The corporality of the client according to nursing students representations

This study based on the theory of the Social Representation that subsidized the apprehension and analysis of how nursing students had perceived and represented the body of their clients and the emergent subjectives of contact and relation of taking care. It was carried with 20 female students of four grades of the nursing faculty of the UNIFESP The data were obtained using interview and analysed by content analysis method (Categorial Analysis) that showed the following categories: body object, stigmatisation, student-client relationship, body communication, privacy's intrusion and embarrassing.     

The nurse and the nursing staff according to mothers of hospitalized children

This study was carried out at the Pediatrics Unit in a School Hospital of the city of S?o Paulo during the second semester of 2000. This is a qualitative research with the following objectives: (1) to understand how mothers with a child in hospital identify the nurse as well as other components of the nursing Staff (technicians and assistants) and (2) to learn about their perceptions about the care provided by the nursing staff. Eight mothers with a child hospitalized were individually interviewed. Speeches were submitted to a thematic analysis of the content. Two categories were observed: Identification of the nurse/nursing staff by mothers with a child in hospital and the perception of these mothers about the nursing staff. In the first category, the difficulty to identify the components of the nursing staff was observed. In the second, it was observed that the nursing activity is seen as subordinated to the medical area. Eventually, mothers have difficulty to distinguish what is performed by the nurse or by the other members of the staff but the entire nursing care is evaluated as very good. Besides, the nurse is considered as the one who solves the problem. Nursing is seen by these mothers as an activity mediated by the representation of motherhood. The care performed by this staff in spite of being considered as very good, still needs to be presented to mothers as professionals and self-employed in order to change a stereotyped view of nursing.     

Nurse's care practice according to the view of the healthcare team

This study aims to comprehend the healthcare team perception about the (in)visibility of care practice of being a nurse in pediatric critical care units, according to Paterson and Zderad Humanist Theory. This is a qualitative research that combines the phenomenological approach. For data collection, it was used semi-structured interviews with nurses, physicians, psichologists, physiotherapists, nurse aides and hygienization employes working in pediatric critical care units of a hospital in Curitiba. The analysis followed the steps proposed by Giorgi and presented six categories, being three related to nurses' perception and three related to the multiprofessional team. Based on these statements it was possible to outline a conceptual model of nurses' perception about invisibility in their care practice, and also showed ways to obtain nurses' visibility.     

The health care delivery system in the year 2000: nursing care for the societal client

The health care delivery system is defined as a societal entity consisting of all persons in the country capable of acting responsibly, and is seen as a client requiring nursing care. Using the nursing process (assessment, diagnosis, planning, intervention, and evaluation), the author determines a NANDA-approved diagnosis of body image disturbance and offers a care plan with the year 2000 as a time limit for short-term goals.     

Prevalent nursing diagnoses and interventions in the hospitalized elder care

OBJECTIVES: to identify the prevalent nursing diagnoses (ND) in the hospitalized elder care; to compare the prevalent ND with the duration of hospital stay and with the prescribed cares for their respective diagnoses. METHOD: Transversal historical study carried through in Porto Alegre, RS, by analyzing patient records age e60 years old, interned in clinical unities of a university hospital. RESULTS: 1665 records were analyzed; the four prevalent NANDA nursing diagnoses--within 62 identified ones--were: Self-Care Deficit--Bathing/Hygiene, Imbalanced Nutrition--Less than Body Requirements, Risk for Infection and Ineffective Breathing Patterns, varying from 14 to 17 days of hospital stay. THE MAIN CARES WERE: aiding bed bath, communicating diet acceptance, implementing routines of care in venous puncture and checking respiratory pattern. CONCLUSION: four prevalent ND were identified with the appropriate prescribed care. However, other care could have been established as a priority.     

Conversation: the fundamental nursing care from the perspective of the hospitalized patient

The study focuses conversation as care that integrates other elements of hospital nursing. It had as its objective to analyze conversation as an essential stage of the dialogue between the patient and the nursing team. Five people participated who had already been hospitalized and that were now under clinical monitoring due to learning to live with AIDS. The information was obtained by means of the "Almanac" technique of sensitivity and creativity, semi-structured interview, and by active observation. The study contributed to reinforce the relational nature of the nursing care and the position of the patient as an object of this care who expresses his/her requests and wants in the process of dialoguing between this person and the nursing staff, expressed by conversation, which is viewed as a significant factor in nursing care.     

Managed care in home health: social work practice and unmet client needs

Findings from a sample (n = 117) obtained through a survey mailed to a random sampling of social workers in home health agencies nation-wide suggest that the characteristics of patients discharged with unmet needs were psychosocial. Social work practice activities targeted transferring responsibility for care for patients from agencies and government/commercial third party payers to informal caregivers and community resources. Desired continuing education topics evidence the emphasis on effective interventions that facilitate discharge, interdisciplinary collaboration and practice evaluation.     

我院对首例艾滋病住院患者的护理体会

目的:探讨护理人员消除对艾滋病人的恐惧心理,对患者做好心理护理、药物治疗观察和饮食指导等措施和方法.方法:介绍对首例艾滋病住院患者的护理体会.结果:患者及亲属对病情有了正确认识,患者病情好转出院.结论:护理人员消除对艾滋病人的恐惧心理,是做好艾滋病住院病人护理工作的前提.     

The need for nursing care in intensive care units: daily patient assessment according to the nursing activities score (NAS)

This study aimed to characterize patients admitted to ICU according to their bio-social factors and admissions and verify the daily needs for nursing care according to NAS. The sample was composed by 50 adult patients who were consecutively admitted to the ICU of a University Hospital in S?o Paulo city. It was concluded that most patients were older than 60 with an average of 3.5-day stay in the ICU; they came from the Emergency Room and were referred to the Semi-Intensive Care Unit. NAS average was 66.5% (+/- 9.1) with a score higher than 50.0% during their stay in the ICU.     

Practice compatibility and type of framework: Essential dimensions in the salaried primary care practitioners'' approach to practice

A multivariate paradigm, aimed at furthering the understanding of the factors underlying the devotion to practice of salaried primary care practitioners, has been developed and subjected to empirical verification. A study among a sample of Israeli primary care practitioners (N = 134) revealed an empirical structure of "Practice Compatibility', suggesting that the devotion to practice is conditioned by the clinical and professional role compatibility. Compatibility in turn is contingent on the practitioners' conviction in the sincerity of manifest health care oriented goals of the care-providing-framework. The herein developed notion of "Practice Compatibility' facilitated the distinction between types of employing frameworks according to the factors predicting the salaried primary care practitioners' devotion to practice. In this respect the contribution of the present study is in identifying the factors underlying the salaried practitioners' motivation to practice. However, contrary to the expected, practice compatibility does not predict the primary care practitioners' likelihood to demonstrate affective behavior. Thus the data were unable to repudiate earlier evidence regarding the significance of the private fee-for-service framework in predicting affective behavior.     

Nursing care to the client with hypertension: a bibliographic review

This study aimed to identify the nursing care practices to the client with hypertension in the scientific production in the last ten years. It was carried out a bibliographic study, using in the BIREME, the LILACS, SciELO and BDENF's data basis, selecting thirty articles. The results were exposed in charts, tables and graphics, where prevails, in the literature analyzed, the nursing consultation as the more used practice, through the nursing attendance systematization and the Health Education with individual approaches, besides the realization of home visits with family approach. One believes that the systematization of nursing care will contribute in an expressive manner to the adhesion to the antihypertensive treatment.     

Classification of patients according to the degree of dependence on nursing care and illness severity in a post-anesthesia care unit

This study aimed to classify patients according to their degree of dependence on nursing care (Perroca Classification System) and correlate this with the anesthetic risk (American Society of Anesthesiologists--ASA classification) in a post-anesthesia care unit. A cross-sectional study was conducted, which included 402 patients, mean age 51.57 (±16.73) years, of which 216 (54%) were female. The results indicate that patients had a degree of dependence between intermediate and semi-intensive with an ASA classification of between two and three. There was a significant relationship between degree of dependence and ASA classification. The results indicate that the post-anesthesia care unit admits patients with semi-intensive care requirements and with moderate anesthetic risk.     

Mobile computing and the quality of home care nursing practice

We investigated the effects of the introduction of mobile computing on the quality of home care nursing practice in Québec. The software, which structured and organized the nursing activities in patients' homes, was installed sequentially in nine community health centres. The completeness of the nursing notes was compared in 77 paper records (pre-implementation) and 73 electronic records (post-implementation). Overall, the introduction of the software was associated with an improvement in the completeness of the nursing notes. All 137 nurse users were asked to complete a structured questionnaire. A total of 101 completed questionnaires were returned (74% response rate). Overall, the nurses reported a very high level of satisfaction with the quality of clinical information collected. A total of 57 semi-structured interviews were conducted and most nurses believed that the new software represented a user-friendly tool with a clear and understandable structure. A postal questionnaire was sent to approximately 1240 patients. A total of 223 patients returned the questionnaire (approximately 18% response rate). Overall, patients felt that the use of mobile computing during home visits allowed nurses to manage their health condition better and, hence, provide superior care services. The use of mobile computing had positive and significant effects on the quality of care provided by home nurses.     

Gender representations in nursing student and client relations: contributions to the learning process

The purpose of the study was to identity, to know, and to improve the knowledge about the relationships of gender among the students and the clients in the practice of nursing care. That was a qualitative study, based in the theory of social representation and analyzed concerning the gender theoretical references. Concerning the data base made, based in the technique of Central Core Theory. The results were organized in a "tree". Two main thematic ways were arisen as second interest elements: "The triad equality/difference/inequality in the nursing care" and "The lack of knowledge: a gap in the learning process". The results have showed a students' difficulty in the process to take care a patient who has a different gender of theirs; showed a speech based in the perception of the gender differences and in the belief of heterosexuality presumed.     

Quality of primary care practice in a large HMO according to physician specialty.

OBJECTIVE: To determine whether physician specialty was associated with differences in the quality of primary care practice and patient satisfaction in a large, group model HMO. DATA SOURCES/STUDY SETTING: 10,608 patients ages 35-85 years, selected using stratified probability sampling from the primary care panels of 60 family physicians (FPs), 245 general internists (GIMs), and 55 subspecialty internists (SIMs) at 13 facilities in the Kaiser Permanente Medical Care Program of Northern California. Patients were surveyed in 1995. STUDY DESIGN: A cross-sectional patient survey measured patient reports of physician performance on primary care measures of coordination, comprehensiveness, and accessibility of care, preventive care procedures, and health promotion. Additional items measured patient satisfaction and health values and beliefs. PRINCIPAL FINDINGS: Patients were remarkably similar across physician specialty groups in their health values and beliefs, ratings of the quality of primary care, and satisfaction. Patients rated GIMs higher than FPs on coordination (adjusted mean scores 68.0 and 58.4 respectively, p<.001) and slightly higher on accessibility and prevention; GIMs were rated more highly than SIMs on comprehensiveness (adjusted mean scores 76.4 and 73.8, p<.01). There were no significant differences between specialty groups on a variety of measures of patient satisfaction. CONCLUSIONS: Few differences in the quality of primary care were observed by physician specialty in the setting of a large, well-established group model HMO. These similarities may result from the direct influence of practice setting on physician behavior and organization of care or, indirectly, through the types of physicians attracted to a well-established group model HMO. In some settings, practice organization may have more influence than physician specialty on the delivery of primary care.     

Continuity of care in family practice. Part 1: dimensions of continuity.

This is the first in a series of four articles exploring the issue of continuity of care in family practice. There are four dimensions of continuity of care in family practice: chronological, geographical, interdisciplinary, and interpersonal. Each of these dimensions can be measured by specific actions and can, therefore, be evaluated and learned. Subsequent articles will deal with implications of continuity of care in family practice, its measurement and evaluation, and problems with its integration into family practice residency training.