Teaching science in nursing: challenges of learning through research in the undergraduate context

A dinâmica dos tempos reitera o desafio de as profissões se manterem atualizadas diante das demandas que solicitam dos profissionais, conhecimentos para o enfrentamento dos problemas sociais e para elevar a qualidade de vida e bem-estar das pessoas. Nesse sentido, é na sua capacidade de adaptação e de provisão de respostas requeridas diante das incertezas que se descortinam na cinemática das mudanças sociopolíticas; nas iniquidades sociais; nas vicissitudes biológicas, conforme observado na pandemia da COVID-19, que uma profissão se mantém viva e fortalecida no decurso da história. Todavia, tal flexibilidade adaptativa requer vigilância ontológica para que a identidade de uma profissão não pereça diante dos movimentos globais da ciência, pois sendo também políticos, tais movimentos revelam interesses capazes de projetar saberes hegemônicos e de segregar saberes emergentes(1). Por essa razão, a Enfermagem, que é profissão, disciplina acadêmica e ciência em desenvolvimento, deve ser compreendida à luz de sua ontologia para uma identidade epistemológica delimitada nas ciências do impreciso e afins. Logo, há que ser concebida como área de conhecimento cujas especificidades requerem domínios metodológicos que contemplem a natureza disciplinar da profissão, sem que isso rotule a Enfermagem como ciência subdesenvolvida. [...]

Reflections on nursing students fear and anxiety arising from clinical practicums

BACKGROUND

Anxiety and fear are emotional responses that may emerge when individuals anticipate threats. Undergraduate nursing students may experience feelings of hopelessness and anguish in the clinical learning experience, directly impacting their academic performance. This study aims to reflect upon the fear and anxiety faced by nursing students during clinical training.

SYNOPSIS OF CONTENTS

Two thematic axes were focused: Students' perception regarding preceptorship attitudes and positions; Relational teaching-learning processes and their influence on the students' professional identity. Preceptors are expected to encourage the establishment and maintenance of good relationships in the collaborative network in which students are included, especially with the multi-professional health team, to have more comprehensive academic support.

CONCLUSIONS

The role and importance of each individual in academic training, such as students and professors, is emphasized, seeking to promote positive experiences in the teaching-learning process to enable undergraduate students to more effectively develop moral sensitivity and take responsibility for patient-centered care.

Covid-19 pandemic and Brazilian Nursing: unveiling meanings of work

The objective of this study was to reflect on the meanings of the work of Brazilian nursing care in the context of the Covid-19 pandemic. This is a theoretical study anchored in the definition of meanings of work, according to Estelle Morin's perspective. The work developed by nursing professionals became even more evident in pandemic times, with the precarious conditions of health services in Brazil coming to light. During the pandemic, the incorporation of meanings of work became more important, given that the society recognized the relevance of these professionals in dealing with the pandemic, and this allowed the discussion about their social, political, and economic recognition. The impacts of nursing performance during the Covid-19 pandemic are related to the economic issue, social values, autonomy in the exercise of the profession, recognition, and safety, reflecting on the sense of purpose of work. Thus, the work that makes sense for nursing professionals is related to professional appreciation, specifically, to salary recognition, while what makes no sense is what hinders intellectual, cognitive, and financial progress. Thus, conditions were imposed that give directions to ambivalent meanings to work.

Longitudinal treatment of smoking in Primary Health Care: an evaluation research

ABSTRACT Objectives: to evaluate the coordination of the attention for continuing treatment for smoking cessation in the Primary Health Care, from the perspective of users. Methods: the conceptual base was longitudinal care, which is an attribute of the National Policy of Primary Care. The methodological framework was that of an evaluative research, as informed by theory-based evaluation. Data collection used observation with moderate participation in the groups to abandon smoking, intensive interviews with 22 users, and analysis of medical records. The interviews used initial and focused coding, which are analytical stages of the Grounded Theory, with the aid of the MaxQDA® software. Results: the interviewees had a positive evaluation of their treatment for smoking, although they mentioned limitations for medium- and long-term continuity. Final Considerations: the smoking treatment sessions, even if infrequent, were found to be a successful experience for smoking cessation.

Pandemia da Covid-19 e a Enfermagem brasileira: desvelando sentidos do trabalho

RESUMO Objetivou-se refletir sobre os sentidos do trabalho da Enfermagem assistencial brasileira no contexto da pandemia da Covid-19. Estudo teórico ancorado na definição de sentidos do trabalho, segundo a perspectiva de Estelle Morin. O trabalho desenvolvido pelos profissionais de Enfermagem ficou ainda mais evidenciado em tempos pandêmicos, vindo à tona as condições precárias dos serviços de saúde no Brasil. Durante a pandemia, a incorporação de sentidos ao trabalho passou a ter importância maior, tendo em vista que a sociedade reconheceu a relevância desses profissionais no enfrentamento da pandemia, e isso possibilitou a discussão acerca do seu reconhecimento social, político e econômico. Os impactos da atuação da Enfermagem durante a pandemia de Covid-19 têm relação com a questão econômica, valores sociais, autonomia no exercício da profissão, reconhecimento e segurança, refletindo na razão de ser do trabalho. Assim, o trabalho que faz sentido para os profissionais de Enfermagem relaciona-se à valorização profissional, especificamente, ao reconhecimento salarial, enquanto o que não faz sentido é aquele que impossibilita avanços do ponto de vista intelectual, cognitivo e financeiro. Dessarte, foram impostas condições que dão rumos para sentidos ambivalentes ao trabalho.

ESTRATÉGIAS PARA A REDUÇÃO DE ERROS DE MEDICAÇÃO DURANTE A HOSPITALIZAÇÃO: REVISÃO INTEGRATIVA

Objetivo: sintetizar o conhecimento relacionado às estratégias para redução de erros de medicação durante a hospitalização de pacientes adultos. Método: revisão integrativa da literatura realizada em outubro de 2020 por meio da busca de publicações nas bases de dados eletrônicas: Web of Science, Pubmed, Cumulative Index of Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Google Scholar. Resultados: amostra composta por 12 estudos, cujas estratégias para a redução de erros de medicação foram apresentadas de acordo com as categorias: envolvimento do farmacêutico clínico nas atividades clínicas, implantação de tecnologiasda informação, estratégias educacionais mediadas por simulação e jogos, e redução da carga de trabalho. Conclusão: associado às tecnologias, o envolvimento do farmacêutico clínico com a equipe médica e de enfermagem resultará em melhorias na redução dos eventos adversos a medicamentos e na qualidade da assistência prestada ao paciente

Nursing Now Brazil Campaign: alignments with global evidence for the development of national nursing

OBJECTIVE

To analyze the goals and strategies of the Nursing Now Brazil Campaign in the light of global documents that focus on perspectives for the strengthening of Brazilian Nursing.

METHODS

Documentary research, carried out from the comparative analysis of the goals and strategies of the Nursing Now Brazil Campaign and documents with high global repercussion for social and economic development in the health context. Data were collected between May and July 2020.

RESULTS

The evidence set bases the need for strategies to achieve excellence in the training of nurses, better working conditions and the dissemination of successful experiences undertaken by these professionals in different health contexts for the strengthening of leadership and competencies capable of boosting socioeconomic development and people's quality of life.

CONCLUSION

The achievement of the Nursing Now Brazil Campaign goals, based on global health evidence, may directly impact the socioeconomic development of the country.

Information and communication technologies: interfaces the nursing work process

OBJECTIVES

to unveil the meanings that nurses attribute Information and Communication Technologies for the nursing work process.

METHODS

qualitative research, theoretically and methodologically based on the Complexity Theory and on the Grounded Theory, respectively. Research with 19 participants, being 12 clinical nurses, and 7 resident nurses. Semi-structured interviews were used for data collection.

RESULTS

the results revealed the meanings that clinical nurses attribute to Information and Communication Technologies and, thus, the motivations and limitations for the use of these technologies, pointing out possibilities and strategies that impact the nursing work process, based on the interactions promoted by the official and non-official use of these resources.

FINAL CONSIDERATIONS

the meanings that nurses attribute to Information and Communication Technologies are dependent on their ability to successfully employ those technologies and their importance to the work process developed by the professionals.

Methodological path to reach the degree of saturation in qualitative research: grounded theory

OBJECTIVES

to achieve the degree of saturation in study that applied the grounded theory.

METHODS

qualitative research, carried out in four Family Health Units, between June 2018 and May 2019. The data from the interviews with 30 health professionals and non-participant observation were coded in the stages: open, axial and integration.

RESULTS

the degree of saturation was achieved by two conceptual models - theoretical saturation and inductive thematic. Theoretical saturation was considered: the development of conceptual codes and observation, in the collection and analysis of data, when they generated new categories/subcategories or only indicated increasing instances. For thematic inductive saturation, the use of new codes based on each interview stood out.

FINAL CONSIDERATIONS

the visual layout for the number of codes, the theoretical scope of the concepts and the delimitation of the sample groups guided the identification of the degree of saturation for the development of the conceptual body that supported the substantive theory.

Mapping of advanced practice nursing actions in the Family Health Strategy

OBJECTIVES

to map advanced practice nursing actions implemented in the Family Health Strategy context.

METHODS

cross-sectional exploratory study carried out with Family Health Strategy nurses. Data obtained in the mapping were compared to the characteristics that define advanced practice nurses and are adopted internationally by using a checklist based on the International Council of Nurses Guidelines.

RESULTS

the mapping allowed to identify advanced practice nursing actions, such as advanced assessment, judgement, decision-making, and diagnostic reasoning skills and authority to diagnose and prescribe medications, diagnostic testing, and therapeutic treatments. However, evidence found in the educational preparation domain indicated evident fragility, expressed as the low percentage of nurses credentialed with a professional master's degree.

CONCLUSIONS

the present study showed that nurses in the Family Health Strategy carry out advanced practice nursing actions without the professional master's degree recommended for credentialing, with pertinent legislation, which requires initiatives to be taken by nursing leaders to overcome this deficiency.

Knowledge management: connections for teaching research in undergraduate nursing

OBJECTIVES

to understand the meanings that nursing students and professors attribute to research and research teaching in the context of undergraduate studies.

METHODS

this is a qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Sixteen students and 14 undergraduate nursing professors from a public university in Rio de Janeiro were interviewed. Semi-structured interviews were used for data collection.

RESULTS

causes, actions, and interactions related to research and teaching research in undergraduate nursing are connected with learning science for nursing praxis, which ranges from students' ability to question to their and their professors' understanding of social demands guided by science.

FINAL CONSIDERATIONS

nursing professors and students signify research and teaching of this as a structure for the training of nurses for the critical professional capacity needed to meet social demands.

De autonomia roubada ao fortalecimento da profissão: conexões entre Enfermagem Brasileira e Africana

Resumo Objetivo caracterizar os desafios vivenciados pela Enfermagem nos países africanos de língua portuguesa e discutir as potencialidades da cooperação internacional neste contexto. Método estudo qualitativo, descritivo. Dados obtidos por meio de entrevista semiestruturada com enfermeiros de países africanos de língua portuguesa e categorizados por análise de conteúdo. Resultados participaram nove enfermeiros, provenientes dos seguintes países: Angola, Cabo Verde, Guiné-Bissau, Moçambique e São Tomé e Príncipe. Foram desenvolvidas duas categorias: a primeira retrata as dificuldades da Enfermagem de países africanos de língua portuguesa acerca da autonomia e valorização necessárias ao desenvolvimento e exercício de suas competências. A segunda categoria evidenciou possibilidades de conexões a partir de redes para integração e fortalecimento da Enfermagem, em cooperação internacional. Conclusão e implicações para a prática o estudo caracterizou como principais dificuldades aquelas relacionadas a processos de trabalho, falta de autonomia, de estrutura humana e física. Nessa perspectiva, a cooperação internacional representou importante estratégia para o fortalecimento da formação dos enfermeiros de países africanos de língua portuguesa, assim como para lidarem com os expressivos desafios que se apresentam em sua prática cotidiana.

Alignment and contribution of nursing doctoral programs to achieve the sustainable development goals

BACKGROUND

Different social segments from several regions of the world face challenges in order to achieve the sustainable development goals (SDGs). Nursing represents the greatest number of health workforce in the globe, dealing with these challenges in different paths, among them the training of human resources. In this context, the goal of this study was to compare the relationship between the objectives and research areas underlying nursing doctoral programs in Latin America and the SDGs.

METHOD

Documental research comparing data of all Latin American nursing doctoral programs and the SDGs, conducted between January and March 2020.

RESULTS

From the total of 56 existing programs in Latin America, this study analyzed 52 of them, representing 92.8% of the total. Most nursing doctoral programs have contributed to SDG 3, in addition to goals 1, 2, 4, 5, 6, 8, 9, 10, 12 and 16. The SDGs 11, 13, 14, 15 and 17 were not related to any of the analyzed programs. Data reveal that the training of nursing PhDs is essential to fulfilling these goals. Results also indicate a need of programs to remain committed to relationships that enhance nursing skills to cope with the current challenges in terms of global health, such as investments for the reduction of social and gender inequities.

CONCLUSION

The doctoral training of nurses in Latin America needs to be better aligned with the sustainable development goals (SDGs), since there is a high concentration in SDG 3. We believe that nursing will bring a greater contribution to the movement to protect planetary health as the principles governing nursing practices are better aligned with international health demands and agendas.

Nursing now and always: evidence for the implementation of the Nursing Now campaign

OBJECTIVE

to identify the guiding axes of the documents that grounded the Nursing Now campaign and relate the recommendations of these documents to the campaign goals.

METHOD

documentary research, based on the analysis of the documents that promoted the Nursing Now campaign. The data were collected between March and April 2020, using a form structured into: background, scope, challenges and potentials of health/nursing professionals and recommendations for the future.

RESULTS

the challenges and the need for investments in the health and nursing workforce to achieve the Sustainable Development Goals were evidenced. The report of the High Level Commission on health Employment and Economic Growth presents important recommendations, also introduced in the Triple Impact Report and in the Strategic Directions for Nursing and Midwifery, converging to the goals of the Nursing Now campaign, stimulating a profile of nurses with technical, political and leadership skills, engaged in health policy-making, and the effectiveness of their practice is clear to the entire society.

CONCLUSION

knowledge about the dynamics of the factors that converged to the development of the Nursing Now campaign may be a condition for achieving its goals. This reality reveals evidence that global health will not be ensured without strengthening Nursing first.

Strategic directions for strengthening nursing and midwifery: potentialities and connections in the complex perspective

OBJECTIVE

to understand from the complex perspective the connections established between the Strategic Directions for Strengthening Nursing and Midwifery, delimited by the World Health Organization; to discuss the implications of these strategies for the investment of human resources in nursing and midwifery, with a view to strengthening the technical health capacity to face global health demands.

METHOD

a documentary research, carried out from official WHO documents, from September to October 2019. A categorical analysis technique was performed, and the interpretation of the data was achieved based on the theoretical framework of Complexity.

RESULTS

three interdependent categories were defined, namely: challenges for the training of human resources in nursing and midwifery in order to meet the needs for global health; challenges for the development of the work of nursing and midwifery professionals in different contexts of practice; challenges for governments, leaders and health services to strengthen human resources in nursing and midwifery.

CONCLUSION

the strategic directions corroborate the complex perspective because they value multidimensionality in the challenges for the professional practice of nurses and obstetricians. However, these challenges are also related to contextual, political, and leadership factors.

Essential management competencies of nurses: actions and interactions in the context of the Family Health Strategy

OBJECTIVE

to understand the meanings attributed by the Family Health Strategy (FHS) nurses to the management competencies essential to the performance of their actions.

METHOD

explanatory, qualitative study, whose methodological framework was based on Grounded Theory. A total of 12 Family Health Strategy nurses from a municipality in southern Brazil participated through semi-structured interviews, between December 2018 and February 2019.

RESULTS

the experience was understood by the phenomenon "Lapidating management competencies daily to play the role of a nurse in the context of the Family Health Strategy". As action/interaction strategies, the following categories emerged: "Evidencing the management skills of Family Health Strategy nurses" and "Recognizing the need for strategies to work on specificities in the context of the Family Health Strategy".

FINAL CONSIDERATIONS

according to the meanings attributed by nurses, there are several essential management skills for the work in the Family Health Strategy, but they are still little worked and developed in this context, mainly because it is a complex health care scenario.

Conditioning factors for nurses to defend the autonomy of the elderly on the terminality of life

OBJECTIVE

to understand the meanings attributed by nurses about conditions that interfere in defending of the elderly's autonomy on the terminality of life in the context of hospitalization.

METHOD

qualitative and exploratory study, which applied the Grounded Theory. Data were collected between November 2016 and May 2017, in the internal medicine wards of a hospital in Rio de Janeiro, Brazil, through non-participant observation and semi-structured interviews. Three sample groups composed of ten nurses, eight doctors, and 15 nursing technicians were investigated.

RESULTS

the conditions are related to the medical power, subordination of nurses, family influences; the functional decline of the elderly; and biomedical model. Final considerations: the elderly's autonomy is veiled and violated since their abilities are subjugated, and the family's will and professional paternalism may prevail. However, this right must guide contemporary care models and integrate palliative care.

Nurses defending the autonomy of the elderly at the end of life

ABSTRACT Objective: to understand how nurses deal with the elderly’s autonomy at the end of life. Method: qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil. Results: nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team. Final considerations: the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.

Nurse researchers and nursing assistants: construction and projection of polymorphous identities

OBJECTIVE

To understand the meanings that nurse researchers and nursing assistants attribute to one another, and to the development of research produced by Nursing.

METHOD

Qualitative research. The Grounded Theory and the Complexity Theory were used as theoretical and methodological frameworks, respectively. Ten nursing assistants and six research nurses participated in the research. The semi-structured interview was used as a data collection technique. The results were categorized by comparative analysis and validated by ten judges.

RESULTS

The valuation of nursing care research as well as interactions between research development and nursing care may be related to the way nursing assistants and nurse researchers perceive themselves. These perceptions are multifaceted.

CONCLUSION

The meanings nurse researchers and nursing assistants attribute to each other reveal mechanisms of closeness and distance between these actors, as well as between research and nursing care.

SIGNIFICADOS ATRIBUÍDOS PELO HOMEM ACERCA DA RELAÇÃO ENTRE O TABAGISMO E O ADOECIMENTO POR CÂNCER

Objetivo: conhecer os significados que o homem atribui acerca do tabagismo e seus riscos relacionados ao desenvolvimento do câncer.Método: estudo qualitativo, realizado em um instituto especializado na atenção à saúde, no Rio de Janeiro, Brasil. Foram entrevistados 18 homens fumantes e ex-fumantes entre novembro de 2015 e abril de 2016. Utilizou-se a análise de conteúdo na modalidade temática.Resultados: a falta de conhecimento acerca do tabagismo e a sensação de prazer proporcionada relacionaram-se à maior probabilidade de se iniciar o hábito. O significado atribuído pelos homens sobre a relação com o processo saúde-doença relacionou-se ao histórico familiar ou à vulnerabilidade própria. Mas muitos homens não se sentem preparados para parar de fumar, pela dependência física e psicoemocional.Conclusão: a cessação do vício pode requerer ajuda profissional. É preciso reconhecer o tabagismo como problema de saúde, desejar parar de fumar e identificar o próprio fator motivacional.

Care management for the hospitalized child with chronic cancer pain: intervening conditions

ABSTRACT Objective: To understand the intervening conditions of care management for the hospitalized child with chronic cancer pain. Method: Qualitative research, anchored in the methodological and theoretical frameworks, respectively, Grounded Theory and Complex Thinking. The semi-structured interview and non-participant observation were used to collect the data. Twenty-one health professionals, organized in three sample groups: nurses; nursing technicians; and professionals of the multiprofessional health staff. Results: They emerged as intervening conditions of care management: human resources and materials, teamwork, absenteeism, professional relocation, professional qualification, family, playful, dialogue, empathy and caring relationship. Conclusion: It was understood as limiting conditions for care management: deficits of human resources and materials, absenteeism, ineffective teamwork, professional relocation, and insufficient professional qualification. On the other hand, they were presented as facilitating conditions: adequate professional knowledge, effective teamwork, dialogue, empathy, playful and affective relationship with the child.

COMMUNICATION IN THE MANAGEMENT OF THE NURSING CARE BEFORE THE DEATH AND DYING PROCESS

ABSTRACT Objective: to understand, from the perspective of complexity, the factors related to communication for the management of the nursing care before the death and dying of hospitalized people. Method: the Complex Thought and Grounded Theory were used as theoretical and methodological references, respectively. The data were collected through semi-structured interviews, from May 2015 to January 2016, with three sample groups, totaling 41 participants: nurses, nursing technicians and members of the multidisciplinary team of a public hospital in Minas Gerais, Brazil. The data analysis followed the steps of open, axial and selective coding. Results: the management of the nursing care before the terminality and death involves a complex process of communication among patient, relatives and professionals, in which the interactions are permeated by the meanings of the end of life. Subjective, educational, sociocultural and institutional conditions influence nurses' interactions, generating order/disorder in the management of care. Conclusion: communication represents an important challenge for nursing management because it involves different actors, given the context of uncertainties and affectivities in the process of death and dying. It is important to emphasize the importance of the nurses being open to communication with these people, because this process requires complex actions regarding the demand for training and permanent education, as well as interdisciplinary action to guarantee humanization and comprehensive care.

Management challenges for best practices of the Kangaroo Method in the Neonatal ICU

OBJECTIVE

To understand the conditions that influence the adherence and application of best practices by nurses in the context of the Nursing care management in the Kangaroo Mother Care in the Neonatal ICU.

METHOD

Study of qualitative approach, whose theoretical and methodological frameworks were Symbolic Interactionism and Grounded Theory, respectively. We used the in-depth interview with 8 nurses from the Neonatal ICU of a public maternity hospital in the city of Rio de Janeiro.

RESULTS

The conditions involved in adhering to the best practices of humanization in the Neonatal ICU are related mainly to human resources, interaction among professionals, work processes and leadership strategies; and care management.

CONCLUSION

Professional and institutional challenges have been identified that need to be addressed to improve adherence and implementation of the Kangaroo Mother Care best practices.

ESTRATÉGIAS DE AÇÃO E INTERAÇÃO PARA O CUIDADO À CRIANÇA HOSPITALIZADA COM DOR ONCOLÓGICA CRÔNICA

RESUMO Objetivo: discutir, a partir do referencial da complexidade, as estratégias de ação e interação adotadas pelos profissionais de saúde para o cuidado à criança hospitalizada com dor oncológica crônica. Método: pesquisa de abordagem qualitativa, realizada com base no referencial metodológico da Teoria Fundamentada nos Dados e no referencial teórico do Pensamento Complexo, na perspectiva de Edgar Morin. A entrevista semiestruturada e a observação não participante foram utilizadas para a coleta de dados. Participaram da pesquisa 21 profissionais de saúde, os quais foram organizados em três grupos amostrais: enfermeiros; técnicos de enfermagem; e profissionais da equipe multiprofissional de saúde. Os resultados da pesquisa foram validados por cinco examinadores, dos quais três apresentam expertise no método de pesquisa. Resultados: a categoria “Lidando com a complexidade do contexto gerencial de cuidado à criança com dor oncológica crônica”, por meio de suas subcategorias, revelou que os profissionais de saúde utilizam o lúdico, o diálogo, a empatia, a relação afetiva e o trabalho em equipe como estratégias de interação para cuidar da criança e do familiar. Ademais, os resultados apresentam a busca da espiritualidade e do equilíbrio emocional como estratégias de ação necessárias para lidar com o sofrimento infantil e familiar. Conclusão: os resultados revelam a necessidade de os profissionais de saúde estabelecerem estratégias de ação que melhorem a sua interação com a criança e com o familiar, posto que uma efetiva interação facilita o processo de avaliação e manejo da dor, bem como viabiliza a continuidade e a qualidade do cuidado prestado.

The process of dying/death: intervening conditions to the nursing care management

OBJECTIVE

To exhibit the factors that influence the Nursing care management in the face of death and the process of dying/death of hospitalized adults in the medical-surgical units for hospitalization.

METHOD

The Grounded Theory was applied with the theorical support of the Complex Thinking Theory. Data have been collected through semi-structured interviews from May, 2015 to January, 2016 with three sample groups totaling 41 participants: nurses, assistant nurses and members of multidisciplinary group. Data analysis followed the steps of open coding, axial coding and selective coding.

RESULTS

The category "Pointing out the interfaces of care management to patients in process of death/dying and their families" and its respective subcategories show the complex interactions established by the nurse due to the Nursing care management.

FINAL CONSIDERATIONS

Subjective, educational, sociocultural and institutional conditions influence the nurse interactions, causing order/disorder on care management.

ASPECTOS CONTEXTUAIS SOBRE O GERENCIAMENTO DO CUIDADO DE ENFERMAGEM À CRIANÇA COM DOR ONCOLÓGICA CRÔNICA

RESUMO Objetivo: discutir os aspectos contextuais relacionados ao gerenciamento do cuidado de enfermagem à criança hospitalizada com dor oncológica crônica. Método: pesquisa de abordagem qualitativa, desenvolvida com base no referencial metodológico da Teoria Fundamentada em Dados e no referencial teórico do Pensamento Complexo, a partir de Edgar Morin. A coleta de dados ocorreu por meio da entrevista semiestruturada e da observação não participante. Os 21 participantes da pesquisa foram organizados em três grupos amostrais: o primeiro foi composto por sete enfermeiros; o segundo foi constituído por sete técnicos de enfermagem e o terceiro foi formado por sete profissionais da equipe multiprofissional de saúde. Os resultados da pesquisa foram validados por cinco examinadores, dos quais três apresentavam expertise no método de pesquisa. Resultados: a categoria intitulada “Desvelando aspectos contextuais sobre o gerenciamento do cuidado de enfermagem à criança com dor oncológica crônica” revelou por meio de suas subcategorias que a hospitalização dessa criança é longa, marcada por mudanças na dinâmica familiar, perdas e limitações impostas pela doença e/ou tratamento. O gerenciamento do cuidado de enfermagem é complexo, realizado por meio do trabalho em equipe e da demanda um planejamento que valorize as múltiplas necessidades da criança e do familiar. Conclusão: os resultados apontam para a necessidade do profissional de enfermagem contextualizar suas relações de cuidado, a partir da valorização de aspectos que transcendem a dimensão biológica da criança hospitalizada com dor oncológica crônica.

Desvelando os cuidados aos pacientes em processo de morte/morrer e às suas famílias

Resumo OBJETIVO Compreender, na perspectiva da complexidade, as condições que influenciam as interações dos profissionais de saúde diante da morte e do morrer de pacientes adultos hospitalizados e às suas famílias. MÉTODO Adotou-se como referenciais teórico e metodológico, respectivamente, o Pensamento Complexo e a Grounded Theory. Os dados foram coletados mediante entrevistas semiestruturadas, entre maio de 2015 e janeiro de 2016, com três grupos amostrais: enfermeiros, técnicos de enfermagem e membros da equipe multidisciplinar. A análise dos dados seguiu as etapas de codificação aberta, axial e seletiva. RESULTADOS A categoria “Desvelando os cuidados aos pacientes em processo de morte/morrer e às suas famílias” e suas respectivas subcategorias apresentam as complexas inter-retro-ações dos profissionais da saúde diante da morte e do morrer de pacientes. CONCLUSÃO As condições causais destacam as múltiplas conexões estabelecidas para o cuidado no processo dialógico da morte/morrer e revelam a complexidade do cuidado ao corpo sem vida.

Fundamentals of Implementation Science: an intensive course on an emerging field of research

Abstract Objective: Report the participation in the Intensive Course on Fundamentals of Implementation Science (IS) in Global Health and present the theoretical scope of IS methods and the potential applicability perspectives for improving global health. Method: Experience report on participation in the course, promoted by the University of Washington, USA, September, 2017. Results: The course introduced IS methodologies and selected case studies, focusing on opportunities and challenges in applying IS in practice. Conclusion: The IS offers tools for the selection of published scientific material and its use through plans, programs, intervention projects, models and protocols that assume diminishing inconsistencies and leverage results on a large scale in health science. Implications for practice: Multidisciplinary teams can benefit from IS training to address in a related way the gaps consistent with progress in the health sciences.

Cultural adaptation of The End-Stage Renal Disease Adherence Questionnaire for hemodialysis patients

ABSTRACT Objective: To describe the stages in the cultural adaptation of "The End-Stage Renal Disease Adherence Questionnaire" for use in Brazil. Method: A descriptive, transversal study with a quantitative approach. The cultural adaptation followed the steps of translation, professional committee, back translation, panel of patients and pretest. Results: the translation stage created a version in Portuguese that was analyzed by specialists, who suggested alterations in the title, seven sentences in the questions and three sets of answers. In the panel of patients phase, two questions were altered. The back translation considered the original characteristics of the instrument were maintained, likewise there were no modifications in the pretest phase. The third version written in Portuguese was considered to be the final version of the questionnaire. Conclusion: this instrument should facilitate nursing care management in hemodialysis, enabling the monitoring of adherence among these patients and also contribute to improving the indicators of morbidity and mortality.

CONEXÕES ENTRE PESQUISA E ASSISTÊNCIA: DESAFIOS EMERGENTES PARA A CIÊNCIA, A INOVAÇÃO E A TECNOLOGIA NA ENFERMAGEM

RESUMO Objetivo: compreender os significados que permeiam as conexões entre a produção/resultados de pesquisa e o processo de trabalho da enfermagem no âmbito assistencial. Método: pesquisa do tipo explicativa, de abordagem qualitativa, que teve como referenciais teórico e metodológico, respectivamente, a Teoria da Complexidade e a Teoria Fundamentada nos Dados. Os dados foram coletados com 25 sujeitos, distribuídos em três grupos amostrais: dez enfermeiros assistenciais, vinculados a um hospital universitário; seis enfermeiros pesquisadores e nove estudantes de graduação em enfermagem. A entrevista semiestruturada foi utilizada como técnica de coleta de dados. A pesquisa foi validada por dez juízes de diferentes regiões do Brasil. Resultados: apresenta-se a categoria: Enfrentando desafios emergentes da enfermagem na era da ciência, inovação e tecnologia, alicerçada pelas subcategorias: Pontos de partida para uma enfermagem contextualizada: da produção científica ao consumo de resultados de pesquisa; e Conexões fragilizadas entre produção científica e prática assistencial da enfermagem. Conclusão: os sistemas de significados que influenciam as conexões entre pesquisa científica e prática assistencial da enfermagem são estruturados e fortalecidos por fenômenos plurais, dentre os quais estão as inflexões negativas do processo de comunicação, presença e pertencimento dos pares, entre quem produz pesquisa e quem poderá consumi-la.

Learning through research: from teaching science to the sphere of nursing care

Abstract Objective: To understand the connections established between the teaching of research in undergraduate school and reflections on the context of nursing care based on the meanings assigned by nurses and undergraduate nursing students. Method: Qualitative research, the theoretical and methodological frameworks of which were Complexity Theory and Grounded Theory. Sixteen nurses and nine undergraduate nursing students participated. Data were collected through semi-structured interviews. Results: The study revealed that aspects that structure and maintain the scientific practice of nurses are connected with the teaching of nursing in undergraduate school. The transversality of teaching of research and strategies adopted by professors influence this process. Conclusion: In the nursing field, learning through research requires strategies that contextualize research within the context of care delivery, so that students perceive science as an element that structures their profession. For that, research should be a non-linear, transversal procedure that takes place over the course of the undergraduate program.

Validation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis

ABSTRACT Objective: To validate the evaluation questionnaire on adherence of chronic kidney disease (CKD) patients under hemodialysis. Method: We verified the following psychometric properties of the instrument: reliability (stability and internal consistency) and validity (face, content, and construct). Results: The intraclass correlation coefficient reached a value of 0.98 for the adherence questions and 0.91 for the perception questions. Regarding the kappa of the 14 questions examined, 12 had a value > 0.8, whereas the Cronbach's alpha had a value of 0.57. Experts ensured the face and content validity of the instrument, giving it an overall content validity index of 0.96. Construct validity, analyzed by Mann-Whitney test, was achieved as all domains showed a significant association with p<0.01. Conclusion: We verified, by the presented results, that the instrument has been validated for use in Brazil.

[Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence]

OBJECTIVE

to understand the perception of nurses on the vulnerabilities to STD/AIDS in light of the process of adolescence.

METHOD

qualitative research conducted with 15 nurses in a centre for the studies of adolescent healthcare of a university hospital in Rio de Janeiro/Brazil. The adopted theoretical and methodological frameworks were the Complexity Theory and the Grounded Theory, respectively. The semi-structured interview was used to collect data from January to August 2012.

RESULTS

this research presents the category: Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence, and the subcategories: Risks and uncertainties of the process of adolescence: paths to STD/AIDS; Age-adolescence complex: expanding knowledge from the perception of nurses.

CONCLUSION

once the nurses understand the complexity of adolescence, they create strategies to reduce the vulnerability of adolescents to STD/AIDS. This signals the need to invest in education, assistance and the management of nursing care for adolescents.

INTERACTIONS IN THE MANAGEMENT OF NURSING CARE TO HOSPITALIZED CHILDREN WITH CHRONIC CONDITIONS: SHOWING INTERVENING CONDITIONS

ABSTRACT The study aimed to understand the intervening conditions in the interactions of nurses in managing the nursing care for hospitalized children with chronic conditions. To do that, it used Complex Thinking and Grounded Theory as theoretical and methodological references, respectively. Eighteen subjects participated in the study, pooled into three sample groups: nurses, nursing technicians, and their families. A semi-structured interview was used for data collection. Data analysis followed three stages of coding: open, axial, and selective. The study considered family members, professional experience, the physical structure of the unit, human and material resources, good mood, job satisfaction, confidence, dialogue, and empathy as conditions that influence nurses' interactions in care management. It found that subjective, cognitive, socio-cultural and institutional conditions influence the interactions of nurses, creating order/disorder in nursing care management.

COMPLEX THINKING suPPOrTING CArE sTrATEGIEs FOr THE PrEVENTION OF sTDs/AIDs IN ADOLEsCENCE

ABsTrACTThis was qualitative research performed with 15 nursing professionals of a study cohort on adolescent health, in the capital of Rio de Janeiro/Brazil. The objective of the study was to discuss nursing care strategies for the prevention of STDs/AIDS in adolescence, from the perspective of complexity. A semi-structured interview was used for data collection from January to August of 2012. Grounded Theory was used as the methodological framework. The category "Starting points for the nursing care of adolescents in the context of STDs/AIDS" is presented, which discusses aspects related to interdisciplinarity; multidimensionality and specificities of the adolescence-related process, in the midst of vulnerabilities to STDs/AIDS, thereby revealing the importance of contemplating the phenomenon as delimited by its complexity.

Gerenciamento do cuidado de enfermagem à criança em condição crônica hospitalizada

RESUMO Objetivo: compreender as interações do enfermeiro na prática do gerenciamento do cuidado de enfermagem à criança em condição crônica hospitalizada. Método: foram utilizados como referenciais teórico e metodológico, respectivamente, o Pensamento Complexo e a Grounded Theory. Participaram do estudo 18 sujeitos organizados em três grupos: enfermeiros, técnicos de enfermagem e familiares. A técnica empregada para a coleta de dados foi a entrevista semiestruturada. A análise dos dados seguiu as três etapas de codificação: aberta, axial e seletiva. Resultados: a categoria "Necessitando gerenciar o cuidado de enfermagem à criança em condição crônica na Unidade de Internação Pediátrica" e suas respectivas subcategorias apresentam as complexas vinculações intersubjetivas estabelecidas pelo enfermeiro que sustentam a prática do gerenciamento do cuidado de enfermagem. Conclusão: nota-se dificuldade dos profissionais de enfermagem em interagir com o familiar da criança e na implementação do processo gerencial de cuidado, a dialógica ordem/desordem/interação/organização.

FUNCIONALIDADE DE FAMÍLIAS DE ADOLESCENTES DE ESCOLAS PÚBLICAS: UMA ABORDAGEM DESCRITIVA

A funcionalidade familiar caracteriza-se como fio estruturante para a construção de comportamentos de adolescentes. Trata-se de estudo exploratório descritivo e quantitativo, cujo objetivo foi classificar as famílias de adolescentes segundo o APGAR (Adaptation, Participation, Growth, Affection, Resolution) familiar envolvendo 1.035 adolescentes de duas escolas públicas de um estado nordestino. Os dados foram coletados com o apoio do APGAR Familiar, nos horários das aulas, em dia e horários definidos pela direção da escola e analisados por meio da estatística descritiva a partir de banco de dados do Excel. Foram classificadas como funcionais 73,2% das famílias e 26,8% como disfuncionais; a maior satisfação dos adolescentes esteve relacionada às dimensões adaptação e dedicação. Os resultados suscitam desafios para pesquisa e para inserção profissional do enfermeiro em contexto escolar assim como para um trabalho interdisciplinar e em rede no cuidado ao adolescente.