Intervenções do enfermeiro de família na consulta de vigilância da diabetes / Family health nurse interventions in the diabetes surveillance consultation / Intervenciones de la enfermera de familia en la consulta de vigilancia de la diabetes

Resumo Enquadramento: Os enfermeiros de família desenvolvem intervenções direcionadas à família como unidade, considerando as transições que ocorrem ao longo do seu ciclo vital, como as que decorrem do diagnóstico de uma doença crónica num dos seus membros, como é o caso da diabetes. Objetivo: Identificar as intervenções realizadas pelo enfermeiro de família na consulta de vigilância da diabetes. Metodologia: Estudo transversal, exploratório e descritivo de abordagem quantitativa, utilizando uma amostra aleatória simples de 106 pessoas portadoras de diabetes, que efetuaram consultas de enfermagem, de novembro a dezembro de 2019, em três unidades de saúde familiar. Resultados: Foram realizadas 27 intervenções do tipo avaliar, das 30 integrantes do instrumento de colheita de dados. Nas do tipo monitorizar foram realizadas as oito previstas. Do tipo ensinar foram realizadas 15 das 19 intervenções. Conclusão: O conhecimento sobre as intervenções realizadas, a maioria de avaliação diagnóstica poderá contribuir para a gestão da dotação segura dos enfermeiros de família, considerando os cuidados desenvolvidos em todas as etapas do processo de enfermagem.

Abstract Background: Family health nurses develop interventions aimed at the family as a unit, considering the transitions that occur throughout its life cycle, such as those resulting from the diagnosis of a chronic disease in one of its members, like diabetes. Objective: Identify the interventions performed by the family health nurse in the diabetes surveillance consultation. Methodology: Cross-sectional, exploratory, and descriptive study with a quantitative approach, using a simple randomized sample of 106 people with diabetes, who received nursing consultations from November to December 2019 in three family health units. Results: Twenty-seven assessing interventions were carried out, out of the 30 planned in the data collection tool. The eight planned monitoring interventions were performed. Of the educating type, 15 of the 19 interventions were carried out. Conclusion: Knowledge about the interventions carried out, most of which are diagnostic assessments, can contribute to the management of safe staffing of family health nurses, considering the care provided at all stages of the nursing process.

Resumen Marco contextual: Las enfermeras de família desarrollan intervenciones dirigidas a la familia como unidad, considerando las transiciones que ocurren a lo largo de su ciclo de vida, como las que resultandel diagnóstico de una enfermedad crónica en uno de sus miembros, como la diabetes. Objetivo: Identificar las intervenciones realizadas por la enfermera de família en la consulta de vigilancia de diabetes. Metodología: Estudio transversal, exploratorio y descriptivocon enfoque cuantitativo, utilizando una muestra aleatoria simple de 106 personas con diabetes, que realizaron consultas de enfermería, de noviembre a diciembre de 2019, entres unidades de salud de la familia. Resultados: Se realizaron 27 intervenciones del tipo evaluación, de los 30 integrantes del instrumento de recolección de datos. En el tipo de seguimiento se realizaron los ocho previstos. Del tipo de enseñanza, se realizaron 15 de las 19 intervenciones. Conclusión: El conocimiento sobre las intervenciones realizadas, la mayoría de las cuales son evaluaciones diagnósticas, puede contribuir para la gestión de la dotación segura de personal de enfermería de la familia, considerando el cuidado desarrollado en todas las etapas del proceso de enfermería.

Self-perception of nurses' competence in family assessment and intervention.

OBJECTIVES: To describe nurses' self-perception of competence in family assessment and intervention. METHODS: A sample of 551 Portuguese primary care nurses was selected. A Likert-type questionnaire with 11 items corresponding to the areas of care proposed by the Dynamic Model of Family Assessment and Intervention (MDAIF) was administered. Each item consists of 7 optional responses; a score equal to or greater than 4 denotes competence. RESULTS: The nurses perceived themselves as competent in areas of care belonging to the development dimension of the MDAIF (parental role, adaptation to pregnancy, and family planning), as well as in the caregiver role (which belongs to the functional dimension). There was a progressive decline in self-perception of competence over the stages of the nursing process. CONCLUSIONS: In this study, crucial aspects related to nurses' self-perception of their competence in family assessment and intervention were observed, and need to be addressed in the training of nurses in all areas of care included in the Model. This should facilitate awareness of the competences needed to provide the best care for families.

Self-perception of nurses' competence in family assessment and intervention / Autopercepción de la competencia del enfermero en la valoración e intervención familiar / Autopercepção da competência do enfermeiro na avaliação e intervenção familiar

Objective. To describe nurses' self-perception of competence in family assessment and intervention. Methods. A sample of 551 Portuguese primary care nurses was selected. A Likert-type questionnaire with 11 items corresponding to the areas of care proposed by the Dynamic Model of Family Assessment and Intervention (MDAIF) was administered. Each item consists of 7 optional responses; a score equal to or greater than 4 denotes competence. Results. The nurses perceived themselves as competent in areas of care belonging to the development dimension of the MDAIF (parental role, adaptation to pregnancy, and family planning), as well as in the caregiver role (which belongs to the functional dimension). There was a progressive decline in self-perception of competence over the stages of the nursing process. Conclusion. In this study, crucial aspects related to nurses' self-perception of their competence in family assessment and intervention were observed, and need to be addressed in the training of nurses in all areas of care included in the Model. This should facilitate awareness of the competences needed to provide the best care for families.

Objetivo. Describir la autopercepción de la competencia del enfermero en la valoración e intervención familiar. Métodos. Estudio exploratorio descriptivo de naturaleza cualitativa. Se seleccionó una muestra de 551 enfermeros portugueses de atención primaria. Se utilizó un cuestionario con opciones de respuesta tipo Likert, con 11 ítems correspondientes a las áreas de atención propuestas por el Modelo Dinámico de Evaluación e Intervención Familiar. Cada ítem tiene 7 opciones de respuesta, y se considera competente un valor igual o superior a 4. Resultados. Los enfermeros se autoperciben como competentes en las áreas de atención de la dimensión de desarrollo del Modelo (rol parental, adaptación al embarazo y planificación familiar), así como en el rol de brindar cuidados, en el que se realza que esta última área está integrada en la dimensión funcional. Se destaca también la disminución progresiva de la autopercepción a lo largo de las etapas del proceso de enfermería. Conclusión. En este estudio se observó que hay aspectos cruciales relativos a la autopercepción de la competencia de los enfermeros en la evaluación e intervención familiar que necesitan ser intervenidos en la formación de estos profesionales en todas las áreas de cuidados del Modelo, lo que facilitará la concienciación de las habilidades necesarias para proporcionar los mejores cuidados a las familias.

Objetivo. Descrever a autopercepção da competência do enfermeiro na avaliação e intervenção familiar. Métodos. Foi selecionada uma amostra de 551 enfermeiros portugueses dos cuidados de saúde primários. Foi utilizado um questionário com opções de resposta tipo Likert, com 11 itens correspondentes às áreas de atenção propostas pelo Modelo Dinâmico de Avaliação e Intervenção Familiar. Cada item integra 7 respostas opcionais, sendo considerado competente um valor igual ou superior a 4. Resultados. Os enfermeiros autopercionaram-se como competentes, em áreas de atenção da dimensão de desenvolvimento do MDAIF (papel parental, adaptação à gravidez e planeamento familiar), assim como no papel de prestador de cuidados, realçando-se que esta última área está integrada na dimensão funcional, destacando também uma progressiva diminuição da autopercepção ao longo das etapas do processo de enfermagem. Conclusão. Neste estudo observou-se que existem aspectos cruciais relacionados à autopercepção da competência do enfermeiro na avaliação e intervenção familiar que precisam ser tratados na formação do enfermeiro em todas as áreas de cuidado do Modelo, facilitando a conscientização de competências necessário para proporcionar o melhor cuidado às famílias.

Implicações sobre o uso de ventilação mecânica não invasiva na pessoa e família em contexto domiciliário / Implications of non-invasive mechanical ventilation in the person and family in the home context

A Ventilação Mecânica Não Invasiva (VMNI) é uma terapia utilizada no tratamento da insuficiência respiratória tipo 2 e enquadra-se na modalidade de ventiloterapia maioritariamente utilizada em contexto domiciliário. Acredita-se que este tipo de ventilação tenha um impacto positivo na qualidade de vida da pessoa utilizadora e da sua família. Apesar de existirem muitos estudos relativos à sua utilização em contexto hospitalar, pouco se sabe sobre as implicações da utilização desta modalidade terapêutica em contexto domiciliário. Foi realizado um estudo qualitativo de carácter exploratório e descritivo, tendo como objetivos:(1) explorar e descrever as implicações da utilização de ventilação mecânica não invasiva para a pessoa, em contexto domiciliário e (2) explorar e descrever as implicações da utilização de ventilação mecânica não invasiva para a família, em contexto domiciliário. Optou-se pela entrevista semi-estruturada dirigida a dez doentes portadores de insuficiência respiratória crónica a realizar VMNI em contexto domiciliário e cinco familiares. A análise das narrativas foi realizada com recurso à análise de conteúdo. Desta emergiram duas unidades temáticas "A pessoa utilizadora de VMNI" e "Família". A primeira unidade temática integra seis categorias: pessoas envolvidas, complicações, benefícios, dificuldades percebidas, estratégias adaptativas e hábitos implementados. A segunda unidade temática, Família, integra três categorias: desajuste, benefícios e processo familiar. Os resultados sugerem que a utilização de VMNI em contexto domiciliário tem subjacente o tratamento da patologia do sono com repercussões respiratórias. A utilização deste tipo de ventilação tem implicações na vida da pessoa e da sua família tendo os participantes no estudo atribuído significado positivo e negativo ao seu uso. É de salientar que a melhoria da qualidade do sono, o bem estar psicológico e a energia são as implicações mais percecionadas pela pessoa utilizadora de VMNI. É possível ainda inferir que a utilização de VMNI tem implicações no sistema familiar, nomeadamente na interação de papéis, na qual emerge o reconhecimento e a reorganização de tarefas familiares, a partilha de ideias e sentimentos, e a mudança de padrões de comunicação, entre outros.

Non-Invasive Mechanical Ventilation (NIMV) is a therapy used in the treatment of respiratory failure type 2 and fits on the type of ventilation therapy most widely used at home.This type of ventilation is believed to have a positive impact on the quality of life of the user and his family. Although there are many studies related to its use in a hospital context, little is known about the implications of using this therapeutic modality in a home context. An exploratory and descriptive qualitative study was carried out, with the following objectives: (1) explore and describe the implications of using NIMV for the person, in the home context and (2) explore and describe the implications of using NIMV for the family, in the home context. We opted for the semi-structured interview aimed at ten patients with chronic respiratory failure undergoing NIMV in a home context and five family members. The analysis of the narratives was carried out using content analysis.Two thematic units emerged from this: "The person using NIMV" and "Fam#y". The first thematic unit includes six categories: people involved, complications, benefits, perceived difficulties, adaptive strategies and implemented habits. The second thematic unit, Family, integrates three categories: maladjustment, benefits and family process. The results suggest that the use of NIMV in the home context underlies the treatment of sleep pathology with respiratory repercussions.The use of this type of ventilation has implications for the life of the person and his family, with the participants in the study attributed a positive and negative meaning to its use. It should be noted that improving sleep quality, psychological well-being and energy are the implications most perceived by the person using NIMP. It is also possible to infer that the use of VMNI has implications for the family system, namely in the interaction of roles, in which emerges the recognition and reorganization of family tasks, the sharing of ideas and feelings, and the change in communication patterns, among others.

A mudança nas perceções dos enfermeiros de família sobre os pressupostos da intervenção familiar após o processo formativo MDAIF / Change in perceptions of family nurses about the assumptions of family intervention after the MDAIF formative process

The Dynamic Model of Family Assessment and Intervention (MDAIF) aims to constitute itself as a reference that promotes clinical decision processes based on systemic proposition. This study aimed to evaluate the changes in nurses' perceptions about the assumptions of family intervention after the training process centered on this referential. This is an exploratory and quantitative study with a sample of 553 family nurses who participated in the "MDAIF" training, organized by the Northern Regional Health Administration, until 2017. A 10 item Likert scale was used with responses between 1 "totally incompetent and 7" "fully compe-tent", based on MDAIF and applied in the pre and post training periods. T-test was performed for paired samples using SPSS version 23.0. There were very significant statistical changes regarding the perception of competence in all items evaluated, and participants after training perceived with higher competence on the assumptions of family intervention. The results confirm the importance of formative processes based on family health nursing theoretical references. May contribute to the development of family-centered practices as a client, as well as to investigate the health returns resulted from them

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Etiologia e tratamento de queimaduras provocadas por agente químico: scoping review / Etiology and treatment of chemical burns: scoping review

It is estimated that over 60,000 different chemicals might be used in industry, agriculture and the home environment. Chemical burns account for only 3% of the total, yet account for approximately 30% of burn deaths. The aim of the study was to identify the latest evidence on treatment of skin burns caused by chemical agents.A scope review was chosen, and articles published between 2013 and 2019 were selected. The research was conducted with the following descriptors: chemical burn and skin burn or skin injury or burn care or treatment burn and therap. CINAHL, MEDLINE, MedicLatina and Cochrane Database were searched. The survey was conducted in January and February 2019. Eleven articles were selected, such as case studies, retrospective and prospective studies. The circumstances in which the burns occurred were workplace accidents, home accidents and personal attacks. The chemical agents used were acid and base type. The burned body area was between 30% and 0.5%. The most severe outcome was three deaths. The first-line treatment approach to the lesion was prolonged lavage or H2O. Continuity of treatment integrates systemic, topical pharmacological measures, pain control, surgical and non-pharmacological therapies.The etiology of skin burns by chemist is multiple. The treatment integrates particularities that distinguish it from other burn types, and an appropriate approach has significant results in survival and recovery of the person with chemical burn

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Perspetiva da famíliasobre as implicações do uso de ventilação mecânica não-invasiva em casa / Family perspective about home non-invasive ventilation implications

Several studies have demonstrated that non-invasive home mechanical ventilation is a therapy that brings benefits to people with type 2 respiratory failure and their family. The objective of this study is to explore the implications of non-invasive home ventilation for the user's family. An exploratory desc riptive study with quantitative qualitative nature in 10 families using noninvasive home ventilation. Mainly, they are nuclear families (8) belonging to the middle class (7). The data were collected through a semi-structured interview, with a data collection instrument that integrated sociodemographic issues and two open questions related to the participants' perspective on the implications of non-invasive home ventilation for the family. They were processed with descriptive statistics and content analysis. From the narratives, three categories emerged: maladjustment, benefits and family process. They are divided into eight subcategories that describe the issues related to the use of non-invasive home ventilation: discomfort, sleep impairment, silence, crisis reduction, role interaction, dynamic relationship, coping and communication. The results demonstrate that non-invasive mechanical ventilation has implications for the users ́ families, can be a stress cause, bring benefits and cause changes in the family process

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A perceção dos enfermeiros face à identificação da necessidade de cuidados de enfermagem nas famílias reconstruídas, com filhos adolescentes / The perception of nurses to identify the need for nursing care in reconstituted families with adolescent children

The Perception of Nurses to Identify the Need for Nursing Care in Reconstituted Families with Adolescent Children.Abstract: Family health nursing aims to promote the empowerment of families in the development of competencies, fostering a healthy living of their processes of change, throughout the life cycle. With respect to these families, dysfunctions can occur due to family coexistence and overlapping of parental roles over the adolescent. In this context the MDAIF arises, aiming to guide the action of nurses, proposing diagnoses and interventions, from the needs identified. The aim was to analyze nurses' perception of the need for nursing care in reconstituted families with adolescent children. Descriptive and exploratory study, of a qualitative nature, whose participants were nurses who perform functions in primary health care. A questionnaire was used, applied in 2018, with an open question in which the participants were asked to describe strategies for identifying nursing care needs in rebuilt families with adolescent children. For data analysis, content analysis was used, and three categories emerged: "Family Assessment", focused essentially on observation, interviewing and data collection; the "Context of the evaluation", predominating the functional unit, within the scope of the nursing consultation; and "Referential", the MDAIF being the theoretical and operative support for clinical decision making. In the identification of nursing care needs, the family assessment stands out as a methodology valued by nurses. These results may contribute to the development of formative processes, within the framework of family assessment, leading to the improvement of the quality of care

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A perceção dos enfermeirosrelativamente ao seu grau de competência para a prestação de cuidados de enfermagem às famílias reconstruídas, com filhos adolescentes, na área de atenção satisfação conjugal / The perception of nurses regarding their degree of competence to provide nursing care to reconstituted families, with adolescent children, in the area of attention 'conjugal satisfaction'

The Perception of Nurses Regarding their Degree of Competence to Provide Nursing Care to Reconstituted Families, with Adolescent Children, in the Area of Attention "Conjugal Satisfaction". Abstract: The family has undergone numerous modifications and adaptations, with the formation of new family identities, which require nurses to identify possible problems. The aim of this study was to analyse nurses' perceptions regarding the degree of competence to provide nursing care to reconstituted families, with adolescent children, in the area of attention marital satisfaction. Descriptive and exploratory study, of a quantitative nature. 25 primary care nurses participated. An online questionnaire was used, Lickert type, where the participants were asked to indicate their perception about the level of competence to provide nursing care in these families, in the domain of conjugal satisfaction. Of the 25 nurses, 15 considered themselves competent to carry out the identification of needs, formulate diagnoses and plan nursing interventions, 8 are between incompetent and poorly qualified; in the implementation of interventions, 14 considered competent and 9 incompe-tent or have little competence; regarding to the evaluation of the interventions, 13 consider themselves competent and 10, incompetent or not competent. Thus, 35% of the sample considered not to have the necessary skills to provide care in the context of marital satisfaction, which indicates the need for greater investment in the development of formative processes in the context of marital satisfaction, leading to the improvement of the quality of care and the development of research to identify health gains arising from nurses' interventions

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Inter-professional education and primary care: EFPC position paper.

Inter-professional education (IPE) can support professionals in developing their ability to work collaboratively. This position paper from the European Forum for Primary Care considers the design and implementation of IPE within primary care. This paper is based on workshops and is an evidence review of good practice. Enablers of IPE programmes are involving patients in the design and delivery, providing a holistic focus, focussing on practical actions, deploying multi-modal learning formats and activities, including more than two professions, evaluating formative and summative aspects, and encouraging team-based working. Guidance for the successful implementation of IPE is set out with examples from qualifying and continuing professional development programmes.

Unipersonal families and literacy: economic partner characterization and nursing care needs

The maintenance of good health levels is strongly related to personal, cognitive and social skills that compose the concept of health literacy (HL) (Soellner, Lenartz & Rudinger, 2017). Since low HL levels are associated with vulnerable groups (Pedro, Amaral & Escoval, 2016), we intend to analyze the social, economic and social characteristics of a group of unipersonal families with an elder person as well as to identify needs in nursing care. An exploratory and descriptive study was conducted in unipersonal families with members over 65 years of age, users of primary care. The sample consisted of clients that had the characteristics of the population who used a health unit in the northern part of Portugal requesting a nursing consultation, between March and April 2017. The data collection was performed based on the structural dimension of the MDAIF (Figueiredo, 2012). Data analysis was done through descriptive sta-tistics. In the sample composed of 15 families, 80% pertained to the lower middle class. All individuals suffer of one or more chronic diseases. The most common nursing interventions were directed to the residential building, safety precaution and water supply. The assessment of the structural dimension of unipersonal households is an essential resource in identifying potentialities or vulnerabilities, in order to guide nursing interventions to improve patients' levels of HL, or proactively preventing complications arising from their limitations

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Viral respiratory infections in young children attending day care in urban Northeast Brazil.

A cohort of children attending a day care center in Salvador (Bahia, Brazil) was studied prospectively to determine the incidence of viral respiratory infectious episodes and to identify the viruses associated with them. Two hundred seventy-one nasopharyngeal samples were collected over a 1-year period for examination, using indirect immunofluorescence with monoclonal antibodies against adenovirus, influenza A and B, parainfluenzae 1-3, and respiratory syncytial virus, and reverse transcriptase-polymerase chain reaction for picornavirus. Examination yielded positive results in 116 samples (42.8%). Rhinovirus was identified alone in 56 samples (48.3%) and was observed along with other viruses in 11 additional samples. Incidence density of viral respiratory infectious episodes was 7.66 episodes/1,000 child-days.