Browsing by Author "Oliveira, Palmira"
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- Dynamic model for assessment and family intervention: impact on families health gainsPublication . Figueiredo, Maria Henriqueta; Silva, Renata; Andrade, Carmen; Brás, Manuel Alberto; Oliveira, PalmiraThe current Primary Health Care reform is focused on e!ectiveness patterns, targeted at ensuring the best possible health gains for its users. In regard to this approach the aim is to assess health gains as a result of the implementation of the Dynamic Model for Assessment and Family Intervention. For this quantitative study, the focus of attention areas described in the operative dimensions of this Nursing Model. Data collection was performed based on the information produced by Primary Health Care Nurses, through the Information System in use. The family health gains indexes computed into the Microsoft O"ce Excel 2007 were used for data processing and analysis. In the structural dimension, the major health gains were found in the residential house (50%). In the development dimension, the interventions targeted at family planning were found e!ective for 85.19% of the families, with the adaptation to pregnancy showing the lowest rates in health gains (50%). As to the functional dimension, the highest rates in health gains were found for an adequate caregiver role in 33% of the families, whilst in the family process, health gains rates were at 5.56%. The implementation of the MDAIF had a positive impact on health gains outcomes for families, fostering the development of assessment and family intervention competencies as well as the identi#cation of training needs in speci#c intervention areas.
- Family process and systemic questions: new ways of family intervention in primary health carePublication . Figueiredo, Maria Henriqueta; Oliveira, Palmira; Ferré-Grau, Carme; Lebreiro, Marlene; Charepe, Zaida; Andrade, Carmen; Brás, Manuel AlbertoIn the context of practices supported by the Dynamic Model for Family Assessment and Intervention (MDAIF) the assessment of this model impact suggested the deepening of “Family Process”. Systemic issues (circular and reflexive), will allow the expansion of the reflection capacity of each familymember about themselves, about others, about family history. This study a im is to identify systemic issues of intervention used by Primary Health Care nurses regarding dysfunctional family process. Methods: Qualitative study, using Focus Group as a methodological approach with nurses from health centers in the province of Tarragona–Spain, developed in 2014. For the focus group was placed the starting issue: W hat kind of systemic questions the nurses mobilize when exist one family process alteration? After obtaining informed consent, the data were submitted to content analysis, co-existing deductive and inductive procedures, supported by the matrix of analysis propose in the MDAIF. Results: No differences were identified in the intervention strategies used by nurses in the context of family communication and coping. Regarding interactions in family roles it is highlighted the mobilization of family system resources “...explain them who can help... to whom can they ask for help, right?..” E3: “How do you think you’d be better (...) will pass the decision to them...” E8. Intervention proposals emerged related to systemic issues particularly in the area of interaction of roles and dynamic relationship, which reflect a systemic view of family unit. Conclusions: Reflections on interactional practices with family, while nursing care customer, based in MDAIF allowed the development of new conceptions of family health nursing. Concerning general interventions proposed associated to “dysfunctional family process” diagnosis, the integration of new action typologies, supported by systemic issues, will maximize the health potential of fami lies by the opportunity to co-construct new stories and interactions
- From meanings of spirituality to the challenges of nurses in family interventionPublication . Figueiredo, Maria Henriqueta; Charepe, Zaida; Brás, Manuel Alberto; Oliveira, Palmira; Melo, PedroSpirituality incorporates key principles of family rituals that determine to be in family and being with others, involving the search for a sense of family continuity. As a field of family assessment and intervention requires nurses to promote their own spiritual health and acknowledge their spiritual needs.
- Impacte do modelo dinâmico de avaliação e intervenção familiar nos ganhos em saúde para as famíliasPublication . Figueiredo, Maria Henriqueta; Silva, Renata; Andrade, Carmen; Brás, Manuel Alberto; Oliveira, PalmiraA atual reforma dos Cuidados de Saúde Primários centra-se em padrões de efetividade, que pretendem garantir os maiores ganhos de saúde possíveis para os seus clientes. Nesta perspetiva pretendeu-se avaliar os ganhos em saúde produzidos pela implementação do Modelo Dinâmico de Avaliação e Intervenção Familiar (MDAIF). De natureza quantitativa, exploratório-descritivo foram definidas como variáveis as áreas de atenção descritas nas dimensões operativas do MDAIF (Figueiredo, 2012). O estudo decorreu no contexto dos Cuidados de Saúde Primários. Para a recolha dos dados, efetuada de janeiro a julho de 2012, considerou-se a informação produzida pelos enfermeiros no Sistema de Informação em uso, cujos padrões de documentação traduzem a matriz operativa do MDAIF. Para o tratamento e análise de dados foram considerados os indicadores de ganhos em saúde familiar, decorrentes da matriz operativa e referentes aos ganhos em saúde, utilizando-se o programa Microsoft Office Excel 2007. Na dimensão estrutural, a maior produção de ganhos situou-se no edifício residencial (50%) Na dimensão de desenvolvimento as intervenções direcionadas para o planeamento familiar foram eficazes em 85,19% das famílias, sendo adaptação à gravidez a area de atenção que apresentou uma taxa menos elevada em ganhos em saúde (50%).. Na dimensão funcional, a liderança dos ganhos em saúde traduziu-se no papel de prestador de cuidados adequado em 33% das famílias, enquanto que no processo familiar a taxa de ganhos em saúde situaram-se em 5,56. Os resultados relativos ao processo familiar confirmam a importância do desenvolvimento de competências associadas à intervenção familiar sistémica (Sawin, K., 2016), considerando que a totalidade dos enfermeiros que desenvolveram os cuidados com as famílias não tinham formação nesta area.
- Representações e significados dos enfermeiros de cuidados de saúde primários, em Espanha, sobre o conceito de famíliaPublication . Figueiredo, Maria Henriqueta; Ferré-Grau, Carme; Oliveira, Palmira; Andrade, Carmen; Brás, Manuel AlbertoAs políticas de saúde direcionam-se ao aumento da efetividade, para que os cuidados de saúde possam dar respostas efetivas às necessidades das populações (O'Reilly et al., 2017; Lowen et al., 2017). As representações sociais sobre família, influenciam as respostas às suas necessidades de cuidados, visto que têm um objetivo prático, a partir da construção de uma realidade comum. Constituiu objetivo deste estudo identificar as representações e significados dos enfermeiros que desenvolvem funções nos Cuidados de Saúde Primários, em Espanha, sobre o conceito de família. Metodologia: Estudo de natureza descritiva e exploratória. Por amostragem de conveniência os participantes corresponderam a 28 enfermeiros, 96,4 do sexo feminino e 3,4 do sexo masculino. A média de idade corresponde a 46, 5 anos, a média de tempo de exercício da profissão de 23,2 anos e 15,2 anos em CSP. O instrumento de colheita de dados foi um questionário constituído por duas partes: A primeira referente aos dados sócio demográficos e a segunda parte, com uma questão aberta, sendo solicitado aos participantes, para definirem família. Para tratamento e análise dos dados optou-se pela análise de conteúdo, com procedimentos indutivos. Resultados e Discussão: As narrativas sobre o conceito de família permitiram o estabelecimento das seguintes categorias: Família como sistema relacional, onde sobressaem os vínculos afetivos: “Conjunt de persones (…) i que comparteixen vincles afectius” Q20, Família como fator de proteção, salientando-se os atributos familiares que contribuem para a manutenção da funcionalidade familiar e individual, “Família com unitat que tots el membres fan pinya junts, lluiten, caminen, celebren, comparteixen els problemes i alegries i junts es fan forts i són capaços de superar les adversitats i els triomfs” Q4; Família como sistema auto organizado, de onde se salienta “El grup es molt organitzat i te definids les funcions de cadasqu.” Q10. Na generalidade, os participantes incorporam um paradigma sistémico nas suas representações sobre família (Figueiredo, 2012), embora algumas narrativas traduzam significados associados, em exclusivo, aos atributos da família nuclear. Conclusão: Os resultados permitem identificar necessidades de formação no âmbito da intervenção sistémica, visando a melhoria da qualidade da prática dos enfermeiros, em Espanha, no contexto dos CSP.
- Teaching and learning in family nursing: from theoretical framework to experiential reflectionPublication . Figueiredo, Maria Henriqueta; Charepe, Zaida; Brás, Manuel Alberto; Oliveira, PalmiraThe complexity of the family system, as the target of nursing care, requires specific skills to act in a situation. The Dynamic Model of Family Assessment and Intervention - MDAIF (Figueiredo, 2009), based in the systemic paradigm can contribute to the experiential reflection on nursing care with families in nursing education
- The family nursing health care and the indicators of health: new challenges for the practicePublication . Figueiredo, Maria Henriqueta; Oliveira, Palmira; Lebreiro, Marlene; Andrade, Carmen; Charepe, Zaida; Brás, Manuel AlbertoThe assessment of the implementation focuses in aspects which are considered fundamental for an effective measurement of the Dynamic Model of Family Assessment and Intervention (MDAIF) implementation as a theoretical and operative referential in the nurses' clinical decision-making: satisfaction of families, satisfaction of nurses, assessment of health gains which are sensitive to nursing care, and the identification of the main needs of families.This study aim is to define the indicators of structure, process and outcome, based in MDAIF. Methods: Exploratory study procedure: 1) define the Minimum Data Set (MDS), based in MDAIF, describe the nurses diagnosis, interventions and outcomes; 2) define the indicators according the Order of Nurses orientations; 3) The finalpropose reviewed and validated by experts. The summary data includes the diagnosis and sub diagnosis by MDAIF matrix. For formulation of diagnosis judgment were used the International Classification of Nurses Practice (ICNP®). Results: If define structure indicators related to the nurses satisfaction, process indicators produc e rates of family assessment incident and diagnosis incident, outcome indicators defining rates of diagnosis efficacy and heath gains, epidemiological indicators that propose diagnostic prevalence rates. Conclusions: The definition of MDS and the health gains indicators will allow nurses to be informed on the data resulting from the care provided to the families that must be mandatorily registered. It will also enable to monitoring of the implementation process through the identification of critical points that lead to the introduction of strategies and which will optimize the outcomes inherent to the following tasks.