Elenice Valentim Carmona

Planejamento da alta hospitalar do paciente diabético: construção de uma proposta

The acute and chronic complications that patients with diabetes and their families have to deal with after hospital discharge may be a consequence of the deficiencies in the educational process across hospitalization and the formal preparation for discharge. The objective of this study is to present a proposal of the plan for hospital discharge of adult patients with diabetes. A literature review on the hospital discharge of the assessed population was performed, including articles published between 2004 and February 2009. Taking the literature into consideration, a flier was created to guide the discharge process. The flier lists the information that should be collected and worked with the patient during the first four days of hospitalization, considering their individual needs and the Ineffective self health management. The discharge must be inserted in the Nursing Process, as nurses have an essential role in identifying the needs of patients and their families. The flier helps to identify the patients needs and the actions to be performed by the team.The acute and chronic complications that patients with diabetes and their families have to deal with after hospital discharge may be a consequence of the deficiencies in the educational process across hospitalization and the formal preparation for discharge. The objective of this study is to present a proposal of the plan for hospital discharge of adult patients with diabetes. A literature review on the hospital discharge of the assessed population was performed, including articles published between 2004 and February 2009. Taking the literature into consideration, a flier was created to guide the discharge process. The flier lists the information that should be collected and worked with the patient during the first four days of hospitalization, considering their individual needs and the Ineffective self health management. The discharge must be inserted in the Nursing Process, as nurses have an essential role in identifying the needs of patients and their families. The flier helps to identify the patients needs and the actions to be performed by the team.

Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o periodo em que consideraram realiza-lo e a idade de introducao de outros liquidos. METODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitario do interior de Sao Paulo, Brasil. Foi realizada analise descritiva dos dados, com cruzamento das variaveis de interesse por meio de teste nao parametrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introducao de outros liquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associacao das seguintes variaveis com a introducao precoce de liquidos: mulheres sem vinculo empregaticio (p=0,0386), mais jovens (p=0,0159) e primiparas (p= 0,003). CONCLUSAO: e possivel que o conceito de aleitamento exclusivo nao seja claro para as mulheres, pois entendem que pratica-lo significa nao dar outro tipo de leite, podendo oferecer outros liquidos. Isto mostra que a promocao do aleitamento materno deve contemplar a abordagem de crencas e valores, assegurando dialogo efetivo e compreensao junto as maes.Objetivo: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparacion con el periodo de duracion de la lactancia considerado por ellas y la edad de los bebes al momento de introduccion de liquidos adicionales. Metodo: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebes en un hospital universitario en Sao Paulo, Brasil. Los datos fueron sometidos a analisis descriptivo; las variables de interes fueron cruzados mediante la prueba no parametrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. Resultados: el 30% de las mujeres reportaron haber introducido liquidos adicionales antes de que los bebes llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introduccion temprana de liquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). Conclusion: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los ninos con otros tipos de leche, pero que la administracion de otros liquidos se permite. Esto demuestra que la promocion de la lactancia materna deberia tomar en consideracion creencias y valores para lograr el dialogo y la comprension efectiva con las madres.Descriptores: Lactancia Materna; Ingestion de Liquidos; Conocimiento; Madres; Nutricion del Lactante; Destete.

Avaliação da autoestima de gestantes com uso da Escala de Autoestima de Rosenberg

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the socio-demographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.

Planning the hospital discharge of patients with diabetes: the construction of a proposal

The acute and chronic complications that patients with diabetes and their families have to deal with after hospital discharge may be a consequence of the deficiencies in the educational process across hospitalization and the formal preparation for discharge. The objective of this study is to present a proposal of the plan for hospital discharge of adult patients with diabetes. A literature review on the hospital discharge of the assessed population was performed, including articles published between 2004 and February 2009. Taking the literature into consideration, a flier was created to guide the discharge process. The flier lists the information that should be collected and worked with the patient during the first four days of hospitalization, considering their individual needs and the Ineffective self health management. The discharge must be inserted in the Nursing Process, as nurses have an essential role in identifying the needs of patients and their families. The flier helps to identify the patients needs and the actions to be performed by the team.The acute and chronic complications that patients with diabetes and their families have to deal with after hospital discharge may be a consequence of the deficiencies in the educational process across hospitalization and the formal preparation for discharge. The objective of this study is to present a proposal of the plan for hospital discharge of adult patients with diabetes. A literature review on the hospital discharge of the assessed population was performed, including articles published between 2004 and February 2009. Taking the literature into consideration, a flier was created to guide the discharge process. The flier lists the information that should be collected and worked with the patient during the first four days of hospitalization, considering their individual needs and the Ineffective self health management. The discharge must be inserted in the Nursing Process, as nurses have an essential role in identifying the needs of patients and their families. The flier helps to identify the patients needs and the actions to be performed by the team.

Prática de aleitamento materno exclusivo informado pela mãe e oferta de líquidos aos seus filhos

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o periodo em que consideraram realiza-lo e a idade de introducao de outros liquidos. METODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitario do interior de Sao Paulo, Brasil. Foi realizada analise descritiva dos dados, com cruzamento das variaveis de interesse por meio de teste nao parametrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introducao de outros liquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associacao das seguintes variaveis com a introducao precoce de liquidos: mulheres sem vinculo empregaticio (p=0,0386), mais jovens (p=0,0159) e primiparas (p= 0,003). CONCLUSAO: e possivel que o conceito de aleitamento exclusivo nao seja claro para as mulheres, pois entendem que pratica-lo significa nao dar outro tipo de leite, podendo oferecer outros liquidos. Isto mostra que a promocao do aleitamento materno deve contemplar a abordagem de crencas e valores, assegurando dialogo efetivo e compreensao junto as maes.Objetivo: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparacion con el periodo de duracion de la lactancia considerado por ellas y la edad de los bebes al momento de introduccion de liquidos adicionales. Metodo: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebes en un hospital universitario en Sao Paulo, Brasil. Los datos fueron sometidos a analisis descriptivo; las variables de interes fueron cruzados mediante la prueba no parametrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. Resultados: el 30% de las mujeres reportaron haber introducido liquidos adicionales antes de que los bebes llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introduccion temprana de liquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). Conclusion: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los ninos con otros tipos de leche, pero que la administracion de otros liquidos se permite. Esto demuestra que la promocion de la lactancia materna deberia tomar en consideracion creencias y valores para lograr el dialogo y la comprension efectiva con las madres.Descriptores: Lactancia Materna; Ingestion de Liquidos; Conocimiento; Madres; Nutricion del Lactante; Destete.

Assessment of self-esteem in pregnant women using Rosenberg's self-esteem scale

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the socio-demographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.

Baby Boy Jones Interactive Case-Based Learning Activity: A Web-Delivered Teaching Strategy.

Faced with limited resources, nurse educators are challenged with transforming nursing education while preparing enough qualified nurses to meet future demand; therefore, innovative approaches to teaching are needed. In this article, we describe the development of an innovative teaching activity. Baby Boy Jones is a Web-delivered, case-based learning activity focused on neonatal infection. It was created using e-learning authoring software and delivered through a learning management system.

Diagnóstico de enfermagem "conflito no desempenho do papel de mãe" em mães de recém-nascidos hospitalizados

Objetivo: Verificar si las madres de los recien nacidos hospitalizados reconocen las caracteristicas definitorias de “conflicto de rol parental” como representativas de esa experiencia. Metodos: Estudio transversal y descriptivo realizado en una unidad neonatal de un hospital de ensenanza publica en el estado de Sao Paulo. La muestra consistio en 100 mujeres que le asignaron puntuaciones de 1 a 5 para las caracteristicas que definen el diagnostico, en la que 1 significa “nada caracteristico” y 5 significa “completamente caracteristico de lo que estoy viviendo”. Resultados: De la muestra total, 96 mujeres se auto-identificaron con el diagnostico. Las caracteristicas mas comunes que definen fueron: “ansiedad”, “ expresa preocupacion por los cambios en el rol parental”, “ expresa sentimientos de frustracion”, “ expresa preocupacion sobre la familia (p. ej., funcionamiento, comunicacion, salud), “ y “temor”. Las mujeres que estaban con sus hijos con menor frecuencia durante la hospitalizacion tenian un mayor numero de caracteristicas definitorias. Conclusion: Se observo una alta prevalencia de las caracteristicas definitorias del diagnostico estudiado, lo que sugiere la relevancia del tema y la necesidad de nuevos estudios que se desarrollaran en la unidad neonatal.

Nursing diagnoses of diabetic patient medical charts: a descriptive study

Aim: identifying taxonomy II nursing diagnoses from the North American Nursing Diagnoses Association International using nursing records associated with outpatient diabetic treatment. Method: a descriptive and retrospective study. Data obtained from 35 patients’ medical charts, using a tool devised by the authors and analyzed using relative and absolute frequencies. Result: from eight diagnoses, three of the following showed up in more than 50% of the samples: Ineffective health maintenance; Imbalanced nutrition - more than body requirements; Sedentary lifestyle. Discussion: The findings show that these three diagnoses relate to a very important and unique issue in treating diabetic patients: the difficulty on the part of patients to adhere to treatment and self-care. Conclusion: The findings show that nursing diagnoses are useful with regard to identifying phenomena that require attention in specific treatment contexts, as well as acting as a guide in terms of the assistance offered.

Factors related to unsuccessful lactogenesis – a literature review

The objective of this literature review was to investigate the factors that may interfere in the production of breast milk (lactogenesis), making difficult the establishment of lactation and having hypogalactia as a result. Since breast milk is widely known as the most natural and important food for newborns, it is necessary for nurses to understand and acknowledge the physiological mechanisms involved in lactation in order to help mothers to achieve a successful breastfeeding. Methodology: Two computerized databases were assessed in search for articles: Literature Latin American and Caribbean Health Sciences and Medical Literature and Retrieval System On Line, both covering a 10 years (1997-2007) period. Considering the objective of the study, 21 articles were selected; other academic text-books were also consulted for supporting the development of contents and concepts on lactation physiology. Results: Factors related to failure and/or delay in lactogenesis were: placental retention; deficiency and /or resistance to prolactine; presence of ovarian cysts; breast’s structural alterations; obesity; primiparity; prolonged labor and delivery; cesarean and hypotension. Conclusion: Lactogenesis is a subject that has not been properly acknowledged by nurses, although being essential for the proper establishment of breastfeeding, which is an important issue in nursing care and research. Relevance to clinical practice: When nurses take care of women who experience difficulties on breastfeeding, it is important to consider factors that may interfere in their lactogenesis; this issue seems to be rarely discussed in nursing literature. Therefore, in order to make women’s breastfeeding experience meaningful, enjoyable and effective, nurses should improve their knowledge to investigate factors related to those difficulties and plan interventions. This review is hoped to contribute in raising some aspects that should be addressed in client’s assessment and taken into consideration on planning nursing care.