Ana Cláudia Giesbrecht Puggina

Messages from relatives of patients in coma: hope as common element

Objective: Identifying common meanings in messages from relatives of patients in coma who had been admitted into intensive care units. Methods: Descriptive study, qualitatively analyzing 30 messages from families of critical state patients. Results: Seven categories emerged: search for spiritual support to overcome difficulties; the necessity of expressing one’s feelings; the wish for the patients to return to family life; patients should not worry about external events; family is concerned with reporting the visits, reaffirming that the patient is not alone; concerns about the patient’s recovery; memories about daily life and news from home. Conclusions: Feelings and concerns emerged, along with a universal feeling: hope. This was a part of all categories; hope not only about a cure, but also in adaptation. Describers: Intensive care unit; Hospitalized patients; Family; ComaOBJETIVO: Identificar los significados comunes en los mensajes de los familiares de pacientes en estado de coma internados en una Unidad de Cuidados Intensivos (UCI). METODOS: Se trata de un estudio descriptivo con abordaje cualitativo de analisis de contenido de 30 mensajes de familiares de pacientes en estado critico. RESULTADOS: Emergieron siete categorias: la busqueda de apoyo espiritual para superar las dificultades; la necesidad de expresion de los sentimientos; el deseo de que los pacientes retornen a la convivencia familiar; no se preocupen con los acontecimientos externos; preocupacion de los familiares para relatar las visitas reafirmando que el paciente no esta solo; preocupacion en la recuperacion de los mismos; recuerdos de la vida cotidiana y noticias de casa. CONCLUSIONES: Emergieron sentimientos y preocupaciones, ademas de algo universal: la esperanza. Ella permeo practicamente todas las categorias; esperanza no solo en la cura, sino tambien en la adaptacion.

Sinais vitais e expressão facial de pacientes em estado de coma

The objective was to check music and voice message influence on the vital signals and facial expressions of patients in physiological or induced comas. A randomized controlled clinical trial was done. The sample was consisted of 30 patients from Intensive Care Unit, being divided in 2 groups: Group Control (without auditory stimuli) and Experimental Group (with auditory stimuli). The patients were submitted to 3 sessions for consecutive days. Significant statistical alterations of the vital signs were noted (oxygen saturation - session 1; oxygen saturation - session 3; respiratory frequency - session 3) during the message playback and with facial expression, session 1, during both music and message. Apparently, the voice message is a stronger stimulus than the music in relation to the capacity of producing suggestive physiological auditory responses.O objetivo foi verificar a influencia da musica e mensagem oral sobre os Sinais Vitais e Expressao Facial dos pacientes em coma fisiologico ou induzido. Realizou-se um Ensaio Clinico Controlado e Randomizado. A amostra consistiu-se de 30 pacientes de Unidade de Terapia Intensiva, que foram divididos em 2 grupos: Grupo Controle (sem estimulos auditivos) e Grupo Experimental (com estimulos auditivos). Os pacientes foram submetidos a 3 sessoes, em dias consecutivos. Encontraram-se alteracoes estatisticamente significativas nos sinais vitais (saturacao de O2 - sessao 1; saturacao de O2 - sessao 3; frequencia respiratoria - sessao 3) durante a mensagem e na expressao facial, sessao 1, durante a musica e a mensagem. Aparentemente a mensagem foi um estimulo mais forte do que a musica em relacao a capacidade de produzir respostas fisiologicas sugestivas de audicao.

A percepção auditiva nos pacientes em estado de coma: uma revisão bibliográfica

Much is still needed to be discovered by the neuroscience in relation to the consciousness regarding cognitive processes and the auditive perception in coma. Thus, this study is a bibliographic review on the auditive perception of patients in coma and shows its relevance to explain and identify evidence. To identify, in the publications found, the gaps, consistencies and inconsistencies on this subject. This study consists of a bibliographical survey based on LILACS and PUBMED database. Ten articles were selected about the subject, none of them are national publications. Most of the selected studies were published within the period of 1971-1995 (80%), by the United States (70%), as longitudinal research (50%) or study of case (30%); the sample in general varied between 1 and 5 (70%), the majority used music (80%); the EEG (60%) and behavior observation (50%) were the most used measuring ways of the responses to the stimulus. The procedures were varied, however most of the studies, show that there is an auditory perception in patients with coma.Much is still needed to be discovered by the neuroscience in relation to the consciousness regarding cognitive processes and the auditive perception in coma. Thus, this study is a bibliographic review on the auditive perception of patients in coma and shows its relevance to explain and identify evidence. To identify, in the publications found, the gaps, consistencies and inconsistencies on this subject. This study consists of a bibliographical survey based on LILACS and PUBMED database. Ten articles were selected about the subject, none of them are national publications. Most of the selected studies were published within the period of 1971-1995 (80%), by the United States (70%), as longitudinal research (50%) or study of case (30%); the sample in general varied between 1 and 5 (70%), the majority used music (80%); the EEG (60%) and behavior observation (50%) were the most used measuring ways of the responses to the stimulus. The procedures were varied, however most of the studies, show that there is an auditory perception in patients with coma.

Mensagens dos familiares de pacientes em estado de coma: a esperança como elemento comum

Objective: Identifying common meanings in messages from relatives of patients in coma who had been admitted into intensive care units. Methods: Descriptive study, qualitatively analyzing 30 messages from families of critical state patients. Results: Seven categories emerged: search for spiritual support to overcome difficulties; the necessity of expressing one’s feelings; the wish for the patients to return to family life; patients should not worry about external events; family is concerned with reporting the visits, reaffirming that the patient is not alone; concerns about the patient’s recovery; memories about daily life and news from home. Conclusions: Feelings and concerns emerged, along with a universal feeling: hope. This was a part of all categories; hope not only about a cure, but also in adaptation. Describers: Intensive care unit; Hospitalized patients; Family; ComaOBJETIVO: Identificar los significados comunes en los mensajes de los familiares de pacientes en estado de coma internados en una Unidad de Cuidados Intensivos (UCI). METODOS: Se trata de un estudio descriptivo con abordaje cualitativo de analisis de contenido de 30 mensajes de familiares de pacientes en estado critico. RESULTADOS: Emergieron siete categorias: la busqueda de apoyo espiritual para superar las dificultades; la necesidad de expresion de los sentimientos; el deseo de que los pacientes retornen a la convivencia familiar; no se preocupen con los acontecimientos externos; preocupacion de los familiares para relatar las visitas reafirmando que el paciente no esta solo; preocupacion en la recuperacion de los mismos; recuerdos de la vida cotidiana y noticias de casa. CONCLUSIONES: Emergieron sentimientos y preocupaciones, ademas de algo universal: la esperanza. Ella permeo practicamente todas las categorias; esperanza no solo en la cura, sino tambien en la adaptacion.

Análise da percepção dos professores em relação aos sentimentos dos alunos em sala de aula

O estudo teve como objetivo verificar a diferenca na percepcao dos sentimentos dos alunos pelos professores antes e depois de uma apresentacao explicativa sobre o tema. Estudo de natureza exploratoria de fonte primaria, abordagem quantitativa com 13 professores de Enfermagem e Medicina. Um video com a imagem dos alunos foi apresentado aos professores que responderam ao questionario de identificacao de sentimentos e, apos uma apresentacao explicativa sobre comunicacao nao verbal e sentimentos, assistiram ao mesmo video e responderam novamente ao questionario. Quanto a identificacao de sentimentos, a alegria, a ansiedade e o interesse foram os mais identificados. Encontramos valores estatisticamente significantes em relacao a media da pontuacao total antes e depois da apresentacao explicativa (p=0,02). O professor e capaz de identificar os sentimentos, porem, apos a apresentacao explicativa, sua percepcao melhorou e ele conseguiu identifica-los mais vezes.The objective of this study is to verify the difference in professors perception of students feelings before and after an explanatory presentation on the theme. This is an exploratory study using a primary source, and a quantitative approach with 13 Nursing and Medicine professors. A vide showing student images was presented to the professors, who answered a feeling-identification questionnaire, and, after an explanatory presentation about non-verbal communication and feelings, the professors watched the same video and answered the questionnaire again. As to the identification of feelings, joy, anxiety, and interest were the most often identified. We found statistically significant values regarding the mean total score before and after the explanatory presentation (p=0.02). The professor is capable of identifying the feelings, but after the explanatory presentation, their perception improved and they were able to make identifications more often.

Pacientes com desordem de consciência: respostas vitais, faciais e musculares frente música ou mensagem

PURPOSESnTo compare vital signs, facial expression and basal electroneurographic signs with measures during stimuli music, message or silence in coma patients, vegetative status or sedated; and relating the score of Glasgow Results Scale with the intervention realized.nnnMETHODnA Monoblind Transversal Controlled Clinical Trial to researcher. The distribution, among the three groups, was randomized (experiment with music, experiment with message or control). Two assessments (sessions) were performed with interval of 40 minutes on the same day.nnnRESULTSnMost of the 76 patients were male, between 18 to 36 years old and hospitalized due to trauma. Statistically significant changes were found in the variables referred to temperature, facial expression, electroneurography and Glasgow Results Scale; more frequent alterations in second session, in coma and vegetative patients, in frontal muscles and in experiment group.nnnCONCLUSIONSnThe facial expression and the electroneurography seem to be more trustworthy variables than vital signs to evaluate consciousness.

Patients with disorders of consciousness: vital, facial and muscular responses to music or messages.

PURPOSESnTo compare vital signs, facial expression and basal electroneurographic signs with measures during stimuli music, message or silence in coma patients, vegetative status or sedated; and relating the score of Glasgow Results Scale with the intervention realized.nnnMETHODnA Monoblind Transversal Controlled Clinical Trial to researcher. The distribution, among the three groups, was randomized (experiment with music, experiment with message or control). Two assessments (sessions) were performed with interval of 40 minutes on the same day.nnnRESULTSnMost of the 76 patients were male, between 18 to 36 years old and hospitalized due to trauma. Statistically significant changes were found in the variables referred to temperature, facial expression, electroneurography and Glasgow Results Scale; more frequent alterations in second session, in coma and vegetative patients, in frontal muscles and in experiment group.nnnCONCLUSIONSnThe facial expression and the electroneurography seem to be more trustworthy variables than vital signs to evaluate consciousness.

Vital signs and facial expression of patients in coma

The objective was to check music and voice message influence on the vital signals and facial expressions of patients in physiological or induced comas. A randomized controlled clinical trial was done. The sample was consisted of 30 patients from Intensive Care Unit, being divided in 2 groups: Group Control (without auditory stimuli) and Experimental Group (with auditory stimuli). The patients were submitted to 3 sessions for consecutive days. Significant statistical alterations of the vital signs were noted (oxygen saturation - session 1; oxygen saturation - session 3; respiratory frequency - session 3) during the message playback and with facial expression, session 1, during both music and message. Apparently, the voice message is a stronger stimulus than the music in relation to the capacity of producing suggestive physiological auditory responses.O objetivo foi verificar a influencia da musica e mensagem oral sobre os Sinais Vitais e Expressao Facial dos pacientes em coma fisiologico ou induzido. Realizou-se um Ensaio Clinico Controlado e Randomizado. A amostra consistiu-se de 30 pacientes de Unidade de Terapia Intensiva, que foram divididos em 2 grupos: Grupo Controle (sem estimulos auditivos) e Grupo Experimental (com estimulos auditivos). Os pacientes foram submetidos a 3 sessoes, em dias consecutivos. Encontraram-se alteracoes estatisticamente significativas nos sinais vitais (saturacao de O2 - sessao 1; saturacao de O2 - sessao 3; frequencia respiratoria - sessao 3) durante a mensagem e na expressao facial, sessao 1, durante a musica e a mensagem. Aparentemente a mensagem foi um estimulo mais forte do que a musica em relacao a capacidade de produzir respostas fisiologicas sugestivas de audicao.

MOTIVAÇÃO DE ALUNOS DE ENFERMAGEM NO USO DAS TECNOLOGIAS DA INFORMAÇÃO E COMUNICAÇÃO

Objetivos: mensurar a motivacao no uso de Tecnologia da Informacao e Comunicacao na Educacao a Distância de alunos do curso de enfermagem e avaliar a interferencia de caracteristicas pessoais na motivacao para o uso dessas tecnologias. Metodo: estudo transversal quantitativo com o uso da Escala de Avaliacao de Fatores de Motivacao com Relacao a Integracao das Tecnologias de Informacao e Comunicacao ao Ensino. Foram realizadas analises descritiva e inferencial. Resultados: a amostra de 188 alunos de graduacao em enfermagem apresentou baixa media de motivacao, com escore medio de 77,49 (±25,57). A desmotivacao no uso da Tecnologia da Informacao e Comunicacao foi evidente e mais acentuada no sexo feminino. Conclusao: em geral, maior motivacao foi encontrada em alunos viuvos ou separados e naqueles matriculados no quinto ou oitavo semestres. Descritores: Educacao a distância. Educacao superior. Tecnologia educacional. Enfermagem.

Análisis de la percepción de los profesores en relación a los sentimientos de los alumnos en sala de clases

O estudo teve como objetivo verificar a diferenca na percepcao dos sentimentos dos alunos pelos professores antes e depois de uma apresentacao explicativa sobre o tema. Estudo de natureza exploratoria de fonte primaria, abordagem quantitativa com 13 professores de Enfermagem e Medicina. Um video com a imagem dos alunos foi apresentado aos professores que responderam ao questionario de identificacao de sentimentos e, apos uma apresentacao explicativa sobre comunicacao nao verbal e sentimentos, assistiram ao mesmo video e responderam novamente ao questionario. Quanto a identificacao de sentimentos, a alegria, a ansiedade e o interesse foram os mais identificados. Encontramos valores estatisticamente significantes em relacao a media da pontuacao total antes e depois da apresentacao explicativa (p=0,02). O professor e capaz de identificar os sentimentos, porem, apos a apresentacao explicativa, sua percepcao melhorou e ele conseguiu identifica-los mais vezes.The objective of this study is to verify the difference in professors perception of students feelings before and after an explanatory presentation on the theme. This is an exploratory study using a primary source, and a quantitative approach with 13 Nursing and Medicine professors. A vide showing student images was presented to the professors, who answered a feeling-identification questionnaire, and, after an explanatory presentation about non-verbal communication and feelings, the professors watched the same video and answered the questionnaire again. As to the identification of feelings, joy, anxiety, and interest were the most often identified. We found statistically significant values regarding the mean total score before and after the explanatory presentation (p=0.02). The professor is capable of identifying the feelings, but after the explanatory presentation, their perception improved and they were able to make identifications more often.