Saberes do enfermeiro para o cuidado no processo transfusional em recém-nascidos / Conocimiento de los enfermeros para cuidado en el proceso de transfusión en recién nacidos / Nurses' knowledge of blood transfusion in neonate

RESUMO Objetivo Analisar o conhecimento do enfermeiro acerca do processo transfusional para o cuidado do recém-nascido na unidade de terapia intensiva neonatal. Métodos Estudo descritivo, exploratório, qualitativo, realizado em dois hospitais da cidade de Belo Horizonte, Minas Gerais. Participaram 15 enfermeiras atuantes na unidade de terapia intensiva neonatal, no período de agosto a dezembro de 2014. Os dados foram submetidos à análise de conteúdo na modalidade temática. Resultados A categoria formada resultou nas seguintes subcategorias, a saber: A atenção do enfermeiro durante a transfusão sanguínea: cuidados no acompanhamento transfusional; A perspectiva de um olhar diferenciado do enfermeiro diante das reações transfusionais e das notificações: a essência do cuidado. Conclusões Com a identificação do conhecimento do enfermeiro neonatologista a respeito do processo transfusional, é possível promover a sua capacitação tendo em vista a qualidade e a segurança dos cuidados relacionados ao processo transfusional em recém-nascidos.

RESUMEN Objetivo Analizar el conocimiento del enfermero sobre el proceso de transfusión para cuidar del recién nacido en la Unidad de Cuidados Intensivos Neonatales. Métodos Estudio cualitativo exploratorio descriptivo, realizado en dos hospitales en la ciudad de Belo Horizonte, Minas Gerais. Participaron 15 enfermeras que trabajaron en la Unidad de Cuidados Intensivos Neonatales, en el período de agosto a diciembre de 2014. Los datos fueron sometidos a análisis de contenido en la modalidad temática. Resultados La categoría transmitida resultó en las siguientes subcategorías, a saber: la atención de la enfermera durante la transfusión de sangre: el cuidado de la transfusión de monitoreo; La perspectiva de una visión diferente de la enfermera antes de las reacciones transfusionales y notificaciones: la esencia de la atención. Conclusión La identificación de los conocimientos de la enfermera neonatóloga sobre el proceso de transfusión, es capaz de promover su formación con miras a la calidad y seguridad de la atención relacionada con el proceso de transfusión en los recién nacidos.

ABSTRACT Objective To analyze nurses' knowledge of blood transfusion in neonates in a neonatal intensive unit care. Methods A descriptive and exploratory qualitative study conducted in two hospitals in the city of Belo Horizonte, Minas Gerais. The participants were 15 nurses who performed their activities in the neonatal intensive unit care, from August to December 2014. Data was subjected to thematic content analysis. Results The category created was divided into the following sub-categories, namely: nurses' care during blood transfusion: care during blood transfusion monitoring; a different perception of nurses regarding responses to blood transfusion and notification: the essence of care. Conclusion The identification of nurses' knowledge of blood transfusion, it is possible to promote their capacity for quality and safety of care related to the transfusion process in newborns.

Testemunhas de jeová ante o uso de hemocomponentes e hemoderivados / Jehovah's Witnesses attitude towards hemocomponents and hemoderivatives

OBJETIVO: Estudar o grau de conhecimento e aceitação de hemocomponentes e hemoderivados, frescos e armazenados, pelas testemunhas de Jeová e propor ferramentas bioéticas para o enfrentamento de eventuais conflitos éticos e morais nas relações com médicos e dentistas. MÉTODOS: Aplicação de questionários a 150 testemunhas de Jeová que frequentam Salões do Reino no Distrito Federal, Brasil. Os questionários buscaram respostas a aspectos sociodemográficos relacionados à possível aceitação de hemocomponentes e hemoderivados pelos pesquisados, bem como a atitude dos profissionais de saúde ante à opção religiosa dos pacientes. RESULTADOS: Dos pesquisados: 74 por cento acreditam que usar sangue provoca mais malefícios do que benefícios à saúde (fundamentação essencialmente bíblica); 96 por cento não aceitam usar hemocomponentes, mas 76 por cento aceitam usar hemoderivados em situações específicas, demonstrando haver entendimentos particulares sobre o tema; 80 por cento se sentem moralmente ofendidos com o uso de sangue armazenado e apenas 45 por cento com sangue fresco, confirmando a interpretação religiosa de que produtos frescos são em geral mais aceitos; segundo 83 por cento dos pesquisados, seus dentistas não perguntaram a religião dos pacientes contra 71 por cento dos médicos, demonstrando pouca preocupação dos profissionais neste aspecto. CONCLUSÃO: As testemunhas de Jeová são vistas por seus "estranhos morais" (aqui, médicos e dentistas) como religiosos que simplesmente "não aceitam sangue". Todavia, diversos tratamentos sanguíneos são hoje aceitos, o que não impede, por livre convicção, a recusa no recebimento de qualquer deles. As interpretações particulares costumam ampliar o rol de proibições e de conflitos morais, já que médicos e dentistas, além de não considerar estas particularidades, também não perguntam a religião na anamnese.

OBJECTIVE: To study extent of knowledge and acceptance of hemocomponents and hemoderivatives, fresh and stored, by Jehovah's Witnesses and also propose bioethical tools for any ethical and moral conflicts identified in their relationship with physicians and dentists. METHODS: A questionnaire was used to interview 150 Jehovah's Witnesses who attend "Salões do Reino" in the Distrito Federal, Brazil. The questionnaire was directed towards information on socio-demographic aspects related to the use (or not ) of hemocomponents and hemoderivatives by those interviewed and also approach of healthcare professionals with patients of this belief. RESULTS: 74 percent believe that the use of blood causes more harm than benefits to health - refusal is essentially based on the Bible 96 percent do not support hemocomponents, but 76 percent support hemoderivatives in specific situations, showing that personal understandings do exist; 80 percent feel morally offended with use of stored blood and only 45 percent with fresh blood, confirming the religious interpretation that fresh products are in general more accepted; according to 83 percent of the interviewees dentists do not ask about patients' religion, whereas 71 percent of physicians do, showing little professional concern about this aspect. CONCLUSION: Jehovah's Witnesses are seen by their "moral outsiders" (here physicians and dentists) as the religious group that simply "does not use blood". Although, several blood treatments are nowadays permitted,. it does not deprive them from a free conviction to refuse blood treatments. Their particular understandings frequently extend the list of blood prohibitions and, consequently, the number of moral conflicts, when considering that physicians and dentists usually do not ask about a patient's religion.

Perception of the Risks of Blood Transfusion in Koreans / 대한진단검사의학회지

BACKGROUND: The perceived risks of blood transfusions are important to be considered in creating a blood service policy. We surveyed the perception of blood transfusion risks among Korean laypeople. METHODS: A one-month nationwide telephone survey was conducted in September, 2007. The questionnaire was designed to assess the demographics of respondents, their responses to the term 'blood transfusion', and the perceived risks of a transfusion. A total of 500 interviews were completed. RESULTS: The words evoked by the term 'blood transfusion' included blood, donation, AIDS, help, and patients. About one third (33.6-35.8%) of the respondents gave a moderate to high rating for the perceived risks of blood transfusions. More than half (55.6%) of the respondents agreed that the blood supply in Korea is safe, and 81.6% of the respondents agreed to be transfused when transfusion is needed. The perceived risk of a blood transfusion was greater in women than in men and in people who never had a transfusion than those who had. More men than women agreed that the blood supply in Korea is safe, and the proportion of respondents who agreed to be transfused when needed was higher in men and in less educated people. The relative perceived transfusion risk (scale of 10) was 4.5+/-2.3. CONCLUSIONS: The Koreans in the survey had a tendency of positive thinking about blood transfusions, and previous transfusion experiences appear to decrease the fear about transfusions. These results will be useful in understanding how Koreans think about the risks associated with transfusions.

Testigos de Jehová y transfusion sanguínea: reflexion desde una ética natural

El rechazo por parte de los Testigos de Jehová de recibir transfusiones sanguíneas siempre ha representado para los médicos un conflicto ético y un problema en la relación médico paciente. Las razones de este grupo para rechazar las transfusiones se basan en motivos religiosos por un mandato explícito de Dios que se encontraría en la Biblia. Para ellos el hecho de aceptar esta medida terapéutica les significa una pérdida en el ámbito espiritual de tal importancia que se les presenta como intolerable. Tanto es así, que prefieren morir antes de aceptar una transfusión. Este trabajo analiza este conflicto desde una ética natural, donde un médico buscando la salud de su paciente comprende que ella no es todo lo que aspira un ser de carácter personal. Debe aceptar entonces que algunas medidas terapéuticas, aunque disponibles, pueden ser consideradas como desproporcionadas y no ser implementadas. En todo caso, en esas situaciones, el médico y las instituciones de salud deben establecer todas las medidas para asegurar que este tipo de decisiones se realicen con la debida información, confidencialidad, libertad y en ausencia de toda coacción.

Jehovah's Witnesses rejection on receiving blood transfusion has always represented an ethical conflict for physicians and a problem for doctor-patient relationship. The reason of their rejection, is based on one of God's commandment written in the Bible. For them, the fact of accepting this therapy means such a spiritual loss that it appears to them intolerable and they prefer to die before accepting a transfusion. This paper analyzes this conflict from a natural ethical perspective, where a physician who is seeking for his patient's health, understands that health is not all the good that a being of personal nature seeks. The physician must accept that some therapies, even if available, may be considered as disproportionate and not be implemented. In these situations, the physician and health institutions should establish the necessary dispositions to ensure that this kind of decisions may be taken with proper information, confidentiality, liberty and absence of coercion.

Autonomía del paciente: los testigos de Jehová y la elección de alternativas a la transfusión

Hoy día los medios médicos, jurídicos, bioéticos y farmacológicos que existen permiten al paciente elegir desde una amplia y variadas opciones para su cuidado médico. Los testigos de Jehová aprecian el trabajo duro que hacen los médicos que enfrentan el desafío de proveer tratamiento seguro y efectivo mientras respetan sus derechos autónomos. Esto incluye a muchos ginecólogos y obstetras que han empleado estrategias alternativas a la transfusión de sangre como métodos seguros y eficaces. Este artículo provee una vista general de la posición de los Testigos de Jehová respecto a la transfusión de sangre y considera los principios éticos y legales que apoyan su decisión a elegir alternativas a la transfusión. La cooperación continua sirve directamente para promover los conceptos de la autonomía del paciente, consentimiento informado y decisiones sobre su propio cuerpo.

Today the medical, legal, bioethical, and pharmacological means exist to permit patients to choose from among wide and varied options for their medical care. Jehovah's Witnesses appreciate the hard work of physicians who have met the challenge of providing safe and effective treatment while respecting their autonomous rights. This includes the many obstetricians and gynecologists who have employed safe and effective transfusion-alternative strategies. This article provides an overview of the position of Jehovah's Witnesses with respect to blood transfusion and discusses the bioethical and legal principles that support their decision to choose transfusion alternatives. Continued cooperation can only serve to advance the concepts of patient autonomy, informed consent, and bodily self-determination.

Les aspects psychosociaux de la transfusion autologue differee au Togo

Une enquete hospitaliere etudiant les facteurs psychosociaux de la transfusion autologue differee a ete menee au CHU de Lome sur une periode de dix mois allant d'avril 1990 a janvier 1991. Au total 45 malades de 15 a 65 ans ont ete enquetes dont 26 hommes et 19 femmes. La transfusion autologue differee (ATD) est une therapeutique transfusionnellle qui etait totalement inconnue de tous nos malades. Malgre cette meconnaissance de l'A.T.D.; elle a ete acceptee par la grande majorite (89;89 pour cent) de nos malades qui l'ont effectivement subie apres une explication detaillee de sa realisation et de ses avantages. Les principaux motifs d'acceptation de cette therapeutique etaient: la recherche de securite transfusionnelle; la recherche d'une satisfaction morale qui etait inherente au caractere mystique que l'Africain donne au sang; et le desir d'etre vite opere. [abstract terminated]

Psycho-social aspects of HIV infection and AIDS in multiple transfused thalassemic children.

Two hundred and three multi-transfused children with thalassemia attending the thalassemia clinic of the Charak Palika Hospital, New Delhi were screened for human immuno-deficiency virus (HIV) antibodies by ELISA test. All positive cases were confirmed by the Western blot test. Of the 203 children screened, 17 (8.37%) were HIV seropositive and the other 3 children referred to the AIIMS were from neighbouring states. These children were compared with 20 age matched HIV negative thalassemics as controls. Of the 20 HIV positive children, four were diagnosed to have clinical AIDS according to the WHO criteria. The clinical features were similar to those described in pediatric AIDS from other parts of the world. This paper describes the clinical features, behavioural problems, cognitive functions and developmental milestones of the children with AIDS.