The COVID-19 pandemic and nurses' attitudes toward death.

OBJECTIVE: to analyze nurses' attitudes toward death in a hospital context after the critical period of the COVID-19 pandemic in Portugal. METHOD: this quantitative, descriptive, exploratory study was conducted in a university hospital and addressed 995 nurses. Revised Death Attitude Profile (DAP-R) was used to collect data, which were analyzed using analytical and inferential statistics. RESULTS: the nurses most frequently agreed with the statements concerning the Neutral/Neutrality Acceptance and Fear. Age, marital status, profession, and unit of work influenced the nurses' attitudes toward death. During the critical pandemic period, the nurses providing care to patients with COVID-19 presented the following means: Fear (28.89/±8.521) and Avoidance Acceptance (18.35/±7.116), which were higher than the mean obtained in the Escape Acceptance dimension, with significant differences (p=0.004). CONCLUSION: the nurses held Fear and Avoidance attitudes, revealing the need to qualify and support Nursing workers to cope with the death of those they provide care and manage pandemics and catastrophes.

Dying in the emergency service: nurses' attitudes before and after the first critical period of COVID-19.

BACKGROUND: Death is an increasingly frequent event in hospitals, and nurses are the health professionals who live with this reality the most. The pandemic caused by COVID-19 made this event more present, showing that nurses' attitudes toward death may influence the care provided to people at the end of life. The objective of this study was to analyze the attitudes of nurses in the emergency service toward death, before and after the first critical period of the pandemic by COVID-19 in Portugal. METHODS: A quantitative, comparative, and cross-sectional study was conducted in a hospital in Northern Portugal at 2 different moments: the first in February 2018 and the second in May 2020, after the first critical period of the pandemic by COVID-19. In both moments, data were collected using a self-completion questionnaire, which included the Death Attitude Profile Assessment Scale. RESULTS: The attitudes fear, avoidance, closeness, and escape did not show significant differences. In neutral/neutral acceptance, differences were found between the first and second moments of data collection (P = .01), with a lower mean after the critical period of the pandemic. CONCLUSIONS: The results obtained in 2018 and 2020 showed slight changes in attitudes toward death. The need to invest in the training and preparation of nurses who deal directly with death and the dying process was evident. Nurse managers should promote spaces for reflection and team training on death, aiming to reduce the professionals' suffering and anxiety.

COVID-19: articulação das políticas de saúde e sociais para promoção de cuidados seguros aos idosos

Objetivou compreender o processo de articulação das políticas de saúde e sociais dirigidas aos idosos durante estado de emergência por COVID-19 e implicações para a enfermagem. Estudo qualitativo, documental que utiliza como fonte de dados discursos de órgãos governamentais e dirigentes sociais, veiculados em 20 jornais portugueses, de acesso online, entre 2 de março a 2 de maio de 2020. Da análise dos dados emergiram três macrocategorias: dever de proteção dos idosos como grupo vulnerável, medidas promotoras da segurança dos idosos e consciencialização das lacunas de supervisão e apoio nos cuidados aos idosos em instituições sociais. De fato, apesar dos esforços na articulação das políticas de saúde e sociais e reorganização dos serviços durante a pandemia, observaram-se algumas lacunas nos cuidados aos idosos. Ficou evidente que é necessário aproximar cuidados de saúde comunitários às instituições sociais, através da capacitação dos seus profissionais e supervisão dos cuidados. The aim of this study was to understand the process of coordinating health and social welfare policies aimed at older adults during the COVID-19 state of emergency and its implications for nursing. This was a qualitative documentary study based on reports from government organizations and social welfare authorities published in 20 Portuguese news outlets with online access between March 2 and May 2, 2020. Three macrocategories emerged from data analysis: Duty to protect older adults as a vulnerable group;Measures that promote the safety of older adults;Awareness of the gaps in supervision and support of older adult care in social welfare institutions. Despite efforts to coordinate health and social welfare policies and reorganize services during the pandemic, some gaps were observed in older adult care. This study points to the need to bring community health care closer to social institutions, training their professionals and supervising care provision.

COVID-19: articulação das políticas de saúde e sociais para promoção de cuidados seguros aos idosos

Objetivou compreender o processo de articulação das políticas de saúde e sociais dirigidas aos idosos durante estado de emergência por COVID-19 e implicações para a enfermagem. Estudo qualitativo, documental que utiliza como fonte de dados discursos de órgãos governamentais e dirigentes sociais, veiculados em 20 jornais portugueses, de acesso online, entre 2 de março a 2 de maio de 2020. Da análise dos dados emergiram três macrocategorias: dever de proteção dos idosos como grupo vulnerável, medidas promotoras da segurança dos idosos e consciencialização das lacunas de supervisão e apoio nos cuidados aos idosos em instituições sociais. De fato, apesar dos esforços na articulação das políticas de saúde e sociais e reorganização dos serviços durante a pandemia, observaram-se algumas lacunas nos cuidados aos idosos. Ficou evidente que é necessário aproximar cuidados de saúde comunitários às instituições sociais, através da capacitação dos seus profissionais e supervisão dos cuidados. The aim of this study was to understand the process of coordinating health and social welfare policies aimed at older adults during the COVID-19 state of emergency and its implications for nursing. This was a qualitative documentary study based on reports from government organizations and social welfare authorities published in 20 Portuguese news outlets with online access between March 2 and May 2, 2020. Three macrocategories emerged from data analysis: Duty to protect older adults as a vulnerable group;Measures that promote the safety of older adults;Awareness of the gaps in supervision and support of older adult care in social welfare institutions. Despite efforts to coordinate health and social welfare policies and reorganize services during the pandemic, some gaps were observed in older adult care. This study points to the need to bring community health care closer to social institutions, training their professionals and supervising care provision.

Nursing managers'attitudes towards death: repercussions of the COVID-19 pandemic Actitudes de los gerentes de enfermería ante la muerte: repercusiones de la pandemia COVID-19

Objetivo: analisar as atitudes dos enfermeiros gestores face à morte, antes e após o período crítico da pandemia por COVID-19. Método: estudo quantitativo, transversal e comparativo, realizado em uma instituição hospitalar do Norte de Portugal. A coleta de dados ocorreu através de questionário, que integrava a Escala de Avaliação do Perfil de Atitudes acerca da Morte, em dois momentos. O primeiro ocorreu em 2018, com participação de 28 enfermeiros gestores, e o segundo, em 2020, com 21 enfermeiros gestores. Resultados: globalmente, os participantes manifestaram maior concordância com as atitudes "aceitação neutral/neutralidade"e "medo". Embora algumas das cinco dimensões das atitudes não tenham apresentado diferenças significativas entre o primeiro e segundo momento, constatou-se que em relação à "aceitação como aproximação", a média obtida no momento, após o período crítico da pandemia por COVID-19, foi superior. Conclusão: a partir dos resultados emerge a importância de se investir na preparação dos enfermeiros gestores para lidar com a morte e o processo de morrer, com uma dupla intencionalidade: minimizar o seu sofrimento e assegurar a otimização do acompanhamento e apoio aos enfermeiros da equipe que lidera. Objective: to analyze the attitudes of nurse managers towards death, before and after the critical period of the pandemic by COVID-19. Method: quantitative, cross-sectional and comparative study, carried out in a hospital in Northern Portugal. Data collection occurred through a questionnaire, that integrated the Attitude Profile Assessment Scale about Death, in two stages. The first occurred in 2018, with the participation of 28 nurse managers, and the second, in 2020, with 21 nurse managers. Results: globally, the participants showed greater agreement with the attitudes of "neutral acceptance/neutrality"and "fear". Although some of the five dimensions of attitudes did not show significant differences between the first and second moments, it was found that in relation to "acceptance as approximation", the average obtained at the moment, after the critical period of the pandemic by COVID-19, was superior. Conclusion: from the results emerges the importance of investing in the preparation of nurse managers to deal with death and the process of dying, with a double intention: to minimize their suffering and ensure the optimization of monitoring and support to the nurses of the team that leads. Objetivo: analizar las actitudes de los gerentes de enfermería hacia la muerte, antes y después del período crítico de la pandemia por COVID-19. Método: estudio cuantitativo, transversal y comparativo, realizado en un hospital del norte de Portugal. La recolección de datos se realizó a través de un cuestionario, que integró el Escala de Evaluación del Perfil de Actitud sobre la Muerte, en dos etapas. El primero ocurrió en 2018, con la participación de 28 gerentes de enfermería, y el segundo, en 2020, con 21 gerentes de enfermería. Resultados: globalmente, los participantes mostraron mayor acuerdo con las actitudes de "aceptación neutral/neutralidad"y "miedo". Si bien algunas de las cinco dimensiones de las actitudes no mostraron diferencias significativas entre el primer y segundo momento, se encontró que en relación a la "aceptación como aproximación", el promedio obtenido en el momento, luego del período crítico de la pandemia por COVID-19, fue superior. Conclusión: de los resultados surge la importancia de invertir en la preparación de los gerentes de enfermería para afrontar la muerte y el proceso de morir, con una doble intención: minimizar su sufrimiento y asegurar la optimización del seguimiento y acompañamiento a los enfermeros del equipo que lideran.