before discharge,patients in the study group,state anxiety and trait anxiety and depression scale scores were 42.19 ±2.16,47.20±2.74 and 44.25± 4.36,the control group were respectively 58.96±3.35,55.27±2.75,55.23±3.12,before discharge respectively 44.35± 3.13, 49.35 ± 3.13, 48.67 ± 5.16, two groups were SAI, TAI and SDS score comparison no statistical significance (t=0.591, 0.420, 0.222, P > 0.05), the difference between the two groups before discharge compared with statistical significance (t=3.038, 2.775, 3.511, P<0.01);the time of termination of pregnancy, postpartum hemorrhage and neonatal postpartum 1min Apgar scores of the study group were 36.15± 0.77,1 000.19 ± 14.21,9.13± 0.10,the control group were 33.50±0.66,1 516.71 ±29.08,8.79± 0.50, and the difference was statistically significant (t=14.102, 32.490, 3.531, P<0.01);comparison of body mass in two groups showed no statistical significance (P>0.05);group of maternal and neonatal complications for a total of 7.14% (2/28), significantly lower than the control group 20.00%(6/30), the difference between significant(χ2=7.050,P<0.01);evaluation of nursing measures of maternal satisfaction in the study group(95.23+4.65)was higher than that of the control group(91.36±5.63),the difference was statistically significant correlation (t=2.842,P<0.05). Conclusions The high quality nursing interventions have an obvious effect in patients with pernicious placenta previa.It can relieve the negative emotions and improve the mom&infant's outcomes and the clinical satisfaction.

Initially identification of core interventions to pediatric nursing based on Nursing Interventions Classification / 中国实用护理杂志

Objective To identify the core interventions preliminarily performed by pediatric nurses for hospitalized children. Methods Based on Nursing Interventions Classification (NIC), the data of survey related to the factors of representation and frequency derived from the definition of Core Nursing Interventions were collected from 59 pediatric senior nurses above the 3rd clinical ladder, working in one of Shanghai university affiliated and tertiary children hospitals. The data was analyzed by L type of Metric Diagram. The intervention with product of two factors above 12 was selected as the core intervention. Results A total of 109 interventions were selected as core interventions on pediatric nursing from 497 interventions of NIC. The top 3 domains in quantity of interventions were physiological complex domain (36 items), physiological basic domain (26 items) and health system domain (19 items). The domain with the highest score (16.79 ± 3.42) was safety domain, followed by physiological complex domain (16.19 ± 2.98), while domain with the lowest score (13.62±2.05) was family domain. Conclusions The initial and systematic pediatric nursing core interventions were identified based on NIC and definition of core intervention. Part of core interventions reflects the characteristics of pediatric nursing practice, but more is requested to reflect the pediatric-specific care related to family-center and age-appropriated concepts. Some of inefficient interventions remind nursing administers further reflect thinking, especially on human resource management.

Clinical application of nursing diagnosis, nursing outcome clacication and nursing interventions clacica-tion in health education for hospitalized patients with coronary heart disease / 现代临床护理

Objective To validate the effect of nursing diagnosis, outcomes clacication and interventions clacication(NNN Link)on health education in hospitalized patients with coronary heart disease. Methods Ninety-six patients with coronary heart disease in our hospital during July 2016 to July 2017 were randomly divided into experimental group and control group equally. The control group was given the conventional health education, while the experimental group was given health education by NNN Link at days 1,2,3,7 and one day before discharge.The two groups were compared in terms of nursing outcome scores on admission day,the 5th day and discharge day. Result Day 5 after hospitalization and the day discharged,the scores of knowledge in the experimental group were significantly higher than those of the control group(all P＜0.05). Conclusion The linked nursing diagnosis, nursing outcome and nursing interventions can promote the knowledge of health knowledge and help to improve the quality of nursing service so as to promote research and application of standardized nursing language.

Mapping analysis of application of nursing interventions classification in pediatric cardiology nursing docu-mentation / 中华护理杂志

Objective To analyze the feasibility of nursing interventions classification in pediatric cardiology,and to provide references for standardizing nursing terms and promoting its clinical application in the future. Methods We collected nursing records in department of cardiology in a pediatric hospital from September 1st,2016,to November 31st,2016,and used mapping method to find out the conceptual congruence between nursing interventions classification (NIC-6th) and nursing records. We analyzed characteristics of standardized nursing interventions using dimensions of time and difficulty. Results Totally 71 nursing interventions were mapped from 4191 independent nursing statements,which involved 7 domains. Of the 4191 statements,3046 (95.33%) were labelled as "perfect fit",142 (4.44%) as "partial fit",and 7 (0.23%) as "not fit at all". The average difficulty of nursing interventions was 1.77 and the average time was 2.11. Conclusion Nursing interventions classification can describe daily nurs-ing activities in pediatric cardiology and can be used as standard nursing language in China. The extracted nursing interventions demonstrate certain specificity of specialty nursing,but still have defects. The results of this study can be used for analysis of staff performance.

Carga de trabalho dos profissionais de saúde: instrumentos de medida segundo a Classificação das Intervenções de Enfermagem / Health professionals workload: measurement instruments according to the Nursing Interventions Classification

Introdução: Conhecer e medir a carga de trabalho dos profissionais de saúde pode contribuir para a gestão eficiente e eficaz das organizações de saúde, a carga de trabalho excessiva é a principal causa de estresse e insatisfação. Objetivo: Levantar e analisar as dissertações e teses referentes à distribuição da carga de trabalho dos profissionais de saúde, fundamentadas na Classificação das Intervenções de Enfermagem, desenvolvidas por participantes do grupo de pesquisa Gerenciamento de recursos humanos: conceitos, instrumentos e indicadores do processo de dimensionamento de pessoal, cadastrado no diretório do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Método: Estudo secundário tipo documental para identificar os instrumentos produzidos para medir a carga de trabalho, as intervenções/atividades realizadas, bem como a probabilidade de ocorrência e o percentual do tempo produtivo na jornada de trabalhadores profissionais de saúde. As fontes de dados foram dissertações e teses desenvolvidas pelos participantes do grupo de pesquisa disponíveis no banco de TESES-USP e DEDALUS. Resultados: Foram selecionados dezessete estudos nos quais foram construídos dezessete instrumentos de medida da carga de trabalho para profissionais de saúde sendo: 11,7% enfermeiros, 76,5% enfermeiros e técnicos/auxiliares de enfermagem, 5,9% assistente técnico administrativo e 5,9% nutricionista clínico. Os instrumentos foram aplicados nas unidades de alojamento conjunto, ambulatório de especialidades de oncologia e hematologia, centro cirúrgico de oncologia, centro de diagnóstico por imagem, clínica cirúrgica, clínica médica, emergência, serviço de nutrição, sala de recuperação pós-anestésica, unidade de internação pediátrica, unidades de terapias intensivas: adulto, pediátrica e neonatal; unidade de saúde da família. Os instrumentos apresentaram 192 intervenções de cuidado direto, 75 com frequência 1% e 80 intervenções de cuidado indireto, 39 com frequência 1%. As intervenções com maior frequência, no conjunto das unidades, foram Documentação, Administração de medicamentos, Passagem de plantão. O tempo produtivo dos profissionais na jornada ficou distribuído entre intervenções de cuidado direto e indireto e atividades associadas ao trabalho. Conclusões: Os instrumentos elaborados e aplicados evidenciaram as intervenções/atividades essenciais em cada unidade estudada e por categoria profissional que mais contribuem na medida da carga de trabalho e no tempo produtivo, mostrando ser importante estratégia gerencial para reorganizar os processos de trabalho.

Introduction: Knowing and measuring the workload of health professionals can contribute to the efficient and effective management of health organizations; excessive workload is the main cause of stress and dissatisfaction. Objectives: Analyze the dissertations and theses related to the distribution of the workload of health professionals, based on the Classification of Nursing Interventions, developed by participants of the research group "Human resources management: concepts, instruments and indicators of the nursing staff process registered in the directory of the National Council of Scientific and Technological Development (CNPq). Methods: Documentary study secondary type to identify the instruments produced to measure the workload, was performed, the interventions / activities performed, the interventions / activities performed, as well as the probability of occurrence and the percentage of productive time in the workday of health professionals. The data sources were dissertations and theses, developed by the research group participants available at the thesis base USP and DEDALUS. Results: Were selected seventeen studies were carried out in which 17 workload measurement instruments were constructed for health professionals: 11.7% nurses, 76.5% nurses and technicians/Nursing assistants, 5.9% administrative assistant and 5, 9% clinical nutritionist. They were applied in pediatric areas, medical clinic, surgical clinic, emergency, rooming-in, surgical center, units of intensive therapies: adult, pediatric and neonatal, oncology and hematology outpatient clinic, diagnostic imaging center; family health unit and nutrition service. The instruments presented 192 direct care interventions, 75 with 1% frequency and 80 indirect care interventions, 39 with frequency 1%. The most frequent interventions, in the units as a whole, were Documentation, Medication Administration, Shift work. The productive time of the professionals on the journey was distributed between direct and indirect care interventions and work-related activities. Conclusions: The instruments elaborated and applied showed the essential interventions / activities in each unit studied and by professional category that contribute the most to the work load and productive time, showing that it is an important managerial strategy to reorganize work processes.

Factors Affecting Nursing Interventions for Pain among Nurses in Neonatal Intensive Care Unit

PURPOSE: The purpose of this study was to investigate NICU nurses' nursing interventions for pain and factors affecting nursing interventions for pain. METHODS: Participants were 120 NICU nurses from 5 university hospitals located in Daejeon Metropolitan City and Chungcheong Province. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA and Duncan test, Pearson correlation coefficients and multiple regression analysis with SPSS Windows 23.0 IBM program. RESULTS: The factors affecting nursing interventions for pain included knowledge about non-pharmacological nursing interventions for pain and self-efficacy about nursing interventions for pain. These variables explained 28.3% of nursing interventions for pain. CONCLUSION: The results of this study suggest that it is necessary to develop education programs in which effective nursing interventions for neonatal pain are considered. The programs should be made available to NICU nurses.

Género y efectividad de la metodología enfermera en pacientes con insuficiencia cardiaca / Gender and Effectiveness of the Nursing Methodology in Heart Failure Patients / Gênero e efetividade da metodologia enfermeira em pacientes com insuficiência cardíaca

Estudios recientes demostraron que una intervención enfermera de educación sanitaria en la insuficiencia cardiaca (IC) evita descompensaciones. Por otro lado, dado que existen diferencias de género en los patrones de la IC, las intervenciones tendrán también efectos distintos. Objetivos: determinar la existencia de posibles diferencias según el género de los pacientes, en el efecto de una intervención enfermera respecto al autocuidado. Materiales y métodos: se realizó un estudio cuasiexperimental con pacientes atendidos en consulta de IC (129), seleccionados en dos tiempos, primer trimestre año grupo control (62), y segundo trimestre año grupo intervención (67). Todos se evaluaron tres veces: primera consulta, tres y seis meses. Al grupo intervención se aplicó en cada visita una intervención enfermera que consistía en educación terapéutica, control y seguimiento de su IC. Resultados: Inicio: T.A. sistólica hombres 133,90 ± 0,96 (DE 27,77); mujeres 119,64 ± 0,57 (DE 18,72). Cuidador 93 % hombres, 63 % mujeres. Conducta terapéutica 2,07 ± 0,02 (DE 0,20) hombres; 3,04 ± 0,01 (DE 0,31) mujeres. Final: autocuidado -16,00 ± 2,08 (DE 10,99) hombres; -9,68 ± 2,22 (DE 12,92) mujeres. Adherencia terapéutica 1,32 ± 0,35 (DE 1,83) hombres, 2,94 ± 1,87 (DE 10,93) mujeres. Mejoría muy similar de la Nursing Outcomes Classification (NOC) en todos. Conclusiones: en el grupo de estudio participaron más mujeres. Los hombres tuvieron más comorbilidad, consumo de tabaco, alcohol. Inicialmente los hombres presentaban mejor calidad de vida. Después de la intervención mejora el autocuidado en todos los participantes pero el doble en hombres. También mejora adhesión terapéutica en todos, en las mujeres mejora el doble. Todos los pacientes mejoran respecto a la calidad de vida y resultados NOC.

Recent studies show that nurse intervention in health education in Heart Failure (HF) prevents decompensation in Heart Failure (HF). Furthermore, given gender differences in HF patterns, the interventions will also have different effects. Objective: To determine the existence of possible differences in the effects of a nurse's intervention regarding self-care based on the patient's gender. Materials and method: A quasi-experimental study was carried out with HF patients (129). They were selected at two different times: first quarter's control group (62) and second quarter's intervention group (67). They were all assessed three times: first appointment, three and six month check-ups. The intervention group underwent a nurse intervention during each visit, consisting of therapeutic education, control and monitoring of their HF. Results: Beginning: Systolic blood pressure in men 133.90±0.96 (DE 27.77), women 119.64±0.57 (DE18.72). Caregiver 93% male, 63% female. Therapeutic approach 2.07 + 0.02 (DE0.20) men, 3.04+0.01 (DE 0.31) women. Final: self-care -16.00±2.08 (DE10.99) men, -9.68±2.22 (DE12.92) women. Therapeutic adherence 1.32±0.35 (DE1.83) men, 2.94±1.87 (DE10.93) women. Very similar improvements in the NOC of all patients. Conclusions: More women participated in the study than men; [1] the former showed a higher percentage of comorbidity, smoking and alcohol consumption than women and they had an informal caregiver. As to self-care and adherence to treatment, no significant differences were found between genders, while quality of life was better in men. After the intervention, the researchers found that all patients improved in terms of quality of life and NOC (Nursing outcomes classification), as did the self-care and therapeutic adherence of all participants. [2] It is worth noting that men scored twice as high in self-care, while women did so in therapeutic adherence.

Estudos recentes demonstraram que uma intervenção enfermeira de educação sanitária na insuficiência cardíaca (IC) evita descompensações. No entanto, tendo em vista que existem diferenças de gênero nos padrões da IC, as intervenções terão também efeitos diferentes. Objetivo: determinar a existência de possíveis diferenças segundo o gênero dos pacientes, no efeito de uma intervenção enfermeira a respeito do autocuidado. Material e método: realizou-se um estudo quase experimental com pacientes atendidos em consultas de IC (129). Selecionados em dois tempos, primeiro trimestre ano grupo controle (62) e segundo trimestre ano grupo intervenção (67). Todos foram avaliados três vezes, primeira consulta, três e seis meses. Ao grupo de intervenção, foi aplicada, em cada visita, uma intervenção enfermeira que consistia na educação terapêutica, controle e seguimento de sua IC. Resultados: início: TA sistólica homens 133.90±0.96 (DE 27.77), mulheres 119.64±0.57 (DE18.72). Cuidador 93% homens, 63% mulheres. Comportamento terapêutico 2.07 + 0.02 (DE0.20) homens, 3.04+0.01 (DE 0.31) mulheres. Final: autocuidado -16.00±2.08 (DE10.99) homens, -9.68±2.22 (DE12.92) mulheres. Adesão terapêutica 1.32±0.35 (DE1.83) homens, 2.94±1.87 (DE10.93) mulheres. Melhora muito semelhante dos NOC (Nursing Outcomes Classification) em todos. Conclusão: do grupo de estudo, participaram mais mulheres do que homens; contudo, estes últimos tiveram mais comorbidade, consumo de tabaco e de álcool e dispunham de uma cuidadora informal. Com relação ao autocuidado e a adesão ao tratamento, na valoração inicial, não se constatou uma diferença significativa entre ambos os gêneros, enquanto na qualidade de vida, o resultado foi melhor nos homens. Após a intervenção, observou-se que todos os pacientes melhoraram os resultados em qualidade de vida e em Nursing outcomes classification (NOC), bem como no autocuidado e na adesão terapêutica. É relevante destacar que os homens dobraram a pontuação em autocuidado e as mulheres em adesão terapêutica.

Multi-intervención para disminuir el estrés agudo del cuidador familiar del paciente en la UCI / Multi-intervention to reduce the acute stress of the family caregiver of the patient in the ICU

El internamiento de un familiar en la Unidad de Cuidados Intensivos (UCI) causa estrés en la familia por el alto riesgo de muerte e incertidumbre sobre el pronóstico, lo cual dificulta la toma de decisiones del Cuidador Familiar (CF) e incrementa el riesgo de anular la atención de sus necesidades. La información publicada sobre intervenciones para disminuir el estrés agudo en los CF son limitadas y controvertidas, por lo que se propone una intervención basada en la mejor evidencia disponible adaptado al contexto del CF de la UCI en México. Objetivo: Evaluar el efecto de una multi-intervención que involucra una plática estructurada, información impresa y consultoría sobre el estrés agudo del CF del paciente en la UCI. Metodología: Se trata de un estudio cuasi-experimental, pre y post-test, que incluyó a 64 CF para evaluar la Ansiedad Estado-Rasgo, se utilizó el inventario IDARE, se comparó el nivel de estrés entre los grupos y al interior de cada grupo pre y post-test. Resultados: en la Ansiedad-Estado hubo diferencias significativas entre los grupos control y experimental en el postest, mediana=48 (P25-P75=44.2-60.7), mediana= 45.5 (P25-P75=38.2-49) respectivamente. Así mismo se observó una disminución en el grupo experimental antes y después de la intervención, mediana=54 (P25-P75= 48-60.7), mediana=45.5 (P25-P75=38.2-49), (p=0.005). Conclusiones/implicaciones: Implementar una multi-intervención multidisciplinar que involucre la educación, información impresa y consultoría, reduce los niveles de estrés agudo del CF comparado con quienes reciben una información rutinaria. Se observó que los CF tienen niveles elevados de ansiedad en especial las mujeres, jefe de familia, residentes del Estado de México y cuando la probabilidad de muerte es alta. La investigación refrenda el tema que el desempleo y el desarrollo de enfermedades en el CF son condiciones que sin duda inciden en el desarrollo de la ansiedad.

The placement of a relative in the Intensive Care Unit (ICU), may cause family stress due to the high risk of death and uncertainty about the prognostic, which hampering decision-making by the Family Caregiver (FC), and could increases the risk of cancel the attention of their needs. Interventions to reduce acute stress in FC are limited and controversial, so an intervention based on the best available evidence adapted to the context of FC UCI in Mexico is proposed. Objective: To evaluate the effect of a multi-intervention involving a structured discussion, printed information and consultancy on the acute stress of CF of patient in the ICU. Methodology: This is a quasi-experimental study, pre and post-test, that includes 64 CF to assess the State-Trait Anxiety, with IDARE inventory, stress level was compared between and within groups, pre and post-test. Results: Anxiety-State showed significant differences between the control and experimental group in the posttest, median = 48 (P25-P75 = 44.2-60.7), median = 45.5 (P25-P75 = 38.2-49) respectively. Likewise, a signifcant decrease of Anxiety-State was observed after the intervention in the experimental group, median = 54 (P25-P75 = 48-60.7), median = 45.5 (P25-P75 = 38.2-49), (p = 0.005). Conclusions / Implications: a multidisciplinary multi-intervention involving education, printed information and consulting, reduces acute stress levels of FC compared with those receiving routine information. It was noted that the FC have elevated levels of anxiety especially women, household head, residents of the State of Mexico and in those with a high likelihood of death. This investigation authenticates that the unemployment and the development of diseases in the CF are conditions that have a direct influence on the develompent of anxiety.

Establishment of nursing measures for patients with hemiplegia after stroke in various functions based on Nursing Interventions Classification / 中国实用护理杂志

Objective To identify the nursing interventions and activities for hemiplegic patients in various functions suffered from stroke,and guide clinical practice.Methods Review rehabilitation of evidence-based clinical practice and literature of hemiplegic patients,stroke patients in different functional states were continuously cared and recorded by a researcher.Nursing program was identified according to patients' functions and the sixth edition of Nursing Interventions Classification,8 experts were consulted by a questionnaire survey,which was based on the initial screened nursing interventions and activities,30 nurses and 41 experts were consulted then.Results The established nursing program included 20 interventions and 307 activities.80％-100％ nurses' opinions culminated in consensus on the selected interventions.The selected activities scored 4.00-5.00 in average,with the coefficient of variations ranging from 0.00 to 0.25.Conclusions The established nursing program is convenient to communication and could be a tool to guide the clinical nursing practice.

Intervenciones de enfermería en la persona con vasoespasmo cerebral secundario a hemorragia subaracnoidea aneurismática / Nursing interventions in the person with a secondary cerebral vasospasm aneurysmal subarachnoid haemorrhage

Introducción. El vasoespasmo cerebral como complicación de la Hemorragia subaracnoidea aneurismática, es considerado como una vasoconstricción patológica de las arterias principales de la base del encéfalo; es una condición reversible, que se caracteriza con la reducción del calibre de la luz de las arterias y por lo consiguiente una disminución del flujo sanguíneo al área perfundida por el vaso comprometido. Objetivo. Desarrollar un proceso enfermero basado en la taxonomía Nanda, Noc, Nic a una persona con vasoespasmo cerebral. Metodología. Se realizó la elección de un caso clínico, con la metodología del proceso de atención de enfermería estableciendo un plan de cuidados en el área de recuperación y terapia intermedia del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez durante el periodo postquirúrgico inmediato. Se detectaron las necesidades básicas alteradas al realizar la valoración neurológica de enfermería. Se procedió a formular los diagnósticos de enfermería reales y de riesgo y con base en estos se planearon las intervenciones de enfermería. Conclusión. El realizar las intervenciones de enfermería de forma sistematizada a partir del proceso enfermero, se establece un método científico, en donde cada intervención se fundamenta y da pauta a la aplicación de un cuidado especializado, dirigido hacia la mejora de la persona desde el punto de vista individual y con ello detectar oportunamente signos y síntomas de alarma así como posibles complicaciones.

Introduction. The cerebral vasospasm as complication of the Haemorrhage subarachnoid aneurismática, is considered to be a pathological vasoconstriction of the main arteries of the base of the brain; it is a reversible condition, which is characterized by the reduction of the caliber of the light of the arteries and for consequent a decrease of the blood flow to the area perfundida for the awkward glass. Target. To develop a process nurse based on the taxonomy Nanda, NOC, NIC to a person with vasospasm cerebral. Methodology. There was realized the election of a clinical case, with the methodology of the process of attention of infirmary establishing a care plan in the field of recovery and intermediate therapy of the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez during the immediate postsurgical period. The basic needs were detected altered on having realized the neurological infirmary evaluation. One proceeded to formulate the real diagnoses of infirmary and of risk and with base in these the infirmary interventions were planned. Conclusion. Realizing the interventions of infirmary of form systematized from the process nurse, establishes a scientific method, where every intervention is based and gives rule to the application of a specializing care, directed to the progress of the person from the individual point of view and with it to detect opportunely signs and symptoms of alarm as well as possible complication.

Intervenções de enfermagem prescritas para idosos hospitalizados segundo grau de dependência para as Atividades Básicas de Vida Diária / Nursing Interventions prescribed for hospitalized elderlies according to the level of dependence in activities of daily living

Objetivando identificar as intervenções de enfermagem mais prescritas para idosos hospitalizados, de acordo com seu nível de dependência para as Atividades Básicas de Vida Diária (ABVDs), foram analisados 51 idosos admitidos em uma enfermaria geriátrica de um hospital de grande porte da cidade de São Paulo, após consentimento informado. Observou-se que 51% dos indivíduos apresentava dependência grave, e as intervenções significativamente mais prescritas estavam relacionadas com a mobilidade, banho e segurança do paciente.

In order to identify the nursing interventions most prescribed for hospitalized elderly, according to their level of dependence for Activity of Daily Living (ADL), we analyzed 51 elderlies admitted to a geriatric ward belonging to a large hospital in São Paulo, after informed consent. It was observed that 51% of subjects had severe dependence and the most significantly prescribed interventions were related to mobility, bathing and safety of the patient.

Tensão do papel de cuidador: aplicabilidade das intervenções de enfermagem da NIC em cuidadores familiares de idosos dependentes / Role of caregiver strain: applicability of NIC interventions in family caregivers of dependent elderly

O cuidado voltado para o idoso tem despertado o interesse dos profissionais da área da saúde, em especial, dos enfermeiros, por estudos que envolvam o impacto físico, psicológico e emocional gerados no cuidador pelo processo de cuidar. Apesar disso, ainda existem lacunas significativas de pesquisas cujo foco sejam intervenções de enfermagem que visem melhorar o bem-estar desse cuidador em nosso contexto. Objetivo: Analisar a aplicabilidade das intervenções propostas pela Classificação das Intervenções de Enfermagem (NIC) para o diagnóstico de enfermagem da NANDA-I Tensão do papel de cuidador evidenciado em cuidadores familiares de idosos dependentes. Método: Estudo metodológico, em que se utilizam métodos de validação, estruturado em três etapas consecutivas e interdependentes. Na primeira, participaram sete enfermeiras assistenciais do Serviço de Atenção Domiciliar (SAD) de João Pessoa-Paraíba, para identificação, de acordo com a experiência clínica, da aplicabilidade de trinta intervenções e trezentas atividades propostas pela NIC para o cuidador familiar com evidência do diagnóstico em estudo. Na segunda etapa, trinta enfermeiras especialistas, selecionadas por meio dos critérios de Fehring, analisaram, segundo o seu julgamento de pertinência, as atividades de cada intervenção indicada pelas enfermeiras assistenciais como mais aplicáveis aos referidos cuidadores. A terceira etapa foi realizada com onze cuidadoras familiares com evidência de Tensão do papel de cuidador para verificar a aplicabilidade dessas intervenções na prática clínica.

Introduction: The care toward the elderly has aroused the interest of professionals in the area of health, in particular, of the nurses, for studies involving the impact physical, psychological and emotional generated on the caregiver by care process. In spite of this, there are still significant gaps in research whose focus are nursing interventions aimed at improving the well-being of caregivers in our context. Objective: This study aims to analyze the applicability of the proposed interventions for Nursing Intervention Classification (NIC) for the nursing diagnosis of NANDA-I Tension on the role of caregiver evidenced in family caregivers of dependent elderly. Method: Methodological study, using methods of validation, structured in three consecutive stages and interdependent. In the first, participated in seven nurses Service Homecare of João Pessoa - Paraíba, for identification, according to the clinical experience, the applicability of 30 interventions and 300 activities proposed by NIC for the family caregiver with evidence of diagnosis in study. In the second step, 30 nurses specialists, selected by means of the criteria of Fehring, analyzed, according to the judgment of relevance, the activities of each intervention indicated by clinicians as more applicable to those caregivers. The third step was performed with 11 family caregivers with evidence of Tension on the role of caregiver to confirm the applicability of these interventions in clinical practice.

Intervenciones de enfermería para la atención de la mujer en el proceso del climaterio y la menopausia, aplicada en el primer nivel de atención / Nursing interventions for the care of women in menopause and menopause process applied at three levels of care

Introducción: La menopausia es el resultado de la pérdida de la actividad folicular del ovario . En México el aumento de la esperanza de vida nos sitúa ante un nuevo perfil epidemiológico, se espera que para el año 2035, una de cada 3 mujeres estará en la etapa del climaterio o menopausia . El objetivo de esta Guía de Práctica Clínica (GPC) es establecer un referente nacional para generar intervenciones de enfermería en el cuidado de la mujer en el proceso de climaterio y menopausia. Metodología: La búsqueda sistemática de información se enfocó en documentos relacionados con el tema, intervenciones de enfermería en el climaterio y menopausia, para dar respuesta a las preguntas estructuradas, a partir de las climacteric, menopause, postmenopause, premenopause, diagnosis, etiology, metabolism, psychology, complications, therapy, drug effects. Se utilizaron los buscadores PUBMED, LILACS, CINAHL y TRIP DATABASE. Las recomendaciones se tomaron de GPC internacionales, meta-análisis, ensayos clínicos aleatorizados y estudios observaciones. La información se expresa en niveles de evidencia (E) y grado de recomendación (R) de acuerdo al características del diseño y tipo de estudio.Resultados: Esta GPC ofrece evidencia sobre las intervenciones del profesional de enfermería al cuidado de la mujer en el proceso de climaterio y menopausia, para la promoción de la salud, detección oportuna y limitación de daños y riesgos en el climaterio y menopausia. Conclusión: La aplicación de la GPC permite homogeneizar criterios en el cuidado del climaterio y la menopausia para otorgar una atención con calidad.

Introduction: Menopause is the result of loss of ovarian follicular activity. In Mexico the increase in life expectancy presents us with a new epidemiological profile, it is expected that by the year 2035, one out of every 3 women will be in menopause or climacteric. The objective of this Clinical Practice Guideline (CPG) is to establish a national benchmark to generate nursing interventions in the care of women in the process of menopause and menopause.Methodology: The systematic search for information focused on related subject, nursing interventions in climacteric and menopause, to respond to structured questions from keywords documents: climacteric, menopause, postmenopause, premenopause, diagnosis, etiology, metabolism, psychology, complications, therapy, drug effects. the PUBMED, LILACS, CINAHL and TRIP DATABASE searchers were used. The recommendations were taken from international GPC, meta-analyzes, randomized trials and observational studies. The information is expressed in levels of evidence (E) and grade of recommendation (R) according to the characteristics of the design and type of study.Results: This CPG provides evidence on interventions nurse to care for women in menopause and menopause process, for health promotion, early detection and damage limitation and risks in the climacteric and menopause. Conclusion: The application of the GPC allows homogenize criteria in the care of climacteric and menopause to provide quality care.

Introduction: La ménopause est le résultat de la perte de l'activité folliculaire ovarienne. Au Mexique, l'augmentation de l'espérance de vie nous présente un nouveau profil épidémiologique, il est prévu que d'ici l'an 2035, une personne sur 3 femmes seront en ménopause ou climatérique. L'objectif de ce guide de pratique clinique (CPG) est d'établir une référence nationale pour générer des interventions de soins infirmiers dans les soins des femmes dans le processus de la ménopause et de la ménopause.Méthodologie: La recherche systématique de l'information axée sur sujet connexe, les interventions infirmières en climatère et la ménopause, pour répondre à des questions structurées à partir des mots-clés: documents climatérique, la ménopause, la postménopause, la préménopause, le diagnostic, effets étiologie, le métabolisme, la psychologie, les complications, la thérapie, la drogue. PubMed, LILACS, CINAHL et TRIP chercheurs DATABASE ont été utilisés. Les recommandations ont été prises à partir de GPC, les méta-analyses internationales, des essais randomisés et des études d'observation. L'information est exprimée en niveaux de preuve (E) et la teneur de la recommandation (R) en fonction des caractéristiques de la conception et le type d'étude. Résultats: Ce CPG fournit la preuve sur les interventions infirmières aux soins pour les femmes en ménopause et le processus de la ménopause, pour la promotion de la santé, la détection précoce et la limitation des dommages et des risques dans la ménopause et la ménopause.Conclusion: L'application de la GPC permet d'homogénéiser les critères de la prise en charge de la ménopause et de la ménopause pour fournir des soins de qualité.