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"Raciocínio clínico: o desafio do cuidar" ; Clinical Reasoning: the challenge of caring

Corrêa, Consuelo Garcia
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 29/10/2003 PT
Relevância na Pesquisa
36.28%
Corrêa CG. Raciocínio Clínico: o desafio do cuidar. [tese] São Paulo (SP): Escola de Enfermagem da USP; 2003. RESUMO O objetivo deste estudo é compreender a experiência do raciocínio clínico de enfermeiros especialistas. Utiliza-se como referencial teórico o Interacionismo Simbólico e como referencial metodológico a Teoria Fundamentada em Dados (Grounded Theory). Em entrevistas, 11 enfermeiros especialistas foram solicitados a relatar a experiência de identificar necessidades de cuidados em uma situação clínica que haviam vivenciado. A análise comparativa dos dados conduziu o delineamento de um modelo sobre a experiência do raciocínio clínico do enfermeiro especialista. O raciocínio diagnóstico apresentou-se indissociável do raciocínio terapêutico na maioria dos relatos. O modelo foi definido por três constructos. O constructo ENCONTRANDO-SE NO DESAFIO DO CUIDAR representa os processos pelos quais o enfermeiro vivencia o desafio do raciocínio clínico. A partir da vivência do desafio emerge o segundo constructo CUIDANDO que se refere ao processo central do raciocínio clínico. Trata-se de um processo sistematizado e dinâmico, composto de uma seqüência de pensamentos do enfermeiro no sentido de tomar decisões sobre suas ações. Esses dois constructos integrados são permeados por um terceiro...

A família no hospital

Pereira, Vanda Maria Veiga
Fonte: Universidade Católica Portuguesa Publicador: Universidade Católica Portuguesa
Tipo: Dissertação de Mestrado
Publicado em 17/12/2011 POR
Relevância na Pesquisa
46.13%
O presente relatório é referente ao estágio clínico do curso de mestrado de natureza profissional em Enfermagem Médico-Cirúrgica 2008/2010 da Universidade Católica Portuguesa, realizado no Serviço de Cirurgia Geral e Serviço de Urgência do Hospital do Montijo. Contém a descrição e análise das várias etapas do caminho percorrido nos campos de estágio, procurando documentar as aprendizagens conseguidas assim como os impactos da presente formação na prestação de cuidados, na formação, na gestão e na investigação de modo a comprovar o desenvolvimento de competências necessárias ao enfermeiro especialista. Está organizado a partir do planeamento prévio às actividades de estágio, sendo descrita a instituição e serviços escolhidos, seguindo-se a análise da experiência profissional creditada ao abrigo da legislação em vigor e posteriormente relatado o processo de desenvolvimento de competências trabalhadas nos estágios clínicos. As pesquisas, reflexões, análises de incidentes críticos, conteúdos de toda a formação realizada, bibliografia e principais recursos utilizados, foram organizados num portefólio de aquisição de competências em suporte digital e que serviu de apoio à realização deste relatório. Por fim é apresentada a síntese e as conclusões do trabalho efectuado...

The Psychiatric Family Nurse Practitioner: A Collaborator in Family Practice

Cunningham, Patricia D.
Fonte: Physicians Postgraduate Press, Inc. Publicador: Physicians Postgraduate Press, Inc.
Tipo: Artigo de Revista Científica
Publicado em /02/1999 EN
Relevância na Pesquisa
46.1%
The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of health care delivery. At this time, dual certification as a Psych.C.N.S. and F.N.P. best reflects the broad practice expertise of the psychiatric family nurse practitioner. The experienced psychiatric family nurse practitioner provides direct care for both physical and psychological needs of patients in a family practice setting.

Cardiac catheterisation performed by a clinical nurse specialist.

Boulton, B. D.; Bashir, Y.; Ormerod, O. J.; Gribbin, B.; Forfar, J. C.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1997 EN
Relevância na Pesquisa
66.44%
OBJECTIVE: To establish the feasibility and safety of an appropriately trained clinical nurse specialist performing diagnostic cardiac catheterisation. DESIGN: Non-randomised retrospective comparison between the first 100 and second 100 consecutive investigations by a clinical nurse specialist and 200 consecutive patients investigated by two cardiology registrars over a similar period. SETTING: Regional cardiac centre performing 3200 catheterisation procedures per annum. PATIENTS: 200 patients undergoing routine (non-emergency) cardiac catheterisation for investigation of ischaemic heart disease. MAIN OUTCOME MEASURES: Procedural complications, image quality, fluoroscopy times. RESULTS: Satisfactory diagnostic images in all nurse specialist cases with no deaths and two complications (coronary artery dissection and femoral pseudoaneurysm). Procedure duration and fluoroscopy times slightly shorter for clinical nurse specialist by 3 and 1.6 minutes, respectively (P < 0.05). CONCLUSIONS: Non-medical practitioners can be trained to perform straightforward cardiac angiography in low risk patients with consultant supervision, as for cardiology registrars. With important restrictions such posts may have a limited role in supporting future consultant based services.

Cost effectiveness and cost utility analysis of multidisciplinary care in patients with rheumatoid arthritis: a randomised comparison of clinical nurse specialist care, inpatient team care, and day patient team care

van den Hout, W B; Tijhuis, G; Hazes, J; Breedveld, F; Vliet, V
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/2003 EN
Relevância na Pesquisa
66.13%
Objective: To assess the relative cost effectiveness of clinical nurse specialist care, inpatient team care, and day patient team care.

A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?

Donald, Faith; Kilpatrick, Kelley; Reid, Kim; Carter, Nancy; Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Kaasalainen, Sharon; Marshall, Deborah A.; Charbonneau-Smith, Renee; Donald, Erin E.; Lloyd, Monique; Wickson-Griffiths, Abigail
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.1%
Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles. Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization). Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012. Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n = 11), NP-transition (n = 5), NP-inpatient (n = 2), CNS-outpatient (n = 11), CNS-transition (n = 13), and CNS-inpatient (n = 1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity. Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education...

Concordance entre les interventions de l’infirmière et de médecins spécialistes dans la prise en charge des fractures de fragilisation

Senay, Andréa
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
46.26%
Introduction. L’ostéoporose est une maladie chronique habituellement asymptomatique jusqu’à ce qu’il y ait fracture de fragilisation (FF). Ces fractures engendrent des coûts importants dont une partie pourrait être évitée par la prise en charge de ces patients pour l’ostéoporose. L’implantation d’un programme de prévention des fractures subséquentes géré par des infirmières en orthopédie pourrait permettre de parer à ces problèmes. Objectifs. L’objectif principal de ce projet était de déterminer si une infirmière peut gérer de façon efficace et sécuritaire un service de liaison pour fracture. Méthode. Les décisions cliniques d’infirmières entre 2010 et 2012 pour 525 patients d’un service de liaison pour fracture à l’étude ont été évaluées par deux médecins spécialistes indépendants avec expertise dans les soins pour l’ostéoporose. Résultats. Les infirmières ont pu identifier la totalité des sujets à risque et référer 26.7% de ceux-ci à un spécialiste. L’accord entre chacun des évaluateurs et les infirmières était de >97%. Les évaluateurs ont donné les mêmes réponses à >96% pour chaque type de décision et le niveau d’accord inter-juge était presque parfait (AC1 >0.960). Aucune référence n’a été jugée inutile. Les comorbidités majeures ont toutes été prises en charge. Conclusion. L’accord élevé entre les décisions cliniques des infirmières et des médecins évaluateurs démontre que la prise en charge par une infirmière est sécuritaire et recommandable pour les patients avec FF. Ce type d’intervention pourrait contribuer à résoudre les problèmes d’accessibilité aux soins chez les patients avec fragilité osseuse...

The development of clinical nurse specialist roles in Ireland

Doody, Owen; Bailey, Maria E.
Fonte: Mark Allen Healthcare Publicador: Mark Allen Healthcare
Tipo: Article; all_ul_research; ul_published_reviewed; none
ENG
Relevância na Pesquisa
86.35%
peer-reviewed; While the term specialist in nursing can be traced to the turn of the 20th Century, it is only since 2001 that a framework was developed for a clinical career pathway in Ireland. This framework has promoted the development and expansion of the clinical nurse/midwife specialist (CNS/CMS) throughout Ireland over the past 10 years guided by the National Council for the Professional Development of Nursing and Midwifery (NCNM). To build upon the achievements of the NCNM and advance nursing practice, it is imperative that CNS/CMS’s adopt and fulfil the components of their role. Since CNS/CMS practice is relatively new to Ireland, there is the opportunity to learn from experiences of other countries. This article outlines the development and challenges of the CNS role in Ireland.

The role and development of consultancy in nursing practice

Doody, Owen
Fonte: Mark Allen Healthcare Publicador: Mark Allen Healthcare
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
ENG
Relevância na Pesquisa
66.28%
peer-reviewed; The term consultancy is used in many contexts. It has been applied to advanced nursing practice roles such as clinical nurse specialist, advanced nurse practitioner, nurse practitioner and other occupations. This causes confusion in the healthcare setting as the word is often used interchangeably between roles and has traditionally been used in a medical context. In addition, the development of nurse consultant posts has further compounded the uncertainty around consultancy. However, regardless of the role holder, consultancy in nursing is normally used in the context of a person in possession of expertise. This article describes consultancy in nursing; identifying its development, approaches, application and possibilities for the future.

Role of the gerontological nurse practitioner in Australia.

Lee, Caroline G.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2009
Relevância na Pesquisa
36.22%
The role of an aged care nurse practitioner (ACNP) is well recognised internationally however, in Australia, the implementation of this advanced role is still in its infancy with few gerontological nursing experts registered as nurse practitioners (NP). This single Victorian facility 2002 study was the first to consider the role of an ACNP in Australia and the first to describe the clinical and social benefits or otherwise of ACNP interventions in an Australian context. NP Studies in the Australian Capital Territory (ACT) from 1999 – 2002 investigated the role in other nursing domains followed by an ACNP study conducted over 2004-2005. A subsequent national ACNP study in 2005 provided complementary results to this first Australian ACNP study which created the framework for these subsequent projects. This study aimed to establish: clinical or other outcomes that a gerontological nurse practitioner (ACNPs) could achieve for older persons in an Australian residential aged care facility, factors that impacted upon the introduction of such a role, a definition of the role and to establish whether such a role would benefit older persons in Australia. Various methods were used to determine the numerous outcomes which were to be studied in this project. A quantitative analysis of the functional and social status of residents who participated in the project...

The experience of being an advanced practice nurse in Australian acute care settings: a systematic review of qualitative evidence

Ramis, M.A.; Pearson, A.; Wu, C.J.
Fonte: Joanna Briggs Institute Publicador: Joanna Briggs Institute
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
56.19%
BACKGROUND There is a vast amount of international literature which, although agreeing on the need for advanced practice nurse roles, simultaneously debates and discusses the difficulties with nomenclature, definition and subsequent implementation of such roles. Due to this ambiguity it is difficult to equally compare evidence in this field across different countries. A context-specific systematic review on the qualitative evidence of the experience of being an advanced practice nurse in Australia has not been undertaken previously, however it is imperative for nursing managers and leaders to understand the complexities of advanced nursing roles in order to effectively utilise and retain these experienced and valuable nurses. With the creation of a national nursing regulating authority in 2010, it is timely to explore in-depth the experience of being an advanced practice nurse from a national perspective. OBJECTIVE To identify the experience of being an advanced practice nurse working in Australian acute care settings. INCLUSION CRITERIA TYPES OF PARTICIPANTS Registered nurses working in advanced practice roles in acute care settings throughout Australia. PHENOMENA OF INTEREST The experience of being an advanced practice registered nurse working in an Australian acute care setting...

Experience of being an advanced practice nurse within Australian acute care settings: A systematic review of qualitative evidence

Ramis, M.A.; Wu, C.J.; Pearson, A.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
56.18%
BACKGROUND Nationally and internationally, advanced practice nurses are working under various titles and in different contexts to address gaps within healthcare systems. Analysis of advanced practice roles in different countries has been undertaken, but due to variations in cultural, geographical and professional factors, it is difficult and perhaps ineffectual to compare roles between countries. Contextual factors may also affect the actual experience of being an advanced practice nurse. A systematic review was therefore undertaken of qualitative evidence on the experience of being an advanced practice nurse in Australia, to provide deeper understanding of the role in the defined context. METHODS The review followed the method for qualitative synthesis as per the Joanna Briggs Institute. An extensive search was undertaken of databases and online resources to find published and unpublished studies. Papers from 1990 to October 2011 which met specified inclusion criteria were appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. RESULTS Three published studies and one unpublished dissertation were included in the review. From these studies, 216 findings were extracted and these were formed into 18 categories. Six meta-syntheses grouped under the headings of expert knowledge...

The experience of being an advanced practice nurse within Australian acute care settings: a systematic review of qualitative evidence.

Ramis, Mary-Anne
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2013
Relevância na Pesquisa
56.2%
Background: Shortages of health care professionals and an ageing nursing workforce are some of the factors leading to the creation and evolution of many new nursing roles. Advanced practice nurses across the globe are working under many different titles and within various contexts, in order to address gaps within current health care systems. Comparison of roles between countries is difficult and possibly inappropriate due to Australia’s unique environmental and demographic characteristics. A context-specific systematic review on the qualitative evidence of the experience of being an advanced practice nurse in Australia has not been undertaken previously, however it is imperative for nursing managers and leaders to understand the complexities of advanced nursing roles in order to effectively utilise and retain these experienced and valuable nurses. Aim: This study aims to provide deeper understanding of the experience of being an advanced practice nurse working in Australian acute settings and identify personal, professional and organisational factors influencing experiences. Methods: A three-step search strategy, following the Joanna Briggs Institute method was used to identify published and unpublished interpretive studies meeting set inclusion criteria. Critical appraisal and data extraction were completed the Joanna Briggs Institute Qualitative Assessment and Review Instruments. Results: Following the search and appraisal process...

Escuta ativa nos cuidados de enfermagem : uma intervenção confortadora

Martins, Patrícia Andreia Pimenta de Castro
Fonte: Universidade Católica Portuguesa Publicador: Universidade Católica Portuguesa
Tipo: Dissertação de Mestrado
Publicado em 02/12/2015 POR
Relevância na Pesquisa
46.19%
O presente Relatório de Atividades descreve, reflete, e analisa criticamente, o percurso realizado ao nível do Mestrado em Enfermagem na área de especialização em Enfermagem Médico-Cirúrgica, no Instituto de Ciências da Saúde - Universidade Católica Portuguesa (ICS-UCP). Com o intuito de adquirir e desenvolver competências na prestação de cuidados especializados à pessoa em situação crítica e sua família, realizei os meus Estágios nos seguintes serviços: Unidade de Cuidados Paliativos, Unidade de Cuidados Intensivos (UCI) e Atendimento Médico Permanente (AMP) do Hospital da Luz. A área transversal do meu percurso é a “Escuta Ativa nos cuidados de enfermagem – Uma intervenção confortadora”. A escuta ativa é uma arte situada no coração da prática do Enfermeiro e, por isso, cada um de nós deverá desenvolvê-la. Constitui-se a chave para a diminuição dos fatores de risco, impedindo complicações e melhora os resultados de saúde, permitindo que o cliente se sinta confortável, seguro e compreendido. No decorrer dos Estágios foi possível mobilizar esta área de conhecimento, tornando-a parte integrante do meu agir profissional, através da relação estabelecida com os clientes e sua família e da sensibilização dos enfermeiros para a sua prática na prestação de cuidados. Na Unidade de Cuidados Paliativos desenvolvi a temática inerente à promoção da Esperança nos cuidados de enfermagem com o objetivo de contribuir para a determinação do nível de esperança da pessoa internada. Realizei uma Ação de sensibilização...

Effectiveness of brief alcohol interventions by clinical nurse specialist (CNS) in primary care settings

Barroso, Tereza Maria Mendes Diniz de Andrade; Castanhola, Rui Alexandre Pereira; Matias, Marta Margarida Gonçalves; Claro, Maria Margarida Grácio da Silva
Fonte: WILEY-BLACKWELL PUBLISHING, INC, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA Publicador: WILEY-BLACKWELL PUBLISHING, INC, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA
Tipo: Outros
Publicado em 27/08/2010 ENG
Relevância na Pesquisa
66.22%
Excessive alcohol consumption is a major source of social, economic and health problems. Brief interventions (BI) are low in cost and have proven to be effective across the spectrum of alcohol problems (Babor and Higgins-Biddle, 2001). There have been numerous randomized clinical trials of brief interventions in a variety of health settings, finding that BI were often as effective as more extensive treatments (Bien et al., 1993; Kahan et al., 1995; Wilk et al. 1997). Brief interventions can help reduce the drinking levels of nondependent drinkers who drink more than the recommended limits. Adolescents and young people face a high risk of becoming heavy drinkers and experiencing negative consequences of alcohol use. Brief interventions, aimed at young people, are very important, namely because is the heaviest drinking period in life and young people do not see drinking as a problem. Despite the evidence for their usefulness, however, brief interventions for alcohol-related problems have not yet been widely implemented in Portugal primary care settings. Aim: evaluation of the effectiveness of Clinical Nurse Specialist screening and brief intervention in reducing excessive alcohol consumption among young people (students curso de formação profissional) Methods: Pre-experimental design...

The development of competency standards for specialist critical care nurses

Dunn, S.; Lawson, D.; Robertson, S.; Underwood, M.; Clark, R.; Valentine, T.; Walker, N.; Wilson-Row, C.; Crowder, K.; Herewane, D.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
Relevância na Pesquisa
36.38%
In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice...

Hospital nurse staffing models and patient and staff-related outcomes

Butler, M.; Collins, R.; Drennan, J.; Halligan, P.; O'Mathuna, D.; Schultz, T.; Sheridan, A.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
36.4%
BACKGROUND: Nurse staffing interventions have been introduced across countries in recent years in response to changing patient requirements, developments in patient care, and shortages of qualified nursing staff. These include changes in skill mix, grade mix or qualification mix, staffing levels, nursing shifts or nurses' work patterns. Nurse staffing has been closely linked to patient outcomes, organisational outcomes such as costs, and staff-related outcomes. OBJECTIVES: Our aim was to explore the effect of hospital nurse staffing models on patient and staff-related outcomes. SEARCH STRATEGY: We searched the following databases from inception through to May 2009: Cochrane/EPOC resources (DARE, CENTRAL, the EPOC Specialised Register), PubMed, EMBASE, CINAHL Plus, CAB Health, Virginia Henderson International Nursing Library, the Joanna Briggs Institute database, the British Library, international theses databases, as well as generic search engines. SELECTION CRITERIA: Randomised control trials, controlled clinical trials, controlled before and after studies and interrupted time series analyses of interventions relating to hospital nurse staffing models. Participants were patients and nursing staff working in hospital settings. We included any objective measure of patient or staff-related outcome. DATA COLLECTION AND ANALYSIS: Seven reviewers working in pairs independently extracted data from each potentially relevant study and assessed risk of bias. MAIN RESULTS: We identified 6...

Symptoms and problems in the end-of-life phase of high-grade glioma patients

Sizoo, Eefje M.; Braam, Lies; Postma, Tjeerd J.; Pasman, H. Roeline W.; Heimans, Jan J.; Klein, Martin; Reijneveld, Jaap C.; Taphoorn, Martin J. B.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.87%
Despite multimodal treatment, it is not possible to cure high-grade glioma (HGG) patients. Therefore, the aim of treatment is not only to prolong life, but also to prevent deterioration of health-related quality of life as much as possible. When the patient's condition declines and no further tumor treatment seems realistic, patients in the Netherlands are often referred to a primary care physician for end-of-life care. This end-of-life phase has not been studied adequately yet. The purpose of this study was to explore specific problems and needs experienced in the end-of-life phase of patients with HGG. We retrospectively examined the files of 55 patients who received treatment in our outpatient clinic and died between January 2005 and August 2008. The clinical nurse specialist in neuro-oncology maintained contact on a regular basis with (relatives of) HGG patients once tumor treatment for recurrence was no longer given. She systematically asked for signs and symptoms. The majority of the patients experienced loss of consciousness and difficulty with swallowing, often arising in the week before death. Seizures occurred in nearly half of the patients in the end-of-life phase and more specifically in one-third of the patients in the week before dying. Other common symptoms reported in the end-of-life phase are progressive neurological deficits...

The informational roles and psychological health of members of 10 oncology multidisciplinary teams in the UK

Catt, S; Fallowfield, L; Jenkins, V; Langridge, C; Cox, A
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.32%
We report here the different roles undertaken by the members of 10 multidisciplinary cancer teams in conveying information to patients during their care. Team members completed an Informational Roles Questionnaire measuring an individual's perception of their major role and that of their colleagues in giving information to patients. They also completed two standard psychological health measures, the General Health Questionnaire and Maslach Burnout Inventory. The information giving roles of the surgeon, oncologist, radiologist and clinical nurse specialist were well recognised by their colleagues; however, other team members' roles were more ambiguous and less well understood. The clinical nurse specialist provided the broadest information coverage for patients. Few professional groups regularly informed patients about clinical trials and family history and the clinical nurse specialist was often the only person to deal with patients' sexual well being, consequently these areas are likely to receive poor coverage. Probable psychiatric morbidity (GHQ⩾4) in teams ranged from 5 to 27%. High levels of emotional exhaustion were particularly apparent in team leaders and nurses and feelings of low levels of personal accomplishment were prevalent in the histopathologists and radiologists. Putative benefits to patients and healthcare professionals from multidisciplinary team working may not be realised without investment in team training.

Clinical Nurse Specialist: a model of advanced nursing practice in pediatric oncology in Brazil; Enfermero Clinico Especialista: un modelo de practica avanzada de enfermeria en oncologia pediatrica en el Brasil; Enfermeiro Clinico Especialista: um modelo de pratica avancada de enfermagem em oncologia pediatrica no Brasil

Dias, Carla goncalves; Duarte, Adriana Maria; Ibanez, Adriane da Silva Santos; Rodrigues, Daniela Bonfietti; Barros, Daniele Porto; Soares, Juliana dos Santos; Perin, Juliana Pepe Marinho; Santos, Nancy da Silva; Paiva, Priscila Mendes; Gutierrez, Maria G
Fonte: Universidade de São Paulo. Escola de Enfermagem Publicador: Universidade de São Paulo. Escola de Enfermagem
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf; application/pdf
Publicado em 01/12/2013 POR; ENG
Relevância na Pesquisa
66.37%
The objective of this paper is to report the experience of implementing a model of advanced nursing practice that integrates a clinical nurse specialist into the nursing staff. The authors describe the concept of this model and the process of its implementation in a pediatric oncology reference institution in the city of São Paulo, Brazil. The main result achieved in evaluating the clinical nurse specialist was strengthening of the role of the nurse as a reference professional for the articulation of the various demands of care in assisting the child, adolescent or young adult with cancer and his/her family. The satisfaction of these users due to the closer relationship between the patient, family and clinical nurse in all stages of the caring process also stands out.; El objetivo de este artículo es relatar la experiencia de implantación de un modelo de práctica avanzada en enfermería, por medio de la incorporación del enfermero clínico especialista en la composición del cuadro de personal de enfermería. Las autoras presentan el concepto de este modelo y describen el proceso de implantación en una institución de referencia para el cuidado de niños y adolescentes con cáncer de la ciudad de São Paulo, Brasil. Las enfermeras clínicas especialistas evalúan que el principal resultado de la adopción de este modelo fue el fortalecimiento del rol del enfermero como profesional de referencia para la articulación de las diferentes demandas de cuidado para la atención a los niños...