Glenda Agra

Percepção dos enfermeiros sobre o significado dos cuidados paliativos em pacientes com câncer terminal

This study sought to assess the perception of nurses with respect to cancer patients under palliative care. It is an exploratory study with a qualitative approach conducted with nurses from a hospital attending cancer patients under palliative care located in the city of Joao Pessoa, State of Paraiba. The study included nine nurses who worked in the hospital. The empirical material was collected using the technique of semi-structured interviews and analyzed using the content analysis technique. The interpretative analysis of the interviews led to the definition of three categories: Improving the quality of life through the alleviation of pain and suffering; Palliative Care: a multi-professional study of terminal patients and their families in the grieving process; Communication: a source of dignity in the terminal care process. The conclusion reached is that the study revealed that the nurses involved acknowledge the importance of the multidisciplinary team. It enables the nurses to reflect on the use of communication as an essential element of care for patient and family under palliative care. It is hoped that the data obtained may foster further research on the topic.

Perfil diagnóstico de enfermagem de pacientes hospitalizados em unidade de infectologia

OBJECTIVE To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit. METHODS This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPER version 2.0 to construct the diagnoses. RESULTS Data analysis resulted in 36 nursing diagnoses statements, with a higher prevalence of impaired food intake, cachexia, impaired spontaneous bladder elimination, impaired oral cavity hygiene, exposure to contamination, rapid heart rate, insomnia, drug abuse, alcohol and tobacco abuse, social isolation, acceptance and fear. CONCLUSIONS The identification of a diagnostics profile is critical to guide nursing interventions.

Characterization of People with Diabetes Mellitus Assisted in an Outpatient Follow-up Clinic

Objective: To characterize the profile of people with diabetes, according to sociodemographic, clinical and laboratory variables. Method: Cross-sectional study with a quantitative approach, conducted with 110 people with diabetes mellitus treated at outpatient follow-up of a teaching hospital in Joao Pessoa - PB, Brazil, during February-June 2015. To collect data, we used a form contemplating sociodemographic, clinical and laboratory variables. For the analysis, we used descriptive statistics often measures for categorical variables, mean and standard deviation for numeric variables. Results: The study revealed that the socio-demographic, clinical and laboratory characteristics increase the risk of morbidity and mortality for people studied, as well as being impediments to the realization of self-care. Conclusion: The importance of achieving education for self-care was evident, for many of these identified factors can be modified when the person with diabetes has knowledge about their health-disease process, promoting positive attitudes in their care.

Parents experiences of children with diabetes mellitus

Objective: to investigate experiences for parents of children with diabetes mellitus. Method: exploratory, descriptive study, with a qualitative approach, carried out in the municipalities of Alagoinha and Guarabira/PB, in March 2013, with the participation of 20 parents of children with diabetes mellitus, from semi-structured interviews. The data were analyzed using thematic analysis technique. Results: from the speeches of the participants the categories for analysis emerged: << Feelings of sadness, worry and helplessness before the diagnosis >>; << Change routines and daily habits >>; << Watch the child before the treatment >>; << Fear of the consequences of the disease >>; << >> Suffering; << The child self-care and difficulties in support area >>. Conclusion: attention to parents by health professionals is essential for diagnosis and the following treatment so that they feel more secure and able to care for a child with diabetes mellitus. Descriptors: Children; Chronic Disease; Parents. RESUMO Objetivo: investigar experiências por pais de crianças com diabetes mellitus. Método: estudo exploratório, descritivo, com abordagem qualitativa, realizado nos municípios Alagoinha e Guarabira/PB, no mês de março de 2013, com a participação de 20 pais de crianças com diabetes mellitus, a partir de entrevistas semiestruturadas. Os dados foram analisados pela Técnica de Análise Temática. Resultados: a partir dos discursos dos participantes, emergiram as categorias para análise: << Sentimentos de tristeza, preocupação e impotência perante o diagnóstico >>; << Mudança de rotinas e hábitos cotidianos >>; << Cuidado com a criança diante do tratamento >>; << Medo das consequências decorrentes da doença >>; << Sofrimento >>; << Autocuidado do filho e dificuldades na rede de apoio >>. Conclusão: a atenção aos pais pelos profissionais de saúde é essencial no momento do diagnóstico e no seguimento do tratamento para que estes se sintam mais seguros e capazes de cuidar de uma criança com diabetes mellitus. Descritores: Crianças; Doença Crônica; Pais. RESUMEN Objetivo: investigar experiencias por padres de niños con diabetes mellitus. Método: estudio exploratorio, descriptivo, con enfoque cualitativo, realizado en los municipios Alagoinha y Guarabira/PB, en el mes de marzo de 2013, con la participación de 20 padres de niños con diabetes mellitus, a partir de entrevistas semiestructuradas. Los datos fueron analizados por la Técnica de Análisis Temático. Resultados: a partir de los discursos de los participantes, surgieron las categorías para análisis: << Sentimientos de tristeza, preocupación e impotencia frente al diagnóstico >>; << Cambios de rutinas y hábitos cotidianos >>; << Cuidado com el niño frente al tratamiento >>; << Miedo de las consecuencias decurrentes de la enfermedad >>; << Sufrimiento >>; << Autocuidado del hijo y dificultades en la red de apoyo >>. Conclusión: la atención a los padres por los profesionales de salud es esencial en el momento del diagnóstico y en el seguimiento del tratamiento para que estos se sientan más seguros y capaces de cuidar de un niño con diabetes mellitus. Descritores: Niños; Enfermedad Crónica; Padres. Nurse, Professor Bachelor in Nursing, Federal University of Campina Grande/UFCG Campus Cuité/PB. Ph.D. student, Graduate Nursing Program, Federal University of Paraíba/PPGENF/UFPB. João Pessoa (PB), Brazil. E-mail: g.agra@yahoo.com.br; Nurse graduated from Federal University of Campina Grande, specialist in Urgency and Emergency Care from the CBPEX. Currently, nurse at SAMU (PicuíPB). Guarabira (PB), Brazil. E-mail: danyellysm@hotmail.com; Nurse. Professor, Bachelor of Nursing course /UFCG/PB. Ph.D. student, Graduate Program in Nursing, Federal University of Paraíba/PPGENF/UFPB. João Pessoa (PB), Brazil. E-mail: nathaniellycristina@gmail.com; Nurse, Master Professor, Health Technical School of Cajazeiras ETSC/UFCG, Ph.D. student, Associated Program of Graduate in Nursing UPE/UEPB. João Pessoa (PB), Brazil. E-mail: cecilia.dbo@gmail.com; Nurse, Ph.D. Professor in Nursing, Lauro Wanderley University Hospital/HULW/UFPB/PB, Federal University of Paraíba/PPGENF/UFPB. João Pessoa (PB), Brazil. E-mail: elimoreirafreire@gmail.com; Nurse, Ph.D. Professor in Nursing, Graduate Nursing Course, Federal University of Paraíba/PPGENF/UFPB. João Pessoa (PB), Brazil. E-mail: marthamiryam@hotmail.com ORIGINAL ARTICLE Agra G, Meneses DS, Santos NC et al. Parents experiences of children with... English/Portuguese J Nurs UFPE on line., Recife, 10(6):2066-74, June., 2016 2067 ISSN: 1981-8963 DOI: 10.5205/reuol.9199-80250-1-SM1006201620 Diabetes Mellitus (DM) is a metabolic disorder of multiple etiology associated with absolute or relative deficiency of insulin, whose symptomatology is characterized by metabolic and vascular and neuropathic complications. Being considered a chronic disease, it requires a continuous treatment of the people affected, resulting most often in physical, psychological and social distress linked to the limitations and changes in various spheres of life of the patient and his family. DM1 or children-young diabetes is a metabolic disorder syndrome caused by lack of insulin secretion due to damage in the beta cells of the pancreas or disorders that impair insulin production, characterized by chronic hyperglycemia with carbohydrate metabolism disorders, lipid, and proteins. Its incidence mainly affects children and adolescents. In the face of hyperglycemia, the patient may experience manifestations of the symptomatic triad, as polyuria, polydipsia, and polyphagia, and sudden weight loss, nausea, vomiting or abdominal pain. When the patient does not follow the recommended treatment, he may develop complications, such as neuropathy, nephropathy, among others. According to the International Diabetes Federation in recent decades, the number of people affected is growing every year in almost all age groups. Estimates for 2012 pointed to over 370 million people with diabetes worldwide; 4.8 million people are undiagnosed, and over

A vivência dos cuidados paliativos de um discente de enfermagem a um ente familiar: relato de experiência doi: http://dx.doi.org/10.5892/ruvrv.2013.111.2098305

471 million was spent on health care for diabetes. Brazil is the fifth country with the highest absolute number of diabetics in the world, with prospects of remaining in the same position until 2030. Study conducted by the Ministry of Health in collaboration with the Brazilian Society of Diabetes found that in 2012, there were in Brazil over 12 million diabetics and the incidence of type 1 DM, for the same year was in the order of one to two cases per thousand young people. With regard to the incidence of the disease in children, Eurodiab Collaborative Group published in 2008, a survey of 16,362 cases of DM at this stage and noted a 6.3% rate in children under four years of age; 3.1% for those between five and nine years and 2.4% for those between ten fourteen years. In children and adolescents, DM1 has grown 3% per year worldwide, rising to 5% among children in preschool. It is estimated that about 70,000 young people under 15 develop the disease. The Brazilian estimate provided for 2030 is that, on average, 200 young people have been diagnosed with diabetes per day. Childhood being a stage of physical, psychological and social requires special attention, since it is observed the development and infant growth, and when it presents a diagnosis of a chronic degenerative disease such as DM1, parents are almost always responsible for the care to be performed, as well as observation of clinical symptoms and/or complications arising from the clinical course of the disease. Parents of children with chronic diseases often feel powerless in the living process on limitations and suffer the new situation, changes in lifestyle and the demand for specific care that the treatment of the disease requires. Faced with these difficulties by parents and children, health professionals should reflect on their responsibility to the process of their adaptation to the disease, continually seeking strategies to provide them develop skills and knowledge, important tools for motivation to treatment adherence of the son and family reorganization. In this sense, it is essential psychological support for both the child and for the parents, because the impact of the diagnosis of a chronic disease, such as DM, hinders the acceptance of the health-disease process, and this creates family strength on the break of paradigms, especially nutritional treatment which must be performed successfully for the control of endocrine disorder. 5 In this perspective, knowing the expectations, perceptions and experiences of parents of children with diabetes, it is extremely important for health professionals, especially those working in primary care, serving as grants to improve the quality of care for these people to help them to recognize and understand the behavior of their children; encourage them to participate in care to promote and facilitate the interaction of the child who has diabetes with their family, strengthening family ties. ● To investigate experiences for parents of children with diabetes mellitus. ● To describe the care that they provide to these children. Considering the study involves the pursuit of elements of the context of the experiences of parents of children with diabetes mellitus, the qualitative approach shows relevant to the scope of the proposed objective. INTRODUCTION

Constipação em pacientes com doençaoncológica avançada em uso de opioides

Objetivo: Relatar a vivencia dos cuidados paliativos a um familiar. Metodologia: Trata-se de um estudo descritivo do tipo relato de experiencia, das vivencias de um discente de Enfermagem no processo de terminalidade de um familiar. Resultados: A experiencia se deu com uma paciente de 83 anos, com diagnostico de câncer de colo uterino e metastase intestinal, que evoluiu com ulcera por pressao em regiao sacral (Categoria IV), alopecia, edema em membros superiores e inferiores. Os cuidados de enfermagem diarios se iniciavam com o banho no leito, seguido das trocas de curativos e do banho de sol. A longa permanencia a restricao ao leito, geravam a necessidade de cuidados especiais com a protecao da pele e mucosas, suporte nutricional e administracao de medicacoes sintomaticas, antibioticos e quimioterapicos. Apesar de todo o aparato tecnologico necessario ao tratamento, percebeu-se que o acompanhamento e o cuidar de um membro da familia enquanto estudante do curso de Graduacao em Enfermagem proporcionou maior conforto e acolhimento a paciente por se sentir amada em um momento tao importante e inevitavel do nosso ciclo vital, a morte. A aceitacao dessa etapa da vida minimiza o sofrimento de pacientes, familiares e profissionais de saude. Conclusao: os cuidados paliativos a paciente desse estudo proporcionaram vivencias inesqueciveis para o cuidador e o ser cuidado, pois, contribuiram para uma melhor qualidade de vida e um entendimento dos familiares diante da situacao por eles vividos, colaborando para um amparo mais solidificado diante da perda esperada.

Vivência de mães na unidade de terapia intensiva neonatal

A constipacao e um disturbio muito comum em pacientes oncologicos com doenca avancada, podendo causar dor, distensaoabdominal, nauseas e vomitos. O presente estudo teve como objetivo identificar evidencias disponiveis na literatura sobre asacoes de cuidados paliativos para o paciente oncologico, em uso de opioides com constipacao intestinal, considerando-seque sao as acoes decorrentes das necessidades de cuidado que podem contribuir para o controle desse sintoma. A presenteinvestigacao trata-se de uma revisao integrativa da literatura e, para selecionar as publicacoes cientificas, foram acessadas asbases de dados da Biblioteca Virtual de Saude, especificamente LILACS e SciELO. Os criterios de inclusao adotados foram:artigos que retratassem cuidados paliativos ao paciente com constipacao intestinal decorrente do uso de opioides; que estivessemindexados nas bases de dados supracitadas; que fossem publicados na lingua portuguesa, no periodo de 2002 a 2012e cujos resumos e textos estivessem disponiveis online, na integra. Foram excluidos os artigos com acesso restrito. Ao finalda busca, encontraram-se 20 referencias, contudo somente sete se enquadravam nos criterios de inclusao desse estudo. Osartigos inseridos nesta pesquisa ressaltaram que a constipacao e um sintoma bastante comum em pacientes oncologicos comdoenca avancada em uso de opioides. Essa revisao mostrou que a adequada avaliacao, o tratamento nutricional, o uso racionalde medicamentos laxativos e antagonistas de opioides, assim como novos recursos dietoterapicos, como o uso do fungoAgaricus sylvaticus, podem promover o adequado controle desse sintoma, evitando complicacoes e procedimentos invasivos. Constipation is a very common disorder in oncologic patients with advanced disease, and it may cause pain, abdominal distension,nausea and vomit. This study had as its aim to identify available evidences on the literature about actions of palliativecare for oncologic patients, considering these actions to be the result from the necessities of care that may contribute to thecontrol of this symptom. This investigation is a literature integrative review; and to select scientific publications, we accessedthe databases from Virtual Health Library (VHL), specifically LILACS and SciELO. Inclusion criteria were adapted: the articlesportraying palliative care to patients with constipation due to the use of opioids, with were indexed in the databases mentionedabove, which were published in Portuguese in the period from 2002 to 2012 and whose abstracts and texts were availableonline in its entirety. We excluded studies with restricted access. At the end of the research, we found 20 references but onlyseven met the criteria for inclusion. The articles included in this study pointed out that constipation is a very common symptomin cancer patients with advanced disease using opioids. This review showed that a proper evaluation, nutritional management,rational use of medicines and laxatives opioids antagonists, as well as new features such as the use of diet-therapeutic drugsbased on Agaricus sylvaticus can promote adequate control of symptoms, preventing complications and invasive procedures.