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Abstract(s)
A partir de investigações nacionais e estrangeiras constata-se a existência de dissonância entre o objecto de estudo da disciplina referida nos “modelos expostos” na teoria de enfermagem e os “modelos em uso” no contexto da acção. Assim, formulámos a pergunta de partida: A intencionalidade subjacente à concepção de cuidados de enfermagem dos novos enfermeiros – estudantes finalistas – contribuirá para a diminuição do distanciamento actualmente verificado entre os modelos em uso na prática e os modelos expostos na teoria de enfermagem?
Foi desenvolvido um inquérito electrónico, no qual cada estudante foi colocado face a um cenário clínico concreto, sendo-lhe pedido que solicitasse ao investigador dados iniciais. Munido das respostas aos dados iniciais foi-lhe então solicitado que identificasse os diagnósticos de enfermagem,
definisse os objectivos e planeasse as intervenções. A amostra foi constituída por 128 estudantes finalistas dos cursos superiores de enfermagem das escolas portuguesas – que aderiram ao estudo –
no ano lectivo 2006/2007, e que voluntariamente aceitaram participar. Recolhidos os dados procedemos à análise de conteúdo. As dimensões, categorias e subcategorias, que resultaram do processo de análise permitiram-nos construir um questionário administrado a um grupo de peritos nacional que pontuou a relevância de cada categoria e subcategoria em duas perspectivas: “gestão de sinais e sintomas da doença” e “resposta humana às transições”. A fiabilidade das medições e a
consistência interna achada pelo cálculo do Alpha de Cronbach permitiu-nos evoluir para
procedimentos estatísticos que possibilitaram atingir os objectivos definidos e assegurar a validade interna das conclusões a partir desses dados.
Os resultados mostram que a concepção de cuidados na perspectiva da “gestão de sinais e sintomas da doença” é mais consistente, com maior especificidade na explanação, revelando maior domínio do conhecimento formal envolvido. Nesta perspectiva, os cuidadores familiares tendem a ser vistos, mais como meio para prover os cuidados necessários ao doente, do que como pessoas a viverem uma transição. Na perspectiva da concepção de cuidados focada na “resposta humana às transições” há intenção dos estudantes em integrar aspectos característicos dos focos de atenção de enfermagem diluídos, no entanto, na elevada e inconsistente quantidade de dados solicitados. Há uma correlação positiva entre a nota de acesso ao ensino superior dos estudantes da amostra e a qualidade da
concepção de cuidados.
Constata-se a necessidade de promover a sistematização na explanação da concepção de cuidados, bem como a necessidade de modelos operativos e de mais conhecimento formal.
From Portuguese and international research it is noticed the existence of dissonance between the core of discipline referred to in "exposed models” in nursing theory and “models in use" in the context of professional practice. Thus, we have assumed the research question: does the intentionality that underlies the conception of nursing care of new nurses – finalist students – contribute to the decrease of dissonance verified between the professional exercise models in use in practice and models exposed in nursing theory. Was developed an electronic inquiry through which each student faces a specific clinical vignette and is invited to ask for the necessary clinical data to initiate a diagnostic reasoning. Fitted with the responses to the initial data, then the student was asked to identify nursing diagnoses, define the objectives and plan nursing interventions. The sample consisted of 128 finalist students from Portuguese nursing schools – who agreed to participate – in the academic year of 2006/2007 and who voluntarily agreed to participate. After, we submitted the collected data to content analysis. The dimensions, categories and subcategories, which resulted from the content analysis process, have allowed the construction of a questionnaire administered to a group of national nursing experts. They scored the relevance of each category and subcategory in two perspectives: "management of signs and symptoms of disease" and "human response to transitions”. The reliability of measurements found by using the method of Alpha Cronbach allowed evolving into statistical procedures that enabled the achievement of the objectives defined and ensures the internal validity of conclusions aroused from the data. The results show that the nursing care planed by students under the perspective of "management of signs and symptoms of disease" is more consistent, with greater specificity in explanation, revealing a greater domain of the formal knowledge involved. In this perspective family caregivers tend to be seen more as a means to provide care to the dependent patient rather than a client living a transition. On the perspective of nursing care planed by students focused on "human response to transitions" it appears the intention of students to assimilate specific aspects of nursing; however dispersed in high and inconsistent amount of data requested. From this study arises the need of promoting systematization in the explanation of the care conception, as well as the need for operative models and more formal knowledge. There is a positive correlation between the classification of students to access at higher education and the quality of the care planed.
From Portuguese and international research it is noticed the existence of dissonance between the core of discipline referred to in "exposed models” in nursing theory and “models in use" in the context of professional practice. Thus, we have assumed the research question: does the intentionality that underlies the conception of nursing care of new nurses – finalist students – contribute to the decrease of dissonance verified between the professional exercise models in use in practice and models exposed in nursing theory. Was developed an electronic inquiry through which each student faces a specific clinical vignette and is invited to ask for the necessary clinical data to initiate a diagnostic reasoning. Fitted with the responses to the initial data, then the student was asked to identify nursing diagnoses, define the objectives and plan nursing interventions. The sample consisted of 128 finalist students from Portuguese nursing schools – who agreed to participate – in the academic year of 2006/2007 and who voluntarily agreed to participate. After, we submitted the collected data to content analysis. The dimensions, categories and subcategories, which resulted from the content analysis process, have allowed the construction of a questionnaire administered to a group of national nursing experts. They scored the relevance of each category and subcategory in two perspectives: "management of signs and symptoms of disease" and "human response to transitions”. The reliability of measurements found by using the method of Alpha Cronbach allowed evolving into statistical procedures that enabled the achievement of the objectives defined and ensures the internal validity of conclusions aroused from the data. The results show that the nursing care planed by students under the perspective of "management of signs and symptoms of disease" is more consistent, with greater specificity in explanation, revealing a greater domain of the formal knowledge involved. In this perspective family caregivers tend to be seen more as a means to provide care to the dependent patient rather than a client living a transition. On the perspective of nursing care planed by students focused on "human response to transitions" it appears the intention of students to assimilate specific aspects of nursing; however dispersed in high and inconsistent amount of data requested. From this study arises the need of promoting systematization in the explanation of the care conception, as well as the need for operative models and more formal knowledge. There is a positive correlation between the classification of students to access at higher education and the quality of the care planed.
Description
Keywords
Ensino de enfermagem Tomada de decisão em enfermagem Processo de enfermagem Cenários clínicos Nursing education Nursing decision making Nursing process Clinical scenarios