Elaine Cristina Rodrigues Gesteira

Estágio de neonatologia na graduação de enfermagem: enfrentamentos e desafios num contexto de mudanças

Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.This work aimed to analyze the situational diagnosis of the Undergraduate Nursing clinical practice in the field of Neonatology in different institutions of higher education in the city of São Paulo, Brazil, in order to identify the challenges with regard to the new educational requirements. The research, with an exploratory design and a qualitative approach, concerned the characterization of the clinical practice in the institutional sphere and its dimensioning from the perspective of students. According to the results, along with the conventional planning, having or not a proper environment for training constitutes a significant difference in its development. The generalist clinical practice, as it is now conceived, coexists with the desire for specialization. Students ask for a closer contact to the high-risk newborn infants. One concludes that theres a need for rethinking these issues within the Undergraduate Nursing course.Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.

Método canguru: benefícios e desafios experienciados por profissionais de saúde

Aim: to know the benefits and challenges experienced by health professionals in relation to the kangaroo care method. Method: exploratory, descriptive and of a qualitative nature study that used the Social Representation Theory, and the Collective Subjects Speech as an analytical method. It was carried out with 22 health professionals from a Neonatal and Pediatric Intensive Care Unit through semi-structured interviews held during the period of November and December 2012. Results: eight speeches of the collective subject emerged, four signaled the benefits of the method to the newborn and to the family, while the others showed the challenges encountered from the experience of the method. Conclusion: adjustments in the physical structure, improvement of human resources and commitment of the managers are key aspects for the consolidation of the method. This study may contribute to health professional insights, including the nursing order to improve their care practices

Assessment of nutritional status in comparison to neuropsychomotor development in children: a descriptive study

Aim: To assess nutritional status by relating it to the neuropsychomotor development of children. Method: This is a descriptive and quantitative study that was developed in an early childhood education center in the north part of the city of Sao Paulo. The sample consisted of 82 children aged one to four years. The data obtained were analyzed descriptively by calculating the absolute and relative frequencies for the quantitative variables. Results: Most children were male (60.9%), and had white skin color (59%). We observed an incidence of approximately 36% of cases of overweight and a relationship with the participants’ psychomotor development, especially in the gross motor area and in terms of balance, where the greatest difficulties were found with regard to such overweight children. Conclusion: The nutritional status affects the neuropsychomotor development in the sample studied. The development of children may be influenced by their nutritional status, and obesity may pose risks in terms of gross motor performance.

Divine clowns and the art of animating elderly: experience report

Objective: report the activities of a university outreach project as a proposal for the humanization of assistance and a tool for academic education in the health field. Method: descriptive study, with an experience report design, conducted by means of observational methods, within the period from April 2011 to March 2012, in a home for the aged in Divinópolis, Minas Gerais, Brazil. Results: the study was approved by the institutions involved and creating the group “Divine Clowns” enabled the making of the “Divine Medical Record”, the preparation of clown actors, and the participation of elderly people in clown activities. Conclusion: in the project reported in this study, the theoretical knowledge about the health of the elderly are put into practice when the student plays the role of a clown, constituting both a proposal for humanization of assistance and a teaching tool in the health field. Descriptors: Home for the Aged; Laugh; Humanization of Assistance; Health of the Elderly. RESUMO Objetivo: relatar as atividades de um projeto de extensão universitária como proposta de humanização da assistência e ferramenta de formação acadêmica na área da saúde. Método: estudo descritivo, do tipo relato de experiência, realizado a partir de métodos observacionais, no período de abril de 2011 a março de 2012, em uma instituição de longa permanência em Divinópolis (MG). Resultados: o estudo obteve aprovação das instituições envolvidas e a criação do grupo “Divinos Palhaços” proporcionou a elaboração do “Divino Prontuário”, a preparação de atores palhaços e a participação de idosos em atividades de clown. Conclusão: no projeto relatado neste estudo, os conhecimentos teóricos sobre a saúde do idoso são postos em prática na atuação do discente como clown, constituindo tanto uma proposta de humanização da assistência como uma ferramenta de ensino na área da saúde. Descritores: Instituição de Longa Permanência para Idosos; Riso; Humanização da Assistência; Saúde do Idoso. RESUMEN Objetivo: relatar las actividades de un proyecto de extensión universitaria como una propuesta para humanización de la atención y una herramienta para la formación académica en el área de la salud. Método: estudio descriptivo, del tipo relato de experiencia, llevado a cabo por medio de métodos de observación, en el período comprendido entre abril de 2011 y marzo de 2012, en un hogar para ancianos en Divinópolis, Minas Gerais, Brasil. Resultados: el estudio fue aprobado por las instituciones involucradas y la creación del grupo “Payasos Divinos” proporcionó la elaboración del “Divino Prontuario”, la preparación de payasos actores y la participación de ancianos en actividades de clown. Conclusión: en el proyecto relatado en este estudio, los conocimientos teóricos acerca de la salud del anciano se ponen en práctica durante la actuación del discente como clown, lo que constituye tanto una propuesta de humanización de la atención como una herramienta de enseñanza en el área de la salud. Descriptores: Hogar de Ancianos; Risa; Humanización de la Atención; Salud del Anciano. Nurse. MS in Health Sciences. Ph.D Nursing student at the University of São Paulo (USP). Professor at the Federal University of São João del-Rei (UFSJ). Divinópolis (MG), Brazil. Email: ecr.gesteira@hotmail.com; Nurse. Post-Ph.D Nursing student at USP. Professor at UFSJ. Divinópolis (MG), Brazil. Email: juliana@pessalacia.com.br; Nurse. MS in Nursing. Ph.D Nursing student at the Federal University of Minas Gerais (UFMG). Professor at UFSJ. Divinópolis (MG), Brazil. Email: tati_prette@yahoo.com.br; Undergraduate student in Medicine at UFSJ. Divinópolis (MG), Brazil. Email: wrgelles@gmail.com CASE REPORT ARTICLE Gesteira ER, Pessalacia JDR, Kuznier TP et al. Divine clowns and the art of animating... English/Portuguese J Nurs UFPE on line., Recife, 8(Suppl. 3):4159-64, Nov., 2014 4160 ISSN: 1981-8963 DOI: 10.5205/reuol.5353-44734-1-RV.0811supl201416 In developing countries, where poverty and social inequality coexist, population aging has posed a great challenge by requiring more attention from public health mainly with regard to the allocation of resources. As this scenario takes place, our country has shown an accelerated demographic transition process, with an increased elderly population that, as a consequence, will boost the demand for homes for the aged (HAs). The HA is regarded as a social and organizational system whose purpose is embracing elderly people devoid of financial resources, with no family group, or even in a situation of family abandonment. A part of the Brazilian population may, at some point in its life, live and/or need the care provided by these institutions. In addition to these assignments, it is worth highlighting that the HA must provide the elderly person with a comprehensive living, with a daily life of his own, as well as her/his senses, her/his intellectual capabilities, her/his feelings, and her/his ideologies. According to the Elderly Health Program and the Brazilian Elderly Statute, we must seek innovative proposals regarding elderly health, encouraging their citizenship, identity, autonomy, and well-being, that can be achieved through projects and/or programs that encourage hours of entertainment, including activities aimed at this audience. Thus, the activities aimed at the elderly should include activities that encourage them to a more active and creative life, covering humanization aspects that favor the elderly communication, socialization, and autonomy. It is worth stressing that humanize includes the act of listening to the other, identifying themselves as human beings. In line with this thinking, a physician, founder and director of the Gesundheit Institute, who works as a clown for over thirty years, claims that joy, laugh, and kindness help people maintaining or improving their health, because there is encouragement for life. By means of this view, there emerged the university outreach project “Divine Clowns and the art of animating elderly people” by a federal public university in Divinópolis, Minas Gerais, Brazil, where students from the courses of Medicine, Nursing, and Pharmacy, along with professors from the Nursing course, this project for humanization in the institutionalized environment of the elderly. Thus, this experience report aims to introduce the activities conducted in this outreach project, as an innovative proposal in the elderly health area and as an academic education tool. Descriptive study, with an experience report, on the activities conducted in an outreach project, as an innovative proposal in the elderly health area and as an academic education tool. The activities were introduced through descriptive and observational methods. The experience report is regarded as a tool for descriptive research, which aims to present a reflection on an action or set of actions related to a practice experienced in the professional or educational context and having interest on the part of the scientific community. The activities that resulted in the writing of this report occurred within the period from April 2011 to March 2012 in a HA in Divinópolis. There was no need to submit it to an Ethics Committee on Research involving Human Beings, because it reports an experience of authors themselves. However, confidentiality and anonymity were guaranteed for the subjects participating in the project and the institution where the activities took place. The outreach project “Divine Clowns and the art of animating elderly people” started through the expression of interest from a group of students of Medicine in engaging in clown activities (clown’s art) along with hospitalized people. Initially, the proposal was focused on animation for hospitalized children and adults, however, during group meetings, a need for working along with HAs in Divinópolis was found out. Thus, students’ interest in clown activities enabled the construction of this project, something which reinforces the importance of university outreach in academic education, by providing students with the opportunity to freely think and learn the interaction with other services beyond the curriculum, favoring an autonomous learning that consolidates knowledge. The practice of animation poses a challenge and a new working perspective in the Brazilian public and private institutions. In Brazil, such experiences are scattered throughout the territory and they have a huge potential towards humanization. However, RESULTS AND DISCUSSION METHOD INTRODUCTION Gesteira ER, Pessalacia JDR, Kuznier TP et al. Divine clowns and the art of animating... English/Portuguese J Nurs UFPE on line., Recife, 8(Suppl. 3):4159-64, Nov., 2014 4161 ISSN: 1981-8963 DOI: 10.5205/reuol.5353-44734-1-RV.0811supl201416 such experiences are often conducted with the hospitalized population, there are few reports of projects involving animation for institutionalized elderly people. The need for humanizing the relations and care provided for the elderly living in a HA confirms the importance of an activity that aims to bring joy to the elderly, dealing in a playful way with her/his routine and the procedures to which they are exposed. Scholars from a university in Ontario, Canada, highlight that clown interventions along with the elderly population are relatively new, but recent researches have suggested that some elderly people who use humor as a way to deal with the challenges of aging may be more likely to live longer, age well, and be more satisfied with their physical health, enjoying better quality of life. The purpose of this project was inspired by the history of Hunter Adams, a physician who, in the 1960s, proposed a bond between doctor and patient not focused on disease, providing “medical care” in a playful way, through clown characters. The project had the support from the university campus principal’s office, the Dean’s Office for University Outreach, and a theater group responsible for training the group, wh

Clinical practice in neonatology during undergraduate nursing course: coping and challenges in a context of changes

Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.This work aimed to analyze the situational diagnosis of the Undergraduate Nursing clinical practice in the field of Neonatology in different institutions of higher education in the city of São Paulo, Brazil, in order to identify the challenges with regard to the new educational requirements. The research, with an exploratory design and a qualitative approach, concerned the characterization of the clinical practice in the institutional sphere and its dimensioning from the perspective of students. According to the results, along with the conventional planning, having or not a proper environment for training constitutes a significant difference in its development. The generalist clinical practice, as it is now conceived, coexists with the desire for specialization. Students ask for a closer contact to the high-risk newborn infants. One concludes that theres a need for rethinking these issues within the Undergraduate Nursing course.Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.

Práctica clínica en neonatología en la graduación de enfermería: enfrentamientos y desafíos en un contexto de cambios

Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.This work aimed to analyze the situational diagnosis of the Undergraduate Nursing clinical practice in the field of Neonatology in different institutions of higher education in the city of São Paulo, Brazil, in order to identify the challenges with regard to the new educational requirements. The research, with an exploratory design and a qualitative approach, concerned the characterization of the clinical practice in the institutional sphere and its dimensioning from the perspective of students. According to the results, along with the conventional planning, having or not a proper environment for training constitutes a significant difference in its development. The generalist clinical practice, as it is now conceived, coexists with the desire for specialization. Students ask for a closer contact to the high-risk newborn infants. One concludes that theres a need for rethinking these issues within the Undergraduate Nursing course.Este trabajo objetivo analizar el diagnostico situacional de la practica clinica de Enfermeria en el area de Neonatologia en diferentes instituciones de ensenanza superior en la ciudad de Sao Paulo, Brasil, a fin de identificar los desafios con relacion a las nuevas exigencias educacionales. La investigacion, de naturaleza exploratoria y con abordaje cualitativo, envolvio la caracterizacion de la practica clinica en el plano institucional y su dimensionamiento en la perspectiva de los alumnos. Como apuntan los resultados, junto con la programacion convencional, tener o no campo propio para la practica constituyo diferencial significativo en su desarrollo. La formacion generalista, en la manera como es concebida, coexiste con la aspiracion por la especializacion. Los alumnos reivindican una mayor aproximacion a los recien nacidos de alto riesgo. Se concluye que hay necesidad de repensar esas cuestiones en el ambito de la Graduacion en Enfermeria.

Neonate pain assessment and non-pharmacological methods of pain relief utilized by nurses in a Neonatal ICU

ABSTRACT Objective : to identify how nurses in a Neonatal Intensive Care Unit (NICU) recognize the signs of pain in neonates and the nonpharmacological methods utilized in their nursing practice. Method : this is about an exploratory and descriptive study from quantitative approach. After approval by the Research Ethics Board (protocol no. 011009), questionnaires were applied to twelve nurses in the NICU of a Hospital in Sao Paulo from September to October 2009, and subsequently the data collected were quantitatively analyzed. Results : all the nurses use the NIPS pain scale (an assessment scale of neonate behavioral responses to pain) and assess some signs of response to pain by means of observation of vital signs, crying and facial expression. As regards nonpharmacological methods, 12 (34.3%) of the nurses use the nonnutritive sucking method and 11 (32.4%) use sucrose. Conclusion : it was possible to identify that nurses use the NIPS for pain assessment, signaling the need to get to know other pain assessment methods and to validate them for use in our nursing practice. With relation to nonpharmacological methods, nurses utilize different interventions to relieve and prevent neonate pain. Descriptors : newborn; pain; pediatric nursing. RESUMO Objetivo : identificar como os enfermeiros de uma Unidade de Terapia Intensiva Neonatal (UTIN) reconhecem os sinais da dor no recem-nascido e os metodos nao farmacologicos utilizados em suas praticas profissionais. Metodo : estudo exploratorio, descritivo, com abordagem quantitativa. Apos a aprovacao pelo Comite de Etica em Pesquisa (numero do protocolo 011009), foram aplicados questionarios junto aos doze enfermeiros que atuam na UTIN de um Hospital em Sao Paulo nos meses de setembro e outubro de 2009. Em seguida, os dados foram analisados quantitativamente. Resultados : todos os enfermeiros utilizam a escala de avaliacao da dor tipo NIPS (Escala comportamental de dor para recem-nascidos) e avaliam alguns sinais de reacao dolorosa por meio da observacao de sinais vitais, do choro e da expressao facial. No quesito metodos nao farmacologicos 12 (34,3%) dos enfermeiros aplicam o metodo da succao nao-nutritiva e 11 (32,4%) o uso da sacarose. Conclusao : foi possivel identificar que os enfermeiros utilizam a escala de avaliacao tipo NIPS, o que sinaliza a necessidade de conhecer outros metodos de avaliacao e valida-los em nossa pratica profissional. Em relacao aos metodos nao farmacologicos, os enfermeiros utilizam diferentes intervencoes no alivio e na prevencao da dor neonatal. Descritores : recem-nascido; dor; enfermagem pediatrica. RESUMEN Objetivo : identificar como los enfermeros de una Unidad de Cuidados Intensivos Neonatal (UCIN) reconocen las senales del dolor en el recien nacido y los metodos no farmacologicos utilizados en sus practicas de Enfermeria. Metodo : estudio exploratorio, descriptivo, con abordaje cuantitativo. Despues de aprobacion por el Comite de Etica de Pesquisa (protocolo numero 011009), se aplicaron cuestionarios a 12 enfermeros que actuan en la UCIN de un Hospital en Sao Paulo, de septiembre y octubre de 2009 y, en seguida, los datos recogidos fueron analizados cuantitativamente. Resultados : todos los enfermeros utilizan la escala de dolor NIPS (escala de evaluacion del comportamiento de los recien nacidos ante el dolor) y evaluan algunas senales de respuesta al dolor por medio de la observacion de los senales vitales, del llanto y de la expresion facial. Al respecto de los metodos no farmacologicos, 12 (34,3%) de los enfermeros utilizan el metodo de la succion no nutritiva y 11 (32,4%), el de la sacarosa. Conclusion : es posible identificar que los enfermeros utilizan la escala NIPS, apuntandose la necesidad de conocer otros metodos de evaluacion y de validarlos para uso en la practica de enfermeria. Relativo a los metodos no farmacologicos, los enfermeros realizan diversas intervenciones para el alivio y la prevencion del dolor neonatal. Descriptores : recien nacido; dolor; enfermeria pediatrica.