Rudval Souza da Silva

Cuidando do paciente no processo de morte na Unidade de Terapia Intensiva

The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.

Sistematização da Assistência de Enfermagem ao portador de Diabetes Mellitus e Insuficiência Renal Crônica

This is a clinical case study developed during the practical activities of the discipline Surgical Clinical Nursing I, of course of Graduation in Nursing of a public university of Bahia State, that aimed to report the application of the Systematization of Nursing Assistance in the assistance to a client whit Diabetes Mellitus and Chronic Renal Insufficiency. With the development of the study, especially after the positive improvement of the client, face to assistance planned and implemented and considering the reflections that emerged, it was possible to evidence the need for interface between Systematization of Nursing Assistance, the nursing staff and client in the care process, at the excellence and uniqueness of nursing care.Tratou-se de um estudo de caso clinico desenvolvido durante as atividades praticas da disciplina Enfermagem Clinico-Cirurgica I, do curso de Graduacao em Enfermagem de uma universidade publica do Estado da Bahia, que objetivou relatar a aplicacao da Sistematizacao da Assistencia de Enfermagem na assistencia a um paciente portador de Diabetes Mellitus e Insuficiencia Renal Cronica. Com o desenvolvimento do estudo, em especial apos a melhora positiva da paciente face as condutas planejadas e implementadas e, considerando as reflexoes que emergiram, foi possivel constatar a necessidade da interface entre a Sistematizacao da Assistencia de Enfermagem, equipe de enfermagem e paciente no processo do cuidar, frente a excelencia e singularidade dos cuidados de enfermagem

Women experiencing the intergenerationality of conjugal violence.

Objetivo: analisar a relacao familiar, na infância e adolescencia, de mulheres que vivenciam violencia conjugal.Metodo: estudo qualitativo. Foram entrevistadas 19 mulheres, em vivencia de violencia conjugal, residentes em uma comunidade de Salvador, Bahia, Brasil. O projeto foi aprovado pelo Comite de Etica em Pesquisa (no 42/2011).Resultados: os dados foram organizados pelo metodo Discurso do Sujeito Coletivo, identificando-se as ideias centrais sintese: presenciaram violencia entre os pais; sofreram repercussoes da violencia entre os pais; indignaram-se com a submissao da mae ao companheiro; e reproduziram a violencia conjugal. O discurso mostrou que as mulheres presenciaram, na infância e adolescencia, violencia entre os pais, sendo agredidas fisicamente e moralmente. Diante da submissao da mae surgiram sentimentos de indignacao dos filhos. No entanto, na fase adulta, perceberam que sua vida conjugal assemelha-se a dos pais, reproduzindo a violencia.Conclusao: e necessario o investimento em estrategias de rompimento da violencia intergeracional, e os profissionais de saude tem importância neste processo, por ser um fenomeno com repercussao na saude. Por atuarem na Estrategia Saude da Familia, que foca na prevencao de agravos e doencas, promocao da saude e intersetorialidade, os enfermeiros sao essenciais no processo de prevencao e enfrentamento deste fenomeno.Objective: to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence. Method: qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011). Results: the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mothers submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mothers submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence. Conclusion: investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.

Comfort for a good death: perspective nursing staff's of intensive care

Objective: It is a qualitative research aimed to know the meaning of nursing care for a good death from the perspective of a team of intensive care nursing. Methods: Symbolic Interactionism was adopted as a theoretical framework and content analysis of Bardin as the methodological framework for analysis. Ten nurses were interviewed, who experienced the care of the terminally ill person, in the ICU of a hospital specializing in oncology. Results: It showed that the meaning of caring for a good death focuses on the promotion of comfort as the central category and three subcategories: Relief of physical discomforts, social and emotional support and maintenance of the health and body positioning. Conclusion: To care for a good death means to promote comfort as a results of therapeutic interventions that combine rationality and sensitivity in interactions of health professionals with patients and their families, ensuring their dignity.Objetivo: Trata-se de uma pesquisa qualitativa que objetivou conhecer o significado do cuidar em enfermagem para uma boa morte na perspectiva de uma equipe de enfermagem intensivista. Metodos: Adotou-se o Interacionismo Simbolico como referencial teorico e a Analise de Conteudo de Bardin como referencial metodologico para analise. Foram entrevistados 10 profissionais de enfermagem, que vivenciavam o cuidado a pessoa em processo de terminalidade, numa UTI de um hospital especializado em oncologia. Resultados: O significado do cuidar para uma boa morte centra-se na promocao do conforto como categoria central e tres subcategorias: Alivio de desconfortos fisicos, Suporte social e emocional e Manutencao da integridade e do posicionamento corporal. Conclusao: Cuidar para uma boa morte significa promover conforto como um resultado de intervencoes terapeuticas que conciliem racionalidade e sensibilidade nas interacoes dos profissionais de saude com o paciente e sua familia assegurando a sua dignidade.

Conforto para uma boa morte: perspectiva de uma equipe de enfermagem intensivista

Objective: It is a qualitative research aimed to know the meaning of nursing care for a good death from the perspective of a team of intensive care nursing. Methods: Symbolic Interactionism was adopted as a theoretical framework and content analysis of Bardin as the methodological framework for analysis. Ten nurses were interviewed, who experienced the care of the terminally ill person, in the ICU of a hospital specializing in oncology. Results: It showed that the meaning of caring for a good death focuses on the promotion of comfort as the central category and three subcategories: Relief of physical discomforts, social and emotional support and maintenance of the health and body positioning. Conclusion: To care for a good death means to promote comfort as a results of therapeutic interventions that combine rationality and sensitivity in interactions of health professionals with patients and their families, ensuring their dignity.Objetivo: Trata-se de uma pesquisa qualitativa que objetivou conhecer o significado do cuidar em enfermagem para uma boa morte na perspectiva de uma equipe de enfermagem intensivista. Metodos: Adotou-se o Interacionismo Simbolico como referencial teorico e a Analise de Conteudo de Bardin como referencial metodologico para analise. Foram entrevistados 10 profissionais de enfermagem, que vivenciavam o cuidado a pessoa em processo de terminalidade, numa UTI de um hospital especializado em oncologia. Resultados: O significado do cuidar para uma boa morte centra-se na promocao do conforto como categoria central e tres subcategorias: Alivio de desconfortos fisicos, Suporte social e emocional e Manutencao da integridade e do posicionamento corporal. Conclusao: Cuidar para uma boa morte significa promover conforto como um resultado de intervencoes terapeuticas que conciliem racionalidade e sensibilidade nas interacoes dos profissionais de saude com o paciente e sua familia assegurando a sua dignidade.

Caring for the patient in the process of dying at the Intensive Care Unit

The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.

Differents ways from existence: concept of vulnerability in people living with deficiency

Objective: To approach the concept of social vulnerability and belonging to a community in conjunction with the theme of people with disabilities Methods: Articles were consulted in the areas of political, social and health books and magazines, and the authors experience to reflective analysis regarding the concept of socially vulnerable and disabled people . Results: We infer from this study that individuals with disabilities are doubly victimized and invisible, even with a broad law that relates their rights and guarantees . Conclusion: the individual with disabilities misses the point of belonging and recognition of a community, a fact which makes it vulnerable to develop feelings of low self-esteem, increased susceptibility to social isolation, inaccessibility to services offered, work and easier to become victims of violence in its various forms .

Palliative care in primary health care: providing care for a good death

ABSTRACT Objective : to understand the philosophies of palliative care and discuss your coverage under the Unified Health System. Methodology : in the quest to develop the objectives proposed in this paper, we conducted a literature with authors who address the issues of palliative care and primary care as well as their integration. Results : the integration of palliative care in primary care is of great relevance to an increasingly careful near entirety, as well as the way of the joint organization of the network of primary health care with the hospital network, with an integration where there are qualified human resources within the philosophy of palliative care, availability of drugs, especially opioids and foremost a policy of welcoming effective. Conclusion : it is necessary to reflect on the importance of palliative care and its place in the context of primary care, since it comes to contribute with greater comfort and dignity for the patient who is in the process of death and his family. Descriptors : hospice care; primary health care; single health system; death; nursing care.xa0xa0xa0xa0 RESUMO Objetivos : compreender a filosofias dos cuidados paliativos e discutir a sua abrangencia no âmbito do Sistema Unico de Saude. Metodologia : na busca por desenvolver os objetivos propostos neste ensaio, realizamos uma pesquisa bibliografica com autores que abordam as tematicas dos cuidados paliativos e a atencao basica, bem como a sua integracao. Resultados : a insercao dos cuidados paliativos na Atencao Basica e de grande relevância para um cuidado cada vez mais proximo da integralidade, como tambem o modo de organizacao a articulacao da rede de atencao primaria a saude com a rede hospitalar, com uma integracao onde haja recursos humanos qualificados dentro da filosofia dos cuidados paliativos, disponibilidade de medicamentos, especialmente os opioides e acima de tudo uma politica de acolhimento eficaz. Conclusao : faz-se necessario refletir sobre a importância dos cuidados paliativos e sua insercao no contexto da Atencao Basica, uma vez que vem a contribuir com um maior conforto e dignidade para o paciente que esta em processo de morte e sua familia. Descritores : cuidados paliativos; atencao primaria a saude; sistema unico de saude; morte; cuidados de enfermagem. RESUMEN Objetivo : comprender la filosofia de los cuidados paliativos y discutir su cobertura por el Sistema Unico de Salud. Metodologia : en la busqueda del desarrollo de los objetivos propuestos en este trabajo, realizamos una literatura con autores que abordan los temas de los cuidados paliativos y la atencion primaria, asi como su integracion. Resultados : la integracion de los cuidados paliativos en la atencion primaria es de gran relevancia para un conjunto cada vez mas cerca de cuidado, asi como la forma de la organizacion conjunta de la red de atencion primaria de salud con la red hospitalaria, con una integracion donde hay recursos humanos calificados dentro de la filosofia de los cuidados paliativos, disponibilidad de medicamentos, especialmente los opiaceos y sobre todo una politica de acogida eficaz. Conclusion : es necesario reflexionar sobre la importancia de los cuidados paliativos y su lugar en el contexto de la atencion primaria, ya que se trata de contribuir con mayor comodidad y dignidad para el paciente que esta en el proceso de la muerte y su familia. Descriptores : cuidados paliativa; atencion primaria de salud; sistema unico de salud; muerte; atencion de enfermeria.

Family conference in palliative care: concept analysis

OBJECTIVEnto analyze the attributes, antecedents and consequents of the family conference concept.nnnMETHODnWalker and Avantes method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care.nnnRESULTSnthe most cited antecedents were the presence of doubts and the need to define a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements.nnnFINAL CONSIDERATIONSnthe scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their efficacy and effectiveness as a therapeutic intervention.Objective: to analyze the attributes, antecedents and consequents of the family conference concept. Method: Walker and Avante’s method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care. Results: the most cited antecedents were the presence of doubts and the need to defi ne a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements. Final considerations: the scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their effi cacy and effectiveness as a therapeutic intervention. Descriptors: Palliative Care; Consensus Conference; Family; Communication; Concept Formation. RESUMEN Objetivo: analizar los atributos, antecedentes y consecuentes del concepto conferencia familiar. Método: el estudio siguió el Modelo de Análisis de Concepto de Walker y Avante y los pasos de la revisión integradora, con selección de publicaciones en las bases de datos PubMed, Cinahl y Lilacs, con el foco en la temática conferencia familiar en el contexto de los cuidados paliativos. Resultados: los antecedentes más citados fueron presencia de dudas y necesidad de defi nición de un plan de cuidados. Como atributos fueron evidenciados reunión familiar e instrumento de trabajo. Con relación a los consecuentes, promover la comunicación efi caz y establecer un plan de actuación consensual fueron los elementos más marcados. Consideraciones fi nales: posibilitó evidenciar la escasez de publicaciones sobre la temática y los estudios empíricos restrictos al espacio de la terapia intensiva. Así, analizar los atributos, los antecedentes y los consecuentes del concepto posibilitó acompañar su evolución y evidenciar su efi cacia y efectividad en cuanto intervención terapéutica. Descriptores: Cuidados Paliativos; Conferencia de Consenso; Familia; Comunicación; Formación de Concepto. Conferência familiar em cuidados paliativos: análise de conceito Family conference in palliative care: concept analysis Conferencia familiar en cuidados paliativos: análisis de concepto REVISÃO Rudval Souza da Silva E-mail: rudsouza@uneb.br AUTOR CORRESPONDENTE

Conferência familiar em cuidados paliativos: análise de conceito

OBJECTIVEnto analyze the attributes, antecedents and consequents of the family conference concept.nnnMETHODnWalker and Avantes method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care.nnnRESULTSnthe most cited antecedents were the presence of doubts and the need to define a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements.nnnFINAL CONSIDERATIONSnthe scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their efficacy and effectiveness as a therapeutic intervention.Objective: to analyze the attributes, antecedents and consequents of the family conference concept. Method: Walker and Avante’s method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care. Results: the most cited antecedents were the presence of doubts and the need to defi ne a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements. Final considerations: the scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their effi cacy and effectiveness as a therapeutic intervention. Descriptors: Palliative Care; Consensus Conference; Family; Communication; Concept Formation. RESUMEN Objetivo: analizar los atributos, antecedentes y consecuentes del concepto conferencia familiar. Método: el estudio siguió el Modelo de Análisis de Concepto de Walker y Avante y los pasos de la revisión integradora, con selección de publicaciones en las bases de datos PubMed, Cinahl y Lilacs, con el foco en la temática conferencia familiar en el contexto de los cuidados paliativos. Resultados: los antecedentes más citados fueron presencia de dudas y necesidad de defi nición de un plan de cuidados. Como atributos fueron evidenciados reunión familiar e instrumento de trabajo. Con relación a los consecuentes, promover la comunicación efi caz y establecer un plan de actuación consensual fueron los elementos más marcados. Consideraciones fi nales: posibilitó evidenciar la escasez de publicaciones sobre la temática y los estudios empíricos restrictos al espacio de la terapia intensiva. Así, analizar los atributos, los antecedentes y los consecuentes del concepto posibilitó acompañar su evolución y evidenciar su efi cacia y efectividad en cuanto intervención terapéutica. Descriptores: Cuidados Paliativos; Conferencia de Consenso; Familia; Comunicación; Formación de Concepto. Conferência familiar em cuidados paliativos: análise de conceito Family conference in palliative care: concept analysis Conferencia familiar en cuidados paliativos: análisis de concepto REVISÃO Rudval Souza da Silva E-mail: rudsouza@uneb.br AUTOR CORRESPONDENTE