Brazilian Nursing Journal (Revista Brasileira de Enfermagem - REBEn)

335-6

Authors: Rosa Maria Godoy Serpa da Fonseca, Vânia Paula Stolte Rodrigues

Editorial.

347-53

Authors: Fernanda Machado da Silva, Maria de Lourdes Denardin Budó, Nara Marilene Oliveira Girardon-Perlini, Raquel Pötter Garcia, Graciela Dutra Sehnem, Dalva Cezar da Silva

This study investigated how the health knowledge is constructed by individuals with hypertension, accompanied by a team of family health. This is a qualitative descriptive study, conducted with nine individuals whose data were collected through semi-structured interviews and observation. The data was analyzed through thematic analysis. The construction of knowledge in health is influenced by many elements in the everyday life of the subjects. The dialogue and interaction with others are elements of greatest impact to build such knowledge. Thus, the health education group was pointed out as a relevant activity, both due to the explanations presented by the professionals, as well as the Exchange of knowledge and experiences with the other participants. It is concluded that although living the same pedagogical activities, the repercussions of the health education actions will take effect and will be noticed differently by the subjects. Key words: Health Education; Health Promotion; Hypertension; Community Health Nursing; Nursing.

360-5

Authors: Maria de Fátima da Silva Vieira Martins, Paula Cristina Almeida Cadima Remoaldo

This study aimed to identify the social representations of the nurse specialist in maternal health and obstetrical care under the gaze of the pregnant woman using a qualitative study of 50 pregnant women in three municipalities of the Northwest Portugal, which carry out their antenatal care in the health center of their residence area. Data were collected through semi-structured interviews between February and July 2007 and analyzed based on content analysis. The results showed that the nurse midwife is faced as a friend, guide and support in helping to experience the whole process inherent in the birth. This research can be a contribution for the improvement of the quality of care provided during pregnancy. Key words: Nurse’s Role; Pregnant; Qualitative Research.

373-80

Authors: Riany Moura Rocha Brites, Ângela Maria Mendes Abreu, Jorge Eduardo da Silva Soares Pinto

This study aimed to describe the causes of morbidity among servers retired for disability in a federal university; identify the socio-demographic and occupational profile of the retired for disability in general and for alcoholism; and make an association between these causes. This was a retrospective cross-sectional descriptive study; the population consisted of all servers retired for disability registered at the university. The total disability retirees was of 553 servers, especially in cases of retirement for psychiatric disorders (35.6%) as the leading cause of disability, and alcoholism led to the retirement of 9% of retirees. It was concluded that the highest percentage of disability retirement was composed of workers concentrated in the university hospital. Key words: Retirement; Morbidity; Alcoholism; Occupational Health.

386-93

Authors: Renata Maria Dias de Abreu, Rejane Maria Dias de Abreu Gonçalves, Ana Lúcia de Assis Simões

This is an exploratory, descriptive study, with a qualitative approach, which aimed to identify the reasons attributed by nursing professionals for the absences at work; and to describe the alternatives proposed for the reduction of the absences in a teaching hospital. It was carried out in a Federal Public Hospital with 29 professionals from the Intensive Care Unit, the unit with the greater number of absences at work in 2008. Data were collected through focus groups and submitted to thematic content analysis. It was evidenced, as reasons for the occurrence of absenteeism, the influence of the physical environment, management and interpersonal skills. It was highlighted, as alternatives for the reduction of absences at work, the participatory management, team work, service organization and therapeutic support. It was concluded that the absenteeism involves subjective issues with multiple dimensions, which cannot be clarified only through quantitative perspective. Key words: Nursing; Absenteeism; Human Resource Management; Nursing Human Resources; Worker’s Health.

401-7

Authors: Cinthia Calsinski Assis, Juliana de Lima Lopes, Luiz Antônio Nogueira-Martins, Alba Lucia Bottura Leite de Barros

This is a randomized clinical trial, aimed to compare the frequency and intensity of symptoms of anxiety in patients of preoperative cardiac surgery who received empathic behavior from nurse or family or those who received no specific type of empathic behavior. The sample consisted of 66 patients in preoperative of cardiac surgery, which were divided in three groups: empathic behavior by nurses, without specific empathic behavior and by family. Anxiety was assessed at two points in time: before and after the intervention. The instrument used was developed and validated by Suriano, comprising 19 defining characteristics of the nursing diagnosis anxiety. It was observed that the reduction of anxiety symptoms was higher in the group receiving empathic behavior of relatives when compared to the other two groups. The results suggested that encouraging the participation of family members can contribute to the reduction of anxiety symptoms in patients in preoperative cardiac surgery. Key words: Anxiety; Thoracic Surgery; Nursing Care; Preoperative Care.

415-21

Authors: Vanessa Cristina Mauricio, Norma Valéria Dantas de Oliveira Souza, Márcia Tereza Luz Lisboa

This study focused the social determinants of people with an ostomy that facilitate and / or hamper their work inclusion. The objectives were to identify and analyze the difficulties and facilities for people with an ostomy for work inclusion. Descriptiveexploratory, qualitative research, carried out with 20 stomized through semi-structured interviews, using the Thematic Content Analysis. The results revealed that the main difficulties of ostomy to step into the working environment were the loss of sphincter control, social isolation and lack of opportunities suitable to your health condition new jobs. The main facilitators were the creation of adapted toilets and flexible schedules. We conclude that the biopsychosocial changes caused by the presence of the stoma may hinder inclusion in the work of ostomy patients, however, with social support can be created flexible terms that help them in their return to work activities. Key words: Worker´s Health; Surgical Stoma; Rehabilitation.

430-7

Authors: Elisandra de Araújo Saldanha, Ana Beatriz de Almeida Medeiros, Cecília Maria Farias de Queiroz Frazão, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes, Ana Luisa Brandão de Carvalho Lira

Cross-sectional study conducted in a university hospital located in the Brazil´s northeastern with 50 patients in the prostatectomy immediate postoperative. The study aimed to identify the defining characteristics and related/ risk factors that are associated with nursing diagnoses present in patients undergoing to prostatectomy. Nine nursing diagnoses that are statistically associated with related/ risk factors and defining characteristics were identified. We conclude that the considerable number of identified associations between nursing diagnoses and their elements shows that professionals, especially those in the urology clinic, should be prepared for the various care needs of this clientele. Key words: Prostatectomy; Nursing Diagnosis; Statistical Analysis.

443-9

Authors: Rafaella Pessoa Moreira, Thelma Leite de Araujo, Tahissa Frota Cavalcante, Nirla Gomes Guedes, Marcos Venicios de Oliveira Lopes, Emília Soares Chaves

This study aimed a concept analysis of the nursing outcome Mobility in patients with stroke. A literature review was conducted, through the online access to databases: Scopus, Pubmed, CINAHL, Cochrane, and Lilacs, using the descriptors: mobility, stroke, nursing and their synonyms in Portuguese and Spanish. 1.521 articles were identified, resulting in 49, after careful selection. Noteworthy are the articles published in Canada (26.7%), on 2001 (95.9%), by physiotherapists (34.6%), and in rehabilitation units (61.5%). The attributes identified for Mobility were: walking, standing, sitting, put the leg side to side, turn around, start and stop walking, stair climbing, motor function, and motor skill transfer. A model case and a contrary case were built, and identified, as antecedents: postural control and balance; and, as consequents: performs tasks inside and outside the house and wanders without difficulty. It was concluded that the concepts of Mobility found in this study need to be validated with experts in the field and in clinical practice. Key words: Nursing; Stroke; Outcome Assessment.

457-61

Authors: Christiane Pereira Martins Casteli, Clayton Casteli, Maria Madalena Januário Leite

This study aimed to evaluate the data in the Computer System of Continuing Education in Nursing (SIEC), from the perspective of nurse specialists. In this exploratory study, seven experts attributed relevance / priority to the data set, through a questionnaire. The SIEC data set was evaluated with 70% of opinions, which confirms the user’s satisfaction with respect to the content of the system, according to the Brazilian standard ISO / IEC 14598-1. Professional categories, institution and scientific production, data of technical visiting and professional skills of the teaching activity category, and the assessment report of the student category assessment were scored with borderline percentage of 71% (n=5). It was concluded that the SIEC data set is relevant / priority for Continuing Education Service, constituting a minimum data set required for this service. Key words: Continuing Education; Information Systems; Telenursing; Informatics; Nursing.

468-72

Authors: Cristiane Cardoso de Paula, Stela Maris de Mello Padoin, Marlene Gomes Terra, Ívis Emília de Oliveira Souza, Ivone Evangelista Cabral

This paper aimed to report the experience of driving modes of an interview on data production in phenomenological research. The proposed study is an experience report of a phenomenological investigation in which the researchers present their experience with children, considering the interview as an existential encounter. It describes ways of conducting the interview in its ontic and ontological dimensions. The ontic dimension refers to the facts related to the interview, presented in the researcher, in the researched subject and in the environment; both in its planning and its development. The ontological dimension is based on empathy and intersubjectivity. The interview enables the access to meaningful structures to comprehend the being, as a way of building investigative/assistance possibilities that enable to reveal the being of the human. Key words: Interview; Data Collection; Qualitative Research.

175-6

Authors: Maria Márcia Bachion

Editorial.

187-94

Authors: Luciano Marques dos Santos, Hosana Rocha Valois, Silvone Santa Bárbara da Silva Santos, Evanilda Souza de Santana Carvalho, Rosana Castelo Branco de Santana, Sheila da Silva Sampaio

This study examines the applicability of the theoretical model “Looking to maintain the balance to meet the demands and take care of the hospitalized child” to families of children with chronic diseases in intensive care. This is a qualitative study that complied with Resolution 466/2012, and was approved by the Ethics Committee through the Resolution 0111.0.441.099-11. The Grounded Theory was adopted as methodological framework. The data were collected through semi-structured interviews with seven families of children hospitalized for chronic diseases. The research identified three phenomena, which were analyzed according to the theoretical model cited above: Difficult experience for the family; Modifying the functioning and family routine; and Receiving support in coping with chronic illness. The study showed that the theoretical model used can be applied to families of children with chronic illnesses because they experience an unexpected event that disrupts their daily life and demand the search for new strategies for coping. Key words: Pediatric Nursing; Child Hospitalized; Family; Chronic Disease.

202-7

Authors: Luciano Marques dos Santos, Jucélia Cavalcante Rodrigues da Silva, Evanilda Souza de Santana Carvalho, Ana Jaqueline Santiago Carneiro, Rosana Castelo Branco de Santana, Maria Cristina de Camargo Fonseca

The objective was to understand the puerpera’s experience during the first skin to skin contact with the newborn in the immediate postpartum period, the obstetric ward of a public hospital in a city in Bahia. Exploratory, descriptive and qualitative study, approved by the Ethics Committee and conducted with fourteen postpartum women, through semi-structured interviews in the period July-August 2011. The data were analyzed using Grounded Theory, identifying the phenomenon “Experiencing skin to skin contact as a mechanical act” and its three subcategories: “Encouraging the only contact”, “Contact as a mechanical act” and “Being forced to initiate breastfeeding. “Encouraging the skin to skin contact and immediate breastfeeding occur mechanically, being highlighted only the contact, requiring the puerperas to initiate breastfeeding in sudden and abrupt manner, not respecting their willingness to perform or not this practice. Key words: Humanized Childbirth; Obstetric Nursing; Breastfeeding; Mother and Son Relationships.

213-9

Authors: Monique Pio Astolpho, Aline Cristiane Cavicchioli Okido, Regina Aparecida Garcia Lima

The study aimed to characterize the institutions to support children with special health care needs and apprehend how to happen the interactions between these institutions and the other services that make up the network of care. This is a descriptive and exploratory study with qualitative approach. Ten people responsible for institutions which assist this clientele participated in this study. Semi structured interview was used as the instrument of data collection. The institutions assist approximately 3310 clients, with 432 children; eight assist beyond their capabilities and the pent-up demand is 200 patients; two have 24 hour care; most are non-governmental and the funding sources consist of donations, own and transfer government resources. With regard to the dynamics of the work process, integration and deficient articulation were mentioned. It is necessary to reorganize the services in order to have a qualified and integrative care, minimizing the difficulties of communication and cooperation among services. Key words: Pediatric Nursing; Child Care; Health Services; Non-Governmental Organizations.

227-32

Authors: Lara de Sá Neves Loureiro, Maria das Graças Melo Fernandes, Maria Miriam Lima da Nóbrega, Rosalina Aparecida Partezani Rodrigues

This is an epidemiological research, descriptive and transversal, which had as objectives to estimate the prevalence of overburden among family caregivers of dependent elderly in the city of João Pessoa, Paraíba, and to identify its relationship with the elderly’s conditions of health, functionality and demand for care. The population comprised 240 elderly people residents in the twenty census sectors in the referred city. The sample was composed of 52 elderly people with functional inability and their caregivers. To data collection, it was applied a structured questionnaire and the scales of Mini Mental State Examination, Katz Index and Burden Interview. The results demonstrated that 84.6% of caregivers showed overburden, which was associated with clinical and functional characteristics of the elderly and with the demand for care. The findings bring relevant contributions to the elaboration of public policies in order to establish formal support for families’ caregivers. Key words: Caregivers; Family; Overburden; Elderly; Nursing.

241-6

Authors: Paula Beatriz de Oliveira, Darlene Mara dos Santos Tavares

The study aimed to characterize the elderly residents in long-stay nursing homes (HHs) according to gender, age, education, cause of admission and length of stay; and to describe their health conditions according to the theory of Basic Human Needs. This was an analytical, observational and cross-sectional study with a quantitative approach, conducted with 86 seniors from eight NHs in a city of Triângulo Mineiro, state of Minas Gerais. For data analysis, it was used the descriptive statistics, simple and average frequency and standard deviation. The elderly were predominantly female (70.9 %), 80 years or older (44.2 %) and illiterate (48.8 %). The physiological needs affected were: high blood pressure (30.2 %); cognitive decline (58.7 %) and urinary incontinence (50 %). As psychosocial needs, everyone was dependent to perform the instrumental activities of daily living and 52.3 % have indicative of depression. As for the psicoespiritual needs, 70.9 % did not practice any religion. The basic human needs identified as affected were contributing to a decreased on the quality of life of seniors. Key words: Health of Institutionalized Elderly; Homes for the Aged; Geriatric Assessment; Geriatric Nursing; Needs Assessment.

252-60

Authors: Rafael Celestino da Silva, Márcia de Assunção Ferreira, Thémistoklis Apostolidis

The objective was to identify the social representations of the intensive therapy nurses about the care practices in face of the technology. Participant observation and interviews were conducted with twenty one nurses of an intensive therapy center, at a Rio de Janeiro public hospital. Lexical analysis was applied, using the Alceste 2010. The results were organized in two categories, each of them with three lexical classes. The first brought the meaning of the technology in intensive therapy and the organization of the styles of caring; the second showed the client’s condition and its impact on nurses’ care practices. It was concluded that the technology organizes the nurses’ styles of caring, that are built on client assistance in the work context. These lead nurses to assign meaning to their practices driving them to the elaboration of ways of acting in face of the technologies. Key words: Nursing. Social Psychology; Nursing Care; Biomedical Technology.

268-73

Authors: Lilian Cristiane Gomes-Villas Boas, Maria Cristina Foss-Freitas, Ana Emilia Pace

This cross-sectional and quantitative study aimed to evaluate the adherence to drug treatment of the people with diabetes mellitus and its relation to clinical, treatment and metabolic control variables. Sample consisted of 162 people with type 2 diabetes mellitus on follow-up outpatient care. The Measure of Treatment Adherence and consultation to the participants’ medical records were used for data collection. A high adherence to drug treatment was obtained. For a p<0.05, it was obtained an inverse correlation with diastolic blood pressure and a direct correlation with the frequency of daily administration of insulin and oral antidiabetic agents. There were no statistically significant correlations between adherence and metabolic control variables. Results diverge from the literature regarding the adherence to drug treatment in chronic diseases, as well as in the correlation between adherence and complexity of drug regimen, which points to the need for more studies on this theme. Key words: Diabetes Mellitus; Patient Compliance; Nursing Care.

282-9

Authors: Manuela Beatriz Velho, Evanguelia Kotzias Atherino dos Santos, Vânia Sorgatto Collaço

Aiming to understand the social representations of natural childbirth and caesarean section for women who experienced them, it was developed a descriptive, qualitative research. Interviews were conducted from July to October 2010, with twenty women who experienced both types of birth. The number of participants was determined by theoretical saturation during data collection and content analysis. The results showed, during the experience of motherhood: the search for information, the experience of childbirth alone versus support at birth; and that the woman has no option of choice on type of birth. Natural childbirth includes important issues such as: the ambivalence of feelings, positive perception and hospitalization. Cesarean section is associated with ambivalence of feelings, understood as a solution of a problem and the preference for cesarean section. The natural childbirth is a challenge for women, but the positive feelings outweigh the difficulties, while the cesarean section is associated to the physical benefits of its execution. Key words: Natural Childbirth; Cesarean Section; Nursing; Social Behavior; Qualitative Research.

296-301

Authors: Eder Pereira Rodrigues, Urbanir Santana Rodrigues, Luciana de Matos Mota Oliveira, Rodrigo Cunha Sales Laudano, Carlito Lopes Nascimento Sobrinho

This study aimed to describe the prevalence of “suspected” of common mental disorders (CMD) in nursing workers at a general hospital in the state of Bahia. It was carried out a cross-sectional epidemiological study with 309 nursing workers, who worked in welfare activities in a large hospital. The nurses mentioned overwork and low pay. The most frequent health complaints were related to body posture and mental health. The overall prevalence of “suspected” of CMD was 35.0%. Regarding the psychosocial aspects of work, it was reported high psychological demand and low control over their work activities. The results indicated that the working and health conditions observed are not suitable for the effective realization of nursing work in the hospital. Key words: Working Conditions; Worker Health; Nursing Human Resources; Mental Disorders.

306-11

Authors: Vita Guimarães Mongiovi, Rita de Cássia Cordeiro Bastos Leite dos Anjos, Suellem Beatriz Holanda Soares, Tânia Maria Lago-Falcão

The National Policy of Care Humanization and Health System Management are configured as a complex public policy which encompasses the structural, technical and relational aspects of the health service. However, this policy has failed at establishing the boundaries of its activities and the conceptual aspects of the humanization term. This study aimed to perform a reflection about the humanization of health through a conceptual analysis of the term itself and in the interpretation of speeches of nurses working in Intensive Care Units, collected in a qualitative research. It was concluded that nurses have an intuitive insight of the definition of humanization, understanding the necessity of conducting a holistic assistance beyond mere technique and also covering the physiological, psychological, social and spiritual aspects of care. At the same time they demonstrate the lack of preparation in professional education for the implementation of this humanized assistance. Key words: Humanization of Assistance; Intensive Care; Health Policy.

9-10

Authors: Angela Maria Alvarez , Lucília de Fátima Santana Jardim

Editorial

22-7

Authors: Eliana Rocci, Rosa Aurea Quintella Fernandes

The study aimed to verify the average time of exclusive breastfeeding (AME) of infants born at Baby-Friendly Hospital Initiative(BFHI) and to associate it with the following variables: marital status, mother’s age, infant’s weight, difficulties found and instructions received. This is a cohort study with a sample of 225 mothers interviewed postpartum and on the 15th, 30th, 60th, 120th and 180th days after discharge, by telephone. The monitoring of AME showed median of 113 days and 34,1% of the mothers kept it for up 180 days. There was a significant statistical correlation between the time of AME and difficulties found. There was no significant statistical correlation between time of AME and the variables: marital status, mother’s age, infant’s weight and instructions received. This research showed increased weaning at 60 days in women who have had difficulty in pre-discharge. The study showed the positive influence of the BFHI in adherence of mothers to the AME. Key words: Breastfeeding; Weaning; Child Nutrition; Public Policies.

36-42

Authors: Kézia de Oliveira, Marly Veronez, Camilla Delavalentina Cavalini Marques, Ieda Harumi Higarashi, Sonia Silva Marcon

Exploratory and descriptive study, of qualitative nature, developed with the purpose of knowing the route of the child’s family admitted to the hospital. The data were collected at the pediatric unit of the Regional University Hospital of Maringá (HUM), through semi-structured interviews with the accompanying family members. After analysis of content, two categories emerged: the role of the family in the identification of deviations in the child’s health, and the (un)readiness of the health services: impacts on the child health attendance. The study evidenced an expectation of the family in face of the child’s illness, searching for alternative strategies and late seeking for health services. These, in turn, show gaps along the attendance process, from diagnosis to treatment, thus raising familiar stress and increasing the possibilities of aggravation of the clinical condition of the child. Key words: Child; Family; Illness; Attendance; Early Diagnosis.

48-53

Authors: Ana Clara Patriota Chaves, Elys Oliveira Bezerra, Maria Lúcia Duarte Pereira, Wolfgang Wagner

The research objectives were to describe the knowledge about the transmission of HIV/AIDS, analyze the sexual behavior and attitudes towards condom use among adolescents. Exploratory survey conducted in 2009 with 234 students of a school in Fortaleza, Brazil. We used semi - structured questionnaire and Likert Scale. The results showed that 46.6% of the sample have already initiated sexual life, 40.7% and 29.5% did not use condoms at the first or last intercourse, respectively, due to various reasons like not having a condom at the time (27.3%), use of contraceptive pill (15.2%) and trust in their partner (15.2%). These teenagers have questions about HIV transmission. Women were more favorable to condom use than men. One conclude that early initiation of sexual life, doubts about HIV transmission and ineffective condom use are factors that make young people’s vulnerability. Key words: Acquired Immunodefi ciency Syndrome; Knowledge; Attitudes to Health; Adolescent.

62-70

Authors: Kallen Dettmann Wandekoken, Marluce Miguel de Siqueira

The objective was to propose a care strategy for crack users, through implementation of the nursing process. This is a case study, descriptive and exploratory with qualitative approach based on Neuman and the NANDA-NIC-NOC. Scenario: Psychosocial Care Center - Alcohol and Drugs from Vitória-ES. We applied the standard questionnaire of crack consumption, Addiction Severity Index, Mini International Neuropsychiatric Interview and Parental Bonding Instrument. It was found the complexity that lining the intra, inter and extra personal stressful situations. We discussed three diagnoses: ‘poor knowledge about the substance use control‘, ‘ineffective coping’ and ‘social isolation’, and interventions were suggested by articulation between NIC, NOC and secondary prevention of Neuman. It is therefore an important function of the nurse to mobilize system resources - internal and external - for stabilization and conservation of energy, in order to strengthen the lines of resistance, in addition to considering all the variables of the system and not only the use of crack. Key words: Nurse’s Practice Patterns; Crack; Nurse’s Role.

78-84

Authors: Cátia Inácia Brand, Rosane Teresinha Fontana

This is a descriptive study with a qualitative approach that aimed to investigate the knowledge and practices of the nursing staff about biosafety in Intensive Care Units, and identify biohazard situations to which the worker is exposed, and the units’ adherence to standard Regulating nº 32. Data collection was done through interviews and observation, in the first half of 2012, and the processing of data was done through thematic analysis. This study showed partial adherence to biosafety standards by institutions and professionals surveyed and deficiency of discussions on the topic in the spaces of continuing education. The promotion of initiatives for education of safe practices and the update was established as promoter of health and the prevention of legal exposures by health infractions so configured. Key words: Biosafety; Occupational Health; Intensive Care.

91-6

Authors: Edaiane Joana Lima Barros, Silvana Sidney Costa Santos, Giovana Calcagno Gomes, Alacoque Lorenzini Erdmann, Marlene Teda Pelzer, Daiane Porto Gautério

The goal was to identify the ecosystem and gerontogeriatric technological actions to be done in a complex nursing care for the elderly patients of ostomy. To do so, a qualitative and descriptive research was made on a Case Study. The data were collected through interviews. The elderly were classified due to the Functioning, Disability and Health. They also went through physical exams and systematic observation. Ten people from the Estomatherapy Service of the south of Brazil took part in the research along the period of June to August of 2012. A theoretical model was developed and the data were compared with a protocol. The ecosystem actions identified the construction of a therapeutic environment, the guaranty of physical access and environmental adaptation. The gerontogeriatric technological actions identified a health educative process, the routing to the support group and the material and necessary equipment distribution for self-care. Being the nursing care primordial for the elderly patients of ostomy, they are able to face their limitations, demystifying their deficiency/ disability /health. Key words: Nursing care; Ostomy; Elderly; International Classifi cation of Functioning, Disability and Health; Nursing.

104-10

Authors: Gisele Vieira Dourado Oliveira Lopes, Tânia Maria de Oliva Menezes, Adriana Cerqueira Miranda, Kênya Lima de Araújo, Eleonora Lima Peixinho Guimarães

Qualitative study conducted between April and June 2010, in a health-care teacher who works in the Family Health Strategy, located in Salvador -Bahia, the study aimed to analyze the perceptions of users about the embracement. Study participants were 12 subjects of both sexes. The data were submitted to categorical analysis, from which emerged four categories: User understanding on embracement; Relationship between the health team and embracement; Embracement as part of accountability, co-responsibility and problem solving; Barriers to embracement. The analysis and discussion of the above categories suggests that the embracement is a proposal on continuous improvement even when there is an effort to achieve them in health practices coming in the intersubjectivity of the subjects involved. Key words: Family Health; User Embracement; Health Care.

119-26

Authors: Renata Siqueira Julio, Monique Borsato Silva Filardi, Maria Helena Palucci Marziale

The study aimed to identify the profile accidents involving exposure to biological material occurring in Minas Gerais. A descriptive study carried out by querying the Information System for Notifiable Diseases, 50 cities in south of Minas Gerais State, Brazil, in the period of 2007-2011. Were recorded 460 accidents, and about half occurred among nursing assistants and technicians, followed by nurses and physicians. There were more accidents due to improper disposal of sharps. Among the source patients, there was a 8.0% prevalence of positive serology for HIV, 1.0% for HBsAg, 6.0% for anti-HBc and 3% for anti-HCV. Among the injured 14.0% were not immunized to hepatitis B; however, the vaccine and immunoglobulin prescription was lower than necessary. The results will subsidize the plan preventive measures and new approach towards the occurrence of such accidents. Key words: Occupational Health; Exposure to Biological Agents; Biohazard; Nursing.

133-40

Authors: Tiago Cristiano de Lima, Fábio Ricardo Consorti Paixão, Elaine Cristina Cândido, Claudinei José Gomes Campos, Maria Filomena Ceolim

Qualitative study aimed to analyze the experience of students in the development of Supervised Curricular Internship activities which are part of the curricula of the undergraduate nursing course from a public university in the state of Sao Paulo, Brazil. The material for analysis was composed of the students’ final reports taken on the end of the activities. Documental analysis was used in order to understand the experiences of the students. We analyzed six documents for which we used thematic content analysis as theoretical framework in an attempt to identify meanings and to obtain inferences about the documents produced. The reports allowed to conclude that the students’ experience with the Supervised Curricular Internship was positive and contributed to develop a link between theory offered by the academy and daily routine/practice of nursing profession. Personal and professional growth was mentioned by the students as essential for them to feel empowered to act as confident and competent professionals. Key words: Students; Curriculum; Nursing; Teaching.

149-54

Authors: Suzana de Oliveira Mangueira, Marcos Venícios de Oliveira Lopes

Alcoholism is considered an associated factor to the family dysfunction, revealing the need for health professionals to overcome the purely individual perspective to offer a systemic focus. The aim of this study was to analyze the concept dysfunctional family in the context of alcoholism. The study followed the Concept Analysis Model and steps of integrative literature review. It was identified the antecedents of alcoholism, the attributes and the consequent dysfunctional family and it was reported a model case which illustrated the presence of these elements. It was observed that this is a broad concept, subjective and complex, with emphasis on studies on the consequents related to children of alcoholics. Key words: Alcoholism; Family; Nursing.

9-10

Authors: Telma Ribeiro Garcia

Editorial.

24-32

Authors: Vilma de Carvalho

This paper is a contribution to the 80th years of the Brazilian Nursing Journal, official journal of the Brazilian Nurses Association, first nominated Nursing Annals and created in May 1932. At that time, the issues were focused as proposals to assure exchange communication between the Professional Class – the National Brazilian Graduate Nurses Association – and the associates, including all the people. In this way, the associate leaders were impelled through professional advances allied to the knowledge production regarding to the Professional Know/Knowledge, the practice assistance and education. The approach is through discussion and analytical appreciation about professional identity with punctual reconsiderations in philosophical vision. Instead of researching parameters the author prefers a pragmatic style around examples of three situations-problem as succeeded in the practical assistance, so that they could be critically appreciated alike fundamental basis to the nurses’ art and enough to assure the definition of the professional profile in the historical-evolutive trajectory – with beginning in the nightingalean modernity and the proper assumed parsonian concepts – as such they are observed in the Brazilian Nursing literature. Without through off the subject, only the specific questions are submitted. Key words: Nursing; Professional Identity; Nurse Art.

39-44

Authors: Denise Elvira Pires de Pires

The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care. Key words: Nursing; Profession; Care; Science.

51-9

Authors: Alacoque Lorenzini Erdmann, Lorita Marlena Freitag Pagliuca

The aim was to describe aspects of the nursing evolution in the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq), focusing on the organizational structure and positions of the Area Representation and the advances in nursing knowledge. This is an experience report, accompanied by reflections and attitudes towards science, technology and innovation of Brazilian nursing and the creation of the Nursing Advisory Committee at the CNPq, in 2006. This paper is intended for the special issue of the Brazilian Nursing Journal (Revista Brasileira de Enfermagem), a prominent scientific nursing journal of nursing, in the celebration of its 80 years of existence. Brazilian nursing records scientific qualification advances in the preparation of its researchers, marking a new era in the consolidation and recognition of the discipline and profession. Key words: Nursing; Science; Nursing Research; History of Nursing.

66-75

Authors: Rosa Maria Godoy Serpa da Fonseca, Rebeca Nunes Guedes Oliveira

The article aimed to recover historical and synthesis of discussions within the National Seminar on Nursing Research (SENPE) about research lines, materializing in this context, the construction of nursing knowledge. This is a documentary research, whose sources were the Annals of sixteen SENPE, conducted from 1979 to 2011. It was observed that the discussion on the research lines was a constant concern in those Seminars, although with different gradations, from its genesis to the present time. The scenario configures itself with the inclusion of adverse consequences of the quantitative production and dissemination of studies without necessarily articulated them with a praxis purpose. The concerns externalized in the trajectory analyzed inaugurate the search for praxis in nursing to contribute to the discussion of the research from the perspective of the political nature of the construction, dissemination and evaluation of knowledge, from the understanding of the contradictions inherent in this process. Key words: Nursing; Nursing Research; Congresses; Knowledge; Methodology.

80-9

Authors: Carmen Gracinda Silvan Scochi, Denize Bouttelet Munari, Francine Lima Gelbcke, Alacoque Lorenzini Erdmann, Maria Gaby Rivero de Gutiérrez, Rosalina Aparecida Partezani Rodrigues

Nursing is a specific field of knowledge and social practice that has been consolidated and strengthened as science. In Brazil, it has been developed due to the increase and qualification of strict sense post-graduate programs. This study aims to present a historical review of the strict sense post-graduate nursing courses in Brazil and to reflect on their evolution, progress, challenges and future perspectives. It explores the creation of strict sense post-graduate courses, highlighting the movement to build a culture of academic and professional post-graduation in nursing. The historical path of their consolidation, expansion, conquest of excellence and international visibility over four decades, and the challenges and future perspectives are showed. It is found that the post-graduate programs in the field has contributed to the advancement and consolidation of scientific, technological knowledge and innovation in nursing and health care, having as philosophy the respect for diversity and the free exchange of ideas, the improvement of quality of life and health, and the effectiveness of citizenship. Key words: Nursing Post-Graduate Education; Nursing Research; Nursing.

95-101

Authors: Josicelia Dumêt Fernandes, Lyra Calhau Rebouças

The Curriculum Guidelines of the Undergraduate Nursing are references to the strengthening of the changes in training of professionals critics and committed to health. Seeking to identify these changes, this study aimed to analyze the progress and challenges of a decade of these Guidelines. This is a documentary research, in which it was analyzed the Law of Guidelines and Bases of National Education, the CNE / CES Resolution n º 03/2001, and the Brazilian intellectual production on the theme in the decade of 2001 to 2011. This production was sought in scientific journals, through the data bases BDENF, SciELO and LILACS. The analysis was anchored on the methodological framework of the dialectic which provided the study of the subject in its dynamism, contradictions and all of its inclusion in public policy. The results showed improvements in the strengthening of change in nursing education, in line with the policies of education and health. Key words: Curriculum Guidelines; Nursing Education; Nursing.

111-8

Authors: Wilza Rocha Pereira

The research aimed to analyze the production of knowledge in nursing at a public university, in order to evaluate the impact of that production during the Nursing Graduation. An exploratory and descriptive research has been done in two stages. The first one consisted of gathering the reports of researches executed by the teachers who coordinated them from 2000 to 2009. As a result of this stage, it was mapped the type of studies performed, the themes and the theoretical and methodological references most utilized. During the second stage we studied the current pedagogical project used in the Graduation course, and crossed the data with the previously, to create a dimension to some of the transpositions and applications of the knowledge produced by the researches to the Nursing Graduation course. We concluded that, in different ways, not only the application of the studies has been occurring but also the transposition of ideals that cross through the research groups to which they belong, being able to bring change to nursing education. Key words: Nursing; Knowledge; Education; Teaching.

134-41

Authors: Emilia Campos de Carvalho, Dina de Almeida Lopes Monteiro da Cruz, T. Heather Herdman

The standardized language systems are important tools for dealing with the increasing complexity of nursing care. In this article the authors present the main benefits that the use of these systems provide for the required clinical reasoning in nursing care, the construction and organization of knowledge of the discipline, and for the clinical practice of nursing. The potential contributions of the standardized language systems in these fields stem from the fact that these systems provide a formal structure for supporting clinical reasoning, organizing knowledge and nursing experience. Key words: Classification; Judgment; Clinical Competency; Professional Practice; Knowledge.

151-7

Authors: Rosane Härter Griep, Maria de Jesus Mendes da Fonseca, Enirtes Caetano Prates Melo, Luciana Fernandes Portela, Lucia Rotenberg

The study aimed at analyzing socio-demographic and working characteristics of nurses from public hospitals. It was carried out a cross-sectional study, involving 3.229 nurses from the eighteen largest public hospitals of the city of Rio de Janeiro. It was observed a feminine predominance (87.3%), with mean age of 39.9±10 years. Around 7% referred having master or doctorate degree, 58.5% got their degree from public institutions and 24.5% used to work at the health sector before becoming nurses. Half the group has thought of abandoning their career, and almost a quarter is unsatisfied with their profession. Around 10% searched for a job outside nursing area in the previous month and 30% searched for a job in the same working area. Night work, engagement in more than one job and long professional work hours were more frequently found among men. The study has pointed challengeable aspects of nurses’ profession. Results can subsidize support strategies to improve the working conditions in public hospitals due to their comprehensiveness. Key words: Nurses; Working Conditions; Job Satisfaction; Labor Force; Work Hours, Occupational Health.

165-70

Authors: Tânia Cristina Franco Santos

This is a historical-social study, which aimed to analyze and argue the on the importance of the Brazilian Nursing Memory Centre for preservation and publicity of the professional memory. As data sources it was used the documentary Associação Brasileira de Enfermagem: 1926-1976, and the Project of Implantation and the Technical Report of the Memory Centre’s Documentary and Phonic Collection, both filed in the referred Centre. The data, collected in June 2013, were subjected to external and intern criticism, aiming to its validation. The analysis occurred concurrently with data collection and was made based on knowledge about the topic, supported by Bourdieu’s concept of habitus. It was observed that, since 1926, the directions of the Brazilian Nursing Association contributed for the Memory Centre implantation, by means of the importance attributed to the preservation of the memory. It was concluded that the memory enshrined in the collection constitutes material and symbolic goods for the Brazilian nursing to be transmitted through the historiography derived from it. Key words: Nursing; History of Nursing; Documentation.

177-81

Authors: Angela Maria Alvarez, Annelita Almeida de Oliveira Reiners, Sandra Helena Isse Polaro, Lucia Hisako Takase Gonçalves, Célia Pereira Caldas, Margarita Ana Rubin Unicovsky, Maria Célia de Freitas

This paper aimed to consider the creation of the Scientific Department of Gerontological Nursing within the Brazilian Nursing Association, considering the context of population ageing, and the development and consolidation of this specialty in the country. In the reflexive process, it was possible to rely on the historical analysis of the revised literature and authors’ reports. The results showed the movement of nurses, in recent decades, to the production of knowledge, as well as their incorporation by the entity, and the commitment of its members to achieve the goals proposed to the Scientific Department of Gerontological Nursing. It is concluded that its creation represents a milestone to the scientific and political organization of the nursing professionals who seek to qualify themselves for an autonomous and competent care of the elderly and their families. Key words: Nursing; Elderly Health; Nursing Care.

817-8

Authors: Sonia Acioli de Oliveira, Sonia Maria Alves

Editorial.

827-32

Authors: Jamille Gregório Dombrowski, Jéssika Abrantes Pontes, Walédya Araújo Lopes de Melo e Assis

The aim of this study was to evaluate the performance of nurses in the prescription of hormonal reversible contraceptives in Primary Care. A descriptive and transversal study was conducted, with 64 nurses at healthcare units as subjects, in the period of September-November 2010 in the county of Rio Branco-Acre. Data were collected through structured interviews using a questionnaire. The results showed that 96.9% of nurses are prescribing hormonal contraceptives and that the majority (90.6%) is aware of the government laws about nursing prescription. We also observed that the contraceptive was chosen based on client’s decision and anamnesis (36% and 34% respectively), and that 90% of the nurses always give orientation about advantages and disadvantages of each contraceptive method. Thus, for choosing a contraceptive method based on given information and free will, the methods must be available and dispensed by trained professionals, after correct and complete orientation. Key words: Contraception; Nurse’s Role, Primary Health Care.

840-6

Authors: Suzane Cristina Costa Melo, Raíra Gomes de Santana, Déborah Cardozo dos Santos, Neide Aparecida Titonelli Alvim

This is a qualitative, descriptive and exploratory research, aiming to describe the set of ideas and knowledge that guide the use of complementary and integrative health practices (CIHP) by nurses, and analyze the challenges facing the applicability of these therapies by nurses in the hospital setting. The subjects were nurses in public hospital institutions of Rio de Janeiro. Data collection was done through semi-structured interviews and a technique of creativity and sensibility called Almanac. The results showed that the hegemony of the biomedical model in the formation and performance of health professionals hinders implementation of CIHP in hospital. However, as this model does not account for the complexity of the human being emerges the possibility of sharing with CIHP in care aiming, therefore, at comprehensiveness of the human being. Key words: Nursing Care; Health Technology; Complementary Therapies.

854-9

Authors: Leticia Gramazio Soares, Leila Maria Mansano Sarquis, Ana Lúcia Cardoso Kirchhof, Vanda Elisa Andres Felli

In order to analyze the multiple causes of occupational accidents with biological exposure among nursing staff was carried out a descriptive and exploratory research in a medium-sized hospital in the State of Paraná, in the period between January 2008 and January 2009. The population was 26 nursing staff of the medical clinic. Data collection was performed by semi-structured interviews with five of the eight injured in the period and its contents were analyzed by Causes and Effects Diagram. The categories of causes material, organizational, institutional and worker’s behavior, showed the inappropriate disposal of sharps, work overload, no use of bio-security standards and poor supervision and training of workers, as factors for the occurrence of these accidents. The adoption of the tool of Causes and Effects Diagram provided an analysis of accidents in its multiple causes, showing the interaction between them. Key words: Occupational Health; Biological Accidents and Events; Accidents, Occupational; Nursing, Supervisory; Causality.

866-72

Authors: Daiani Modernel Xavier, Giovana Calcagno Gomes, Edison Luiz Devos Barlem, Alacoque Lorenzini Erdmann

This is a descriptive study with a qualitative approach, carried out during the second half of 2011, in a Pediatric Unit in a city in the extreme South of Brazil. The study aimed to understand the situations in which families reveal themselves as beings of rights during the hospitalization of the child. Fifteen family caregivers participated, divided into three sample groups. Data collection was conducted through semi-structured interviews, and the data were analyzed using open, axial and selective analysis. The study had the Grounded Theory as methodological framework. It was found that the family revealed itself as a being of rights, when recognized as such, is called and fights for their rights; suggests improvements for the care and maintains its autonomy, even if it has to submit to the decisions of the team in the child favor. It was concluded that is essential to allow them to be families in the hospital, enabling the exercise of their rights and citizenship. Key words: Family; Child; Health Rights; Acquired Immunodeficiency Syndrome; Nursing.

879-86

Authors: Iara Simoni Silveira Feyer, Marisa Monticelli, Astrid Eggert Boehs, Evanguelia Kotzias Atherino dos Santos

This ethnographic study aimed to understand the rituals of care performed by families, while preparing for the experience of planned home birth. 25 families participated in the period September 2010 to April 2011. The techniques of data collection were participant observation and interview. Through the processes of apprehension, synthesis, theorization and re-contexture, two categories emerged: The house to be born in and Preparing baby’s arrival. Homebirth is an experience built within the pregnant couple. The house is considered the sacred place to experience childbirth, aggregating existential values to the physiological act of giving birth. Understanding these rituals contributes to offer a nursing care of quality in order to respect the cultural aspects involved in this assistance. Key words: Homebirth; Ritualistic Behavior; Obstetric Nursing; Culture.

893-900

Authors: Iací Proença Palmeira, Ana Beatriz Azevedo Queiroz, Márcia de Assunção Ferreira

Qualitative research whose objective was to understand the social representations of the body by women with alterations caused by leprosy, for nursing care can meet more broadly to your needs. The theoretical framework was the social representations. Fortythree women participated, all of them from a reference unit specialized in sanitary dermatology. Interviews were conducted, which contents were processed by the software ALCESTE, generating a class whose words were associated with preconception anchored in the negative perception of leprosy. The explanatory framework of social representations showed a strong brand of the social memory of leprosy, whose symbolic construction sustains itself on fear of the disease. It was concluded on the need to invest in the deconstruction of archaic beliefs about leprosy so that to have new ways of acting towards the disease. Key words: Leprosy; Human Body; Prejudices; Nursing Care.

907-13

Authors: Calíope Pilger, Mario Umberto Menon, Thais Aidar de Freitas Mathias

This study aimed to analyze the functional capacity of elderly registered in Basic Health Units of Guarapuava-PR, Brazil. The subjects were 359 elderly, interviewed from January to April 2010, using Section I and IV of the questionnaire Brazil Old Age Schedule. The results showed that 89.9% had some degree of dependency, of which 70.8% light and 19.2% moderate or severe dependence. Women have a higher degree of mild (70.5%) and moderate and severe dependence (62.3%). Factors associated with the degree of dependence among the elderly living in Guarapuava were age, schooling, living arrangements, employment, place of residence, marital status and family income. It is concluded that most of the elderly in the community is affected by limitations and live with some kind of dependence to perform basic activities of daily living. Key words: Health Profile; Work Capacity Evaluation; Health of the Elderly; Nursing.

921-7

Authors: Vera Dib Zambon, Márcia Niituma Ogata

This study uses a qualitative approach based on semi-structured interview for analyzing the social control perspective of health counselors, considering that there are still challenges for the consolidation of community participation. It was identified that some counselors do not recognize the social participation as a Single Health System directive. Despite the recognition of the councils as deliberative spaces, there are difficulties such as the centralization of decisions in the management, an over evaluation of technical knowledge and lack of health conferences. There are limitations on the exercise of effective advisory role because of the influence of the municipal administration, difficulties of communication with the bases of representation and access to information. It is concluded that it is necessary to search for the strengthening of social control to highlight the continuing health education for empowerment of counselors inside the councils established by the Health Pact. Key words: Health Councils; Social Control Policies; Single Health System.

935-41

Authors: Bruna Pedroso Canever, Marta Lenise do Prado, Vânia Marli Schubert Backes, Mariana Cabral Schveitzer

This is a qualitative, descriptive, exploratory and analytical research, with documentary basis. The objective was to characterize and analyze teaching trends found in scientific articles related to the topic Education in Nursing, captured from the publication of the researchers of Research Groups in Nursing Education of the State of São Paulo from 2004 to 2010. We identified the following teaching trends: Traditional, Renewed, Tecnicist, Liberating and Critical Social-Contents. We analyzed 131 studies, of which 46.56% are graded in trends centrally marked by political and social concerns. He noticed a movement in search of intense transformation of Nursing Education within Research Groups. A large concentration of studies grounded in liberating tendencies or the ambition to adopt such postures, reveals a positive factor of Research Groups in Nursing Education. Key words: Nursing Education; Nursing Research; Research in Nursing Education.

949-55

Authors: Maíra Rosa Apostolico, Emiko Yoshikawa Egry

This is an experience report on the use of an instrument to collect data from primary sources available on the Internet. Considering the advances in technology that are changing the formation and the professional scenarios, the use of informatics in nursing research encourages the development of methodologies and information search. This study described since the construction of the instrument to collect data and revealed the possibility of facilities like approach much interviewed and offered a similar instrument used by professionals. The main difficulty was the low rate of response. It was considered a positive experience and even the low return of responses did not compromise the results of the qualitative study. It is expected that, in the near future, professionals use computational tools and make them instruments of performance in the routine of health services. Key words: Nursing Informatics; Investigative Techniques; Data Collection; Internet.