Privacidade e confidencialidade em saúde na vigilância epidemiológica: relato de experiência sob o olhar bioético / Privacy and confidentiality in health in epidemiological surveillance: experience report on bioethical look

Durante experiência de trabalho em vigilância epidemiológica, na Bahia, entre as atividades desenvolvidas, destaca-se a notificação compulsória de agravos e doenças. O estudo da disciplina Bioética em Ciência da Saúde, do Programa de Pós Graduação em Enfermagem e Saúde, nível de Mestrado, mobilizou-nos à retomada de vivências cotidianas nos serviços de saúde que envolve questões bioéticas e que merece reflexão crítica. O presente estudo teve como objetivo desenvolver uma reflexão, segundo a perspectiva bioética, sobre a experiência vivenciada, envolvendo privacidade e confidencialidade em saúde, no contexto da vigilânciaepidemiológica. Trata-se de estudo descritivo da vivência em atividade de notificação compulsória no serviço de vigilância epidemiológica da Secretaria Municipal de Saúde de município da Bahia, no período de novembro de 2011 a março de 2013. Permitiu-nos perceber que a negligência na aplicação de princípios bioéticos no âmbito da notificação compulsória pode interferir na saúde do usuário, pois não garante a integridade de seus direitos e reflete a inadequação da ambiência para os atendimentos e o despreparo dos profissionais, no que se refere ao conhecimento teórico-prático de bioética

During work experience in epidemiological surveillance, Bahia, between the activities, there is mandatory reporting of injuries and Illnesses. The study of the discipline of Health Scienc and in Bioethics, the Graduate Program in Nursing and Health, Master level, mobilized us to the resumption of daily experiences in health services Involving bioethical issues que deserve critical reflection. The present study Aimed to develop the reflection, According to bioethical perspective on the lived experience Involving privacy and confidentiality in health, in the context of epidemiological surveillance. This is a descriptive study of the experience of Mandator y reporting on activity in the epidemiological surveillance service of the Municipal Health Secretariat of the state of Bahia, in the period november 2011 to march 2013.Allowed us to perform que negligence in the application of bioethical principles under compulsory notification may interfere with the health of the user, it does not guarantee the integrity of Their Rights and Reflects the inadequacy of ambience for consultations and the unpreparedness of professionals, with regard to the theoretical and practical knowledge of bioethics.

Questões éticas do cotidiano profissional e a formação do enfermeiro / Cuestiones éticas del cotidiano profesional y la formación del enfermero / Ethical issues in daily work routine and nursing training

Estudo de natureza qualitativa que objetivou conhecer as percepções das enfermeiras sobre como vivenciam os principais problemas éticos do cotidiano do trabalho e se a formação profissional recebida na graduação mostrou-se suficiente para o enfrentamento destes problemas. Os dados foram coletados entre março e abril de 2009, junto a cinco enfermeiras de uma unidade de terapia intensiva de um hospital universitário do Rio Grande do Sul, por meio de observações livres seguidas de entrevista semi-estruturada. Utilizou-se a técnica de análise textual qualitativa no tratamento dos dados. Dos resultados emergiram duas categorias: a dimensão ética do cuidado e na formação profissional. Mostrou-se necessária uma reflexão mais profunda sobre o cotidiano do trabalho ainda na graduação, fortalecendo as futuras enfermeiras para o enfrentamento do exercício profissional. Paralelamente, precisa-se priorizar a construção de espaços para a reflexão e discussão coletiva dos profissionais atuantes, identificando e construindo novas maneiras de atuar eticamente.

This qualitative study aimed to learn nurses’ perceptions of how they experience the main ethical problems of their day-to-day work and whether the professional training they received in their undergraduate studies has proved sufficient to meet these problems. Data were collected from March to April 2009 by free observation followed by semi-structured interviews of five nurses at a university hospital intensive care unit (ICU) in Rio Grande do Sul, and were treated using the technique of qualitative textual analysis. Two categories emerged from the results: the ethical dimension in care and in professional training. There was found to be a need for undergraduate studies to consider in greater depth the day-to-day experience of nursing work, so as to strengthen future nurses to exercise the profession. There is a parallel need to prioritize construction of settings where practicing nurses can think and discuss together with a view to identifying and building new ways to act ethically.

Estudio de naturaleza cualitativa que objetivó conocer las percepciones de las enfermeras, acerca de como vivencian los principales problemas éticos del trabajo diario y sí la formación profesional recibida en el pregrado se ha mostrado suficiente para hacer frente a estos problemas. Los datos fueron recolectados entre marzo y abril de 2009, con cinco enfermeras en una unidad de cuidados intensivos (UCI) de un hospital universitario de Río Grande do Sul-Brasil, por medio de observaciones libres, seguidas de entrevista semiestructurada. Se utilizó la técnica de análisis textual cualitativa en el tratamiento de los datos. Los resultados destacan dos categorías: dimensión ética de la atención y en la formación profesional. Se ha mostrado necesaria una reflexión más profunda sobre el trabajo diario aun en los estudios de graduación, fortaleciendo las futuras enfermeras para enfrentar el futuro de la profesión. Al mismo tiempo, es necesario dar prioridad a la construcción de espacios de reflexión y discusión colectiva de los profesionales actuantes, identificando y construyendo nuevas formas de actuar éticamente.

Relationship between organizational culture and ethics work satisfaction among baccalaureate nurses at main Assiut University Hospital

There is an important ethical aspect to any organizational culture and depending on the nature of the culture different ethical standards may guide the behavior of organization members, each culture has somewhat different potential for supporting a healthy, successful organization and has different impact on the satisfaction and careers of employees. This study was conducted with the aim of identify the relationship between the organizational culture and ethics work satisfaction. Subjects of this study included all nurses who have Baccalaureate degree [no. 110] working in the Main Assiut University Hospital. They classified into [97 head nurses] and [13 supervisors]]. Tools used in data collection include three tools Socio-demographic Data Sheet, Organizational Culture questionnaire developed by [Daft, 2000] and modified by the researcher, which profiling three types of culture: strong, medium, and weak. Ethics work satisfaction questionnaire was developed by Joint Commission on Accreditation of Health care Organizations [1994] and Hinshow [1987]. It divided into two factors: organizational ethics [7 items]and personnel ethics [9 items].The response for both tools will be measured on five point likert scale that ranged from [5] strongly agree to [1] strongly disagree. Work Variable Questionnaire divided into three parts as regard to the organizational support [6 items] was developed by Marques and Huston, [2006], recommendation [7 items], and retention [9 items] developed by Mohamed, [2001] response will be measured on [3] for agree, [2] for not decided, and [1] for disagree. The result revealed that there were a positive statistically significant correlation between strong culture and personnel ethics [r= -453, P<0.05]. While, strong positive statistically significant correlation was found between medium type of organizational culture and personnel ethics items [r=354, 415, statistically significant at p<0.01]. Additionally, as regard weak type of organizational culture there was a positive statistically significant correlation with personnel ethics items [r=982, p<0.05]. On the light of the study findings the researcher recommended that: Instituting an ethics committee made up of interdisciplinary representative from nursing, medicine, administration, these committees provide guidance to patients and their families as well as the health care team, provide ongoing support to nurses through feedback and positive reinforcement and positive environment or culture, Give opportunities to nurses to participate in choosing topics which needed to improve their abilities and needs, Provide safety measures to protect health care providers from occupational health hazard

Análise das diretrizes curriculares: uma visão humanista na formação do enfermeiro / Analysis of the curricular guides: a humanist vision in nurse's education

Estudo teórico-reflexivo acerca da formação do enfermeiro, cujo objetivo foi refletir e analisar as Diretrizes Curriculares para o Curso de Graduação em Enfermagem, instituídas pela Resolução CNE/CES de 2001, sob o enfoque ético-humanístico nela contida. Destacamos nos incisos os aspectos que se referem a essa abordagem, os quais nos parecem articulados no contexto geral do documento. Vimos que a reforma curricular dos Cursos de Graduação em Enfermagem, que está ocorrendo em todo o Brasil, sob as orientações do referido documento, deixa clara a preocupação com a solidariedade e cidadania, com o saber conviver, com o aprender a ser e o aprender a viver juntos, elementos que constituem a essência do humanismo e da ética como mola mestra do comportamento humano e das ações profissionais.

A Q-methodological Study on Nursing Students' Attitudes toward Nursing Ethics / 간호학회지

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decisionmaking that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.