Wilson Danilo Lunardi Filho

A humanização hospitalar como expressão da ética

The practice of health professionals in the hospital environment has been loosing its human characteristics in view of the care delivered to the disease rather than to the sick being, and also in view of the increasing technological complexity, associated with increasing costs. Ethics requires the implementation of a reflective process concerning the principles, values, rights, and duties ruling the practice of health professionals, the latter including the dimension of care from a humanized perspective. Thus, this study aimed to reflect on ethical considerations upon which humanization actions must be grounded, highlighting the importance of a human dimension in professional relations.A pratica dos profissionais de saude, no âmbito hospitalar, vem desumanizando-se frente a atencao a doenca, e nao ao ser doente, a complexificacao tecnologica crescente associada ao crescimento de custos. A etica requer a implementacao de um processo reflexivo acerca dos principios, valores, direitos e deveres que regem a pratica dos profissionais de saude, inserindo-se, ai, a dimensao de um cuidado entendido como humanizado. Assim, o presente estudo teve por objetivo refletir acerca de consideracoes eticas que necessitam fundamentar as acoes de humanizacao, destacando a importância da dimensao humana nas relacoes profissionais.

O cuidado de si como condição para o cuidado dos outros na prática de saúde

We need to take a critical look at our practices and the relationships we construct in our personal and professional life, with a view to leading a life guided by ethics. In this text, we discuss governability practices that are built in the relations between health and especially nursing professionals, with the health institutions, with the clients and with the nursing profession. We conclude that, for persons to deliver care and guide others, like nurses do in their practice, they first need to demonstrate that they can guide themselves, that they know the limits of their practice and can respect the other as someone different from themselves.We need to take a critical look at our practices and the relationships we construct in our personal and professional life, with a view to leading a life guided by ethics. In this text, we discuss governability practices that are built in the relations between health and especially nursing professionals, with the health institutions, with the clients and with the nursing profession. We conclude that, for persons to deliver care and guide others, like nurses do in their practice, they first need to demonstrate that they can guide themselves, that they know the limits of their practice and can respect the other as someone different from themselves.

Vivências de cuidados da mulher mastectomizada: uma pesquisa bibliográfica

This study aimed at knowing the scientific production concerning the care to the mastectomized woman, focusing the revealed feelings, the difficulties faced and the care strategies adopted by the nursing, a bibliographical search was carried out with 23 published articles since 1990, in national periodics. Using the proposed methodology by Salvador, the main womens feelings identified was fear, rejection, guilty and loss; amongst the difficulties, stand out the auto-image acceptance, the confrontation of the prejudice and the collateral effect of chemotherapeutic treatment, specially the alopecia, the pain and the physical difficulties. As main care strategy, it was identified the group activities, aiming at promotin the mastectomized woman self-esteem and to contribute for her quality of life.This study aimed at knowing the scientific production concerning the care to the mastectomized woman, focusing the revealed feelings, the difficulties faced and the care strategies adopted by the nursing, a bibliographical search was carried out with 23 published articles since 1990, in national periodics. Using the proposed methodology by Salvador, the main women’s feelings identified was fear, rejection, guilty and loss; amongst the difficulties, stand out the auto-image acceptance, the confrontation of the prejudice and the collateral effect of chemotherapeutic treatment, specially the alopecia, the pain and the physical difficulties. As main care strategy, it was identified the group activities, aiming at promotin the mastectomized woman self-steem and to contribute for her quality of life. Descriptors: Mastectomy; Breast neoplasms; Nursing care.

Resiliência e promoção da saúde

Resiliencia refere-se a capacidade dos seres humanos em enfrentar e responder de forma positiva as experiencias que possuem elevado potencial de risco para sua saude e desenvolvimento. Falar de resiliencia significa, portanto, falar de producao de saude em contextos adversos. Com o objetivo de responder ao que faz com que uma familia, mesmo vivendo em um contexto adverso, tenha uma pratica de cuidado capaz de criar as condicoes para que seus membros construam uma trajetoria de vida que pode ser considerada resiliente, e discutido o conceito de resiliencia e sua aproximacao com o de promocao da saude, apontando algumas acoes que podem potencializar as acoes dos profissionais que trabalham com familias em situacao de risco, tais como o deslocamento da enfase da dimensao de negatividade da doenca, para as potencialidades das pessoas/familias; a articulacao de acoes intersetoriais e interdisciplinares, compatibilizando politicas publicas saudaveis e a ampliacao de medidas protetoras a saude.

Apropriação e uso de conhecimentos de gestão para a mudança de cultura na enfermagem como disciplina

Este trabajo es una reflexion acerca de la posibilidad del uso de conocimientos de gestion en el proceso del trabajo en el area de la salud, presentando aspectos generales del proceso administrativo y las consideraciones sobre el trabajo de la enfermeria en el contexto general del trabajo en la salud y los elementos de la cultura organizativa y sus implicaciones en el contexto del trabajo de la Enfermeria. El mantenimiento del modelo de la gerencia tradicional como el principal orientador de la organizacion del trabajo en el area de la salud viene cohibiendo la produccion de la Asignatura de Enfermeria. Es urgente, en la Enfermeria, que se propicien en los trabajadores las debidas posibilidades para crear, desarrollar, usar nuevas herramientas y tecnologias para administrar el proceso de trabajo, encontrar formas creativas e innovadoras de producir y vivir, tener calidad de vida personal y profesional, ser etico/estetico, entre otros. Apropiarse y utilizar conocimientos acerca de las diferentes formas de administrar el proceso de produccion en el trabajo se presenta como una importante estrategia capaz de deparar y proporcionar el desarrollo de la Enfermeria como una asignatura.This project is a reflection concerning the possibility of using management knowledge in the process of health care work, presenting general aspects of the management process and considerations about nursing work in the general context of health care work, and elements of the organizational culture and their implications in the context of Nursing work. The maintenance of the traditional management model as the main orientation of work organization in health care has been inhibiting production within the academic area of Nursing. It urges, in Nursing, that workers are given possibilities to create, develop, and use new tools and technologies to manage the work process; to find creative and innovative forms to produce and to live, attaining satisfactory quality of life in personal and professional ways, and being ethical/aesthetic, amongst others. Taking possession and using knowledge concerning the different forms of managing the productive process in work is presented as an important strategy capable of making possible the development of Nursing as a subject.

Assistência humanizada ao cliente oncológico: reflexões junto à equipe

The present study is concerning a practice of assistance built and implemented with the health team members of an Oncology and Radiotherapy Service in a large general hospital in the east part of the state of Rio Grande do Sul, attempting to make the assistance more humane. It was a possibility of reflecting with the work team about the assistance provided to the patients in light of the proposals of SUS (New Public Health System) and with the perspective of the humanistic approach and its methodological proposals.The present study is concerning a practice of assistance built and implemented with the health team members of an Oncology and Radiotherapy Service in a large general hospital in the east part of the state of Rio Grande do Sul, attempting to make the assistance more humane. It was a possibility of reflecting with the work team about the assistance provided to the patients in light of the proposals of SUS (New Public Health System) and with the perspective of the humanistic approach and its methodological proposals. Descriptors: Oncology nursing; Education; Nursing Team; Ethics Title: Humanized assistance with an oncology patient: reflections with the health team

Uma tentativa de humanizar a relação da equipe de enfermagem com a família de pacientes internados na uti

The internment in the Unit of Intensive Therapy and the situation lived by the patient extends the suffering of this moment to the family, so much for the possible present risks as for his/her family members ́ distance. The objective of this experiment summary is to share experiences and knowledge built in the relationship with patients, family and nursing staff, in way to demonstrate the relevance of the humanization of the care in Unit of Intensive Therapy, contemplating the recognition of the patient’s individuality and his/her family, as well as, the own workers’ humanization. We used the stages proposed by Travelbee for the construction of a process of interpersonal interaction. The reflections on those existences allowed us to recognize the meaning of the interaction set with the nursing staff, patients and family members; it facilitated the expression of the feelings of the ones involved in the relationship, retrieving the sensibility and the ability to observe and the evaluation of the nursing actions. RESUMEN: El internamiento en la Unidad de Cuidados Intensivos y la situación vivida por el paciente extiende el sufrimiento durante este momento a la familia, tanto por los posibles riesgos presentes, cuanto por la distancia de su grupo familiar. El objetivo de este relato es de compartir las experiencias y los conocimientos construidos en la relación con los pacientes, la familia y el equipo de enfermería de manera de demostrar la relevancia de la humanización del cuidado en la Unidad de Cuidados Intensivos, el qual contempla el reconocimiento de la individualidad del paciente y de su familia, asi como, la humanización de los propios trabajadores. Nosotros usamos las fases propuestas por Travelbee para la construcción de un proceso de interacción interpersonal. Las reflexiones acerca de estas vivencias nos permitieron reconocer el significado de la interacción entre el equipo de enfermería, los pacientes y los miembros de la familia; facilitando la expresión de los sentimientos involucrados en la relación, también, el rescate de la sensibilidad y la habilidad para observar y la evaluación de las acciones de la enfermería. PALABRAS-CHAVE: Serviço hospitalar de enfermagem. Unidades de terapia intensiva. Relações profissional-família.A internacao na Unidade de Terapia Intensiva e a situacao vivida pelo paciente estende o sofrimento deste momento a familia, tanto pelos possiveis riscos presentes, como pelo distanciamento do seu familiar. O objetivo desse relato e compartilhar experiencias e conhecimentos construidos na relacao com pacientes, familiares e equipe de enfermagem, de modo a demonstrar a relevância da humanizacao do cuidado na Unidade de Terapia Intensiva, contemplando o reconhecimento da individualidade do paciente e de sua familia, bem como, a humanizacao dos proprios trabalhadores, utilizando as etapas propostas por Travelbee para a construcao de um processo de interacao interpessoal. Tais vivencias permitiram reconhecer o significado da interacao estabelecida com a equipe de enfermagem, pacientes e familiares; possibilitou a expressao dos sentimentos dos envolvidos na relacao, o resgate da sensibilidade e da habilidade para observar e a avaliacao das acoes de enfermagem.

As reuniões de equipe como elemento fundamental na organização do trabalho

The present study was developed as part of the Integrated Research Project New Forms of Health Work Organization: emphasis on nursing work, carried out at the University Hospital of the Rio Grande Federal University. A series of studies were carried out with the objective of identifying the occurrence, content, periodicity and vision of nursing personnel about staff meetings in order to understand the importance of holding periodic meetings. Interviews were carried out with 21 nursing professionals. Data analysis revealed two main categories: differences in vision about staff meetings among nursing personnel and dichotomy between what theory dictates and what truly happens in staff meetings.O presente estudo foi desenvolvido como parte do projeto integrado de pesquisa Novas formas de organizar o trabalho em saude: enfase no trabalho da enfermagem3, no Hospital Universitario Dr. Miguel Riet Correa Jr. da Fundacao Universidade Federal do Rio Grande. Os objetivos propostos foram os de realizar estudos para constatar a ocorrencia, o conteudo, a periodicidade e a visao dos trabalhadores da enfermagem sobre as reunioes de equipe para, assim, produzir conhecimentos a respeito da importância de sua realizacao periodica. Foram entrevistados 21 profissionais de enfermagem. Atraves da analise das entrevistas, emergiram duas grandes categorias: as diferentes visoes dos trabalhadores da enfermagem sobre as reunioes de equipe e a dicotomia entre o que a teoria preconiza e o que ocorre, na pratica, nas reunioes da equipe de enfermagem.

Hospital humanization as an expression of ethics

The practice of health professionals in the hospital environment has been loosing its human characteristics in view of the care delivered to the disease rather than to the sick being, and also in view of the increasing technological complexity, associated with increasing costs. Ethics requires the implementation of a reflective process concerning the principles, values, rights, and duties ruling the practice of health professionals, the latter including the dimension of care from a humanized perspective. Thus, this study aimed to reflect on ethical considerations upon which humanization actions must be grounded, highlighting the importance of a human dimension in professional relations.A pratica dos profissionais de saude, no âmbito hospitalar, vem desumanizando-se frente a atencao a doenca, e nao ao ser doente, a complexificacao tecnologica crescente associada ao crescimento de custos. A etica requer a implementacao de um processo reflexivo acerca dos principios, valores, direitos e deveres que regem a pratica dos profissionais de saude, inserindo-se, ai, a dimensao de um cuidado entendido como humanizado. Assim, o presente estudo teve por objetivo refletir acerca de consideracoes eticas que necessitam fundamentar as acoes de humanizacao, destacando a importância da dimensao humana nas relacoes profissionais.

AIDS e Diabetes Mellitus versus justiça distributiva no sistema público de saúde

Reflection about the way of distributing public resources in the area of health and the ensuing consequences. The fairness of distributive justice is questioned. We propose a contextual reading of the official figures through interrelations that make it possible to understand the meaning of government figures. AIDS and Diabetes, which have been chosen as paradigms, represent, respectively, the groups of Transmitted Diseases and Non-Transmitted Diseases. The official figures relating to the two diseases are correlated in some precise aspects such as expenses on drugs, prevalence, and evolution of mortality rates. We alert to the remarkable differences in official attention between these two diseases and to the consequences suffered by people affected with Diabetes and other nontransmitted diseases, arising from the insufficiency of public resources allotted for their health care.Reflection about the way of distributing public resources in the area of health and the ensuing consequences. The fairness of distributive justice is questioned. We propose a contextual reading of the official figures through interrelations that make it possible to understand the meaning of government figures. AIDS and Diabetes, which have been chosen as paradigms, represent, respectively, the groups of Transmitted Diseases and Non- Transmitted Diseases. The official figures relating to the two diseases are correlated in some precise aspects such as expenses on drugs, prevalence, and evolution of mortality rates. We alert to the remarkable differences in official attention between these two diseases and to the consequences suffered by people affected with Diabetes and other non- transmitted diseases, arising from the insufficiency of public resources allotted for their health care. Descriptors: fairness in the distribution and use of resources; transmitted diseases; diabetes Title: AIDS and diabetes mellitus versus distributive justice in the public health system