LIVRO EXAME CLINICO CELMO CELENO PORTO PDF

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Rev Latino-am Enfermagem julho-agosto; 12 4 www. Artigo Original. Trends and priorities in nursing research. Rev Latino-am Enfermagem julho-agosto; 12 4 This document initially presents an introduction to the global scenario in which nursing research is set today. Next, the main nursing research priorities are described in accordance with the agendas of international health and nursing organizations on different continents, as well as the characteristics of nursing research in Latin America until the end of the XXth century, based on studies and publications in which the main thematic tendencies are identified.

Finally, the author reflects on the priority definition process in nursing knowledge production, with a view to attending the need for foundations of the subject area as well as public health needs. O artigo aborda o contexto geral em que desenvolve-se hoje a pesquisa em enfermagem. Economically, we are undergoing the restructuring of productive processes as well as changes in market dynamics, deep financial weakness in all economic sectors and a clear imbalance in employment.

As a consequence, poverty, unemployment and informal employment are expanding and labor reforms are being attempted, which may have a deep impact on working conditions and on the future prospect for elderly populations.

Socially, the strength of several social movements -ecologists, feminists and homosexuals to name a few — is re-shaping traditional relationships among actors and questioning old values and practices.

Culturally, changes are evident by the shifting structure and functions of the family, the globalization of needs, the rise in competitiveness and isolation, the loss of solidarity and the revival of certain mystic and religious trends. Alongside these changes, we are witnessing an accelerated demographic transition towards an ageing population and a heterogeneous and complex epidemiological landscape where new and old endemic diseases and the rising prevalence of chronic and degenerative ones demand complex answers from health services.

At the same time, scientific and technological developments in the fields of molecular biology, genetics and biotechnology, among others, are continuously transforming the basis of medical diagnosis and treatment. On the other hand, dramatic changes in time and space generated by the evolution of communications and information technology have brought about a new dimension to work processes and to the dynamics of social and family lives. One important dimension of globalization is the gradual generalization of ideas and values such as human rights, sustainable social development, gender equity, the respect for ethnic and cultural diversity and environmental protection.

Paradoxically, these ideas have flourished in a world with increasing environmental deterioration, where inequalities are present in every scenario, impoverishment is epidemic, unemployment tends to become a chronic evil, starvation still claims thousands of lives and violence, terrorism and social insecurity seem to be hallmarks of the time.

The main strategic resources in this process are knowledge, information and technology. However, the unprecedented growth of human knowledge has also increased the gap between those who have access to it and those who do not, generating new inequalities within and among nations in the planet.

At the World Conference on Science 1 it was acknowledged that most of its derived benefits are unevenly distributed due to the structural asymmetries that exist among countries, regions, social groups and genders. While scientific knowledge has become a determining factor in the generation of wealth, its distribution has become progressively more asymmetric. Nevertheless, science and technology are potential sources of social redemption if they are put to the service of human development and its supporting values and they should be shared with solidarity for the benefit of all people.

This is especially true for the field of health and life care, where better use of scientific knowledge can lead to significant improvements in the health and well-being of mankind. It is precisely because we are involved in a situation of growing interdependency, where our future and that of the following generations is closely tied to the preservation of life systems on the planet, that science must be at the service of mankind and must contribute to provide people with a deeper understanding of nature and society, a better quality of life, and a healthy and sustainable environment.

Thus, prioritizing research to lay the foundations for good practices and training the new generations are imperative for this century.

As Hildegard Peplau has said, the question for nursing today is not about what it does; it is about what it knows and how it applies this knowledge 2. On describing the situation in non-Latin American countries, I found it extremely helpful to exchange data with Rita Allinger of George Mason University. Sources also include some considerations presented in previous dissertations, documents from Pan-American Colloquia, articles on the state of the art and analyses of the generation of knowledge in different institutional and geographic scenarios.

The first two priorities set the stage for nurse scientists in multiple countries to identify the major health care problems in their geographical areas which nursing could influence and help to change. These major health care problems became the focal point for the nursing research priorities. The objective was to produce knowledge through research which could be used to change health care by guiding practice 3.

They also include matters related to life style, home care, alternative medicine and self-care. In some Asian countries, like Korea, research has been centered on health services.

Thailand appears to be mainly oriented towards clinical nursing research, nursing education and management 4. Data from some European countries refer to health promotion, geriatric care, health care models and health- disease models.

Nurses in Great Britain have identified, among others, the following priorities: Patient perspectives on care; the functions of people who provide informal care; nursing interventions; access to health services and the role of the nurse; living with chronic diseases and nursing technology 5. In , The World Health Organization 6 established a list of priorities for nursing research which, among others, include:. Organization, current research priorities for the health sector.

For example, the identification of inequities. The evaluation of organizational. Evaluation of risks and mechanisms for prevention and control. Pan American. The most significant changes appeared at the end of that decade, when studies on nursing care were performed from. Other researchers emphasized educational aspects and yet others performed research aimed at the evaluation of health.

In Brazil, the formation of a critical mass of nursing researchers through different masters and doctoral courses. Five areas of research were proposed, which for the most part represent those problems commonly encountered in the countries of the region. These areas were: research on the work process of nursing; research on nursing actions related to the promotion, recovery and rehabilitation of health; studies oriented towards the advancement of knowledge specific to nursing practice, nursing technologies and the instruments used for healthcare interventions; and studies on the formation of human resources in nursing.

At the VII Pan American Colloquium, held in October of , we presented the results of a retrospective study on the research projects presented at this event between and 2 8. The research projects reviewed inn our study were classified as follows:.

Public Health. Human Resources. As the table shows, the most conspicuous topics were those related to public health and human resources. These include studies that portray the magnitude of health problems, identify high risk groups and risk factors for some transmissible and non- transmissible diseases, analyze the use of psychoactive substances and tobacco and evaluate occupational health issues in nursing practice.

The study presented by Do Prado and Lima. This study grouped research projects in three areas: Nursing as a profession, patient care and the administration of care. The area of nursing as a profession included the fundamentals of care in nursing practice, the theoretical and philosophical concepts involved, the technologies, the ethical aspects and the history of nursing.

The area of patient care included the process of care in nursing practice, the concept of care in the health-disease process and the determinants of the quality of life, health and disease of individuals and populations. The administration of care as a research area included policies and practices in nursing and health care, the process of work in nursing practice, the management of health and nursing services, and the interplay between information, communication and nursing.

According to the authors, the development of a body of knowledge and the topics around which nursing research in Latin America has evolved, show differences and contradictions that are inherent to the evolution of this profession in different countries.

Although many nurses in Latin America have worked on research for several years, there is little evidence of this effort in English language publications. During the past two decades, several processes that stimulate nursing research have taken place. It is also essential to promote the articulation of nursing. The task of defining research priorities is essentially.

The actors involved are the government, the financing organizations, the scientific community, service providers and the community. The answer to the question of priorities will vary depending on the perspective or interests of the specific population, profession or discipline.

From the perspective of the population and the health authorities, it is necessary to carry out:. Epidemiological Studies to understand the behavior of diseases in their relationship with the consumption of goods and services, the work process, the environment, gender, ethnicity, culture, the life cycle and social class. Also, to understand the behavior of morbidity and mortality, the risk factors and the protective factors involved.

Studies on the conditions of life and well-being , which involve the identification of the determinants of life quality and health-disease in population groups. An evaluation of health policies and health services to assess their coherence, their pertinence, the possibility of social participation. Health promotion , where the central categories include life, well-being and human development in their ethical, cultural and political dimensions.

From the perspective of nursing as a profession there is a need for historical and sociological research, research in the pedagogy of nursing, nursing policies and regulation, the way in which different interests are represented, the job market, the working conditions of nurses and the. From the perspective of nursing as a discipline it is necessary to inquire on the ontological, ethical, aesthetic and epistemological foundations of nursing and to develop, implement and validate models and theories.

Studies are needed on the context of care, the response to nursing interventions, the nurse-patient relationship and the nursing care process in children, adolescents, adults and the elderly. Research priorities in nursing must take into consideration individual and collective needs in health clinical and public health , within macro and micro social environments.

The theoretical frameworks should be inter and transdisciplinar constructions. North-south approximations through colloquia represent a hope to reduce the scientific and technological gaps in nursing, through the use of networks, multicentric studies and the socialization of knowledge. World Conference on Science Declaration on Science. Peplau H. Hinshaw AS. International Nursing Research Priorities Pose.

Opportunities and Challenges. Proceedings of 7 t h Pan. American Colloquium on Nursing Research. Tierney AJ. Nursing Research in Europe. Int Nurs Rev ;.

High priority. Nurs Times. Hirschfeld MJ. Research agenda. Int Nurs Rev ; 45 1 Pan American Health Organization. Research Program. Web Site access on September Nursing Research: International guidelines.

Proceedings of the Pan American Colloquium on Nursing. Research projects.

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