706 resultados para Education. Nursing. Associate. Nurses Aides. Patient care planning. Nursing process
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This research was conducted in Chia-Yi, Taiwan to study the needs of adult education participants to determine the factors necessary to provide direction for the development of university adult education curriculum and supportive government educational policies. Factors researched were characteristics of the adult learner, theories of adult learning, demands of adult education, and implications of university adult education as the theoretical foundation for the development of specific curriculum development efforts. The study investigated adult learning needs and their relationship with demographic variable. Analyzing the needs of adult education participant and the relative factors through a survey resulted in recommendations for the development of adult education program plans, content of curriculum, and teaching. Research questions were analyzed using descriptive statistics, frequencies, chi square, one-way analysis of variance (ANOVA), and post hoc analysis. ^ The study showed that most participants in these adult education activities were under forty, middle class, of above average educational levels, and either living or working in the city. People who were older, of lesser social and economic positions, with lower educational standards, and living/working in the country, did not participate as much in adult education opportunities. Recommendations included that in the planning or setting up of adult education activities, attention be given to all the possible barriers or problems that are likely to occur in people's participation, e.g., motivation, interests, content of courses, teaching methods, willingness of participation, qualification of teachers, time, funds, locations, and so on. It is suggested that the resolution of these problems can significantly increase the participation of adult education. ^
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The Acquired Immune Deficiency Syndrome (AIDS), considered today one chronic nature of the disease due to the advent of antiretroviral therapy (TARV), brings to individuals living with this disease, difficulties related to social interaction and adaptation to new physical condition and the routines imposed by the treatment. This reality has a strong impact on the lives of these people in order of overcoming them use coping strategies, Coping. In this context, the aim of this study was to characterize the epidemiological, clinical and life habits of people living with AIDS and analyze the coping strategies used with the situation of the disease, according to sociodemographic, clinical and life habits. This is a cross-sectional study with a quantitative approach. The sample consisted of 331 people registered at the clinic of the Hospital Giselda Trigueiro (HGT), located in Natal / RN, who had scheduling for outpatient medical consultation from January to August 2014. The study was approved by the Ethics Committee the Federal University of Rio Grande do Norte with the Presentation of Certificate for Ethics Assessment (CAAE), paragraph 16578613.0.0000.5537. The data of social characterization showed predominance of men (52%), young people (42%) coming from the capital (58%), mulatto (53%), single (56%), heterosexual (79%), poor (68 %). With regard to clinical aspects it has been found that most held the first HIV testing for less than five years (60%) had signs and symptoms of AIDS before the examination (90%) were hospitalized (90%) started ART for less than five years (60%) believe they have good knowledge of the disease (75%) and believe that their health has improved (92%). For lifestyle, it became clear that most do not consume alcohol (71%), do not smoke (88%) and do not use illicit drugs (92%) and never used condoms before diagnosis (62%) and only 192 (58%) use the currently codon. With regard to the reference was higher coping focused modes of emotion, although the problem solving has been the second most common. The mean scores of women, workers, religious and never abandoned the treatment were higher for all factors. Having a partner, living with family members and support in the treatment had higher average scores for various factors, coinciding in the confrontation, withdrawal and social support. As for the leisure and physical exercise also dominated the modes focused on emotion as was seen in the correlation between the time of treatment, education and family income and IEEFL factors, although with low intensity. The profile of the study population confers with national characteristics, suggesting feminization, internalization, pauperization, heterosexual, increased CD4 cell count and viral load reduction during treatment and maintaining healthy lifestyle habits. Coping strategies used were more focused on emotion. In this context, it is understood that the identification of these strategies can facilitate care planning, encouraging such persons to adapt to stressors with the situation of the disease
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This study aimed to build a virtual learning environment for application of the nursing process based on the NANDA-I, NOC, NIC and ICNP . Faced with problems related to learning of the nursing process and classifications, there is an urgent need to develop innovative teaching resources that modify the relationship between students and teachers. The methodology was based on the steps inception, development, construction and transition, and the software development process Rational Process Unifield. The team involved in the development of this environment was composed by researchers and students of The Care and Epidemiological Practice in Health and Nursing and Group of the Software Engineering curse of the Federal University Rio Grande do Norte, with the participation of the Lisbon and Porto Schools of Nursing, in Portugal. In the inception stage the inter research communication was in order to define the functions, features and tools for the construction process. In the preparation, step the planning and modeling occurred, which resulted in the creation of a diagram and a architectural drawings that specify the features and functionality of the software. The development, unit testing and integrated in interfaces of the modules and areas (administrator, teacher, student, and construction of the NP). Then the transition step was performed, which showed complete and functioning system, as well as the training and use by researchers with its use in practice. In conclusion, this study allowed for the planning and the construction of an educational technology, and it is expected that its implementation will trigger a substantial change in the learning of the nursing process and classifications, with the student being active agent of the learning process. Later, an assessment will be made of functional performance, which will enable the software development, with a feedback, correction of defects and necessary changes. It is believed that the software increment after the reviews, this tool grow further and help insert this methodology and every language under the educational and health institutions, promoting paradigmatic desired change by nursing.
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OBJECTIVE: To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. METHODS: In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. RESULTS: Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. CONCLUSIONS: Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.
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<p>AIMS: Prevention of cardiovascular disease and heart failure (HF) in a cost-effective manner is a public health goal. This work aims to assess the cost-effectiveness of the St Vincent's Screening TO Prevent Heart Failure (STOP-HF) intervention.</p><p>METHODS AND RESULTS: This is a substudy of 1054 participants with cardiovascular risk factors [median age 65.8years, interquartile range (IQR) 57.8:72.4, with 4.3years, IQR 3.4:5.2, follow-up]. Annual natriuretic peptide-based screening was performed, with collaborative cardiovascular care between specialist physicians and general practitioners provided to patients with BNP levels >50pg/mL. Analysis of cost per case prevented and cost-effectiveness per quality-adjusted life year (QALY) gained was performed. The primary clinical endpoint of LV dysfunction (LVD) with or without HF was reduced in intervention patients [odds ratio (OR) 0.60; 95% confidence interval (CI) 0.38-0.94; P = 0.026]. There were 157 deaths and/or emergency hospitalizations for major adverse cardiac events (MACE) in the control group vs. 102 in the intervention group (OR 0.68; 95% CI 0.49-0.93; P = 0.01). The cost per case of LVD/HF prevented was 9683 (sensitivity range -843 to 20 210), whereas the cost per MACE prevented was 3471 (sensitivity range -302 to 7245). Cardiovascular hospitalization savings offset increased outpatient and primary care costs. The cost per QALY gain was 1104 and the intervention has an 88% probability of being cost-effective at a willingness to pay threshold of 30 000.</p><p>CONCLUSION: Among patients with cardiovascular risk factors, natriuretic peptide-based screening and collaborative care reduced LVD, HF, and MACE, and has a high probability of being cost-effective.</p><p>TRIAL REGISTRATION: NCT00921960.</p>
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<p>IMPORTANCE: Prevention strategies for heart failure are needed.</p><p>OBJECTIVE: To determine the efficacy of a screening program using brain-type natriuretic peptide (BNP) and collaborative care in an at-risk population in reducing newly diagnosed heart failure and prevalence of significant left ventricular (LV) systolic and/or diastolic dysfunction.</p><p>DESIGN, SETTING, AND PARTICIPANTS: The St Vincent's Screening to Prevent Heart Failure Study, a parallel-group randomized trial involving 1374 participants with cardiovascular risk factors (mean age, 64.8 [SD, 10.2] years) recruited from 39 primary care practices in Ireland between January 2005 and December 2009 and followed up until December 2011 (mean follow-up, 4.2 [SD, 1.2] years).</p><p>INTERVENTION: Patients were randomly assigned to receive usual primary care (control condition; n=677) or screening with BNP testing (n=697). Intervention-group participants with BNP levels of 50 pg/mL or higher underwent echocardiography and collaborative care between their primary care physician and specialist cardiovascular service.</p><p>MAIN OUTCOMES AND MEASURES: The primary end point was prevalence of asymptomatic LV dysfunction with or without newly diagnosed heart failure. Secondary end points included emergency hospitalization for arrhythmia, transient ischemic attack, stroke, myocardial infarction, peripheral or pulmonary thrombosis/embolus, or heart failure.</p><p>RESULTS: A total of 263 patients (41.6%) in the intervention group had at least 1 BNP reading of 50 pg/mL or higher. The intervention group underwent more cardiovascular investigations (control, 496 per 1000 patient-years vs intervention, 850 per 1000 patient-years; incidence rate ratio, 1.71; 95% CI, 1.61-1.83; P<.001) and received more renin-angiotensin-aldosterone system-based therapy at follow-up (control, 49.6%; intervention, 56.5%; P=.01). The primary end point of LV dysfunction with or without heart failure was met in 59 (8.7%) of 677 in the control group and 37 (5.3%) of 697 in the intervention group (odds ratio [OR], 0.55; 95% CI, 0.37-0.82; P=.003). Asymptomatic LV dysfunction was found in 45 (6.6%) of 677 control-group patients and 30 (4.3%) of 697 intervention-group patients (OR, 0.57; 95% CI, 0.37-0.88; P=.01). Heart failure occurred in 14 (2.1%) of 677 control-group patients and 7 (1.0%) of 697 intervention-group patients (OR, 0.48; 95% CI, 0.20-1.20; P=.12). The incidence rates of emergency hospitalization for major cardiovascular events were 40.4 per 1000 patient-years in the control group vs 22.3 per 1000 patient-years in the intervention group (incidence rate ratio, 0.60; 95% CI, 0.45-0.81; P=.002).</p><p>CONCLUSION AND RELEVANCE: Among patients at risk of heart failure, BNP-based screening and collaborative care reduced the combined rates of LV systolic dysfunction, diastolic dysfunction, and heart failure.</p><p>TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00921960.</p>
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Although health policy would suggest that day surgery is the best service for patients undergoing a surgical procedure, it is important to consider the patient and whether this type of service is what they want. This information can be generated through a service evaluation with the results used to inform local decision-making, changes to care delivery and improvements in patient care. This article describes the results of a service evaluation performed in a single-site day surgery unit.
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<p>Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n=327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have benefits such as improved caregiver health outcomes, and enhancing their ability to meet care-giving demands, thereby potentially allowing for longer patient care in the home setting.</p>
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Introduction: Family members including children are all impacted by a family members mental illness. Although mental health services are increasingly encouraged to engage in family-focused practice, this is not a well-understood concept or practice in mental health care. Methods: An integrative review using systematic methods was conducted with international literature, with the aim of identifying concepts and practices of family-focused practice in child and youth and adult mental health services. Results: Findings from 40 peer-reviewed literature identified a range of understandings and applications of family-focused practice, including who comprises the family, whether the focus is family of origin or family of procreation or choice, and whether the context of practice is child and youth or adult. Family as defined by its members forms the foundation for practice that aims to provide a whole-of-family approach to care. Six core practices comprise a family focus to care: assessment; psychoeducation; family care planning and goal-setting; liaison between families and services; instrumental, emotional and social support; and a coordinated system of care between families and services. Conclusion: By incorporating key principles and the core family-focused practices into their care delivery, clinicians can facilitate a whole-of-family approach to care and strengthen family members wellbeing and resilience, and their individual and collective health outcomes.
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Bakgrund: Sjukskterskan har stor del i den nra patientvrden och frvntas vara en god lyssnare genom sitt personcentrerade vrdgivande. Hndelser som r traumatiska drabbar frutom den direkt berrda patienten ven sjukskterskan genom sekundr exponering. Syfte: Syftet med studien var att belysa frekomst av STS hos sjukskterskor samt beskriva hur det pverkar vrdkvalitet och personcentrerad vrd. Metod: Litteraturstudie med en versikt av relevanta artiklar i databaserna PubMed och CINAHL. Resultatet baseras p 14 artiklar som uppfyllde inklusionsoch kvalitetskrav. Resultat: Sjukskterskan pverkas av STS p flera plan, bde professionellt och personligt. Vrdkvaliteten blir lidande om STS pvisas. Den personcentrerade vrden utgr grunden i sjukskterskans yrkesutvande men om medvetenhet saknas fr STS finns risken att sjukskterskan pverkas s till den grad att hen vljer att sjukskriva sig och/eller byta arbetsplats. Slutsats: STS r ett relativt oknt begrepp och det kan vara svrt att se tecken p begynnande symtom. Sjukskterskan kan utsttas fr STS oberoende arbetsplats. Detta kan snka effekten i yrkesutvandet genom personliga symtom som; irritabilitet, trtthet, minskad empati, depression, terupplevelser av tidigare upplevda traumatiska hndelser med flera. Arbetsplatsens ledarskap inverkar p identifieringen av sjukskterskans utveckling/hanterande av STS.
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Objetivou-se caracterizar os saberes de enfermeiros sobre o Processo de Enfermagem. Mtodos: Trata-se de um estudo qualitativo de natureza exploratrio-descritivo, efetivado nos meses de agosto de 2010 a junho de 2011 com 12 enfermeiros atuantes da Estratgia de Sade da Famlia da cidade de Juazeiro do Norte-Cear. Aplicou-se uma entrevista atravs de um roteiro semiestruturado aps a assinatura do termo de anuncia pelos participantes. Resultados: Os enfermeiros percebem o Processo de Enfermagem como uma ferramenta tecnolgica que permite a oferta de uma assistncia de enfermagem sistemtica, racional e planejada, tendo em vista o reconhecimento e atendimento das necessidades humanas bsicas do ser cuidado. Concluso: Portanto, os enfermeiros detm uma convico clara acerca da significao do Processo de Enfermagem e sua capacidade de satisfazer as demandas de cuidado do indivduo, famlia e comunidade
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A prematuridade um problema de sade pblica que est intimamente ligada aos ndices de mortalidade infantil. Para que se consiga solucionar esse problema necessrio o preparo do sistema de sade em atender as necessidades das gestantes e por meio de uma eficaz assistncia pr-natal sejam identificados precocemente os fatores de risco na gestante, de forma a possibilitar uma interveno efetiva, caso seja necessrio. Este estudo tem por objetivo analisar a inter-relao entre as alteraes de sade e complicaes gestacionais que costumam estar relacionadas ocorrncia do parto prematuro e a rede de ateno sade disponibilizada s gestantes. Estudo quantitativo longitudinal, do tipo estudo de caso-controle. O local foi municpio do Rio Grande RS e os contextos de estudo referem-se s maternidades dos dois hospitais existentes no municpio, Hospital Universitrio Dr. Miguel Riet Corra Jr. e Associao de Caridade Santa Casa. Esta pesquisa trabalhou com dados secundrios, com a coleta realizada no banco de dados da pesquisa intitulada Parto prematuro: estudo dos fatores associados para construo de estratgias de preveno, do Grupo de Pesquisa Viver Mulher, da Escola de Enfermagem, da Universidade Federal do Rio Grande. A populao da pesquisa foram mulheres que apresentaram seu parto de forma prematura (casos) e mulheres com parto a termo (controles) em momento imediatamente posterior s que tm parto prematuro, durante os meses de novembro e dezembro de 2013, totalizando 29 casos e 29 controles. A coleta de dados foi iniciada em 01 de novembro e finalizada em 31 de dezembro, sendo realizada por integrantes do Grupo de Pesquisa Viver Mulher. A anlise dos dados se deu por meio da estatstica descritiva simples, com medidas de frequncia, para que se consiga visualizar a presena de complicaes e presena de tratamento aos agravos de sade e como foi organizada a rede de ateno sade nos casos e controles e assim constatar a relao das causas e dos efeitos nestes dois grupos. Os aspectos ticos envolvendo pesquisas com seres humanos foram respeitados, bem como se obteve aprovao dos comits de tica das instituies envolvidas, parecer n 134/2013 CEPAS FURG, parecer n 05/2013 CEPAS Santa Casa