Portuguese nurses' knowledge of and attitudes toward hospitalized older adults.

Portugal is impacted by the rapid growth of the aging population, which has significant implications for its health care system. However, nurses have received little education focusing on the unique and complex care needs of older adults. This gap in the nurses' education has an enormous impact in their knowledge and attitudes and affects the quality of nursing care provided to older adults. A cross-sectional study was conducted among 1068 Portuguese nurses in five hospitals (northern and central region) with the following purposes: (i) explore the knowledge and attitudes of nurses about four common geriatric syndromes (pressure ulcer, incontinence, restraint use and sleep disturbance) in Portuguese hospitals; and (ii) evaluate the influence of demographic, professional and nurses' perception about hospital educational support, geriatric knowledge, and burden of caring for older adults upon geriatric nursing knowledge and attitudes. The mean knowledge and attitudes scores were 0.41 ± 0.15 and 0.40 ± 0.21, respectively (the maximum score was 1). Knowledge of nurses in Portuguese hospitals about the four geriatric syndromes (pressure ulcers, sleep disturbance, urinary incontinence and restraint use) was found inadequate. The nurses' attitudes towards caring for hospitalized older adults were generally negative. Nurses who work in academic hospitals demonstrated significantly more knowledge than nurses in hospital centers. The attitudes of nurses were significantly associated with the hospital and unit type, region, hospital educational support, staff knowledge, and perceived burden of caring for older adults. The study findings support the need for improving nurses' knowledge and attitudes towards hospitalized older adults and implementing evidence-based guidelines in their practice.

[HIV/aids care according to the perspective of healthcare providers]. / O cuidado a pessoas com HIV/aids na perspectiva de profissionais de saúde.

The present study aimed to understand the care provided to patients with HIV/AIDS in Portugal according to the healthcare providers' perspective. Thompson's method of oral history was used in the study, which included 22 healthcare providers. The data were collected by means of semi-structured interviews and were analyzed from the narrative compilation perspective formulated by the author using QSR Nvivo software. The study complied with the ethical precepts for research. Care was analyzed according to three dimensions: cognitive, affective-relational, and technical-instrumental. The participants attributed particular relevance to the cognitive dimension in association with the moment when the diagnosis of HIV/AIDS was established, as well as throughout the course of disease. The affective-relational dimension was cross-sectional and considered to be valuable throughout the course of the disease from its diagnosis to the death of the patients with HIV/AIDS. The technical-instrumental dimension was more expressive in the advanced stages of the disease, in patients suffering from addiction and in terminal illness. As a function of the results, we can conclude that the three investigated dimensions are highly relevant for the care of patients with HIV/AIDS.

Validation of the professional issues scales with Portuguese nurses.

The Professional Issues (PI) scales were designed to measure potential barriers that nurses perceive as obstacles to providing quality care to hospitalized older adults. This study involved validation of the PI scales among 1,068 Portuguese nurses and evaluated the influence of hospital and nurse characteristics on the perception of PI related to nursing care. A six-factor solution was obtained (i.e., staff/family/patient disagreement, perceived legal vulnerability, burden of upsetting behaviors, staff disagreement, perceived upsetting behaviors, use of geriatric services), with Cronbach's alpha coefficients ranging from 0.857 to 0.716. These factors were significantly associated with the following variables: sex, hospital type, hospital location, unit type, perceived institutional support for geriatric-specific education, perceived staff knowledge, and the burden of caring for older adults. The PI scales are reliable and valid for assessing the geriatric-related PI of nurses working in Portuguese hospitals and are useful for developing, planning, and implementing geriatric programs.

Use of the Geriatric Institutional Assessment Profile: an integrative review.

The Geriatric Institutional Assessment Profile (GIAP) is a self-report survey, designed to assess a hospital's readiness to implement a geriatric program. Considering the importance of the GIAP in delivering high-quality geriatric care, it is appropriate and relevant to conduct an integrative review about its use for the improvement of knowledge in this area. The primary aim of this study was to undertake an integrative review of the strengths and weaknesses of the GIAP and its main implications for geriatric nursing care. This integrative review was inspired by Whittemore's method. A total of 15 articles met the criteria for review. Data analysis revealed three themes: (a) the GIAP quality metrics, (b) geriatric nursing care initiatives assessment, and (c) geriatric nursing practice environment assessment. This review revealed a high degree of specificity, conformity, appropriateness, and utility in the evaluation of nurses' perceptions of the geriatric care, and the GIAP was considered to be a crucial tool in the development and improvement of caring for hospitalized older adults.

Nursing in the era of globalisation: challenges for the 21st century.

The purpose of this paper was to reflect about issues related to the processes of globalization and the global impacts on health, pointing out some challenges for Nursing in the twenty-first century. In this sense, the author outlines the forms and trends of globalization in the contemporary world, and the drastic impacts on human health and environment. To respond to the challenges of the globalized world, some ways are indicated, among which, the strengthening of nursing discipline stands out, together with some guidelines for education, research and Nursing care, in a local and global scope.

[Intuitive knowledge in nursing care]. / O conhecimento intuitivo no cuidado de enfermagem.

This is a qualitative study in a descriptive exploratory approach with the purpose to characterize the intuitive knowledge in nursing care. The qualitative data were generated through semi-structured interviews with 87 nursing professionals. The analysis of the data was done using QSR Vivo and interpreted through a framework based on studies of the North-American nursing literature. Intuition emerged as a feeling, as a type of knowledge, and as both. Further analysis showed three defining attributes: 1) knowledge of a fact or the truth, as a whole; 2) immediate possession of knowledge; 3) knowledge independent from linear reasoning process, as well as three types of intuition: cognitive inference, gestalt intuition, and precognitive function. The result of this study shows a parallel with the others found in North-American nursing literature.

[Child care in day nurseries: a space for nursing]. / O cuidado de crianças em creches: um espaço para a enfermagem.

In this article, we discuss the care of newborns and infants in day nurseries. We approach childcare within an historical perspective, emphasizing the current childhood situation. Based on the present conceptions of care and caring, and the Lei das Diretrizes e Bases da Educaçao Nacional n. 9394/96 (Brazilian Guiding and Bases Law for the National Education no. 9394/96) we discuss the childcarers' qualification for attending children up to two years old in day nurseries. Considering the education level currently held by nursing professionals, we consider them qualified for the role of providing day care. In this sense, we identify the day nursery as an important social and political space for nursing.

[Intuitive ability in nursing care]. / Habilidade intuitiva no cuidado de enfermagem.

This study aimed to understand the intuitive ability of nursing professionals in caring. The study method was qualitative, adopting a descriptive exploratory approach. Sampling involved 87 female nursing professionals, being 31 nurses, 29 nursing technicians and 18 nursing auxiliaries. The result showed different levels of intuitive abilities, related to novice, standard, and veteran. The relation between the three levels of intuitive abilities and the corresponding figures in years, observed in a North American study, was not identified. The factors described as affecting the intuitive experience were both environmental and intra-interpersonal (personological). The experiences of the professionals portrayed the importance of intuition in nursing care, mainly in doubtful and conflicting situations and, in this sense, its vital function was decision-making towards better quality of nursing care.

[Counterpoint among personalities of the Brazilian Nursing Congresses and of the Revista Brasileira de Enfermagem from 1977 to 1987]. / Um contraponto entre os personagens dos Congressos Brasileiros de Enfermagem e da Revista Brasileira de Enfermagem no período de 1977 a 1987.

This is a qualitative study, using an exploratory approach, which has as its main aim to analyze and counterpoint central issues and personalities of the Brazilian Nursing Conferences and the editorials of the Brazilian Nursing Journal, from 1977 to 1987. It was analyzed 09 annuals and 24 editorials. The results show that the contents were aligned with the policy of the central ABEn. The leadership of Ana Nery School and USP Nursing School is evident in this period. Male nurses had no expressive participation in the nursing conferences, except those who were members of the PARTICIPACAO movement. We found only one editorial written by a male nurse. We observed changes in the central ABEn policy after 1984 provoked by the PARTICIPACAO movement and, influencing the change of subjects at the conferences, and the editorials of the REBEn.

[Professional image and identity in the building of nursing knowledge]. / Imagem e identidade profissional na construção do conhecimento em enfermagem.

Based on a historic qualitative study, using documental analyse we searched for the dispersions in the construction of knowledge in the articles of the Anais do Congresso Brasileiro de Enfermagem, from 1977 through 1987. The dispersions emerged as categories that repeat themselves as subjects of note or as smaller punctuation. Our analyze converged into two main categories: professional image and professional identity. These categories took the shape of a complex and dynamic network, in which there were two explicit sub-categories: professional status and professional role.

[Analysis of Watson's curative factors at an emergency unit]. / Análise dos fatores de cuidado de Watson em uma unidade de emergência.

The objective of this study was to analyze the development of Jean Watson's ten carative factors in the process of caring with clients and their families in an emergency unit of a general hospital in Florianópolis. It was based on the convergent-assistance research design, and developed with 91 clients, from September 3 to November 30, 2001. The development of Watson's ten carative factors in the process of caring was effective in the emergency unity contributing to an approach more humanized and with greater quality when compared to another which emphasizes only the biological dimension.

[Coma and its impact on the process of being and living: implications for nursing care]. / O coma e seu impacto no processo de ser e viver: implicações para o cuidado de enfermagem.

This is a hermeneutic phenomenological study based on the Van Manen's framework, that aimed to distinguish the meanings of the experiences lived in the state of coma and its impact on the being and living process. It was developed with four participants, three males and one female. Based on the analysis of the information three themes were identified: the unexpected as reality; the singularity of the modified states of consciousness, and the transformation of the being and living process. The coma emerged as an unexpected and unique process, permeated by different and modified states of consciousness; and possibly the unconsciousness as a state of inner life; and having a great impact on the life process of the participants. Finally we addressed some implications for the nursing care.