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1.
Pulm Circ ; 13(4): e12308, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38027456

RESUMO

Relationships between obesity and outcomes in pulmonary arterial hypertension (PAH) are complex. Previous work suggested obesity, occurring alongside PAH, may be associated with better survival. In our work, we suggest obesity prior to PAH development is associated with worse survival. This may add a novel temporal element to the "obesity-paradox."

2.
Respir Med ; 211: 107215, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36934856

RESUMO

INTRODUCTION: Balloon pulmonary angioplasty (BPA) is a less invasive treatment alternative for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are unable to move forward with pulmonary thromboendarterectomy. This report describes a single-center experience with a nascent BPA program in the United States (US). METHODS: All patients who underwent BPA between August 2018-2021 were included in this retrospective, single-center observational cohort. Pre- and post-procedure clinical information was collected, along with procedural characteristics. RESULTS: Thirty patients began their BPA series during the study period. The majority of patients had segmental disease (n = 25, 83.3%). A total of 135 BPA procedures were performed on 417 segments. On average, patients completed 4.5 sessions and the majority of patients (n = 23, 76.7%) underwent more than 2. There were 24 episodes of hemoptysis and 20 procedural events that required treatment, typically with either heparin reversal or balloon tamponade. Of 26 participants with completed series, mean PA pressure (-6 mmHg, 95% CI -9 to -4 mmHg, p = 0.0001), PVR (-1.9 Wood units, 95% CI -2.9 to -1.0, p = 0.0002), and pulmonary compliance (-1.0 mL/mmHg, 95% CI -1.5 to -0.5, p = 0.0002) improved. Improvement was also seen in NYHA functional classification and walk distance (p = 0.01). Two deaths occurred, with one death peri-procedurally. CONCLUSION: This paper describes an early experience with BPA at a single US center. Improvement in non-invasive and invasive metrics were seen without adding a significant morbidity to an already high-risk patient population.


Assuntos
Angioplastia com Balão , Hipertensão Pulmonar , Embolia Pulmonar , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/cirurgia , Embolia Pulmonar/complicações , Embolia Pulmonar/cirurgia , Estudos Retrospectivos , Doença Crônica , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/métodos , Artéria Pulmonar/cirurgia , Resultado do Tratamento
3.
Crit Care Clin ; 38(4): 657-693, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36162904

RESUMO

This review provides insights on the current state of roles and responsibilities, on-the-job training, barriers, and facilitators of critical care nursing (CCN) practice. Some of the established roles and training of CCN were providing care for acutely ill patients, delivering expert and specialist care, working as a part of a multidisciplinary team, monitoring, and initiating timely treatment, and providing psychosocial support and advanced system treatment, especially in high-income countries. In low-resource settings, critical care nurses work as health care assistants, technical or ancillary staff, and clinical educators; manage medications; care for mechanically ventilated patients; and provide care to deteriorating patients.


Assuntos
Enfermagem de Cuidados Críticos , Cuidados Críticos , Humanos
4.
BMJ Open Respir Res ; 9(1)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35879020

RESUMO

INTRODUCTION: Pulmonary arterial hypertension (PAH) remains a serious and life-threatening illness. Thyroid dysfunction is relatively understudied in individuals with PAH but is known to affect cardiac function and vascular tone in other diseases. The aim of this observational study was to evaluate the association between thyroid-stimulating hormone (TSH), mortal and non-mortal outcomes in individuals with PAH. METHODS: The Seattle Right Ventricle Translational Science (Servetus) Study is an observational cohort that enrolled participants with PAH between 2014 and 2016 and then followed them for 3 years. TSH was measured irrespective of a clinical suspicion of thyroid disease for all participants in the cohort. Linear regression was used to estimate the relationships between TSH and right ventricular basal diameter, tricuspid annular plane systolic excursion and 6-minute walk distance. Logistic regression was used to estimate the relationship with New York Heart Association Functional Class, and Cox proportional hazards were used to estimate the relationship with mortality. Staged models included unadjusted models and models accounting for age, sex at birth and aetiology of pulmonary hypertension with or without further adjustment for N-terminal-pro hormone brain natriuretic peptide. RESULTS: Among 112 participants with PAH, TSH was strongly associated with mortality irrespective of adjustment. There was no clear consistent association between TSH and other markers of severity in a cohort with PAH. DISCUSSION: This report reinforces the important observation that TSH is associated with survival in patients with PAH, and future study of thyroid dysfunction as a potential remediable contributor to mortality in PAH is warranted.


Assuntos
Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Hipertensão Pulmonar Primária Familiar/complicações , Ventrículos do Coração , Humanos , Hipertensão Pulmonar/etiologia , Recém-Nascido , Tireotropina
6.
Rev. Enferm. Atual In Derme ; 96(37): 1-13, Jan-Mar. 2022.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1378461

RESUMO

Objetivo: Identificar os cuidados à mulher internada no Centro de Terapia Intensiva pormiocardiopatia periparto. Metodologia: Revisão integrativa da literatura realizada emtrês bases de dados durante o mês de maio de 2021 utilizando estratégias de buscas quecombinavamatravésdosoperadoresbooleanosAND,ORostermosexatosealternativos:Cardiopatias/Heartdiseases;Insuficiênciacardíaca/Heartfailure;Cuidadoscríticos/Criticalcare;Gravidez/Pregnancy;Puerpério/Puerperium;Períodoperiparto/Peripartum period. Foram selecionados sete artigos para esta revisão. Resultados: Destacaram-se os cuidadosrelacionadosaomonitoramentoeestabilizaçãodasfunções cardíacas, renais e respiratórias, principais sistemasafetadospelapatologia. A variabilidade de desfechosclínicos,aponta paraa necessidade de capacitação dos profissionais de saúde para diagnosticar em tempo oportuno e tratar corretamente a patologia minimizando as chances de óbito materno e fetal. Consideraçõesfinais:Amiocardiopatiaperipartoaindaéumapatologiapoucoevidenciadanoâmbitocientífico,havendonecessidadedeampliarodesenvolvimentodeestudosacercadatemática,sobretudocomdiretrizesquenorteiemaspráticasassistenciais.


Objective: To identify the care provided to women admitted to the Intensive Care Unitfor peripartum cardiomyopathy. Methodology: Integrative literature review carried outin three databases during the month of May 2021 using search strategies that combinedthe exact and alternative terms using the Boolean operators AND, OR (DECS/MeSH):heartdiseases/heartdiseases;Heartfailure/Heartfailure;Criticalcare/Criticalcare;Pregnancy/Pregnancy; Puerperium/Puerperium; Peripartum period/Peripartum period.Seven articles were selected for this review.Results:Care related to monitoring and stabilization of cardiac,renal and respiratory functions, the main systems affected by the pathology, stood out. The variability of clinical outcomes points to the need to train health professionals to diagnose in a timely manner and correctly treat the pathology, minimizing the chances of maternal and fetal death. Conclusion:Peripartumcardiomyopathy is still a disease little evidenced in the scientific field, with the need toexpand the development of studies on the subject, especially with guidelines that guidecare practices.


Objetivo: Identificar la atención a las mujeres hospitalizadas en el Centro de Cuidados Intensivos por miocardiopatía periparto. Metodología: Revisión integrativa de la literatura realizada en tres bases de datos durante el mes de mayo de 2021 utilizando estrategias de búsqueda que combinaron los términos exactos y alternativos utilizando los operadores booleanos AND, OR: Cardiopatías/Enfermedades del corazón; insuficiencia cardíaca/insuficiencia cardíaca; Cuidados críticos/Cuidados críticos; Embarazo/Embarazo; Puerperio/Puerperio; Periodo periparto/Periodo periparto. Siete artículos fueron seleccionados para esta revisión. Resultados:Se destacaron los cuidados relacionados con el seguimiento y la estabilización de las funciones cardiaca, renal y respiratoria, principales sistemas afectados por la patología. La variabilidad de los resultados clínicos apunta a la necesidad de capacitar a los profesionales de la salud para diagnosticar oportunamente y tratar correctamente la patología, minimizando las posibilidades de muerte materna y fetal. Consideraciones finales:La miocardiopatía periparto aún es una patología poco evidenciada en el campo científico, y existe la necesidad de ampliar el desarrollo de estudios sobre el tema, especialmente con lineamientos que orienten las prácticas asistenciales.


Assuntos
Humanos , Feminino , Gravidez , Gravidez , Cuidados Críticos , Período Pós-Parto , Período Periparto , Cardiopatias
7.
Am J Trop Med Hyg ; 104(3_Suppl): 3-11, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33410394

RESUMO

Effective identification and prognostication of severe COVID-19 patients presenting to healthcare facilities are essential to reducing morbidity and mortality. Low- and middle-income country (LMIC) facilities often suffer from restrictions in availability of human resources, laboratory testing, medications, and imaging during routine functioning, and such shortages may worsen during times of surge. Low- and middle-income country healthcare providers will need contextually appropriate tools to identify and triage potential COVID-19 patients. We report on a series of LMIC-appropriate recommendations and suggestions for screening and triage of COVID-19 patients in LMICs, based on a pragmatic, experience-based appraisal of existing literature. We recommend that all patients be screened upon first contact with the healthcare system using a locally approved questionnaire to identify individuals who have suspected or confirmed COVID-19. We suggest that primary screening tools used to identify individuals who have suspected or confirmed COVID-19 include a broad range of signs and symptoms based on standard case definitions of COVID-19 disease. We recommend that screening include endemic febrile illness per routine protocols upon presentation to a healthcare facility. We recommend that, following screening and implementation of appropriate universal source control measures, suspected COVID-19 patients be triaged with a triage tool appropriate for the setting. We recommend a standardized severity score based on the WHO COVID-19 disease definitions be assigned to all suspected and confirmed COVID-19 patients before their disposition from the emergency unit. We suggest against using diagnostic imaging to improve triage of reverse transcriptase (RT)-PCR-confirmed COVID-19 patients, unless a patient has worsening respiratory status. We suggest against the use of point-of-care lung ultrasound to improve triage of RT-PCR-confirmed COVID-19 patients. We suggest the use of diagnostic imaging to improve sensitivity of appropriate triage in suspected COVID-19 patients who are RT-PCR negative but have moderate to severe symptoms and are suspected of a false-negative RT-PCR with high risk of disease progression. We suggest the use of diagnostic imaging to improve sensitivity of appropriate triage in suspected COVID-19 patients with moderate or severe clinical features who are without access to RT-PCR testing for SARS-CoV-2.


Assuntos
Teste para COVID-19/métodos , COVID-19/diagnóstico , Países em Desenvolvimento , Programas de Rastreamento/métodos , Guias de Prática Clínica como Assunto , Triagem/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19/normas , Serviço Hospitalar de Emergência , Humanos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/normas , Triagem/organização & administração
8.
Am J Trop Med Hyg ; 104(3_Suppl): 12-24, 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33355072

RESUMO

Infection prevention and control measures to control the spread of COVID-19 are challenging to implement in many low- and middle-income countries (LMICs). This is compounded by the fact that most recommendations are based on evidence that mainly originates in high-income countries. There are often availability, affordability, and feasibility barriers to applying such recommendations in LMICs, and therefore, there is a need for developing recommendations that are achievable in LMICs. We used a modified version of the GRADE method to select important questions, searched the literature for relevant evidence, and formulated pragmatic recommendations for safety while caring for patients with COVID-19 in LMICs. We selected five questions related to safety, covering minimal requirements for personal protective equipment (PPE), recommendations for extended use and reuse of PPE, restriction on the number of times healthcare workers enter patients' rooms, hand hygiene, and environmental ventilation. We formulated 21 recommendations that are feasible and affordable in LMICs.


Assuntos
COVID-19/prevenção & controle , Atenção à Saúde/normas , Países em Desenvolvimento , Controle de Infecções/normas , Corpo Clínico Hospitalar , Guias de Prática Clínica como Assunto , Segurança , Higiene das Mãos , Humanos , Equipamento de Proteção Individual , SARS-CoV-2 , Ventilação
9.
Am J Trop Med Hyg ; 104(3_Suppl): 72-86, 2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33350378

RESUMO

As some patients infected with the novel coronavirus progress to critical illness, a subset will eventually develop shock. High-quality data on management of these patients are scarce, and further investigation will provide valuable information in the context of the pandemic. A group of experts identify a set of pragmatic recommendations for the care of patients with SARS-CoV-2 and shock in resource-limited environments. We define shock as life-threatening circulatory failure that results in inadequate tissue perfusion and cellular dysoxia/hypoxia, and suggest that it can be operationalized via clinical observations. We suggest a thorough evaluation for other potential causes of shock and suggest against indiscriminate testing for coinfections. We suggest the use of the quick Sequential Organ Failure Assessment (qSOFA) as a simple bedside prognostic score for COVID-19 patients and point-of-care ultrasound (POCUS) to evaluate the etiology of shock. Regarding fluid therapy for the treatment of COVID-19 patients with shock in low-middle-income countries, we favor balanced crystalloids and recommend using a conservative fluid strategy for resuscitation. Where available and not prohibited by cost, we recommend using norepinephrine, given its safety profile. We favor avoiding the routine use of central venous or arterial catheters, where availability and costs are strong considerations. We also recommend using low-dose corticosteroids in patients with refractory shock. In addressing targets of resuscitation, we recommend the use of simple bedside parameters such as capillary refill time and suggest that POCUS be used to assess the need for further fluid resuscitation, if available.


Assuntos
COVID-19/complicações , Países em Desenvolvimento , Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto/normas , Choque/complicações , Choque/diagnóstico , Choque/terapia , Humanos , Pacientes Internados , SARS-CoV-2
10.
Am J Trop Med Hyg ; 104(3_Suppl): 48-59, 2020 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-33377451

RESUMO

The therapeutic options for COVID-19 patients are currently limited, but numerous randomized controlled trials are being completed, and many are on the way. For COVID-19 patients in low- and middle-income countries (LMICs), we recommend against using remdesivir outside of a clinical trial. We recommend against using hydroxychloroquine ± azithromycin or lopinavir-ritonavir. We suggest empiric antimicrobial treatment for likely coinfecting pathogens if an alternative infectious cause is likely. We suggest close monitoring without additional empiric antimicrobials if there are no clinical or laboratory signs of other infections. We recommend using oral or intravenous low-dose dexamethasone in adults with COVID-19 disease who require oxygen or mechanical ventilation. We recommend against using dexamethasone in patients with COVID-19 who do not require supplemental oxygen. We recommend using alternate equivalent doses of steroids in the event that dexamethasone is unavailable. We also recommend using low-dose corticosteroids in patients with refractory shock requiring vasopressor support. We recommend against the use of convalescent plasma and interleukin-6 inhibitors, such as tocilizumab, for the treatment of COVID-19 in LMICs outside of clinical trials.


Assuntos
Tratamento Farmacológico da COVID-19 , COVID-19/terapia , Países em Desenvolvimento , Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto/normas , Hospitalização , Humanos , Pacientes Internados , SARS-CoV-2
11.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 525-530, jan.-dez. 2020. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096969

RESUMO

Objetivo: identificar as tecnologias utilizadas por enfermeiros no processo educativo de pessoas com cardiopatia no ambiente hospitalar. Método: trata-se de uma revisão integrativa realizada nas bases de dados virtuais Pubmed, Scielo e Lilacs. Foram selecionados dez publicações e ao final, foi realizado uma análise dos estudos selecionados a fim de identificar sua relevância e aplicabilidade. Resultados: verifica-se a grande diversidade de tecnologias elaboradas e implementadas, variando entre programas educativos com a utilização de vídeos, questionários e instrumentos, programas de rastreamento, de acompanhamento após alta hospitalar, encontros grupais e momentos educativos direcionados aos pacientes no ambiente da pesquisa. Conclusão: foi identificado uma grande variedade de tecnologias utilizadas por enfermeiros no processo educativo de pessoas com cardiopatia no ambiente hospitalar, o que contribui para diminuição do tempo de internação hospitalar, menores índices de reinternações e reincidências por Doenças Cardiovasculares, atuando ainda na reabilitação cardiovascular do paciente


Objective: to identify the technologies used by nurses in the educational process of people with heart disease in the hospital environment. Method: it is an integrative review carried out in the virtual databases Pubmed, Scielo and Lilacs. Ten publications were selected and at the end, an analysis of the selected studies was carried out to identify their relevance and applicability. Results: there is a great diversity of technologies developed and implemented, varying between educational programs with the use of videos, questionnaires and instruments, tracking programs, follow-up after hospital discharge, group meetings and educational moments directed to patients in the research environment. Conclusion: a great variety of technologies used by nurses in the educational process of people with cardiopathy in the hospital environment was identified, which contributes to a reduction in hospitalization time, lower readmissions and recidivism rates for Cardiovascular Diseases, and also to cardiovascular rehabilitation patient


Objetivo: identificar las tecnologías utilizadas por enfermeros en el proceso educativo de personas con cardiopatía en el ambiente hospitalario. Método: se trata de una revisión integrativa realizada en las bases de datos virtuales Pubmed, Scielo y Lilacs. Se seleccionaron diez publicaciones y al final se realizó un análisis de los estudios seleccionados para identificar su relevancia y aplicabilidad. Resultados: se verifica la gran diversidad de tecnologías elaboradas e implementadas, variando entre programas educativos con la utilización de videos, cuestionarios e instrumentos, programas de rastreo, de seguimiento tras alta hospitalaria, encuentros grupales y momentos educativos dirigidos a los pacientes en el ambiente de la investigación. Conclusión: se identificó una gran variedad de tecnologías utilizadas por enfermeros en el proceso educativo de personas con cardiopatía en el ambiente hospitalario, lo que contribuye a disminuir el tiempo de internación hospitalaria, menores índices de reinternaciones y reincidencias por Enfermedades Cardiovasculares, actuando aún en la rehabilitación cardiovascular del paciente paciente


Assuntos
Humanos , Doenças Cardiovasculares/terapia , Educação em Saúde , Tecnologia Biomédica , Enfermagem Cardiovascular
12.
J Neurosurg ; 134(1): 244-250, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31860819

RESUMO

OBJECTIVE: The high global burden of traumatic brain injury (TBI) disproportionately affects low- and middle-income countries (LMICs). These settings also have the greatest disparity in the availability of surgical care in general and neurosurgical care in particular. Recent focus has been placed on alleviating this surgical disparity. However, most capacity assessments are purely quantitative, and few focus on concomitantly assessing the complex healthcare system needs required to care for these patients. The objective of the present study was to use both quantitative and qualitative assessment data to establish a comprehensive approach to inform capacity-development initiatives for TBI care at two hospitals in an LMIC, Cambodia. METHODS: This mixed-methods study used 3 quantitative assessment tools: the World Health Organization Personnel, Infrastructure, Procedures, Equipment, Supplies (WHO PIPES) checklist, the neurosurgery-specific PIPES (NeuroPIPES) checklist, and the Neurocritical Care (NCC) checklist at two hospitals in Phnom Penh, Cambodia. Descriptive statistics were obtained for quantitative results. Qualitative semistructured interviews of physicians, nurses, and healthcare administrators were conducted by a single interviewer. Responses were analyzed using a thematic content analysis approach and coded to allow categorization under the PIPES framework. RESULTS: Of 35 healthcare providers approached, 29 (82.9%) participated in the surveys, including 19 physicians (65.5%) and 10 nurses (34.5%). The majority had fewer than 5 years of experience (51.7%), were male (n = 26, 89.7%), and were younger than 40 years of age (n = 25, 86.2%). For both hospitals, WHO PIPES scores were lowest in the equipment category. However, using the NCC checklist, both hospitals scored higher in equipment (81.2% and 62.7%) and infrastructure (78.6% and 69.6%; hospital 1 and 2, respectively) categories and lowest in the training/continuing education category (41.7% and 33.3%, hospital 1 and 2, respectively). Using the PIPES framework, analysis of the qualitative data obtained from interviews revealed a need for continuing educational initiatives for staff, increased surgical and critical care supplies and equipment, and infrastructure development. The analysis further elucidated barriers to care, such as challenges with time availability for experienced providers to educate incoming healthcare professionals, issues surrounding prehospital care, maintenance of donated supplies, and patient poverty. CONCLUSIONS: This mixed-methods study identified areas in supplies, equipment, and educational/training initiatives as areas for capacity development for TBI care in an LMIC such as Cambodia. This first application of the NCC checklist in an LMIC setting demonstrated limitations in its use in this setting. Concomitant qualitative assessments provided insight into barriers otherwise undetected in quantitative assessments.

13.
Rev Gaucha Enferm ; 38(2): e60658, 2017 Jun 29.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28678900

RESUMO

OBJETIVO: To identify how the clinical and educational nursing care based on the Theory of Human Becoming can contribute to the transcendence process of heart transplant patients in pursuit of good living. METHOD: Research-intervention developed with four heart transplant patients linked to a reference transplant hospital in Ceara. Data was collected through interviews in 2014 and analyzed using Parse's theoretical framework and pertinent literature. RESULTADOS: Transplant patients revealed they gave living in such condition an ambiguous meaning, showing satisfaction and dissatisfaction. Dietary restrictions, difficulties with medication and curiosity about the transplant were identified as disharmonies involving the process. Care was developed focused on educating the transplant patients, approaching the themes healthy eating, organ rejection, immunosuppressant use and facts about heart transplantation. CONCLUSION: Educative care based on Parse favors the decision-making and autonomy of individuals regarding their health, contributing to transcendence in pursuit of good living.


Assuntos
Transplante de Coração/enfermagem , Teoria de Enfermagem , Satisfação do Paciente , Qualidade de Vida , Brasil , Tomada de Decisões , Dieta , Rejeição de Enxerto , Transplante de Coração/psicologia , Transplante de Coração/reabilitação , Humanos , Imaginação , Imunossupressores/uso terapêutico , Cuidados de Enfermagem/psicologia , Educação de Pacientes como Assunto , Autonomia Pessoal , Pesquisa Qualitativa , Valores Sociais , Centros de Atenção Terciária
14.
Rev. gaúch. enferm ; 38(2): e60658, 2017.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-901591

RESUMO

RESUMO Objetivo Identificar como os cuidados clínicos e educativos de enfermagem, fundamentados na Teoria Human Becoming, contribuem para o processo de transcendência das pessoas transplantadas cardíacas na busca do bem viver. Método Pesquisa-intervenção desenvolvida com quatro transplantados cardíacos vinculados a um Hospital de referência em transplantes do Ceará. Dados coletados em 2014, mediante entrevistas, analisados pelo referencial teórico de Parse e literatura pertinente. Resultados Os significados de viver como transplantado cardíaco revelaram ambiguidade, mostrando satisfação e insatisfação. Restrições alimentares, dificuldades com a medicação e curiosidade acerca do transplante foram apontadas como desarmonias que envolvem o processo. Visando a mobilização da transcendência, foi desenvolvido um cuidado educativo com os temas alimentação saudável, rejeição do órgão, uso de imunossupressores e curiosidades sobre o transplante cardíaco. Conclusão O cuidado educativo, fundamentado em Parse, favorece a tomada de decisão e a autonomia dos sujeitos diante de sua saúde, contribuindo para a transcendência na busca do bem viver.


RESUMEN Objetivo Identificar cómo los cuidados clínicos y educativos de enfermería, fundamentados en la Teoría Human Becoming, contribuyen para el proceso de trascendencia de las personas trasplantadas cardíacas en búsqueda del bien vivir. Método Investigación de intervención desarrollada con cuatro trasplantados de corazón vinculados a un hospital de referencia en trasplantes de Ceará. Los datos recogidos en el año de 2014 a través de entrevistas, analizaron el marco teórico de Parse y su literatura. Resultados El significado de la vida como trasplantado de corazón reveló ambigüedad, que muestra la satisfacción y la insatisfacción. Restricciones en la dieta, las dificultades con la medicación y la curiosidad por el trasplante fueron identificados como desarmonías relacionadas con el proceso. Objetivando la movilización de la trascendencia, se desarrolló atención educativa con temas sanos de alimentación, el rechazo del órgano, el uso de inmunosupresores y curiosidades sobre el trasplante de corazón. Conclusión Cuidado educativo, sobre la base de Parse, favorece la toma de decisiones y la autonomía de las personas delante de su salud, lo que contribuye a la trascendencia en búsqueda del bien vivir.


ABSTRACT Objetivo To identify how the clinical and educational nursing care based on the Theory of Human Becoming can contribute to the transcendence process of heart transplant patients in pursuit of good living. Method Research-intervention developed with four heart transplant patients linked to a reference transplant hospital in Ceara. Data was collected through interviews in 2014 and analyzed using Parse's theoretical framework and pertinent literature. Resultados Transplant patients revealed they gave living in such condition an ambiguous meaning, showing satisfaction and dissatisfaction. Dietary restrictions, difficulties with medication and curiosity about the transplant were identified as disharmonies involving the process. Care was developed focused on educating the transplant patients, approaching the themes healthy eating, organ rejection, immunosuppressant use and facts about heart transplantation. Conclusion Educative care based on Parse favors the decision-making and autonomy of individuals regarding their health, contributing to transcendence in pursuit of good living.


Assuntos
Humanos , Qualidade de Vida , Teoria de Enfermagem , Transplante de Coração/enfermagem , Satisfação do Paciente , Valores Sociais , Brasil , Educação de Pacientes como Assunto , Transplante de Coração/psicologia , Transplante de Coração/reabilitação , Autonomia Pessoal , Tomada de Decisões , Pesquisa Qualitativa , Dieta , Centros de Atenção Terciária , Rejeição de Enxerto , Imaginação , Imunossupressores/uso terapêutico , Cuidados de Enfermagem/psicologia
15.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 7(2): 2241-2253, abr.-jun. 2015.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: lil-755366

RESUMO

Objective: to analyze the contribution of the media for promoting cardiovascular health. Method: case study, qualitative, theoretically based on the method of Paulo Freire for reasoning and data analysis. There search was conducted using as a scenario the "Bem Estar" TV program of “Rede Globo”, in the episodes whose thematic was cardiovascular disease. Results: there was a concern of the program to involve participants in the educational process, ensuring, in a mediated way, their involvement in the educational process. However, there are limitations to the adoption of a model of liberating education as proposed by Paulo Freire. Another finding was the absence of nursing professionals as collaborators. Conclusion: the study allowed the expansion of knowledge about a subject not explored by Nursing, reaffirming the importance of more qualified professionals related to participation in the educational act.


Objetivo: analisar a contribuição do meio midiático para a promoção da saúde cardiovascular. Método: estudo de caso, de caráter qualitativo, tendo como referencial teórico o método de Paulo Freire para fundamentação e análise dos dados. A pesquisa foi desenvolvida utilizando-se como cenário o Programa Bem-Estar, veiculado pela Rede Globo, nos episódios cuja temática era o adoecimento cardiovascular. Resultados: verificou-se a preocupação do programa em envolver os participantes no processo educacional, garantindo, de forma mediada, seu envolvimento no processo educativo. Porém, existem limitações para a adoção de um modelo de educação libertadora como o proposto por Paulo Freire. Outra constatação foi a ausência de profissionais da enfermagem como colaboradores. Conclusão: o estudo permitiu a ampliação do conhecimento acerca de uma temática ainda pouco explorada pela Enfermagem, reafirmando a importância da participação de profissionais mais capacitados quanto ao ato educativo.


Objetivo: analizar la contribución de los medios de comunicación para la promoción de la salud cardiovascular. Método: estudio de caso, basado en teoría de Paulo Freire para el razonamiento y el análisis de dados. La investigación se realizó utilizando como escenario el Programa “Bem Estar” de la Rede Globo, episodios cuyo tema fue la enfermedad cardiovascular. Resultados: hubo una preocupación del programa para involucrar a los participantes en el proceso educativo, asegurando su participación en el proceso educativo. Hay limitaciones a la adopción de un modelo de educación liberadora en la forma propuesta por Paulo Freire. Otro hallazgo fue la ausencia de profesionales de enfermería como colaboradores. Conclusión: el estudio permitió la expansión del conocimiento sobre un tema no explorado por la Enfermería, reafirmando la importancia de los profesionales más cualificados a participar en proceso educativo.


Assuntos
Humanos , Masculino , Feminino , Estilo de Vida Saudável , Doenças Cardiovasculares/prevenção & controle , Educação em Saúde/métodos , Promoção da Saúde/métodos , Promoção da Saúde/tendências , Televisão , Brasil
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