Trabajo en equipo y negociación con la familia en Pediatría / Teamwork and negotiation with family in pediatrics

OBJETIVO: Analizar el proceso de negociación e interacción en la práctica enfermera con las madres de los niños hospitalizados en Pediatría desde la perspectiva del trabajo en equipo. MÉTODO: Estudio cualitativo, basado en la teoría fundamentada y tomando como referencia el interaccionismo simbólico. Participaron en el estudio 12 enfermeras de la unidad pediátrica y 18 madres cuyos hijos se encontraban hospitalizados en dicha unidad. El número de participantes fue definido con respecto al criterio de la saturación de los datos. Para la recogida de datos se utilizó la observación participante y la entrevista semiestructurada, y posteriormente se analizaron mediante el programa NVivo8. RESULTADOS: Del análisis efectuado emergió la categoría central, «debilidades en el proceso de negociación», en las interacciones que las enfermeras establecen con las madres. Las enfermeras revelaron dificultades en la comunicación; no contemplaron la necesaria clarificación de los roles junto a las madres para su participación en el proceso de cuidados y fue evidente un desequilibrio de poder en las relaciones que establecían con ellas. CONCLUSIONES: En el contexto estudiado, se observaron importantes carencias en el desarrollo del trabajo colaborativo con las madres de los niños hospitalizados. Las debilidades en el proceso de negociación, en particular, las dificultades en la comunicación, la falta de clarificación de los roles y tareas que cada uno debe asumir así como el desequilibrio de poder percibido en las relaciones obstaculizan el compromiso de las madres en el proceso de atención del niño, lo cual es esencial para conseguir una mayor implicación, unos mejores resultados en términos de salud y un menor impacto de la hospitalización en el niño

OBJECTIVE: Analyze the negotiation and interaction process within nurses' practice with mothers of hospitalized children in pediatric unit from the teamwork perspective. Method: A qualitative approach was used in this study, based on the Grounded Theory from the symbolic interaction perspective. The study included 12 nurses of the pediatric unit and 18 mothers who stayed in the hospital with their hospitalized children. The number of participants was defined according to data saturation. Participant observation and semi-structured interviews were chosen as data collection techniques and it was analyzed using the program NVivo8. RESULTS: From the analysis performed, the central category identified was «weaknesses in the negotiation process», within the interactions between nurses and mothers. Nurses revealed difficulties in the communication process, they did not include roles definition with mothers in order to establish their participation in the care process and a power imbalance was also evidenced. CONCLUSIONS: Within the studied settings, an important lack of collaborative work with hospitalized children's mothers was observed. The weaknesses in the negotiation process and specifically the difficulties found in communication; the lack of roles and tasks clarification and the perceived power imbalance regarding relationships, prevent mothers involvement in their children care process, considered a basic component to achieve a greater mother implication, better results in terms of health and a lower impact of hospitalization in the children

[Teamwork and negotiation with family in pediatrics]. / Trabajo en equipo y negociación con la familia en Pediatría.

OBJECTIVE: Analyze the negotiation and interaction process within nurses' practice with mothers of hospitalized children in pediatric unit from the teamwork perspective. METHOD: A qualitative approach was used in this study, based on the Grounded Theory from the symbolic interaction perspective. The study included 12 nurses of the pediatric unit and 18 mothers who stayed in the hospital with their hospitalized children. The number of participants was defined according to data saturation. Participant observation and semi-structured interviews were chosen as data collection techniques and it was analyzed using the program NVivo8. RESULTS: From the analysis performed, the central category identified was «weaknesses in the negotiation process¼, within the interactions between nurses and mothers. Nurses revealed difficulties in the communication process, they did not include roles definition with mothers in order to establish their participation in the care process and a power imbalance was also evidenced. CONCLUSION: Within the studied settings, an important lack of collaborative work with hospitalized children's mothers was observed. The weaknesses in the negotiation process and specifically the difficulties found in communication; the lack of roles and tasks clarification and the perceived power imbalance regarding relationships, prevent mothers involvement in their children care process, considered a basic component to achieve a greater mother implication, better results in terms of health and a lower impact of hospitalization in the children.

A intervenção do enfermeiro de reabilitação na promoção do autocuidado: gestão do regime terapêutico, no planeamento da alta do idoso com DPOC / The intervention of the rehabilitation nurse in the promotion of self-care: management of the therapeutic regimen, in the planning of the discharge of the elderly with COPD

Este relatório de trabalho de projeto visa a análise e reflexão sobre a intervenção do enfermeiro de reabilitação, no âmbito do projeto "promoção do autocuidado: gestão do regime terapêutico, no planeamento da alta do idoso com DPOC", implementado na Pneumologia-C/ CHO-Torres Vedras. Realizou-se a revisão sistemática da literatura, utilizando-se a metodologia PI[C]O. O objetivo foi analisar a evidência científica sobre as intervenções de enfermagem de reabilitação, na promoção do autocuidado: gestão do regime terapêutico, no sentido de as integrar na prática clinica. Formulou-se a pergunta: Quais as intervenções de enfermagem de reabilitação, que promovem o autocuidado: gestão do regime terapêutico, no idoso com DPOC?, e selecionaram-se três artigos de investigação. Concluiu-se que as intervenções de enfermagem de reabilitação (no hospital e domicilio), baseadas no treino da respiração diafragmática, da técnica de conservação de energia e gestão de esforço, melhoraram a adesão, a autonomia nas AVD e a qualidade de vida

The aim of this report project is to analyze and reflect on the intervention of the rehabilitation nurse, under the project "Promotion of self-care: management of therapeutic regimen, in planning the discharge of the elderly with COPD", implemented in Pulmonology-C/ CHO - Torres Vedras. We conducted a systematic literature review using the methodology PI[C]O. The objective was to review the scientific evidence on the rehabilitation nursing interventions, promotion of self-care: management regimen in order to integrate them into clinical practice. The question formulated: What are the rehabilitation nursing interventions that promote self-care: management of therapeutic regimen in elderly patients with COPD?, and we selected three research articles. It was concluded that the rehabilitation nursing interventions (household and hospital), based on the practice diaphragmatic breathing, technique in energy conservation and management efforts, improved adherence, autonomy in activities of daily living and quality of life

La experiencia de las madres en la participación del cuidado de sus hijos hospitalizados / Mothers experience in participating in the care of their hospitalised children

Objetivos. Describir la experiencia de las madres en la participación del cuidado de sus hijos, el significado y la importancia para ellas, así como también identificar las intervenciones en las que las madres se implican. Método. Estudio cualitativo, fundamentado teóricamente en el interaccionismo simbólico. Fue usada como metodología de referencia la Grounded Theory. Se utilizaron la entrevista semiestructurada y la observación para la recogida de datos. Participaron en el estudio 18 madres con niños hospitalizados. Fueron seleccionadas con respecto al criterio de inclusión: madres con niños hospitalizados 5 o más días y con disponibilidad para participar. El número de participantes fue definido con respecto al criterio de la saturación de los datos. Los datos se analizaron mediante el programa Nvivo 8. Resultados. Las madres perciben la participación en el cuidado de sus hijos como una obligación y una ayuda a las enfermeras. Pero la consideran también una contribución al cuidado personalizado de sus hijos, al bienestar de éstos y a la continuidad del papel parental. Los cuidados en que las madres se implican son los cuidados familiares. Las madres realizan otros cuidados delegados por las enfermeras, pero falta la negociación de los mismos. La indefinición de funciones y el uso del poder mal repartido causan ansiedad en las madres cuando son confrontadas con nuevos cuidados. Conclusiones. Las madres consideran importante la participación en el cuidado de sus hijos. Esta participación se caracteriza por una continuidad de los cuidados prestados en casa. Ellas cumplen otros cuidados pero no hay plena implicación (AU)

Objectives. The purpose of this study was to describe the experience, the meaning and importance to them, of mothers participating in the care process of their child, as well as to identify interventions in which mothers were involved. Method. A qualitative approach was employed for this study, which was theoretically based on Symbolic Interactions and the Grounded Theory reference methodology. A semi-structured interview and observation were chosen as data collection techniques. The study included 18 mothers with hospitalised children. They were selected based on inclusion criteria: mothers with children hospitalised 5 or more days, and with a willingness to participate. The number of participants was defined using the criterion of data saturation. The data was analysed using the program Nvivo8. Results. Mothers understood the participation as an obligation and an aid to nurses. They also considered it as a contribution to the personal care of their children, for their well-being and for continuity of the parental role. The care in which the mothers were involved were those of family care, already developed in the home. They developed other forms of care, which were delegated by nurses without negotiation. The confusion of roles and the non-distribution of power caused anxiety in mothers when confronted with new forms of care. Conclusions. The mothers considered their participation in their child's care as very important, but this involvement was characterised by a continuation of the care provided at home. They developed other forms of care but were not fully involved (AU)

[Mothers experience in participating in the care of their hospitalised children]. / La experiencia de las madres en la participación del cuidado de sus hijos hospitalizados.

OBJECTIVES: The purpose of this study was to describe the experience, the meaning and importance to them, of mothers participating in the care process of their child, as well as to identify interventions in which mothers were involved. METHOD: A qualitative approach was employed for this study, which was theoretically based on Symbolic Interactions and the Grounded Theory reference methodology. A semi-structured interview and observation were chosen as data collection techniques. The study included 18 mothers with hospitalised children. They were selected based on inclusion criteria: mothers with children hospitalised 5 or more days, and with a willingness to participate. The number of participants was defined using the criterion of data saturation. The data was analysed using the program Nvivo8. RESULTS: Mothers understood the participation as an obligation and an aid to nurses. They also considered it as a contribution to the personal care of their children, for their well-being and for continuity of the parental role. The care in which the mothers were involved were those of family care, already developed in the home. They developed other forms of care, which were delegated by nurses without negotiation. The confusion of roles and the non-distribution of power caused anxiety in mothers when confronted with new forms of care. CONCLUSIONS: The mothers considered their participation in their child's care as very important, but this involvement was characterised by a continuation of the care provided at home. They developed other forms of care but were not fully involved.

Percepção de auto-eficácia na influência sobre adolescentes: o ponto de vista dos avós / Self-efficacy perceptio concerning the influence on adolescents: the grandparent's point of view

Este estudo visou conhecer a percepção de auto-eficácia de avós na influência sobre seus netos e a variação de resultados consoante a idade, o sexo, a escolaridade, freqüência de contacto com o neto, a natureza da filiação e o sexo da(o) neta(o), a partir de uma amostra de 96 idosos, de uma escala adaptada a partir de King e Elder (1998), a que chamamos 'avaliação das percepções de auto-eficácia de avós na influência sobre seus netos'. Não encontramos diferenças na percepção de auto-eficácia entre os sexos. A idade mais baixa do avô relaciona-se com percepção de maior auto-eficácia em duas dimensões de influência. A freqüência do contato com o neto, bem como a escolaridade, são também significativamente associadas com percepção de maior eficácia em todas as dimensões, com excepção de 'compreender e partilhar valores'. Finalmente, a natureza da filiação também se relaciona com uma percepção de maior auto-eficácia em duas dimensões. O crescente papel que os avós desempenham na educação e socialização de crianças parece ser acompanhado por uma significativa dose de confiança nessas tarefas