Mariluci Hautsch Willig

Gerenciamento e cuidado em unidades de hemodiálise

The study aimed at investigating a theoretical practical experience as well as the prospects concerning care management reported by nursing professionals working at hemodialysis units in Curitiba/Brazil. It is a practice-converging research; information was obtained by means of interviews, and team discussions and reflections during a workshop of educational practice. The approach of Collective Speech was used in order to organize data for the analysis. Research results pointed out the existence of a conflict between care management and care delivery to patients. This would result, according to the nurses, from the excess of administrative tasks, shortage of nursing staff and lack of effective planning.El estudio tiene como objetivo investigar la experiencia teorico-practica y las perspectivas referentes al gerenciamiento del cuidado verbalizadas por los profesionales de enfermeria en que actuan en unidades de hemodialisis de Curitiba. El estudio se configura como convergente-asistencial; las informaciones fueron obtenidas por el metodo de entrevista e por discusiones e reflexiones en grupo durante un taller de practica educativa. El metodo del Discurso Colectivo fue utilizado en la organizacion de los datos para el analisis. Los resultados del estudio apuntaron la existencia de conflicto entre gerenciar el cuidado y prestar el cuidado directo al paciente, resultante, segun la vision de las enfermeras, del exceso de actividades administrativas, del numero inadecuado del personal de enfermeria y de la ausencia de un planeamiento efectivo.

Fragilidade e qualidade de vida de idosos usuários da atenção básica de saúde

OBJECTIVE to investigate the association between physical frailty and quality of life in elderly users of primary health care in the capital of the state of Paraná. METHOD a cross-sectional, quantitative study with 203 elders. Data collected included: physical activity questionnaires, weight loss, fatigue/exhaustion, quality of life, performance of gait speed tests, and handgrip strength. RESULTS of the 203 older adults, 115 were pre-frail, 49 were non-frail, and 39 were frail, with a significant association with functional capacity and quality of life in all groups. The dimensions resulting from physical aspects, pain, and vitality were associated with those that were non-frail. CONCLUSION in this study, frailty syndrome was inversely proportional to the quality of life, and significantly associated with functional capacity of older adults. Physical frailty is a manageable condition which can be targeted through geriatric nursing interventions.

Quality of life of frail elderly users of the primary care

Objective Identifying the quality of life of frail elderly patients, users of primary care services. Methods A cross-sectional, quantitative study. The sample size was calculated based on the estimate of population proportion and consisted of 203 elderly. Data were collected by using a questionnaire of physical activity for the elderly, fatigue/exhaustion, quality of life, and by carrying out a test of gait speed, handgrip strength and anthropometric measurement. Results Among the 203 seniors, 39 were fragile. The mean scores for quality of life presented by the frail elderly were the following: 60.4 for pain, functional capacity 61.1, limitations due to physical aspects 71.1, general state of health 71.4, vitality 75, mental health 76.4, emotional aspects 81.1 and social aspects 85.6. Conclusion The dimensions of quality of life of the frail elderly that had lower mean scores were pain, functional capacity, limitations due to physical aspects and general state of health.

Frailty and quality of life in elderly primary health care users

OBJECTIVE to investigate the association between physical frailty and quality of life in elderly users of primary health care in the capital of the state of Paraná. METHOD a cross-sectional, quantitative study with 203 elders. Data collected included: physical activity questionnaires, weight loss, fatigue/exhaustion, quality of life, performance of gait speed tests, and handgrip strength. RESULTS of the 203 older adults, 115 were pre-frail, 49 were non-frail, and 39 were frail, with a significant association with functional capacity and quality of life in all groups. The dimensions resulting from physical aspects, pain, and vitality were associated with those that were non-frail. CONCLUSION in this study, frailty syndrome was inversely proportional to the quality of life, and significantly associated with functional capacity of older adults. Physical frailty is a manageable condition which can be targeted through geriatric nursing interventions.

Management and care in hemodialysis units

The study aimed at investigating a theoretical practical experience as well as the prospects concerning care management reported by nursing professionals working at hemodialysis units in Curitiba/Brazil. It is a practice-converging research; information was obtained by means of interviews, and team discussions and reflections during a workshop of educational practice. The approach of Collective Speech was used in order to organize data for the analysis. Research results pointed out the existence of a conflict between care management and care delivery to patients. This would result, according to the nurses, from the excess of administrative tasks, shortage of nursing staff and lack of effective planning.El estudio tiene como objetivo investigar la experiencia teorico-practica y las perspectivas referentes al gerenciamiento del cuidado verbalizadas por los profesionales de enfermeria en que actuan en unidades de hemodialisis de Curitiba. El estudio se configura como convergente-asistencial; las informaciones fueron obtenidas por el metodo de entrevista e por discusiones e reflexiones en grupo durante un taller de practica educativa. El metodo del Discurso Colectivo fue utilizado en la organizacion de los datos para el analisis. Los resultados del estudio apuntaron la existencia de conflicto entre gerenciar el cuidado y prestar el cuidado directo al paciente, resultante, segun la vision de las enfermeras, del exceso de actividades administrativas, del numero inadecuado del personal de enfermeria y de la ausencia de un planeamiento efectivo.

As contribuições da educação continuada em disfagia orofaríngea para a assistência de enfermagem pediátrica em um hospital de ensino

PURPOSE: to assess the effectiveness of carrying out educational activities on oropharyngeal dysphagia for pediatric nursing team at a teaching hospital. METHODS: it is an evaluation research. The study was carried out in a tertiary hospital from the National Health System. The sample consisted of 62 professionals including nurses, technicians and nursing assistants who deliver care to pediatric patients. A questionnaire was applied to check prior knowledge of dysphagia, and later was held an educational action and its immediate evaluation. RESULTS: nursing knowledge on dysphagia was evidenced as positive, especially the question on the concept with 96.77% accuracy, symptoms with 83.87% accuracy, causes with 74.19% accuracy, consequences with 70.97% correctness, identification of the professional qualified for rehabilitation with 85.48% accuracy, and importance of rehabilitation with 87.10% accuracy. Concerning the expected answers for yes, we emphasize the ones not in agreement: the phases of swallowing (50%), specific tests (45.16%) and position for oral nutrition (32.26%). The need for continuing education was justified as 85.48% of the participants reassured training importance. CONCLUSION: the study found that nursing knowledge on dysphagia, although fragmented, has had professionals interested and willing to learn if content is available through continuing education. Thus, research participants, after the educational activity, expressed the expansion of knowledge on dysphagia, and recognized its importance, also expressing a desire to receive more information about this and other pathologies.

Do real ao ideal - o (des)cuidar da saúde dos idosos longevos

OBJECTIVE to analyze similarities and dissimilarities in the meanings assigned to health care by long-lived elders and nursing professionals in a healthcare setting. METHOD ethnographic qualitative research, based on the Spradley-McCurdy method and the interpretive anthropology of Geertz and Kleinman. The sample consisted of 20 key informants. Data were collected through participatory observation and ethnographic interviews from March to October 2013 and analyzed in domains, taxonomies and cultural themes. RESULTS Six domains and cultural taxonomies emerged and revealed reasons, attributes, and resources in providing care in relationship to long-lived elders and nursing professionals; finally, the following cultural theme emerged: the real to the ideal - the health (un)care of long-lived elders. CONCLUSION The study showed the distance between the desired and actual health care provided to aged people in the scenario studied.

Fatores de risco para mortalidade de idosos com infecção do sítio cirúrgico

PURPOSE: to relate risk factors for mortality in elderly patients undergoing abdominal surgery with surgical site infection. METHOD: it is a descriptive quantitative cross-sectional retrospective study, performed in teaching hospital in Curitiba-PR. The sample period was from January 1999 to December 2008. Data were collected through structured instrument in secondary sources: Registration Service Infection Control and the patients chart. A sample consisted of records of 114 elderly patients with surgical site infection. Variables were investigated classified into three categories: clinical, surgical hospitalization and surgical procedures among the elderly. Data were analyzed using Epi Info version 6.04 and were considered statistically significant when p <0,05. RESULTS: life habits and preexisting conditions were not significantly associated with mortality. It is inferred that the longer hospitalization, surgical site infection in the cavity, the combination of two or more surgeries and emergency surgery were significantly related to mortality risk. The readmission of elderly related the significant values for discharge. CONCLUSION: knowing the factors that influence the progression to death of these patients allows nurses to extend the possibilities of managing the geriatric care and intervene in risk factors for mortality.

Avaliação de intervenção educativa voltada à preservação auditiva de trabalhadores de uma lavanderia hospitalar

OBJECTIVE Evaluate the effectiveness of educational interventions on hearing health developed at a hospital laundry. METHODS Quantitative assessment conducted at a hospital laundry. The study sample comprised 80 workers of both genders divided into two groups: Study Group (SG) and Control Group (CG). The educational interventions in hearing preservation were evaluated based on a theoretical approach using the Participatory Problem-based Methodology in five workshops. To assess the results of the workshops, an instrument containing 36 questions on knowledge, attitudes, and practices in hearing preservation at work was used. Questionnaires A and B were applied prior to and one month after intervention, respectively. The answers to both questionnaires were analyzed by group according to gender and schooling. RESULTS Results of the pre-intervention phase showed low scores regarding knowledge about hearing health in the work setting for both groups, but significant improvement in knowledge was observed after intervention in the SG, with 77.7% of the answers presenting significant difference between the groups. There was also an improvement in the mean scores, with 35 responses (95.22%) presenting scores >4 (considered adequate). The women presented lower knowledge scores than the men; however, these differences were not observed in the SG after the workshops. Schooling was not a relevant factor in the assessment. CONCLUSION The educational proposal grounded in the Participatory Problem-based Methodology expanded knowledge about hearing health at work among the participants.OBJECTIVE Evaluate the effectiveness of educational interventions on hearing health developed at a hospital laundry. METHODS Quantitative assessment conducted at a hospital laundry. The study sample comprised 80 workers of both genders divided into two groups: Study Group (SG) and Control Group (CG). The educational interventions in hearing preservation were evaluated based on a theoretical approach using the Participatory Problem-based Methodology in five workshops. To assess the results of the workshops, an instrument containing 36 questions on knowledge, attitudes, and practices in hearing preservation at work was used. Questionnaires A and B were applied prior to and one month after intervention, respectively. The answers to both questionnaires were analyzed by group according to gender and schooling. RESULTS Results of the pre-intervention phase showed low scores regarding knowledge about hearing health in the work setting for both groups, but significant improvement in knowledge was observed after intervention in the SG, with 77.7% of the answers presenting significant difference between the groups. There was also an improvement in the mean scores, with 35 responses (95.22%) presenting scores >4 (considered adequate). The women presented lower knowledge scores than the men; however, these differences were not observed in the SG after the workshops. Schooling was not a relevant factor in the assessment. CONCLUSION The educational proposal grounded in the Participatory Problem-based Methodology expanded knowledge about hearing health at work among the participants.

Children and adolescents with cerebral palsy in the perspective of familial caregivers

Mailing address: Giselle Massi Rua Benjamin Lins, 750, ap. 61, Batel CEP: 80:420-100 – Curitiba, Paraná, Brasil Email: giselle.massi@utp.br ABSTRACT Objective: to analyze family caregivers’ perceptions on care delivered to children and adolescents presented with cerebral palsy. Methods: a quantitative, qualitative study developed with 50 family caregivers of children and adolescents diagnosed with cerebral palsy. Data collection was carried out by means of an interview with semi-open questions whose answers were analyzed based on the Content Analysis. Results: family members’ accounts on care delivered to children and adolescents with cerebral palsy are mostly connected with positive feelings, such as love, happiness, privilege and overcoming. However, for a significant share of these family members, their own quality of life depends on the cared subject’s health condition, blurring the distinction between their own needs and those of the cared subjects. Conclusions: health professionals need to recognize the importance of caregivers’ health promotion as a major condition to keep caring. In this dimension, they may contribute by helping caregivers identify their own health needs.