Explanatory approach to the grounding of the professional nursing practice

Introduction: In the current health care environment, the needs of the population provided the perfect opportunity for nurses to (re)define their practice and professional career. Within this framework, this study aimed thus at identifying the bases that are underlying the practice, as well as the factors that stimulate or jeopardise the quality of care and a practice that is consistent with the desired grounding. Method: Qualitative study with a phenomenological nature carried out in 19 public hospitals in mainland Portugal with the participation of 56 nurses. The tool used for collecting data was a semi-structured interview. Results: Regarding the factors that stimulate or jeopardise the quality of care a prac-tice that is consistent with the desired grounding, we could highlight features that were perfectly integrated in the triad structure, process and result. In relation to "structure", we could point out the following: organizational resources, human and material resources, service organization, nursing sustainment practices and organization of nursing care. Concerning "process", we could analyse: decision-making process, guiding principles for the professional practice, scientific methodology of health care service, health care documentation process, communication process, collaborative practice and management practice. In what concerns "result", the features were less evident in the participants' speech, and more stressed among clients and nurses. Conclusion: The explanatory approach to the grounding of the professional nursing practice, outlined in a three-dimensional perspective, makes clear the theoretical framework that grounds the practice, as well as the factors in hospital environment, that stimulate or jeopardise the quality of the nursing care

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Validación de las actividades en centros de día para ancianos: contribuciones a la evaluación de la calidad / Validação das atividades desenvolvidas em centros dia para idosos: subsídios para avaliação da qualidade / Validation of activities developed in day-care centers for elderly: subsidies for assessing the quality

Objetivo: Validar el contenido de las actividades de atención al anciano desarrolladas en los centros de día. Métodos: Estudio metodológico con validez de contenido realizada por nueve especialistas, según los atributos relevancia, claridad, pertinencia y simplicidad. El índice de consenso establecido correspondió al 80%. La recopilación de datos se llevó a cabo entre septiembre y noviembre de 2014. Resultados: Ocho actividades fueron validadas y dos incluidas. En la dimensión salud fueron: capacidad funcional y fragilidad, alimentación y nutrición, higiene y confort, medicación continuada, manejo y estímulo cognitivo; en participación: actividades culturales, acogida y supervisión, apoyo espiritual/religioso; en seguridad, accesibilidad y control de factores de riesgo de caída y en educación, actividades educativas. De los 82 ítems evaluados, el 100% alcanzó el consenso respecto a la relevancia; el 91,4% respecto a la claridad; el 97,5% respecto a la pertinencia, el 92,6% respecto a la simplicidad. Conclusión: Creemos que la validez y la sistematización de las actividades contribuirán en el proceso de evaluación de la calidad en esta modalidad de atención

Objetivo:Validar o conteúdo das atividades de atenção ao idoso desenvolvidas em centros dia. Métodos: Estudo metodológico, com validação de conteúdo realizada por nove especialistas, segundo os atributos relevância, clareza, pertinência e simplicidade. O índice de consenso estabelecido correspondeu a 80%. A coleta de dados ocorreu entre setembro e novembro de 2014 Resultados: Oito atividades foram validadas e duas incluídas. Na dimensão saúde, foram: capacidade funcional e fragilidade, alimentação e nutrição, higiene e conforto, medicamentos de uso contínuo, manejo e estímulo cognitivo; na participação as atividades socioculturais, acolhimento e monitoramento, apoio espiritual/religioso; na segurança, acessibilidade e controle dos fatores de risco para queda e na educação, as atividades educativas. Dentre 82 itens avaliados, 100% atingiram o consenso quanto à relevância; 91,4% à clareza; 97,5% à pertinência; 92,6% à simplicidade. Conclusão: Acreditamos que a validação e a sistematização das atividades contribuirão para subsidiar a avaliação da qualidade nessa modalidade de atenção

Objective: Validate the content of care activities for elderly developed in day-care centers. Methods: Methodological study, with content validation carried out by nine specialists, based on the attributes relevance, clearness, pertinence and simplicity. The established consensus rate was at 80%. The data collection period was between September and November 2014. Results: Eight activities were validated and two included. In the health dimension, the activities were: functional capacity and frailty, food and nutrition, hygiene and comfort, drugs of continuous use, handling and cognitive stimulation; concerning participation: the socio-cultural activities, acceptance and monitoring, spiritual/religious support; concerning safety: accessibility and control of risk factors in falls; and concerning education: educational activities. Among 82 items assessed, 100% were considered relevant; 91,4% were considered clear; 97,5% were considered pertinent; and 92,6% were considered simple. Conclusion: We believe that validation and systematization of activities contribute to support the assessment of quality in this type of attention