Análise do conceito de profissionalismo para o ensino de enfermagem / Analysis of the concept of professionalism in nursing education

Objetivo: Clarificar o conceito de profissionalismo para o ensino de enfermagem. Métodos: Análise conceitual, por meio do método de Walker e Avant, identificando o uso do conceito nas bases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed®), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Índice Bibliográfico Español em Ciencias de la Salud (IBECS), Literatura Latino-Americana e do Caribe em Ciências da Saúde(LILACS) e Banco de Dados de Enfermagem (BDENF), utilizando termos Medical Subject Headings (MeSH) "Professionalism", "Teaching" e "Nursing". Resultados: Após aplicação dos critérios de inclusão e exclusão, selecionaram-se 18 artigos. Houve identificação dos atributos pela técnica de análise de conteúdo. Elaboraram-se casos modelo e contrário, com respectivo uso e não uso do conceito. Identificaram-se elementos antecedentes, atributos e consequentes. Como antecedentes: experiência, educação profissional, valores profissionais, socialização e formação positiva; como atributos: identidade profissional, atitude profissional, competência, domínio, ética, autonomia, papel profissional e comportamento profissional; e como consequentes: qualidade profissional, profissionais preparados, aquisição de habilidade, compromisso,auto conceito profissional e colocações práticas bem-sucedidas. Conclusão: Pode-se entender profissionalismo como conjuntura de qualidades que perpetuam o comportamento e o desempenho do papel profissional para o âmbito do ensino, como conhecimento, ética,atitude, domínio, autonomia e competência. Descritores: Profissionalismo. Ensino. Enfermagem.

Objective: To clarify the concept of professionalism innursing education. Methods: Conceptual analysis, using the method of Walker and Avant, identifying the use of the concept in the bases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed®), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Latin American and Caribbean Literature on Health Sciences (LILACS) and the Nursing Database (BDENF), using the Medical Subject Headings (MeSH) terms "Professionalism", "Teaching",and "Nursing". Results: After applying the inclusion and exclusion criteria, 18 articleswere selected. The attributes were identified by the content analysis technique. Model and opposite cases were elaborated, with respective use and non-use of the concept. The antecedent elements, attributes, and consequents were identified. The following were identified as antecedents: experience, professional training, professional values, socialization, and positive education; as attributes: professional identity, professional attitude, competence, mastery,knowledge,ethics, autonomy, professional role,and professional behavior; and as consequents: professional quality,skilledprofessionals, skill acquisition, commitment, professional self-concept, and successful practical applications.Conclusion: Professionalism can be understoodas a conjuncture of qualities that perpetuate the behavior and performance of the professional role for the scope of teaching, such as knowledge, ethics, attitude, mastery, autonomy, and competence. Descriptors: Professionalism. Teaching. Nursing.

Cuidados de enfermagem ao paciente politraumatizado: revisão integrativa / Nursing care for polyramed care: integrative review / Polytraumatized patient nursing care: revisión integrativa

OBJETIVO: Descrever os cuidados de enfermagem ao paciente politraumatizado grave. MÉTODO: Revisão integrativa com buscas nas bases de dados CINAHL, MEDLINE/BIREME, IBECS, BDENF e LILACS, utilizando os MeSH (Medical Subject Headings) obtidos através da estratégia PVO e operador booleano em duas estratégias distintas: estratégia 01 "nursing care AND multiple trauma" e estratégia 02 "nursing care AND patient AND multiple trauma". RESULTADOS: Após buscas e aplicação dos critérios de elegibilidade restaram uma totalidade de 09 artigos. Nesse sentido, observou-se que os cuidados de enfermagem ao paciente politraumatizado estão ligados ao âmbito do manejo adequado com a estrutura corporal, com ênfase na técnica de imobilização; aos cuidados à restauração e manutenção da pele; à administração medicamentosa e controle da dor; e, ao monitoramento de sistemas fisiológicos. CONCLUSÃO: O cuidado de enfermagem é um instrumento complexo que abrange o ser em sua totalidade, onde na assistência ao politraumatizado várias intervenções são necessárias para que haja progressão no estado de saúde deste individuo, demonstrando a importância desta profissão em virtude das inúmeras atividades desempenhadas.(AU)

OBJECTIVE: To describe nursing care for severe polytrauma patients. METHOD: Integrative review with searches in the following databases: CINAHL, MEDLINE/BIREME, IBECS, BDENF and LILACS, using MeSH (Medical Subject Headings) obtained through the PVO strategy and Boolean operator in two different strategies: strategy 01 "nursing care AND multiple trauma "and strategy 02" nursing care AND patient AND multiple trauma". RESULTS: After searching and applying the eligibility criteria, a total of 09 articles remained. In this sense, it was observed that nursing care for polytrauma patients is linked to the scope of adequate management with body structure, with an emphasis on the immobilization technique; care for the restoration and maintenance of the skin; medication administration and pain control; and, the monitoring of physiological systems. CONCLUSION: Nursing care is a complex instrument that encompasses the being in its entirety, where in assistance to multiple trauma patients, several interventions are necessary for there to be progression in the health status of this individual, demonstrating the importance of this profession due to the numerous activities performed.(AU)

OBJETIVO: Describir la atención de enfermería a pacientes politraumatizados graves. METODO: Revisión integrativa con búsquedas en las bases de datos CINAHL, MEDLINE/BIREME, IBECS, BDENF y LILACS, utilizando el MeSH (Medical Subject Headings) obtenido a través de la estrategia PVO y operador booleano en dos estrategias distintas: estrategia 01 "cuidado de enfermería y trauma múltiple" y estrategia 02 "cuidado de enfermería y y y trauma múltiple del paciente". RESULTADOS: Después de buscar y aplicar los criterios de elegibilidad, se mantuvieron un total de 09 artículos. En este sentido, se observó que la atención de enfermería para pacientes politraumatizados está vinculada al ámbito de un manejo adecuado con estructura corporal, con énfasis en la técnica de inmovilización; cuidado de la restauración y mantenimiento de la piel; administración de drogas y control del dolor; y, el monitoreo de los sistemas fisiológicos. CONCLUSION: La atención de enfermería es un instrumento complejo que abarca el ser en su totalidad, donde en el cuidado de la politraumatizada son necesarias varias intervenciones para que haya progresión en el estado de salud de este individuo, demostrando la importancia de esta profesión debido a las numerosas actividades realizadas.(AU)

Autonomic responses induced by aerobic submaximal exercise in obese and overweight adolescents.

BACKGROUND: Graded exercises tests are performed in adult populations; nonetheless, the use of this type of assessment is greatly understudied in overweight and obese adolescents. OBJECTIVE: To investigate heart rate autonomic responses to submaximal aerobic exercise in obese and overweight adolescents. METHODS: We recruited 40 adolescents divided into two groups: (1) overweight group comprising 10 boys and 10 girls between Z-score +1 and +2 and (2) obese group comprising 10 boys and 10 girls above Z-score >+2. Heart rate variability was analysed before (T1) and after exercise (T2-T4) on treadmill at a slope of 0%, with 70% of the maximal estimated heart rate (220 - age) for 20 minutes. RESULTS: Heart rate in the overweight group was: 93.2±10.52 bpm versus 120.8±13.49 bpm versus 94.6±11.65 bpm versus 93.0±9.23 bpm, and in the obese group was: 92.0±15.41 bpm versus 117.6±16.31 bpm versus 92.1±12.9 bpm versus 91.8±14.33 bpm. High frequency in the overweight group was: 640±633.1 ms2 versus 84±174.66 ms2 versus 603.5±655.31 ms2 versus 762.6±807.21 ms2, and in the obese group was: 628.4±779.81 ms2 versus 65.4±119.34 ms2 versus 506.2±482.70 ms2 versus 677.9±939.05 ms2; and root mean square of successive differences in the overweight group was: 37.9±18.81 ms versus 10.9±8.41 ms versus 32.8±24.07 ms versus 36.7±21.86 ms, and in the obese group was: 38.7±23.17 ms versus 11.5±8.62 ms versus 32.3±16.74 ms versus 37.3±24.21 ms. These values significantly changed during exercise compared with resting values in overweight and obese groups. Moreover, we also reported no significant difference of resting parasympathetic control of heart rate between obese and overweight adolescents. CONCLUSION: There was no significant difference of autonomic responses elicited by submaximal aerobic exercise between overweight and obese adolescents.

Relação entre ansiedade e modulação autonômica cardíaca / Relationship between anxiety and autonomic heart modulation

A ansiedade é caracterizada pelo sentimento de tensão, nervosismo, apreensão e preocupação que pode alterar a modulação do sistema nervoso autônomo sobre a condução elétrica ligada ao coração, determinando a intensidade nos batimentos cardíacos modificando a variabilidade da frequência cardíaca que é um importante indicador de condições normais e patológicas. Assim, o objetivo do estudo foi analisar a relação existente entre a ansiedade e o processo de regulação autonômica cardíaca. Este estudo trata-se de uma revisão integrativa desenvolvido por meio de buscas nas bases de dados da Lilacs, Medline e SciELO, com os descritores em ciências da saúde e operador booleano: ansiedade AND frequência cardíaca e, ansiedade AND sistema nervoso autônomo. A busca foi realizada durante o mês de setembro de 2017, sendo incluídos artigos disponíveis na íntegra; em português e inglês e; publicados nos últimos 06 anos. Excluiu-se artigos que não fossem originais, teses, dissertações e monografias. Obteve-se um total de 10 artigos, nos quais observou-se que a ansiedade altera a resposta autonômica, assim quando o corpo entra em tensão, aumenta-se a frequência cardíaca, o predomínio do sistema simpático e no relaxamento ocorre o domínio parassimpático. Assim indivíduos portadores de ansiedade apresentam menor variação na frequência cardíaca e possuem uma capacidade menor de interação social. Com isto, evidencia-se uma baixa adaptação do sistema nervoso autônomo em casos de ansiedade, sendo que a variabilidade da frequência cardíaca encontra-se reduzida; condição esta que pode ser classificada como patológica.

The anxiety is characterized by the sensation of tension, nervousness, apprehension and worry that can alter the modulation of autonomic nervous system on the electrical conduction linked to the heart, determining the intensity in the heart beats modifying the heart rate variability, which is an important indicator of conditions normal and pathological. Thus, the study objective is to analyze the relationship between anxiety and the process of autonomic cardiac regulation. This study is an integrative review developed through searches in the databases of Lilacs, Medline and SciELO, with the descriptors in health sciences and boolean operator: anxiety AND heart rate and anxiety AND autonomic nervous system. The search was performed during the month of September of 2017, being included articles available in full; in Portuguese and English and; published in the last 6 years. Was excluded articles that were not original, theses, dissertations and monographs. Was obtained a total of 10 articles, in which it was observed that anxiety alters the autonomic response, so when the body is in tension, increases your heart rate, the predominance of the sympathetic system and in the relaxation occurs the domain of the parasympathetic. Thus, individuals with anxiety present lower variation in heart rate and have a lower capacity for social interaction. With this, it is evident a low adaptation of the autonomic nervous system in cases of anxiety, being that the variability of the heart rate is reduced; condition that can be classified as pathological.

Musical auditory stimulus acutely influences heart rate dynamic responses to medication in subjects with well-controlled hypertension.

Music can improve the efficiency of medical treatment when correctly associated with drug action, reducing risk factors involving deteriorating cardiac function. We evaluated the effect of musical auditory stimulus associated with anti-hypertensive medication on heart rate (HR) autonomic control in hypertensive subjects. We evaluated 37 well-controlled hypertensive patients designated for anti-hypertensive medication. Heart rate variability (HRV) was calculated from the HR monitor recordings of two different, randomly sorted protocols (control and music) on two separate days. Patients were examined in a resting condition 10 minutes before medication and 20 minutes, 40 minutes and 60 minutes after oral medication. Music was played throughout the 60 minutes after medication with the same intensity for all subjects in the music protocol. We noted analogous response of systolic and diastolic arterial pressure in both protocols. HR decreased 60 minutes after medication in the music protocol while it remained unchanged in the control protocol. The effects of anti-hypertensive medication on SDNN (Standard deviation of all normal RR intervals), LF (low frequency, nu), HF (high frequency, nu) and alpha-1 scale were more intense in the music protocol. In conclusion, musical auditory stimulus increased HR autonomic responses to anti-hypertensive medication in well-controlled hypertensive subjects.

Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment.

We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.

Non-linear indices of heart rate variability during endodontic treatment.

Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p < 0.0001). The α2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the α1/α2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation.

Non-linear indices of heart rate variability during endodontic treatment

Abstract Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p < 0.0001). The α2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the α1/α2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation.