RESUMO
BACKGROUND: The Chronic Care Model promotes the link between informed, activated patients with proactive and prepared health care teams. AIM: To evaluate the effect of an intervention aimed at strengthening the implementation of the Chronic Care Model in the care provided by health teams to users with chronic diseases. MATERIAL AND METHODS: Quasi-experiment study. Four health centers were randomly selected, divided into intervention and control groups, with 86 participants who met the selection criteria and agreed to participate in the study. A blended learning training program, lasting six months, was applied in intervened centers to incorporate the elements of the Chronic Care Model. The results were assessed using the questionnaire "Assessment of chronic illness care, internal client version 3.5" adapted to Chilean Spanish. RESULTS: A significant post-intervention improvement in the global score of attention evaluation was observed in the group that received the intervention, changing from basic su- pport to reasonably good support. Also, specific improvements were seen in five sections of the attention assessment. CONCLUSIONS: This intervention improved the evaluation of chronic disease care in the intervention group.
Assuntos
Humanos , Pessoal de Saúde/educação , Chile , Doença CrônicaRESUMO
BACKGROUND: The Chronic Care Model promotes the link between informed, activated patients with proactive and prepared health care teams. AIM: To evaluate the effect of an intervention aimed at strengthening the implementation of the Chronic Care Model in the care provided by health teams to users with chronic diseases. MATERIAL AND METHODS: Quasi-experiment study. Four health centers were randomly selected, divided into intervention and control groups, with 86 participants who met the selection criteria and agreed to participate in the study. A blended learning training program, lasting six months, was applied in intervened centers to incorporate the elements of the Chronic Care Model. The results were assessed using the questionnaire "Assessment of chronic illness care, internal client version 3.5" adapted to Chilean Spanish. RESULTS: A significant post-intervention improvement in the global score of attention evaluation was observed in the group that received the intervention, changing from basic su- pport to reasonably good support. Also, specific improvements were seen in five sections of the attention assessment. CONCLUSIONS: This intervention improved the evaluation of chronic disease care in the intervention group.
Assuntos
Pessoal de Saúde , Humanos , Pessoal de Saúde/educação , Doença Crônica , ChileRESUMO
RESUMEN Objetivo: Identificar las barreras percibidas por las enfermeras(os) en la implementación de los hallazgos de la investigación y las sugerencias establecidas para su abordaje. Material y método: Revisión sistematizada de la literatura en las bases de datos de Web of Science y Pubmed, utilizando los términos Barriers and Research Utilization and Nursing, publicados entre los años 2008 al 2014. El total de artículos recuperados fue de 158, luego de aplicar los criterios de inclusión y exclusión, 22 artículos fueron elegibles para revisión: 15 artículos de Web of Science y 7 de Pubmed. Resultados: Las principales barreras identificadas fueron falta de tiempo, falta de conocimiento de las enfermeras(os) en investigación, falta de autoridad y/o autonomía de las enfermeras(os) en la implementación de resultados que lleven a cambios en los cuidados otorgados a las personas y falta de apoyo organizacional. Las principales sugerencias de enfrentamiento fueron: apoyo organizacional y formación de enfermeras en investigación. Conclusión: Existen diversas barreras que dificultan la implementación en los hallazgos de la investigación, las que han permanecido en el tiempo y no son diferentes entre países. Es opor tuno comenzar a realizar intervenciones efectivas sobre las sugerencias de enfrentamiento y así favorecer el uso de los resultados de la investigación en la práctica clínica y de esta manera contribuir a elevar la calidad de los cuidados de enfermería.
ABSTRACT Objective: To identify barriers perceived by male and female nurses in the implementation of research findings and the suggestions set forth for this approach. Method: Systematized review of the literature in the databases PubMed and Web of Science using the terms Barriers and Nursing Research Utilization and published between the years 2008 and 2014; the total of articles recovered was 158. After applying the inclusion and exclusion cri teria, 22 articles were eligible for reviewing: 15 articles from Web of Science and 7 from PubMed. Results: The main barriers identified were lack of time, nurses lack of knowledge about in researching, lack of authority and/ or autonomy of nurses in the implementation of results that lead to changes in the care provided to people, and also lack of organizational support. The main suggestions of improvement were: organizational support and training of nurses in researching. Conclusion: There are various barriers to the implementation of research findings, which have remained over time and are similar among countries. It is necessary to implement effective interventions based on the suggestions of confrontation and thus promote the use of research findings in clin ical practice and also to contribute to the improvement of the quality of nursing care.
Assuntos
Humanos , Pesquisa em Enfermagem , Difusão de Inovações , Enfermagem Baseada em Evidências/educação , Lacunas da Prática Profissional , Desempenho Profissional , Enfermeiras e EnfermeirosRESUMO
OBJECTIVE: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. METHOD: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. RESULTS: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. CONCLUSION: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life.
Assuntos
Doenças Cardiovasculares/enfermagem , Aconselhamento Diretivo/métodos , Telefone , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Autoeficácia , Método Simples-Cego , Apoio SocialRESUMO
Abstract Objective: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. Method: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. Results: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. Conclusion: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life.
Resumen Objetivo: evaluar efecto y diferencias por sexo de una intervención innovadora "Consejería de Enfermería Personalizada y Telefónica", dirigida al control de factores de riesgo cardiovascular (hipertensión arterial, dislipidemia y sobrepeso) y al mejoramiento de la calidad de vida relacionada con la salud, fortaleciendo la autoeficacia y el apoyo social en personas usuarias del programa de salud cardiovascular de los Centros de Salud Municipales de Concepción. Método: ensayo clínico controlado aleatoriamente y selección aleatoria de participantes; grupo intervención con consulta tradicional más consejería de enfermería personalizada y telefónica durante 7 meses (n=53); y grupo control (n=56); siguiendo la declaración del Consolidated Standards of Reporting Trials. Resultados: mujeres del grupo intervención, presentaron aumento significativo con respecto al grupo control, en componentes de salud física y mental; disminución de: peso, circunferencia abdominal, colesterol total, colesterol lipoproteínas de baja densidad e índice de aterogenicidad. En hombres del grupo intervención se reflejó como efectos atribuibles a la intervención: 1) aumento en dimensiones del rol físico y emocional; 2) disminución: presión sistólica y diastólica, circunferencia abdominal, colesterol total, colesterol lipoproteínas de baja densidad, índice de aterogenicidad, factor de riesgo cardiovascular y riesgo coronario a 10 años. Conclusión: esta intervención es una estrategia efectiva para el control de tres factores de riesgo cardiovascular y mejoría de calidad de vida relacionada con la salud.
Resumo Objetivo: avaliar o efeito e as diferenças por sexo de uma intervenção inovadora: o aconselhamento personalizado e por telefone em enfermagem, visando o controle de fatores de risco cardiovascular (hipertensão arterial, dislipidemia e sobrepeso) e a melhora na qualidade de vida relacionada à saúde, fortalecendo a autoeficácia e o apoio social a pessoas que usam o programa de saúde cardiovascular de Centros Municipais de Saúde. Método: ensaio clínico controlado e randomizado, participantes randomizados, grupo de intervenção: consulta tradicional mais aconselhamento personalizado e por telefone em enfermagem por 7 meses (n = 53); e grupo de controle (n = 56); seguindo a declaração Consolidated Standards of Reporting Trials Statement. Resultados: mulheres do grupo intervenção apresentaram um aumento significativo, em relação ao grupo controle, nos componentes de saúde mental e física, com diminuição do peso, circunferência abdominal, colesterol total, colesterol de lipoproteínas de baixa densidade e índice aterogênico. Em homens do grupo intervenção, os efeitos atribuíveis à intervenção foram: aumentos nos papeis físicos e emocionais, com diminuições na pressão sistólica e diastólica, circunferência abdominal, colesterol total, colesterol de lipoproteínas de baixa densidade, índice aterogênico, fator de risco cardiovascular e risco coronariano em 10 anos. Conclusão: essa intervenção é uma estratégia eficaz para o controle dos três fatores de risco cardiovascular e a melhora da qualidade de vida relacionada à saúde.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Telefone , Doenças Cardiovasculares/enfermagem , Aconselhamento Diretivo/métodos , Qualidade de Vida , Apoio Social , Método Simples-Cego , Fatores de Risco , AutoeficáciaRESUMO
The objective was to describe the sexual life satisfaction of couples in the climacteric stage and determine whether there are differences between the perception of satisfaction and the sex life of each partner. We studied 142 couples obtained by stratified sampling of family health centers, Concepción, Chile. 66% of women and 84% of men reported being very or somewhat satisfied with their sex lives. Slight concordance was found between the responses of the partners in relation to satisfaction with their sexual life. Moreover, a slight degree of agreement was found between the sexual life satisfaction reported by women and their partners' perceptions of the women's sexual life satisfaction. Additionally, a slight degree of agreement was reported between the sexual life satisfaction reported by men and their partners' perceptions of the men's sexual life satisfaction. This study provides new information about Chilean couples in the climacteric stage in relation to self-reported sexual satisfaction and perceived satisfaction in couples.
Assuntos
Andropausa , Características da Família , Menopausa/psicologia , Comportamento Sexual/fisiologia , Parceiros Sexuais , Adulto , Chile , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Percepção , Satisfação Pessoal , Fatores SocioeconômicosRESUMO
The objective was to describe the sexual life satisfaction of couples in the climacteric stage and determine whether there are differences between the perception of satisfaction and the sex life of each partner. We studied 142 couples obtained by stratified sampling of family health centers, Concepción, Chile. 66% of women and 84% of men reported being very or somewhat satisfied with their sex lives. Slight concordance was found between the responses of the partners in relation to satisfaction with their sexual life. Moreover, a slight degree of agreement was found between the sexual life satisfaction reported by women and their partners' perceptions of the women's sexual life satisfaction. Additionally, a slight degree of agreement was reported between the sexual life satisfaction reported by men and their partners' perceptions of the men's sexual life satisfaction. This study provides new information about Chilean couples in the climacteric stage in relation to self-reported sexual satisfaction and perceived satisfaction in couples.
O objetivo foi descrever a satisfação com a vida sexual dos casais no período do climatério e determinar se existem diferenças entre as percepções da satisfação com a vida sexual de cada membro do casal. Foram seleccionados cento e quarenta e dois casais por meio de uma amostragem estratificada dos centros de saúde familiar em Concepción, Chile. Sessenta e seis porcento das mulheres e 84% dos homens relataram ser muito ou moderadamente satisfeitos com suas vidas sexuais. Verificou-se uma leve concordância entre as respostas de cada membro do casal em relação à satisfação com a vida sexual. Também identificou-se um leve grau de concordância entre a satisfação com a vida sexual referida pela mulher e a percepção da satisfação com a vida sexual que seu parceiro tem dela. Da mesma forma, verificou-se um discreto grau de acordo para a referida pelo homem e a percepção da satisfação com a vida sexual que sua companheira tem dele. É oferecida uma nova informação a respeito dos casais chilenos no período do climatério, em relação à satisfação sexual autoinformada e a satisfação percebida no parceiro, evidenciando-se a diferença da percepção entre os casais.
El estudio describe la satisfacción con la vida sexual de parejas en etapa de climaterio, además de determinar si existen diferencias entre las percepciones de satisfacción con la vida sexual de cada miembro de la pareja. Se estudiaron 142 parejas, obtenidas mediante muestreo estratificado en centros de salud familiar de Concepción, Chile. Un 66% de mujeres y un 84% de hombres informaron sentirse muy o algo satisfechos con su vida sexual de pareja. Se encontró una concordancia leve entre las respuestas de cada miembro de la pareja, en relación con la satisfacción en la vida sexual. También, se encontró un grado de acuerdo leve entre satisfacción con la vida sexual informada por la mujer y la percepción de satisfacción con la vida sexual que su pareja tiene de ella. Asimismo, se reportó un grado discreto de acuerdo para la satisfacción con vida sexual referida por el hombre y la percepción de satisfacción con la vida sexual que su pareja tiene de él. Este estudio proporciona nueva información respecto a parejas chilenas en etapa de climaterio, en relación con la satisfacción sexual autoinformada y percibida en la pareja.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Andropausa , Características da Família , Menopausa/psicologia , Parceiros Sexuais , Comportamento Sexual/fisiologia , Chile , Estudos Transversais , Relações Interpessoais , Percepção , Satisfação Pessoal , Fatores SocioeconômicosRESUMO
Antecedentes: para gestionar el cuidado del grupo familiar resulta útil conocer cuál es su situación de salud y la estratificación de las familias según tal condición. Objetivos: determinar la situación de salud de las familias inscritas en el CESFAM Lorenzo Arenas de Concepción, Chile y determinar la aceptación de la intervención familiar por parte del jefe de hogar y del grupo familiar. Métodos: diseño transversal y descriptivo. El universo estuvo constituido por 5591 familias inscritas en el CESFAM Lorenzo Arenas y la muestra correspondió a 204 familias seleccionadas mediante muestreo probabilístico. Se trabajó con un 95 por ciento de confianza y un intervalo de confianza del 5 por ciento. Se utilizó como instrumentos de recolección de datos un cuestionario de antecedentes biodemográficos, la prueba de percepción de funcionamiento familiar (FF-SIL), el inventario de características familiares de riesgo y la matriz de salud familiar. Se aplicó a los jefes de familias previo consentimiento informado. El procesamiento de datos se realizó con el programa SPSS 17.0 y para su análisis se utilizó estadística descriptiva. Resultados: el 75 por ciento de las familias clasificó en la zona de elevada criticidad y buen funcionamiento intrafamiliar, el 22 por ciento presentó ajuste familiar, el 3 por ciento presentó afección de extrema gravedad, con elevada criticidad y disfuncionalidad. No se presentaron casos de relaciones intrafamiliares disfuncionales con baja criticidad. El 74 por ciento de los jefes de hogar declararon que aceptarían la intervención familiar y el 42 por ciento declararon que todo el grupo familiar la aceptaría. Conclusiones: predominan las familias con afección grave dada por la criticidad familiar, de ellas un alto porcentaje aceptaría la intervención del equipo de salud. Esta información orienta la gestión del cuidado y la elaboración de un plan de cuidado para las familias de esta localidad(AU)
Background: to manage the family group care, it is useful to know the health situation and the stratification of the families according to their conditions. Objectives: to determine the health situations of families registered at CESFAM Lorenzo Arenas de Concepcion in Chile and to determine the acceptance of family intervention by the head of the household and the family group. Methods: cross-sectional and descriptive design. The universe of study was formed by 5591 families registered at CESFAM Lorenzo Arenas and the final sample consisted of 204 families selected by the probabilistic sampling. The confidence index of 95 percent and the confidence interval was 5 percent. The instruments of data collection were a questionnaire on biodemographic antecedents, the family functioning perception test, the inventory of risky family characteristics and the family health matrix. It was all applied to the heads of households after informed consent. SPSS program 17.0 served to process data which were analyzed through summary statistics. Results: in the group, 75 percent of families classified into the highly critical condition area and good intrafamily functioning, 22 percent presented family adjustment, 3 percent had extremely severe problems, highly critical conditions and dysfunctionality. There was no case of dysfunctional intrafamily relationships with low critical conditions. In this study, 74 percent of the heads of households stated that they would accept family intervention and 42 percent said that the whole family group would also do it. Conclusions: predominance of families with serious illnesses due to highly critical conditions in the family, a high percentage of which would accept the health team intervention. This information is useful to direct the care management and the preparation of a care program aimed at the families living in this locality(AU)
Assuntos
Humanos , Saúde da Família/tendências , Enfermagem Familiar/métodos , Medicina de Família e Comunidade/métodos , Epidemiologia Descritiva , Estudos Transversais , Coleta de Dados/estatística & dados numéricosRESUMO
El presente artículo tiene por objetivo exponer de forma general la visión de la Escuela del pensamiento Humanbecoming de Parse, como una alternativa para guiar la práctica de la Enfermería, evidenciándose a través de las investigaciones que se han desarrollado con esta teoría en el ejercicio profesional. Para ello se enfatiza en los principios, conceptos, paradojas y postulados de la Teoría Humanbecoming, la cual se centra en el accionar del ser humano, su calidad de vida y salud, a partir de sus contextos, vivencias y creencias. Dichos fundamentos teóricos son desarrollados a partir de la filosofía de la ciencia humana y del existencialismo, los cuales se fusionan y entregan un innovador esquema para la disciplina de Enfermería. Además se aborda la propuesta que hace esta Escuela a los y las profesionales de Enfermería para vivenciar el Humanbecoming, a partir de las herramientas que otorga para guiar la práctica profesional.
This article aims to expose the vision of the School of Parse Humanbecoming School of Thought, as an alternative to guide nursing practice, thus evidence by the research that has been developed with this theory in practice. For this, the principles, concepts, paradoxes and postulates of the Humanbecoming theory are enphasized, which focuses on the actions of human beings, their quality of life and health, from their contexts, experiences and beliefs. These theoretical foundations are developed from the philosophy of human science and existentialism; both philosophies deliver an innovative work plan for the nursing discipline. It also addresses this school proposal to the nursing professionals to experience the Humanbecoming, from the tools granted to guide professional practice.
Assuntos
Humanos , Cuidados de Enfermagem/métodos , Humanismo , Teoria de Enfermagem , Modelos de Enfermagem , Filosofia em EnfermagemRESUMO
The aim of this paper is to develop applications of Orem's Theory of Self Care in order to address nursing interventions during pregnancy and menopause, and to determine its usefulness as a theoretical framework for addressing self care during stages of development. It is concluded that the application by nurses and midwives of this theoretical framework, in assisting women during pregnancy and menopause, contributes to identifying the requirements of self care, the required interventions, necessity of self care and the methods of assistance that women require with special emphasis on training and development of self care procedures.
Assuntos
Menopausa , Teoria de Enfermagem , Enfermagem , Autocuidado , Feminino , Humanos , GravidezRESUMO
El objetivo de este trabajo es desarrollar aplicaciones de la teoría de Autocuidado de Orem, para el abordaje de intervenciones de enfermería el embarazo y climaterio, y determinar su utilidad como un marco teórico para el abordaje del autocuidado durante las fases de desarrollo. Se concluye que la aplicación de este marco teórico, en la asistencia de mujeres durante el embarazo y climaterio, por parte de enfermeras y enfermeras obstétricas contribuye a identificar los requisitos de autocuidado, las intervenciones requeridas, la necesidad de autocuidado y los métodos de ayuda que las mujeres requieren con especial énfasis en la capacitación y desarrollo de la capacidad de autocuidado.
O objetivo deste trabalho foi desenvolver aplicações da Teoria do Autocuidado de Orem para realizar intervenções em enfermagem durante a gestação e climatério, mas tentamos também determinar a sua utilidade como marco teórico para pensar (ou) planejar o autocuidado nestas fases da vida da mulher. Pudemos observar que a aplicação desta teoria e a sua utilidade como marco teórico na assistência à mulheres durante a gestação e climatério, por parte de enfermeiras e enfermeiras obstétricas, contribuiu não só para identificar os requisitos necessários para o autocuidado e planejar as intervenções requeridas e as necessidades específicas de autocuidado, mas constatamos também que esta pode ser a base para elaboração de métodos de desenvolvimento da ampliação da capacidade feminina para o auto-cuidado.
The aim of this paper is to develop applications of Orem's Theory of Self Care in order to address nursing interventions during pregnancy and menopause, and to determine its usefulness as a theoretical framework for addressing self care during stages of development. It is concluded that the application by nurses and midwives of this theoretical framework, in assisting women during pregnancy and menopause, contributes to identifying the requirements of self care, the required interventions, necessity of self care and the methods of assistance that women require with special emphasis on training and development of self care procedures.