Concepções da equipe multiprofissional sobre a implementação dos cuidados paliativos na unidade de terapia intensivaPerceptions of the multi-professional team on the implementation of palliative care in intensive care units

Submissão: 02-03-2011 aprovação: 26-11-2012ReSUmO Objetivou-se identificar, na ótica do cuidador, mudanças ocorridas nas relações familiares após evento gerador de dependência no idoso e os fatores causadores. Trata-se de um estudo de campo, com abordagem qualitativa. Realizou-se entrevista gravada, com questões norteadoras e observações registradas em diário de campo, com oito cuidadores familiares, durante visitas domiciliares. Aplicou-se análise de conteúdo de Bardin, sendo construídas categorias e subcategorias. A união familiar preexistente à dependência predispõe alterações positivas, favorecida com suporte formal e informal. A sobrecarga do cuidador familiar, por falta de apoio, pela idade e atividades do cuidador, leva a situações negativas na família. A efetividade das políticas públicas para prestar suporte formal aos idosos e seus cuidadores, e a criação de grupos de apoio, podem contribuir no bem estar da família. descritores: Cuidadores; Idosos Dependentes; Relações Familiares; Enfermagem. aBStRaCt The study aimed to identify, in the view of the caretaker, the changes that happened in the family relationships after a dependence generator event on aged person, and the factors that provoked it. It is a field study with a qualitative approach. It was carried out recorded interviews with eight family caregivers, during home visits, with guiding questions and observations being recorded in a field diary. The content analysis of Bardin was applied, being constructed categories and subcategories. The familiar union preexisting to the dependence situation predisposes positive changes, favored with formal and informal support. The family caregiver burden due to lack of support, age and activities of caregiving, leads to negative situations in the family. The effectiveness of public policies to provide formal support for the elderly and their caregivers, and the creation of support groups, may contribute to the family wellbeing. Key words: Caregivers; Frail Elderly; Family Relations; Nursing. ReSUmeNObjetivó-se identificar cambios ocurridos en las relaciones familiares, posterior al evento generador de dependencia en el mayor y los factores causales. Estudio de campo con un enfoque cualitativo. La colecta fue hecha a través de observaciones registradas en diario de campo y cuestionario aplicado a ocho cuidadores familiares, durante visitas domiciliares. Se utilizó el análisis de contenido de Bardin, siendo construidas categorías y subcategorias. La unión familiar preexistente a la dependencia predispone a alteraciones positivas y apoyo familiar, favorecida con soporte formal e informal. La sobrecarga del cuidador familiar, por falta del soporte y del apoyo de los otros familiares, por la edad y actividades del cuidado, llevó a situaciones negativas en la familia. La efectividad de las políticas públicas para ofrecer soporte formal a los mayores y sus cuidadores, la creación de grupos de apoyo, puede garantizar calidad en el atendimiento de las necesidades y contribuir al bienestar familiar.

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Objective: to identify evidence of scientific production on hospital transition care provided to the elderly. Method: an integrative review, with publications search in the MEDLINE, PubMed, LILACS, BDENF, Index Psychology and SciELO databases, with keywords and Mesh terms: elderly, hospitalization, patient discharge, health of the elderly, and transitional care, between 2013 and 2017 in English, Portuguese and Spanish. The 14 selected articles analysis was carried out through exploratory and critical reading of titles, abstracts and results of the researches. Results: transitional care can prevent re-hospitalizations as they enable rehabilitation, promotion and cure of illnesses in the elderly. Final considerations: transitional care implies the improvement of the quality of life of the elderly person, requiring skilled health professionals who involve the family through accessible communication.

This research can help health professionals better understand the worldliness of older caregivers. Such understanding will enhance the assistance available to caregivers, which must extend beyond the care of the sick person: interventions can reduce their overburden and risk of illness, improving their experiences as caregivers and their quality of life.

Objective: to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients. Method: this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil. Results: ten problems regarding nursing practices for prevention and monitoring of delirium were identifi ed. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported signifi cant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation. Conclusion: the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments. Descriptors: Delirium; Dementia; Amnestic Disorder, and Other Cognitive Disorders; Older adults; Nursing Team. RESUMO Objetivo: realizar uma intervenção educativa com membros da equipe de enfermagem de uma unidade de terapia intensiva (UTI), com vistas a ampliar o conhecimento e introduzir melhorias nas suas práticas de prevenção e monitorização do delirium nos pacientes idosos. Método: pesquisa-ação em que foram realizadas ofi cinas com onze enfermeiras e uma técnica em enfermagem de uma UTI de Salvador, Bahia-Brasil. Resultados: dez problemas relacionados a práticas de enfermagem para prevenção e monitorização do delirium foram identifi cados. Planejaram-se ações de caráter educativo, prático, técnico e gerencial, envolvendo a articulação intersetorial para o equacionamento desses problemas. O grupo relatou mudanças signifi cativas nas práticas, com a implementação de medidas não farmacológicas para prevenção e gestão do quadro. Conclusão: a intervenção educativa contribuiu para a melhoria nas práticas da enfermagem da UTI pesquisada, assim como favoreceu o desenvolvimento da consciência crítica acerca da problemática levantada, possibilitando a revisão permanente do cuidado ofertado. Descritores: Delirium; Demência; Transtorno Amnéstico e Outros Transtornos Cognitivos; Idoso; Equipe de Enfermagem. RESUMENObjetivo: realizar intervención educativa en un personal de enfermería de una unidad de cuidados intensivos (UCI), con el objetivo de ampliarles conocimiento e introducirles mejoras en sus prácticas de prevención y monitorización del delirium al tener a las personas mayores como pacientes. Método: investigación-acción en la que se llevaron a cabo talleres con 11 enfermeras y 1 técnica de enfermería de una UCI de Salvador de Bahía. Resultados: se identifi caron diez problemas relacionados a las prácticas de enfermería en la prevención y monitorización del delirium. Se planearon acciones educativas, prácticas, técnicas y de gestión, que implican ...

Objective: to identify factors inherent in hospital care that favor urinary incontinence in the elderly. Method: an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model. Results: 13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly. Conclusion: modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.

Objective: To know the health-related consequences of caring for dependent relatives in older adult caregivers. Method: Qualitative research carried out with older adult women who cared for family members enrolled in a federal public home care program. The identification of the older adult caregivers was done by consulting the patient's charts, and the interview took place from March to June 2017. The data were systematized based on Content Analysis. Results: Six older adult caregivers of people with impaired functional capacity participated in the study. Three categories emerged: care-related musculoskeletal pain; health problems related to the somatization of the lived feeling; and self-care deficit by virtue of caring for another. Conclusion: The study revealed the consequences of caring for dependent family members on the health of older adult caregivers. Careful management is essential to prevent and/or reduce health problems, especially regarding the musculoskeletal system. Health-related consequences of caring for dependent relatives in older adult caregivers*Consequências do cuidado para a saúde de idosas cuidadoras de familiares dependentes Consecuencias del cuidado para la salud de las ancianas cuidadoras de familiares dependientes