Teaching and learning in the gynecological brachytherapy nursing appointment: the nurses' perspectives. I Nurse. PhD in Nursing. University Hospital Clementino Fraga Filho. Rio de Janeiro, Brazil. E-mail: clauregingomes hotmail.
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Teaching and learning in the gynecological brachytherapy nursing appointment: the nurses' perspectives. I Nurse. PhD in Nursing. University Hospital Clementino Fraga Filho.
Rio de Janeiro, Brazil. E-mail: clauregingomes hotmail. Associate Professor. E-mail: annmaryrosas gmail. Master student in Nursing. E-mail: harlonmenezes hotmail. Full Professor. Rio de Janeiro State University. E-mail: benedeusdara gmail. Objectives : to identify nurses' expectations in teaching and learning in the gynecological brachytherapy nursing appointment and to discuss the links between the intentionalities expressed by these professionals.
Method : this descriptive study, based on Sociological Phenomenology, was conducted from January to May The participants were six nurses working in two radiotherapy referral services. Data were obtained by phenomenological interview. Results : analysis of the declarations yielded two concrete categories of lived experience: Contemplating the uniqueness of each subject in treatment; and Giving due value to the technical care.
Conclusion : the lived experience of nurses is that of professionals with the sensitivity to adapt individual care to the technology, where teaching and learning in the nursing appointment provides nurses with input to understanding each client with their own degree of understanding, which is what demands personalized care, so that there is quality of life in the treatment.
Gynecological brachytherapy is a method in which ionizing radiation is applied directly into the tumor through intra-cavitary applicators and has been used in cervical neoplasias since the s. However, this technique was only introduced in Brazil in the s. This is an invasive and painful procedure that requires anesthesia and is used to complement uterus or vagina cancer-fighting treatments 1,2.
The experience of providing care in the radiotherapy service at a university hospital showed that the implementation of the nursing consultation NC to customers who are subjected to such treatment has benefited them.
When they have the nursing consultation before gynecologic brachytherapy, the situation of coping with the therapy becomes milder. Scholars argument that the NC represents a soft-hard technology that favors self-care because it allows customers to develop their own skills to improve their quality of life.
Through the NC, nurses exercise complete autonomy to develop comprehensive health care promotion strategies to customers, families or communities, fulfilling their main function as health educators 3. The educational process that takes place during the CE helps customers to optimize self-care as well nurses in planning care.
With the consultations, nurses can identify the individual needs of customers, learning how each one acts and reacts before the treatment, customizing the assistance. Given the above, it is necessary to understand the guiding question: how do nurses experience teaching and learning in nursing consultations during application of gynecological brachytherapy?
Scholars indicate that the medical literature does not report exactly what undergoing this type of treatment means for the client and does not specify the necessary attention of the healthcare team to provide detailed guidance on the procedure 4.
Thus, while it is understood that the technical information reported in the literature is important, concern with emotional aspects of customers is also fundamental.
In a bibliometric review, there was a predominance of studies concerned with nursing care to clients submitted to radiotherapy, whether to prevent, identify and treat complications and side effects, or to report the experiences of customers and their families in face of the diagnosis and treatment of cancer 5. These themes cause unease among nurses. Thus, these professionals should be sensitive when providing comprehensive health care to cancer patients beyond their questions on the professional practice.
This would lead to the production of new knowledge, contributing to organizational changes and the spread of new technologies 5,6. Thus, studies of this nature are justified by the fact that research on the exchange of experiences and knowledge in nursing consultations during gynecological brachytherapy is scarce, as well as by the importance of listening to nurses about their educational needs, in order to direct nursing actions towards the reasons that lead customers to seek nursing consultations.
In this context, the objective of this study was to identify the expectations of nurses in teaching and learning in nursing consultations for gynecological brachytherapy and discuss the connections between the intentionalities expressed by these professionals. The choice of this approach is due to the recognition of the importance of knowledge on each client, understanding that every nursing consultation constitutes a teaching-learning opportunity, fruit of the interpersonal relationships of this meeting.
For this, he chooses the understanding that comes from the everyday life of human existence, considered the social world, as essential. This study highlights the characteristics of each relationship, whose actions occur consciously, as they are intentional, discussing the relationship between consciousness and action, which has a meaning for the individual 9.
Thus, men act according to goal-directed motivations pointing to the future called "reasons for" , and the reasons for their actions rooted in past experiences, in the personality developed throughout the life called "reasons why" 8. We understand that in this reference, reality is constructed by men from their inter-subjective experiences. The author, with his ideas, founds a sociology of knowledge that starts from the common sense of everyday life and the cognitive processes through which is established and applied, treating inter-subjectivity as intra-mundane data on which stands any activity of personal relation and of social science itself.
Both services have their attention focused mainly on clients of the Unified Health System, receiving people from all states of Brazil. The technique used was phenomenological face to face interview, where interviewer and interviewee face each other and are subject to verbal and non-verbal influences aiming at accessing the experience of human beings through any movement of understanding Interviews took place from January to May, , in rooms of those institutions.
Nurses were asked about professional data and the guiding question was: what does it mean for you to teach and learn from customers during the NC in brachytherapy? The participants were six nurses who work with clients undergoing gynecologic brachytherapy through nursing consultation, no matter the time they have exercised the profession and this activity.
Interviews were recorded in full-length, with the aid of a digital recorder and then were transcribed by the authors. Anonymity of participants was guaranteed by replacing the names of respondents by color names that are unique, as each individual. All nurses agreed to participate in the study and signed two copies of the Informed Consent. For analysis of the interviews, the steps of Social Phenomenology were developed: listening to the recorded content of interviews; transcription; full-length text reading; grouping speeches according to affinity common ideas ; capture of the reasons for , through clippings of speeches that responded to the research question; rereading the text in full-length, in order to confirm that these ideas specific categories of the experience expressed the reasons for participation in nursing consultation; identification of relations of categories between themselves, reaching the typical action.
The specific categories of the experience that emerged from the testimonies of participants were: meeting the uniqueness of the patients in treatment and valuing the technical care. To illustrate the profile of participants, the Figure 1 was drawn up with their professional characteristics. Rio de Janeiro, The time elapsed since conclusion of the nurses' graduation course ranges from 2 to 29, and the time of experience with nursing consultation to customers in question ranges from 2 months to 7 years.
There was recognition of the need for training by the interviewed nurses, and all of them had degrees specialized for care to oncological clients.
The commitment with the profession, with care and with nursing consultation appeared in all speeches, regardless of the time elapsed since graduation. Nurses reported they consider educational activities important, and that this should take place according to the needs of customers.
For them, customers' self-care must be taught in a specific way, so that they may have quality of life during and after treatment. The exploration and analysis of reports of the interviewed participants resulted in two categories which are interpreted below. The category emerged from the experience lived by nurses that said that customers should receive individualized care. After all, when the customer is guided according to their basic needs, she tends to understand the disease and to care satisfactorily of herself, passing through the treatment with the least possible adverse events.
Perceptions, interpretations and health actions are constructed in culture and in the individuality of every being. Self-knowledge, while facing a chronic and degenerative disease such as cancer, arises in the flow of the confrontations experienced, and leads one to reflect on the own life.
However, this reflection is inserted in a meeting with oneself dangling in the various psychological stages of living with cancer.
This process of exercising the thinking and feeling transforms the being, and self-knowledge emerges as an effect of this exercise, helping health by contributing to the balance of the being, a woman with cancer Thus, when social action of care is directed towards the motivations of the other team members, this is harmonizing itself with the intentionalities 4.
Thus, the nursing staff must act in order to minimize these effects and serve as a link, working on achieving specific care and education of patients and families. Nursing consultation in the radiotherapy sector deserves special attention because this is the most specific activity performed by nurses in the sector. Patients seek the nursing consultation as a means of information for the practice of self-care and of facing the treatment. Thus, the NC makes nursing care personalized Given the above, the complexity of the process of teaching and learning that takes place in nursing consultations to the client in question becomes evident.
Furthermore, it is noteworthy that the way the customer presented herself at the moment of consultation influences the quality of what will be taught and learned. Hence the importance of respecting the individuality of each human being. The statements below illustrate how nurses showed interest in personal impressions of customers about experiencing cancer. Teaching and learning that happens in nursing consultation is very important; we learn a lot from patients.
Each one has their own perception of the treatment, their experiences are singular. This enriches us and helps us to plan the care for these patients.
I learn from the personal account of each of them. Some may have had skin lesions, other difficulties passing urine; each one reacts differently. Consequently, it is during brachytherapy that I learn what they went through before that, and what they are going through at that moment and this will help me to direct care for this treatment.
Empathy was cited by the interviewed nurses as a key element in the relationship with clients. We cannot forget that cancer changes the life of those who fall ill, making people to learn to think according to their new life experience. Therefore, nurses should follow the reasoning of clients about their sensations arising from the reality, which is to have the disease. In the reports, the emergence of partnership among parties in the NC was registered.
After all, change in the educational process is necessary, as the following reports show:. We learn a lot from the experience of patients, with all that concerns their routine.
Mainly because there are cases where they patients only relate their experiences to the nurses, then the need of acknowledging the importance and the value of this exchange. It has been rewarding to see customers feeling less anxious at the moment of undergoing treatment. It is good to see that the consultation was of great benefit for both, us as nurses and for clients. This interaction helps us to know if we are on the right track.
Indeed, the uniqueness of the human being can only be understood when you have direct contact with them. Nursing professionals get to know the universe of clients with whom they get in contact when they show to be interested in their specific biography. The combination of these singularities will bring forth the typical common of the clientele, helping to build the model of care to be offered.
This means that private interests may be in the same context of the interests of a group 7. Here is a reflection:. Teaching and learning are very important. In some situations, the doubt that a customer brings us may be the doubt of others.
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High-dose rate brachytherapy in Brazil. A braquiterapia de alta taxa de dose foi introduzida em nosso meio em janeiro de High-dose rate brachytherapy was first introduced in Brazil in January Significant changes in the management of malignant neoplasms were observed since utilization of high-dose rate brachytherapy. The high number of gynecological patients awaiting for brachytherapy also decreased during this period.
ANÁLISIS DOSIMÉTRICO EN BRAQUITERAPIA GINECOLÓGICA DE ALTA TASA DE DOSIS.