Feelings of nurses faced with death: pleasure and suffering from the perspective of psychodynamics of Dejours / Los sentimientos de los enfermeros que enfrentan la muerte: el placer y el sufrimiento desde la perspectiva de la psicodinámica de Dejours / Sentimentos de enfermeiros confrontados com a morte: prazer e sofrimento sob a ótica da psicodinâmica de Dejours

Abstract Objective To analyze the feelings of nurses confronting death, according to the Dejourian psychodynamic. Methods. This is a qualitative, exploratory study, analyzed, interpreted and discussed emphasizing the suffering and pleasure, proposed by Dejours. Results. Participants were 11 nurses, mostly woman, single, white, Catholic, between two sixteen years of profession. The analysis of responses allowed finding some driving and potentiating factors of feelings of pleasure and suffering. It was identified as pleasure: feeling of accomplishment, comfort and relief; as suffering, sadness, frustration, difficulty with grief, impotence and incapacity. They also have defense mechanisms to prevent suffering, as not to think about suffering and death, taking refuge in work. Conclusion The factors related to the pleasure and the pain of Nurses when facing death were identified. Therefore, education is necessary regarding the process of death in academic training and studies that approach the nurse to this natural process.

Resumen Objetivo. Analizar los sentimientos de los enfermeros frente a la muerte, a la luz de la psicodinámica dejouriana. Métodos. Estudio cualitativo exploratorio, analizada, interpretada y discutida haciendo hincapié en el sufrimiento y el placer, propuesto por Dejours. Resultados. Los participantes fueron 11 enfermeros, en su mayoría mujeres, solteros, blancos, católicos y que llevaban entre dos y dieciséis años de egresados. El análisis de los resultados permitió encontrar algunos factores propulsores y potencializadores de los sentimientos de placer y sufrimiento. Se identificaron como placer: la sensación del deber cumplido, la comodidad y el alivio; y como sufrimiento: la tristeza, la frustración, dificultad con el luto, la impotencia y la incapacidad. También, tienen mecanismos de defensa para evitar el sufrimiento como no pensar en este ni en la muerte, refugiándose en el trabajo. Conclusión. Se identificaron los factores relacionados con el placer y el sufrimiento de los enfermeros cuando enfrentan la muerte. Por lo tanto, en el ámbito académico existe la necesidad de la educación en el proceso de la muerte, así como la realización de estudios que acerquen a la enfermera a este proceso natural.

Resumo Objetivo . analisar os sentimentos de enfermeiros confrontados com a morte, a luz da psicodinâmica Dejouriana. Métodos . Estudo qualitativo, exploratório, analisado, interpretado e discutido enfatizando o sofrimento e prazer, proposto por Dejours. Resultados . Os participantes foram 11 Enfermeiros, maioria mulheres, solteiras, brancas, católicas, entre dois e dezesseis anos de profissão. A análise das respostas permitiu encontrar alguns fatores propulsores e potencializadores dos sentimentos de prazer e sofrimento. Identificou-se como prazer: sensação de dever cumprido, conforto e alívio; como sofrimento: tristeza, frustração, dificuldade com o luto, impotência e incapacidade. Também apresentam mecanismos de defesa para evitar o sofrer, como: não pensar no sofrimento e morte, refugiando-se no trabalho. Conclusão . Identificou-se os fatores relacionados com o prazer e o sofrimento dos Enfermeiros quando enfrentam a morte. Há, portanto, necessidade da educação para a o processo de morte na formação acadêmica e estudos, que aproximem o enfermeiro deste processo natural.

Feelings of nurses faced with death: pleasure and suffering from the perspective of psychodynamics of Dejours.

OBJECTIVES: To analyze the feelings of nurses confronting death, according to the Dejourian psychodynamic. METHODS: This is a qualitative, exploratory study, analyzed, interpreted and discussed emphasizing the suffering and pleasure, proposed by Dejours. RESULTS: Participants were 11 nurses, mostly woman, single, white, Catholic, between two sixteen years of profession. The analysis of responses allowed finding some driving and potentiating factors of feelings of pleasure and suffering. It was identified as pleasure: feeling of accomplishment, comfort and relief; as suffering, sadness, frustration, difficulty with grief, impotence and incapacity. They also have defense mechanisms to prevent suffering, as not to think about suffering and death, taking refuge in work. CONCLUSIONS: The factors related to the pleasure and the pain of Nurses when facing death were identified. Therefore, education is necessary regarding the process of death in academic training and studies that approach the nurse to this natural process.

A formação do enfermeiro, o sistema único de saúde e a saúde como um direito: uma revisão sobre a tipologia de conteúdos de ensino-aprendizagem / Nursing education, the unified health system and health as a right: a review of the typology of teaching-learning content

A saúde tem sido uma questão amplamente discutida no mundo todo, especialmente devido a sua importância para o trabalho. Apenas nas últimas décadas, a saúde passou a ocupar lugar privilegiado, com foco nas pessoas e em seus direitos e não necessariamente no que representavam como força de trabalho. Entretanto, no âmbito do ensino da saúde, tem havido muita influência de correntes biologicistas, médico-centradas, enfatizando a doença e a sua implementação de formas de cuidar. Contudo, essa forma de pensar e organizar as ações em saúde não têm apoiado o movimento de garantia da saúde como um direito. Nesse sentido, o ensino superior em saúde tem sido palco de muitas discussões acerca da demanda por novas formas de trabalhar o conhecimento com base em uma perspectiva crítico-reflexiva, com vistas à implementação do Sistema Único de Saúde (SUS). Trata-se de uma revisão sistemática da literatura, com organização dos resultados baseada na tipologia de conteúdo. Os resultados mostraram desarticulação entre a formação de profissionais, sua atuação e os princípios e diretrizes do SUS. Percebeu-se também a maior ênfase aos conteúdos conceituais e procedimentais no ensino e no trabalho em saúde.

Health has been an issue discussed worldwide, especially due to its importance for work. Only in recent decades, health has come to occupy a privileged place, with a focus on people and their rights and not necessarily in what they represented as workforce. However, considering health professionals' education, there has been much influence of some philosophical trends, such as the biologicist, physician-centered currents, emphasizing the disease and the implementation of its care forms. Nevertheless, this way of thinking and organizing health actions has not supported the movement of guaranteeing health as a right. Thus, higher education in health has been the scenario of many discussions about the demand for new ways of working the knowledge in a critical-reflective perspective aiming at implementing and consolidating the Unified Health System (SUS). This is a systematic literature review, in which the organization of the results was based on the content typology. Results showed mismatch between the professionals' education, their performance and the principles and guidelines of SUS. It was also possible to note the greater emphasis on conceptual and procedural contents in health professionals' education and health work, compared to the lower emphasis on attitudinal transformation.

Spirituality and humanization according to nursing undergraduates: an action research.

OBJECTIVE: To know the conceptions of undergraduates from the Teaching Diploma Program with Bachelor degree in Nursing at a public state-owned higher education institution in an interior city in the State of São Paulo about spirituality and humanization, as well as to propose educative action in that sense. Methodoly. A qualitative study was undertaken, using the action research method. The data were collected in the second semester of 2012 through participant observation, registered in a field diary, and interviews with the help of questionnaires. For the interpretative data analysis, categorization was used. RESULTS: The implicit predominance of the technical-procedure care discourse was observed, to the detriment of the educational care discourse, as complementary constructs, according to the participant' statements. Nevertheless, the educational action permitted constructivism and the problematization of knowledge. CONCLUSION: Although the results may not reflect the reality at the investigated institution, it is concluded that the academic education of nurse educators is a moment of possibilities to include spirituality and humanization, regarding the development of competences that grant individual support to patients and families, in health promotion and coping with disease situations.

Conceptions of nursing students on health promotion related to psychoactive substances.

This qualitative study aimed to investigate the perception of undergraduate nursing students on health promotion in view of the use of psychoactive substances. Nine undergraduate students, attending the last disciplines of the first semester, participated in the study and were divided in two focal groups. The theoretical-methodological referential was based on Paulo Freire's theory of conscientization. Data were processed through content analysis, demonstrating that students find difficulties in planning intervention strategies in health promotion in view of the drug phenomenon, because the knowledge provided by the university has a biologist tendency, typical of the medical model, recognizing a gap between theory and practice. Nevertheless, they manage to reconstruct their knowledge and become aware of their role as future health promoters in the face of drug use and abuse.

Reflexiones filosoficas y pedagogicas: contribucion para el estudio de los curriculos de enfermeria centrados en la propuesta de atencion primaria en salud / Philosophic and pedagogic reflections: contribution to reestructuration of nursing curricula centered in the primary health care proposal

El presente trabajo reflexiona sobre las concepciones filosoficas y pedagogicas de la educacion que puedan orientar la planeacion curricular dentro de un abordaje critico y reflexivo, teniendo en cuenta la propuesta de atencion primaria en salud. Aborda las corrientes fisoloficas (humanista tradicional y moderna, dialectica y analitica) y las pedagogicas (transmision, condicionamiento y problematizacion), relacionando tales concepciones con la planeacion curricular, y con las propuestas de innovacion centradas en la atencion primaria en salud. Resalta tambien, la modernizacion del proceso educativo, la articulacion docente asistencial y el desarrollo de la investigacion. El estudio no tiene la pretension de presentar propuestas concretas y definitivas, sino de reflexionar y cuestionar la viabilizacion de la incorporacion de conceptos filosoficos y pedagogicos a las propuestas en la ensenanza y en la practica de enfermeria