A actuação do enfermeiro como gestor na unidade de terapia intensiva do Hospital Regional do Baixo Amazonas-Santarém-Pará-Brasil : um estudo de caso

Estudo descritivo que teve como objetivo avaliar a atuação do enfermeiro como gestor da Unidade de Terapia Intensiva do Hospital Regional do Baixo Amazonas Dr. Waldemar Pena – HRBA, o qual obteve o selo de Acreditado em Nível 1 em 2012. Para a obtenção dos dados utilizou-se um questionário elaborado com 10 perguntas subjetivas e aplicado aos enfermeiros gerentes que atuam nas Unidades de Terapia Intensiva e CTI do HRBA. Verificou-se nesse estudo que são indivíduos na faixa etária de 25 a 45 anos, com predominância do gênero feminino, com especialização em áreas diversas da enfermagem. Na atuação no setor de gerência, os enfermeiros estabelecem prioridades, direcionando sua equipe para os atendimentos assistenciais complexos aos pacientes, ficando o trabalho burocrático para ser realizado por último. Os entraves relatados são a insatisfação e o desgaste no exercício da função de gerente da unidade devido ao excesso de funcionários sem experiência em UTI, falta de autonomia, dupla jornada de trabalho, excesso de burocracia entre outras situações que se tornam motivos de estresse. Concluiu-se que a atuação do enfermeiro como gerente se respalda na função assistencial ao paciente através de cuidados diretos e indiretos e na organização dos trabalhos burocráticos na Unidade de Terapia Intensiva.

Análise de clima organizacional : um estudo com os militares do comando de fronteira Amapá

As organizações militares são sistemas constituídos com a finalidade de operacionalizar suas forças armadas para atuarem contra ameaças à integridade política do país. Dentro deste contexto é essencial que se tenha recursos humanos altamente qualificados, treinados, motivados e bem equipados para a preservação dos interesses vitais de uma nação. Desta forma analisar o clima organizacional do Comando de Fronteira Amapá é de fundamental importância para verificar aspectos que possam ocasionar deficiências no processo gerencial, bem como potencializar aspectos motivacionais inerentes à gestão de pessoas O trabalho realizado utilizou a pesquisa bibliográfica, de campo e documental na qual possibilitou o estudo de forma sistematizada, permitindo analisar o clima organizacional no Comando de Fronteira Amapá. A pesquisa foi realizada em caráter exploratório na qual empregou-se técnicas como o questionário e entrevistas com os militares da organização, na qual oportunizou-se a visualização de fatos através de observações na corporação.A análise da estrutura organizacional é primordial para a obtenção de fatores que possam prejudicar o clima organizacional e conseqüentemente a motivação dos militares, propondo estratégias a fim de melhorar o desempenho organizacional.

Comunicação nas organizações e tácticas de socialização : o caso dos estagiários de jornalismo televisivo

A presente investigação trata um tema muito discutido hoje em dia nos meios da comunicação social em Portugal, mas que se relaciona com uma problemática mais ampla de comunicação nas organizações: a integração dos estagiários de jornalismo nas estruturas redactoriais. Vários autores como Sara Meireles Graça, Paulo Faustino e José Luís Garcia têm-se debruçado sobre o problema do “corrupio” de jornalistas estagiários nas redacções e sobre outro tema muito controverso, directamente relacionado, que é o “trabalho escravo” no jornalismo (Garcia et. al., 2009, p. 147). Pretendemos aprofundar estas questões, averiguando a sua dimensão e qual o interesse das empresas neste e noutros processos de recrutamento e integração organizacional, assim como o que pensam sobre tudo isto os estagiários e outros intervenientes. O estudo terá como objecto as três estações generalistas de televisão em Portugal. A pesquisa empírica desenvolveu-se nestas três estações de televisão que, salvaguardando as suas particularidades, foram tomadas como organizações-exemplo para a análise dos processos de integração e socialização organizacional. Realizámos um estudo longitudinal com base numa metodologia de cariz qualitativo a partir do olhar, nomeadamente, dos responsáveis pelos estágios nas redacções e dos estagiários, que são os principais atores neste processo. Os resultados apontam para a existência em algumas televisões, de estagiários curriculares a desempenhar funções como se de jornalistas profissionais se tratassem. Em relação a este tema, também existem divergências de opinião entre as entidades que regulam a profissão e as que representam as televisões. Quanto às tácticas de socialização, as televisões conseguem formar profissionais autónomos, apesar da existência de alguns casos de insatisfação e desinvestimento por parte de estagiários.

Private industrial project management: a systems-based case study

The technique of linear responsibility analysis is used for a retrospective case study of a private industrial development consisting of an extension to existing buildings to provide a warehouse, services block and packing line. The organizational structure adopted on the project is analysed using concepts from systems theory which are included in Walker's theoretical model of the structure of building project organizations (Walker, 1981). This model proposes that the process of building provision can be viewed as systems and subsystems which are differentiated from each other at decision points. Further to this, the subsystems can be viewed as the interaction of managing system and operating system. Using Walker's model, a systematic analysis of the relationships between the contributors gives a quantitative assessment of the efficacy of the organizational structure used. The causes of the client's dissatisfaction with the outcome of the project were lack of integration and complexity of the managing system. However, there was a high level of satisfaction with the completed project and this is reflected by the way in which the organization structure corresponded to the model's propositions.

The influence of age and gender on food choice: a focus group exploration

With 25% of the UK population predicted to be obese by 2010, the costs to individuals and society are set to rise. Due to the extra economic and social pressures obesity causes, there is an increasing need to understand what motivates and prevents consumers from eating a healthy diet so as to be able to tailor policy interventions to specific groups in society. In so doing, it is important to explore potential variations in attitudes, motivation and behaviour as a function of age and gender. Both demographic factors are easily distinguished within society and a future intervention study which targets either, or both, of these would likely be both feasible and cost-effective for policy makers. As part of a preliminary study, six focus groups (total n = 43) were conducted at the University of Reading in November 2006, with groups segmented on the basis of age and gender. In order to gather more sensitive information, participants were also asked to fill out a short anonymous questionnaire before each focus group began, relating to healthy eating, alcohol consumption and body dissatisfaction. Making use of thematic content analysis, results suggested that most participants were aware of the type of foods that contribute to a healthy diet and the importance of achieving a healthy balance within a diet. However, they believed that healthy eating messages were often conflicting, and were uncertain about where to find information on the topic. Participants believed that the family has an important role in educating children about eating habits. Despite these similarities, there were a number of key differences among the groups in terms of their reasons for making food choices. Older participants (60+ years old) were more likely to make food choices based on health considerations. Participants between the ages of 18–30 were less concerned with this link, and instead focused on issues of food preparation and knowledge, prices and time. Younger female participants said they had more energy when they ate healthier diets; however, very often their food choices related to concern with their appearance. Older female participants also expressed this concern within the questionnaire, rather than in the group discussions. Overall, these results suggest that consumer motivations for healthy eating are diverse and that this must be considered by government, retailers and food producers.

Environmental quality and the productive workplace

A good working environment will help to provide the user with a good sense of wellbeing, inspiration and comfort. The main advantages of good environments is in terms of reduced upgrading investment, reduced sickness absence, an optimum level of productivity and improved overall satisfaction. Individuals respond very differently to their environments and research suggests a correlation between worker productivity and well-being, environmental, social and organisational factors. Research shows the occupants who report a high level of dissatisfaction about their job are usually the people who suffer more work and office environment related illnesses which affect their wellbeing, but not always so. Well-being expresses overall satisfaction. There is a connection between dissatisfied staff and low productivity; and a good sense of well-being is very important as it can lead to substantial productivity gain. If the environment is particularly bad people will be dissatisfied irrespective of job satisfaction. This paper describes research showing how environment affects productivity.

An experimental analysis of body checking

The relationship between repeated body checking and its impact on body size estimation and body dissatisfaction is of interest for two reasons. First, it has importance in theoretical accounts of the maintenance of eating disorders and, second, body checking is targeted in cognitive-behavioural treatment. The aim of this study was to determine the impact of manipulating body checking on body size estimation and body dissatisfaction. Sixty women were randomly assigned either to repeatedly scrutinize their bodies in a critical way in the mirror ("high body checking") or to refrain from body checking but to examine the whole of their bodies in a neutral way ("low body checking"). Body dissatisfaction, feelings of fatness and the strength of a particular self-critical thought increased immediately after the manipulation among those in the high body checking condition. Feelings of fatness decreased among those in the low body checking condition. These changes were short-lived. The manipulation did not effect estimations of body size or the discrepancy between estimations of body size and desired body size. The implications of these findings for understanding the influence of body checking on the maintenance of body dissatisfaction are considered. (c) 2006 Elsevier Ltd. All rights reserved.

Patients' attitudes towards, and information needs in relation to, nurse prescribing in rheumatology

Aims and objectives: To assess the level of confidence that rheumatology patients would have in nurse prescribing, the effects on likely adherence and particular concerns that these patients have. In addition, given that information provision has been cited as a potential benefit of nurse prescribing, the present study assessed the extent to which these patients would want an explanation for the selected medicine, as well as which types of information should be included in such an explanation. Background: Nurse prescribing has been successfully implemented in the UK in several healthcare settings. Existing research has not addressed the effects on patients' confidence and likely adherence, nor have patients' information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction. Methods: Fifty-four patients taking disease-modifying drugs for inflammatory joint disease attending a specialist rheumatology clinic self-completed a written questionnaire. Results: Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication. The level of concern was relatively low and the majority of concerns raised did not relate to the nurse's status. Strong support was expressed for the nurse providing an explanation for medicine choice. Conclusion: This research provides support for the prescription of medicines by nurses working in the area of rheumatology, the importance of nurses providing a full explanation about the selected medicines they prescribe for these patients and some indication as to which categories of information should be included. Relevance to clinical practice: Rheumatology patients who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood.

Communication and social regulation. the criminalization of work-related death

This paper addresses the movement towards criminalization as a tool for the regulation of work-related deaths in the United Kingdom and elsewhere in the last 20 years. This can be seen as reflecting dissatisfaction with the relevant law, although it is best understood in symbolic terms as a response to a disjunction between the instrumental nature and communicative aspirations of regulatory law. This paper uses empirical data gathered from interviews with members of the public to explore the role that such an offence might play. The findings demonstrate that the failures of regulatory law give rise to a desire for criminalization as a means of framing work-related safety events in normative terms.

Assessment of thought–shape fusion: initial validation of a short version of the trait thought–shape fusion scale

Objective: Thought–shape fusion (TSF) is a cognitive distortion that has been linked to eating pathology. Two studies were conducted to further explore this phenomenon and to establish the psychometric properties of a French short version of the TSF scale. Method: In Study 1, students (n 5 284) completed questionnaires assessing TSF and related psychopathology. In Study 2, the responses of women with eating disorders (n 5 22) and women with no history of an eating disorder (n 5 23) were compared. Results: The French short version of the TSF scale has a unifactorial structure, with convergent validity with measures of eating pathology, and good internal consistency. Depression, eating pathology, body dissatisfaction, and thought-action fusion emerged as predictors of TSF. Individuals with eating disorders have higher TSF, and more clinically relevant food-related thoughts than do women with no history of an eating disorder. Discussion: This research suggests that the shortened TSF scale can suitably measure this construct, and provides support for the notion that TSF is associated with eating pathology.

Why cancer patients choose in-patient complementary therapy in palliative care: a qualitative study at Arokhayasala Hospice in Thailand

Cancer patients often choose complementary and alternative medicine (CAM) in palliative care, often in addition to conventional treatment and without medical advice or approval. Herbal medicines (HM) are the most commonly used type of CAM, but rarely available on an in-patient basis for palliative care. The motivations which lead very ill patients to travel far to receive such therapies are not clear. A qualitative study was therefore carried out to investigate influences on choosing to attend a CAM herbal hospice, to identify cancer patients’ main concerns about end-of-life care. Semi-structured interviews with 32 patients were conducted and analysed using thematic analysis. Patients were recruited from Arokhayasala, a Buddhist cancer hospice in Thailand which provides CAM, in the form of HM, a restricted diet, Thai yoga, deep-breathing exercises, meditation, chanting, Dhamma, laughter and music therapy, free-of-charge. The main factors influencing decision-making were a positive attitude towards HMs and previous use of them, dissatisfaction with conventional treatment, the home environment and their relationships with hospital doctors. Patients’ own perceptions and experiences were more important in making the decision to use CAM, and especially HM, in palliative cancer care than referral by healthcare professionals or scientific evidence of efficacy. Patients were prepared to travel far and live away from home to receive such care, especially as it was cost-free. In view of patients’ previously stated satisfaction with the regime at the Arokhayasala, these findings may be relevant to the provision of in-patient cancer palliative care to other patients.

Dissonant Voices : Philosophy, Children's Literature, and Perfectionist Education

Dissonant Voices has a twofold aspiration. First, it is a philosophical treatment of everyday pedagogical interactions between children and their elders, between teachers and pupils. More specifically it is an exploration of the possibilities to go on with dissonant voices that interrupt established practices – our attunement – in behaviour, practice and thinking. Voices that are incomprehensible or expressions that are unacceptable, morally or otherwise. The text works on a tension between two inclinations: an inclination to wave off, discourage, or change an expression that is unacceptable or unintelligible; and an inclination to be tolerant and accept the dissonant expression as doing something worthwhile, but different. The second aspiration is a philosophical engagement with children’s literature. Reading children’s literature becomes a form of philosophising, a way to explore the complexity of a range of philosophical issues. This turn to literature marks a dissatisfaction with what philosophy can accomplish through argumentation and what philosophy can do with a particular and limited set of concepts for a subject, such as ethics. It is a way to go beyond philosophising as the founding of theories that justify particular responses. The philosophy of dissonance and children’s literature becomes a way to destabilise justifications of our established practices and ways of interacting. The philosophical investigations of dissonance are meant to make manifest the possibilities and risks of engaging in interactions beyond established agreement or attunements. Thinking of the dissonant voice as an expression beyond established practices calls for improvisation. Such improvisations become a perfectionist education where both the child and the elder, the teacher and the student, search for as yet unattained forms of interaction and take responsibility for every word and action of the interaction. The investigation goes through a number of picture books and novels for children such as Harry Potter, Garmann’s Summer, and books by Shaun Tan, Astrid Lindgren and Dr. Seuss as well narratives by J.R.R. Tolkien, Henrik Ibsen, Jane Austen and Henry David Thoreau. These works of fiction are read in conversation with philosophical works of, and inspired by, Ludwig Wittgenstein and Stanley Cavell, their moral perfectionism and ordinary language philosophy.

Kvinnors erfarenheter av sjuksköterskors bemötande i vårdandet av deras bröstcancer En litteraturöversikt

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor i Sverige. Att drabbas av bröstcancer beskrivs som en utmaning för kvinnans självkänsla, självbild, kvinnlighet och existens. Kvinnorna vill bli bemötta som en enskild individ och inte som en diagnos samt uppleva känslomässigt stöd från sjuksköterskorna. Syfte: Syftet är att genom en vetenskaplig litteraturöversikt beskriva vad kvinnor med bröstcancer har för erfarenheter av sjuksköterskors bemötande. Metod: Underlaget till denna litteraturöversikt består av 15 kvalitativa artiklar varav två delvis kvantitativa. Litteraturen har sökts via databaserna PubMed och Cinahl. Resultatet har sammanställts med hjälp av en analysmetod för kvalitativ forskning. Resultat: Majoriteten av kvinnorna var nöjda och tillfreds med sjuksköterskornas bemötande. Få kvinnor uttryckte missnöje. Kvinnorna uttryckte att sjuksköterskorna hade en viktig roll under deras sjukdomstid och kunde tillmötesgå deras behov. Sjuksköterskornas bemötande uppfattades empatiskt, hänsynsfullt och omtänksamt. De negativa erfarenheter vissa kvinnor beskrev var dålig uppföljning, obesvarade frågor om psykiska besvär, brist på emotionellt stöd och en rädsla av att vara till besvär. Slutsats: Sjuksköterskorna spelar en central roll i mötet med- och i tillfrisknandet hos kvinnor med bröstcancer.

Empregado, autônomo e empresário : a tomada de decisão no setor de transporte rodoviário de cargas em São Marcos, RS

São Marcos, no Rio Grande do Sul, caracteriza-se por sua participação no setor do transporte rodoviário de cargas, sendo o município brasileiro com maior número de veículos pesados por habitante. Este trabalho busca identificar os fatores que influenciam a tomada de decisão dentro desse ramo de negócios. Assim, são estudados quatro casos de profissionais da área. Esses indivíduos iniciaram sua trajetória na condição de empregados, passando em seguida para a fase de autônomos. No entanto, apenas dois deles prosperaram, tornando-se empresários; os outros dois retornaram à condição de empregados. O estudo também possibilitou identificar o nível de insatisfação dos empregados do setor na busca de um progresso dentro do mesmo, assim como observar o perfil de competência daqueles que chegam a implantar suas próprias organizações. Dessa forma, é possível formar um paralelo entre as experiências bem-sucedidas e as tentativas frustradas. Os dados foram levantados a partir de uma série de fontes de evidências como entrevistas, registros de arquivos e documentos dos personagens referidos. A análise desses dados leva à interpretação de dois fatores como fundamentais na tomada de decisões dos indivíduos que trabalham no transporte rodoviário de cargas: a intuição e a influência de outras pessoas que cercam os tomadores de decisão. Esses fatores reforçam a idéia da subjetividade dentro do processo administrativo. O trabalho possibilita a formação de um quadro de dados gerais a respeito do setor. Além disso, serve de referencial às atitudes de organizações públicas e privadas, de pessoas ligadas ao ramo e de jovens que pretendem entrar nesse universo de trabalho.