Nursing students' perception about humanized care: an integrative review

La percepción de los estudiantes de Enfermería sobre el cuidado humanizado: una revisión integrativa

ABSTRACT

Objective:

To analyze the productions of knowledge about the students' perception of humanized care.

Method:

Study of bibliographical revision of the integrative type. The databases Pubmed, Lilacs, Cuiden and the SciELO virtual library were chosen for selection in October 2017, using the health descriptors "Students, Nursing", "Perception" and "Humanization of assistance", in the languages Portuguese, English and Spanish.

Results:

Only eight studies were included that met the objectives of the study, where the majority portrays the Brazilian reality.

Conclusion:

Given the current discussion of society on the subject and the scarcity of publications, it is clear the need to adapt the academic field to complaints of society, as well as reflection of why the problem does not have a significant approach in international setting.

Descriptors:
Students, Nursing; Perception; Care; Humanization of Assistance; Research

RESUMEN

Objetivo:

Analizar las producciones del conocimiento sobre la percepción de los estudiantes de Enfermería acerca del cuidado humanizado.

Método:

Estudio de revisión bibliográfica del tipo integrativa. Se utilizó para la selección de los artículos las bases Pubmed, Lilacs, Cuiden y la biblioteca virtual SciELO, en el mes de Octubre de 2017, con el uso de los descriptores en salud "estudiantes de Enfermería", "percepción" y "humanización de la asistencia", en los idiomas portugués, inglés y español.

Resultados:

Se incluyeron sólo ocho estudios que se adecuaron a los objetivos del estudio, y la mayoría retrata la realidad brasileña.

Conclusión:

En vista de la actual discusión de la sociedad sobre la temática y la escasez de publicaciones, es clara la necesidad de adecuación del campo académico a las quejas de la sociedad, así como la reflexión del por qué la problemática no tiene un enfoque significativo en el escenario internacional.

Descriptores:
Estudiantes de Enfermería; Percepción; Cuidado; Humanización de la Asistencia; Investigación

RESUMO

Objetivo:

Analisar as produções do conhecimento sobre a percepção dos estudantes de Enfermagem acerca do cuidado humanizado.

Método:

Estudo de revisão bibliográfica do tipo integrativa. Utilizando-se para seleção as bases Pubmed, Lilacs, Cuiden e a biblioteca virtual SciELO, no mês de outubro de 2017, com o uso dos descritores em saúde "estudantes de Enfermagem", "percepção" e "humanização da assistência", nos idiomas português, inglês e espanhol.

Resultados:

Foram incluídos apenas oito estudos que se adequaram aos objetivos do estudo, onde a maioria retrata a realidade brasileira.

Conclusão:

Tendo em vista a atual discussão da sociedade sobre a temática e a escassez de publicações, fica clara a necessidade de adequação do campo acadêmico às queixas da sociedade, bem como a reflexão do porquê a problemática não ter uma abordagem significativa no cenário internacional.

Descritores:
Estudantes de Enfermagem; Percepção; Cuidado; Humanização da Assistência; Pesquisa

INTRODUCTION

Currently, we are seeing a change in Brazilian society, regarding the search for their rights. Inappropriate conduct, which damages rights and/or damages others in any social context, but which is culturally accepted and standardized, is now reviewed. In this way, the health area has been the subject of great discussions regarding the conduct of professionals, ranging from the elementary level to the more specialized⁽¹⁾.

For years, humanization has been put on the agenda, as evidenced by the creation of the National Humanization Policy (PNH- Política Nacional de Humanização), in 2003. This policy aims to humanize health services, through the feasibility of practices that will change the management and care⁽²⁾.

In this scenario, Nursing is inserted, which is the profession that stands out for the art and science of caring⁽³⁾, and the training period of these professionals is paramount to guide the professional conduct mold.

In Brazil, Nursing courses are based on the National Curriculum Guidelines of the Undergraduate Nursing Course (Enfermagem são baseados nas Diretrizes Curriculares Nacionais do Curso de Graduação em Enfermagem - DCNCGE), instituted by the National Education Council (Conselho Nacional de Educação - CNE), through Resolution 3 CNE/ CES of November 7, 2001⁽⁴⁾.

The DCNCGE deals with the profile of graduates, their competence and abilities, as well as other points related to the course, humanization being reported as competence that the professional must possess in the exercise of the profession⁽⁴⁾.

Thus it is essential to have knowledge of the student's perception of Nursing on the following points: what is humanization of care; that conduct is used to put into practice the humanization and the positioning of the academy to which they are inserted on the said theme. The investigation of these topics is important, since besides the student of today is the professional of tomorrow, there are divergences between theory and practice, being these inherent in the academic context evidencing that the formation in line with the reality of work is closely related to the quality of the assistance provided⁽⁵⁾.

Nowadays, knowledge is inserted and the practice begins in the future, that is, the perception of today will be linked to the future practice, justifying the importance of knowing the perception of the students, in order to execute a mechanism to improve such knowledge, helping to improve care practice, since the student of today is the professional of tomorrow⁽⁶⁾.

OBJECTIVE

This study aims to analyze the productions of the knowledge about the students' perception of the humanized care.

METHOD

Ethical aspects

Since it is a rstudy that does not involve human beings, this work did not have to go through ethical appreciation⁽⁷⁾.

Type of study

This is a bibliographical review of the integrative type, whose purpose is the survey of research related to the theme^(8-9), drawing a panorama, evolution and future possibilities of research about the theme.

The six steps of the integrative review were carried out, which are: 1) development of the research question; 2) search in the literature; 3) data collection; 4) critical analysis of the articles included; 5) discussion of results; and 6) presentation of the integrative review⁽¹⁰⁾.

The research question in this study is the following sentence: How do Nursing students perceive the humanization of assistance?

Methodological procedures

The search was carried out in the Pubmed, Lilacs - via Virtual Health Library (VHL), Cuiden and the SciELO virtual libraries.

Collection and data organizaton

For the search strategy, the health descriptors (DECS) that best fit the guiding sentence were chosen: Perception, Humanization of Assistance and Students, Nursing, as well as their correspondents in English and Spanish.

Crossings with the descriptors were performed in pairs and trios, in the Portuguese and English languages, interconnected by the Boolean operator "AND" in order to demonstrate the state of the art of the theme. In light of the above, Chart 1 is presented.

Chart 1
Search for descriptors in databases

Strategy/Bases	Pubmed	SciELO	Lilacs	Cuiden
Estudantes de Enfermagem AND Humanização da Assistência	0	9	12	3
Humanização da Assistência AND Percepção	0	137	111	61
Estudantes de Enfermagem AND Percepção	3	212	18	111
Estudantes de Enfermagem AND Humanização da Assistência AND Percepção	0	0	1	2
Students, Nursing AND Humanization of Care	7	28	0	21
Humanization of Assistance AND Perception	21	121	0	76
Students, Nursing AND Perception	1497	294	16	361
Students, Nursing and Humanization of Assistance AND Perception	0	3	7	6
Estudiantes de Enfermería AND Humanización de la Atención	0	14	12	19
Humanización de la Atención AND Percepción	0	86	57	123
Estudiantes de enfermería AND Percepción	3	260	131	365
Estudiantes de Enfermería AND Humanización de la Atención AND Percepción	0	1	4	5

Inclusion criteria were: original articles; publication period comprised in the period from 2006 to 2016 since the humanization policy was started in 2003 and we have a space for dissemination of research after a theoretical framework, adherence to the objective of the study, published in Portuguese, English and Spanish.

The exclusion criteria adopted were the scientific productions that presented only the abstract and articles that did not exclusively address the perspective of Nursing academics on the subject.

The search with descriptors associated to the Boolean operator allowed the identification of the pre-selected studies (Chart 2).

Chart 2
Pre-selected studies

Article	Basis	Included	Reason
Spirituality and health: an experience in undergraduate schools of Medicine and Nursing	SciELO	No	Multidisciplinary study.
Social representation of nursing care in mental health: a qualitative study	SciELO	Yes	Linking with clients and employees encourages humanized care.
Gardening referential as teaching-learning instrument in Nursing: convergent care research	SciELO	No	Integrative review study.
Spirituality and health: an experience in undergraduate schools of medicine and nursing	SciELO	No
Perception of nursing students on mental health home-care: a qualitative approach	Lilacs	Yes	University extension assists in the holistic view and favors humanized care.
Perception of undergraduate Nursing students on the work of nurses	Lilacs	No	It does not meet the study's objectives.
Perception of nursing students on mental health home-care: a qualitative approach	Lilacs		Duplicated.
Spirituality and health: an experience in undergraduate schools of Medicine and Nursing	Lilacs		Duplicated.
Research in the care approach: Nursing students' perspective [La investigación en el enfoque de los cuidados: perspectiva de los estudiantes de enfermería]	Lilacs	Yes	The study results in Nursing students visualizing research with a focus on care as a contribution to humanized practice.
Social representation of nursing care in mental health: a qualitative study	Lilacs		Duplicated.
Nurses and the humanization of health services in the municipality: an exploratory study	Lilacs	No	Participants are nurses and not academics.
Gardening reference as teaching-learning instrument in Nursing: convergent care research: [review]	Lilacs		Duplicated.
Perception of undergraduate Nursing students on the work of nurses	Lilacs		Duplicated.
Perception of nursing students on mental health home-care: a qualitative approach	Lilacs		Duplicated.
Spirituality and health: an experience in undergraduate schools of Medicine and Nursing	Lilacs		Duplicated.
Research in the care approach: Nursing students' perspective [La investigación en el enfoque de los cuidados: perspectiva de los estudiantes de enfermería]	Lilacs		Duplicated.
Understanding of Nursing Students on Patient Safety [Comprensión de los estudiantes de enfermería sobre la seguridad del paciente]	Cuiden	Yes	The concept of humanization is associated with patient safety.
Humanization in the process of academic training of health professionals [La humanización en el proceso de formación académica de los profesionales de la salud]	Cuiden	No	The humanization is portrayed in the academic and non-assistance plan as the study proposes.
Orthotanasia: the meaning of dying with dignity in the perception of nurses of the specialization course in Intensive Care Unit	Cuiden	No	Participants are nurses and not academics.
Social Representation of Nursing Care in Mental Health: a qualitative study [Representación social del cuidado de enfermería en salud mental: estudio cualitativo]	Cuiden		Duplicated.
Gardening reference as teaching-learning instrument in Nursing: convergent care research	Cuiden		Duplicated.
Gardening reference as teaching-learning instrument in Nursing: convergent care research	Cuiden		Duplicated.
Perception of Humanized Care Behaviors in Nursing Students[Percepción deComportamientos de Cuidado Humanizado en Estudiantes de Enfermería]	Cuiden	No	Participants are the subjects who received paternal care from academics.
The distance between the proximity between psychiatric asylums and the production of meanings: current learning of Psychiatric Nursing	Cuiden	Yes	Students point out.
Social Representation of Nursing Care in Mental Health: a qualitative study	Cuiden		Duplicated.
Playful practices daily care in Pediatric Nursing	Cuiden	Yes	The study shows that students visualize in playful practices a way to perform humanized work.
Something is changing in hospitals, is it perhaps clinical humanization?[Algo se está moviendo en los hospitales, ¿Será quizás la humanización clínica?]	Cuiden	Yes	The article brings the students' perception about the humanization process of Nursing care, referring this process as being in progress.

After the identification of the pre-selected studies (n=27), the titles, abstracts and descriptors were checked for the adequacy of the subject matter and relevance of these included in the review, for the full reading and categorization, analysis and interpretation of the results and presentation of the review.

Starting refining by repeated studies, we have a new group of studies that totals 14. Continuing the refining of studies, 6 articles are excluded that do not fit the theme researched for addressing the perception of death, be developed with undergraduate students in Medicine, an/or have taken place with already graduated participants. There remained 8 articles after refining. These 8 remaining articles had their data extracted through the extraction chart.

Figure 1
Refining flowchart for repeated studies

Data analysis

The data analysis was performed by summarizing the methodological characteristics of the selected studies, in order to reach the proposed objective. In light of the above, the data extracted were described and organized in a chart with information regarding their content (Chart 3).

Chart 3
Summarization of selected studies

Title	Year/Country	Objectives	Method/Participants	Results	Conclusion
Social representation of Nursing care in mental health: a qualitative study(11)	2011 Brazil	The purpose of this study was to understand the social representations of Nursing care in Mental Health elaborated by undergraduate students of Nursing courses.	The sample consisted of 12 students who participated in semi-directive interviews.	Nursing care in mental health is represented in the humanization of mental health care.	This representation facilitates the change in the perception of undergraduates from the theoretical-practical experiences and allows them to visualize a distinction between the professional practice of nurses in the current context and the role attributed to it according to the precepts of the Psychiatric Reform.
Gardening reference as teaching-learning instrument in Nursing: convergent research assistance(12)	2014 Brazil	To use the reference of Wanda Horta with fifteen students of undergraduation of Nursing, during practical internship, in private institution in Curitiba City, and to verify the perception of them about the relation of the path.	Qualitative convergent assistance research. Nursing students in practical internship in a care unit.	The students considered that the practice provided an integral visualization of individuals, the integration of theory and practice in the discipline, and the facilitation of the humanization of care.	Nursing practices must be based on theoretical references, in order to provide the client's holistic view; scientificity as the basis of Nursing care, in order to minimize technical care present in health institutions and universities.
Perception of nursing students about home mental health care: a qualitative approach(13)	2016 Brazil	To understand the perception of Nursing students about mental health care at home, carried out through university extension activities.	Exploratory descriptive research with a qualitative approach. Nursing students.	The data resulted in three categories: "The university extension in mental health as an opportunity for personal and academic growth", "Reformulating concepts of care through university extension in mental health" and "The university extension in mental health as a facilitator of humanized care".	Students understand university extension as a way to acquire diverse knowledge and skills by having the opportunity to work an effective approach to the family and the daily lives of the people with Mental Disorders.
Research in the care approach: the perspective of Nursing students(14)[La investigación en el enfoque de los cuidados: perspectiva de los estudiantes de enfermeira(14)]	2013 Portugal	To know the perception of Nursing students about the relationship between research and the quality of nursing care.	Transversal, descriptive exploratory study with qualitative approach. Students of the second year of Nursing, with criterion of inclusion having studied the discipline of "Research in Nursing" developed at least two periods of care practices.	From the analysis of participants' discourses, the following categories emerged: Humanization/uniqueness of care and professional development.	According to students, research enables professional improvement and focus on holistic care.
Understanding Nursing students about patient safety(15)	2016 Brazil	To know the understanding of Nursing students about patient safety.	Descriptive exploratory qualitative study. Students of the 3rd and 4th year of Nursing.	The categories "Meaning of Patient Safety" and "Articulation of Theoretical Knowledge with Care Practice" emerged. Students associated patient safety with the hospital environment and the concepts of humanization, professional ethics, patient autonomy and biosafety.	The perception that safe care is guaranteed by error-free assistance has been evidenced.
The distance between psychiatric asylum and the production of meanings: Psychiatric Nursing education in the present day(16)	2010 Brazil	Identify the challenges of the field of practice in mental health in the production of knowledge about the impact of changes on the stigmatized view to the humanized look on psychiatric asylums.	Qualitative and descriptive study. Nursing students in course of the Nursing discipline in the Attention to Psychiatry.	Focus on the care of the body and the Nursing performance in relation to the characterization of clients; specificity and fear of treatment; the concern to know the environment; discipline activities before and during the period of practical training.	The field of practical training has also enabled the student's rapprochement with the issues of prejudice, biomedical model of exclusion of senses,which brought a humanized learning for care.
Playful practices in the daily care of Pediatric Nursing(17)	2009 Brazil	Seize studentsto perform playful practices with children hospitalized during vocational training.	Phenomenological qualitative approach. Nursing students of the 8th period.	Evidenced by the categories motivation/gratification, lack of commitment and initiative, and impotence.	The insertion of playful activities into Pediatrics takes place gradually, and performing them implies a review of academic education, making teaching/ research/ extension articulation strong and coherent, so that the contents emphasize the humanization and provision of care.
Something is chaning in hospitals, is it perhaps clinical humanization?(18)[Algo se está moviendo en los hospitales, ¿Será quizás la humanización clínica?(18)]	2009	We present results obtained from the analysis of student's answers, regarding the perception, beliefs and attitudes about the process of Clinical Humanization in hospitals.	Descriptive crosssectional study. Students of the 3rd year of Nursing.	Students believe that it is fundamental to acquire knowledge and communicative and social strategies for the emotional approach to patients and their families.	We conclude that "something is happening", albeit very slowly, given the change in the process of humanizing care.

RESULTS

The eight studies included having a time span of seven years, ranging from 2009 to 2016. These are qualitative studies, carried out in Northeastern, Southern and Southeastern Brazil, North of Portugal, in a province of Spain, but most of studies focused on Brazil.

Participants were from different periods, and participation criteria were conditioned to participation of minimum period of two months in a particular project extension, discipline, or period. The criteria aimed at minimizing contact with the subject studied.

The number of participants involved in the survey ranged from 12 to 133. The Brazilian studies had between 12 and 16, Portuguese 72 and Spanish 133 participants. Only one study had a phenomenological approach.

DISCUSSION

In the first study⁽¹¹⁾, the students emphasize that humanized care is based on respect for the individuality of the different subjects and dissociation of negative social behaviors of confinement, discrimination and fear.

What is proposed by the National Humanization Policy (PNH- Política Nacional de Humanização) Policy in the field of Mental Health is challenging. The mechanisms to obtain the protagonism of the subjects and the production of health must be worked during the graduation of health professionals.

The students have become part of the process of acquiring mechanisms that facilitate humanized care, which demonstrates a process of co-responsibility. They emphasize that the lessons precedent to the practice must be transposed by the formation of knowledge by the student-teacher pair, in a joint process.

The second study⁽¹²⁾ is based on the reference of Wanda Horta as an instrument of the teaching-learning process, in this study the students emphasize that the practice contributes to the holistic view of the client which facilitates the linking of ideas from the practical field with the theoretical and minimizing the chances of occurrence of mechanistic care, thus facilitating the use of humanized care.

The third study⁽¹³⁾ shows that extension activity contributes to the emergence of humanized care in the field of Mental Health. This is evidenced not only by the reading of the full text, but also by the fact that a category that related the extension with humanized care has emerged.

The students mention that the possibility of exercising sensitive listening, communication and the creation of bonds with the clients and their families constitute the first competences for the accomplishment of a humanized care in the field of Mental Health.

The fourth study⁽¹⁴⁾ refers to the link between research and practice, and students emphasize that research is an extremely important tool for advancing professional and holistic care.

In the fifth study⁽¹⁵⁾, students perform the association between respect for autonomy and the humanization of care, collaborating with what is advocated in the PNH, which concerns the co-responsibility of the subjects involved in the process and the need for change in care client, in its cultural aspect.

The sixth study⁽¹⁶⁾ collaborates with the idea of the need for the holistic view of the patient as an inspirational and driving source of humanized care.

The seventh study⁽¹⁷⁾ has a pediatric approach and shows that the insertion of play into care leads to reflection on the academy, that practice is a good link for teaching-research-extension triad, resulting in strength and coherence of the same, facilitating the humanization approach and the payment of assistance.

The last study⁽¹⁸⁾ brings students to visualize the humanization process of care in a slow way, where professionals are sensitized with the change of practice, but who need to develop more humanistic qualities to make the process more profitable. They also need to change the look on the family, I am aware of its importance to the client's health illness process, and not as a hindrance to being transposed. Among the human qualities mentioned are: empathy, knowing how to listen, respect and interest in the problematic of the family.

The eight studies bring us the importance of research, as well as care based on science or a theory, as suggested by Wanda Horta, for the improvement of care, since with the use of these light technologies, the student would have ease of chaining practice and theory, a movement that often proves to be a challenge⁽¹⁹⁾.

It is evident the scarcity of bibliographies on the subject, in both realities, inside and outside the country, becoming even more evident in the publications of the international scene. The studies in English contain content of Brazilian research.

This absence of international bibliography is not justified by the search mode, since decs and mesh terms were used for this.

The studies do not present a discrepancy in results, even when compared to studies carried out outside Brazil, or the different care fields, all are unanimous about the vision of humanization in care: it requires a holistic view of the patient so that it is favored, as well as the incorporation of the family into the process^(20-21).

The ease in the chaining of practice and theory is cited in the studies - whose achievement took place in distinct countries like the humanized care carrier.

The achievement of human qualities as a facilitating process of humanized care also has corresponding in another study⁽²²⁾.

The PNH brings a series of questions and mechanisms that may contribute to the humanization of care in the fields of professional activity⁽²⁾. It is evident that this is a gain and a great advance for the improvement of the quality of care, but there is a gap with respect to the formation of the professional,

There is no policy of encouraging the awareness of the need for humanized care in universities. The guideline that guides the undergraduate curriculum is somewhat summarized, since it only mentions humanized care as competence, but does not provide a viability mechanism for the development of such competence, leaving the educational institutions to define the mechanisms for achieving it it, but without any parameter to verify the effectiveness of such, only the possibility of application of the Axiological Scale for the Humanization of Nursing⁽²³⁾.

Studies point out that there are professionals with difficulty in implementing humanization in various care sectors^(24-27). These difficulties are mainly related to the overload of work and the high use of hard technologies^(24-27).

The work developed in the universities needs to be in line with the interests of society, since they form professionals to act in society, directly or indirectly. In the case of Nursing students, who, due to the development of their activities in the assistance, will act directly in the society, making necessary the implementation of a parameter of evaluation of the apprehension of such offer, as well as the expansion of researches in the area, related that the perception of the academics can be known for the elaboration of an intervention that corroborates with the humanized practice^(19,23).

Research is the most palpable mechanism for scenario change. Research is what will renew the knowledge and contribute to the restructuring of care and consequent reach of status the science of Nursing. It is this process that will reaffirm the art of nursing. The art of caring^(3-28).

The study presents limitations regarding the universe of studies obtained due to the scarcity of publications, despite the fact that it is in great evidence, discussion and a challenge both in the academic and in the care setting⁽²⁹⁾.

Reading leads us to the finding of scarcity of publication and the reflection of the need to invest in new research on the subject within the field of Nursing, because only in this way will we improve the formation and consequently the practice and the art of Nursing.

Study limitations

The scarcity of literature is a limitation of the study, evidenced by the low number of articles included in the review.

Contributions to Nursing, Health or Public Policy

The results are relevant, whereas the proposed objectives were contemplated, contributing to the understanding and improvement of the approach regarding the humanization of the student.

FINAL CONSIDERATIONS

In view of the exposed research, it is evident the need to explore the field, considering the timid results and the importance of the subject, since there is in force a nationwide policy of humanization and professionals with difficulty to implement humanization in their practices.

We are also led to reflect on the reasons for the almost non-existence of international publications. Is it the absence of publications arising from the inexistence of problems related to the humanization of assistance?

The student should emerge from the academy, having had the opportunity to contact knowledge that subsidizes their care practice in relation to humanization, since the knowledge from the undergraduate will subsidize their practice, guiding, facilitating or making difficult their practice over of your work day, according to how it was learned.

The university, having knowledge of the understanding and perception of humanization by its clientele, has the possibility to intervene with strategies that best suit them. Having access to information about humanization and/or humanized practices in undergraduate courses, such as through an elective course, a practice based on theories and/or science, the student will already have a foundation when it is formed, remaining only to execute and improve it in your professional life.

REFERENCES

• ¹
  Nations KM, Gomes AMA. Patients' complaints of verbal abuse by health professionals during hospital care in Northeast Brazil. Cad Saúde Pública[Internet]. 2007[cited 2017 Feb 09];23(9):2103-12. Available from: http://dx.doi.org/10.1590/S0102-311X2007000900018
  » http://dx.doi.org/10.1590/S0102-311X2007000900018
• ²
  Brasil. Ministério da Saúde. Secretaria-Executiva. Núcleo Técnico da Política Nacional de Humanização. HumanizaSUS: Política Nacional de Humanização: a humanização como eixo norteador das práticas de atenção e gestão em todas as instâncias do SUS. Brasília: Ministério da Saúde, 2004.
• ³
  Silva LWS, Nazário NO, Silva DS, Martins CR. Art in nursing: initiating a reflexive dialogue. Texto Contexto Enferm[Internet]. 2005[cited 2017 Oct 20];14(1):120-3. Available from: http://dx.doi.org/10.1590/S0104-07072005000100016
  » http://dx.doi.org/10.1590/S0104-07072005000100016
• ⁴
  Brasil. Diretrizes Curriculares Nacionais do Curso de Graduação em Enfermagem. Resolução CNE/CES nº 3, de 7 de novembro de 2001.
• ⁵
  Ortega MCB, Cecagno D, Llor AMS, Siqueira HCH, Montesinos MJL, Soler LM. Academic training of nursing professionals and its relevance to the workplace. Rev Latino-Am Enfermagem[Internet]. 2015[cited 2017 Nov 06];23(3):404-10. Available from: http://dx.doi.org/10.1590/0104-1169.0432.2569
  » http://dx.doi.org/10.1590/0104-1169.0432.2569
• ⁶
  Bracarense CF, Duarte JMG, Soares HM, Côrtes RM, Simões ALA. La humanización en el proceso de formación académica de los profesionales de la salud. Cultura Cuid[Internet]. 2014[cited 2017 Nov 06];18(40):72-81. Available from: http://dx.doi.org/10.7184/cuid.2014.40.10. 10.7184/cuid.2014.40.10
  » http://dx.doi.org/10.7184/cuid.2014.40.10. 10.7184/cuid.2014.40.10
• ⁷
  Brasil. Conselho Nacional de Saúde. Resolução n o 466, de 12 de dezembro de 2012. Brasília, 2012. Available from: http://www.conselho.saude.gov.br/web_comissoes/conep/index.html
  » http://www.conselho.saude.gov.br/web_comissoes/conep/index.html
• ⁸
  Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative review: concepts and methods used in nursing. Rev Esc Enferm USP[Internet]. 2014[cited 2017 Nov 06];48(2):335-45. Available from: http://dx.doi.org/10.1590/S0080-6234201400002000020
  » http://dx.doi.org/10.1590/S0080-6234201400002000020
• ⁹
  Ercole FF, Melo LS, Alcoforado CLGC. Integrative Review versus Systematic Review. Rev Min Enferm[Internet]. 2014[cited 2017 Nov 06];18(1):1-260. Available from: http://reme.org.br/artigo/detalhes/904
  » http://reme.org.br/artigo/detalhes/904
• ¹⁰
  Souza MT, Silva MD, Carvalho R. Integrative review: what is it? how to do it? Einstein[Internet]. 2010[cited 2017 Nov 06];8(1):102-6. Available from: http://dx.doi.org/10.1590/s1679-45082010rw1134
  » http://dx.doi.org/10.1590/s1679-45082010rw1134
• ¹¹
  Macedo JQ, Silveira MFA, Eulálio MC, Fraga MNO, Braga VAB. Social representation of nursing care in mental health: qualitative study. O Braz J Nurs[Internet]. 2011[cited 2017 Oct 21];9(3). Available from: http://dx.doi.org/10.5935/1676-4285.20103139
  » http://dx.doi.org/10.5935/1676-4285.20103139
• ¹²
  Montezeli JH, Venturi KK, Peres AM, Labronici LM, Maftum MA, Wolff LDG. Horta's benchmark as a tool of nursing teaching-learning: assistential convergent research. O Braz J Nurs[Internet]. 2009 [cited 2017 Feb 10];8(1). Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/205555
  » http://www.objnursing.uff.br/index.php/nursing/article/view/205555
• ¹³
  Lima G, Feltrin J, Rodrigues J, Buriola A. Perception of nursing students on mental health home-care: a qualitative approach. JRFCO[Internet]. 2016[cited 2017 Oct 21];8(2):4255-68. Available from: http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/4310
  » http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/4310
• ¹⁴
  Lobo A. Research approach to care: perspective of nursing students. Horiz Enferm[Internet]. 2013[cited 2017 Oct 21];24(1):17-23. Available from: http://horizonteenfermeria.uc.cl/images/pdf/24-1/16_investigaci_horizonte%2024-12013.pdf
  » http://horizonteenfermeria.uc.cl/images/pdf/24-1/16_investigaci_horizonte%2024-12013.pdf
• ¹⁵
  Eberle CC, Silva APSS. Nursing students' understanding on patient safety. Rev Baiana Enferm [Internet]. 2016[cited 2017 Oct 21];30(4):1-9. Available from: https://portalseer.ufba.br/index.php/enfermagem/article/view/21701/pdf
  » https://portalseer.ufba.br/index.php/enfermagem/article/view/21701/pdf
• ¹⁶
  Rocha G, Barcelos I, Coloda R. The distance between the psychiatric asylum and the production of meaning: learning in psychiatric nursing today. Rev Pesqui: Cuid Fundam[Internet]. 2010 [cited 2017 Oct 21];2(4). Available from: http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/580
  » http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/580
• ¹⁷
  Brito TRP, Resck ZMR, Moreira DS, Marques SM. The playful in the daily practices of care in pediatric nursing. Esc Anna Nery[Internet]. 2009[cited 2017 Oct 21];13(4):802-8. Available from: http://eean.edu.br/detalhe_artigo.asp?id=489
  » http://eean.edu.br/detalhe_artigo.asp?id=489
• ¹⁸
  Jiménez AP, Amengual CH, Perdiz AM, Vicens EP, Agullo IR. Algo se está moviendo en los hospitales, ¿será quizás la humanización clínica? Cultura Cuid [Internet]. 2009[cited 2017 Oct 21];10(25):98-103. Available from: https://doi.org/10.14198/cuid.2009.25.13
  » https://doi.org/10.14198/cuid.2009.25.13
• ¹⁹
  Freitas FDS, Ferreira MA. Humanization knowledge of undergraduate nursing students. Rev Bras Enferm[Internet]. 2016[cited 2017 Oct 21];69(2):282-9. Available from: http://dx.doi.org/10.1590/0034-7167.2016690211i
  » http://dx.doi.org/10.1590/0034-7167.2016690211i
• ²⁰
  Luiz FF, Caregnato RCA, Costa MR. Humanization in the Intensive Care: perception of family and healthcare professionals. Rev Bras Enferm[Internet]. 2017[cited 2017 Oct 21];70(5):1040-7. Available from: http://www.scielo.br/pdf/reben/v70n5/0034-7167-reben-70-05-1040.pdf
  » http://www.scielo.br/pdf/reben/v70n5/0034-7167-reben-70-05-1040.pdf
• ²¹
  Salazar OAB. Impersonal Care or Humanized Care: a decision made by nurses? hourglass model. Invest Educ Enferm[Internet]. 2016[cited 2017 Oct 21];34(3):444-55. Available from: http://dx.doi.org/10.17533/udea.iee.v34n3a03
  » http://dx.doi.org/10.17533/udea.iee.v34n3a03
• ²²
  Salazar OAB. The meaning of humanized nursing care for those participating in it: importance of efforts of nurses and healthcare institutions. Invest Educ Enferm[Internet]. 2016[cited 2017 Oct 21];34(1):18-28. Available from: https://dx.doi.org/10.17533/udea.iee.v34n1a03
  » https://dx.doi.org/10.17533/udea.iee.v34n1a03
• ²³
  Serna JMGG, Mencia SF, Marín JMA. Development and validation of the Hospitality Axiological Scale for Humanization of Nursing Care. Rev Latino-Am Enfermagem[Internet]. 2017[cited 2017 Oct 23];25: e2919. Available from: http://dx.doi.org/10.1590/1518-8345.1767.2919
  » http://dx.doi.org/10.1590/1518-8345.1767.2919
• ²⁴
  Pina RZ, Lapchinsk LF, Pupulim JSL. Percepção de pacientes sobre o período de internação em unidade de terapia intensiva. Cienc Cuid Saude[Internet]. 2008 [cited 2017 Oct 23];7(4):503-8. Available from: http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/6658/0
  » http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/6658/0
• ²⁵
  Costa SC, Figueiredo MRB, Schaurich D. Humanization within adult intensive care units (ICUs): comprehension among the nursing team. Interface[Internet]. 2009[cited 2017 Nov 06];13(Suppl-1):571-80. Available from: http://dx.doi.org/10.1590/S1414-32832009000500009
  » http://dx.doi.org/10.1590/S1414-32832009000500009
• ²⁶
  Farias FBB, Vidal LL, Farias, RAR, Jesus ACP. Humanized Care In The Icu: Challenges From The Viewpoint Of Health Professionals. Rev Pesqui: Cuid Fundam[Internet]. 2013[cited 2017 Nov 06];5(4):635-42. Available from: http://seer.unirio.br/index.php/cuidadofundamental/article/view/2283
  » http://seer.unirio.br/index.php/cuidadofundamental/article/view/2283
• ²⁷
  Souza LEPF. Health, development and innovation: a contribution of the critical theory of technology to the discussion. Cad Saúde Pública[Internet]. 2016[cited 2017 Oct 23];32(Suppl-2):e00029615. Available from: http://dx.doi.org/10.1590/0102-311X00029615
  » http://dx.doi.org/10.1590/0102-311X00029615
• ²⁸
  Ferreira MA. Nursing art and science of care. Esc Anna Nery[Internet]. 2011[cited 2017 Oct 20];15(4):664-66. Available from: http://dx.doi.org/10.1590/S1414-81452011000400001
  » http://dx.doi.org/10.1590/S1414-81452011000400001
• ²⁹
  Medeiros AC, Siqueira HCH, Zamberlan C, Cecagno D, Nunes SS, Thurow MRB. Comprehensiveness and humanization of nursing care management in the Intensive Care Unit. Rev Esc Enferm USP[Internet]. 2016[cited 2017 Oct 23];50(5):816-22. Available from: http://dx.doi.org/10.1590/s0080-623420160000600015
  » http://dx.doi.org/10.1590/s0080-623420160000600015

Publication Dates

• Publication in this collection
  2018

History

• Received
  07 Nov 2017
• Accepted
  21 Apr 2018