Olga Maria Pimenta Lopes Ribeiro

Quality of nursing care: instrument development and validation

ABSTRACT Objectives: to describe the development and validation process of a scale to measure the nurses’ perception of the activities that contribute to nursing care quality. Method: methodological study based on a literature review, the opinion of experts and the experience of study investigators. An instrument was designed containing six dimensions and 25 items, applied as a questionnaire to 775 nurses from a hospital in northern Portugal, from May to July 2014. The instrument validation used an exploratory factor analysis and an internal consistency assessment of each factor/dimension. Results: the factor analysis indicated the need to adjust the original composition of the scale, which then received one more dimension, totaling seven dimensions and the same 25 items, and presented a high internal consistency (Cronbach’s alpha of 0.940). Conclusion: the fi nal version of the scale presents adequate psychometric properties, with potential use in future studies. Descriptors: Nursing; Health Care Quality Assurance; Nursing Services; Nursing Care; Validation Studies.Objetivos: descrever o processo de construcao e validacao de uma escala para mensurar a percepcao dos enfermeiros acerca das atividades que contribuem para a qualidade dos cuidados de enfermagem. Metodo: estudo de cunho metodologico pautado na revisao da literatura, na opiniao de peritos e na experiencia dos investigadores. Foi desenvolvido um instrumento contendo seis dimensoes e 25 itens, sendo aplicado no formato de questionario a 775 enfermeiros em um hospital do norte de Portugal, no periodo de maio a julho de 2014. Para a validacao empregou-se a analise fatorial exploratoria e a avaliacao da consistencia interna de cada fator/dimensao. Resultados: a analise fatorial indicou para ajustes na composicao original da escala, que passou a ser constituida por sete dimensoes, mantendo-se os 25 itens, apresentando uma elevada consistencia interna (alfa de Cronbach de 0,940). Conclusao: a versao final da escala apresenta adequadas propriedades psicometricas, revelando potencial para utilizacao em futuros estudos.

A pessoa dependente no autocuidado: implicações para a Enfermagem

Theoretical framework: As a result of the growing ageing of thepopulation and the subsequent increase in chronic diseases, we are facedwith a signif...

O OLHAR DOS ENFERMEIROS PORTUGUESES SOBRE OS CONCEITOS METAPARADIGMÁTICOS DE ENFERMAGEM

Objective: to identify the level of agreement between the concepts that nurses have about the nursing metaparadigm and the application of these ideas in professional practice. Methods: Exploratory, descriptive and quantitative study, carried out from July 2015 to March 2016 in 36 hospital institutions in Continental Portugal, with the participation of 3,451 nurses. Data were collected through the application of a questionnaire with two parts, one regarding the characterization of the participants and another about personal, health, environment and nursing conceptions according to 13 nursing theoreticians. Agreement with the mentioned metaparadigmatic concepts was evaluated through a Likert scale. Results: analysis showed that the sample was predominantly made up of women (77.1%), with an average age of 36.4 years. As for professional training, 76.3% were nurses, 19.9% specialized nurses and 3.8% nurse managers. The conceptions that obtained higher agreement were those by Virginia Henderson, Afaf Meleis, Dorothea Orem, Madeleine Leininger, and Callista Roy. Nurses qualified the conceptions of Virginia Henderson and Afaf Meleis as “totally in line with their practice” regarding the four metaparadigmatic concepts. Conclusion: the congruence verified between the concepts established by theoretical models and the practice of nurses is an opportunity to evolve a logic marked by the assumption of “doing for clients what they cannot do by themselves”, as advocated by Virginia Henderson, to a reasoning centered on the principle “do with clients”, in the context of their transitions, influenced by Afaf Meleis’s approach

Olhares sobre o ensino de enfermagem em Portugal

Objective: to understand nurses’ perception of hospital care about nursing education. Methods: a qualitative study was carried out in 19 hospital institutions, with 56 nurses. For the data collection, the semi-structured interview was used and, in the analysis, the Atlas.ti® software. Results: these aspects emerged as units of analysis: positive and negative aspects of nursing teaching in a theoretical context; and positive and negative aspects of nursing teaching in a practical context. The perception of nurses about nursing education is essentially related to the existence of much diversified training processes. Conclusion: despite the evolution of nursing as a discipline and profession, nurses recognize that many of the weaknesses in nursing education are based on the differences between nursing schools, and the need for a closer approximation of theory to practice is evident, among other strategies, the follow-up of the students during the internships by the teachers of the School.

Aplicação do processo de enfermagem em hospitais portugueses

Objetivo: Descrever a aplicacao do processo de enfermagem pelos enfermeiros, que exercem funcoes em instituicoes hospitalares. Metodos: Trata-se de um estudo descritivo com abordagem qualitativa, realizado em 19 Centros Hospitalares de Portugal continental, no qual participaram 56 enfermeiros. Os dados foram coletados atraves de entrevista semiestruturada. Resultados: Da analise de conteudo realizada emergiram como categorias: processo de enfermagem; avaliacao inicial; diagnostico; planejamento; implementacao e avaliacao final. Apesar de nos ultimos anos se ter assistido a uma progressiva apropriacao do processo de enfermagem, a descricao das praticas dos enfermeiros tornam evidentes algumas fragilidades. Conclusao: Os resultados do estudo evidenciam que a aplicacao do processo de enfermagem requer maior clarificacao e completude dos conteudos incluidos nas etapas que o constituem. Palavras-chave: Enfermagem. Processo de enfermagem. Hospitais.

Posicionamento de gestores e lideranças de enfermagem diante dos erros divulgados na mídia

Objetivo: Analisar o posicionamento de gestores e liderancas de enfermagem acerca dos erros de enfermagem divulgados na midia. Metodologia: Estudo qualitativo, retrospectivo, documental, coleta de dados realizada em jornais do Brasil e Portugal, entre 2012 e 2016. Analise realizada no Atlas.ti, utilizando a hermeneutica de Ricoeur fundamentada na Teoria do Agir Comunicativo de Habermas. Resultados: Gestores e liderancas destacam as condicoes de trabalho da enfermagem, e prestaram esclarecimentos quanto a ausencia de supervisao e deficits na forca de trabalho, seguiram com a abertura de sindicância interna, afastamento do cargo e demissao. As liderancas se posicionaram abrindo Processo Etico Disciplinar, realizando fiscalizacao, solicitando documentos e questionando acerca dos fatos, assim como repudiando algumas notas divulgadas. Conclusao: As liderancas em enfermagem desempenham papel crucial no momento da divulgacao de noticias que envolvem erros assistenciais, a fim de expor uma problematica complexa. Entretanto, isso nao tem sido feito de forma eficiente. Palavras-chave: Seguranca do paciente. Enfermagem. Meios de comunicacao. Lideranca. Gestao de riscos.OBJECTIVE To analyze the behavior of nursing managers and leaders when nursing errors are disclosed in the media. METHODOLOGY A qualitative, retrospective, documental study of the collection carried out in newspapers in Brazil and Portugal, between 2012 and 2016. Analysis performed at Atlas.ti, using a Ricoeur technique based on Habermas Theory of Communicative Action. RESULTS Managers and caretakers focused on the workforce, continuing with the opening of internal syndication, removal of position and dismissal. How to lead the discipline process, carrying out inspections, requesting documents and questioning about the facts, as well as repudiating some disclosed notes. CONCLUSION Leaderships in nursing played a crucial role in developing a complex problem strategy. However, this was not done efficiently.

Views on nursing education in Portugal

Objective: to understand nurses’ perception of hospital care about nursing education. Methods: a qualitative study was carried out in 19 hospital institutions, with 56 nurses. For the data collection, the semi-structured interview was used and, in the analysis, the Atlas.ti® software. Results: these aspects emerged as units of analysis: positive and negative aspects of nursing teaching in a theoretical context; and positive and negative aspects of nursing teaching in a practical context. The perception of nurses about nursing education is essentially related to the existence of much diversified training processes. Conclusion: despite the evolution of nursing as a discipline and profession, nurses recognize that many of the weaknesses in nursing education are based on the differences between nursing schools, and the need for a closer approximation of theory to practice is evident, among other strategies, the follow-up of the students during the internships by the teachers of the School.

Nursing care quality: a study carried out in Portuguese hospitals

Background: In a constant pursuit for professional excellence, nurses are required to comply with the quality standards of nursing care. Thus, it is essential to understand this phenomenon in the hospital setting. Objectives: To analyze nurses’ perception of the implementation of quality standards in nursing care. Methodology: A quantitative, descriptive-exploratory study was conducted in 36 public hospital institutions located in mainland Portugal, involving a total of 3.451 nurses. Data were collected using a questionnaire. Results: Most nurses often or always performed activities that enhance the quality of nursing care. This analysis showed that nurses perceive activities related to Health Promotion, Well-being and Self-care, and Functional Readaptation as less implemented. On the other hand, activities related to Responsibility and Rigor and Prevention of Complications are implemented

Dimensioning the instrumentation: Exploratory or confirmatory factor analysis?

Objective: to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. Method: methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition. Results: the work resulted in the production of the final version of the educational booklet, which was titled Aplicando a insulina: a aventura de Beto [Applying insulin: Betos adventure]. The process of developing of the booklet was based on the active participation of the children and guided by the theoretical framework of Piagetian Constructivism. Conclusion: the resource is a facilitator for the improvement of the knowledge and practices of self care of children with Diabetes Mellitus type 1.Objective: to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. Method: methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition. Results: the work resulted in the production of the final version of the educational booklet, which was titled Aplicando a insulina: a aventura de Beto [Applying insulin: Betos adventure]. The process of developing of the booklet was based on the active participation of the children and guided by the theoretical framework of Piagetian Constructivism. Conclusion: the resource is a facilitator for the improvement of the knowledge and practices of self care of children with Diabetes Mellitus type 1.

Bath for dependent patients: theorizing aspects of nursing care in rehabilitation

OBJECTIVE to produce a reflective essay on what has been produced in relation to bath as a procedure related to nursing care and diagnosis for dependent patients undergoing mediate and immediate rehabilitation processes after a traumatic event. METHOD discursive, reflective study supported by classical content analysis consisting of the following stages: a) reading of the texts in their most comprehensive form; b) emphasizing the relevant elements produced about bathing; c) reflection on texts and what is produced about bathing. RESULTS the texts point out to three categories for nursing practice and reflection: Meaning to patients on the purposes of bathing; Representation for nurses in the work process; Representation for nurses in the management of care and nursing care planning. CONCLUSION the reflection points out understandings on bathing as a care focused on the autonomy of nursing rehabilitation patients, requiring further investigations.