Ana Paula Ribeiro Razera

Doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty

OBJECTIVE To identify the main doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty. METHOD Cross-sectional study carried out in a reference hospital, between September and November 2012. The sample was composed of 50 individuals divided in two groups, of which 25 caregivers of children submitted to cheiloplasty, and 25 of children submitted to palatoplasty. The doubts were identified by an interview applied during the preoperative nursing consultation and were then categorized by similarity. Descriptive statistics was used for analysis of the outcomes. RESULTS Concerning cheiloplasty, the doubts were related to feeding (36%), hygiene and healing (24% each), pain and infection (8% each). With regard to palatoplasty, the doubts were related to feeding (48%), hygiene (24%), pain (16%), bleeding (8%) and infection (4%). CONCLUSION The study evidenced the concern of caregivers in relation to feeding and care of the postoperative wound.Objetivo Identificar as principais duvidas dos cuidadores de criancas com fissura labiopalatina sobre os cuidados pos-operatorios das cirurgias de queiloplastia e palatoplastia. Metodo Estudo transversal realizado em um hospital de referencia, entre os meses de setembro a novembro de 2012. A amostra constou de 50 individuos divididos em dois grupos, sendo 25 cuidadores de criancas submetidas a queiloplastia e 25 criancas submetidas a palatoplastia. As duvidas foram identificadas por meio de entrevista, realizada durante a consulta de Enfermagem pre-operatoria, e, posteriormente, foram categorizadas por similaridade. Utilizou-se a analise estatistica descritiva para construcao dos resultados. Resultados Observou-se que, em relacao a queiloplastia, as duvidas foram sobre alimentacao (36%), higienizacao e cicatrizacao (24% cada), e dor e infeccao (8% cada). Quanto a palatoplastia, as duvidas se relacionaram a: alimentacao (48%), higienizacao (24%), dor (16%), sangramento (8%) e infeccao (4%). Conclusao Evidenciou-se a preocupacao dos cuidadores em relacao a alimentacao e aos cuidados com a ferida pos-operatoria.

Nursing workload in specialized Semi-intensive Therapy unit: workforce size criteria

OBJECTIVE To assess the nursing workload (NW) in Semi-intensive Therapy Unit, specialized in the care of children with Craniofacial anomalies and associated syndromes; to compare the amount of workforce required according to the Nursing Activities Score (NAS) and the COFEN Resolution 293/04. METHOD Cross-sectional study, whose sample was composed of 72 patients. Nursing workload was assessed through retrospective application of the NAS. RESULTS the NAS mean was 49.5%. Nursing workload for the last day of hospitalization was lower in patients being discharged to home (p<0.001) and higher on the first compared to last day of hospitalization (p< 0.001). The number of professionals required according to NAS was superior to the COFEN Resolution 293/04, being 17 and 14, respectively. CONCLUSION the nursing workload corresponded to approximately 50% of the working time of nursing professional and was influenced by day and outcome of hospitalization. The amount of professionals was greater than that determined by the existing legislation.OBJETIVO Avaliar a carga de trabalho de enfermagem (CTE) em Unidade de Terapia Semi-intensiva, especializada no atendimento de criancas com anomalias craniofaciais e sindromes associadas; comparar o quantitativo de pessoal requerido segundo o Nursing Activities Score (NAS) e a Resolucao COFEN-293/04. METODO Estudo transversal, cuja amostra foi de 72 pacientes. A carga de trabalho de enfermagem foi avaliada por meio da aplicacao retrospectiva do NAS. RESULTADOS A media do NAS foi de 49,5%. A carga de trabalho de enfermagem referente ao ultimo dia de internacao foi menor em pacientes que receberam alta para o domicilio (p<0,001) e maior no primeiro dia de internacao em comparacao ao ultimo (p<0,001). O quantitativo de profissionais requerido segundo o NAS foi superior ao da Resolucao COFEN-293/04, sendo 17 e 14, respectivamente. CONCLUSAO A carga de trabalho de enfermagem correspondeu a aproximadamente 50% do tempo de trabalho do profissional de enfermagem e foi influenciada pelo dia e desfecho da internacao. O quantitativo de profissionais foi superior ao determinado pela legislacao existente.

Vídeo educativo: estratégia de treinamento para cuidadores de crianças com fissura labiopalatina

Objective To check the knowledge informal caregivers of children with cleft lip and palate acquire about the postoperative care of cheiloplasty and palatoplasty through the use of an educational video. Methods Randomized clinical trial conducted with 80 caregivers of children with cleft lip and palate, arranged into two groups: experimental (G1) and control (G2). Data collection occurred during the child’s hospital stay, in three stages, using a structured questionnaire and an educational video developed and validated for this study. Results There was evidence of improvement in the acquisition of knowledge about postoperative care in both groups (p <0.001), but it was higher in G1 compared to G2. Conclusion The educational video was shown to be effective to train caregivers of children with cleft lip and palate after cheiloplasty and palatoplasty.

Carga de trabalho de enfermagem em Unidade de Terapia Semi-intensiva especializada: critérios para dimensionamento de pessoal

OBJECTIVE To assess the nursing workload (NW) in Semi-intensive Therapy Unit, specialized in the care of children with Craniofacial anomalies and associated syndromes; to compare the amount of workforce required according to the Nursing Activities Score (NAS) and the COFEN Resolution 293/04. METHOD Cross-sectional study, whose sample was composed of 72 patients. Nursing workload was assessed through retrospective application of the NAS. RESULTS the NAS mean was 49.5%. Nursing workload for the last day of hospitalization was lower in patients being discharged to home (p<0.001) and higher on the first compared to last day of hospitalization (p< 0.001). The number of professionals required according to NAS was superior to the COFEN Resolution 293/04, being 17 and 14, respectively. CONCLUSION the nursing workload corresponded to approximately 50% of the working time of nursing professional and was influenced by day and outcome of hospitalization. The amount of professionals was greater than that determined by the existing legislation.OBJETIVO Avaliar a carga de trabalho de enfermagem (CTE) em Unidade de Terapia Semi-intensiva, especializada no atendimento de criancas com anomalias craniofaciais e sindromes associadas; comparar o quantitativo de pessoal requerido segundo o Nursing Activities Score (NAS) e a Resolucao COFEN-293/04. METODO Estudo transversal, cuja amostra foi de 72 pacientes. A carga de trabalho de enfermagem foi avaliada por meio da aplicacao retrospectiva do NAS. RESULTADOS A media do NAS foi de 49,5%. A carga de trabalho de enfermagem referente ao ultimo dia de internacao foi menor em pacientes que receberam alta para o domicilio (p<0,001) e maior no primeiro dia de internacao em comparacao ao ultimo (p<0,001). O quantitativo de profissionais requerido segundo o NAS foi superior ao da Resolucao COFEN-293/04, sendo 17 e 14, respectivamente. CONCLUSAO A carga de trabalho de enfermagem correspondeu a aproximadamente 50% do tempo de trabalho do profissional de enfermagem e foi influenciada pelo dia e desfecho da internacao. O quantitativo de profissionais foi superior ao determinado pela legislacao existente.

Study of Burden Among Caregivers of Children with Cleft Lip and Palate

espanolResumen: La salud fisica y psicologica de los cuidadores de ninos con fisura labiopalatina puede ser fuertemente influenciado por el estado y el comportamiento del nino, y por la demanda de atencion prestada en el tratamiento. Este estudio tuvo como objetivo identificar los niveles de sobrecarga de estos cuidadores. Participaron 100 cuidadores de ninos que estaban en el periodo perioperatorio de queiloplastia y/o palatoplastia. Fue utilizada como instrumento la Escala Burden Interview. Los datos fueron analizados cuantitativamente. Niveles leves y moderados-graves fueron identificados en el 43% de la muestra. Se observo que las madres de ninos en edad alrededor de doce meses tuvieron sobrecarga significativamente mayor. Los resultados fueron indicativos de una mayor demanda de cuidados para el nino en esta fase de desarrollo, debido a la busqueda de autonomia en la locomocion, la exploracion de los objetos en el entorno circundante, con continuas solicitaciones de interaccion comunicativa y afectivo-sociales, juntamente con la referencia de mayor apego (el cuidador), lo que puede haber contribuido a una sobrecarga mayor. portuguesResumo: A saude psicologica e fisica dos cuidadores das criancas com fissura labiopalatina pode ser fortemente influenciada pela condicao e comportamento da crianca e pela demanda de cuidados dispensados no tratamento. Este estudo objetivou identificar os niveis de sobrecarga nesses cuidadores. Participaram 100 cuidadores cujos filhos se encontravam no periodo perioperatorio de queiloplastia e/ou palatoplastia. A Escala Burden Interview foi utilizada como instrumento. Os dados foram analisados quantitativamente. Foram identificados niveis moderados e moderados-severos de sobrecarga em 43% da amostra. Observou-se que maes de criancas com idade em torno de 12 meses apresentaram sobrecarga significativamente maior. Os resultados foram indicativos de maior exigencia de cuidados com a crianca nessa fase do desenvolvimento, decorrente da busca de autonomia na locomocao, exploracao de objetos no ambiente proximo, com solicitacoes continuas de interacao comunicativa e afetiva-social junto a referencia de maior apego (o cuidador), o que pode ter contribuido para uma maior sobrecarga. EnglishAbstract: The psychological and physical health of caregivers of children with cleft lip and palate can be strongly influenced by the child’s condition and behavior, and care required by the treatment. This study’s objective was to identify overload levels among these caregivers. A total of 100 caregivers, whose children were in the perioperative period of cheiloplasty and/or palatoplasty, were interviewed using the Scale Burden Interview. The data were analyzed quantitatively. Moderate and moderate severe burden levels were identified in 43% of the sample. The mothers of children aged around 12 months presented significantly higher overload. The results indicate that children in this developmental stage present greater care demand because they seek autonomy in locomotion, explore objects in their surrounding environment, and continually request communicative and affective-social interaction with their reference to greater attachment (the caregiver), which may have contributed to higher burden.

Impact of promoting self-care in nursing workload

OBJECTIVES To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. METHODS Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). CONCLUSION The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation. OBJETIVOS Verificar o impacto da promoção do autocuidado na carga de trabalho de enfermagem e associá-la às variáveis: idade, gênero, classificação socioeconômica, escolaridade, estado civil e número de filhos dos cuidadores. MÉTODO Estudo prospectivo, onde participaram 31 crianças e seus respectivos cuidadores. Os participantes foram avaliados em dois momentos, 1ª e 2ª internação, quanto à carga de trabalho de enfermagem mensurada por meio do Nursing Activities Score (NAS). RESULTADOS A média NAS na 1ª internação foi de 60,9%, e na 2ª internação foi de 41,6%, ou seja, 14,6 e 9,9 horas de enfermagem, respectivamente. A carga de trabalho de enfermagem no primeiro dia de internação foi maior quando comparada ao último dia, tanto na 1ª (p<0,001) como na 2ª internação (p<0,001), e maior no primeiro (p<0,001) e último dia (p=0,025) na 1ª internação. Ainda, na 1ª internação, foi maior quando comparada à 2ª internação (p<0,001), e os itens NAS referentes à capacitação do autocuidado a influenciaram (p<0,001). CONCLUSÃO A carga de trabalho de enfermagem referente à promoção do autocuidado correspondeu a 14,6 horas e foi superior ao determinado pela legislação existente.Trettene AS. The impact of promoting self-care upon nursing workload [thesis]. Bauru: Bauru: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo; 2015. Objectives: to verify the impact of promoting self-care upon nursing workload, in relation to children with Isolated Robin Sequence and their self-care agents; to elaborate and validate a Tutorial referring to the application of the Nursing Activities Score (NAS) in a Specialized Semi-Intensive Care Unit; to identify and compare the nursing workload at two different periods, including the 1 hospitalization (untrained caregivers for self-care) and the 2 hospitalization (caregivers trained for self-care); to associate NAS items related to the promotion of self-care (support and care concerning family members) between the 1 and the 2 hospitalization; to associate the sociodemographic characteristics of children and the self-care agents to nursing workload; to identify and compare the staff dimensioning, according to NAS in the 1 and 2 hospitalization, according to Cofen Resolution n° 293/04. Method: prospective study carried out at Specialized Semi-Intensive Care Unit of the Rehabilitation Hospital of Craniofacial Anomalies, based on the Self-Care Theoretical Framework of Dorothea Orem. The sample consisted of 31 infants with Isolated Robin Sequence and their respective self-care agents. Participants were evaluated on the 1 and 2 hospitalization, regarding the nursing workload. For this evaluation, NAS was applied, whose Tutorial was developed and validated for this study, considering the specificity of the population. Data collection took place from February to October 2014. For the statistical analysis, the Student T-test, the analysis of variance and Pearson correlation were employed. Values for p=0.05 (5%) were accepted as significant difference. Results: a total of 519 assessments, related to nursing workload were generated. The average period of the 1 hospitalization consisted of 10.3 days (±5.7), while the 2 consisted of 6.4 days (±3.4). NAS average in the 1 hospitalization was 60.9% and in the 2 was 41.6%, that is, a total of 93.4 and 63.4 nursing hours, referring to 24 hours, respectively. The nursing workload on the 1 day of hospitalization was higher, when compared to the last day, either on the 1 (p<0.001) as on the 2 hospitalization (p<0.001). Nursing workload was higher on the 1 (p<0.001) and last day (p=0.025) during the 1 hospitalization. Nursing workload in the 1 hospitalization was higher when compared to the 2 hospitalization (p<0.001). NAS items related to self-care training influenced the nursing workload (p<0.001), while the socio-demographic characteristics of children and self-care agents, did not influence. The staff dimensioning according to NAS comprised 26 professionals in the 1 hospitalization and 18 professionals in the 2. As for Cofen Resolution, a total of 60.2 nursing hours were necessary, referring to 24 hours, and comprised 14 professionals, thus, it was evidenced, a deficit of eight professionals when compared to the 2 hospitalization, and 12 professionals, when compared to Cofen Resolution 293/04. Conclusion: nursing workload was higher when promoted self-care and influenced the amount of nursing professionals, demonstrating the necessity for reconsidering the staff dimensioning, regarding this type of service.4 Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil. ABSTRACT Objective: To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. Methods: Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). Results: The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). Conclusion: The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.

Impacto de la promoción del autocuidado en la carga laboral de enfermería

OBJECTIVES To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. METHODS Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). CONCLUSION The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation. OBJETIVOS Verificar o impacto da promoção do autocuidado na carga de trabalho de enfermagem e associá-la às variáveis: idade, gênero, classificação socioeconômica, escolaridade, estado civil e número de filhos dos cuidadores. MÉTODO Estudo prospectivo, onde participaram 31 crianças e seus respectivos cuidadores. Os participantes foram avaliados em dois momentos, 1ª e 2ª internação, quanto à carga de trabalho de enfermagem mensurada por meio do Nursing Activities Score (NAS). RESULTADOS A média NAS na 1ª internação foi de 60,9%, e na 2ª internação foi de 41,6%, ou seja, 14,6 e 9,9 horas de enfermagem, respectivamente. A carga de trabalho de enfermagem no primeiro dia de internação foi maior quando comparada ao último dia, tanto na 1ª (p<0,001) como na 2ª internação (p<0,001), e maior no primeiro (p<0,001) e último dia (p=0,025) na 1ª internação. Ainda, na 1ª internação, foi maior quando comparada à 2ª internação (p<0,001), e os itens NAS referentes à capacitação do autocuidado a influenciaram (p<0,001). CONCLUSÃO A carga de trabalho de enfermagem referente à promoção do autocuidado correspondeu a 14,6 horas e foi superior ao determinado pela legislação existente.Trettene AS. The impact of promoting self-care upon nursing workload [thesis]. Bauru: Bauru: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo; 2015. Objectives: to verify the impact of promoting self-care upon nursing workload, in relation to children with Isolated Robin Sequence and their self-care agents; to elaborate and validate a Tutorial referring to the application of the Nursing Activities Score (NAS) in a Specialized Semi-Intensive Care Unit; to identify and compare the nursing workload at two different periods, including the 1 hospitalization (untrained caregivers for self-care) and the 2 hospitalization (caregivers trained for self-care); to associate NAS items related to the promotion of self-care (support and care concerning family members) between the 1 and the 2 hospitalization; to associate the sociodemographic characteristics of children and the self-care agents to nursing workload; to identify and compare the staff dimensioning, according to NAS in the 1 and 2 hospitalization, according to Cofen Resolution n° 293/04. Method: prospective study carried out at Specialized Semi-Intensive Care Unit of the Rehabilitation Hospital of Craniofacial Anomalies, based on the Self-Care Theoretical Framework of Dorothea Orem. The sample consisted of 31 infants with Isolated Robin Sequence and their respective self-care agents. Participants were evaluated on the 1 and 2 hospitalization, regarding the nursing workload. For this evaluation, NAS was applied, whose Tutorial was developed and validated for this study, considering the specificity of the population. Data collection took place from February to October 2014. For the statistical analysis, the Student T-test, the analysis of variance and Pearson correlation were employed. Values for p=0.05 (5%) were accepted as significant difference. Results: a total of 519 assessments, related to nursing workload were generated. The average period of the 1 hospitalization consisted of 10.3 days (±5.7), while the 2 consisted of 6.4 days (±3.4). NAS average in the 1 hospitalization was 60.9% and in the 2 was 41.6%, that is, a total of 93.4 and 63.4 nursing hours, referring to 24 hours, respectively. The nursing workload on the 1 day of hospitalization was higher, when compared to the last day, either on the 1 (p<0.001) as on the 2 hospitalization (p<0.001). Nursing workload was higher on the 1 (p<0.001) and last day (p=0.025) during the 1 hospitalization. Nursing workload in the 1 hospitalization was higher when compared to the 2 hospitalization (p<0.001). NAS items related to self-care training influenced the nursing workload (p<0.001), while the socio-demographic characteristics of children and self-care agents, did not influence. The staff dimensioning according to NAS comprised 26 professionals in the 1 hospitalization and 18 professionals in the 2. As for Cofen Resolution, a total of 60.2 nursing hours were necessary, referring to 24 hours, and comprised 14 professionals, thus, it was evidenced, a deficit of eight professionals when compared to the 2 hospitalization, and 12 professionals, when compared to Cofen Resolution 293/04. Conclusion: nursing workload was higher when promoted self-care and influenced the amount of nursing professionals, demonstrating the necessity for reconsidering the staff dimensioning, regarding this type of service.4 Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil. ABSTRACT Objective: To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. Methods: Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). Results: The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). Conclusion: The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.

Impacto da promoção do autocuidado na carga de trabalho de enfermagem

OBJECTIVES To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. METHODS Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). CONCLUSION The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation. OBJETIVOS Verificar o impacto da promoção do autocuidado na carga de trabalho de enfermagem e associá-la às variáveis: idade, gênero, classificação socioeconômica, escolaridade, estado civil e número de filhos dos cuidadores. MÉTODO Estudo prospectivo, onde participaram 31 crianças e seus respectivos cuidadores. Os participantes foram avaliados em dois momentos, 1ª e 2ª internação, quanto à carga de trabalho de enfermagem mensurada por meio do Nursing Activities Score (NAS). RESULTADOS A média NAS na 1ª internação foi de 60,9%, e na 2ª internação foi de 41,6%, ou seja, 14,6 e 9,9 horas de enfermagem, respectivamente. A carga de trabalho de enfermagem no primeiro dia de internação foi maior quando comparada ao último dia, tanto na 1ª (p<0,001) como na 2ª internação (p<0,001), e maior no primeiro (p<0,001) e último dia (p=0,025) na 1ª internação. Ainda, na 1ª internação, foi maior quando comparada à 2ª internação (p<0,001), e os itens NAS referentes à capacitação do autocuidado a influenciaram (p<0,001). CONCLUSÃO A carga de trabalho de enfermagem referente à promoção do autocuidado correspondeu a 14,6 horas e foi superior ao determinado pela legislação existente.Trettene AS. The impact of promoting self-care upon nursing workload [thesis]. Bauru: Bauru: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo; 2015. Objectives: to verify the impact of promoting self-care upon nursing workload, in relation to children with Isolated Robin Sequence and their self-care agents; to elaborate and validate a Tutorial referring to the application of the Nursing Activities Score (NAS) in a Specialized Semi-Intensive Care Unit; to identify and compare the nursing workload at two different periods, including the 1 hospitalization (untrained caregivers for self-care) and the 2 hospitalization (caregivers trained for self-care); to associate NAS items related to the promotion of self-care (support and care concerning family members) between the 1 and the 2 hospitalization; to associate the sociodemographic characteristics of children and the self-care agents to nursing workload; to identify and compare the staff dimensioning, according to NAS in the 1 and 2 hospitalization, according to Cofen Resolution n° 293/04. Method: prospective study carried out at Specialized Semi-Intensive Care Unit of the Rehabilitation Hospital of Craniofacial Anomalies, based on the Self-Care Theoretical Framework of Dorothea Orem. The sample consisted of 31 infants with Isolated Robin Sequence and their respective self-care agents. Participants were evaluated on the 1 and 2 hospitalization, regarding the nursing workload. For this evaluation, NAS was applied, whose Tutorial was developed and validated for this study, considering the specificity of the population. Data collection took place from February to October 2014. For the statistical analysis, the Student T-test, the analysis of variance and Pearson correlation were employed. Values for p=0.05 (5%) were accepted as significant difference. Results: a total of 519 assessments, related to nursing workload were generated. The average period of the 1 hospitalization consisted of 10.3 days (±5.7), while the 2 consisted of 6.4 days (±3.4). NAS average in the 1 hospitalization was 60.9% and in the 2 was 41.6%, that is, a total of 93.4 and 63.4 nursing hours, referring to 24 hours, respectively. The nursing workload on the 1 day of hospitalization was higher, when compared to the last day, either on the 1 (p<0.001) as on the 2 hospitalization (p<0.001). Nursing workload was higher on the 1 (p<0.001) and last day (p=0.025) during the 1 hospitalization. Nursing workload in the 1 hospitalization was higher when compared to the 2 hospitalization (p<0.001). NAS items related to self-care training influenced the nursing workload (p<0.001), while the socio-demographic characteristics of children and self-care agents, did not influence. The staff dimensioning according to NAS comprised 26 professionals in the 1 hospitalization and 18 professionals in the 2. As for Cofen Resolution, a total of 60.2 nursing hours were necessary, referring to 24 hours, and comprised 14 professionals, thus, it was evidenced, a deficit of eight professionals when compared to the 2 hospitalization, and 12 professionals, when compared to Cofen Resolution 293/04. Conclusion: nursing workload was higher when promoted self-care and influenced the amount of nursing professionals, demonstrating the necessity for reconsidering the staff dimensioning, regarding this type of service.4 Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil. ABSTRACT Objective: To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. Methods: Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). Results: The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). Conclusion: The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.

Carga de trabajo de enfermería en unidad de cuidados semi-intensivos especializada: criterios para dimensionamiento de personal

OBJECTIVE To assess the nursing workload (NW) in Semi-intensive Therapy Unit, specialized in the care of children with Craniofacial anomalies and associated syndromes; to compare the amount of workforce required according to the Nursing Activities Score (NAS) and the COFEN Resolution 293/04. METHOD Cross-sectional study, whose sample was composed of 72 patients. Nursing workload was assessed through retrospective application of the NAS. RESULTS the NAS mean was 49.5%. Nursing workload for the last day of hospitalization was lower in patients being discharged to home (p<0.001) and higher on the first compared to last day of hospitalization (p< 0.001). The number of professionals required according to NAS was superior to the COFEN Resolution 293/04, being 17 and 14, respectively. CONCLUSION the nursing workload corresponded to approximately 50% of the working time of nursing professional and was influenced by day and outcome of hospitalization. The amount of professionals was greater than that determined by the existing legislation.OBJETIVO Avaliar a carga de trabalho de enfermagem (CTE) em Unidade de Terapia Semi-intensiva, especializada no atendimento de criancas com anomalias craniofaciais e sindromes associadas; comparar o quantitativo de pessoal requerido segundo o Nursing Activities Score (NAS) e a Resolucao COFEN-293/04. METODO Estudo transversal, cuja amostra foi de 72 pacientes. A carga de trabalho de enfermagem foi avaliada por meio da aplicacao retrospectiva do NAS. RESULTADOS A media do NAS foi de 49,5%. A carga de trabalho de enfermagem referente ao ultimo dia de internacao foi menor em pacientes que receberam alta para o domicilio (p<0,001) e maior no primeiro dia de internacao em comparacao ao ultimo (p<0,001). O quantitativo de profissionais requerido segundo o NAS foi superior ao da Resolucao COFEN-293/04, sendo 17 e 14, respectivamente. CONCLUSAO A carga de trabalho de enfermagem correspondeu a aproximadamente 50% do tempo de trabalho do profissional de enfermagem e foi influenciada pelo dia e desfecho da internacao. O quantitativo de profissionais foi superior ao determinado pela legislacao existente.

Dúvidas de cuidadores de crianças com fissura labiopalatina sobre os cuidados pós-operatórios de queiloplastia e palatoplastia

OBJECTIVE To identify the main doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty. METHOD Cross-sectional study carried out in a reference hospital, between September and November 2012. The sample was composed of 50 individuals divided in two groups, of which 25 caregivers of children submitted to cheiloplasty, and 25 of children submitted to palatoplasty. The doubts were identified by an interview applied during the preoperative nursing consultation and were then categorized by similarity. Descriptive statistics was used for analysis of the outcomes. RESULTS Concerning cheiloplasty, the doubts were related to feeding (36%), hygiene and healing (24% each), pain and infection (8% each). With regard to palatoplasty, the doubts were related to feeding (48%), hygiene (24%), pain (16%), bleeding (8%) and infection (4%). CONCLUSION The study evidenced the concern of caregivers in relation to feeding and care of the postoperative wound.Objetivo Identificar as principais duvidas dos cuidadores de criancas com fissura labiopalatina sobre os cuidados pos-operatorios das cirurgias de queiloplastia e palatoplastia. Metodo Estudo transversal realizado em um hospital de referencia, entre os meses de setembro a novembro de 2012. A amostra constou de 50 individuos divididos em dois grupos, sendo 25 cuidadores de criancas submetidas a queiloplastia e 25 criancas submetidas a palatoplastia. As duvidas foram identificadas por meio de entrevista, realizada durante a consulta de Enfermagem pre-operatoria, e, posteriormente, foram categorizadas por similaridade. Utilizou-se a analise estatistica descritiva para construcao dos resultados. Resultados Observou-se que, em relacao a queiloplastia, as duvidas foram sobre alimentacao (36%), higienizacao e cicatrizacao (24% cada), e dor e infeccao (8% cada). Quanto a palatoplastia, as duvidas se relacionaram a: alimentacao (48%), higienizacao (24%), dor (16%), sangramento (8%) e infeccao (4%). Conclusao Evidenciou-se a preocupacao dos cuidadores em relacao a alimentacao e aos cuidados com a ferida pos-operatoria.