Taking a look to promoting health and complications' prevention: differences by context

to acknowledge and compare the health promotion and complications' prevention practices performed by nurses working in hospital and primary health care contexts.

Methods:

descriptive, exploratory and crosscutting study, performed with 474 nurses selected by convenience sampling. It was used a form that encompassed two categories of descriptive statements about quality in the professional exercise of nurses. This study had ethical committee approval.

Results:

the nurses' population was mainly women (87,3%) with an average age of 35,5 years. There was more practices of the hospital's nurses related to the identification of potential problems of the patient (p=0.001) and supervision of the activities that put in place the nursing interventions and the activities that they delegate (p=0.003).

Conclusion:

the nurses perform health promotion and complications' prevention activities, however not in a systematic fashion and professional practices differ by context. This study is relevant as it may promote the critical consciousness of the nurses about the need of stressing quality practices.

Descriptors:
Health Promotion; Complications; Nursing; Nursing Process; Patient-Centered Care

Authorship

Rosa Maria de Albuquerque Freire

Doctoral Student, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal. Adjunct Professor, Escola Superior de Enfermagem do Porto, Porto, Portugal.Universidade do PortoPortugalPorto, PortugalDoctoral Student, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal. Adjunct Professor, Escola Superior de Enfermagem do Porto, Porto, Portugal.

Maria José Lumini Landeiro

Maria Manuela Ferreira Pereira da Silva Martins

PhD, Professor, Escola Superior de Enfermagem do Porto, Porto, Portugal.Escola Superior de Enfermagem do PortoPortugalPorto, PortugalPhD, Professor, Escola Superior de Enfermagem do Porto, Porto, Portugal.

Teresa Martins

Heloísa Helena Ciqueto Peres

PhD, Full Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilPhD, Full Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.

Corresponding Author: Rosa Maria de Albuquerque Freire Escola Superior de Enfermagem do Porto. ESEP Rua Dr. António Bernardino de Almeida Porto, Portugal 4200-072 E-mail: rosafreire@esenf.pt

SCIMAGO INSTITUTIONS RANKINGS

Tables

Tables (4)

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Table 1
Frequency distribution of nurses in both contexts according to gender, age, and academic achievement, lifelong time of practice and time of practice in present site. Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

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Table 2
Frequency distribution of nurses by the quality standards for professional practice in health promotion and complications' prevention and their respective descriptive statements (n =474). Porto and Coimbra, Portugal, 2013-2014.

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Table 3
Frequency distribution of nurses of both contexts by the quality standards for professional practice in health promotion and their respective descriptive statements by groups Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

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Table 4
Frequency distribution of nurses of both contexts by the quality standards for professional practice in complications' prevention and their respective descriptive statements by groups Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

Table 1 Frequency distribution of nurses in both contexts according to gender, age, and academic achievement, lifelong time of practice and time of practice in present site. Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

Variables		Hospital (n=235)		ACeS^† (n=239)		Total		p
Variables		n	%	n	%	n	%
Sex								0.001*
	Males	42	17,9	18	7,5	60	12,7
	Females	193	82,1	221	92,5	414	87,3
Age groups
	21-30	85	36,2	80	33,5	165	34,8	0.026*
	31-40	91	38,7	99	41,4	190	40,1
	41-50	45	19,1	30	12,6	75	15,8
	51-60	14	6	30	12,6	44	9,3
Academic achievement								<0.001*
	Degree in nursing	170	72,3	65	27,2	235	49,6
	Post-graduate	65	27,7	174	72,8	239	50,4
Lifelong time of practice (years)								<0.001*
	1-10	116	49,4	172	72	288	60,8
	11-20	79	33,6	52	21,8	131	27,6
	21-30	31	13,2	12	5	43	9,1
	31-40	9	3,8	3	1,3	12	2,5
Time of practice in present site (years)								<0.001*
	1-10	168	71,5	239	100	407	85,9
	11-20	51	21,7	0	0	51	10,8
	21-30	12	5,1	0	0	12	2,5
	31-40	4	1,7	0	0	4	0,8

*p <0.05
†ACeS: Group of Health Units

Table 2 Frequency distribution of nurses by the quality standards for professional practice in health promotion and complications' prevention and their respective descriptive statements (n =474). Porto and Coimbra, Portugal, 2013-2014.

Variables		Never		Seldom		Sometimes		Always		p
Variables		n	%	n	%	n	%	n	%
Health promotion
	Nurses identify the health situations of the population and the patients, family and community resources	1	0,2	51	10,8	294	62	128	27	<0.001^*
	Nurses use the opportunity of hospitalization to promote healthy lifestyles	1	0,2	47	9,9	224	47,3	202	42,6	<0.001^*
	Nurses provide information fostering cognitive learning and new capabilities for the patient	-		31	6,5	249	52,5	194	40,9	<0.001^*
Complications' prevention
	Nurses identify the potential problems of the patient	-		15	3,2	257	54,2	202	42,6	<0.001^*
	Nurses prescribe and implement interventions geared towards the complications' prevention	-		21	4,4	235	49,6	218	46	<0.001^*
	Nurses assess the interventions that will help to avoid problems or minimize undesirable effects	-		41	8,6	221	46,6	212	44,7	<0.001^*
	Nurses show stringent scientific and technical stance in implementing nursing interventions	-		26	5,5	232	48,9	216	45,6	<0.001^*
	Nurses refer problematic cases to other professionals according to social mandates	1	0,2	39	8,2	228	48,1	206	43,5	<0.001^*
	Nurses supervise the activities that put in place nursing interventions and those that they delegate	-		46	9,7	250	52,7	178	37,6	<0.001^*
	Nurses show responsibility for their decisions, for their acts and for those that they delegate	-		11	2,3	55	32,7	308	65	<0.001^*

*p <0.05.

Table 3 Frequency distribution of nurses of both contexts by the quality standards for professional practice in health promotion and their respective descriptive statements by groups Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

Variables		Never	Seldom			Sometimes			Always		p
Variables		n	%		n	%	n	%	n	%
Health promotion
	Nurses identify the health situations of the population and the patients, family and community resources	Hospital	1	0,4	23	9,8	154	65,5	57	24,3	0.301
		ACeS^†	0	0	28	11,7	140	58,6	71	29,7	0.301
	Nurses use the opportunity of hospitalization to promote healthy lifestyles	Hospital	0	0	30	12,8	129	54,9	76	32,3	<0.001^*
		ACeS^†	1	0.4	17	7,1	95	39,7	126	52,7	<0.001^*
	Nurses provide information fostering cognitive learning and new capabilities for the patient	Hospital	0	0	18	7,7	132	56,2	85	36,2	0.098
		ACeS^†	0	0	13	5,4	117	49	109	45,6	0.098

*p <0.05
†Group of Health Units.

Table 4 Frequency distribution of nurses of both contexts by the quality standards for professional practice in complications' prevention and their respective descriptive statements by groups Hospital (n=235) and ACeS (n=239). Porto and Coimbra, Portugal, 2013-2014.

Variables		Never	Seldom			Sometimes			Always		p
Variables		n	%		n	%	n	%	n	%
Complications' prevention
	Nurses identify the potential problems of the patients	Hospital	0	0	4	1,7	112	47,7	119	50,6	0.001^*
	Nurses identify the potential problems of the patients	ACeS^†	0	0	11	4,6	145	60,7	83	34,7	0.001^*
	Nurses prescribe and implement interventions geared towards the prevention of complications	Hospital	0	0	12	5,1	107	45,5	116	49,4	0.205
		ACeS^†	0	0	9	3,7	128	53,6	102	42,7	0.205
	Nurses assess the interventions that will help to avoid problems or minimize undesirable effects	Hospital	0	0	14	6	108	46	113	48	0.077
		ACeS^†	0	0	27	11,3	113	47,3	99	41,4	0.077
	Nurses show stringent scientific and technical stance in implementing nursing interventions. enfermagem	Hospital	0	0	11	4,7	114	48,5	110	46,8	0.696
		ACeS^†	0	0	15	6,3	118	49,4	106	44,3	0.696
	Nurses refer problematic cases to other professionals according to social mandates	Hospital	1	0,4	15	6,4	127	54	92	39,1	0.039^*
		ACeS^†	0	0	24	10	101	42,3	114	47,7	0.039^*
	Nurses supervise the activities that put in place nursing interventions and those that they delegate	Hospital	0	0	12	5,1	126	53,6	97	41,3	0.003^*
		ACeS^†	0	0	34	14,2	124	51,9	81	33,9	0.003^*
	Nurses show responsibility for their decisions, for their acts and for those that they delegate	Hospital	0	0	4	1,7	76	32,3	155	66	0.652
		ACeS^†	0	0	7	2,9	79	33,1	153	64	0.652

*p <0.05
†Group of Health Units

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Taking a look to promoting health and complications' prevention: differences by context

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[1] Corresponding Author: Rosa Maria de Albuquerque Freire Escola Superior de Enfermagem do Porto. ESEP Rua Dr. António Bernardino de Almeida Porto, Portugal 4200-072 E-mail: rosafreire@esenf.pt