Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Impacto do trabalho noturno na qualidade de vida do profissional de enfermagem do gênero masculino

The nursing staff is now the largest contingent of professionals in healthcare environments, with more than 1.8 million professionals, and of these 15% are men, showing a masculinization of the historical profession and culturally conceived and carried out by women (COFEN / FIOCRUZ, 2013). This dissertation discusses the profession forward to some issues related to gender, quality of life and night work. Objective: To analyze the impact that shift work has the professional quality of life male, through a specific instrument to identify the main problems and joint damage to that front group to his professional activity. Methods: descriptivo, Cross-sectional study with a quantitative approach, performed with 72 professional male nursing staff, 41 (56.9%) nursing technicians, 18 (25%) of nursing assistants and 13 (18.1%) of nurses, in January 2015 in a university hospital in the city of Uberlândia (Minas Gerais). For this, we used the WHOQOL-BREF questionnaire. Quantitative variables were described as mean, standard deviation, maximum and minimum, in addition to the Shapiro-Wilk test and Kruskal-Wallis used in the data analysis, with a confidence level of 5% (p <0.05). Results: the profile of respondents, most are married 42 (58.3%) under the employment contract via Single Legal Regime 50 (69.4%) with mean age of 40 and having 16 years of service; and within a range of 0 to 100, the areas with better evaluation were the Social Relations (70.1) and psychological (67.5); already the worst were the Environment (57.4) and Physical (65.4). In the overall assessment, the average was 63.3 and staying below the national average (65-70). Thus, the professionals who were married obtained better scores, regardless of the category which is in the nursing team. Conclusions: The group is average, taking into account the standard deviation, but we can say that working conditions affect their profession, and these results allow the detection of the difficulties experienced by men of the nursing team, and can cooperate with the design strategies that benefit or minimize the search for conflicts that affect the health of these workers and their quality of life.

Eficácia de uma intervenção estruturada de enfermagem forense realizada a estudantes de enfermagem

Enquadramento: As ciências forenses têm um papel na sociedade atual cada vez mais relevante, na articulação entre o papel dos profissionais de saúde na preservação de provas e vestígios forenses e a aplicação da justiça. Os enfermeiros são muitas vezes os primeiros a contactar com as vítimas. Numa perspetiva de cuidados globais à vítima, necessitam de conhecimentos adequados em ciências forenses. Objetivo: Avaliar a eficácia de uma intervenção estruturada de enfermagem forense realizada em estudantes de enfermagem na melhoria dos conhecimentos sobre práticas forenses e as práticas de enfermagem a realizar perante situações forenses. Métodos: Estudo quasi-experimental, do tipo pré-teste e pós-teste, sem grupo controlo, realizado numa amostra não probabilística por conveniência, constituída por 84 estudantes do 3º e 4º ano do CLE. A amostra é constituída por 85,7% indivíduos do género feminino, com uma média de idades de 22,8±3,9 anos. Aplicou-se o QGEF e QCPEF, construídos por Cunha & Libório (2012) e o QPESF (Ribeiro & Dixe, 2016) baseado em três casos clínicos, construído pelos investigadores, antes e após a realização de um Curso Breve em Enfermagem Forense. Resultados: 98,8% dos participantes no estudo referem não ter recebido formação sobre enfermagem forense no CLE e 100% nunca realizou qualquer trabalho nesta área. Destes 97,6% não assistiram a situações que envolviam a colheita e preservação de provas forenses durante os estágios e 97,6% estudantes referem ser importante ou muito importante existência de enfermeiro forense em Portugal, bem como 96,4% referem a intervenção do enfermeiro forense como importante ou muito importante. Relativamente aos conhecimentos sobre práticas forenses num total de 74 questões verificamos que os valores após a formação (69,15±3,05) foram melhores que os obtidos antes da formação (62,95±4,47). Em relação aos conhecimentos sobre práticas de enfermagem a realizar perante situações forenses, num total de 49 questões, verificase que se obtém resultados superiores à mediana tanto no T0 (32,19±3,45) como no T1 (39,01±3,14), podendo pois dizer-se que a intervenção estruturada foi eficaz na melhoria das duas variáveis em estudo. Conclusão: Os resultados obtidos demonstram a importância da frequência de formação específica em Enfermagem Forense, tendo os estudantes participantes no estudo melhorado os seus conhecimentos em práticas forenses e nas práticas de enfermagem forense a realizar em situações forenses.

A ciência-ação: fundamentos filosóficos e relevância para a enfermagem

ENDERS,Bertha Cruz, FERREIRA,Priscila Brigolini Porfírio, MONTEIRO, Akemi Iwata.A ciencia-açao: fundamentos filosoficos e relevancia para a enfermagem. Revista Texto Contexto em Enfermagem, Florianópolis, v.19, n.1,p.161-7.Jan/Mar.2010.