Edinêis de Brito Guirardello

Adaptación cultural de instrumentos utilizados en salud ocupacional

Se han creado numerosos instrumentos estandarizados para evaluar el estado de salud y la eficacia de los tratamientos. Sin embargo, la mayoria de ellos han sido desarrollados y validados en la lengua inglesa. En la literatura se recomienda la utilizacion de escalas y cuestionarios estandarizados cuyos resultados puedan ser comparados internacionalmente. Las diferencias culturales no permiten hacer una simple traduccion de estos instrumentos. En este articulo se resumen normas sistematizadas para la adaptacion cultural de instrumentos utilizados en salud ocupacional, derivadas de investigaciones especializadas.

Professional nursing practice: environment and emotional exhaustion among intensive care nurses

OBJECTIVE to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.OBJETIVO: avaliar as caracteristicas do ambiente da pratica profissional dos enfermeiros e sua relacao com o Burnout, percepcao da qualidade do cuidado, satisfacao no trabalho e a intencao de deixar o emprego nos proximos doze meses. METODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma regiao do interior do Estado de Sao Paulo, Brasil. RESULTADOS: a modelagem de equacoes estruturais, por meio da analise de caminhos, mostrou que as caracteristicas do ambiente da pratica influenciam na satisfacao no trabalho, percepcao da qualidade do cuidado e na intencao de deixar o emprego, quando mediadas pelo sentimento de exaustao emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relacoes com o medico, apresenta maior nivel de exaustao emocional, o que pode influenciar negativamente na sua percepcao da qualidade do cuidado, satisfacao com o trabalho e na intencao de deixar o emprego. CONCLUSAO: a posicao mediadora da exaustao emocional pode influenciar negativamente nos resultados da assistencia, havendo, portanto, a necessidade de adocao de estrategias que minimizem esse sentimento no enfermeiro.

Satisfação do paciente com os cuidados de enfermagem: comparação entre dois hospitais

This is a descriptive study with the objective of measuring and comparing patient satisfaction with the care provided by nurses as well as verifying differences in the satisfaction level in relation to the studys variables in two Sao Paulo hospitals. For data collection was used the Patient Satisfaction Instrument, translated and validated in Brazil. The sample was comprised of 211 patients, of which 128 from Hospital A and 83 from Hospital B. The statistical program SAS was used in the data analysis. The results showed that all patients reported a high level of satisfaction, and the five situations with highest averages were related to the domains Confidence and Professional. However, Hospital A patients showed higher satisfaction level than those of Hospital B. Considering the age variable, only the patients below the age of 60 in Hospital B tend to be more satisfied than the others.This is a descriptive study with the objective of measuring and comparing patient satisfaction with the care provided by nurses as well as verifying differences in the satisfaction level in relation to the studys variables in two São Paulo hospitals. For data collection was used the Patient Satisfaction Instrument, translated and validated in Brazil. The sample was comprised of 211 patients, of which 128 from Hospital A and 83 from Hospital B. The statistical program SAS was used in the data analysis. The results showed that all patients reported a high level of satisfaction, and the five situations with highest averages were related to the domains Confidence and Professional. However, Hospital A patients showed higher satisfaction level than those of Hospital B. Considering the age variable, only the patients below the age of 60 in Hospital B tend to be more satisfied than the others.

Validação da escala de razão das necessidades de familiares em unidade de terapia intensiva

A hospitalizacao, por motivo de doenca grave e inesperada, pode acarretar um desequilibrio na estrutura familiar. A familia exerce um papel importante na recuperacao do paciente e, muitas vezes, suas necessidades sao desconhecidas pelo enfermeiro, e pouca enfase e dada por ele ao atendimento das pessoas. Este estudo teve por objetivo validar, em nivel de razao, a escala de necessidades de familiares em Unidade de Terapia Intensiva (UTI). Participaram do estudo 52 familiares que visitaram o seu parente durante a hospitalizacao na UTI. Utilizaram os metodos psicofisicos de estimacao de magnitude e emparelhamento de comprimento de linhas, com calculo da media geometrica para cada uma das necessidades julgadas, em ambos os metodos. Os resultados mostraram uma concordância significativa, entre os participantes, no julgamento das necessidades, com um coeficiente de correlacao de Pearson de r=0,97 (p<0,0001). A relacao entre esses metodos pode ser descrita por uma funcao de potencia, confirmando que a escala de necessidades de familiares e valida, estavel e consistente.The hospitalization of a close relative due to unexpected critical illness may trigger an unbalance in the patients family structure. The family plays an important role in the patients recovery and, often, its needs are unknown by nurses and little emphasis is given to attention to the familys needs. This study aimed to validate a ratio-level scale of family needs at an intensive care unit (ICU). The sample consisted of 52 family members who visited their relatives during ICU hospitalization. Psychophysical methods of magnitude estimation (ME) and cross modality matching (line length) were used, calculating the geometric mean of each need by both methods. The results showed a high agreement on needs among the participants, with a Pearson coefficient of r= 0.97 (p<0.0001). The relationship between these methods can be described as a power function, confirming that this scale of family needs is valid, stable and consistent.

Nursing workload at a gastroenterology unit

One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.

A percepção do paciente sobre sua permanência na unidade de terapia intensiva

Este estudo procura identificar a percepcao do paciente sobre sua permanencia na UTI. A amostra constituiu-se de10 pacientes, submetidos a cirurgia cardiaca e que receberam intervencao psicologica somente apos a alta da UTI. Para a coleta e analise dos dados, utilizou-se uma abordagem qualitativa (analise de conteudo). Os resultados sugerem que o paciente possue uma visao esteriotipada da UTI, vinculada a ideia de sofrimento e morte; o enfermeiro ocupa um importante papel nos momentos de fragilidade, dependencia fisica e emocional; a dor, por seu carater subjetivo, individual e emocional, e inevitavel por estar relacionada aos procedimentos e, muitas vezes, associada ao sofrimento fisico.

Carga de trabalho de enfermagem em Unidade de Terapia Intensiva de um hospital de ensino

Objective: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. Methods: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. Results: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. Conclusion: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Evaluar la carga de trabajo de enfermeria en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. METODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 dias en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuacion del NAS fue de 62,2%. CONCLUSION: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermeria en la UCI, ya que contempla diversas actividades de enfermeria realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicacion sea parte del cotidiano del enfermero.

Nursing workload in an intensive care unit of a teaching hospital

Objective: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. Methods: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. Results: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. Conclusion: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Evaluar la carga de trabajo de enfermeria en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. METODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 dias en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuacion del NAS fue de 62,2%. CONCLUSION: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermeria en la UCI, ya que contempla diversas actividades de enfermeria realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicacion sea parte del cotidiano del enfermero.

Adaptação cultural e validação do instrumento demandas de atenção dirigida

Este estudo tem como objetivos traduzir e validar o instrumento Requirement for Directed Attention (RDA), desenvolvido por Guirardello, para a cultura brasileira. E um instrumento composto de 39 itens que aborda situacoes no ambiente de trabalho de unidades de cuidados criticos e medico-cirurgica que demandam atencao dirigida do enfermeiro. O procedimento metodologico constituiu nas etapas de: a) traducao do instrumento para a lingua portuguesa; b) back-translation; c) avaliacao por um grupo de juizes e d) pre-teste da versao final do instrumento. O instrumento na versao em Portugues foi aplicado a um grupo de 44 enfermeiros. Os dados resultaram em alta consistencia interna para o total dos itens (a = 0,91) e para os dominios: Ambiente Fisico (a = 0,78), Psicologico (a = 0,85) e Comportamental (a = 0,80). Apenas o dominio Informacao obteve um a de 0,12. Esses resultados sugerem que a versao em Portugues do RDA pode ser usada para avaliar as demandas de atencao do enfermeiro.The aim of this study is to translate and validate the instrument Requirement for Directed Attention (RDA), developed by Guirardello, into Brazilian culture. The instrument, comprised of 39 items, addresses situations in the work environment of critical care and medical-surgical units that demand the nurses direct attention. The methodological approach consists of the following steps: (a) translation of the instrument to the Portuguese language; (b) back-translation; (c) committee review; and (d) pre-testing of the instruments final version. The Portuguese language version was applied to 44 nurses. The data resulted in high internal consistency for the total of the items (alpha = 0.91), and for the domains: Physical Environment (alpha = 0.78), Psychological Envi-ronment (alpha = 0.85) and the Behavioral Environment (alpha = 0.80). Only the domain Information had a low value (a = 0.12). These results suggest that the Portuguese language version of the RDA can be used to evaluate the attention demands for the nurse.

Sistema de Classificação de Pacientes Pediátricos: construção e validação de categorias de cuidados

Patient classification is essential for managing a hospital unit. Literature, however, does not present conceptualizations of pediatric patient categories. The objectives of this study were to define and validate pediatric patient care categories, according to the level of dependency of the nursing team. The care categories were defined based on a literature review, and the content of the proposed categories was validated by a group of judges involved in managing and providing care in a pediatric unit, and by judges involved in pediatric education and research as well as in the construction of patient instruments. Five care categories were established and validated: Minimal, Intermediate, High dependency, Semi-intensive and Intensive. The validation of the care categories were the basis for constructing a system for the classification of pediatric patients, that may contribute with the decision making process of nurses working in management and health care.Patient classification is essential for managing a hospital unit. Literature, however, does not present conceptualizations of pediatric patient categories. The objectives of this study were to define and validate pediatric patient care categories, according to the level of dependency of the nursing team. The care categories were defined based on a literature review, and the content of the proposed categories was validated by a group of judges involved in managing and providing care in a pediatric unit, and by judges involved in pediatric education and research as well as in the construction of patient instruments. Five care categories were established and validated: Minimal, Intermediate, High dependency, Semi-intensive and Intensive. The validation of the care categories were the basis for constructing a system for the classification of pediatric patients, that may contribute with the decision making process of nurses working in management and health care.