Thémistoklis Apostolidis

Explain the ‘unexplainable’: A qualitative enquiry of the representations of the caregivers of brain-injured people:

The aim of our research is to highlight the role of social representations of the traumatic brain-injured person in the adjustments made by caregivers in building and maintaining quality of care. Twenty-three semi-structured interviews were conducted with nursing assistants and medico-psychological assistants, working in a long-term care facility. The interviews were the subject of a thematic content analysis. The analysis shows the role of representations of the traumatic brain-injured person in the way caregivers explain behaviours and situations and in the orientation of their professional practices. In explaining the inexplicable, caregivers establish a more human relationship through individualized care.

A conceptual framework of clinical nursing care in intensive care

Objetivo: propor um marco conceitual para uma clinica do cuidado de enfermagem na terapia intensiva.Metodo: pesquisa de campo, descritiva e qualitativa, realizada com 21 enfermeiros de uma unidade de terapia intensiva de um hospital publico federal. Realizou-se entrevista semiestruturada e analise de conteudo tematico e lexical, com apoio do software Alceste.Resultados: os elementos que caracterizam a clinica do cuidado na terapia intensiva emergem dos saberes especializados, da interacao, do contexto do trabalho, dos tipos de paciente e de enfermeiro, proprios da terapia intensiva, e dos referenciais assistenciais.Conclusao: conclui-se que o marco conceitual da clinica do cuidado de terapia intensiva articula elementos proprios da dinâmica desse cenario: objetivos em relacao as tecnologias e atencao aos equipamentos e subjetivos relacionados a interacao humana, especificos dos cuidados de enfermagem, contrapondo-se as criticas pautadas na desumanizacao.Objective: to propose a conceptual framework for clinical nursing care in intensive care. Method: descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. Results: the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. Conclusion: the conceptual framework of the clinics intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.

Estilos de cuidar de enfermeiras na Terapia Intensiva mediados pela tecnologia

The objective was to identify the social representations of the intensive therapy nurses about the care practices in face of the technology. Participant observation and interviews were conducted with twenty one nurses of an intensive therapy center, at a Rio de Janeiro public hospital. Lexical analysis was applied, using the Alceste 2010. The results were organized in two categories, each of them with three lexical classes. The first brought the meaning of the technology in intensive therapy and the organization of the styles of caring; the second showed the client’s condition and its impact on nurses’ care practices. It was concluded that the technology organizes the nurses’ styles of caring, that are built on client assistance in the work context. These lead nurses to assign meaning to their practices driving them to the elaboration of ways of acting in face of the technologies.

Styles of nurses' caring in Intensive Therapy mediated by technology

The objective was to identify the social representations of the intensive therapy nurses about the care practices in face of the technology. Participant observation and interviews were conducted with twenty one nurses of an intensive therapy center, at a Rio de Janeiro public hospital. Lexical analysis was applied, using the Alceste 2010. The results were organized in two categories, each of them with three lexical classes. The first brought the meaning of the technology in intensive therapy and the organization of the styles of caring; the second showed the client’s condition and its impact on nurses’ care practices. It was concluded that the technology organizes the nurses’ styles of caring, that are built on client assistance in the work context. These lead nurses to assign meaning to their practices driving them to the elaboration of ways of acting in face of the technologies.

Emotional Labour of Caregivers Confronted With Aggressive Brain-injured Patients

Background: Aggressive behaviours are common with people who have suffered brain injuries and induce difficult emotions among certified nursing assistants and medical‐psychological assistants who take care of them. These caregivers carry out emotional labour whose content and strategies are little known. Aim: The study explores the emotional labour of certified nursing assistants and medical‐psychological assistants faced with the aggressive behaviours of brain‐injured patients. Methods: Semi‐structured interviews were conducted with 37 caregivers. Interviews were analysed via a thematic content analysis. Results: The analysis shows that the emotional labour of caregivers varies in accordance with the state of “consciousness” or “non‐consciousness” that they attribute to the brain‐injured patient with regard to this aggressive behaviour. This is a deep acting strategy. Moreover, caregivers shut off their emotions in order not to transmit them to the patient. This surface acting has the first objective for the caregiver of maintaining control of the situation and a second objective of protecting the patient emotionally and therefore of being perceived as a “good” caregiver. Emotional labour also meets a need to preserve the professional self‐image and professional status negatively affected in the interaction with the aggressive brain‐injured patient. Conclusions: Our study specifies the different strategies of the emotional labour of caregivers and their circumstances of use when they are confronted with aggressive behaviour by brain‐injured patients. Targeted support for this emotional labour, such as training and practical analysis, is essential for the development of care practices promoting a caring relationship. HIGHLIGHTSEmotional labour of caregivers who take care of aggressive brain‐injured patients is explored.Emotional labour depends on the supposed “consciousness” of the patient about their aggressive behaviors.The social representations could constitute knowledge for dealing with situations and impacting their emotional regulation.Suppressing emotions in order not to transmit them allows caregivers to keep control of the situation.

Un marco conceptual de la clínica del cuidado de enfermería en la terapia intensiva

Objetivo: propor um marco conceitual para uma clinica do cuidado de enfermagem na terapia intensiva.Metodo: pesquisa de campo, descritiva e qualitativa, realizada com 21 enfermeiros de uma unidade de terapia intensiva de um hospital publico federal. Realizou-se entrevista semiestruturada e analise de conteudo tematico e lexical, com apoio do software Alceste.Resultados: os elementos que caracterizam a clinica do cuidado na terapia intensiva emergem dos saberes especializados, da interacao, do contexto do trabalho, dos tipos de paciente e de enfermeiro, proprios da terapia intensiva, e dos referenciais assistenciais.Conclusao: conclui-se que o marco conceitual da clinica do cuidado de terapia intensiva articula elementos proprios da dinâmica desse cenario: objetivos em relacao as tecnologias e atencao aos equipamentos e subjetivos relacionados a interacao humana, especificos dos cuidados de enfermagem, contrapondo-se as criticas pautadas na desumanizacao.Objective: to propose a conceptual framework for clinical nursing care in intensive care. Method: descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. Results: the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. Conclusion: the conceptual framework of the clinics intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.

Um marco conceitual da clínica do cuidado de enfermagem na terapia intensiva

Objetivo: propor um marco conceitual para uma clinica do cuidado de enfermagem na terapia intensiva.Metodo: pesquisa de campo, descritiva e qualitativa, realizada com 21 enfermeiros de uma unidade de terapia intensiva de um hospital publico federal. Realizou-se entrevista semiestruturada e analise de conteudo tematico e lexical, com apoio do software Alceste.Resultados: os elementos que caracterizam a clinica do cuidado na terapia intensiva emergem dos saberes especializados, da interacao, do contexto do trabalho, dos tipos de paciente e de enfermeiro, proprios da terapia intensiva, e dos referenciais assistenciais.Conclusao: conclui-se que o marco conceitual da clinica do cuidado de terapia intensiva articula elementos proprios da dinâmica desse cenario: objetivos em relacao as tecnologias e atencao aos equipamentos e subjetivos relacionados a interacao humana, especificos dos cuidados de enfermagem, contrapondo-se as criticas pautadas na desumanizacao.Objective: to propose a conceptual framework for clinical nursing care in intensive care. Method: descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. Results: the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. Conclusion: the conceptual framework of the clinics intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.

Estilos de cuidar de las enfermeras en la Terapia Intensiva mediados por la tecnología

The objective was to identify the social representations of the intensive therapy nurses about the care practices in face of the technology. Participant observation and interviews were conducted with twenty one nurses of an intensive therapy center, at a Rio de Janeiro public hospital. Lexical analysis was applied, using the Alceste 2010. The results were organized in two categories, each of them with three lexical classes. The first brought the meaning of the technology in intensive therapy and the organization of the styles of caring; the second showed the client’s condition and its impact on nurses’ care practices. It was concluded that the technology organizes the nurses’ styles of caring, that are built on client assistance in the work context. These lead nurses to assign meaning to their practices driving them to the elaboration of ways of acting in face of the technologies.