Experiencing organ donation: feelings of relatives after consent

Objective:

to identify experiences and feelings on the organ donation process, from the perspective of a relative of an organ donor in a transplant unit.

Method:

this was exploratory research using a qualitative approach, performed with seven family members of different organ donors, selected by a lottery. Sociodemographic data and the experiences regarding the donation process were collected through semi-structured interviews. The language material was transcribed and submitted to content analysis.

Results:

poor sensitivity of the medical staff communicating the relative''s brain death - the potential donor - and the lack of socio-emotional support prior to the situation experienced by the family was highlighted by participants.

Conclusions:

the study identified the need to provide social-emotional support for families facing the experience of the organ donation process. From these findings, other care and management practices in health must be discussed to impact the strengthening of the family ties, post-donation, as well as the organ procurement indexes.     

A behavior model for blood donors and marketing strategies to retain and attract them

Objective

analyze and propose a theoretical model that describes blood donor decisions to help staff working in blood banks (nurses and others) in their efforts to capture and retain donors.

Methods

analysis of several studies on the motivations to give blood in Spain over the last six years, as well as past literature on the topic, the authors'' experiences in the last 25 years in over 15 Non Governmental Organizations with different levels of responsibilities, their experiences as blood donors and the informal interviews developed during those 25 years.

Results

a model is proposed with different internal and external factors that influence blood donation, as well as the different stages of the decision-making process.

Conclusion

the knowledge of the donation process permits the development of marketing strategies that help to increase donors and donations.     

Analysis of the changes and difficulties arising from kidney transplantation: a qualitative study

OBJECTIVE:

to identify the main gains and stressors perceived by the patient, one year subsequent to kidney transplantation.

METHOD:

a qualitative study, in which the data were obtained and analyzed through the Discourse of the Collective Subject and frequency counting, with the participation of 50 patients who had received kidney transplantation.

RESULTS:

the sample presented a mean age of 44±12.8 years old, and a predominance of males (62%). The principal positive changes provided by the transplant were: return to activities; freedom/independence; well-being and health; strengthening of the I; and closening of interpersonal relationships. The most-cited stressors were: fear; medication; excess of care/control; specific characteristics of the treatment; and failure to return to the social roles.

CONCLUSION:

kidney transplantation caused various positive changes in the patient''s routine, with the return to activities of daily living being the most important gain, in the participants'' opinion. In relation to the stressors, fear related to loss of the graft, and questions relating to the immunosuppressive medication were the main challenges to be faced following transplantation.     

The reasons of the nursing staff to notify adverse events

OBJECTIVE:

this research aimed to understand the motivation for reporting adverse events from the perspective of nursing staff in the work environment.

METHOD:

qualitative study that used the phenomenology of Alfred Schutz for reference, which offers a systematic approach to understand the social aspects of human action. Data were collected by open interviews with 17 nurses and 14 technicians/assistant nurses in a university hospital.

RESULTS:

motivation was revealed through six categories: all types of occurrences must be reported; the incident report is an auxiliary instrument to health care provision management; the culture of punishment in transition; nurses as the agents responsible for voluntary reporting; sharing problems with higher management and achieving quality in the work process.

DISCUSSION:

it was unveiled that, when reporting adverse events, team members perceived themselves to be in a collaborative relationship with the institution and trusted that they would receive administrative support and professional security, which encouraged them to continue reporting. Reporting allows health care professionals to share responsibilities with managers and encourages corrective actions.

FINAL CONSIDERATIONS:

the study revealed the nursing staff''s motivation for adverse event reporting, contributing to reflections on institutional policies aimed at patient safety in health care.     

Nursing care in Tuberculosis patients at a Spanish sanatorium, 1943-1975

Objectives

the objective in this study is to identify the profile of the nursing staff, the work conditions and to describe nursing care at a sanatorium located in Barcelona, Spain between 1943 and 1975.

Method

historical study undertaken between 2008 and 2010, based on oral sources, five direct and one indirect testimonies, and the analysis of written documents. The data from the testimonies were collected through semistructured interviews.

Results

the nursing staff, mostly religious women, had scarce material and economic resources and no preventive measures to take care of the ill. The nurses undertook activities centered on the basic needs for physical and spiritual wellbeing.

Conclusion

The study reveals how the nurses, despite working in hostile conditions, attempted to safeguard the wellbeing of the patients and accompany them during the death process.     

Cultural experiences of immigrant nurses at two hospitals in Chile

Objective

to explore the cultural experiences of nurses who immigrated to Chile. The study''s theoretical framework was the Purnell Model for Cultural Competence.

Method

Leininger''s Observation-Participation-Reflection method was developed at two hospitals in the city of Santiago, and ethnographic interviews were held with 15 immigrant nurses.

Results

among Purnell''s 12 domains, the following were identified: Overview/heritage, Communication, Workforce issues, Family roles and organization, Biocultural ecology and Health-care practices. The difficulties were related to the language and its semantic meaning, the new responsibilities and the difficult relationship with colleagues. "In search of better horizons - the decision to immigrate", "Gaining confidence and establishing a support network - employability and professional performance" and "Seeking for people''s acceptance - professional adaptation in a new cultural scenario" are cultural themes that represent their experiences.

Conclusions

the competence to offer cultural care demands the development of public policies and continuing education programs at health institutions, specifically focused on immigrant nurses.     

Weaving meanings from the deliberative process of collegiate management in nursing

Objective

to understand the meanings of the collegiate deliberations attributed by its members on an undergraduate nursing course.

Method

Grounded Theory, interviews being held with 30 participants, making up 4 sample groups, between January and June 2012, in a public higher education institution.

Result

5 categories emerged, indicating the phenomenon and weaving the paradigmatic model: Understanding the experience of the complex relationships and interactions in the deliberations of collegiate management in nursing: intertwining divergences, convergences, dialogs, collectivities and diversities. This deliberative process presents various meanings involving discussion, and divergent, convergent and complementary positions, through dialog, commitment and negotiation.

Conclusion

the deliberations in the collegiate of nursing, intertwining dialogs, collectivities and diversities, mold the complex relational fabrics.     

The illness of women and men with sickle cell disease: a Grounded Theory study

Objective:

to understand the meanings given by women and men with sickle cell disease on the illness experience.

Method:

analytical study with a qualitative approach, conducted with 17 adults with sickle cell disease using the Theory Based on Data, or Grounded Theory, as theoretical-methodological referential. Data were collected between the years of 2012 and 2013, in an individual in-depth interview. All the interviews were recorded and analyzed according to the Grounded Theory comparative analysis technique.

Results:

data show four categories which group the experience of illness, the feelings experienced and the path to living with sickle cell disease.

Conclusions:

it was possible to understand that the experience was built by a process in which these people redefined the meaning of their lives, applying new directions to life and to care regarding the experience of the illness. In the context of chronic disease, the nurse''s care is also seen in this study as a foundation, providing attention, directions, and guidance through the required confrontations. Understanding the experience lived by these people, it is possible to enlarge the dimensions and the essence of nursing care required throughout life.     

Child development surveillance: intervention study with nurses of the Family Health Strategy

Objective:

to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care.

Methods:

interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated.

Results:

after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children''s development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development.

Conclusions:

the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care.     

The Living,Dynamic and Complex Environment Care in Intensive Care Unit

OBJECTIVE:

to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care.

METHOD:

Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units.

RESULTS:

built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions); "Providing a suitable environment" and "having relatives with concern" (context); "Mediating facilities and difficulties" (intervenienting conditions); "Organizing the environment and managing the dynamics of the unit" (strategy) and "finding it difficult to accept and deal with death" (consequences).

CONCLUSION:

confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".     

Factors associated with reporting of abuse against children and adolescents by nurses within Primary Health Care

OBJECTIVE:

to analyze the factors associated with the underreporting on the part of nurses within Primary Health Care of abuse against children and adolescents.

METHOD:

cross-sectional study with 616 nurses. A questionnaire addressed socio-demographic data, profession, instrumentation and knowledge on the topic, identification and reporting of abuse cases. Bivariate and multivariate logistic regression was used.

RESULTS:

female nurses, aged between 21 and 32 years old, not married, with five or more years since graduation, with graduate studies, and working for five or more years in PHC predominated. The final regression model showed that factors such as working for five or more years, having a reporting form within the PHC unit, and believing that reporting within Primary Health Care is an advantage, facilitate reporting.

CONCLUSION:

the study''s results may, in addition to sensitizing nurses, support management professionals in establishing strategies intended to produce compliance with reporting as a legal device that ensures the rights of children and adolescents.     

Development and validation of an educational booklet for healthy eating during pregnancy

OBJECTIVE:

to describe the validation process of an educational booklet for healthy eating in pregnancy using local and regional food.

METHODS:

methodological study, developed in three steps: construction of the educational booklet, validation of the educational material by judges, and by pregnant women. The validation process was conducted by 22 judges and 20 pregnant women, by convenience selection. We considered a p-value<0.85 to validate the booklet compliance and relevance, according to the six items of the instrument. As for content validation, the item-level Content Validity Index (I-CVI) was considered when a minimum score of at least 0.80 was obtained.

RESULTS:

five items were considered relevant by the judges. The mean I-CVI was 0.91. The pregnant women evaluated positively the booklet. The suggestions were accepted and included in the final version of the material.

CONCLUSION:

the booklet was validated in terms of content and relevance, and should be used by nurses for advice on healthy eating during pregnancy.