From Diagnosis to Outcomes - Escola Superior de Enfermagem de

Transcrição

19th Annual Meeting of the Florence Network 12‐16 April 2011 Escola Superior de Enfermagem de Lisboa From Diagnosis to Outcomes: Researching Nursing and Midwifery Interventions — Educational Challenges — Abstracts eBook ______________________________________________________________ Editorial Coordination Curado, MA | Leal, MT | Santos, J | Bronze, HC Lisboa 3
People in the Annual Meeting Andy Gibbs, Edinburgh Napier University President of the Florence Network Maria Teresa Leal, ESEL, Lisbon Chair of the 19th Annual Meeting of the Florence Network ESEL SCIENTIFIC COMMITTEE ESEL STUDENT COMMITTEE 
Maria Teresa Leal 
Maria Ana Pêgo 
Maria Margarida F. Coelho 
Guilherme Marques 
Maria Alice Curado 
Filipa Grenho 
Cláudia Bacatum 
Maria Inês Barros 
Maria João Delgado 
Inês Barros 
Francisca Manso 
Maria Inês Santos 
Inês Nunes 
Silvério Pisa ESEL ORGANIZING COMMITTEE 
João Santos 
Tiago Santos 
Eunice Sá 
Rita Santos 
Ana Fialho 
Inês Diogo 
Maria Ana Pêgo 
Joana Silva 
Guilherme Marques 
Maria Matilde Santos 
Helena Bronze 
Raquel Cravinho 
Catarina Nunes 
Mariana Cravo 19th Annual Meeting of the Florence Network, 12 – 16 April 2011 From Diagnosis to Outcomes: Researching Nursing and Midwifery Interventions Educational Challenges: Abstracts eBook. Published by Escola Superior de Enfermagem de Lisboa, April 2011, Lisboa Editorial Coordination: Curado, MA, Leal, MT, Santos, J, Bronze, HC ISBN 978‐989‐97181‐3‐5 No liability is assumed by the publisher with respect of the use of information contained herein. While every precaution has been taken in the preparation of this book, the published assumes no responsibility for errors or omissions.
TABLE OF CONTENTS
1 - INTRODUTION................................................................................................................... 9
2 - POSTER PRESENTATIONS ................................................................................................. 11
2.1 - COMMUNITY NURSING
12
Calouste Gulbenkian Nursing Scholl of Lisbon and the Local Administration Alcochete’s and Seixal’s
communities…A Partnership Experience ............................................................................................................ 13
Talking in neighbourhoods… A (collective) Feeling on approach to Alcochete’s and Seixal’s communities .......... 15
The Population Functioning and Social Weaknesses in Community A (collective) feeling on approach
to Alcochete’s and Seixal’s communities............................................................................................................ 17
Health Education and Nursing Care in Integrated Continuous Care: A Literature Review ..................................... 19
2.2 - NURSING HISTORY
21
Calouste Gulbenkian Nursing School of Lisbon in 90’s: A look into the Past… ....................................................... 23
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Evolution care and healthcare in Portugal From 13 Century to 20 Century....................................................... 25
The Mission and Action of the Portuguese military nurses in the course of the Independence War
(from 1640 to 1668) ........................................................................................................................................... 27
Nurses and Midwives in Portugal: Training/Education from XIX to XX Century ..................................................... 29
Ethel Fenwick: the woman who had a dream ......................................................................................................... 31
Renaissance, Protestant Reformation and the Decadence of Nursing (1500 to 1700) – St. Vicent de Paul........... 33
Escola Técnica de Enfermeiras (Learning to teach)................................................................................................. 35
Kaiserswerth Institute´s Superintendents: Matriarchs of Modern Nursing ............................................................ 37
2.3 - GENERAL NURSING
39
Nurses’ satisfaction with regard to the intrinsic characteristics of the nursing working methods......................... 41
Using ICNP® to describe self care deficit due to inability to perform self-hygiene................................................. 43
Developing an ICNP® catalogue to promote comfort in nursing practice: complexity vs. pragmatism ................. 45
Spiritual Nursing Care to Relief Suffering in Haemato-Oncology Patients .............................................................. 47
Needs of Involvement of Health services in people with pain and economic, social impact: A
systematic review of literature ........................................................................................................................... 49
2.4 - ADULT AND CRITICAL NURSING
51
The Person in a Post CVA Situation: The nurse's intervention over the process of rehabilitation
and reintegration into the community with hospitalized clients. ...................................................................... 53
The Patient with Chronic Heart Failure: Transition in Self-care and Quality of Life ............................................... 55
Intensive Care Unit: a nursing profession gateway? ............................................................................................... 57
CARE: an Emergency at the Emergency Department ............................................................................................. 59
How can I, person with chronic illness help you, nurse, to take care of me? – The know-how of
person with chronic illness – .............................................................................................................................. 61
The importance of nursing intervention in the promotion of HIV/AIDS patient’s compliance to
antiretroviric therapy ......................................................................................................................................... 63
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The Nurse as a promoter of inclusion and empowerment of the family in the management of
chronic disease ................................................................................................................................................... 65
Caring for a Person with stroke ... Prevention of spastic pattern ........................................................................... 67
How is Quality of Life in patients with Rheumatoid Arthritis - Contributions for nursing ...................................... 69
2.5 - ELDERLY NURSING
71
Promotion of self-care to the person dependent on nursing care – Preparing the home return,
of the elderly person, after fracture of the proximal end of the femur. ............................................................ 73
Preparing the Family Caregiver of the Adult / Elder Dependent Person on Self Care Hygiene in
the Transition from Hospital to Home................................................................................................................ 75
The Elderly Person with Dementia Abused by the Family: partnership as a Nursing Intervention
to Promote the Care of the Self. ......................................................................................................................... 77
Dyspnoea Assessment as a Nursing Intervention: Facilitating Therapeutic Regime Management in
Elderly Patients with COPD ................................................................................................................................. 79
Assessment of the risk of falls in elderly patients admitted in a Medical ward ...................................................... 81
Elderly Falls Prevention in Nursing Home Context – An Intervention Project ........................................................ 83
2.6 - CHILD HEALTH AND PEDIATRIC NURSING
85
Adolescents and health care providers in a health service for adolescents: What they say about it? ................... 87
Play activities during hospitalization A way of caring the children with chronic illness ......................................... 89
Play in Nursing Education: From Project to Practice An Optional Course in Nursing Degree: “The
Child and Play Activity” ....................................................................................................................................... 91
Scientific Evidence in Nursing Care Evaluating the effectiveness of non-pharmacological strategies
for pain relief in Paediatrics: A meta-analysis .................................................................................................... 93
Sting…Does Hurt… Representations of pain in children of school age, who underwent venipuncture ................. 95
The early feeding skills during the introduction of oral feeding on preterm infants: Prevalidation
study and determination of feeding skills .......................................................................................................... 97
Child injuries at home- Prevention, Precautions and Intervention with focus on scalds ....................................... 99
The Development of Autonomy in Young Patients with Spina Bifida: What do the youngsters and
their parents/careers say ................................................................................................................................. 101
The quality of life of the children with heart disease Systematic Revision of Literature 2005-2010 ................... 103
Parenting and Transition in Chronic Illness – Thinking about the contribution of nursing................................... 105
Nursing skills valorised by children with chronic illness and their families inside a hospital................................ 107
Indicators and tools for assessment of body composition A Practical experience ............................................... 109
Children Obesity and the Overweight Assessment A critical perspective of nursing practices ............................ 111
Childhood obesity - Somatotypology .................................................................................................................... 113
Methods of Assessing Body Composition ............................................................................................................. 115
A magic cube to magic children Project of a toy adapted to blind children ......................................................... 117
Children's Playing in the Park: Observation of the Quality of Play ....................................................................... 119
Teddy nursing: A different way to approach health to children ........................................................................... 121
Learning with Kiko and Tobias: A learning game for children with Spina Bifida ................................................... 123
2.7 - WOMAN CARE NURSINH AND MIDWIFERY
125
Smoking during pregnancy: knowledge, attitudes and practice of gynaecologists and midwives in
Flanders, Belgium. ............................................................................................................................................ 127
Discharge procedures from the delivery room ..................................................................................................... 129
When preventing is an option – Early detection behaviours and breast cancer perceptions of ESEL
women (2008) .................................................................................................................................................. 131
The desire of having a child: The experience of the infertile couple .................................................................... 133
A Path through Infertility…All for a Child: The implications of the diagnosis and treatment of infertility ........... 135
2.8 - NURSING EDUCATION
137
Feedback in clinical nursing education: Tutors’ use and students’ perceptions ................................................... 139
Portfolio as a tool for professional development: Proposal to use it for the integration of a new
clinical teacher and preliminary results ............................................................................................................ 141
Reflective-practice in nursing student’s Clinical practice: contributions to the structuring of thought ............... 143
The challenge of cultural diversity: The Project of Nursing Education of Foreign Nurses .................................... 145
Theoretical perspective in use by approved Swedish clinical nursing supervisors ............................................... 147
International project focused on the quality of education - Empowering the Professionalization of
Nurses through Mentorship (EmpNURS) .......................................................................................................... 149
2.9 - MENTAL HEALTH NURSING
151
The meaning of mental illness and emotional skills of nursing students ............................................................. 153
Problems of ageism in view of paramedical healthworkers at Departments of Psychiatry ................................. 155
3 - ORAL COMMUNICATIONS ............................................................................................. 157
3.1 – Professional qualifications directive: implications to nursing education
163
3.1 – PALIATIVE CARE NURSING
163
Caring in the last days of life: Experiences of nursing students during clinical practices ..................................... 165
Outcomes from non-conventional therapies in nursing practice ......................................................................... 167
3.2 - HOW CAN SCHOOLS OF NURSING CO-OPERATE WITH LOCAL AND INTERNATIONAL COMMUNITIES IN
HEALTH PROMOTION AND EMPOWERMENT? (ESEL PROJECTS)
169
Dealing with emergency situations: empowering Cova da Moura neighbourhood residents ............................. 171
Co-operation with a Cape Verde University to improve the quality of nursing education ................................... 173
Flying South, Nursing in Portuguese ..................................................................................................................... 175
3.3 – DIFFERENT PARADIGMS IN MIDWIFERY EDUCATION
177
The Portuguese Perspective.................................................................................................................................. 179
The Belgium Perspective ....................................................................................................................................... 181
3.4 – PARTNERSHIPS IN CHILDREN’S NURSING EDUCATION
183
Mentoring ESEL and Erasmus Students in Clinical Practice .................................................................................. 185
Research partnerships: Early Feeding Skills Scale Validation, ............................................................................... 189
4 - FINAL COMMENTS ........................................................................................................ 191
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1 - INTRODUTION
Dear Colleague,
For a number of years members of the Florence Network for Nursing and Midwifery have discussed introducing a
more academic approach within the annual meetings. I'm pleased to write this introduction to the book of
abstracts produced by the organisers at ESEL and with contributions from members. I hope that this will become a
regular feature of the meetings and one that will strengthen and grow over the years. Of course, introducing this
approach does not mean that we will abandon our existing approaches — the warmth and welcoming
relationships are a hallmark of the network and one of the reasons we have sustained, broadened and deepened
the network over such a long period. My thanks go to the organisers and the contributors, my wishes are that we
all make good contributions next year and I look forward to welcoming and meeting you all in Lisbon.
Best wishes
Andy Gibbs
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Dear Colleagues,
“The Florence Network is an international co-operation in Nursing and Midwifery at Higher Education,
Polytechnic and University level, established with educational, scientific and pedagogical aims. The
Florence Network guarantees to respect the different ideologies, strategies and visions used in Nursing
and Midwifery education across Europe.
The objective of the Florence Network is to develop and increase the quality of higher education in
Nursing, Midwifery and health care by means of international co-operation in the field of education,
scientific research and development. In this way the organisation tries to improve the image of the
profession and to raise the profile of Nursing and Midwifery within Europe” (Regulations of the Florence
Network, 2010).
Developing and increasing the quality and the image of Nursing and Midwifery education requires a research
approach.
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The initiative of introducing a scientific poster contest during the 19 Annual Meeting of the Florence Network was
an attempt to increase the habits of sharing research, even though the posters’ exhibition might include different
levels of research studies, from different schools, countries and, of course, representing different paradigms. Some
posters result from doctoral programs, others are the first steps from pre-graduation thesis, others are
somewhere in between. So, there is a great diversity. Nevertheless, we choose to try and expect your input and
evaluation.
The idea of creating this eBook arose when the number of posters accepted became so big that we understood
that seeing them for such short periods, has was previously determined, wouldn’t be enough to choose the one to
vote for. It would be useful to have access to the abstracts…
Then, we thought, why not include the conferences abstracts too?
The result was this eBook that, we expect, can be a useful tool to select the best abstract, and, maybe, represent
one more step to create some research networks among Florence Network partners.
Be welcome in Lisbon,
Mª Teresa Leal
2 - POSTER PRESENTATIONS
11
2.1 - COMMUNITY NURSING
CALOUSTE GULBENKIAN NURSING SCHOLL OF LISBON AND THE LOCAL ADMINISTRATION ALCOCHETE’S AND SEIXAL’S
COMMUNITIES…A PARTNERSHIP EXPERIENCE
Authors:
Claudia Mariana Julião Bacatum, RN, Lecturer
[email protected]
Maria Alice dos Santos Curado, RN, Professor
[email protected]
Maria Emilia Campos de Brito, RN, Lecturer
[email protected]
Lina Maria Antunes, Lecturer
[email protected]
Lucia de Lemos Vaz Velho, RN, Professor
[email protected]
Maria Odete Matos Pereira, RN, Professor
[email protected]
Viriato Moreira, RN, Professor
[email protected]
Students of the 8th CLE ESECGL
Escola Superior de Enfermagem de Lisboa – Portugal
POSTER ABSTRACT: 1
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The Nursing Degree is based on assumptions that recognize nursing as an autonomous profession with a
framework and a scientific methodology itself. In this context the knowledge of nursing is developed with a
integrate view of health and disease, in which health is a resource for life, a positive concept, a route along which
the individual/group, which appears in its ecological environment, can be realized through the satisfaction of their
needs. Considering person as an open and dynamic system, that interacts with itself, with others and with the
environment, making choices according to the meaning of each situation and recognizes that the therapeutic
projects are established in partnership. This project involves several players such as social partners and ordinary
people who shared a collecting and information experience in Alcochete’s and Seixal’s communities in a clinical
practice setting. We proposed to the nursing students for the 1st year to develop scientific, technical, social,
cultural and psychological skills for the practice and management of nursing care to the person, family, groups and
communities. The student must attend the training in nursing and other related areas to develop continuity in the
teaching/learning process. This acquisition of knowledge requires students to focus on our clinical training settings
in accordance with criteria of continuity and innovation, enhancing existing partnerships and past experiences; the
conditions of the units and the contexts of practice, but without neglecting the establishment of new partnerships.
Aim: Identify social and health determinants and to develop the sharing and reflection about the nursing practice.
Methodology: Develop inter-institutional meetings to know the goals, the conditions and the needs of all partners.
Nursing empiric research tools connected with health, social and human’s sciences were given to enhance the
learning process. We have done an exploratory study, with a quantitative and qualitative approach. A
questionnaire survey were applied to 1000 participants (Alcochete, n=715 and Seixal, n=285) and an observational
guide was used. Results: We identified social determinants that affect the communities’ health, and promoted the
relationship with the partners and their institutions. The network of social resources seemed to us diverse,
although it is not possible for us to affirm that it is sufficient to meet the needs of the population in each county.
Conclusions: With this experience it was possible to identify the social determinants that affect the communities’
health. This interaction in these two communities and the reflexion of nursing practices, in the global and health
policies, enhanced the student’s awareness of good citizenship. Along this project of partnerships the involvement
of the new participants, allowed us to create a larger space for sharing and reflection on the practices with those
involved. Key words: partnership, nursing, community, social-determinants, health-determinants
Bibliography:
Câmara Municipal do Seixal (2006), Diagnóstico Social do Concelho do Seixal, Gabinete de Acção social – Seixal Rede Social, documento
policopiado.
Documento de Planeamento do 8º Curso de Licenciatura em Enfermagem, ESEnfCGL, Outubro 2007.
Lindsey, Elizabeth; Sheilds, Laurene; Stajduhar, Kelli (1999), “Creating effective nursing partnerships: relating community development to
participatory action research”, Journal of Advanced Nursing, Vol. 29, nº. 5, p. 1238-45
St. John, Winsome; Keleher, Helen (2006), Community Nursing Practice – Theory, skills and issues, Crows Nest, Allen & Unwin.
Vollman, Ardene Robinson; Anderson, Elizabeth T.; McFarlane, Judith M. (2007), Canadian Community as Partner: Theory & Multidisciplinary
Practice, Philadelphia, Lippincott William & Wilkins.
TALKING IN NEIGHBOURHOODS…
A (COLLECTIVE) FEELING ON APPROACH TO ALCOCHETE’S AND SEIXAL’S COMMUNITIES
Authors:
[email protected]
[email protected]
[email protected]
[email protected]
Lúcia de Lemos Vaz Velho, RN, Professor
[email protected]
[email protected]
[email protected]
POSTER ABSTRACT: 2
15
Introduction: The concept of space assumes importance in the interpretation that leaders have of the contexts
under observation (Alcochete and Seixal), concerning the sociality, historicity and spatiality. We based our
approach in the relationship between the leader/participant with the territory, and he/her own actions in this
construction. The leader gives meaning to social logics, according to the geographical existence.
The Aim of this work are to interpret the intentional relationship that individuals have with the territorial contexts
that structure their action and how the world built induces the construction of a value system, which determines
interpretation of the phenomena.
Methodology: An exploratory study with a quantitative approach. We administered a questionnaire survey of 50
participants in the municipality of Alcochete and 33 in Seixal.
Results: We perceive from the two contexts that identities mobilize themselves in domination situations with
asymmetric relations within spaces of power. The affiliation of each participant comes from a process of
identification or belonging recognition. These processes refer to the practice and the collective imagination,
associating certain groups attributes with whom they identifies.
Conclusions: The construction of identity images of the contexts and their population converge in ways of living
and specially the ways of expressing those social territories.
Key words: dynamic, social, health, nursing, identities and interactions
Bibliography:
Câmara Municipal do Seixal (2006), Diagnóstico Social do Concelho do Seixal, Gabinete de Acção social – Seixal Rede Social, documento
policopiado.
Dubar, Claude (1991), La Socialisation. Construction des Identités Sociales e Profissionnelles, Paris, Armand Colin.
Freitas, Mª João (2001), “Recentramento do olhar nas questões da habitação”, Cidades, Comunidades e Territórios, n.º 3, pp. 21-41.
Guerra, Isabel (1997), “Um olhar sociológico sobre o alojamento”, Sociologia – Problemas e Práticas, n.º 24, pp. 165-181.
Pinto, José Madureira (1991), “Considerações sobre a produção social de identidade”, Revista Crítica de Ciências Sociais, n.º. 32, pp. 217 – 231.
Silva, Ana M. Santos (1999), “Os constrangimentos de política de habitação em Portugal, texto policopiado, Lisboa,B.N..
THE POPULATION FUNCTIONING AND SOCIAL WEAKNESSES IN COMMUNITY
A (COLLECTIVE) FEELING ON APPROACH TO ALCOCHETE’S AND SEIXAL’S COMMUNITIES
Authors:
[email protected]
[email protected]
[email protected]
[email protected]
Lúcia de Lemos Vaz Velho, RN, Professor
[email protected]
[email protected]
[email protected]
POSTER ABSTRACT: 3
17
INTRODUCTION: Health and vulnerability in life expresses its self in several ways in the different social groups. We
want to recognize the life conditions of Alcochete’s and Seixal‘s communities, responsible for most of the
differences of person and communities health status.
The AIM of this study is: identify participant’s concepts of dependency and disability.
METHODOLOGY: Exploratory study with quantitative approach. We administered a questionnaire survey to the
participants in the communities of Alcochete (n=715) and Seixal (n=285). For analysis we used the International
Classification of Functioning, Disability and Health (ICF) (WHO 2004).
RESULTS: We recognized weaknesses in those areas: body functions, activities and participation with consequent
influences regarding the functioning and disability. And we founded 92 situations of dependency and disability in
Alcochete and 45 in Seixal.
CONCLUSIONS: Based in the ICF in which the deficiencies could be a part or an expression of health condition, but
not necessarily a disease. These data were relevant to the planning of emergence and catastrophe response in
those communities.
Key-words: health, nursing, social weaknesses, functioning, dependency/disability
Bibliography:
Câmara Municipal do Seixal (2006), Diagnóstico Social do Concelho do Seixal, Gabinete de Acção social – Seixal Rede
Social, documenta policopiado.
Documento de Planeamento do 8º Curso de Licenciatura em Enfermagem, ESEnfCGL, Outubro 2007.
World Health Organization (2001), International Classification of Functioning, Disability and Health, Geneve, WHO.
Stanhope, Marcia; Lancaster, Jeanette (1999), Enfermagem comunitária: promoção da saúde de grupos, famílias e Indivíduos, 4ªed., Lisboa,
Lusociência.
St. John, Winsome; Keleher, Helen (2006), Community Nursing Practice – Theory, skills and issues, Crows Nest, Allen & Unwin.
HEALTH EDUCATION AND NURSING CARE IN INTEGRATED CONTINUOUS CARE:
A LITERATURE REVIEW
Authors:
Pedro Lucas – Nursing Lecturer, Escola Superior de Enfermagem de Lisboa
[email protected]
Gisela Teixeira – RN, Centro Social Paroquial, Nossa Senhora do Livramento
Bárbara Vieira – RN, Santa Casa da Misericórdia, Chamusca
POSTER ABSTRACT: 4
19
In 2008 and 2009, one of the foremost motives of referrals to Integrated Continuous Care Units and Community
Care Teams of the National Network for Integrated Continuous Care (RNCCI) was the need to educate the patient
and/or caregiver. In this context, this studies aim was to describe the manner in which Health Care Education
relates to the Network and in which way it relates to patient results and nursing care.
For the consecution of this paper the chosen methodology was a literature review, begun in October of 2010,
which compiled 94 documents, including compositions, investigation studies, thesis’s, reports and web sites.
Throughout this study it was thrown into relief that Health Education is related to the end purpose of the RNCCI
sharing with it guiding principles and goals; it enhances and promotes self-care; the ability for therapeutic self-care
is related to the performance of nursing functions, being that Health Education is one of the main nursing
interventions that contribute to this result.
Health Education has a vast range of intervention in enabling and making individuals accountable for their health,
indubitably being an autonomous nursing intervention and an integrating part of the process of nursing care
outcomes, results and gains in health for the population. As a nursing care intervention, it is possible to empower
individuals and caregivers with capacity, autonomy, more independence and, therefore improving the quality of
life.
Key-words: Health Promotion; Health Education; Nursing care; National Network for Integrated Continued Care
Main References:
DORAN, Diane; [et al] – Relationship between Nursing Interventions and Outcome Achievement in Acute Care Settings. In: Research in
Nursing & Health. Nº 29. 2006. p.61-70.
TONES, K.; TILFORD, S. – Health education. Effectiveness, efficiency and equity. London: Chapman & Hall. 1994.
Unidade de Missão para os Cuidados Continuados Integrados – Orientações Gerais de Abordagem Multidisciplinar e Humanização em
Cuidados Continuados Integrados. Lisboa: Unidade de Missão para os Cuidados Continuados Integrados, Março 2007.
2.2 - NURSING HISTORY
21
CALOUSTE GULBENKIAN NURSING SCHOOL OF LISBON IN 90’S: A LOOK INTO THE PAST…
Authors:
[email protected]
[email protected]
Miguel Joaquim Nunes Serra, RN, Lecturer
[email protected]
Maria Isabel Costa Malheiro, RN, Lecturer
[email protected]
Escola Superior de Enfermagem de Lisboa
POSTER ABSTRACT: 5
23
Introduction: The Calouste Gulbenkian Nursing School of Lisbon, established in 1957 under the name Hospital de
Santa Maria College of Nursing, was for nearly 50 years, a major reference in Portuguese nursing, on educating and
training about 5000 nurses. In the 90’s, the inclusion of Nursing Education on the Portuguese polytechnic
education system provided a new audience and new expectations for the school community, increasing technical
and scientific demands for teachers and students. On addition, professional status became more prestigious.
Simultaneously, we assisted to an investment in higher education, first in Graduate Diploma and then in Masters
and PhD. The aim is to describe the historical development of the Calouste Gulbenkian Nursing School of Lisbon,
since the integration in Higher Education (1990), until the merge with others public schools in Nursing School of
Lisbon (2007).
Methodology: Exploratory study with a qualitative approach. Data were collect by six semi-structured interviews
(teachers and stakeholders) and by analysis and interpretation of different kind of documents: school archives and
legislation. We analyzed different dimensions of school’s life, particularly in terms of their response to social
changes, legislation and how these responses are reflected in its dynamic organization, offering training, resource
development, external relations and the production and dissemination of knowledge.
Findings: We found that the new curriculum includes not only the technical and training dimension but also
scientific and cultural ones. The studies are developed in 6 semesters, 108 weeks, total of 3300 hours (theory 1616 h/46%; training - 1684 h/54%). With the Bachelor Nursing Degree the students had nursing competences to
provide basic nursing cares to persons, families and communities under the 3 levels of prevention and also have
basic skills to collaborate in the nursing care management
Conclusion: These changes were more than the school’s name, it represented a profound revolution in the way
school actors identify their selves. The nursing education curriculum as changed from a patients’ biomedical
approach to an approach based on the contemporary nursing paradigm.
Key words: History; Nursing-School; Higher-Education
Bibliography:
Amendoeira, José (2006), Uma biografia partilhada da enfermagem, Coimbra, Formasau.
Soares, I. (1997), Da blusa de brim à touca branca, Contributo para a história do ensino de Enfermagem em Portugal (1880-1950). Lisboa,
Educa e Associação Portuguesa de Enfermeiros.
Sources:
Legislation from seventies to nineties
Nursing Schools Archives
EVOLUTION CARE AND HEALTHCARE IN PORTUGAL
FROM 13TH CENTURY TO 20TH CENTURY
Authors:
[email protected]
Marília Pais Viterbo de Freitas, RN, Professor
[email protected]
Maria Isabel Soares, RN, Professor
[email protected]
POSTER ABSTRACT: 6
25
The Purpose: Is to show what Portuguese nurses have done in the past until now and to understand future nurse
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competences and share the evolution care and healthcare in Portugal from 13 Century to 20 Century.
Methodology: Is supported in analyses and interpretation of different kind of documents: Official Papers, Manuals,
Hospital Regulations and professional papers.
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Findings: From the 13 to 15 Centuries, care is done by the monastic orders that take care of travellers and
patients. There were also small hospitals organized by rich people or by workers. Only poor people go to the
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hospitals; the families that could pay have home care. At the 15 Century King John the second starts to build the
“Hospital de Todos-os-Santos” and Queen Leonor creates the Charitable Institution both of them in Lisbon. These
Charity Institutions were developed all over the country. Caring is done by nurses (men and women) and by
midwifes (only women). All of them learn from each other because nursing and midwifery education doesn’t exist
at the time. Their competences were established on the Hospital Regulations and on the Manuals. Only the
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midwifes have to do an official examination since 16 century. Since 1949 the nurse’s career in the hospitals were
regulated by law. This law changes almost twenty years later in 1967 including for the first time the three areas of
nurses’ intervention, practice care in hospital, in community care and nursing education. During more than 100
years the nurses and midwifes education changed not only because of the science evolution but also because of
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the study and engagement of these professionals. At the end of 19 Century (1895) the midwifes create their first
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professional organization and the nurses create their first Trade Unions in the beginning of the 20 Century (1926).
During more than 100 years, nurses and midwifery’s education changed not only because of the science evolution
but also because of the study and engagement of these professionals. Finally in 1998 was created the Nurses
Order. The nursing career changed in different occasions.
Conclusions: From the thirteenth to the nineteenth century nursing care didn´t suffer a major evolution. The
political and social changes that occurred in 1975 had a decisive influence on the development of the education,
profession and working conditions of nurses. The development of quality of care was due to the organization of
the National Health Service in 1976, but also and specially by the commitment of nurses in different areas of
practice care. From the nineteenths, with the beginning of scientific training of midwives and nurses, nursing care
began to respond to the needs of the population and in the nineteenth century the first professional organization
was created.
Keywords: nursing, midwives, training, profession, history.
BIBLIOGRAPHY:
Bombarda, Miguel – Enfermeiras Religiosas, in A Medicina Contemporânea, Ano XVIII, nº 21, 22, 24. Série II – Tomo III, 3, 17, 27 de Julho 1900.
Cardeira, L. da Silva – As Irmãs de Caridade nos Hospitais, in Jornal da Sociedade das Ciências Médicas, Tomo XXII, Junho, 1858, p.201-209.
Carvalho, A. da Silva – Subsídios para a História das Parteiras Portuguesas, Medicina Contemporânea, nº 29, 1931, pp. 255-259.
Marques, A. H. Oliveira – História de Portugal. Lisboa: Palas Editores, 1973, 2º Vol.
SOURCES:
Legislation from 1837 to 2001
Hospital Archives
National Archives – Torre do Tombo
THE MISSION AND ACTION OF THE PORTUGUESE MILITARY NURSES IN THE COURSE OF THE INDEPENDENCE WAR (FROM 1640 TO 1668)
Authors:
Jorge Eurico Sousa Ferreira, RN, Professor
[email protected]
POSTER ABSTRACT: 7
27
Introduction: Following a path of Historical research which has a logical, rational, discursive nature, we try to find
out what the mission and action of the Portuguese nurses was, since 1640. The Restoration War was the longest
armed conflict Portugal faced until now. In this War a permanent army emerged for the first time in our country,
and this led to the need of a permanent military Health Service. In this Health Service and according to the
different royal instructions, there were enough nurses to provide health care to the hospitalized soldiers. During
this War King D. João IV established a portable hospital (this was an innovator concept at that time), which could
attend the army during the campaigns. There were nurses escorting this hospital, who took care of the sick and
injured soldiers. At the time, Medicine was essentially based on Hippocrates and Galen, with or without Arab
ascendancy, with a lot of help from God and popular practices. This was the nursing vision too. In their practice,
nurses treated war injured with unguents such as cam (dog) oil, wounds were washed with wine and aquavitae,
and head wounds were treated with Aparicio oil. But, the great healer was the “golden oil”. Methodology: Is
supported in analyses and interpretation of Official Papers, Manuals, Hospital Regulations, and Military Articles.
The aim of the study is to intend to let know that during the Independence War a permanent army aroused for the
first time in Portugal, and therefore, an urgent need of a permanent Health Service too Results/Findings: From the
institution of this Health Service a network of Military Hospitals emerged - named "Royal Military Hospitals". The
purpose of these Hospitals was to help both the injured and the sick soldiers. The management of these Military
Hospitals, by Royal instruction, belonged to the “Ordem Hospitaleira de S. João de Deus”, and the Brothers of this
Order were the persons who worked as nurses. We still intend to refer the sort of given care by the military nurses,
and to show the importance of their Mission and Action. Conclusions: In conclusion we can say that the sick or
injured soldiers were treated by the Religious of 'Ordem Hospitaleira de São João de Deus' who served as nurses.
In this Restoration War, a permanent and professional army emerged for the first time in Portugal, which
demanded also an own military and permanent service. Therefore, a military hospital system emerged, and it was
named 'Reais Hospitais Militares'. For the soldiers this was the last place, the end of the line, the place where they
could be treated from diseases and injuries and rest from the great tiredness of the long marches and other works
concerning the military campaigns. In the Portuguese army that fought this war, nurses had a preponderant action
taking care of the sick and injured soldiers.
Keywords: history, care, nurses, Independence War - (from 1640 to 1668)
BIBLIOGRAPHY:
ALBUQUERQUE, Mathtias de. Carta de Matthias de Albuquerque in Cartas dos Governadores da Província do Alentejo a El-Rei D. João IV, Vol. II
- publicada e prefaciada por P.M. Laranjo Coelho. Lisboa : Academia Portuguesa de História, 1940.
ALEGRETE, Conde de. Carta do Conde de Alegrete in Cartas dos Governadores da Província do Alentejo a El-Rei D. João IV, Vol. I - publicada e
prefaciada por P.M. Laranjo Coelho. Lisboa : Academia Portuguesa de História, 1940.
ATTOUGUIA, Conde. Carta Conde de Attouguia in Cartas dos Governadores da Província do Alentejo a El-Rei D. João IV, Vol. I - publicada e
BETTENCOURT, Nicolau. Apontamentos para a história do serviço de saúde militar. Lisboa : Tipografia da L. C.G.G., 1961.
BORGES, Augusto M.- Os Irmãos Hospitaleiros de S. João de Deus e a assistência aos feridos de guerra
MELLO, Martim Afonso de. Carta de Martim Afonso de Melo in Cartas dos Governadores da Província do Alentejo a El-Rei D. Afonso VI, Vol. III
- publicada e prefaciada por P.M. Laranjo Coelho. Lisboa : Academia Portuguesa de História, 1940.
MELO, Francisco de. Carta de Francisco de Melo in Cartas dos Governadores da Província do Alentejo a El-Rei D. Afonso VI, Vol. II - publicada e
Mémoria sobre o modo de purificar o ar inficionado. Lisboa : Impressão Régia, 1805.
MONTEIRO, Manoel da Costa. Opusculo chirurgico, dividido em tres tratados. O primeyro da gangrena pela via galenistica. O segundo da cura
da gangrena pela via moderna. O terceyro das excellencias do ouro, & cura que se faz com o seu oleo . [S.l. : s.n. 16--].
ROIZ, Matheus. Campanhas do Alentejo (1641-1654) Dactilogrado e paginado pala paleógrafa D. Maria Vaz Pereira. Lisbia : Arquivo Histórico
Militar, 1952. 1.ª div., 2.ª secç., cx n.º 3, n.º2.
NURSES AND MIDWIVES IN PORTUGAL
TRAINING/EDUCATION FROM XIX TO XX CENTURY
Authors:
[email protected]
Marília Pais Viterbo de Freitas, RN, Professor
[email protected]
Maria Isabel Soares, RN, Professor
[email protected]
POSTER ABSTRACT: 8
29
The Purpose: Is to contribute to the dissemination of the Nursing Education and Midwifery’s History in Portugal in
the XIX-XX century.
Methodology: Is supported in analyses and interpretation of different kind of documents: Official Papers, selected
documents from the schools archives and bibliography.
Findings: Since the seventeen century there was a concern to “instruct” the nurses so they could take care of the
sick and obey with medical prescriptions, as shown in works published in Portugal, under the title “Guide” or
“Manual”. But only later in the XIX century there were first attempts to organize training of nurses and at the
beginning of the XX century to create Schools of Nursing. However, historically speaking, the schools for midwives
where the first to formally be created in 1836 following a change to the curriculum of the University of Coimbra,
and 1837 in the medical schools of Lisbon and Porto. First attempts to start training nurses in an organized way
begun in 1881, in the University Hospitals of Coimbra, followed in 1886 the creation of the course for nurses in the
Real Hospital de S. José in Lisboa and then in 1896, in the Hospital de Santo António in Porto. From 1901 to 1919
were created of the Professional School for Nurses linked to the Royal Hospital of S. José in Lisbon and a Nursing
School at the University Hospitals of Coimbra. In 1940, the Rockefeller Foundation supported the creation of the
Technical School of Nursing under the Ministry of Education attached to the Portuguese Institute of Oncology,
which would contribute greatly to the development and training in nursing. In 1942, 1947 and 1952 occurred
reforms of the curriculum and regulation of schools. But it is with the establishment of the Ministry of Health in
1958 in which its structure contained a Department who was coordinating all nursing education, both public and
private, that took place significant changes in nursing education. It was observed a significant changes in nursing
education, reforms of the curriculum and regulation of schools. Meanwhile, there were created specialized courses
in nursing. Later in 1976 was created a nursing school to prepare teachers and managers for positions in nursing
units. Until 1988 the education/training of nurses is under the responsibility of the Ministry of Health and changed
in this year when the education of nurses was integrated into a national higher education system, at the
polytechnic level. In 1999 the network of nursing schools was reorganized and education in nursing is granted a 4
years degree. Since then, nurses have access to a master degree at the universities.
Conclusions: The development of nursing education since the fifties was visible due to the commitment of
professionals to their role. The political and social changes that occurred after 1974 had a decisive influence on the
development of the profession and working conditions of nurses. At this moment we have Masters and PhD
Degrees Courses in Nursing.
Keywords: nursing, midwives, education, training, history.
Bibliography:
Amendoeira, J. (2006), Uma Biografia Partilhada da Enfermagem, Coimbra: Formasau, Formação e Saúde Lda.
Marques, A. H. Oliveira (1973), História de Portugal, 2º Volume, Lisboa: Palas editoras.
Simões, A. A. da Costa (1888), A Minha Administração dos Hospitais da Universidade de Coimbra, Coimbra: Imprensa da Universidade.
Soares, M. Isabel (1997), Da Blusa de Brim à Touca Branca. Contributo para a História do Ensino de Enfermagem em Portugal (1880-1950).
Lisboa: Educa, Associação Portuguesa de Enfermeiros.
Sousa, M. Diniz de – “Evolução do Ensino de Enfermagem em Portugal nos Últimos 25 anos”. Servir. Vol.31- nº2, Lisboa Mar/Abril, 1983, pp 89103.
Sources:
Legislation from 1837 to 2001
Nursing Schools Archives
National Archives – Torre do Tombo
ETHEL FENWICK: THE WOMAN WHO HAD A DREAM
Authors:
Cameira, Catarina
[email protected]
Antunes, Liliana
Medeiros, Sara
Sá, Soraia
Students from the Discipline of Epistemology and History of Nursing I at ESEL
Ferreira, Óscar - Professor of Epistemology and History of Nursing and Adviser
[email protected]
Ferraz, Isabel - Professor of Epistemology and History of Nursing
POSTER ABSCTRACT: 9
31
This paper was carried out in order to remember Ethel Fenwick’s life and her importance for Nursing, but soon
became much more than that. Its main goal is to recognize the importance of Ethel’s struggle for the
professionalization of Nursing and the obligatory registration of nurses. It also makes a clear distinction between
her concept of Nursing and Florence’s concept. Another goal is to demonstrate Ethel Fenwick’s contribution for
the development of Nursing, since her name is not as well known as Florence Nightingales’ by the most part of
nurses’ population. This essay also mentions Ethel Fenwick’s life, particularly her passion for Nursing and the
resources that she mobilized and used to fulfil her goals, since the foundation of the British College of Nurses, in
1926, till the foundation of the Nurses’ Association, in 1987. It also states Ethel’s influence on Nursing’s training
and the development of future associations. The method used to conceive this essay was based on the resource of
historic bibliography from different sources and authors, mainly on several articles made by a Portuguese author,
Luís Graça. The results obtained from our paper exceeded our expectations, since now we can understand that,
despite not having a high profile compared to great nurses who contributed to the history of this profession, Ethel
was a very important element (through her struggle, courage and insight) for the establishment of nursing as we
know it today, a professional service of humanity and for humanity. In conclusion, we can state that Ethel Fenwick
developed all her work into the professionalization of Nursing, which according to her view was based on the
monitoring of such training. This qualification contributed to the creation of competent professionals who
provided excellent nursing care, to avoid like Ethel her-self quoted: “a nurse without appropriate training, a
substitute hastily arranged from whom we have no guarantee of training, can ruin forever a life dearer than
theirs.”
Keywords: History of Nursing; Ethel Fenwick; Professionalization; Nurses’ Associations.
Bibliography:
FREITAS, Marília Viterbo de (2003) – Uma enfermeira a recordar Ethel Fenwick (1857-1947). Enfermagem. Lisboa. ISSN 0871-0775. Nº31-32
(July-December 2003). P.71-73
Graça, Luís (2002) – Ethel Fenwick: O combate pela profissionalização da Enfermagem na Grã-Bretanha e no resto do mundo, (obtained in:
www.ensp.ml.luisgraçatextos141.html on November, 2010)
GRAÇA, Luís; et al. – Irmãos e irmãs da Caridade: os Primórdios da Enfermagem
http://www.ensp.unl.pt/lgraca/textos67.html, on November, 2010)
ICN's Mission: To represent nursing worldwide,
http://www.icn.ch/abouticn.htm, on November, 2010)
advancing
the
profession
and
na Europa;
influencing
health
2000
policy.
(obtained in:
(Obtained
in:
RENAISSANCE, PROTESTANT REFORMATION AND THE DECADENCE OF NURSING (1500 TO 1700) – ST. VICENT DE PAUL
Authors:
Poeira, Bruno
Viveiros, Carolina
Sousa, Jéssica
Carvalho, Renato
Students of the Discipline of Epistemology and History of Nursing at ESEL
Ferreira, Óscar . Professor of Epistemology and History of Nursing and Adviser
[email protected]
Ferraz, Isabel . Professor of Epistemology and History of Nursing
POSTER ABSTRACT 10
33
Our poster’s theme is “Renaissance, Protestant Reformation and the Decadence of Nursing”, which takes place in
the 1500 to 1700 AD period and has St. Vicent de Paul as its dominant personality in the health care area.
The goal of this study is understanding the Nursing History as a nonlinear and phased process that has contributed
to the profession as we know it.
We defined as central theme of our study the changes of healthcare in the studied period and their consequences
in the actual nursing. The method used to conceive this poster was literature review with the resource of
bibliography from different sources and authors.
In the Renaissance there was an investment in science that led to the innovation of the anatomical human concept
(important in health area). In the historical period studied, we verified a decrease in healthcare to the poorer,
because during the Reformation, lots of catholic institutions closed, leading to the decadence of healthcare.
St. Vincent de Paul becomes primordial: he tries to restitute the healthcare provided in this period by founding
many care providing communities and encouraging the formation of health institutions.
The Daughters of Charity intervention brings a mentality change about the local where health care was provided
because from this time has been started the domicile health care, that are in the base of nowadays community
health nursing.
KEY WORDS: Renaissance; St. Vicente de Paulo; Sister Luísa Marillac; Company of the Charity Sisters; Protestant
Reformation; Healthcare Decadence.
BIBLIOGRAPHY:
Brotton, J. (2006) The renaissance: a very short introduction. OUP.
Padilha, M. I. C. S.; Mancia, J. R. (2005) - Florence Nightingale e as Irmãs de Caridade: revisitando a história. Revista Brasileira da Enfermagem,
58, (6), pp.723-726.
Pedrosa, A. (2003). Os cuidados na doença e os serviços assistenciais desde a renascença até à revolução industrial. Revista Referência, 10, pp.
81-90;
ESCOLA TÉCNICA DE ENFERMEIRAS
(LEARNING TO TEACH)
Authors:
Borralho, Débora
Duarte, Andreia
Marques, Vanessa
Martins, Susana
Lopes, Ana
Students of the Discipline of Epistemology and History of Nursing at ESEL
Ferreira, Óscar - Professor of Epistemology and History of Nursing and Research Adviser
[email protected]
Ferraz, Isabel - Regent Professor of Epistemology and History of Nursing
E-mail adress: [email protected]
POSTER ABSTRACT: 11
35
th
On May 17 , 1940 the “Escola Técnica de Enfermeiras” (ETE) was first established through one Decree of “Direcção
Geral do Ensino Superior e das Belas Artes”, with the help of Professor Dr. Francisco Gentil and fundings from the
Rockefeller Foundation.
This school, which today is a campus from ESEL (Nursing High School of Lisbon), was one of the first nursing
schools in Portugal. It was recognized an example in nursing education due to its pedagogical autonomy, thus
strengthening the prestige of the profession. It appeared at a time marked both by the dictatorial regime and by
the need to organize and develop nursing education in Portugal. Therefore, it was following a spirit of renewal that
ETE contributed to nursing education, as it promoted more demanding admission conditions and teaching models.
It was innovative in the education of more qualified and competent nurses and its motto was "learning to teach."
The partnerships with the Rockefeller Foundation secured the introduction of new concepts in the field of nursing
education, with emphasis on the idea of a comprehensive education that prepared nurses for professional practice
in the areas of hospital and public health. In our country, this school has introduced the most modern concept of
nurse training of that time.
This poster aims to highlight the influence of ETE in the history of nursing in Portugal. For this purpose, we adopted
a review of the literature with adequate bibliographic references.
We considered the historical period in which it was founded, explained it, and mentioned the leading personalities
and institutions that played a crucial role in its foundation. We also tried to identify its teaching model and
curriculum. Finally, we emphasized the role of the ETE in the development of nursing in Portugal, acknowledging
the changes it underwent from its early years up to 1988.
Key words: Escola Técnica de Enfermeiras; Professor Dr. Francisco Gentil; Nursing History; Nursing Education.
Bibliography:
AMENDOEIRA, José – Uma biografia partilhada de Enfermagem. Coimbra: Formasau: Formação e Saúde, Lda., 2006. ISBN: 972-8485-67-0;
CORRÊA, Beatriz de Mello – Imagens e Memórias da Escola Técnica de Enfermeiras, 1940-1988. Lisboa: da autora, 2002;
NUNES, Lucília – Um olhar sobre o ombro – Enfermagem em Portugal (1881-1998). Loures: Lusociência, 2003. ISBN: 972-8383-30-4.
KAISERSWERTH INSTITUTE´S SUPERINTENDENTS:
MATRIARCHS OF MODERN NURSING
Authors:
António, Paulo
Brito, Marina
Duarte, Joana
Firme, Ana
Simões, Luísa
Students of the Discipline of Epistemology and History of Nursing at Escola Superior de Enfermagem de Lisboa
[email protected]
Ferraz, Isabel - Professor of Epistemology and History of Nursing and Research Adviser
[email protected]
POSTER ABSTRACT: 12
37
Purpose: The present paperwork aims to analyze the historical context of Kaiserswerth Institute located in Prussia
and its roots at the service of modern nursing. Pastor Theodor Fliedner was the founder of the Institute, being known
as its main figure, but we pretend to highlight his wives Friederike and Caroline Fliedner as matriarchs of the
conceptual model, it´s initial application and subsequent internationalization.
Background/Significance: The historical analysis of Kaiserswerth Institute allows us to better understand the origins
of nursing as a profession and its influences on modern nursing. The bibliographic analysis of Kaiserswerth Institute
indicates that its structure and organization was fundamental to the beginning of nursing as a profession. Friederike
and Caroline Fliedner had the official title of Lady Superintendents, assuming a decisive role in the administration of
the Institute, fundamental to its success and internationalization. Furthermore, the Deaconesses Nursing School
inspired the conceptualization of Florence Nightingale, who used the knowledge imbedded in her academic
experience during the visits at Kaiserswerth to produce her own theoretical assumptions.
Method: The methodological approach used was bibliography research, studying and analyzing primary (GOLDER
(1903); LADY (1857); WINKWORTH (1867)) and secondary sources (RASCHE, (1987); SOINE, A. H. (2009)).
Results and Conclusions: The analysis of bibliographic documents allowed us to contextualize the origin and
development of the Institute, as well as to reflect upon its contribution to the professionalization of nursing care, to
the building of an adequate curriculum and to the enhancement of nursing as an organized, disciplined and accurate
assembly of practices. Analyzing the nursing training plan, we consider that it was holistic and individualized, focused
on different areas of knowledge, allowing the deaconesses students to become experienced professionals. Friederike
e Caroline Fliedner were decisive to a change of vision in the conceptualization of nursing activities, enabling the
permanent transformation of deaconesses at cognitive, spiritual and social levels, contributing to female
empowerment.
Key-words: Kaiserswerth; Friederike Fliedner; Caroline Fliedner; Nursing.
Bibliography:
GOLDER, C. (1903) – History of the Deaconess Movement in the Christian Church. New York: Eaton and Mains. Acedido em: 30/10/2010. Disponível em
http://www.archive.org/stream/historyofthedeac00golduoft/historyofthedeac00golduoft_djvu.txt. ISBN 9781172282241/1172282242
LADY, A. (1857) – Kaiserswerth Deaconesses including a History of the Institution, the Ordination Service and Questions for Self-examination. London:
Joseph
Masters,
Aldersgate
Street,
and
New
Bond
Street.
Accessed
in:
30/10/2010.
Available
at:
http://books.google.com/books?id=1swCAAAAQAAJ&oe=UTF-8
RASCHE, R. W. (1987) – The deaconess sisters: pioneer professional women. In: Zikmund, B. – Hidden Histories in the United Church of Christ. Vol.1 New
York: Pilgrim Press, 1987. p. 95-109. Accessed in: 01/11/2010. Available at: http://www.ucc.org/about-us/hidden-histories/HH1chap7Deaconesses.pdf. ISBN
9780829807530
SOINE, A. H. (2009) – From nursing Sister to a Sisterhood of Nurses: German Nurses and Transnational Professionalization, 1836 – 1918. Minnesota:
University of Minnesota. PhD Thesis. Accessed in: 30/10/2010. Available at: http://conservancy.umn.edu/bitstream/56167/1/Soine_umn_0130E_10673.pdf
WINKWORTH, C . (1867) – Life of Pastor Fliedner of Kaiswerswerth. London: Longmans, Green, and Co. Accessed in: 30/10/2010. Available at:
http://books.google.pt/books?id=l0gBAAAAQAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false.
1103096192/1-10-309619-2
ISBN
10:
2.3 - GENERAL NURSING
39
NURSES’ SATISFACTION WITH REGARD TO THE INTRINSIC CHARACTERISTICS OF THE NURSING WORKING METHODS
Authors:
Ana Margarida Madeira, RN
[email protected]
Vera Nascimento, RN
[email protected]
[email protected]
Escola Superior de Enfermagem de Lisboa, Portugal
POSTER ABSTRACT 13
41
Introduction: Job satisfaction is relevant to the organizational context because employees’ satisfaction is positively
related to professional performance. With regard to nurses, the importance of job satisfaction increases because it
relates to productivity, quality of care and influence the satisfaction of patients themselves. Dissatisfaction at work
is a risk factor for professional burnout syndrome which can lead to absenteeism and inefficiency at work. The
working methods, for defining the organization of the practice of nursing care, are considered an important factor
in job satisfaction of nurses. In this sense it is of high relevance to relate the degree of nurses’ satisfaction with the
particular characteristics of the working methodology. Then, the aim of the study is nurses’ satisfaction with
regard to the intrinsic characteristics of the nursing’s working methods. Methodology: To the achievement of this
work was conducted a review of the literature on the topics mentioned above and was constructed an instrument
for data collection – questionnaire, which underwent pre-test and applied to all nurses who work in Postpartum
Services’ in public hospitals in the Sub-Region of Lisboa and the MAC. The survey data were analyzed using
statistical methods, including descriptive statistics and factor analysis with SPSS program. Results: The analysis of
data showed that all 10 variables presented in this study, regarding to their contribution to the professional
satisfaction, are important to the job satisfaction. The variable considered the most important was the perception
of the quality of care and the less important was the need for set times to discuss plans of care with the team.
Descriptive analysis applied to the dimensions of job dissatisfaction has allowed us to conclude that the selected
items have no significant importance for the dissatisfaction. This might be related to the existence of other factors
which have a higher importance for job dissatisfaction and wasn’t included in this study, as the remuneration.
Conclusions: Applying the method of factor analysis, the dimensions of satisfaction were grouped having been
obtained three factors. So, we could conclude that the most important dimension for nurses’ job satisfaction is the
development of nursing discipline known as a science and as autonomous, which can be related with the need of
being recognised for their work by the society. The second factor extracted is related to the need of education,
which refers to the increasing development of new technologies and, the final factor was the importance of Caring
in the development of nursing interventions, which is the nursing essence.
Key-words: job-satisfaction; dimensions-job-satisfaction; nursing; nursing-work-methods
Bibliography:
Cunha, M. P. (2002), Introdução à qualidade de serviço: A perspectiva da gestão de recursos humanos, 1ª ed. Lisboa: ISPA,. 84p.
Ferreira, M. A.; Monteiro; Costas M.; Sousa, L. M. M. (2006), “Satisfação no Trabalho e Comportamentos estratégicos”, Revista Portuguesa de
Enfermagem, Amadora: Instituto de Formação em Enfermagem, Nº 6 p. 37-46.
Huber, Diane (2000), Leadership and Nursing Care Management. 2ª ed. United States of America:
Loureiro, R.; Ferreira, M.; Duarte, J. (2008), “Liderança em enfermagem versus satisfação profissional”, Revista Investigação em Enfermagem.
Coimbra: Formasau, Formação e Saúde Lda. Nº17 p. 11-27.
Maroco, J.; Bispo, R. (2003), Estatística aplicada às ciências sociais e humanas, Lisboa: Climepsi, 358p.
Queirós, P.J.P. (2005), “Burnout no trabalho e conjugal nos enfermeiros e o clima organizacional”, Revista Investigação em Enfermagem,
Coimbra: Formasau, Formação e Saúde Lda. Nº 11 p. 3-15.
Teixeira, Ana Lina Martins (2005), “A Satisfação Profissional e a Inteligência Emocional”, Sinais Vitais, Coimbra: Formasau, Formação e Saúde,
Lda, Nº59 p. 52-54.
USING ICNP® TO DESCRIBE SELF CARE DEFICIT DUE TO INABILITY TO PERFORM SELF-HYGIENE
Authors:
Barros, Maria Inês – Nursing Student
Castanheira, Patrícia – Nursing Student
Cravo, Mariana – Nursing Student
Lopes, Ana – Nursing Student
Leal, Mª Teresa –Nursing Professor
University: Escola Superior de Enfermagem de Lisboa
E-mail address: [email protected]
POSTER ABSTRACT: 14
43
Background: The development of Health Information Systems (HIS) brought up the need to built nursing
languages, as they seem to be the way to include nursing documentation in data systems, emphasizing the
decision-making and allowing the production of nursing data that contributes for the development of evidence
1,2,4,5
.
based practice
®
The Portuguese Nursing Council selected ICNP as the nursing language to include in HIS. Being self-care a broad
3
focus of autonomous nursing intervention, and having Orem’s self-care deficit theory as reference, the ND selfhygiene dependency was chosen because it’s common in nursing practice and its study gives us a clear perception
of the continuum of judgments/actions, reflecting the decision-making.
The purpose of this study is to understand the relation between using a standardized language – International
®
Classification for Nursing Practice (ICNP ) – and the visibility of decision-making, related to the nursing diagnosis
(ND) self-hygiene dependency. Method: This study is based on a literature review, followed by a reflexive analyze
of the researchers nursing practice.
Results: After acceptance of the project, the following steps were concluded: (1) A broad review about
®
Instruments for Classification of Nursing Practice, focusing on ICNP ; (2) One exploratory interview to the nurse in
®
charge of ICNP implementation in a Lisbon Hospital.
A literature review about the key-words and their relationships is ongoing. The last step will be to relate our
reflections from nursing practice with the results of the literature review.
®
Significance to nursing: It’s expected to highlight how ICNP can contribute to increase the visibility of decisionmaking in autonomous nursing care of clients with self-hygiene dependency as well as to analyze the use of this
focus in nursing documentation. With this project, we intend to identify and propose new words that can enrich
®
ICNP the documentation of autonomous nursing intervention related to the ND self-hygiene dependency.
®
Key-words: Nursing; standard language; ICNP ; decision-making; autonomous nursing intervention; self-hygiene
dependency.
Main References:
(1) LEAL, Mª Teresa (2006) – A CIPE® e a Visibilidade da Enfermagem: mitos e realidades. Loures: Lusociência. ISBN 972-8930-20-8.
(2) NÓBREGA, Maria; GARCIA, Telma. (2009) – Classificação Internacional para a Prática de Enfermagem: instrumental tecnológico para a
prática profissional. Rev. Brasileira de Enfermagem. Brasília. ISSN 0034-7167. Vol.62, nº5. (Set. – Out. 2009), p. 758-761.
(3) OREM, Dorothea Elizabeth (1985) – Nursing: Concepts of Practice. 3rd ed. New York: McGraw-Hill Book Company. ISBN 0-07-047525-3.
(4) PETRONILHO, Fernando (2003) – S.I.E. – Reformulação/Implementação: Que Contributos para a Reflexão e Melhoria das Práticas? Revista
Sinais Vitais. Lisboa. ISSN 0872-8844. nº 48 (Mai. 2003). p. 19-22.
(5) SILVA, Abel (2001) – Sistemas de Informação em Enfermagem: uma teoria explicativa da mudança. Porto: Instituto de Ciências Biomédicas
Abel Salazar. Doctoral Thesis.
DEVELOPING AN ICNP® CATALOGUE TO PROMOTE COMFORT IN NURSING PRACTICE
COMPLEXITY VS. PRAGMATISM
Authors:
Célia Simão de Oliveira (ESEL)
[email protected]
Mª Teresa Leal (ESEL)
[email protected]
Carlos Gaudêncio (CHLC)
[email protected]
Emília Bártolo (CHLC)
emí[email protected]
Ligia Malaquias (CHLC)
lí[email protected]
Mónica Pereira (CHLC)
[email protected]
Paulo Cruchinho (ESEL)
[email protected]
Escola Superior de Enfermagem de Lisboa (ESEL)
Centro Hospitalar Lisboa Central (CHLC)
POSTER ABSTRACT: 15
45
Introduction: The phenomenon comfort is a central concept in nursing discipline, crossing theories, models and
taxonomies, and establishing itself as a fundamental focus for professional intervention, by the expression it takes
in everyday practice of nursing. The process of comforting is based on nurses recognition of the individuality of
human experience, and requires a personal attitude of concern, commitment, respect, sensitivity and urbanity
towards the clients and their needs. Comforting is, therefore, a complex, interactive, personalized and
contextualized process, explained by the holistic, relative, and transient nature of comfort. Moreover, comforting,
although outlined by a nurse, is directed by the client, which adds variability and unpredictability to the
phenomenon.
Morse (1992) defines comfort as the label for the end state of therapeutic nursing actions for a patient and as a
state of well-being that may occur during any stage of the illness-health continuum. To this author, nursing care is
the intervention and comfort is the outcome of that intervention. To Kolcaba (1994, 2003), comfort is defined for
nursing as the satisfaction of the basic human needs for relief, ease or transcendence arising from health care
situations that are stressful.
According to ICN (2008), ICNP® catalogues fill a practical need in building health information systems by describing
nursing diagnoses, outcomes and interventions appropriate for particular areas of care.
In the context of this project, catalogues are subsets of ICNP®, specifically nursing diagnosis, outcome and
intervention statements for a selected and health priority: comfort. They do not replace nursing judgment. A
nurse’s clinical judgment and decision-making will always be essential to providing individualised care (ICN, 2008).
Comfort is an outcome that can arise from a variety of nursing interventions and be related with diverse nursing
phenomena, but a question arises: “How can we bring together the complex nature of the phenomenon comfort
with the "pragmatic and prescriptive meaning" of a catalogue?”
Objective: To develop a catalogue to promote comfort in nurse practice.
Methodology: CHLC and ESEL representatives are working on the identification of (1) the phenomena that can be
related with impaired comfort, (2) the nursing interventions that can promote comfort, and (3) other interventions
that aim to achieve that outcome, in order to build an ICNP® catalogue according to ICN directives (ICN, 2008).
Implications to Nursing: Nurses must improve their patients’ comfort in everyday practice. Nurses’ worldwide
need to understand and describe better the diagnoses and interventions involved in the processes of comforting,
as well as the contexts in which they are generated. With the development of a catalogue to promote comfort, we
expect to contribute to this outcome. As KolKaba says, if enhanced comfort is achieved, patients are strengthened
to engage in health seeking behaviours or a peaceful death.
Keywords: Catalogue development, comfort, comforting, nursing intervention, nursing care
Main references:
International Council of Nurses (2008) Guidelines for ICNP® Catalogue Development, ISBN: 978-92-95065-12-3
Kolcaba K. (1994) A theory of holistic comfort for nursing. Journal of Advanced Nursing 19(6), 1178–1184.
Kolcaba K. (2003) Comfort theory and practice. A vision for holistic health care and research. New York: Springer Publishing Company.
Morse J.M. (1992) Comfort: the refocusing of nursing care. Clinical Nursing Research 1(1), 91–106.
SPIRITUAL NURSING CARE TO RELIEF SUFFERING IN HAEMATO-ONCOLOGY PATIENTS
Authors:
Eunice Sá (Tutor/Lecturer at ESEL, Researcher at UI&DE)
[email protected]
Diana Silva
Liliana Oliveira
Raquel Filipe
[email protected]
Rute Gonçalves (4th year students of the Degree in Nursing from ESEL)
POSTER ABSTRACT: 16
47
Purpose: Identify witch nursing interventions relief suffer in adult with haemato-oncologic disease
Background: Nursing care spiritual dimension is sometimes undervalued, when related with other dimensions of
care. The importance of spiritual nursing care to relief suffering is accurately established in the literature.
Method: Its importance in the context of haemato-oncologic disease was confirmed through a qualitative study
that highlighted what specific spiritual nursing care relieved the suffering in the eight participants of our study.
Results: We concluded that spiritual nursing care relieves suffering in persons with haemato-oncologic disease,
because data showed that the interventions applied reduced suffering in the participants. All participants reported
that care was appropriate for their situation. they specified a few interventions that were the most significant to
them, such as: active listening, facilitation of spiritual growth, spiritual support, conversations (emotional support,
encourage hope), massages, relaxation, therapy of reminiscences and guided imagery.
The effect of care most frequently mentioned by our participants was the relaxation obtained after the assistance
provided, followed by the distraction/recreation associated with the interventions provided by spiritual nursing
care.
Conclusions: This study evidenced the best spiritual nursing care to relieve the suffering of our participants, giving
us the perception of how they were seen by them.
Key Words: Suffering, haemato-oncology disease, spiritual nursing care.
Main references:
CARNEVALE, Franco A. – A Conceptual and Moral Analysis of suffering. Nursing Ethics 16 (2), 2009
DOVER, Leslie J. Van; BACON, Jane M. – Spiritual Care in Nursing Practice: A close-Up View. Nursing Forum Vol.36, No.3, Julho-Setembro,
2001.
EMBLEN, Julia; PESUT, Barbara - Strengthening Transcendent Meaning: A Model for the Spiritual Nursing Care of Patients Experiencing
Suffering. Journal Holistic Nursing, 2001.
GAMEIRO, Manuel Henriques – Sofrimento na doença – Editora Quarteto, Coimbra, ISBN 972-8535-06-6.
UDINA, Eulália Juvé – Enfermería Oncohematológica. Barcelona: Masson, 1996. ISBN 84-458-0412-X.
WATSON, Jean – Enfermagem Pós-moderna e Futura. Loures: Lusociência, 2002. ISBN 972-8383-37-1.
WRIGHT, L.- Espiritualidade, Sofrimento e Doença. Coimbra, Ariadne Editores. 2005.
NEEDS OF INVOLVEMENT OF HEALTH SERVICES IN PEOPLE WITH PAIN AND ECONOMIC, SOCIAL IMPACT: A SYSTEMATIC
REVIEW OF LITERATURE
Authors:
Ana Ramos – RN, Cento Hospitalar Lisboa Norte, Researcher at UI&DE, Lecturer at ESEL
[email protected]
César Fonseca RN, Cento Hospitalar Lisboa Norte, Researcher at UI&DE, Lecturer at ESEL
Filomena Gaspar - RN, PhD, President of ESEL, Researcher at UI&DE
Marta Ferreira - RN, Cento Hospitalar Lisboa Norte, Researcher at UI&DE, Lecturer at ESEL
Ana Escoval – PhD, Professor at Escola Nacional de Saúde Publica/Universidade Nova de Lisboa
POSTER ABSTRACT: 17
49
Aim: To determine the economic and social impact and that needs of intervention by the health services for
persons with pain.
Methodology: Conducted a search in EBSCO (CINAHL, MEDLINE, British Nursing Index). Used the method of PI[C]O
and selected 19 articles of total 325 found.
Results: The neuropathic pain and musculoskeletal location were identified as most responsible for health
expenditures. The factors positively associated with cost-effective met: combination therapeutic regimen with
non-pharmacological strategies, involvement of multidisciplinary teams specializing in pain management,
continuity of care program in community and a telephone line permanent support.
Conclusions: The pain causes significant deterioration in quality of life, with incalculable impact on the
performance of activities of daily living, severely compromises the functional and productive, which translates into
high direct and indirect costs to the economy's health.
Keywords: Pain, social and economic impact and interventions of heath service.
Main References:
A, B., EM, D., & G, O. (2004, April). Clinical characteristics and economic costs of patients with painful neuropathic disorders. The Journal of
Pain: Official Journal of the American Pain Society, 5(3), 143-149. Retrieved June 27, 2009, from MEDLINE database;
A, T., W, J., S, J., J, D., C, B., & H, B., et al. (2006, July). A controlled trial of methods for managing pain in primary care patients with or without
co-occurring psychosocial problems. Annals of Family Medicine, 4(4), 341-350. Retrieved June 27, 2009, from CINAHL Plus with Full Text
database;
B, A., C, E., M, E., & C-W, H. (2004, May). Acute back pain management in primary care: a qualitative pilot study of the feasibility of a nurse-led
service in general practice. Journal of Nursing Management, 12(3), 201-209. Retrieved June 27, 2009, from CINAHL Plus with Full Text database;
C, K., G, H., & F, A. (2009, February 7). Health care costs, work productivity and activity impairment in non-malignant chronic pain patients. The
European Journal of Health Economics: HEPAC: Health Economics In Prevention And Care, 10(1), 5-13. Retrieved June 27, 2009, from MEDLINE
database;
H, I., G, K., K-Z, S., K, U., T, C., & J, B. (2008, September). Healthcare utilization and indirect burden among families of pediatric patients with
chronic pain. Journal of Musculoskeletal Pain, 16(3), 155-164. Retrieved June 27, 2009, from CINAHL Plus with Full Text database;
Melnyk, B.M., & Fineout-Overholt, E. (2005). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia:
Lippincott, Williams & Wilkins.
P, L., C, C., H, J., V, S., C, A., & F, E. (2005, June). Work loss, healthcare utilization, and costs among US employees with chronic pain. Disease
Management & Health Outcomes, 13(3), 201-208. Retrieved June 27, 2009, from CINAHL Plus with Full Text database;
W, D., K, Y., B, P., & W, T. (2006, March). Low back pain in older adults: are we utilizing healthcare resources wisely? Pain Medicine, 7(2), 143150. Retrieved June 27, 2009, from CINAHL Plus with Full Text database;
2.4 - ADULT AND CRITICAL NURSING
51
THE PERSON IN A POST CVA SITUATION: THE NURSE'S INTERVENTION OVER THE PROCESS OF REHABILITATION AND
REINTEGRATION INTO THE COMMUNITY WITH HOSPITALIZED CLIENTS.
Authors:
AFONSO, Tânia
CORDEIRO, Maurício
RODRIGUES, Paula
VIEIRA, Paula
Tutor
MESTRINHO, Maria de Guadalupe
E-mail: [email protected]
POSTER ABSTRACT: 18
53
Purpose: The study focuses on the process of continuity care, subject to a Monograph Project carried out by
th
students in the 4 year of the nursing degree, with focus on preparing the person who has suffered a stroke for
discharge. The process involves training both the client and family in order to make them autonomous in the
management of health and reintegration into the community.
Background / Significance: Based on data collected in the Department of Physical Medicine and Rehabilitation
(DPMR) at the Curry Cabral’s Hospital (CCH) through observation, an interview with a department’s nurse and
bibliographic research. It was found that the process of continuity of care presents some faults in assessing the
preparation for discharge’s effectiveness.
Method: We intend to achieve knowledge related to nursing care of patients in preparation for their reintegration
in the community, not only through consultation of investigative literature currently published, but also through
the exchange of experiences with the DPMR’s nurses at CCH and by direct provision care to the person who has
suffered a stroke and his family.
th
Results: Presently, we do not show many results, since only from the date of February 28 have we been able to
perform the observation in clinical teaching. However, through the research literature and an interview with the
DPMR’s nurse, we have realised that after hospital discharge, clients and their families still have some problems
with functional rehabilitation.
Conclusions: Having suffered a stroke, the occurrence of changes in the client’s project life is common. Therefore,
there is a need to work on this by creating a new "way of life", taking into account the specific needs of the
individual person and family in the preparation process and high continuity of care.
Keywords: Stroke, cerebral vascular accident, rehabilitation, family, care, discharge, rehabilitation-process,
continuity-care.
Main references:
BRANCO, T.; SANTOS, R. (2010) – Reabilitação da pessoa com AVC – Coimbra, Edição: FORMASAU; ISBN: 978-989-8269-09-6
MARTINS, M.M.F.P.S (2002) - Uma crise Acidental na Família. O Doente com AVC. Coimbra: FORMASAU. ISBN 972-8485-30-1
PORTUGAL, Direcção Geral de Saúde (2010) – Acidente Vascular Cerebral - Itinerários Clínicos – Lisboa: Lidel, edições técnicas Lda. ISBN 978972-757-661-1
THE PATIENT WITH CHRONIC HEART FAILURE: TRANSITION IN SELF-CARE AND QUALITY OF LIFE
Authors:
th
Inês da Cunha Baetas Robalo Nunes, 4 year Nursing Student
[email protected]
th
Joana Mafalda da Cunha e Silva, 4 year Nursing Student
[email protected]
th
Maria Inês Leal Brites Costa Santos, 4 year Nursing Student
[email protected]
th
Mário André Silva Balé, 4 year Nursing Student
[email protected]
Anabela Pereira Mendes, RN, PhD Student in Nursing at Universidade Católica Portuguesa, Lecturer at ESEL
[email protected]
Escola Superior de Enfermagem de Lisboa (ESEL) - Portugal
POSTER ABSTRACT 19
55
Title: The Patient with Chronic Heart Failure: Transition in Self-care and Quality of Life
Purpose: The aim of this research was explore the impact in self-care and quality of life experienced by patients
with chronic heart failure.
Background: The prevalence of chronic heart failure will continue to grow as our society increases in age and more
people with heart disease survive. Poor prognosis and clinical instability result in a high frequency of
rehospitalizations and considerable health care costs. Several studies demonstrated that patients living with CHF
face complex biomedical and psychosocial issues, all of which decreases patient’s quality of life.
Method: The research was done in the indexed databases: EBSCO – CINAHL and MEDLINE. The literature review
was restricted to the period among 2005-2010. Transition and Self-Care theoretical frameworks, developed by Afaf
Meleis and Dorothea Orem, were also thoroughly explored. The keywords used were: Chronic Heart Failure,
Nursing, Transition, Self-care, Quality of life.
Results: The literature shows evidence that transitions in self-care experienced by patients with chronic heart
failure are complex and vital in the process of adaptation to living with this condition. Some specific factors are
identified in the literature as compromising the quality of life of these patients, such as feel unable to manage their
condition, debilitating physical symptoms, change or loss of roles, psychological processes of distress, anxiety, lack
of control and feelings of uncertainty, coping strategies and social support. The self management of the disease
implies fewer hospitalizations and improved quality of life.
Conclusions: As nurses are aware of the impact of self-care transitions involved in living with chronic heart failure,
they can, effectively, implement adequate interventions to help patients managing their condition and promote
their quality of life.
MAIN REFERENCES:
CHICK, N. e MELEIS, A.I. Transitions: A nursing concern. [autor do livro] P.L. Chinn. Nursing Research Methodology: Issues and Implantation.
Gaitherburg : Aspen Publications, 1986.
KRALIK, D, VISENTIN, K. e VAN LOON, A. Transition: a literature review. Journal of Advanced Nursing. 2006, Vol. 55(3), pp. 320-329
KRALIK, D., LOON, VAN e M.A. Editorial: Transition and chronic illness experience. Journal of Nursing and Healthcareof Chronic Ilness. 2009, Vol.
I, pp. 113-115.
OREM, D. E. Nursing: Concepts of Practice. 3. Nova Iorque : McGraw-Hill Book Company, 1985. 0-07-047525-3.
SÁNCHEZ RUEDA, G. Dorothea E. Orem. Aproximación a su teoría. Rev ROL Enf. 22, 1999, Vol. 4, pp. 309-311.
YU, D.S.F. et al. Living with chronic heart failure: a review of qualitative studies of older people. 2008, Vol. 61(5), pp. 474-483.
INTENSIVE CARE UNIT: A NURSING PROFESSION GATEWAY?
Authors:
Filipa Silva – Nurse
Isa Félix – RN
[email protected]
Maria de Guadalupe Mestrinho – Professor at ESEL
Carla Nascimento – Lecturer at ESEL
POSTER ABSTRACT: 20
57
The construction of professional nursing identity starts at the initial train formation, but it also suffers a strong
influence when the newly nurses are integrated into professional life. That happens because is when nurses start
to link at the professional “culture”. Our future professional concerns and worries and the lack of existing
literature about it have led us to this thesis work, namely the newly trained nurses’ integration in an Intensive Care
Unit.
Aims:
 To know nurses on the integration process opinion;
 Identify ways that can facilitate the integration process;
 Identify potential difficulties aspects of the integration process;
 Understand nurses role on their integration process;
 Apprehend desires and aspirations of changing on the integration process.
This is a qualitative study, where there were interviewed six nurses: three newly trained nurses and three newly
trained nurses’ integrators.
As conclusions seem possible to assert that the professional integration process is assumed as a fundamental tool
because it allows to the newly formed nurses consolidate and develop or acquire skills that empower them to
professional exercise. On the other hand, promotes knowledge of context and encourages socialization among
peers, contributing positively to the service adaption. Thus, it’s essential that the institution produces and mobilize
resources to enable a consistent and structured integration to professionals, contributing to the excellence of care.
Keywords: Integration process, newly nurses, clinical supervision and Intensive Care Unit
Main references:
ABREU, Wilson Correia de (2001). Identidade, formação e trabalho: das culturas locais às estratégias identitárias dos enfermeiros. Coimbra: coedição Formasau e Educa
ALARCÃO, Isabel; TAVARES, José (2003). Supervisão da Prática Pedagógica: Uma Perspectiva de Desenvolvimento e Aprendizagem. Coimbra:
Livraria Almedina
BENNER, Patricia (2001). De iniciado a perito: excelência e poder na prática clínica de enfermagem. Coimbra: quarteto.
BERNARD, Janine M.; GOODYEAR, Rodney K (2003). Fundamentals of Clinical Supervision. London: Allyn & Bacon
BOND, Meg; HOLLAND, Stevie (1998). Skills of Clinical Supervision for Nurses: a practical guide for supervisees, clinical supervisors and
managers. London: Open University Press
FERNANDES, Maria Teresa Ramalhal Teixeira – Dimensões e contextos da identidade profissional das enfermeiras. Lisboa: ISCTE, 1996.
Dissertação de mestrado em Psicologia Social, na área de especialização-cognição pessoal, apresentado ao Instituto Superior de Ciências do
Trabalho e da Empresa.
FIGUEIREDO, Amélia Simões (2004). À conquista de uma identidade: enfermeiros recém-formados, entre o hospital e o centro de saúde. Lisboa:
Climepsi Editores
JONES, Janice M (2005). Clinical Supervision in Nursing: What’s it all about? In The Clinical Supervisor.
LE BOTERF, Guy (2003). Desenvolvendo a competência dos profissionais. Porto Alegre: Artmed.
CARE: AN EMERGENCY AT THE EMERGENCY DEPARTMENT
Authors:
Miguel Marques Graça (Nurse)
[email protected]
Raquel Sofia Sacramento Rosado (Nurse)
[email protected]
Ruben Ramires Silva (RN)
[email protected]
POSTER ABSTRACT 21
59
This study came up to explore the concept of Care at the Emergency Department (ED). We wanted to understand
how the Care is made there and to know which interventions are taken in terms of Care. Our research question
was “How do the Nurses Care at the Emergency Department?”
It was developed in a Lisbon Hospital ED. It had a mix character, in which we have based our observation and data
(collected from a grid and field notes) about Nurse-Patient first interaction (for Nurses who signed an Informed
Consent).
Our main theoretical support was WATSON (2002). Through our research, we realized that Caring at the ED still
needs more investigation.
The analysis of the data was mainly done through SPSS® and it was based in the domains of Caring:
Communication; Skills and Knowledge; Attitudes and Behaviours; Environmental management.
At the ED, Nurses were focused on the objective and quantifiable aspects of their interventions, but there was also
a preoccupation with the subjectivity of the Patient. Nurses showed communication skills that helped them to
create strategies to be closer to the Patients. The exchange of information fits the Patients in their situation and it
helps them to making informed decisions. However, the nurses found difficult to control and manage the
environment. Even at the ED all the Nursing interventions are guided by the Care.
Key words: Care; Emergency Department; Nursing Care; Patient.
REFERENCES:
HESBEEN, Walter - Cuidar no hospital: enquadrar os cuidados de enfermagem numa perspectiva de cuidar. Loures: Lusociência, 2000. ISBN:
972-8383-11-8.
NUNES, Lucília; AMARAL, Manuela; GONÇALVES, Rogério - Código Deontológico do Enfermeiro: dos comentários à análise de casos. Lisboa:
Ordem dos Enfermeiros, 2005. ISBN 972-99646-0-2.
WATSON, Jean - Enfermagem: ciência humana e cuidar uma teoria de enfermagem. Loures: Lusociência, 2002. ISBN 972-8383-33-9.
HOW CAN I, PERSON WITH CHRONIC ILLNESS HELP YOU, NURSE, TO TAKE CARE OF ME?
– THE KNOW-HOW OF PERSON WITH CHRONIC ILLNESS –
Authors:
Ana Patrícia Conceição (Hospital Garcia de Orta)
João Domingos (Hospital Garcia de Orta )
joã[email protected]
Vera Duque (Hospital Egas Moniz )
Eulália Novais (Lecturer at ESEL)
[email protected]
POSTER ABSTRACT 22
61
Purpose: The present study results from the necessity to understand the know-how that the person detains and be
able to mobilize in its self-care. Thus, we defined as the main objective to understand how the person with chronic
illness mobilizes their knowledge about her/his illness in the self-care and during the nursing care, in order to
improve her/his health conditions.
Method: Concerning the subject we intended to study, we opted to address a qualitative approach, centering itself
in the life experiences of the participants, allow-in exploring them and understanding the know-how of the person
with chronic illness in its own perspective. The study was carried out in a medicine ward and in the continued cares
unit of a central hospital. We appeal to the participant observation and posterior accomplishment of the daily
reports, as the methods of collect and register data information. To perform the data analysis, it was used the
content analysis procedure.
Results: Therefore, the following four categories had emerged: “The person’s know-how related to its chronic
illness”, “Sources of knowledge”, “Ways of knowledge mobilization during the self-care” and “Adaptation of the
person to its health condition”.
Conclusions: We conclude that the person with chronic illness have the know-how about her/his illness,
proceeding from various sources, and could mobilize it in the most sensible self-care. This mobilization depends on
the possibilities, limitations and resources of each person, who could be able to execute the self-care in an
independent form or requesting formal or informal careers. On the other hand, situations where the person does
not mobilize the know-how that withholds or simply does not execute self-care are influenced by the proper
process of the person adaptation to health condition.
Therefore, the main contribution of nursing in these cases would be through the validation, valuation, positive
reinforcement and orientation, in order to follow and promote the adaptation of the person to her/his health
condition.
Keywords: Person with chronic illness; know-how; self-care; nursing –care.
Main references:
Baszanger I. Les maladies chroniques et leur ordre négocié. Revue Française de sociologie. 1986. Jan-Mar; 27(4): 3-25
Collière MF. Promouvoir la vie. Paris: InterEditions; 1982.
Collière MF. Soigner... le primier art de la vie. Paris: InterEditions; 1996.
Lubkin IM, Larsen P. Chronic illness: impact and interventions. Boston: Jones and Bartlett Publisher; 2006.
THE IMPORTANCE OF NURSING INTERVENTION IN THE PROMOTION OF HIV/AIDS PATIENT’S COMPLIANCE
TO ANTIRETROVIRIC THERAPY
Authors:
th
Ana Tavares (4 year nursing student)
[email protected]
th
Catarina Rocha (4 year nursing student)
[email protected]
th
Guilherme Marques (4 year nursing student)
[email protected]
th
Tatiana Glória (4 year nursing student)
[email protected]
Eunice Henriques (RN, MSc, PhD Student UL/ESEL)
[email protected]
Escola Superior de Enfermagem de Lisboa [ESEL]
POSTER ABSTRACT 23
63
Purpose: To understand the nursing intervention in the promotion of HIV/AIDS patient’s compliance to
antiretroviric therapy.
Background/Significance: Since the appearance of the first antiretroviric, Zidovudine (AZT), a progressive
development of the HIV infection treatment has been observed. With this new development the patient no longer
faces imminent death but instead can live for several years with numerous treatment options. In spite of this
development, the compliance rate in these patients remains below of what is expected in order to achieve
therapeutic success. The comprehension of the compliance process is one of the major contributing factors to
reduce the prevalence of the disease and to improve the life of people with this chronic disease. Thus, it is
important to acquire knowledge on the factors that influence the compliance, in order to act on them.
Methods: Literature review using research and analysis of references and updated articles obtained in the
following indexed databases: EBSCO HOST: Medline, Cochrane and SciELO. The literature review will include some
papers in Portuguese and in English, published between 2004 and 2010 using the following keywords: adherence,
compliance, HIV/AIDS, Highly Active Anti-Retroviral Therapy, nursing, antiretroviric therapy.
Results: The results will focus on the main factors that influence HIV/AIDS patient’s compliance to antiretroviric
therapy and on what kind of nursing interventions can be done to promote compliance.
Conclusion: With this work we intend to contribute to the general comprehension of HIV/AIDS patient’s
compliance to therapy. Considering Nursing as a discipline and as a profession, we believe that we can contribute
by focusing the importance of nursing intervention regarding its autonomous intervention in therapy compliance.
Main references:
ANDRÉ, M. R. (2005) – Adesão à terapêutica em pessoas infectadas pelo VIH/SIDA. Stória Editores, Lda., Loures. Depósito legal: 236855/05.
HOFFMANN, C. & ROCKSTROH J. K. (2009) – HIV 2009: A Textbook. Medizin Fokus Verlag, Hamburg. ISBN 978-3-941727-02-1.
ORDEM DOS ENFERMEIROS (2009) – Estabelecer parcerias com os indivíduos e as famílias para promover a adesão ao tratamento – Catálogo da
Classificação Internacional para a Prática de Enfermagem. ISBN 978-989-96021-1-3.
BRAVO et al (2010) - Tough Decisions Faced by People Living With HIV: A Literature Review of Psychosocial Problems. In AidsReviews, nº2,
vol.12, Department of Primary Care and Public Health. School of Medicine. Cardiff University, Wales, UK
THE NURSE AS A PROMOTER OF INCLUSION AND EMPOWERMENT OF THE FAMILY
IN THE MANAGEMENT OF CHRONIC DISEASE
Authors:
Estela Guerreiro
Inês Alves
Márcia Monteiro
Mariana Gonçalves
Carla Nascimento
E-mail address: [email protected]
POSTER ABSTRACT: 24
65
Significance: Nowadays there has been an outstanding growth in the number of people affected by chronic
diseases all over the world. This fact has been caused by the rise of average life expectancy and by the increase of
risk behaviours and risk factors. Chronic diseases affect several aspects in a person’s life and require the
readjustment of their daily activities. Thus, in order to face the difficulties of the adaptation process to disease, the
help of professionals, relatives and friends is vital to make patients accept their condition, exploring new emotions
and new capacities.
Most of the times, the family members assume the role of the informal care taker. So, family members need
nurses that can help them learn effective interventions.
Purpose: The main goal of our study is to understand the nurse’s role in empowering the person/family in the
management of chronicle illness.
Method: Review of the literature and analysis of clinical practice in this field.
Results: In our experience in clinical practice, we understood that family is not always efficiently included in the
planning of nursing care, and interventions that may enable the family members to get knowledge and skills to
take care of the patient. We have also noticed that nursing care in the community is different from nursing care in
a hospital.
Conclusions: With this project we intend to develop our knowledge and technical and relational skills that will
allow us to develop, in our future practice, holistic interventions targeted to the person and their
relatives/meaningful people. Furthermore, our goals are to realize in what way a person’s chronic disease is lived
in the family, and the role of nurses towards both patients and their families; to understand as well how important
the inclusion/ enablement of the family/meaningful person in this process is; to understand the reality of care
partnership nowadays and its advantages.
Main references:
ARTINIAN, Nancy Trygar (2005) – Enfermagem de Cuidados de Saúde à Família – Teoria, Prática e Investigação (2nd ed.). Loures: Lusociência.
HESBEEN, Walter (1997) – Cuidar no Hospital. Loures: Lusociência.
LAVERACK, Glenn (2008) – Promoção da Saúde: Poder e Empoderamento. Loures: Lusociência.
LUBKIN, Ilene Morof; LARSEN, Pamala (2006) – Chronic illness: impact and interventions (6th ed.). Boston: Jones Bartlett Publishers.
CARING FOR A PERSON WITH STROKE ... PREVENTION OF SPASTIC PATTERN
Authors:
Morais, Tatiana - RN
[email protected]
Workplace: Centro Hospitalar Lisboa Norte, Pólo Pulido Valente, Medicina IIIC
POSTER ABSTRACT 25
67
According to recent data from General Health Department (Direcção Geral Saúde) (2008) there are in Portugal, as
average, about 22,500 million hospitalizations for stroke which corresponds to about 5% of total admissions. From
this total, about 70% survive, suffering changes in neuro-sensory abilities. This situation results in health
professionals, namely nurses, a challenge to good practices in order to encourage the adaptation of persons with
stroke to their new condition and rehabilitation.
It is therefore obligatory that nursing care be applied to promote autonomy and restoration of pre-injury
independence. The rehabilitation process of people with stroke should be prepared together with patient, and
viewed as a continuous process in time, and not just a sequence of repeated and isolated exercises. Thus, DAVIES
(1996:61) refers "the successful rehabilitation depends not only on several sessions of therapy but also on what
happens to the patient during the day and night remaining hours. Even the position of sleeping can make a
remarkable difference to the outcome. (...)" So, is role of generalist nurse to encourage continuity of care for
therapy sessions, promoting early in rehabilitation process the prevention of spastic pattern. Thus, the main
objective of this paper is to recall basic concepts in the prevention of spastic pattern settlement and as specific
objectives the remembering of anti-spastic positions.
Keywords: stroke; prevention; anti-spastic standard; spastic standard;
Bibliography :
Branco, Teresa; Santos, Rui – Reabilitação da pessoa com AVC. Coimbra: Formasau. 2010;
Davies, Patricia M. – Recomeçando outra vez. São Paulo: Editora Manole, 1996:61;
Hoeman, Shirley P. – Enfermagem de Reabilitação. 2ª ed. Loures: Lusociencia. 2000;
HOW IS QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS - CONTRIBUTIONS FOR NURSING
Author:
Maria do Céu Sá, RN, Professor
[email protected]
POSTER ABSTRACT: 25_A
69
This study, of quantitative nature, is based on the evaluation of the impact of changes related to the progression of
Rheumatoid Arthritis, namely at physical, psychological and social level, working and pain, or in other words, how
the disease affects patients Quality of Life.
As a methodological support, we used a short version of the Arthritis Impact Measurement Scale (AIMS2)
questionnaire, which was developed to evaluate the Quality of Life of patients with arthritis. After validation, the
questionnaire was administered to 137 individuals who attended outpatient appointments in four hospitals. After
the analysis and discussion of the survey results, we present the most relevant conclusions:
•
The patient with Rheumatoid Arthritis and his health condition is extremely complex in all dimensions
studied.
•
Arthritis Pain was the dimension mostly reported by individuals as responsible for great personal suffering,
with extensive consequences on their personal, familial, social and working life.
•
The Emotional/Psychological Dimension suffered severe changes, such as emotional disturbances, related
with motivation, anxiety, nervousness, and physical limitations of multiple sorts, which lead to
dissatisfaction regarding different health levels.
•
Social Support, especially family and friends support was proven to have a positive impact in the
individuals, softening some negative effects of the illness in these dimensions.
•
The Dimension Work is frequently compromised by the limitation or loss of some capacities, which may
lead to a complete change in professional activity.
•
The satisfaction level with the present health status and future expectations are compromised by the
experienced changes.
The study emphasizes that it is recommended that nurse practitioners ought to participate in the evaluation of
these patients health status, in order to provide the appropriate and adequate help that they require, from the
conception to the implementation of health care services, especially in rehabilitation nurses, aimed to increase the
Quality of Life of these patients.
Key words – nursing, rheumatoid arthritis, quality of life
2.5 - ELDERLY NURSING
71
PROMOTION OF SELF-CARE TO THE PERSON DEPENDENT ON NURSING CARE – PREPARING THE HOME RETURN, OF THE
ELDERLY PERSON, AFTER FRACTURE OF THE PROXIMAL END OF THE FEMUR.
Authors:
Costa, Vanessa
Lino, Nélson
Marques, Ana S
Oliveira, Mário
[email protected]
ESEL Nursing Students
Baixinho, Cristina
Ferreira, Óscar
ESEL Professors
POSTER ABSTRACT: 26
73
The promotion of self-care is one of the nursing quality indicators, particularly in the hospital, where the elderly
person experience a period of reduced autonomy and increased dependence. Furthermore, in one continuum of
care perspective, it is essential to prepare the returning home of the elderly person in order to promote the
acceptance of his limitations, prevent the reduction of functionality and to motivate and responsibilize for the
restoring of his health and progress towards independence.
The purpose of this study is to characterize how the nurse promotes self-care in the preparation of returning
home, of the elderly person, submitted to surgery for fracture of the proximal end of the femur.
From the literature review withdrew the main references: Orem (1993), Petronilho (2007) and Cabete (2005). Will
also be used reflections about the practice based on the Gibbs cycle.
Through the observation and practice reflection, using the Barthel Index (instrument used to assess the level of
independence) and client interviews, we intend to deepen the thematic under study and contribute to the
enhancement of nursing care in terms of self-care promotion as a crucial intervention area, so that a logical,
organized and systematic actuation process exist, where the nurse assess, plan and implement his care.
Keywords: Promotion of self care, preparation for home return, elderly, fracture of the proximal end of the femur.
MAIN REFERENCES
CABETE, Dulce (2005) – O idoso, a doença e o hospital: o impacto do internamento hospitalar no estado funcional e psicológico das pessoas
idosas. Loures: Lusociência.
OREM, Dorothea (1993) – Modelo de Orem: Conceptos de Enfermería en la Práctica. 4ª ed. Barcelona: Masson-Salvat Enfermería.
PETRONILHO, Fernando (2007) - Preparação do Regresso a Casa. Coimbra: Formasau
PREPARING THE FAMILY CAREGIVER OF THE ADULT / ELDER DEPENDENT PERSON ON SELF CARE HYGIENE IN THE
TRANSITION FROM HOSPITAL TO HOME
Authors:
Adelaide Nunes
[email protected]
Berta Couto
[email protected]
Luciana Ramos
[email protected]
Tânia Gaspar
[email protected]
4th year students of the Degree in Nursing from the Escola Superior de Enfermagem de Lisboa – ESEL
Orientation: Isabel Ferraz, Master of Nursing Science and Professor at ESEL
POSTER ABSTRACT 27
75
The project Preparing the Family Caregiver of the Adult / Elder Dependent Person on Self Care Hygiene in the
Transition from Hospital to Home arises in the context of the monograph integrated on the 4th year of the Degree
in Nursing from ESEL, developed in Personal Project in Clinical Nursing.
Our main goal is to help to develop the skills of mastery of the family member caregiver to ensure the care of
Hygiene and Comfort after returning home.
Methodology – We developed a literature review aiming to establishing the object of study, comparing the
evidence with the experiences we had in a personal level and as a student in the Clinical Practice, analyzing and
reflecting continuously on those pathways.
Development – Resulting from the marked population aging and disease processes associated, the phenomenon
of transition is frequently present not only in these people's lives but also in their families. When someone can’t be
independent in Hygiene self care, the family care givers arises. However, this situation of dependence creates
vulnerabilities in the family caregiver and that’s why it requires the nurse’s intervention to the transition process
of care provider role. The hygiene self-care demands that the caregiver has to be able to: deal with the other's
person body and intimacy, dealing with discomfort and shame, what is an embarrassment that family members
must be able to overcome.
Conclusion – This project allowed us to deepen the theoretical knowledge of family caregiver needs to support the
adult/elderly dependent person in hygiene and comfort self-care. The consciencialization and appropriation of
knowledge during practice were integrated and reflected through learning diaries, as a strategy developed on clinic
practice, allowed us the acquisition of competences in the returning home preparation.
Key-Words: Nursing, preparing return home, discharge planning, role transition, family caregiver, comfort and
hygiene care, dependent person.
THE ELDERLY PERSON WITH DEMENTIA ABUSED BY THE FAMILY: PARTNERSHIP AS A NURSING INTERVENTION OF TO
PROMOTE THE CARE OF THE SELF.
Authors:
Ana Carina dos Santos Marques
[email protected]
Ana Rita Antão Gaspar
Hugo Garcia da Silva Reis
Maria Manuel Venâncio Alves
th
Students in the 4 year of the Degree in Nursing, ESEL
Idalina Gomes - PhD, Professor at ESEL, Researcher at UI & DE, Stage Advisor
[email protected]
POSTER ABSTRACT 28
77
Title: The Elderly Person with Dementia Abused by the Family: A partnership as Nursing Intervention to Promote
the Care of the Self.
Background: Elderly abuse is related with every culture and society worldwide. Many studies indicate dementia as
a risk factor for abuse by the family caregiver. As health professionals, nurses are aware of this and hold the
responsibility for elderly abuse management: prevention and intervention.
The aim of this project is to understand elderly persons with dementia abused by family and analyze the familynurse partnership as a nursing intervention which promotes proper care for the elderly person and family.
Method: Narrative review of literature and also analysis of learning diaries of clinical practice of the authors.
1
Results: In Portugal, between 2001 and 2009, there has been 120% rise in crimes against the elderly . The elderly
person, who experiences dementia while living with the family, had 55% more chances of being abused by the
2, 3
2, 3
family . This can be caused by factors such as caregiver stress and social isolation . In the Netherlands, where
5
we’ve been for a clinical practice, the most frequent kind of abuse is psychological (36%) . There’s no such
characterization in Portugal. Research shows that using partnership as a nursing intervention will help the
4
caregiver to care for himself in order to provide a true caring environment towards the other, keeping his dignity .
Conclusions: This project allowed us to get a better understanding about this issue: the elderly person with
dementia abused by family, and to reflect upon partnership as a nursing intervention that promotes the building of
strategies with families, in order to empower them to answer to their elderly relative with dementia the needs; at
the same time, nurses can look at the families as a client for nursing care. Thus, the partnership as nursing
intervention can reduce the risk factors of abuse associated with stress and caregiver’s isolation, and the family
relationship can also be improved.
References:
ASSOCIAÇÃO PORTUGUESA DE APOIO À VÍTIMA (2010) – Estatísticas APAV Pessoas Idosas vítimas de crime 2000 – 2009. Available in
http://www.apav.pt/portal/pdf/Estatisticas_Pessoas_idosas_vitimas_crime_2000-009.pdf, in 28/02/2011.
COOPER, Claudia; OWENS, Colm (2010) – The Relationship between dementia and elder abuse. Working with Older People. Vol. 14, nº 1
(March 2010), p. 19-21.
FERREIRA-ALVES, José (2004) – Factores de risco e Indicadores de Abuso e Negligência de Idosos. Coimbra: Coimbra Editora. ISSN 0870-4791.
GOMES, Idalina Delfina (2009) – Cuidado de Si: a natureza da parceria entre enfermeiro e o doente idoso no domicílio. Lisboa: Instituto de
Ciências da Saúde, Universidade Católica Portuguesa. Dissertação de Doutoramento.
MOVISIE (2010) – Ouderenmishandeling: Cijfers 2009. Utrecht: Movisie.
DYSPNOEA ASSESSMENT AS A NURSING INTERVENTION FACILITATING THERAPEUTIC REGIME MANAGEMENT IN ELDERLY
PATIENTS WITH COPD
Authors:
Helga Rafael Henriques - Student of Master Degree in medical-surgical nursing (Nursing the Elderly), ESEL.
[email protected]
Goreti Rainho - Specialist Nurse, Service of Pneumology C, Centro Hospitalar de Torres Vedras. Stage Co-Advisor.
Idalina Gomes - Ph D, ESEL, member of the UI & DE, Stage Advisor
POSTER ABSTRACT 29
79
Background/Significance: Aging is associated with multiple perceptual losses, including the ability to detect and
interpret physical symptoms. In elderly patients with COPD, dyspnea is one of the most common symptoms. Its
recognition is essential to initiate the process of self-management regimen.
The evaluation of dyspnea perception by Modified Borg Scale (MBS) is a nursing intervention focused on the
person that enables a greater understanding of the transition experience and a greater objectivity in the process of
care.
Purpose: The aim of this project was to implement a systematic evaluation of dyspnea, by the Modified Borg Scale
(MBS), in elderly patients with COPD hospitalized in a pulmonologist service, aiming a better therapeutic regimen
management.
Method: The process of implementing followed the project methodology, on a course of action-research logic,
with nurses' involvement on analyses and discussion of clinical care practices and education to all 16 members of
nursing team. We followed 16 elderly, hospitalized from November 2010 to February 2011.
Results: The results showed changes in the approach and understanding of the elderly with dyspnea. There is a
regular use of MBS in assessing breathlessness perception. This is documented in patient process and its
interference in various dimensions of person is valued on planning and execution of nursing activities, with greater
concern to record actions related to elderly education in order to manage their therapeutic regimen.
Conclusions/relevance to nursing: Concluding, assessing dyspnea perception in elderly patients with COPD,
through the EMB, promotes a better management of therapeutic regimen. Enables the planning of nursing actions,
focusing on person, and allows elderly to learn to recognize and interpret this symptom and manage the effort
spend in their life activities.
MAIN REFERENCES
BERGER, L.; MAILLOUX-POIRIER, D. (Ed.). (1995) – Pessoas Idosas, uma abordagem global. Lisboa, Lusodidata.
BORG, G: (2000) – Escalas de Borg para a Dor e o Esforço Percebido. Editora Manole. São Paulo.
SCHUMACHER, K.L.; JONES, P. S.; MELEIS, A. I. (1999) – Helping Elderly Persons in Transition: A framework for Research and Practice, In
Elizabeth Swanson & Toni Tripp-Reimer (Ed). Life Transitions in Older Adult: Issues for Nurses and Other Health Professionals. Springer
Publishing Company, New York, p. 1-26.
RIEGEL, B.; DICKSON, V.; CAMERON, J.; JOHNSON, J. (2010) – Symptom Recognition in Elders With Heart Failure. Nursing Scholarship; 42:1, p.
92-100.
RIEGEL, B.; DICKSON, V. (2010) – Self-care of Heart Failure: A situation-specific theory of Health Transition: IN: MELEIS (ed.) – Transitions
Theory: Middle-Range and Situation-Specific Theories in Nursing Research and Practice. New York, Springer Publishing Company, p. 320 – 326.
.
ASSESSMENT OF THE RISK OF FALLS IN ELDERLY PATIENTS ADMITTED IN A MEDICAL WARD
Authors:
Helder Lopes (Student of Master Degree in medical-surgical nursing (Nursing the Elderly), ESEL.
[email protected]
Idalina Gomes (Ph D, ESEL, member of the UI & DE, Stage Advisor)
[email protected]
Paula Ferreira (Specialist Nurse, Service of medical, Centro Hospitalar de Lisboa Norte-HPV. Stage Co-Advisor)
[email protected]
Paula Almeida (Specialist Nurse, Risk Management Office, Centro Hospitalar de Lisboa Norte-HPV)
[email protected]
POSTER ABSTRACT 30
81
Background: Falls are one of the main events in elderly lives, generator of incapacity, dependency, decreased
quality of life and loss of autonomy. At hospital level, it’s a serious public health problem. Patient falls occur at an
estimated frequency of 4-10 per 1000 beds per day. It‘s imperative that nurses develop protocols and multifactorial strategies, in order to prevent falls.
Objectives: (1) Prevent and monitor the event of falls in elderly patients admitted in a Medical ward. (2) Develop
nursing staff skills, in the area of monitoring and prevention of elderly falls.
Design: Project methodology centered in an investigation-action course, where the subjects took an active role in
change. Data was collected, using the Morse Scale, clinical file analyses and practice analyses, between October
th
th
15 2010 and February 15 2011.
Results: There is a systematic use of the Morse Scale in evaluating the risk of fall. The results showed that medium
and high risk of falling, highly prevail in elderly. The risk of falling is referred to in the process, as are the planning
and actions developed in function of that same risk. A monitoring sheet was created to register the fall incident,
which is reported to the risk management office.
Conclusions: A systematic team strategy is crucial in preventing elderly patient’s falls. It’s fundamental that
strategy includes evaluation instruments that allow improvement in prevention and control of the falls, improve
the patient well-being and get health gains when complications from falling occur. The fall is an indicator of the
quality of nurse’s care.
References:
MORSE, J. (2009) – Preventing patients falls: establishing a fall intervention program. 2ª Ed. New York: Springer Publishing Company. ISBN
978-0-8261-0389-5.
PORTUGAL (2008). Ministério da Saúde. Inspecção-Geral das Actividades em Saúde - Relatório IGAS N.º 319/2008: Acidentes com macas e
camas em estabelecimentos hospitalares, envolvendo a queda de doentes. IGAS. 2008
SKELTON, T. (2004) – What are the main risk factors for falls among older people and what are the most effective interventions to prevent
these falls? [Online]. Copenhagen. Who Regional Office for Europe (Health Evidence Network Report). 2004. Retrieved 10/12/2010 from
http://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf
STREUBERT, H.; CARPENTER, D. (2002) – Investigação qualitativa em enfermagem: avançando o imperativo humanista. 2ª Ed. Loures:
Lusociência. ISBN 972-8383-29-0
ELDERLY FALLS PREVENTION IN NURSING HOME CONTEXT – AN INTERVENTION PROJECT
Authors:
Sónia Alexandra da Silva Ferrão - RN, MSc in Community Health, Master student in Medical-surgical Nursing at ESEL and PhD
student in Nursing at UCP
[email protected]
Rui Fontes - RN, Coordinator of SAMS/SBSI Nursing Home. Co-orientation of clinical practice project in the Medical-surgical
Nursing Master Course.
Adriana Henriques - RN, MSc in Epidemiology, Coordinator teacher at ESEL. Orientation of clinical practice project of the
Medical-surgical Nursing Master Course.
UNIVERSITY: Escola Superior de Enfermagem de Lisboa (ESEL)
POSTER ABSTRACT: 31
83
TITLE: Elderly Falls Prevention in Nursing Home Context – An Intervention Project.
Purpose: The goal of this project was to implement a systematic nurse intervention on residents falls prevention at
a 100 bed capacity nursing home.
Background: Elderly falls are a major health problem recognized worldwide, being associated with high rates of
mortality and morbidity, as well as multiple individual, familiar and community costs. Usually, elderly falls in
nursing homes occur more often and with more severe consequences than those occurred at home. Prevalence
falls in nursing home context are considered a quality indicator sensitive to nursing care.
Method: The project was based on Morse´s fall prevention Programme (2009), following the 6 steps
recommended: obtain administrative support, conduct an environmental safety check, obtain baseline data,
establish monitoring system, prepare staff, appoint an interdisciplinary assessment team.
Results: Morse´s Modified Risk Fall Evaluation is currently applied to all residents by their responsible nurse. This
evaluation is registered on resident´s chart, and its impact on several dimensions is considered in nursing care
planning. Fall events are more accurately recorded was well as the undertaken interventions. A monitoring
committee was created to follow the work in progress.
Conclusions: Systematic fall risk evaluation in residents, along with multifactorial activities focused on accidental,
anticipated and unanticipated physiological falls constitutes an adequate approach in preventing elderly falls in
this context.
Main References
American Geriatrics Society. AGS/BGS Clinical Practice Guideline: Prevention of Falls in Older Persons; 2010. Disponível em
www.americangeriatrics.org
Australian Commission on Safety and Quality of Healthcare. Preventing Falls and Harm From Falls in Older People. Best Practice Guidelines for
Australian Residential Aged Care Facilities; 2009.
Gillespie L D, Gillespie W J, Robertson M C, et al. Interventions for Preventing Falls in Elderly People (Review). The Cochrane Library, Issue 4;
2008.
Morse J. Preventing Patient Falls – Establishing a Fall Intervention Program. Springer Publishing Company, New York. Second edition; 2009.
National Institute for Clinical Excellenc. Clinical practice guideline for the assessment and prevention of falls in older people. Royal College of
Nursing; 2004.
2.6 - CHILD HEALTH AND PEDIATRIC NURSING
85
ADOLESCENTS AND HEALTH CARE PROVIDERS IN A HEALTH SERVICE FOR ADOLESCENTS: WHAT THEY SAY ABOUT IT?
Authors:
Natacha Palma, RN
Susana Ferreira, RN
Inês Spínola, RN
Sofia Roldão, RN
Maria da Graça Vinagre Graça, RN, Professor
[email protected]
POSTER ABSTRACT 32
87
Background/Significance: Adolescence is a time of life with many changes at biological, cognitive, emotional and
social development that are experienced, in a particularly way, for each adolescent. The need of experimentation
associated with the search of identity can lead to risk behaviours with potential implications for their health and
well being. In adolescent health care it’s pertinent to adopt a comprehensive and integrated approach focused on
health promotion which can include specific spaces for that (Prazeres, 1998; WHO, 2002; UN, 2004; DGS,
2006).Purpose: The study focused on need of health services for adolescents considering its dynamics and
particular function viewed by their intervenient to adequate the responses of health providers, particularly nurses,
to the specific needs of adolescents. Therefore, it was intended to explore the perceptions of adolescents and
health providers about the care provided in one adolescent’s health service. Method: This is an exploratory,
descriptive and qualitative study. We used the semi directive interview in data collection and content analysis in
the data analyse. (Bardin, 1979; Vala, 2001). The sample consists in two groups of participants: ten adolescents (9
girls and 1 boy) aged 16 to 24 years; and seven health providers (3 nurses, 2 doctors, 1 psychologist and 1 social
worker). It was taken into account the time of experience in the area and in the institution. Results: The teens
highlighted the immediate care, the characteristics and attitudes of health providers (sympathy, interest and
availability shown), the adoption of an global, integrated and personalized approach aimed to young people,
assurance of confidentiality, as well as the difficulties in accessing to other health institutions. The professionals
refer identical aspects, emphasizing the relational ones, which are all integrated in the principles recommended for
youth-friendly services. Conclusions and relevance to nursing: The need for specific services for adolescents has
been strengthened both by youth as health professionals, who use these services, making relevant investments in
such spaces. The study provides important guidelines at the physical conditions, intervention approach, attitudes
and behaviours to be adopted by health providers in caring the young people, mainly the nurses which the youth
attributed a referential role in their attendance and in health promotion and well-being.
Keywords: Adolescent; Health Care Provider; Health Promotion; Health Services; Nurse-Teen Relationship
Bibliography:
Bardin, Lauren (1979). Análise de Conteúdo. Lisboa: Edições 70.
Portugal, Ministério da Saúde, Direcção-Geral da Saúde – Divisão de Saúde Materna, Infantil e dos Adolescentes (2006). Programa Nacional de
Saúde dos Jovens 2006/2010. Lisboa: DGS.
Prazeres, Vasco (1998). Saúde dos Adolescentes: Princípios Orientadores. Lisboa: Direcção Geral da Saúde, Divisão de Saúde Materna, Infantil e
dos Adolescentes.
United Nations (2004). World Youth Report - The global situation of young people [em linha]. Nova Iorque: UN. Acedido em: www.un.org
(17/11/2009)
Vala, J. (2001). A Análise de Conteúdo. In: SILVA, Augusto Santos e PINTO, José Madureira (orgs.) – Metodologia das Ciências Sociais. 2ª edição.
Porto: Edições Afrontamento, pp. 101- 128.
World Health Organization (2002).Adolescent friendly health services [em linha]. Génova: WHO. Acedido em: www.who.org (a 15/11/ 2009)
PLAY ACTIVITIES DURING HOSPITALIZATION
A WAY OF CARING THE CHILDREN WITH CHRONIC ILLNESS
Authors:
André B. Valério, RN
[email protected]
Sandra F. P. Curto, RN
[email protected]
[email protected]
POSTER ABSTRACT 33
89
Introduction: The use of playful activity in the pediatric hospitalization, may have many advantages for children,
because it provides moments of distraction, allows the expression of feelings and fears and facilitates the creation
of a relationship based on empathy and trust with the health professionals, so play may represent an important
role in the minimization of the negative effects associated with the period of hospitalization. Thus, the theme
inherent in the use of playful activity in the hospital reinforces the need to rethink the practices of today and how
the play can be used to promote excellence of care in pediatrics services. However, this is a subject still little
explored, so the study of contributions of playful activity during pediatric hospitalization becomes very relevant.
So, this study has as main objective, to describe, in the view of the child with chronic illness, the contributions of
the playful activity during hospitalization. Methodology: An exploratory study using a qualitative methodology,
where the choice of data collection technique falls on the focus group, and has been applied on eleven children
with chronic illness in school ages. The empirical subjects were divided into two groups, which one of them was
constituted by five children from six to eight years old and the other by six children with ages between nine and
twelve years old. Results: Based on the data, a dimension emerged about “Playing in the Hospital”, which is
composed by three categories: positive or negative meaning that children attach to this concept, the role in
minimizing the negative effects of hospitalization and the promotion of strategies for emotional managing, and,
finally, the elements that facilitate this kind of activity. In this context, it was possible to verify that children with
chronic illness in school age recognize a very positive meaning in playful activity in the hospital, identifying several
contributions that these moments can provide in the hospital environment, both for minimizing the negative
effects of hospitalization, especially in pain relief and reduction of fear and anxiety, as in the promotion of
strategies for managing their emotions, useful in the control of anger, the reduction of sadness and to provide
feelings of happiness/joy and distraction/entertainment. Conclusions: It was possible to understand who are, in
their view, the elements that facilitate fun activities during hospitalization, admissions, among which stands out
the other hospitalized children, relatives, nurses, educators, volunteers and the Clown Doctors. Finally, also
enabled to understand that there are some obstacles to the promotion of playful activities in the hospital
environment, mainly related to the space where children are, because it is not adapted to play. Thus, taking into
account all the benefits inherent in the use of playful activity during the hospitalization of the child, we think that
this should be a right protected by all health professionals, particularly the nurses, taking into account the best
interests of the child. Key-words: playful activity, play, caring, child, nursing, hospitalization, chronic illness
Bibliography:
Carvalho, A., & Begnis, J. (Jan./Abr. 2006). Brincar em Unidades de Atendimento Pediátrico: Aplicações e Perspectivas Psicologia em Estudo, 11;
nº 1, 109-117.
Collière, M. F. (Ed.). (2003). Cuidar… A Primeira Arte da Vida. Loures: Lusociência.
Curado, M. A. S. (1996). Comportamento lúdico da criança portadora de Trissomia 21. Faculdade de Motricidade Humana, Universidade Técnica
de Lisboa, Lisboa.
Curado, M. A. S. (2006). Acolher… É Receber… É Dar… É Partilhar…. Acolhimento e estadia da criança e do jovem no hospital. Lisboa: Instituto
de Apoio à Criança.
Favero, L., & outros. (Out./Dez. 2007). A Promoção do Brincar no Contexto da Hospitalização Infantil
Como Ação de Enfermagem: Relato de Experiência. Cogitare Enfermagem, 12, 4, 519-524.
Furtado, M. C., & Lima, R. (Novembro/Dezembro 1994). Brincar no Hospital: Subsídios Para o Cuidado de Enfermagem. Revista da Escola
Universidade de Enfermagem de São Paulo, 33, 4, 364-369.
Gibbs, A. (Ed.). (1997). Focus Groups; Social Research Guildford, Surrey: University of Surrey.
Krueger, R. A. (Ed.). (1998). Analysing & reporting focus group results. Thousand Oaks: Sage Publications.
William, L. H. C., & Lopez, V. (2008). Effectiveness and Appropriateness of Therapeutic Play Intervention in Preparing Children for Surgery: A
Randomized Controlled Trial Study. Journal for Specialists Pediatric Nursing, 13, 2, 63-73.
Morgan, D. L. (Ed.). (1998). The focus group guidebook. London: Sage Publications
Taha, R. (2008). The Importance of Play: Well vs. Hospitalized Children. University of Connecticut School of Nursing.
PLAY IN NURSING EDUCATION: FROM PROJECT TO PRACTICE
AN OPTIONAL COURSE IN NURSING DEGREE: “THE CHILD AND PLAY ACTIVITY”
Authors:
[email protected]
Maria da Graça Vinagre Graça, RN, Professor
[email protected]
Maria Isabel Costa Malheiro, RN, Lecturer
[email protected]
POSTER ABSTRACT 34
91
Introduction: In 1999 in the XIV IPA World Conference – The Community of Play we talked about the importance
of play in nursing education. We discuss the importance of play in life and compare the need of play with basic
needs like nutrition, education and health; the importance of play to deal with children’s and the functions of play
in hospital. Play is a universal language of children and it is one of the most important ways of communication, for
them and for nurses who work with children in community or in pediatric units Illness and hospitalization generally
represents a stressful time for children and families. They constitute major stressors to a child´s development and
are likely to produce drastic changes in normal life style and behaviour. Play is very important in children’s life, but
more important when they are hospitalized and during procedures because play helps them to cope with stress
and pain. So, nurses need to be prepared about the role play has an effective tool for managing the stress, pain
and anxiety. Since illness and hospitalization constitutes crisis in the children’ life and these situations are often
through with over wheeling stresses, to play out their fears and anxieties affords a means by children can cope
with these stresses. In This year we strengthened this subject in pediatric area and we begun to prepare the
inclusion of those subjects in pediatric, because our main objective were to introduce, formally, the study of play
as a main subject, both in basic and advanced nursing education. Methodology: Create a project of a Curricular
Unit to present to Scientific Council. Results: The first step of the project to introduce the study of play in the
curriculum of nursing degree were plain the program of the course: goals (understand the influence of play on
child/youth development in health and illness and take advanced of play and expressive activities in interaction
with child and youth in different context, construct toys to help children’s in different ways), subjects (theories of
play, play/work/exploration, the role of play in development, play activities/expressive activities and play
strategies, Observation of play, play and toys, play in hospital with partnerships with the musicians and clowns
who visit children in hospitals ) and evaluation (practice work with theoretical support, discussion of an article,
observation of a child plying, etc.). The second step was doing the presentation in Scientific Council and awaiting
the approval. In 2004 we begun teaching the new course and never stop because is one of the most chosen
subjects. Conclusions: Many nurses and students deal with children of all ages, of all development’s stages; either
they work in primary health care in community and in hospitals. The nursing degree has an area of healthy child
and pediatric nursing to prepare the future nurse to care children, youth and their families, either in health or
sickness, and students begun constructing a new way of studying play, of using play to communicate with children,
constructing toys to help children in development and support illness and research about this subject using the
outcomes to improve child an youth care, by means of appropriated intervention at different developmental
levels, to assure or safeguard, between other, the child’s right to play. Key words: nursing-care, nursing-education,
play, children, youth, play-hospital
Bibliography:
Azevedo, Nair Rios (2003), Brincar: O que Pensam os Educadores de Infância, in Carlos Neto (Ed.), Jogo & Desenvolvimento da Criança, Cruz
Quebrada, Edição da FMH – UTL.
Batista, Amélia; e tal (2004), A criança, o hospital e o brincar, Revista Investigação em Enfermagem, nº9, Fevereiro, p. 3-13.
Brazelton, T. B. E Greenspan, S. I. (2000), A criança e o seu mundo – Requisitos Essenciais para o crescimento e aprendizagem, Barcarena,
Editorial Presença.
Cibreiros, Sylvia Alves e Oliveira, Isabel Cristina dos Santos (2001), A comunicação do escolar por intermédio dos brinquedos: um enfoque
para a assistência de enfermagem nas unidades de cirurgia pediátrica. Rio de Janeiro: Ed. Anna Nery, UFRJ.
Curado, Maria Alice S. (2003), Comportamento Lúdico da Criança Portadora de Trissomia 21, in Carlos Neto (Ed.), Jogo & Desenvolvimento da
Criança, Cruz Quebrada, Edição da FMH – UTL.
Garvey, Catherine, (1992), Brincar, Lisboa, Edições Salamandra.
Goldstein, Jeffrey H. (1994), Toys, play, and child development, Cambridge: Cambridge University Press.
Lear, Roma (1999), Fingers and thumbs: toys and activities for children with hand-function problems, Oxford: Butterworth-Heinemann.
Lear, Roma (2005), Play helps: toys and activities for children with special needs. 4th ed. rep. Oxford: Butterworth-Heinemann.
SCIENTIFIC EVIDENCE IN NURSING CARE
EVALUATING THE EFFECTIVENESS OF NON-PHARMACOLOGICAL STRATEGIES FOR PAIN RELIEF IN PAEDIATRICS: A METAANALYSIS
Authors:
Ana Filipa Branco Pedroso; RN
[email protected]
Ana Isabel Godinho Oliveira, RN
[email protected]
Carina da Costa Valente, RN
[email protected]
Milene da Silva Monteiro, RN
[email protected]
[email protected]
POSTER ABSTRACT 35
93
Background: Pain is a universal experience, too much variable, different from person to person and from culture to
culture. Improve the treatment of pain is an urgent need in children that has been neglected, because their
evaluation is often seen as difficult and subjective. Despite the pain is the 5th vital sign, it continues to be implied,
under diagnosed and under treated. Pain assessment by the application of rating scales is assumed to be
fundamental, because it is through that, that the nurses can identify the degree of pain in children and support
their interventions in enforcement. Non-pharmacological interventions used to relieve pain simultaneous with
complementary pharmacological and not substitutes, constitute themselves as independent nursing interventions.
However, the nurses that use these methods are still very limited. Thus, there is a need to invest in the search for
knowledge to substantiate the effectiveness of using these strategies with the aim of promoting its use in everyday
practice of nursing care in pediatrics. Objectives: This study is based on a systematic review and meta-analysis
aims to assess the effectiveness of non-pharmacological strategies that can be used in practice care by nurses for
pain relief in children undergoing medical painful procedures. Research Strategies: The research focused only on
studies published in electronic databases, namely: (CENTRAL); MEDLINE; (CINAHL); Nursing and Allied Health
Collection - Comprehensive; British Nursing Index and PsycInfo. Selection Criteria: Were only included randomized
clinical trials. The studies involved children aged between 0 and 18 years old, undergoing medical painful
procedures. Each study presents the experimental group and the control group, the first of which was subject to
non-pharmacological interventions for pain relief. Data Collection and Analysis: To assess the quality of included
studies, these were evaluated by Oxford Quality Scale (Jadad et al., 1996) and the "Framework for Risk of Bias"
provided by the Cochrane Collaboration (Higgins & Green, 2008) . Heterogeneity was assessed by the index I2. The
analysis included the mean difference (MD) with a confidence interval (CI) of 95%, and it was calculated using the
software Review Manager 5.0., like heterogeneity. Results: Seven studies met the inclusion criteria with a total of
712 children who were subjected to various painful procedures, including endotracheal/pharyngeal suctioning,
venipuncture, heel stick and vaccination. The non-pharmacological strategies used during the procedure were the
warmth of parents and nurses, watching cartoons, psychological intervention, distraction with bubbles, massage
and oral administration of sucrose and glucose. The scales of measurement used to assess pain were the Neonatal
Infant Pain Scale, Neonatal Facial Coding System, Premature Infant Pain Profile and Visual Analogue Scale.
Conclusion: In order to appreciate the pain as the 5th vital sign, it should make an assessment as rigorous as
possible in order to act strictly in relief. To this end, the use of validated scales and age-appropriate and situation
of the child becomes crucial. Only this way the nurse can properly apply pharmacological and non-pharmacological
strategies for pain relief. With the results of this meta-analysis we conclude that the non-pharmacological
strategies for pain relief in children during painful procedures are effective.
Key words: pain, children, non-pharmacological-strategies, systematic-revue, meta-analysis
Bibliography:
Boivin, J-M.; et al. (2008), A multifactorial strategy of pain management is associated with less pain in scheduled vaccination of children. A
study realized by family practitioners in 239 children aged 4-12 years old.,In: Family Practice, Vol. 25, 6,p. 423-429.
Higgins, Julian PT; GREEN, Sally (2008), Cochrane Handbook for Systematic Reviews of Interventions, London: John Wiley & Sons.
Julian PT; Green, Sally (2008), Cochrane Handbook for Systematic Reviews of Interventions., London, John Wiley & Sons.
Jadad, AR; [et al.] – Assessing the quality of reports of randomized clinical trials: is blinding necessary? In: Controlled Clinical Trials. Vol.17, nº1
(Fev 1996) p.1-12.
STING…DOES HURT…
REPRESENTATIONS OF PAIN IN CHILDREN OF SCHOOL AGE, WHO UNDERWENT VENIPUNCTURE
Authors:
Manuela Rita Guerreiro, RN
[email protected]
[email protected]
POSTER ABSTRACT 36
95
INTRODUCTION: Pain is a part of human nature and is unalienable of its existence. It is understood as a universal
experience, with an early beginning, in each person, and it wins heterogeneity of social configurations and
variability of intensity. As a non-transmissible experience, it will brand us in different ways, the psychological and
social person construction. For children, pain is a common and disturbing experience that sometimes it is
underestimated in health contexts. METHODOLOGY: This exploratory study regarding a mixed nature, which was
supported by the theory of social representations, has as aims identify the representation associated to pain, in
children in school age submitted to venous puncture and evaluate the pain’s grade associated to venous puncture.
Therefore, it was applied the free association of words, technique with two questions stimulus, «Pain makes me
think about…», the Needle prick makes me feel…», and the numeric scale of pain’s evaluation, to forty three
children with ages between six and twelve years old, who were hospitalized in Lisbon’s Health Sub-region. The
data has been analyzed using SPAD-T (factorial analysis of simple correspondence) and SPSS (descriptive statistics)
software. THE RESULTS shows us that for those children the pain is a factor which arouses suffering and its
associated, by children, to physical manifestations, as weeping and to feelings expressed in presence of pain, like
fear. This procedure provokes fear and anxiety in hospitalized children. The pain’s grade associated to venous
puncture changes with factors like age and mainly with previous experience. IN CONCLUSION, the venipuncture is
a painful procedure and according to the children who participated in the study, causing fear and anxiety.
However, many avoid suggestive feelings of pain, ashamed to be considered weaker and/or deem it a necessary
pain. Hence the fact that some children associate pain and the need to have the needed courage to support it.
Key words: child, school-age, pain, venous-puncture, social-representations
BIBLIOGRAPHY:
Abric, Jean-Claude (2000), “A Abordagem Estrutural das Representações Sociais”, in Antónia Silva Paredes Moreira e Denize Cristina de Oliveira,
Estudos Interdisciplinares de Representação Social, Goiânia, AB Editora, pp. 27-38.
Barros, Luísa (2003), Psicologia Pediátrica – Perspectiva Desenvolvimentalista, Lisboa, Climepsi Editores.
Bowden, Vicky R. e Greenberg, Cindy Smith (2005), Procedimentos de enfermagem pediátrica, Rio de Janeiro, Guanabara Koogan.
Caetano, Ana Cristina Tadeia Ferreira; et al (2003), “Reflexões sobre a actuação do enfermeiro perante a dor na criança e família” Nursing, n.º
176, pp. 13-17.
Jodelet, Denise (2001), “Representações Sociais: Um domínio em expansão”, in Denise Jodelet (org), As Representações Sociais, Rio de Janeiro,
Editora da Universidade do Estado do Rio de Janeiro, pp. 17-44.
Mansson, Marie Edwinson e Dykes, Anna-Karin (2004), “Practices for Preparing Children for Clinical Examinations and Procedures in Swedish
Pediatric Wards”, Pediatric Nursing, Vol.30, nº 3, pp. 182-187.
Pereira, Francisco José Costa (2005), “Análise de Dados Qualitativos Aplicados às Representações Sociais”, in Antonia Silva Paredes Moreira;
Brígido Vizeu Camargo Jorge Correia Jesuíno, Sheva Maia Nóbrega (orgs), Perspectivas Teorico-Metodológicas em Representações Sociais,
Paraíba, Editora Univeritária – UFPB, pp. 25-60.
Vala, Jorge (2004), “Representações sociais e psicologia social do conhecimento quotidiano”, in Jorge Vala e Maria Benedicta Monteiro (coord.),
Psicologia Social, Lisboa, Fundação Calouste Gulbenkian, pp 457-502.
Whaley, Lucille F. e Wong, Donna L. (1999), Enfermagem Pediátrica, Rio de Janeiro, Editora Guanabara Koogan.
THE EARLY FEEDING SKILLS DURING THE INTRODUCTION OF ORAL FEEDING ON PRETERM INFANTS
PREVALIDATION STUDY AND DETERMINATION OF FEEDING SKILLS
Authors:
Cláudia Sofia Martins Madeira Nicolau, RN, BSc
[email protected]
Lígia Cristina Cardoso Marques, RN, BSc
[email protected]
Sílvia Pinto Ramalho de Oliveira, RN, BSc
[email protected]
[email protected]
João Maroco, Professor
[email protected]
POSTER ABSTRACT 37
97
Introduction: After birth, the Preterm Infant does not have the innate capability to be fed orally as we would
expect in a birth at term because it lacks the necessary maturity in the various organic systems. In this way, there’s
a growing concern in this field of study regarding the oral feeding which powers the need to develop a common
practice in the interventions related to the infant’s feeding, improving at the same time the quality of the medical
care in this area. Methodology: Exploratory study with a quantitative approach. The aims is to evaluate the early
skills in Preterm Infants during the introduction of oral feeding, as well as the influence that Gestational Age,
Postnatal Age, weigh and support actions provide to the different skills. The instrument is an observation scale,
Early Feeding Skills (EFS). The sample consisted on 50 observations (N=50), performed to 12 Preterm Infants.
Observation was the main methodology used, aided with an observation scale as a tool for assessing the skills of
these Preterm Infants in the early stages of oral feeding. This work represents a pilot study on a broader project of
adaptation and statistical validation of the Early Feeding Skills (EFS) scale to the Portuguese population. To jump
start this project the EFS scale and the respective application manual was translated to the Portuguese language.
The statistical treatment of the gathered data was performed with the software Statistical Package for Social
Sciences (SPSS17), which allowed descriptive and inferential analysis. Results: The results obtained showed an
average quotation value of 45 (in a 0-58 scale), showing as well the influence of Postnatal Age and weigh in the
Preterm Infants skills for the oral feeding although support actions were not significant for them. In conclusion,
having into account that the Preterm Infants observed are still, in average, in a stage of refinement of their
capabilities, these skills tend to improve with the evolution of the Prenatal Age and weigh.
Keywords: Preterm Infant, oral feeding, skills, Early Feeding Skills.
Bibliography:
Campbell, D.T.; Fiske, D.W. (1959) Convergent and discriminant validity by the multitrait multimethod matrix. Psychological Bulletin. 56: 81-105
Costa, SP da et al. (January 2008), “Sucking and swallowing in infants and diagnostic tools”, Journal of Perinatology, nº 28, Groningen, pp. 247257.
Gomes, António (2004), “Nutrição entérica no Recém-nascido pré-termo”, in António Marques Valido et al, Consensos Nacionais em
Neonatologia, Secção de Neonatologia-Sociedade Portuguesa de Pediatria, Coimbra, pp.109-112.
Landis, J.R.; Koch, G.G. The measurement of observer agreement for categorical data. Biometrics. 33: 159-174.
Lau, Chantal e Ric 1996 Lau, Chantal e Richard Schanler (1996), “Oral Motor Function in the Neonate”, Clinics in Perinatology, Vol.23, nº2, pp.
161 -178.
Neiva, Flávia Cristina B., e Cléa Rodrigues Leone (Maio/Agosto 2006), “A sucção em recém-nascidos pré-termo e estimulação da sucção”, PróFono Revista Actualização Científica, Vol.18, n.º 2, São Paulo, pp. 141-150.
Neiva, Flávia Cristina B., e Cléa Rodrigues Leone (2007), “Efeitos da estimulação da sucção não-nutritiva na idade de início da alimentação via
oral em recém-nascidos pré-termo”, Ver. Paul. Pediatria, Vol. 25, n.º 2., São Paulo, pp. 129-134.
Swaiman, Kenneth F. (2006), “Neurologic Examination of the Term and Preterm Infant”, Pediatric Neurology – Principles and Practice, Vol. 1,
Mosby-Elsevier, Philadelphia, pp. 47-68.
Tamez, Raquel Nascimento e Maria Jones Pantoja Silva (2006), Enfermagem na UTI Neonatal: assistência ao recém-nascido de alto risco,
Guanabara Koogan, Rio de Janeiro.
Thoyre, Suzanne M. et al (May/June 2005), “The Early Feeding Skills Assessment for Preterm Infants”, Neonatal Network, Vol. 24, nº 3, pp. 7-16.
Whaley, L. & Wong D.(2006), Enfermagem pediátrica: elementos essenciais à intervenção efectiva, Guanabara Koogan, Rio de Janeiro.
CHILD INJURIES AT HOME- PREVENTION, PRECAUTIONS AND INTERVENTION WITH FOCUS ON SCALDS
Authors:
Anna Carlsson, RN, PhD
[email protected]
Malmö University, Faculty of Health and Society, Sweden
POSTER ABSTRACT 38
99
The overarching aim of this PhD thesis was to increase the knowledge about children’s (0-6 years old) exposure to
accidents at home by describing parents self-reported precautions taken at home to decrease the risk of child
injuries (Ι), the extent of burn and scalds (ΙΙ), the parents’ opinions about course of events (ΙΙΙ) and in an
intervention study investigate the effect individual-based information have on mothers’ attitudes towards child
injury and injury prevention and to taken precautions at home (ΙV, V). The data collected in the five papers all
came from a city in southern Sweden. Data in paper Ι were collected through parents to 10 month old children,
answered a questionnaire. The questionnaire prompted responses related to parents’ background and socioeconomic factors as well as questions about precautions they had taken to decrease hazards in their home. The
questions focused on actions parents had taken upon receipt of preventive advice given to them during the eightmonth Child Health Care nurse assessment. Thirty-two percent of the parents complied with less than half of the
suggested precautions. Univariate odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to
investigate the associations between compliance and parents’ different background/socio-economic
characteristics. The variables foreign born, low occupational level, 12 years education or less, rented housing and
information provided at Child Health Care clinics proved to be statistically significant for the non-compliant group.
Multiple logistic regression analysis was performed in order to adjust the estimated odds ratios for the influence of
potential confounders such as parents’ nationality, educational and occupational level, place of information and
habitation. After the adjustment the variable nationality and educational level stayed significant. Data in paper ΙΙ
was collected from medical records, in a retro perspective designed register study. Burn injured children (0-6 years
old) consulting the University Hospital or the Health Centres (n=21), during year 1998 and year 2002, were
included. Chi-squared test was used to analyse differences in nominal data and cross-tables was used to analyse
the proportions between the characteristics of the injuries and sex, age and nationality. The burn injured children
were 148 and 80% of those were scalds, caused by hot liquid (71%) or hot food (29%). The greatest number was
boys between one and two years old. Children to foreign born parents were more frequently affected and the
extension of injuries often larger. The data collection method, in paper ΙΙΙ, was tape-recorded interviews, analysed
by content analysis, with parents to 20 children (0-6 years old) recently suffered from scalds. Parents told their
perceptions about causes to the scalds. The analysis resulted in eight categories and two themes. One theme was
‘Deviation from the normal’ and could be when something unusual happened like a sudden visit by a friend or
when a family member was tired, stressed or ill. The tiredness could be due to fever, a cold, other illnesses or
mental stress. It could also be when something was broken in the kitchen and routines were changed.
‘Misjudgement of the child’s capacity’ was the other theme and it concerned the children’s preventive capacity,
rapidity and reach. It was hard for the parents to keep up with the fast development in the young children (9
mounth-2 years). The parents expressed that they often didn’t realise the child’s capacities until the accident
occurred. The intervention study with a comparison group has a quasi-experimental design (ΙV, V). Individualbased information, with an empowerment approach, was given to a group mothers, living in two separate areas of
the city with a low level of education. In total, 99 mothers of children under the age of seven months participated.
The mothers were selected through the local Child Health Care authorities. Observations were made and bivariate
analyses were established to see if the intervention had influence on the mothers’ attitudes (ΙV) and taken
precautions against child accidents at home (V). Mothers who received the intervention significantly improved
their attitudes to the first question about were child injuries happens also compared with the mothers in the
comparison group (OR=2.3, CI=1.3-4.3). No significant improvement of attitudes to child injury prevention was
seen (ΙV). The results showed that the intervention had a significant impact on improving the precautions the
participating mothers introduced to protect their children against burn and scald injuries in the home and further,
in relation to a comparison group (V).
THE DEVELOPMENT OF AUTONOMY IN YOUNG PATIENTS WITH SPINA BIFIDA: WHAT DO THE YOUNGSTERS AND THEIR
PARENTS/CAREERS SAY
Authors:
Joana Pinheiro (RN)
[email protected]
Joel Caseiro (RN)
[email protected]
Maria Isabel Malheiro (RN, Lecturer)
[email protected]
Tânia Gonçalves (RN)
[email protected]
POSTER ABSTRACT 39
101
Today's society is deeply involved by technological advances in health that has allowed to "save" more children,
changing patterns of morbidity in childhood, and most of them require special health care in a sustainable manner,
representing a new challenge for families and health professionals. The Spina Bifida (SB) emerges as one of those
situations, it is a congenital malformation of the spinal cord, according to the level of spinal cord injury, these
children present limitations of the orthopaedic, urological, neuromotor and sensory forum, hindering the
acquisition of skills needed to perform their activities of daily living (ADL's).
This situation is extended during childhood and compromises the development of the autonomy of these young
people as an essential step for its development. Knowing that parents take a central role in this process, and that
how they perceive this need will influence positively or negatively the building process of autonomy of their youth.
Main objectives of this study: know the opinion of young people with Spina Bifida (SB) and their parents /
caregivers, about the building process of autonomy and the factors that are indicated as favourable and
unfavourable to this process.
Methodology: Based on the analysis of two Focus Group interviews, to seven youth with SB and their parents /
caregivers emerged the following categories: construction of autonomy in general, Personal Hygiene and Dressing,
Mobility and Elimination, favourable factors, unfavourable factors and suggestions to improve this process.
The results revealed that being autonomous means being independent and young people see this aspect as
leverage in their self-esteem. Their parents / caregivers associate it with maturity and responsibility. The factors
that relate hinder the construction of autonomy in ADL's connected to the environment: the architectural barriers,
the lack of hygiene and accessibility of toilets; associated to youth or their parents / caregivers: the parental
overprotection, the lack of motivation of the youth and even the feeling of revulsion against its body. The
following were identified as facilitating factors: accessibility of the environment, upgraded bathrooms, some
operational strategies and the existence of support system and a reference model. We believe that this study may
be the first step to identify gaps and consequently allow an appropriate intervention of the nurses resulting in an
improvement of the quality of life of this youth.
Keywords: Youth, Spina Bifida, Autonomy, Daily Activities of Life
Bibliography:
DIAS, Cláudia; SILVA, Mónica; VENTURA, Catarina. A Promoção da autonomia da criança com deficiência múltipla e os internamentos
sucessivos: Um desafio para a enfermagem. Lisboa: Escola Superior de Enfermagem de Lisboa, 2009. Monografia;
HESBEEN, Walter. – A Reabilitação: Criar novos caminhos. Loures: Lusociência, 2003. ISBN 972-8383-43-6.
MINISTÉRIO DO TRABALHO E DA SOLIDARIEDADE SOCIAL – LEI n.º 38/2004 de 18 de Agosto – Define as bases gerais do regime jurídico da
prevenção, habilitação, reabilitação e participação da pessoa com deficiência. Lisboa: Secretariado Nacional para a Reabilitação e Integração
das Pessoas com Deficiência, 2006. ISBN 972-9301-88-3.
MORGAN, David L. – The Focus Group Guidebook – Focus Group Kit 1. United States of America: Sage Publications, 1998. ISBN 0-7619-0760-2.
Image in: http://www.prof2000.pt/users/artefactos/af17/imagens/jogosdef.jpg
THE QUALITY OF LIFE OF THE CHILDREN WITH HEART DISEASE
SYSTEMATIC REVISION OF LITERATURE 2005-2010
Author:
Maria Filomena Abreu de Sousa
[email protected]
POSTER ABSTRACT: 40
103
In infancy the impact of heart disease is experienced in a particular way (Claessens, 2005). However, the cardiac
lesion is not always the biggest problem for these patients but the questions that concern the quality of life (Lane,
et al. 2002).
Health-Related Quality of Life (HRQL) reflects the patient’s perception of the impact of illness and its treatment on
their lives.
In pasted decades the nursing attention was focused on mortality and in the progress to functional capacity of
children with HD, today the nursing care is centred in the development of strategies of coping that permit an
adequate adjustment to the health problems have these patients.
To the nurse is necessary to know the quality of life have the children with congenital heart disease for to help in
the maintenance and promotion of their health.
The aim of that systematic revision of literature is to describe and to compare empirical studies that address the
quality of life of the children with congenital heart disease.
The revision of literature was done use articles published between 2005 and 2010. In this study we analyzed six
studies of investigation.
The research was done in Portuguese, English, French and Spanish language in the search engines database: EBSCO
- CINAHL, Pre-CINAHL, MEDLINE, PubMed, HEART Online, EBSCO Host.
The studies show that the children with heart disease feel different have problems related with their disease, like
as frequents hospitalizations and symptomatology. They have lower tolerance to exercise than healthy children,
retardation growth, alterations of neurological and cognitive development. These children also have alterations
related with behavioural and psychiatric aspects, relationship, learning, and psychological problems such as
anxiety and depression. Key words: Quality of life, heart disease, children, adolescents, parents
Bibliography
CLAESSENS, P. et al. What does it mean to live with a congenital heart disease? A qualitative study on the live experiences of adult patients.
In European Journal of Cardiovascular Nursing, 2005; 4: 3-10.
COLDBERK, I.-, MELCHES, J. The Impact of the severity of disease and social disadvantage on quality of life in families with congenital cardiac
disease. In Cardiology Young, 2006; 16: 67-75
CONNOR, J. A. et al. The Meaning of cost for families of children with congenital heart disease. Journal of Pediatric Health Care. 2010. Volume
24, Nº5
FREDRIKSEN, P. M. et al. Children and adolescents with congenital heart disease: assessment of behavioural and emotional problems. Eur
Child Adolescent Psycology, 2009, 18: 292-300.
KENDALL, L. et al. A simple screening for determining knowledge of the appropriate levels of activity and risk behaviour in young people with
congenital heart disease. Cardiology Young, 2007; 17: 151-157.
LOUP, O. et al. Quality of life of grown-up congenital heart disease patients after congenital cardiac surgery. European Journal Cardiothoracic
Surgery, 2009; 36: 105-111.
MACRAN, S. et al. The development of a new measure of quality of life for children with congenital heart disease. Cardiology Young, 2006; 16:
165-172.
MARKUS, A. et al. Health-related quality of life in children and adolescents after open-heart surgery. Journal Pediatric. 2008; 152: 349-355.
SPIJKERBOER, A. V. et al. Health-related quality of life in children and adolescents after invasive treatment for congenital heart disease.
Quality of Life Research. 2006; 15: 663-673.
WERNOVSKY, G.. Current insight regarding neurological and developmental abnormalities in children and young adults with complex
congenital cardiac. In Cardiology Young, 2006; 16: (Suppl. 1): 92-104
UZARK, K. et al. Quality of life in children with heart disease as perceived by children and parents. Pediatric 2008, 121: 1060- 1067.
PARENTING AND TRANSITION IN CHRONIC ILLNESS
– THINKING ABOUT THE CONTRIBUTION OF NURSING –
Authors:
Cravinho, R.
[email protected]
Grenho, F.
[email protected]
Pêgo, M.
[email protected]
Pinheiro, D.
[email protected]
Ramos, S.
[email protected]
(4th Year Nursing Students from the 9th Course of Nursing Degree)
Colaço, S.
[email protected]
(Equivalent to Assistant Professor from 2nd Triennial)
Institution: Lisbon Nursing School
POSTER ABSTRACT 41
105
The purpose of our work is to understand the experience of parenthood during the transition to the chronic illness
of their children and the contributions of nursing in this process.
The increase of chronic diseases in childhood, has been posing new challenges in health. When the diagnosis of
chronic illness in children is made, parents take the responsibility for their care and treatment. This shift requires
health professionals in general and nurses in particular, greater attention to the needs of the family. The
understanding of the transition process experienced by parents, of children with chronic illness, is essential for the
nurses to develop effective interventions towards the promotion of well-being and health of families
The work comprises a critical review of the literature that seeks to clarify "The way parents experience the
transition to the chronic illness of their children". The literature review will be conducted through research on
electronic databases, national and international: EBSCO HOST: Medline, Cochrane, SciELO, Repositorium from
University of Minho and B-On. Will include all papers in Portuguese or English, published between 2006 and 2010,
focusing on selected key concepts.
These results will be analyzed in accordance with the objectives of the work and faced with reflections drawn from
the experience in clinical nursing practice.
The final results will focus on clarifying the transition process experienced by parents of children with chronic
disease and the identification of nursing interventions that promote it.
Taking as reference the theoretical model of Meleis and colleagues, we aim to contribute to a larger understanding
of the transition process that parents of children with chronic illness face and for the systematization of nursing
interventions in this field.
Keywords: Transition, Parenting (Parenthood), Chronic Illness, Child(ren), Nursing Care
Main references:
HOPIA, H. et al (2005) - Child in hospital: family experiences and expectations of how nurses can promote family health. Journal of Clinical
Nursing. Blackwelll Publishing. Nº 14. Pág. 213.
CHICK, N. e MELEIS, A. I. (1986) – Transition: A Nursing Concern. Nursing Research methodology. Boulder, C.O: Aspen Publications. Págs 237256.
KRALIK, D. e VAN LOON, A. (2010) – Transitional Processes and Chronic Illness. In: KRALIK, Debbie; PATERSON Barbara, COATES Vivien Translating Chronic Illness Research into Practice. United Kingdom: Wiley-Blackwell. ISBN: 978-1-4051-5965-4. Págs 17-33.
SCHUMACHER, K. e MELEIS, A. (1994) - Transitions: a central concept in nursing. Journal of Nursing Scholarship [serial online]. Disponível em:
CINAHL Plus with Full Text. Vol. 26, Nº 2. Ipswich, MA (June 1994). Págs. 119-127. Acedido a 26 de Dezembro de 2010.
NURSING SKILLS VALORISED BY CHILDREN WITH CHRONIC ILLNESS AND THEIR FAMILIES INSIDE A HOSPITAL
Authors:
Ana Marta Albuquerque Miranda, RN
Inês Isabel Esteves Ribeiro, RN
Sara Cristina Magalhães Silva, RN
[email protected]
Maria Manuela Soveral, RN, Professor
Maria Odete Lemos e Sousa, RN, Lecturer
POSTER ABSTRACT 42
107
Nurses are the health professionals who spend the most time with children with chronic illness and their families.
This allows them to play an important part in their lives. This study focuses on nursing skills valorised by children
with chronic illness and their families inside a hospital. This information will be useful to direct and complement
the training of new professionals with expertise in Child Health Care and Paediatrics.
This study has as background the following theory: From Novice to Expert by Patricia Benner. In order to approach
the skill concept with a deeper and more actual sight and including what is told by Ordem dos Enfermeiros, also
the concept of third dimension skills by Ana Pires has been adopted.
This is a systematic literature review using the method of metasummary to analyze and synthesize the study’s
results. Only two articles were analysed and due to the lack of results the research was not limited in time.
The results of this study show that the nursing skills valorised by children with chronic illness are the following:
Presencing: Being with a Patient; Providing Comfort and Communication Through Touch; and Understanding the
Particular Demands and Experiences of an Illness: Anticipating Patient Care Needs. The nursing skills valorised by
the family are: Maximizing the Patient’s Participation and Control in His or Her Own Recovery; Providing an
Interpretation of the Patient’s Condition and Giving a Rationale for Procedures; Understanding the Particular
Demands and Experiences of an Illness: Anticipating Patient Care Needs; Administering Medications Accurately
and Safely: Monitoring Untoward Effect, Reactions, Therapeutic Responses, Toxicity, and Incompatibilities;
Providing a Backup System to Ensure Safe Medical and Nursing Care; and Coordinating, Ordering, and Meeting
Multiple Patient Needs and Requests: Setting Priorities. The only skill valorised both by children and family is:
Understanding the Particular Demands and Experiences of an Illness: Anticipating Patient Care Needs.
Keywords: children, chronic illness, family, hospital, nurse, skills.
Bibliographic references:
ÅNGSTRÖM-BRÄNNSTRÖM, C. – Narratives of Children With Chronic Illness About Being Comforted [em linha]. In: Journal of Pediatric Nursing
Vol. 23, n.º 4 (2008);
BALLING, K. & MCCUBBIN, M. – Hospitalized Children With Chronic Illness: Parental Caregiving Needs and Valuing Parental Expertise [em linha].
In: Journal of Pediatric Nursing Vol. 16, n.º 2 (2001);
BENNER, P. – From Novice to Expert – Excellence and Power in Clinical Nursing Practice. San Francisco: Addison-Wesley Publishing Company,
1984. ISBN: 0-201-00299-X;
PIRES, A. – Desenvolvimento pessoal e profissional: um estudo dos contextos e processos de formação das novas competências profissionais.
Lisboa: Ministério da Educação, Departamento da Educação Básica, 2000. ISBN 972-742-129-6;
SAINT-EXUPÉRY, A. – O Principezinho. Lisboa: Caravela, 1987;
SANDELOWSKI, M.; BARROSO, J. – Handbook for synthesizing qualitative research. NY: Springer Publishing Company, 2007. ISBN 0-8261-5694-0.
INDICATORS AND TOOLS FOR ASSESSMENT OF BODY COMPOSITION
A PRACTICAL EXPERIENCE
Authors:
Carla Maria Tomé Carvalho e Barbosa, RN, MSc
[email protected]
Leticia Libania Santos, RN, MSc
[email protected]
[email protected]
POSTER ABSTRACT 43
109
Introduction: The study of indicators and tools for assessment of body composition is important for nursing
practices and it has been reported as an increased prevalence of overweight and obesity in children around the
world, representing a potential threat to the health of populations in an extensive number of countries (Ribeiro et
al., 2003). Over the past decade the prevalence of obesity among European children increased from 5% to 10%. In
Portugal 30% of children between 7 and 11 years are considered obese or overweight (Rocha et al., 2007). The
nurse's intervention at the health promotion and disease prevention is crucial and can significantly contribute to
the autonomy and quality of their lives. The purpose is to identify, in literature review, some of the techniques for
assessing body composition and body mass index in children and youth. Methodology: It was focused on literature
review, practice reflections, and a case study (evaluation of a youth with 17th). We used two formulas for body
composition assessment practice (Lohman equation and Mukherjee & Roche) and the usage of skin folds
assessment (Tricipital, subscapular, crural) (Fragoso e Vieira, 2005). These were applied to a young female of 17
years of age. Results: The values obtained by evaluation of body mass index values were different from those
obtained by applying the formulas that use the evaluation of skin folds. Conclusion: Nurses have a key role in
developing children and youth, promoting their knowledge, attitudes, behaviours and lifestyles that will influence
their future health in adulthood. Assessment of Body Mass Index is not the only way, to define that a child or
youth are obese. Nurses need to gain skill competences and knowledge to use other indicators, like we experience
in practice. If they use others indicators and anthropometric measurements, they could improve their practices.
Key words: nursing-practices, body-mass, body-composition, children, youth.
Bibliografy
Fragoso, Isabel; Vieira Filomena (2005), Cinantropometria, Cruz Quebrada, Edições da Faculdade de Motricidade Humana.
Ministério da Saúde de Portugal (2004), A Obesidade como Doença Crónica, Circular informativa nº9. Lisboa: Direcção-Geral de Saúde.
Gomes, Susana et al (2010), “Obesidade em idade pré-escolar – Cedo demais para pesar demais!” Acta Med Port, 23, p 371-376.
Pereira, João; Mateus, Céu; Amaral, Maria (1999), “Custos da obesidade em Portugal”, Associação Portuguesa de Economia da Saúde, Lisboa,
Documento de trabalho 4/99.
Ribeiro, J., Guerra, S., Pinto, A., Duarte, J., Mota, J. (2003), “Prevalência de Excesso de Peso e de Obesidade numa População Escolar da área do
grande Porto, de Acordo com diferentes pontos de Corte do Índice de Massa Corporal”, Revista de Medicina da Criança e do Adolescente.
Lisboa, Volume.34, nº1, Janeiro/Fevereiro, 21-24.
Rocha, A.; Castro, C., Santiago, L. (2007), “Obesidade Infantil: que consequências?”, Revista Científica da Unidade de Investigação em Ciências
da Saúde, Coimbra, II série, nº5 (Dezembro 2007). 59-68.
Vieira, Filomena; Fragoso, Isabel (2006), Morfologia e Crescimento, 2ª ed. Cruz Quebrada, Edição da Faculdade de Motricidade Humana.
CHILDREN OBESITY AND THE OVERWEIGHT ASSESSMENT
A CRITICAL PERSPECTIVE OF NURSING PRACTICES
Authors:
Cláudia Celina Costa Martins, RN, MSc
[email protected]
Maria Joaquina Antunes, RN, MSc
[email protected]
Priscila Nogueira Carreira, RN, MSc
[email protected]
[email protected]
POSTER ABSTRACT 44
111
Purpose: A critical perspective of the nursing practices in children obesity.
Background: The most used measure to assess the overweight children is the body mass index (BMI). However,
these measurements are not the most precise to assess the real burden of adipose tissue. We must use other
measures to complete this process. We still need to study the relevance of other measurements in our current
practice.
Method: The current practice at the Primary Care Unit in Lisbon and at the hospital in the outpatient obesity
children, were analyzed and compared with available literature.
Results: Several difficulties must be point out in classifying obesity in children based on BMI, the common
parameter used; and their height varies with age and during development. The use of age adjusted BMI percentiles
is needed. An unfavourable factor in the measurement of BMI is that it does not distinguish and/or set the body
composition and distribution of fat mass; therefore there is a need for additional measures in order to
differentiate overweight muscle and fat (Gibney et al, 2005).The most precise measures to assess the total body
fat is the measurements of skin fold in the arm (tricipital and bicipital skinfolds). This technique is expected to
allow a more accurate assessment of the body fat as compared to the BMI in this particular age group.
Conclusions: It is essential that nurses modify their practices and acquire "new" skills for a better evaluation and
therefore an appropriate references and interventions, so We suggest that nurses, along with the BMI calculation
should use other measures, such as measurements of skinfold.
Key-words: Obesity, Children, Nursing, practices, overweight-assessment
Bibliography:
Björntorp, P (2001), "Centralization of Body Fat", in P. Björntorp, International Textbook of Obesity, Chichester, John Wiley & Sons.
Fragoso I., Vieira, F. (2006), Morfologia e Crescimento, 2ª ed, Lisboa, Faculdade de Motricidade Humana, Cap. 4, 219:271.
Fragoso I., Vieira, F. (2005), Cinantropometria – Curso Prático, Lisboa, Faculdade de Motricidade Humana.
GIBNEY, M. J. e tal, (2005), Introdução à Nutrição Humana, Rio de Janeiro, Guanabara Koogan.
Hockenberry, J. et al (2006), Fundamentos de Enfermagem Pediátrica, 7ª ed., S. Paulo, Elservier
Lean Mej, Han TS, Seidell JC (1998), "Impairment of Health and quality of life in men and Women with a large waist", Lancet, 351:853-856
Portugal, Direcção Geral da Saúde (2005), "Divisão de Doenças Genéticas, Crónicas e Geriátricas", Programa nacional de combate à obesidade,
Lisboa: (DGS), 24 p.
Steinbeck, K. S.(2001), "Conventional treatment for childhood and adolescent obesity" in Diez, W. H.; Chen, C. edit., Obesity in childhood and
adolescence, Nestle Nutrition Workshop Series, Pediatric Program, Volume 49,pg: 38:43.
CHILDHOOD OBESITY - SOMATOTYPOLOGY
Authors:
Célia Pereira, RN, MSc - Pediatric Emergency Department, Garcia da Orta Hospital, Almada (Portugal)
[email protected]
Helder Prata, RN, MSc - Pediatric Emergency Department, S. Bernardo Hospital, Setubal (Portugal)
[email protected]
Paula Figueiredo, RN, MSc - Pediatric Emergency Department, Garcia da Orta Hospital, Almada (Portugal)
[email protected]
[email protected]
POSTER ABSTRACT 45
113
Our experience with overweight in children highlights the relevance of the proportionality on children evaluation.
We feel the need to increase our knowledge in this area, in particular regarding the interventions to be taken by
the child and youth and family with this problem. The prevalence of obesity worldwide is so high that the WHO has
considered the disease as a global epidemic of the XXI century (WHO, 2006). In Europe one in five children is
overweight, from the 14 million overweight children; 3 million are obese (Pereira, 2009). As we develop expertise
in this area, we found gaps in the practical assessment for lack of knowledge on the different services, regarding
the evaluation of the body proportion from each individual. It is the role of specialist nurses to understand the
seriousness of this problem, in order to participate on the prevention and intervention measures. The assessment
of growth and development, currently used, is based on percentile curves included in the Individual Health Bulletin
(IHB), which sometimes is not sufficient for the identification of obesity. In most pediatric services, obesity is
defined only through the Body Mass Index (BMI). We know that BMI gives no indication of body composition or
quality of body weight, so we start searching other ways to a more rigorous evaluation, and easier to apply. We
observed four children in nursing consulting. Anthropometric measurements assessed were: Height, body mass,
skinfolds (triceps, calf, subscapular and supraspinale), Girths (flexed arm and calf) and Bone Breadths (humerus
and femur). We used the Heath-Carter method to view the somatotype of these children and compare with
reference population. We founded for each one, trough the somatochart, the type of body constitution and their
tendency to obesity. During the experience, we confirm that every human being has a single physical structure, so
it is essential to group them according to their constitution. In this sphere we found a Classification System of the
morphological type, the somatotypology, which is found interesting and pertinent to develop, and easy to apply in
the work context. As shown, the challenge is to understand what contributions this type of assessment can bring
us to our daily practice. With the software available and well trained professionals, we believe that determining
the somatotype is an affordable, reliable and quick method, perfectly adaptable to health services, making it
important for the prevention of childhood obesity.
Key words: Children, Obesity, Somatotypology, nursing-practices, development, body-proportion
Bibliography:
Fragoso I., Vieira, F. (2006), Morfologia e Crescimento, 2ª ed, Lisboa, Faculdade de Motricidade Humana, Cap. 4, 219:271.
Fragoso I., Vieira, F. (2005), Cinantropometria – Curso Prático, Lisboa, Faculdade de Motricidade Humana.
Heath, B.H. e Carter, J.E.L. (1990), .Somatotyping: Development and Applications. Cambridge: Cambridge University Press.
Hockenberry, J. et al (2006), Fundamentos de Enfermagem Pediátrica, 7ª ed., S. Paulo, Elservier
Portugal, Direcção Geral da Saúde (2005), "Divisão de Doenças Genéticas, Crónicas e Geriátricas", Programa nacional de combate à obesidade,
Lisboa: (DGS), 24 p.
Pereira, H. (2009), A Intervenção da Psicologia na Obesidade, Braga: Clínica de Nutrição, Acedido a 18 de Janeiro de 2011. Disponível em
http://clinicanutricaobraga.blogs.sapo.pt/1160.html.
Steinbeck, K. S.(2001), "Conventional treatment for childhood and adolescent obesity" in Diez, W. H.; Chen, C. edit., Obesity in childhood and
adolescence, Nestle Nutrition Workshop Series, Pediatric Program, Volume 49,pg: 38:43.
World Health Organization (WHO) (2006), Obesity and Overweight, Fact sheet nº311 (Setembro), Acedido a 15 de Janeiro de 2011, Disponível
em:
http://www.who.int/mediacentre/factsheets/fs311/en/index.html
METHODS OF ASSESSING BODY COMPOSITION
Authors:
Maria do Céu Mendonça
[email protected]
Ana Menino Ribeiro
[email protected]
[email protected]
Escola Superior de Enfermagem de Lisboa - Portugal
POSTER ABSTRACT 46
115
Introduction: Childhood obesity is a very common chronic nutritional disorder in developed countries. It has been
an interesting research topic, and is considered the fastest and most difficult to treat growing nutritional disease
worldwide (Fisberg, 2005). In the early 90s, the World Health Organization began sounding the alarm, and since
then it was estimated that worldwide 18 million of children under 5 years were overweighed. According to WHO
(1997), the Body Mass Index is a economical, non-invasive, and simple method applied universally, that provides a good
measure for overweight and obesity, particularly for the study of large community samples. However, the assessment of
body mass index has limitations. The total body mass, either alone or associated with height, is not a good indicator of
body composition.
Purpose: To understand the concept of body composition, the most widely used measures for evaluating, and
identify the proposed measures for the classification of overweight and obesity.
Methodology: Literature review and a reflexive analysis of body composition concept and of the methodology of
body composition evaluation in nursing practice.
Results: According to Heyword and Stolarczyk (2000), body composition is the ratio between the different body
parts and the total body mass, is usually expressed by the percentages of fat and lean mass. In literature review we
found that we have different methods for assessing body composition, (direct, indirect and doubly indirect) and
different indicators.
In Hospital, the most used method in daily practice, by nurses, is the Body Mass Index, which assesses the weight
and height, according to a formula. So, when we reflect on our practices and comparing with the literature
reviewed, we understand that we have to improve our knowledge and practices.
In conclusion: Childhood obesity is considered a century epidemic, with negative consequences over the quality of
life of our children. Thus, it is an essential commitment of all and a multisectoral character to fight this new
epidemic. Reflecting further on this issue, we have done in realizing the importance of using other measures for
determining body composition, not just the weight, height. Nurses have to use the best indicators to assess obesity
in children, choosing the most effective method.
Key words: childhood obesity, body composition, body mass index
BIBLIOGRAPHY:
Amaral, M. et al (1999), Custos da obesidade em Portugal, documento de trabalho 4/99 Associação Portuguesa de Economia da Saúde
Baptista, MI (2006), Educação Alimentar em Meio Escolar Referencial para uma oferta alimentar saudável, Direcção Geral de inovação e de
desenvolvimento Curricular, 1ª ed
DoCarmo, Isabel; Breda, João; Rito, Ana (2008), “Percepções e expectativas da população portuguesa face à alimentação, actividade física e
peso”, Obesity review, 9.
Fisberg, Mauro (2005), Actualização em Obesidade na Infância e Adolescência, São Paulo, Editora Atheneu.
Fragoso, I.; Vieira,F (2006), Morfologia e crescimento, Universidade Técnica de Lisboa, Faculdade de Motricidade Humana,2ª ed, Edições FMH.
Gomes, S. et al (2010), “Obesidade em idade pré-escolar – cedo demais para pesar demais!” Acta Med Port,23, p 371-376.
Heyward, V & Stolarczyk, L (2000), Avaliação da Composição Aplicada. S. Paulo, Editora Manole..
Palmeira, A.L. (2009), Aconselhamento da actividade física, Faculdade de Educação física e Desporto, Universidade Lusófona de Humanidades e
Tecnologias, Consulta de obesidade do departamento da criança e da família, Hospital de Santa Maria, Lisboa.
WHO (1997), “Preventing and managing the global epidemic of obesity”, Report of the World health Organization. Consolation of Obesity,
Geneva.
A MAGIC CUBE TO MAGIC CHILDREN
PROJECT OF A TOY ADAPTED TO BLIND CHILDREN
Authors:
Lígia Maria Teixeira de Sousa, NS
[email protected]
[email protected]
Maria Isabel Malheiro, RN, Professor
[email protected]
POSTER ABSTRACT 47
117
Introduction: Playing allowed children experience like: discover, grown up, integrate and develop. The toy is
fundamental to the children’s development Blind children should have adapted toys to allow an effective
development. The blind children don’t develop as normal children. It is fundamental the use of touch teaching
materials, that stimulate the sense area, using methods that can help to exceed limitations caused by incapacity.
Main objective: Create a adapted toy to the blind child – the magic cube.
Methodology: Developed a toy through adding applications in a traditional magic cube. This cube has faces with
different textures and shapes. The child recognizes them through touch. Each face has distinct characteristics, wish
are: four faces with 9 salient hearts, 9 ladybugs in a different texture, 9 rounds with emphasis on wool, 9 simple
square in wool, 9 buttons with 4 holes in the centre and 9 squares in salient plastic.
Results: The magic cube develops cognitive area, constriction and symbolic play. This toy is important in different
play, like solitary play, spectator play, parallel play and, also, associative. This game allows individual
entertainment, socializing, thinking, enrichment and development of blind children by exploring new shapes and
textures and acquiring new competences.
Conclusions: With this project could transform a common toy on a suitable and capable toy to be use by blind
children, enabling them to increase their experience in the leisure activity, contributing to his/her development.
This also could be used by nurses in situations of early intervention and intervention leisure during hospitalization.
Key words: blind child, magic cube, toy, development, nurse and early intervention.
BIBLIOGRAPHY:
Azevedo, N.A.P.R. (1995), Brincar o que Pensamos Educadores de Infância, Dissertação de Mestrado, Cruz Quebrada, FMH-UTL.
Solé, M.B. (1992), O Jogo Infantil, Lisboa, Instituto de Apoio à criança.
Neto, C. (2004), Jogo na criança & Desenvolvimento psicomotor, Dissertação de Mestrado, Cruz Quebrada, FMH-UTL:.
Souza, C.M.L.; Batista, C.G. (2008), Interacção entre Crianças com Necessidades Especiais em Contexto Lúdico: Possibilidades de
Desenvolvimento, Campinas, S. Paulo, Universidade Estadual de Campinas, Brasil.
CHILDREN'S PLAYING IN THE PARK
OBSERVATION OF THE QUALITY OF PLAY
Authors:
Suse G. Ribeiro, NS
[email protected]
[email protected]
Maria Isabel Malheiro, RN, Lecturer
[email protected]
POSTER ABSTRACT: 48
119
Introduction: Play is an activity that allows children to complete and accomplish their development stages. By
playing they discover themselves, the others, and the world around them. The way they play reflects, and it is
close-banded to, child’s development stage.
Objective: This work pretends to identify the child’s way of playing, and understand if the way the child plays is
entitled to her development stage.
Methodology: We have done a exploratory study with qualitative approach. The direct observation of play was
guided by the “Play Quality Scale” (Curado, Neto, Van Der Koij, 2003). This scale has four parameters: (A) intrinsic
motivation; (B) intern control; (C) flexibility; and (D) self-mastery. The observed population was ten children
(N=10). Two of those children are between 2 and 3 years old, four children between 5 and 6 years old, and four
children between 8 and 9 years old.
Results: In concerning intrinsic motivation has been observed that younger children were more curious, and
actively used exploration and were the most productive in behaviour initiative. Turns out that older children tend
to show greater persistence in completing an activity. The level of internal control that has been observed in older
children clearly shows the intention of choosing the activity, selecting suitable materials. They also showed greater
consciousness that they understand their responsibility for completing a successful task. The levels of flexibility
and self-mastery increase as the child becomes older, despite we were unable to verify the age in which they are
achieved.
Conclusion: In this observation was visible that the degree of development of the parameters control, motivation,
flexibility and self-mastery observed increased depending on the ages.
Keywords: children, play, child-development
Bibliography:
Copetti & T. Beltram (1997), Discutindo o Desenvolvimento Infantil, in R. Krebs, F. Copetti & T. Beltram, (Eds.), Perspectivas para o
Desenvolvimento Infantil, Santa Maria, Brasil, SIEC , Santa Maria, pp. 161-164.
Curado, Maria Alice Santos; Neto, Carlos; Van Der Koij, Rimmert (2003), Comportamento lúdico da criança com trissomia 21, in Carlos Neto
(Ed.), O Jogo & Desenvolvimento da Criança, Lisboa, Edição da FMH – UTL.
GARVEY, Catherine (1992), Brincar, Lisboa, Edições Salamandra.
Neto, C. (1997), Tempo & espaço de jogo para a criança: rotinas e mudanças sociais, In Carlos Neto (Ed.), O Jogo e o Desenvolvimento da
Criança (pp. 10-22). Lisboa: Edições FMH.
TEDDY NURSING
A DIFFERENT WAY TO APPROACH HEALTH TO CHILDREN
Authors:
Ana Carolina Alves Seuanes, NS
[email protected]
[email protected]
[email protected]
POSTER ABSTRACT: 49
121
Introduction: It is in playing activities and in interactions with toys that children communicate with themselves and
the others and discover the world. Observing children playing, the adult see their way of playing, how they treat
the toys, their learning difficulties and development. The playful activities also assume an important role in the
hospital to minimize stress and incorporate the child in this environment.
This project has the main objective to create a toy for use in hospitalization environment
Methodology: The main purpose of this toy is to prepare children to understand their own bodies by acquiring
some basic concepts in a health context.
In a practice perspective It was draw up a book under title "My First Book of Nursing" that includes basics aspects
of the human body as well basics habits of a healthy lifestyle. With the book is associate a toy to provide children
the ability to interact with the outside world, the use of several senses and the learning of new concepts.
Conclusions: It is really important that we reflect about the need of space and time for children play and explore
the different areas of it. Playing, develop imagination and creativity of the children. As the evidence shows playing
can be use as a therapeutic proceed to reduce pain and treatment adherence, so it’s essential that nurses play
with children to improve their well being during the hospitalization
Key-words: toy, book, nursing, children, playful activity, treatment-adherence, learning
Bibliography:
DUFFLES, Carla [et a] – A importância do brincar na educação infantil. Revista CEFAC. São Paulo. Vol.8 nº2 (Abril-Junho 2006) p.141-146
Brougère, Gilles [et a] – A criança e a cultura lúdica. Revista Faculdade de Educação. São Paulo vol.24 nº2 (Julho/Dezembro 1998)
QUEIROZ, Norma [et a] – Brincadeira e desenvolvimento infantil: um olhar sociocultural construtivista. Revista Paidéa (Ribeirão Preto).
Ribeirão Preto. Vol.16 nº34 (Maio-Agosto 2006).
LEARNING WITH KIKO AND TOBIAS:
A LEARNING GAME FOR CHILDREN WITH SPINA BIFIDA
Authors:
Filipa A. C. Patuleia, NS
[email protected]
Flávia C. S. Caria, NS
[email protected]
[email protected]
[email protected]
POSTER ABSTRACT 50
123
Introduction: Play is a complex and subjective concept, which may differ from culture to culture. It covers a variety
of behaviours, motivations and skills.Is essential to child development, because contributes to the cognitive,
physical, social, and emotional well-being. Since a very early age, children interact with the world around them,
exploring and overcame fears. Play allows the development of new competencies, which build children’s
confidence and resiliency, which they need to face future challenges.
The aim of the project is to create a toy aimed at children with Spina Bifida, taking into account their capacities
and needs, which will facilitate the learning of some procedures.
Methodology: The project began with the consideration of the issue, the type of game and the choice of the age of
the children intended play. The game was directed to children from 8-12 years. At this age the physical and social
context is broader and we intend to create a board game to allow social interaction. We address two main issues
related to the pathology, prevention of pressure ulcers and self-catheterization, with a different theme with
questions of general culture, which allows the child to stop being focused on his illness.
Results: The board game is a social game that allows the child acquiring knowledge and training social attitudes
such as mutual respect, cooperation, obedience to rules, responsibility, justice, personal initiative and the group.
Conclusions: As health professionals, the construction of this game helps us understanding the importance to
provide a toy for a child, because we have to consider all its characteristics, not only their development level, but
the context. Taking into account their culture, the physical and psychological is taking into account his whole. In
introducing the play in the educational context, the child could obtain knowledge through a fun activity that gives
him pleasure.
Keywords: play, toy, learning, spine-bifida, pressure-ulcers, self-catheterization, development
Bibliography:
HOCKENBERRY, M. J.; WILSON, D. - Wong Essentials of Pediatric Nursing, 7th Edition. São Paulo. Elsevier Publishing, 2006. ISBN 978-0-32302593-5.
NETO, Carlos - Play and child development, in grandson Charles (ed.), Play & Child Development, Cruz Quebrada, edition of FMH-UTL, 2003.
HANSEB, J; Macarini, SM.; MARTINS, GDF; WANDERLIND, FH, Vieira, ML - The play and its implications for child development from Evolutionary
Psychology. Journal Human Growth and Development. 2007, 17 (2) :133-143.
Liborio, Ophelia - Vygotzky: The development zone, Share Grow Magazine - Issue of ECAE in the district of Coimbra, No. 0, Year 1, December
2000, pp. 12-14
Cordazzo, Sheila; Vieira, Mauro (2007) - The play and its implications in the processes of learning and development. Study and research in
psychology, UERJ, RJ, Year 7, n. 1, Semester 1.
GINSBURG, Kenneth R; the Committee on Communications; the Committee on Psychosocial Aspects of Child and Family Health - The
Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds - PEDIATRICS Volume 119, Number 1,
January 2007.
2.7 - WOMAN CARE NURSINH AND MIDWIFERY
125
SMOKING DURING PREGNANCY: KNOWLEDGE, ATTITUDES AND PRACTICE OF
GYNAECOLOGISTS AND MIDWIVES IN FLANDERS, BELGIUM.
Authors:
K. De Wilde, RM, MSc, Head of Midwifery Education of KaHo Sint-Lieven, Sint-Niklaas PhD-student Ghent
University
[email protected]
K. Temmerman, RM, MSc, Lecturer Midwifery Education, KaHo Sint-Lieven, Sint-Niklaas
V. Balduyck, RN, MSc, Lecturer Midwifery Education, KaHo Sint-Lieven, Sint-Niklaas
L. Maes, PhD, Department of Public Health, Ghent University
M. Temmerman, PhD, Department of Uro-Gynecology, Ghent University
H. Boudrez, PhD, Department of Public Health, Ghent University
POSTER ABSTRACT 51
127
Background: Smoking during pregnancy is associated with a number of health risks for mother and baby, such as
stillbirth, low birth weight, preterm delivery, placenta pathology and SIDS. The preconceptional and prenatal
period is considered as the ideal teaching moment for smoking cessation counselling, therefore women should be
informed about benefits of smoking cessation programs.
Purpose: The national campaign in Belgium, in which counselling was partially reimbursed, had little success with
pregnant women. Therefore we want to examine if gynaecologists and midwives know the risks of smoking during
pregnancy, what their attitudes are regarding smoking cessation and what they advise their clients.
Method : We used a qualitative research design using semi-structured interviews with gynaecologists and
midwives. We used content analysis to interpret the transcribed verbatim and to extract emergent themes and
codes. In order to control subjectivity in analysis triangulation was used. Ethics approval was received from the
Ethical Committee of the University Hospital of Ghent. Written informed consent was obtained prior to the
interview and participants were assured of confidentiality.
Results: Preliminary results show that there are a number of factors lying on the base of failure of the national
campaign: obscurity of whose task it is to provide smoking cessation information and lack of time, communication
skills and knowledge about the content of the campaign.
Conclusions and relevance: Gynecologists and midwives should be trained in this matter.
Main references
Abatemarco, D., Steinberg, M., Delneveo, C. (2007). Midwives’ knowledge, perceptions, beliefs and practice supports regarding tobacco
dependence treatment. Journal of Midwifery and Women’s Health. 52 (5): 451-7
Bull, L., Whitehead, E. (2006). Smoking cessation intervention with pregnant women and new parents: A survey of health visitors, midwives and
practice nurses. Journal of Neonatal Nursing, 12(6): 209-15
DISCHARGE PROCEDURES FROM THE DELIVERY ROOM
Author:
Francisca Yntema – HBO nursing student
[email protected]
NHL university Leeuwarden
POSTER ABSTRACT 52
129
Introduction: This project refers to an agreement about the decision making reasoning in discharging ‘mothers and
their newborns’ from the hospital to their homes.
(A discharge two hours after the delivery).
Objective: By discharging the mother and her child within two hours after the delivery it is extremely important to
promote a safe return home for mother and child , through an uniform and transparent decision procedure.
Main Question: Which evidence based nursing criteria apply to the discharge procedures concerning mother and
child (from the delivery room to home)?
Method
•
Literature study
•
Field research and observations of the reasoning in discharge procedures
•
Investigation best practices in two Dutch hospitals
Results : Through scientific articles and textbooks the desired discharge criteria of ‘mother and child’ are
described. In particular the desired controls – criteria are described that the mother and newborn must meet
before they can be discharged. Observations in the practical study shows that the approaches of nurses differ and
they are lacking an evidence based approach.
By comparison the discharge criteria in other hospitals, it is clear that the practices are different from each other
and that there is a lack of evidenced based material. There is room for improvement.
Recommendations
•
The use of a valid, evidence based, discharge protocol.
•
Consensus about the Aftercare.
•
Comprehensive health care available 24 hours.
WHEN PREVENTING IS AN OPTION – EARLY DETECTION BEHAVIOURS AND BREAST CANCER PERCEPTIONS OF ESEL
WOMEN (2008)
Authors:
Lúcia Mafalda Bastos da Silva Pinho, RN
Maria Margarida Ferreira Coelho, RN, Lecturer
[email protected]
POSTER ABSTRACT 53
131
Purpose: Identify behaviours and beliefs toward early detection of breast cancer and the importance given to the
early detection exams in working women of a nursing school.
Background/Significance: The known risk factors for breast cancer aren’t consensual around scientific community;
the relationship between risk factors and probability of developing breast cancer isn’t clear. As appropriate
strategies of primary prevention aren’t valid, the emphasis is on secondary prevention through the detection at an
early stage, when more treatment options are available, achieving a reduction in mortality (Lawson et al, 2000).
Method: the quantitative method was used and a questioner survey. The universe of the study was the women
from ESEL (nurses and not nurses) at academic year 2007/2008. The sample was composed by 86 participants
(35.4% of the universe).
The procedures used to identify the behaviours and to describe the importance attributed to the early detection
was the descriptive statistic. To identify the perceptions of breast cancer was used the inferential statistic. The
factors that contribute to breast cancer perceptions were determined using the Factorial Analysis. We also used
the Pearson correlations and the ANOVA to test the influence of the independent variables in the determined
factors.
Results: The subjects regularly performed breast self-exam (BSF), clinical breast exam (CBE) and the
mammography. In general there is an association between the adoption of an exam and the belief of its
importance, except in the case of the BSF. The mammography is the most adopted exam; 74,4% have satisfactory
behaviours toward mammography and only 5,3% under 40 years old had never done a mammography.
The subjects major perceptions of breast cancer are: find themselves quite susceptible to breast cancer (x=5,09);
emotional seriousness (x=9,39); benefits of early detection (x=8,27); disagree with the existence of barriers
(x=10,97); and consider very important the existence of stimulus for the adoption of those behaviours (x=10,69).
Professional activity and academic qualifications influence considerably different perceptions.
Conclusions and relevance to nursing/midwifery: As previous studies showed the importance of early detection
and the perceptions of breast cancer influences behaviours. It is needed to identify, evaluate and demystify
perceptions of breast cancer and improve empowerment strategies remembering the importance of these
behaviours as we look forward to achieve better early detection behaviours.
Key-words: early detection, health behaviours and beliefs, breast cancer,
Main references:
Cohen, Miri (2006), “Breast Cancer Early Detection, Health Beliefs, and Cancer Worries in Randomly Selected women with and without a family
history of breast cancer” [em linha], Psycho-Oncology, nº15, pp. 873-883. [Consult. 06-2008], Disponível na www:
URL:http://journals.elsevierhealth.com/periodicals/ymai/medline/related/MDLN.16374894
Curado, Maria Alice dos Santos (2002), Reorganização das Urgências Pediátricas na Sub-região de Saúde de Lisboa: Têm a palavra… os pais; Têm
a palavra… os profissionais de saúde. Disponível na Escola Superior de Enfermagem de Lisboa, Pólo Calouste Gulbenkian
Honoré, Bernard (2002), A saúde em projecto, Loures, Lusociência.
Lawson, Herschel W. et al (2000), “Implementing Recommendations for the Early Detection of Breast and Cervical Cancer Among Low-Income
Women”, CDC Recommendations Regarding Selected Conditions Affecting Women’s Health, vol.49, n. RR-2, pp. 35- 54 [Consult. 06-2008],
Disponível na www:
URL:http://www.cdc.gov/MMWR/PDF/rr/rr4902.pdf
Pais Ribeiro, José Luís (2005), Introdução á psicologia da saúde, Quarteto, Coimbra.
Parlamento Europeu (2008) Resolução do Parlamento Europeu sobre a luta contra o cancro na União Europeia alargada, Estrasburgo. [Consult.
06-2008], Disponível na www:
URL:http://www.europarl.europa.eu/sides/getDoc.do?language=PT&reference=B6-2008-0132&type=MOTION
THE DESIRE OF HAVING A CHILD
THE EXPERIENCE OF THE INFERTILE COUPLE
Authors:
Maria João Delgado, RN, Lecture
[email protected]
Escola Superior de Enfermagem Lisboa – Portugal
POSTER ABSTRACT 54
133
Introduction: A couple is considered infertile when no pregnancy occurs one year after regular non-protected
sexual intercourse (WHO, 2002)
Infertility has being described as an important crisis which holds a physical, psychological, emotional and socialcultural dimension.
The main purpose of the present study is to understand the experience of the infertile couple who wish to have a
child.
Method: In order to be understood, infertility was evaluated as it is experienced by the infertile individuals. We
carried out a half - structured interview to ten couples followed in a Reproductive Medical Unit, respecting the
ethical determinants.
We used a qualitative methodology, and the data analysis was performed using content analysis, of the
participants produced speech, according to Bardin (2000).
Results: The results put in evidence that infertility experience presents multidimensional aspects: physical,
psychological, marital and social, whose repercussions are largely negative.
Conclusions: It’s suggested of a long term treatment plan, with detailed information about the physical,
psychological and marital consequences of the procedures involved in the infertility diagnosis and treatment.
If there is an expected spectrum of responses to infertility, the nurse/midwife intervention should be planed to
help the couple through pathway of infertility the best way possible.
The recognition of the disturbing character of the infertility crises requires the need of individual, marital and
group support.
Caring for the infertile couple requires not only attention to the medical condition but also to their response to the
infertile condition and to is treatment.
Key-words: Infertility, Crises, Psychical, psychological, marital social implications
Bibliography:
ANDREWS, F. M.; ABBEY, A.; HALMAN, L. J. (1991). Stress from infertility, marriage factors, and subjective well-being of wives and husbands.
Journal of Health and Social Behavior. Vol. 32, September, pp. 238-253.
BARDIN, L. (2000). A Análise de Conteúdo. Lisboa: Edições 70.
COOK, E. P. (1987). Characteristics of the biopsychsocial crisis of infertility. Journal of Counseling and Development. Vol.65, May, pp.465-470.
FARIA, M. C. (2001). Aspectos psicológicos da infertilidade. in: CANAVARRO, C. (Ed.) Psicologia da Gravidez e da Maternidade. Coimbra:
Quarteto Editora, pp. 189-209.
PINTO, H. G. (1998). Infertilidade: aspectos psicológicos, emocionais e sociais. In CARDOSO, R. M., A Outra Metade da Medicina. Lisboa:
Climepsi editores, pp. 95-111.
WORLD HEALTH ORGANIZATION (2002). Current Practices and Controversies in Assisted Reproduction. Geneva: WHO.
A PATH THROUGH INFERTILITY…ALL FOR A CHILD
THE IMPLICATIONS OF THE DIAGNOSIS AND TREATMENT OF INFERTILITY
Authors:
Maria João Delgado, RN, Lecturer
[email protected]
Escola Superior de Enfermagem Lisboa – Portugal
POSTER ABSTRACT 55
135
Introduction: An important reference in the infertility context is the recognition of the disturbing character of the
pathway of the infertility diagnosis and treatment. This requires the exposition of the couple intimacy, is often
long, painful, and involves the submission to invasive, risky and painful medical interventions. The contact with
medical services is presented as an iatrogenic source of stress, inherent to the performed procedures, or the
quality of the established relation with the health professionals.
Purpose: To understand the topic, we aimed to analyze how infertility is experienced by the infertile individuals.
Method: So, we carried out a semi-structured interview to ten couples who were followed in a Reproductive
Medical Unit, respecting the ethical determinants.
It was used a qualitative methodology, and the data analysis was performed using contents analysis of the
speeches of the participants, according to Bardin (2000).
Results: In the results emerged the recognition of the disturbing character of the diagnostic and therapeutic
course that was identified as generating difficulties, related to the functioning of health services, the procedures
and the relationship established with the health professionals.
The participants recognize the professionals as a source of information and support and refer their technical
competence as a way to achieve the desired pregnancy.
Conclusions: If the quality of the relationship interferes with the way on how couples cope with the situation, the
development of relational and communication skills to care for these couples should be a major concern.
The training in communication skills and the teams’ qualifications are essential. Given the importance attributed to
the achievement of the desire to have a child, the team takes a central place in the lives of infertile couples,
conferring a special nature to the relationship established with professionals.
The holistic treatment perspective improves health outcomes and increases user and team satisfaction, reducing
the negative psychological reactions and helping to ensure that the couple might have a more positive experience.
Key-words: Infertility, diagnosis, treatment, couple reaction, health intervention
Bibliography:
BARDIN, L. (2000). A Análise de Conteúdo. Lisboa: Edições 70.
CALLAN, V. J.; HENNESSEY, J. F. (1989). Strategies for coping with infertility. British Journal of Medical Psychology. The British Psychological
Society, nº 62, pp. 343-354.
COOK, E. P. (1987). Characteristics of the biopsychsocial crisis of infertility. Journal of Counseling and Development. Vol.65, May, pp.465-470.
REED, S. A. (2001). Medical and psychological aspects of infertility and assisted reproductive technology for the primary care provider. Military
Medicine. Vol. 166, November, pp. 1018-1022.
WORLD HEALTH ORGANIZATION (2002). Current Practices and Controversies in Assisted Reproduction. Geneva: WHO.
2.8 - NURSING EDUCATION
137
FEEDBACK IN CLINICAL NURSING EDUCATION
TUTORS’ USE AND STUDENTS’ PERCEPTIONS
Authors:
Letizia Prosperi - Master Science in Nursing, Lecturer and Clinical Teacher – Nursing Degree - University of Verona
– Trento Campus (Italy)
[email protected]
-
Anna Brugnolli Doctor of Nursing Science, Dean of Nursing Science - University of Verona – Trento Campus (Italy)
University of Verona
Faculty of Medicine and Surgery
Nursing Degree
Phone +39461904812
POSTER ABSTRACT 56
139
Purpose: To describe tutors’ use of feedback in the clinical setting and students’ perceptions.
Background: Feedback is central in clinical nursing education in promoting learning and ensuring that clinical skills
are met (Boehler et al., 2006; Glover, 2000). There is little information about the nature of feedback provided to
nursing students in their clinical practice.
Methods: A descriptive design was employed to conduct this study. In 2008, a convenience sample was recruited
of 8 tutors and 31 third-year nursing students who were randomly selected. 27 structured observations were
conducted during clinical practice to describe types and elements of feedback provided by tutors; 4 focus group
interviews were conducted to analyse the students’ perceptions. A content analysis technique was used to analyse
data.
Results: The analyses showed that the feedback provided most frequently was negative and oriented on behaviour
or skills, with suggestions for improvement and to involve students actively in learning. The elements less present
were: real examples and an assessment of student understanding. Feedback was focused mainly on technical and
cognitive skills, less on communication and self-learning skills. The students perceived feedback useful to guide
their clinical learning, but sometimes they felt it was difficult to understand. Others indicated it was difficult to ask
and accept the feedback because they felt it was a definitive evaluation. Students would like to receive more
positive feedback.
Conclusions: This study suggested that feedback should: promote the students’ understanding; focus on
communication and self-learning skills; and create a learning environment that helps students perceive feedback
as formative.
Key words: Feedback, Learning strategy, Formative evaluation, Clinical Education, Student's perception, Nursing
Reference
Boehler M.L., Rogers D.A., Schwind C.J., Mayforth R., Quin J., Williams R.G., & Dunnington G. (2006). An investigation of medical student
reactions to feedback: a randomised controlled trial. Medical Education, 40, 746-749.
Glover P.A. (2000). Feedback: I listened, reflected and utilized': Third year nursing students' perceptions and use of feedback in the clinical
setting. International Journal of Nursing Practice, 6, 247-252.
PORTFOLIO AS A TOOL FOR PROFESSIONAL DEVELOPMENT
PROPOSAL TO USE IT FOR THE INTEGRATION OF A NEW CLINICAL TEACHER AND PRELIMINARY RESULTS
Authors:
Daniel Pedrotti - Doctor of Nursing Science, Lecturer and Clinical Teacher – Nursing Degree - University of Verona –
Trento Campus (Italy)
[email protected]
Anna Brugnolli - Doctor of Nursing Science, Dean of Nursing Science - University of Verona – Trento Campus (Italy)
University of Verona
Faculty of Medicine and Surgery
Nursing Degree
Phone +39461904823
POSTER ABSTRACT 57
141
Purpose: Evaluate the utility and efficacy of the Portfolio and mentoring process to improve integration and
professional development of the Clinical Teacher.
Background: Portfolio is a powerful tool for effective learning, as it stimulates complex processes such as critical
thinking, decision making and self-direct learning and it makes the practitioner aware of its professional
development as well (Byrne et al., 2007; Duffy & Holmboe, 2006; Jasper, 2006).
Methods: For the Portfolio 3 steps have been codified. In step one, by serial interviews to experts, a competencies
profile of the Clinical Teacher has been determined by a consensus on categorized competencies defined and their
timing. In second step the Portfolio has been elaborated and the mentoring process has been defined. In step
three it has been tested.
Results: 110 Clinical Teacher competencies, grouped in 16 categories, have been identified, that can be achieved in
1, 2-3 or 5 years. Competencies related to planning and management clinical training can be obtained in 2-3 years,
whereas in 5 years those related to management of students with learning difficulties, the ability to improve
teaching competencies in clinical settings, the management of evaluation processes and the participation in
educational planning at University level. We propose a dynamic Portfolio with guidelines for compilation in
association with mentoring process and formative evaluation. Among 2009-2010, 3 new Clinical Teachers started
to use Portfolio, after that the competencies are been redefined in 107 competencies divided in 15 categories. The
last result is satisfaction of Clinical Teachers and their Mentors: the Portfolio helps to understand easily the
integration process, to direct the Clinical Teachers learning to the priority competencies.
Conclusions: Currently Portfolio has been implemented. From the first evaluation during step 3 both new Clinical
Teachers and Mentors have been satisfied and some competencies have been redefined and grouped. It has been
decided to go on with the testing period.
Key words: Portfolio, Professional Development, Mentoring, Clinical Teacher, Nursing
Reference
Byrne M, Delarose T, King CA, Leske J, Sapnas KG, Schroeter K. Continued Professional Competence and Portfolios. Journal of Trauma Nursing
2007; 14 (1): 24-31
Duffy D, Holmboe ES. Self assessment in lifelong learning and improving performance in practice. JAMA 2006; 296: 1137-1139
Jasper M. Professional Development, Reflection and Decision - making. Vital notes for nurses. Blackwell Publishing, 2006
REFLECTIVE-PRACTICE IN NURSING STUDENT’S CLINICAL PRACTICE: CONTRIBUTIONS TO THE STRUCTURING OF THOUGHT
Authors:
Anabela Mendes - RN, MSc, PhD Student ICS/UCP
[email protected]
Eunice Henriques, RN, MSc, PhD Student UL/ESEL
[email protected]
Maria dos Anjos Pereira Lopes, RN, PhD
[email protected]
Maria do Carmo Domingos, RN
Escola Superior de Enfermagem de Lisboa [ESEL]
POSTER ABSTRACT 58
143
Purpose: Identify how reflective-practice in the context of clinical practice contributes to structuring the thought in
nursing by students of ESEL.
Background/Significance: To question aspects of daily practice, requires reflection about the meaning of “what we
do and how we do”. The practice of nursing to a "single person" should consider "the situation and reflection on
practice. It is as an important way of “empowerment of students and nurses in acquiring a deep understanding of
their knowledge and their practices “.
Methods: A qualitative approach using Grounded theory was adopted: data collected by semi-structured
interviews and written narratives, from a convenience sample of twenty-three students were subjected to
question and thematic analysis.
Key-words: Clinical practice; Nursing education; Nursing students; Reflective-practice.
Results: Reflective-practice is a "process of conscious analysis", that contributes to the structuring of thought in a
very meaningful way. The exercise of "intentional retrospective" helps the organization of activities both
theoretical and practical. The results are perceived by the student in the context of care but also on feedback
received from supervisors of hospital and school.
Conclusion: The reflective practice, with strong scientific evidence, has shown to be useful in the context of clinical
practice in nursing education. For the students it promotes the structuring of thought, ability to respond
successfully to the educational proposals, as well as referring to the practice of direct care.
Main references:
Alarcão, I. e Rua, I. Interdiscisciplinaridade, estágios clínicos e desenvolvimento de competências. Texto contexto enfermagem. 2005,
14(3):373-378.
Fernandes, O. Ensino clínico hospitalar em enfermagem. Formar no confronto com a experiência. Pensar enfermagem. 2008, 12(1):73-78.
Kim, H. Critical reflective inquiry for knowledge development in nursing practice. Journal of advanced nursing. 1999, 29(5):1205-1212.
Pereira, R. Reflectindo e escrevendo sobre as experiências vivenciadas no contexto da escola e do cuidado. [autor do livro] V. Waldow, M.
Lopes e D. Meyer. Maneiras de cuidar. Maneiras de ensinar. Porto Alegre : Artes médicas Sul, Lda, 1995.
Santos, E. e Fernandes, A. Prática reflexiva: Guia para a reflexão estruturada. Referência. 2004, 11:59-62.
Strauss, A. e Corbin, J. Basics of Qualitative Research- Techniques and procedures for developing Grounded Theory. California : SAGE
Publications, 1998. ISBN 0-8039-5939-7.
THE CHALLENGE OF CULTURAL DIVERSITY:
THE PROJECT OF NURSING EDUCATION OF FOREIGN NURSES
Author(s):
Augusta Grou Moita, Nursing Professor
[email protected]
Teresa Reis, Nursing Lecturer
[email protected]
José Pinto Magalhães, Nursing Lecturer
José[email protected]
Lúcia Vaz Velho, Nursing Professor
[email protected]
Deolinda Antunes da Luz, Nursing Professor
[email protected]
University: Lisbon School of Nursing (ESEL), Portugal
POSTER ABSTRACT 59
145
We leave in an increased multicultural world and nursing educators are challenged to understand cultural
differences and also similarities of foreign students and improve different teaching and learning approaches. The
Post Graduate Nursing Education to foreign nurses, being held at, Lisbon School of Nursing is an example. This is a
pioneering initiative, and the aim was: Improvement of skills in nurse at the level of theoretical training, human,
scientific, technical and cultural in order to contribute to building capacity and provision of general nurse care to
human beings throughout the life cycle, family, and community groups in different levels of prevention. At the
end, they will have the possibility to get equivalence of Bachelor in Portugal.
The course curricula, which lasted one year, included nonexistent disciplines in their academic course curricula, as
Analysis of Situations of Nursing (the structural discipline of the course in which we used the methodology of
coaching and Problem Based Learning), History and Epistemology, Ethics and Deontology Nursing, Nursing
Research, Systems and Health Policy and Clinical Practice.
The nurses from Moldova, Ukraine and Russia, showed difficulties in nursing conceptualization, in capacity for
reflection and group work, in use of the language in a professional context, in adaptation and use of the materials
and equipments and in professional autonomy and decision-making. These difficulties appear to be related to biomedical model of their curricula and led us to frequently monitoring the route, to systematically validate the
understanding of concepts, to train the group communication, to stimulate self-assessment and decision-making,
to simulate and train nursing techniques in the laboratory.
This educational experience improved also, us educators, our cultural competence. We believe, for 21st-century,
that is essential to develop cultural competence, either in education or in the field of practice.
Keywords: nursing education, foreign nurses, equivalence of academic qualifications.
References:
CAMPINHA-BACOTE, J. – A Model of Practice to Address Cultural Competence in Rehabilitation Nursing. Rehabilitation Nursing, 26:1 (Jan/Feb
2001) 8-11.
LEININGER, M.; MCFARLAND, M.R. – Culture Care Diversity and Universality: A Worldwide Nursing Theory. 2ª ed., Boston: Jones and Bartlett
Publishers, Inc., 20.
THEORETICAL PERSPECTIVE IN USE BY APPROVED SWEDISH CLINICAL NURSING SUPERVISORS
Authors:
Agneta Berg RNT, MSc, PhD, Assistant Professor Department of Health Sciences, Kristianstad University, SE - 291
88 Kristianstad, Sweden.
[email protected]
Phone +46 44 20 85 55
Marianne Kisthinios RN, MSc, Lecturer - Department of Health and Society, Malmö University, SE – 205 06 Malmö,
Sweden
[email protected]
POSTER ABSTRACT 60
147
Aim: The aim of the study was to explore the theoretical perspectives in use by approved clinical nursing
supervisors in Sweden.
Background: For the time being, we know little of the theoretical perspectives in use on a daily basis by the clinical
nursing supervisors in Sweden.
Methods: A questionnaire (n= 49) and follow-up telephone interviews (n=14) were used. Data analysis was made
by descriptive statistics and qualitative content analysis.
Results: The result from the questionnaire showed that the supervisors often used and combined different
theoretical perspectives with origins in nursing, teaching and learning and psychology. Surprisingly, one fourth of
the respondents did not state any nursing theoretical perspective in use during clinical nursing supervision. The
result from the interviews revealed that the theory of Kathie Eriksson (1987) was the most commonly used nursing
perspective.
Conclusion: Since the overall aim for clinical nursing supervision is to improve nursing for the patient/family, the
supervisor’s competence in nursing is essential. Given this fact, and that only three fourths of the approved clinical
nursing supervisors stated a use of theoretical nursing perspective when supervising, there is obviously a need for
further investigations in this area. In addition there is also a need for approved Swedish clinical nursing
supervisors, to further become aware of the theoretical perspective in use that supports their clinical nursing
supervision. CNS is a multifaceted activity that needs to be supported by different nursing theoretical perspectives
including physical, emotional, intellectual, spiritual as well as socio-cultural aspects.
Keywords: clinical nursing supervision, nurse, theoretical perspectives
INTERNATIONAL PROJECT FOCUSED ON THE QUALITY OF EDUCATION - EMPOWERING THE PROFESSIONALIZATION OF
NURSES THROUGH MENTORSHIP (EMPNURS)
Authors:
Andrea Pokorna, Lecturer, Masaryk University
[email protected]
Mikko Saarikoski, Project Manager, Turku University of Applied Sciences, Finland
Zdenka Surá, Head Nurse, Teaching Hospital Brno Bohunice, Czech Republic
Ildiko Szögdi, Lecturer, Institute for Basic and Continuing Education of Health Workers
Mariann Bódi, Ward Manager, National Institute for Medical Rehabilitation, Budapest, Hungary
Olga Riklikiene, Lecturer, Lithuanian University of Health Sciences
Grazvyde Masiliuniene, Head Nurse, 2nd Kaunas Clinical Hospital, Lithuania
Ileana Antohe, Professor, “Gr. T. Popa” University of Medicine and Pharmacy of Iasi
Camelia Bogdanici, Professor, University Emergency Hospital “Sf. Spiridon” Iasi, Romania
POSTER ABSTRACT 61
149
Purpose: The concepts and context of the project Empowering the Professionalization of Nurses through
Mentorship (EmpNURS) is empowerment. It refers to the positive conception and experience of one’s capability to
cope with different kind of challenges. Special attention will be focused on the relationships and clinical
environments evaluation.
Supervision is the second important part of the project.
Background/Significance: The project Empowering the Professionalization of Nurses through
Mentorship (EmpNURS) is mainly focused on the improvement of the clinical practice education in four new EU
countries; the Czech Republic, Hungary, Lithuania and Romania. We expect that in the involved Eastern European
countries where the professional status of nursing has not date been independent from other professions (Kalnins
et al., 2001) needs some tools how to improve their clinical training. In some of the countries can be seen in nurse
education that the role of medical profession has dominated and registered nurses may not have seen their role as
important. Some countries have quite good system of education but the influence of professional nurses is not as
high as in other countries or the nurses have not enough competencies in the study plan.
Method – Project interventions: There will be the basic situation of supervision practices of nursing students
during their clinical placements explored in the 4 partner hospitals. As research tool will be used the Clinical
Learning Environment and Supervision (CLES) evaluation scale (Saarikoski and Leino-Kilpi, 2002). According the
survey results and literature review, the partner organisations will collaborate in producing a Mentorship model
for participating countries. There is a huge expectations of the collaboration among the Universities and its
teaching hospital which will work together to implement and evaluate the programme in the clinical practice.
Results of the project: The project could promote the professional identity of student nurses and qualified nursing
staff. We would like to prepare the Pilot Mentorship model which will be then adopted in the participating
universities and in partnership teaching hospitals. We hope that there will be traditional educational system
improved and transformed as permanent practice in many similar educational environment in these countries.
Funding: The project is funded by Lifelong Learning Programme/ European Commission.
Key words: mentoring, mentor, empowerment, professionalization, nurses, nursing students
Main reference:
Kalnins, I., Barkauskas, V. H, Seskevicius, A. (2001) Baccalaureate nursing education development in 2 Baltic countries: outcomes 10 years after
initiation. Nursing Outlook 49(3), pp. 142-147.
Saarikoski, M. and Leino-Kilpi, H. (2002) The clinical learning and supervision by staff nurses: developing the instrument. International Journal of
Nursing Studies 39, pp. 259–267.
2.9 - MENTAL HEALTH NURSING
151
THE MEANING OF MENTAL ILLNESS AND EMOTIONAL SKILLS OF NURSING STUDENTS
Authors:
Roberto Manso, Francisca – PhD, MSc, RN
[email protected]
Escola Superior de Enfermagem de Lisboa (ESEL) – Portugal
POSTER ABSTRACT 62
153
The aims of this study were to understand how nursing students conceptualize the mental disease and how they
self-perceive the emotional competences, namely auto-consciousness and dealing with emotions.
Methodology-This investigation was based on a descriptive study of qualitative and quantitative nature, done
through a semi-structural questionnaire to 532 nursing students, from four different nursing schools in Lisbon. This
sample was distributed across three groups: 237 students from 1st year, 160 from 4th year and 135 professional
students, ranging from seventeen to fifty six years.
Concerning the representation of mental illness we applied the Social Representations Theory, in particular, the
central nucleus theory and the methodology of Vergès. We tried to determine the structure, the meanings and the
cognitive schemas about the conceptualization of the mental disease.
Through the investigation we have used two sub-scales: Self-Consciousness scale and the Dealing with Emotion
scale, both from Veiga Branco’s Capacities of Emotional Intelligence Scale.
Results and Conclusion- The global analysis of the results allowed us to find some differences among the student’
groups analyzed, specifically at the level of discrepancy between the mental health image and the self-attribution
regarding the emotional competences.
Therefore, this allowed the identification of a positive perception from the self as a human being and the
recognition of its own limits. In stress, students have reasoning and relational alterations, as well as, anxious and
reactive feelings.
In the Dealing with Emotions, the students have an emotional control of themselves through reasoning
mechanisms and negative strategies of adaptation, the latter with less frequency.
Professional students demonstrate a greater level of emotional competences, with adaptive nature. Students, as
future caregivers, will confront themselves with new information and practices. An improved knowledge of oneself
leads to better care of others.
Keywords: Representation of Mental Illness; Emotional Skills; Nursing Students
Bibliography
Bisquerra, Alzina, R. (2005). Educación emocional y bienestar. Madrid: Praxis.
Branco, M. A. V. (2007). Competência Emocional em Professores, In Candeias e
Almeida (eds). A Inteligência Humana. Coimbra: Quarteto.
Goleman, D.; Cherniss, C. (2005). Inteligencia emocional en el trabajo. Barcelona:
Editorial Kairós.
PROBLEMS OF AGEISM IN VIEW OF PARAMEDICAL HEALTHWORKERS AT DEPARTMENTS OF PSYCHIATRY
Authors:
Pokorná Andrea, PhDr., Ph.D.
[email protected]
Soňa Dubská, MSc.
Petra Juřeníková, MSc., Ph.D.
University: Masaryk University, Faculty of Medicine, Department of Nursing
POSTER ABSTRACT 63
155
Background/Significance: Stereotypes and discrimination are the huge problems of the modern society. As well as
ageistic attitudes to the elderly are quite common in the laic population. The presented research deals with ageism
problem at Departments of Gerontopsychiatry. Main object of the work is to determine different opinions and
knowledge of paramedical health workers with ageism proves in care of seniors within the frame of
gerontopsychiatric staff nursing. The theoretical part of work presents the summary of knowledge about ageism
problems, their supplies and occurring forms and effects. Crux of the matter makes a question form with analysis
and interpretation of results in opinions of paramedical workers about ageism at gerontopsychiatric departments.
Method: The original questionnaire form was prepared for the survey (we have been used some questions from
Palmore´s questionnaire of ageist attitudes). There were 27 items in the questionnaire form used. We have been
evaluated 145 questionnaires from paramedical health workers from gerontopsychiatry department.
Results: The results of questionnaire survey are a muse and contribution to occurrence of proves in discriminatory
treatment of seniors generally in medical facilities. We have been specially focused on the determiners of the
ageist attitudes (e.g. length of professional practice at gerontopsychiatric departments and in the health care
settings in total, age and gender of the respondents, level of the education). There were used statistical tests for
the evaluation. We have been recognized that the length of practice has no influence (no statistic significance was
found) on the ageist attitudes as well as the age of paramedical health workers.
Conclusions and relevance to nursing/midwifery
In the nursing education should be these relevant goals meet:
Cognitive goals - to learn the symptoms and signs of the ageist attitudes to the elderly and methods for elimination
of the stereotypes towards to the elderly ill people.
Affective goals - to show and learn how serious the problems of ageist attitudes are and how to work with it.
Psychomotor goals - to use special questionnaire to recognize the signs and symptoms of the stereotypes (ageist)
attitudes to elderly people and try to find the effective communication styles to elderly for ageism prevention.
Key words: elderly, ageism, paramedical healthworkers, psychiatry, mental health
3 - ORAL COMMUNICATIONS
157
3.1 – NURSING AND NURSING EDUCATION IN PORTUGAL AND EUROPE
PROFESSIONAL QUALIFICATIONS DIRECTIVE: IMPLICATIONS TO NURSING EDUCATION
Authors:
Maria Arminda Costa, RN, PhD, FINE President
This paper is based on European Federation of Nurse Educators (FINE)
Response to the Consultation Paper by DG Internal Market and Services on the Professional Qualification Directive
Since 1995 (FINE Foundation), between the institutional goals are:
To influence policy on national and international level in the European Union and to promote quality
assurance and professionalism in nursing education.
Specifying, on October, 2010, in the ordinary General Assembly, in Lisbon, stated as action plan for 2011-2013:
To join on mapping political support on national, European and international level; To work together with
EU Organizations: Sectorial Skills, Competences, Qualifications; To develop efforts to consolidate higher
education for nurses in EU at three cycles of Bologna Process; To build links with healthcare and education
to push 2nd and 3rd cycles to the political agenda.
In this sense, FINE vision, work and tendencies as Higher Education are:
To promote personal fulfilment, social cohesion and economic growth with the capacity for interinstitutional collaboration, to widen access in a lifelong learning framework, to work for a sufficiently
resourced and sustainable educational system (in conceptual terms and in operational initiatives), to ensure
and enjoy the autonomy necessary to define and fulfil nursing education mission, to prioritise quality
assurance and quality enhancement, to reinforce the links between teaching and research and to facilitate
student centered learning.
Reporting us to the Directive the key issues that we identified are that Knowledge and skills and ‘subjects’ are
variably defined across the sectorial professions (so it is difficult to define the same for so different professions;
really, the 1970 text of Directive is out of date in terms of scientific progress, professional aspirations and
pedagogical approach because, nowadays stated the debate between:
− Competences (a set of Competences?) in order to facilitate professional recognition?
− A core curriculum (body of knowledge?) in order to increase professional identity?
− Student-centered learning, signifying: A shift from an exclusive focus on knowledge transmission to
learner-driven inquiry and study; the reliance on the ‘learning outcome’ as keystone of the levels
supporting the qualifications framework and as markers of transnational academic consensus; the
integration of theoretical, practical and clinical aspects of curriculum, excluding that Student-centered
learning signifies:
• A lower priority given to specialist knowledge
• Abandonment of the specification of course duration
FINE established a strategy for wide consultation of Nurse Educators and key stakeholders to inform the response
including individuals and groups who could offer evidence within this very specific area of the directive review. The
strategy and acknowledgement those consulted can be found at the end of this document, while identified
evidence will be integrated as illustration. A further report on the evidence investigation is available on the FINE
website in due course (www.fine-europe.eu).
The review of the Professional Qualification is recognised by FINE as being timely and appropriate in the context of
the development of future healthcare. The Directive on the Mutual Recognition of Professional Qualifications has
served the EU public well since the first elements were developed in the 1970’s including the challenge of
increasing membership from 9 original states to the 27 member states of 2011, changes in health care needs and
provision and changes in higher education. The mechanism of automatic recognition has enabled the benefit of
159
mobility for nurses in General Care as well as providing a legal benchmark for the development of nursing for those
intending to access the EU. This has resulted in considerable mobility for nursing.
However, changes in health care which include increase in technological advance, change in demographics
including increasing needs for health and social care provision for a growing elderly population in many member
states and the need to compete in a global economy (EU Commission (2011); EU Commission Workforce Green
Paper; (2009), there are sound reasons for this current review. Further, changes in European education systems in
light of the Bologna process as well as the recognition of nursing studies to be situated within higher education
have meant that current legislation is sometimes perceived as inconsistent with the educational requirements of
universities and placing students and course developers with difficult choices over the need for working time and
student life. This review will address the points.
Key Summary Points:
FINE seeks assurance - without any doubt, that the title nurse is only used by professionals with graduate/higher
education including at least 180 ECTS.
FINE seeks assurance - without any doubt, that in preparation for qualification and recognition, nurses will
received quality, competent and sufficient clinical practice in diversity of clinical experiences and a guaranteed
level of knowledge;
1. The current admission requirement for entry to nursing should increase to 12 years.
2. The minimum duration of nursing education (currently 3 years or 4600 hours) must be a minimum of 3
years full time study.
3. Where aptitude testing and compensation takes place for nurses identified within the general system –
these mechanisms must ensure the safety of the patient as a priority. A way to achieve this might be
through using a system of minimum quality training based upon competences.
4. To ensure patient safety and confidence, the qualified accountability for independent nursing practice is
awarded to those with the title ‘nurse’. There are therefore valid public interest reasons to prohibit
‘Partial access’ which would fragment nursing and compromise full accountability.
FINE proposes greater equality in the content and identified competencies of nursing education, both at
undergraduate and postgraduate levels, including equality in the development of new technologies in
care and education;
FINE believes that there must be equity of titles across EU for health professionals, nurses and nurse
educators and for the effective development of these, it is essential to consider regulation of
professional development for teachers and specialists in the health professions;
5. There is a need to take more account of Continuous Professional Development for nursing at EU Level.
6. Mobility for new nurses within preceptorship, and those undertaking further training at higher level or
undertaking research (Master and PHD) should be supported to enhance the development of nursing as
a profession and improve care for patients.
FINE Position:
The current admission requirement for entry to nursing should increase to 12 years.
The minimum duration of nursing education (currently 3 years or 4600 hours) needs to be a minimum of 3 years
full time study.
There is a need to take more account of output based competency outcomes at EU level.
On basis of similar evidence, FINE (2006, 2009) have consistently identified that the title of nurse should be
reserved for those who have completed 12 years of secondary education and awarded a programme of not less
than 180 ECTS or 3 full time years of education. FINE further recognizes ‘de plus’ value given to nursing education
quality by those countries where pre-registration nursing education duration is 3.5 or 4 years (210 or 240 ECTS)
and considers this a challenge to be considered.
FINE considers that within the political agenda around nursing education, other important key points must be
considered with urgency;
1. More debate around developing nurse education – including staff development for nurse educators and
the level, quality, and numbers required. A transitional strategy for development, might include
consideration of staff student ratios, equitable standards,
2. Opportunities and outcomes in respect of E-learning approaches to professional development both for
professionals and for their non-professional co-workers;
3. Adjustment of specialization areas to the requirements of population of each region and country;
4. Harmonization of academic degrees of specialized education to permit mobility between countries;
5. Social protection to assure basic conditions that the study period is concluded with success.
The enhancement of interculturalisation and a climate for youth mobility is a priority for the development of the
European workforce of the future (Youth on the Move; 2011).It is particularly a priority in respect of health care
because of the impact of health on future workforce and subsequently on the wealth and economy of the EU
(Dimitrova; 2010) and because of well recognized forecast shortages of nursing and medical staff.
At postgraduate level, Europe requires an increasing capacity for cutting edge science in the development of
healthcare technologies for the future if it will compete effectively within the Global healthcare market.
Opportunities for postgraduate and postdoctoral development across the EU must be supported if the benefits of
science and technology for health are to be effectively realized. While funding through Framework funding and
other means can achieve substantial scientific development, this must be supported by ease of access to
professional mobility.
The recognized movement from a perception of learned society to a learning society has emerged in nursing as in
other profession over the last 30 years. This is the same in all aspects of the profession, accentuated by the
recognition of the need for lifelong learning (Delors 2005) and updating in order to maintain professional safety
and quality in light of technological advance and global change. It is recognized also that an effective and highly
skilled health workforce is also demonstrably an economically viable one, reducing hospital stays for patents and
improving care outcomes .
There is currently no requirement for Continuous Professional Development (CPD) within the directive. This leads
to inconsistency of provision if one member is requiring a CPD minimum requirement another may not be. This
undermines consumer confidence and disadvantages professionals who wish to be mobile. FINE proposes that for
continuous professional development to be assured and for consistency to be enhanced across all member states
in the current economic climate however presents a significant challenge. The inclusion of CPD within the directive
would be significantly helpful in determining a minimum baseline for lifelong learning and should serve to enhance
delivery of nursing care across the member states.
Further there is no consistency in requirement for the education or monitoring of nurse educators, and across the
member states there is considerable variance in the qualification and support offered to educators of nurses (
Barbieri-Figueiredo, Costa et al 2010).
References
Response to the Consultation Paper by DG Internal Market and Services on the Professional Qualification
Directive (March, 2011)
Barbieri-Figueiredo, MC; Costa, MA; Lekeux, A (2010) - Bologna Process and Nursing Education in Europe: Report
of a Workgroup in the Scope of FINE. NETNEP 2010 Nursing Education in a global community: Collaboration and
networking for the future, Sydney
Response
to
the
Green
Paper
on
The
European
Workforce
for
Health
http://ec.europa.eu/health/archive/ph_systems/docs/fine_en.pdf accessed 13/03/2011
European Commission (2011) Europe 2020 Strategy http://ec.europa.eu/europe2020/index_en.htm accessed
10/03/11
European Public Health Alliance (2010) European Council Summary Council Conclusions on investing in Europe’s
health workforce of tomorrow: Scope for innovation and collaboration. http://www.epha.org/a/4334 accessed
12/03/2011
Tuning
Educational
Structures
in
Europe
Specific
Nursing
Competences
http://www.tuning.unideusto.org/tuningeu/index.php?option=content&task=view&id =193&Itemid=221
The Response to the Consultation Paper by DG Internal Market and Services on the Professional Qualification
Directive paper has been co-ordinated by:
Dr. Maria Arminda Mendes Costa, RN, PhD. FINE President. Coordinator Professor. Instituto de Ciências
Biomédicas Abel Salazar – Porto University. Portugal.([email protected]).
Dr. Carol Hall RN, PhD. FINE Executive Council. Associate Professor. The University of Nottingham UK
([email protected]).
With FINE Executive Council Co-operation:
Jacques Mondoux. FINE Vice president. Head of Nursing Department HES-SO. University of Applied Sciences
Western Switzerland ([email protected]).
161
Jane-Laure Danan. FINE Executive Council, Professor of nursing in charge of Ifsi Nancy Laxou. Centre
psychothérapique de Nancy-laxou. France ([email protected]).
Dr. Maria do Céu Barbieri de Figueiredo, FINE Executive Council, RN, PhD (Coordinator Professor. Escola Superior
de Enfermagem do Porto. Porto) ([email protected]).
Cécile Dury, RN, MSc, FINE Executive Council, Haute Ecole de Namur – HENAM ([email protected]).
Also with FINE Advisory Board and with Nurse Educators collaboration, representing: FINE Associations in EU
Countries, Nursing Faculties, Universities, Nursing Schools, Nursing Departments and others Nurse educators
related or evolved with FINE activities. FINE would also like to acknowledge with thanks the contributions of the
many organisations involved in the dissemination of the FINE survey and in stakeholder consultations; with
particular thanks to Howard Davies of the European Universities Association and Saffron Brown of the European
Nursing Student Association.
3.2 – PALIATIVE CARE NURSING
163
CARING IN THE LAST DAYS OF LIFE: EXPERIENCES OF NURSING STUDENTS DURING CLINICAL PRACTICES
Author:
José Magalhães, Nursing Lecturer
[email protected]
165
Exploring the attitudes of man toward death and dying in a philosophical, historical and sociological context, we
describe the origin and development of the contemporary movement of Palliative Care and its implications for the
actual notion of good death in occidental societies. The nursing profession was conceptually analysed, in the scope
of palliative care, identifying some of the key elements in caring patients in the end of life. Nurse education in
palliative care was analysed from a revision of the research carried through the subject. This case study pretended
to explore the experiences of nursing students, while caring for patients in the end of life, during their clinical
teaching. Data was obtained from semi-structured interviews to 13 students near the end of their final year of
course graduation, from a Nursing High School in Lisbon. The content analysis allowed identifying the difficulties
experienced, as well as the sources of support mobilized by the students. It made clear the value that the
experience of caring patients in the end of life might have for the personal and professional development of
nursing students. From the perception of the students, it was possible the attainment of a picture on the
professional practices in nursing, in terms of the needs of the patients in the end of life, as well in terms of the
nurses attitudes. It also allowed structuring some suggestions of changes in the pre-graduated nursing education.
KEY WORDS: Death and dying, palliative care, patients in the end of life, nursing students, experience.
OUTCOMES FROM NON-CONVENTIONAL THERAPIES IN NURSING PRACTICE
Author:
Mª Irene Santos, Nursing Lecturer
[email protected]
167
The theme presented today comes from an ongoing investigation about the practice of non conventional
therapeutic modalities by nurses. The empirical study was done in Hospitals and covered a broad and diversified
spectrum of services and institutions, covering also an extensive geographical area across the country.
The evaluation of the effectiveness of these practices, which is the topic of this communication, is one of the
categories induced in the study. The dimensions considered to be more interesting in light of the general theme of
this meeting were selected, namely: actors in the process of evaluation; indicators of results; documentation of
the care process. A brief characterization of these is now presented:
- Actors in the process of evaluation are, preferentially, nurses and patients, the prime actors in the care process.
- The results indicator, through which nurses evaluate the efficacy of these therapeutic modalities are essentially
subjective, namely: physiological, behavioral and well-being indicators. An interest for more objective indicators is
starting to emerge.
- The documentation of care through nursing registers is differentiated according to its context: it is assumed in an
observation context (but not always made explicit); and not done / dissimulated in the interview context. In both
situations it does not adequately reflect the efficacy of these care modalities.
3.2 - HOW CAN SCHOOLS OF NURSING CO-OPERATE WITH LOCAL AND INTERNATIONAL
COMMUNITIES IN HEALTH PROMOTION AND EMPOWERMENT? (ESEL PROJECTS)
169
DEALING WITH EMERGENCY SITUATIONS: EMPOWERING COVA DA MOURA NEIGHBOURHOOD RESIDENTS
Authors:
Cândida Durão, Nursing Professor
[email protected]
Students Team from Lisbon Nursing School (ESEL), Portugal
171
Purpose: To empower Cova da Moura neighbourhood residents in emergency situations
Significance: In the context of a Nursing Course “Human Development Promotion” , we visited Cova da Moura
neighbourhood. During those visit we became aware of the experienced difficulties to acting in an emergency
situation, both the activation of emergency services, as knowledge to act on behalf of accidents victims.
Method: The health planning project for community intervention among the Cova da Moura population was
implement using the nursing process centered in the community. The essence of this project lies in the
enforcement mechanisms used, in. health education sessions with small interactive groups and resort to reference
people in the neighbourhood as subjects of change the Cova da Moura neighbourhood. With support of video and
power point we present the design and implementation of the project so far.
Results: The final results will focus on improving communication between the population and health services,
educate the public in relation to strategies for intervention in case of emergency; in providing information on ways
of activating the emergency system (SIEM).
Conclusions: We intend to contribute to the empowerment of the population of Cova da Moura in emergency
situations.
Keywords: Empowerment, Emergency.
Main Reference:
STANHOPE, M. LANCASTER, J. (1999) - Enfermagem Comunitária Promoção da Saúde de grupos, famílias e indivíduos. 4ª ed. Lisboa:
Lusociência.
CO-OPERATION WITH A CAPE VERDE UNIVERSITY TO IMPROVE THE QUALITY OF NURSING EDUCATION
Author:
Maria Odete Matos Pereira – Nursing Professor
[email protected]
173
The cooperation agreement entered into the two institutions on 30 April 2009 is being implemented according to
Mindelo University´s stated needs, under the following features: Developing Study and Programme Plans in the
Nursing course area.
Teachers from ESEL, in close cooperation with locally university recruited teachers, ensure: Technical-scientific
coordination, content lecturing and tutoring of those teachers both on subject content lecturing and organizing,
planning and preparation of Clinic Teaching as well as technical and scientific support to the organization and
equipment of the nursing Laboratories;
ESEL could make available a number of post-Graduation, Master and Doctorate degree places for nursing teachers
from Mindelo University when such may be applied to;
ESEL has given and goes on giving its support to the assembling of a Nursing subjects documental collection,
gradually appropriate to the demands established by the teaching levels that Mindelo University aims at:
Within the framework of the agreement entered into by the two institutions, a few Mindelo University students
may have ESEL support so as to attend clinic practice classes in Portugal. ESEL promotes clinic practice classes (EC)
attendance in Cape Verde for its students (BSc final year, specialist post-BSc, MSc and Doctorate degrees).
FLYING SOUTH, NURSING IN PORTUGUESE
Author:
Mª Deolinda A. Luz - Nursing Professor
[email protected]
175
The Lisbon Nursing School (ESEL) has the mission of training nurses with the ability to provide health care to
persons, as unique human being with diverse characteristics, by promoting a learning process strategies that
empower students on professional level, and to nursing interventions adapted to societies, that are more and
more culturally diverse as well as its scientific, technical and globalized evolution.
For that, ESEL promotes a pedagogical policy that leads to an inter-cultural understanding of the communities,
giving to students opportunities for learning and exchanging knowledge, on others nursing schools in Europe,
Africa, South America and Asia opening higher education in nursing to the world.
The internationalization of higher education, in this case nursing education, is essential for develop ability work
and learning in different cultures and contexts as professionals and citizens.
However, we can find some difficulties in learning and knowledge transfer in social and professional recognition as
well as language barriers.
The evaluation of this learning experiences are very positive according the students opinions and is based on this
that UE program Lifelong Learning, developed “Erasmus Mundus” as an exchange program for students around the
world to promote the intercultural and knowledge competences.
3.3 – DIFFERENT PARADIGMS IN MIDWIFERY EDUCATION
177
THE PORTUGUESE PERSPECTIVE
Author:
Maria Teresa Félix
[email protected]
179
Both the international and national contexts of woman\family assistance during the reproductive cycle have been
changing in the last few years.
These changes are the result from the social-cultural evolution and the growing rights assumed by women, as well
as their increasing role in both society in general and motherhood in particular.
The history of mankind is interwoven with the history of women throughout the ages, their pregnancies and their
deliveries. History has consistently emphasised women's great responsibility in the maintenance of the species, as
well as their vital role in the continuance of human existence.
The level of care provided to women have crossed different ages, each branded by different paradigms, over time.
There was a general tendency towards rituals, thus emerging several cultural beliefs and myths that have marked
the way women have been experiencing their reproductive cycles.
Added to this, there's also the fact that the access to nurse specialized formation courses in this field (Maternal
Care and Obstetrics) also doesn't have a unified stance on a world level within the health community, with each
nation offering varying levels of access to formation.
There is, however, on a European level, a bright light, with the free circulation of these highly specialized health
professionals, which is grounded on universal formation principals and guidelines, thus ensuring a similar level of
competence and specialization within the European community, as stated in the directives issued by the European
Council in the last few years.
We propose to:
•
Approach these EU directives, the national legislation in Portugal that supports the work of our SMCONs
(Specialist Maternal Care and Obstetrics Nurse) , as well as the SMCONs own professional regulations and
guidelines.
•
Present the resources that are available to the growth, regulation and evolution of Maternal Care and
Obstetrics Nursing in Portugal.
•
Explain the specific and common competences available in a SMCON.
•
Propose a final reflection on the way to converge between the academic competences and the practical
clinical practices given to the women during their reproductive cycle in their different contexts, as well as
the difficulties that present themselves to SMCONs exercising in Portugal, and possible ways to improve
the current situation.
THE BELGIUM PERSPECTIVE
Authors:
C. Van der Aa, RM, lecturer Midwifery education, KaHo Sint-Lieven, Sint-Niklaas
[email protected]
K. De Wilde, RM, MSc, Head of midwifery education of KaHo Sint-Lieven, Sint-Niklaas
[email protected]
Campus WAAS - Saint Nikolas - Belgium
181
The Bachelor in Midwifery is organised in another way in the Flemish (180 credits) and French part (240 credits) of
Belgium, because of historical and political reasons. KAHO Sint-Lieven is located in the Flemish part.
Topics in the first year are physiology and everything about the healthy mother and baby, in the second and third
year we discuss dystocia, high-risk pregnancy, birth and baby, infertility and obstetrical primary health care.
According to the European standards there is 50% theoretical education and 50% practical education (45%
practical training and 5% classroom training). In classroom training we strive for integration of competences by
using simulation situations.
The education is organised in two ways:
- daytime education, where students are coming to school to attend the lectures and classroom training - distance
education, where students study the theory ‘at home’ and have the possibility to ask questions about the content
by email, Toledo and in 1 face-to-face contact with the lecturer. The clinical education has limited hours of
classroom training, but the same amount of practical training.
In the first year students perform 8 weeks of practical training, in the second year 14 weeks and in the third year
16 weeks. In the last year they have the possibility to do a part of the practical training in another country.
After obtaining the degree of midwife there is still a possibility to continue to study: master in nursing and
midwifery (120 credits), bachelor in nursing (60 credits), postgraduate education, teachers training, …
For more information: www.kahosl.be
3.4 – PARTNERSHIPS IN CHILDREN’S NURSING EDUCATION
183
MENTORING ESEL AND ERASMUS STUDENTS IN CLINICAL PRACTICE
Author:
Maria Isabel Dias da Costa Malheiro – Professor ESEL
[email protected]
185
The terminology “Mentor” is not consensual and several authors advocate that the designation of clinical
supervisor and preceptor is more adequate. Advisory standards by the United Kingdom Central Council for
Nursing, Midwifery and Health visiting (UKCC -2000) clarified the debate on the terminology employed to refer to a
nurse supporting a student in practice, indicating that the term “Mentor” was preferred and defining it “as a
practitioner who facilitates learning and supervises and assesses students in the practice setting” (ENB&DH 2001,
p6).
According to the Royal College of Nursing, the Mentor, by definition, “facilitates learning, supervises, and assesses
ongoing progress and achievement of students in clinical practice sites.”
The mentor is an essential support for students in practice, which is where students can apply their knowledge,
learn and achieve the necessary competences to be nurses. They prepare the student for life in the “real world” of
practice. The role of mentor is critical in helping to facilitate the development of future generations of nurses.
Have the privilege and the responsibility of helping students translate theory into practice. The attitudes and
behaviour of mentors have the most profound effect on student learning (Waldock, 2010).
According Nursing College of Nursing the role of Mentor is:
•
Helping students to develop critical thinking skills through interaction and guidance in clinical sites;
•
Providing students enough time to use skills and critical thinking appropriately in the care of their
patients;
•
Facilitation of student learning;
•
Assessment and evaluation of the student;
•
Acting as a positive role model;
•
Ensuring students are fit for purpose, practice and award.
Based on my experience, about mentorship in ESEL students, a lot of difficulties can be found in this process, like:
•
In finding motivate nurses to mentorship the ESEL students;
•
In finding nurses with mentorship training available (different schools simultaneously in the same sites);
•
Students with different knowledge level’s (2 year, 3 , 4 year, post graduate);
•
The lack of support from the nursing school for their mentor role;
•
A lack of time was frequently cited by nurses as a barrier to completing their own clinical work and an
increasing reluctance to take on “extra duties” such as mentoring nursing students
•
The need of curriculum experiences to apply for a post graduate education (novice nurses).
nd
rd
th
Evidence suggests this is less than ideal, as these nurses are unable to help students meet objectives and reflect on
practice, effectively (Waldock, 2010)
Trying to find solutions for these difficulties, ESEL found some strategies to improve the quality of mentoring. The
evidence suggests that the school can assist nurses to be better mentors by preparing them for their role, and
sharing the objectives for the students. In 2009 we created a program to train mentors for mentoring ESEL
students, the "Clinical Supervision Program”. The mentorship preparation program, establishes an in-depth
understanding of the role of mentor, the responsibility and accountability for student assessment, and the nurse
education curriculum.
“Nurses prepared for the role, are better able to facilitate the transfer of nursing knowledge and behaviour in an
effective way through expert guidance and assistance. Are more able to teach, evaluate and support students’
learning objectives when they understand the curriculum”(Waldock, 2010 p 15).
"Clinical Supervision Program” for mentoring ESEL students is a 110 hours program with 4,5 ECTS (eligible to
accreditation).
The main goals of this program are:
•
Understanding the Partnership as an Educational Strategy
•
Recognizing and valuing the importance of the mentorship role, and its contribution to a student’s
practice experience
•
Raising awareness of your accountability, in the context of mentorship
•
Identifying the key responsibilities of the mentor and teacher role
•
Developing skills and strategies of educational intervention specific to the orientation of students in
clinical practice
•
Contributing to professional development
This programme has basically four stages, the first one with a theoretical approach (discussing articles in group),
the second one discussing articles and the official documents (Nurse Education Curriculum/orientation document
and the evaluation form) and the third one, consist in mentoring ESEL’s students on clinical practice (precepting
sessions /seminars/ worksheet /reports).
After the assessment of the third stage (approved), the nurses can access to a fourth stage (they have two tutorial
sessions and a Educational Project), after that, the mentor can require accreditation of the Curricular Unit “Clinical
Supervision” of ESEL Master degree.
ERASMUS students, like all students from ESEL, have the same need of learning and of opportunities to develop
nursing care competences. Mentoring Erasmus students brings many benefits like; sharing different experiences
and comparing different realities in clinical practice, knowing different cultures and their implications in nursing
care, training a different language (usually English) and knowing different curriculums of nursing education.
However, as for the ESEL students, the mentoring recruitment process for Erasmus students is difficult in finding to
achieve placements, in finding available mentors for the clinical practice and in finding mentors who speak English.
Erasmus students have had some difficulties in the clinical practice, essentially communicating with Children and
their families, therapeutic administration, to understand the clinical evolution of the children; this situation is
unattractive to mentors.
However the great diversity in previous theoretical preparation in Paediatrics subjects (great diversity in the level
of education, students of the 2nd, 3rd, 4th year and Master degree) requires a greater flexibility of the mentor.
Some strategies we use to improve the quality of mentorship are the partnerships with some services
(hospital/community), using reference services for the clinical practice and having reference mentors
(trained/speak the language fluently/motivated for this role).
REFERENCES:
Dadge, J., & Casey, D. (2009). Supporting mentors in clinical practice. [Article]. Paediatric Nursing, 21(10), 35-37.
Gray, M. A., & Smith, L. N. (2000). The qualities of an effective mentor from the student nurse’s perspective: findings from a longitudinal
qualitative study. [Article]. Journal of Advanced Nursing, 32(6), 1542-1549.
187
Mills, J. E., Francis, K. L., & Bonner, A. (2005). Mentoring, clinical supervision and preceptoring: clarifying the conceptual definitions for
Australian rural nurses. A review of the literature. Rural And Remote Health, 5(3), 410-410.
Nursing, N. C. o. (2009). Guidance for mentors of Nursing Students and Midwives (Second ed.). London: Royal College of Nursing.
Waldock, J. (2010). Facilitating student learning in clinical practice. Nursing New Zealand (Wellington, N.Z.: 1995), 16(1), 14.
Waters, A. (2005). Mentors' toolkit offers checklist for national placement standards. [Article]. Nursing Standard, 20(4), 12-12.
RESEARCH PARTNERSHIPS: EARLY FEEDING SKILLS SCALE VALIDATION,
Author:
Thereza Vasconcellos, RN, Headnurse
[email protected]
This project came about through the necessity to improve the quality of care in the oral feeding of premature
infants. The ESEL (Escola Superior de Enfermagem de Lisboa), with the involvement of the student body, has
agreed to collaborate with the Hospital in this research.
The decision to begin oral feeding in premature infants has historically been based on the following measures:
•
Weight
•
Post-conceptional age
•
Physiological stability
•
Health status
The above have formed the basis of our guidelines when planning feed care. However, as our knowledge
advances, instruments (perhaps the word ‘criteria’ - might be more appropriate, as the scale, if my
understanding is correct, is not a instrument as such - the word instrument general implies a physical object)
have evolved which, through observational assessment, are able to indicate the most appropriate time to
introduce oral feeding, whilst also monitoring the infant’s progress during the feeding process.
Following an extensive bibliographic research, we came across a particularly interesting and exciting scale created
by Thoyre, Shaker & Pridham (2005).
Thoyre, Shaker and Pridham have created an observational scale entitled “The Early Feeding Skills (EFS)”. The
scale comprises 28 different measures by which the capacity of preterm infants to feed orally
(nipple/breastfeeding) is assessed.
The scale itself is composed of three elements. One: Evaluating whether the infant has enough energy to initiate
oral feeding and whether the awake state is appropriate, as well as his physiological stability; Two: “Oral Feeding
Skills”, this measures four critical elements in the success of oral feeding (ability to maintain engagement during
feeding, ability to organise oral-motor function, ability to co-ordinate swallowing, and finally ability to maintain
physiological stability); Three: Evaluates oral feeding tolerance, awake state, energy levels and the physiological
stability after oral feeding. EFS, therefore, comprehensively evaluates the whole feeding process, thus allowing
the caregiver to formulate appropriate intervention strategies whilst also assessing their effectiveness (Thoyre,
Shaker & Pridham – 2005).
The authors firmly acknowledge that the Health Team and patients’ families have a vital role to play in the
successful introduction of oral feeding in preterm infants.
The first phase of our project was the translation of the scale and accompanying manual into Portuguese.
The second phase saw us hosting the main author (Suzanne Thoyre) at a national workshop. Delegates were
made up of nurses and doctors from Neonatal units (all of whom provided varying levels of prenatal support)
189
across Portugal. The aim was to teach and train the participants who, it was hoped, would then go on to apply the
scale in their own facilities.
The third phase was the pre-testing of the scale. This involved 90 observations of oral feeding in preterm infants
(observations were carried out by experienced, trained observers). These took place at the Neonatal units of
Centro Hospitalar de Lisboa Ocidental and Lisboa Centro.
In the fourth phase, we expanded the training programme to all the Units involved on this project:
NORT:
•
Hospital de S. João - Porto
•
Hospital de S. Sebastião - Santa Maria da Feira
•
Hospital da Senhora da Oliveira – Guimarães
•
Centro Hospitalar V. N. Gaia –Espinho
•
Hospital de S. Marcos – Braga
•
CHTS– Unidade Padre Américo (Penafiel)
CENTRE:
•
Maternidade Daniel de Matos - Coimbra
•
Maternidade Bissaya Barreto - Coimbra
LISBON AREA:
•
CHLN – Hospital S. Maria
•
CHLO – Hospital S. Francisco Xavier
•
Hospital D. Estefânia
•
Hospital Garcia de Orta
•
Hospital Fernando da Fonseca
•
Maternidade Alfredo da Costa
SOUTH:
•
Hospital do Espírito Santo - Évora
•
Hospital de Faro
Our goal is to carry out 2000 observations of oral feeding in preterm infants using the EFS scale. We will apply EFS
at initiation of oral feeding (52 weeks post-conceptional age) to the entire population of Portuguese preterm
infants. The scale will be evaluated, referencing content, validity, viability and sensibility.
The project is implemented by a multidiscipline team made up of neonatal nurses, neonatologists, nursing
students and speech therapists. The team proceeded to establish a line of work within the various participant
institutions.
At the end of the project a scale of observation skills will be available to the public domain. This set out a validated
comprehensive set of measures used in the introduction of oral feeding skills in preterm infants born in the
participant institutions.
The team wants to believe that the results of this study will contribute to the definition of essential concepts
within the pediatric community.
4 - FINAL COMMENTS
191
It was a great honour and privilege for ESEL to organize and receive all participants of the 19th Annual Meeting of
the Florence Network.
As organization, we are strongly committed to the belief that this meeting is a great opportunity to share
knowledge and experience within our European partners, as well as a way to enhance the discussion concerning
the current, and innovative issues on nursing education. These issues are mainly related to the growing complexity
of nurses clients and work environment and also to the consolidation of a multicultural society all over Europe.
The challenges mentioned above give us the opportunity, the motivation and the responsibility to look nursing
curricula design, educational projects and contexts in a broader view, concerning multiculturalism, complexity and
critical thinking approaches for the committed goal of quality care delivery, really addressed trough the client
perspective.
ESEL mission states to be: a centre of creation, development, transmission and dissemination of culture and
science of nursing, which aims excellence and innovation. For our community and faculty, the development of
nursing discipline and profession, performed through basic and applied research; the training of cultural, scientific,
technical, ethical, aesthetic and professional aspects in nursing, based on an attitude of continuous scientific and
pedagogic innovation, is a crucial concern.
Receiving the 19th Annual Meeting of the Florence Network has given to our school community a very important
stimulus to show and improve our organizational skills and a challenge to the efficient use of human and structural
resources, particularly in a context of strong economic constraints. This meeting also ensures our vitality as an
institution, which is mobilized to demonstrate its capacity to fulfil its mission and to address one our most
important and strategic purpose: the internationalisation.
Today, internationalisation is one of the most relevant criteria to access the ability of an institution of higher
education to project and open to the world, in order to be recognized and receive input from other countries,
exchanging different views and perspectives that challenge and stimulates us to do better every day.
ESEL seeks autonomy, innovation, leadership and individual responsibility for lifelong learning and, therefore, it
was gratifying to see how the school community, students and teachers, are involved sharing their work, with
posters and oral presentations. We must also emphasize the presence of our partner institutions that are closely
working and helping us to fulfil our mission.
In this event, students and teachers from the partner institutions can also share their projects of national and
international cooperation within the nursing education, nursing and health, contributing to the development and
cooperation between countries.
Finally, on behalf of ESEL, I want to thank to the Organizational and Scientific Comities and collaborators for all the
work and to the Conference Chair Professor Maria Teresa Leal to bring this opportunity to ESEL and to show how
Florence Network is so important to us!
Thank you!
Filomena Gaspar
ESEL President
193

From Diagnosis to Outcomes - Escola Superior de Enfermagem de

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