Evaluación del conocimiento enfermero en el manejo al paciente neutropénico

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Abstract

Objetivo: Evaluar el conocimiento del personal de enfermería sobre el manejo del paciente oncológico con neutropenia febril. Método: Estudio observacional descriptivo evaluativo con 35 enfermeros pertenecientes a centros hospitalarios de Ciudad de la Habana durante el período 2006-2008. Se diseño un cuestionario estructurado que fue aplicado con previo consentimiento de los enfermeros participantes. Resultados: De los 35 enfermeros encuestados, el 51.4% son licenciados, 54.4% trabajan en institutos, el 57.1% ejercen funciones asistenciales, y el 37.7% laboran en servicios oncohematologicos. Los años de experiencia de trabajo en el servicio oscilan entre 1 y 2 años. El 68.5% posee mucho conocimiento sobre neutropenia, poco un 25.7% y no tienen conocimientos el 5.7%. Conclusiones: El nivel de conocimiento fue evaluado en su mayoría de mucho, y se asoció al antecedente de haber recibido cursos postgrados sobre Oncología y adiestramientos de los enfermeros en los servicios donde laboran.

Translated abstract

Objective: To evaluate the nursing staff's knowledge about management of cancer patients with febrile neutropenia. Methodology: An observational descriptive study was carried out with 35 nurses of hospital centers in Havana city, from 2006 to 2008. A structured survey was designed and then applied, with previous consent, to the participating nurses. Results: Out of 35 nurses interviewed, 51.4% have their degree, 54.4% work in institutes, 57.1% perform assistance functions and 37.7% work in oncohematologic services. Work experience in this service is between one and two years. 68.5% of nurses know a lot about neutropenia, 25.7 % know a little, and 5.7 % do not know anything about the topic. Conclusions: The knowledge level was high in the majority, and it was associated with the precedent of having received postgraduate courses regarding Oncology and training from the nurses in the units where they work.

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Borderline personality disorder across the lifespan.

Melissa Hunt (2007)

Borderline personality disorder is characterized by affective dysregulation, intense, unstable interpersonal relationships, impulsivity and unstable identity. It overlaps considerably with both PTSD and bipolar spectrum disorders. Research on true late-life BPD is limited, but suggests that some of the core features of BPD including interpersonal difficulties, unstable affect and anger remain relatively unchanged, while impulsivity and identity disturbance decline or change their mode of expression in late life. Diagnosis of BPD in late life requires both flexible application of the standard diagnostic criteria as well as a thorough longitudinal history. The etiology of BPD is best explained as a combination of genetic, neurobiological vulnerability combined with childhood trauma, abuse or neglect that leads to dysregulated emotions, distorted cognitions, social skills deficits, and few adaptive coping strategies. Treatment options include pharmacotherapy (especially mood stabilizers, SSRIs and atypical antipsychotics) and psychotherapeutic interventions that focus on distress tolerance, affective regulation, changing distorted beliefs, and introducing new social and relationship problem solving skills (especially Dialectical Behavior Therapy and Schema Focused Cognitive Therapy). In late life care environments, such as nursing homes and other residential facilities, staff need to be empowered to set appropriate limits on problematic behavior while maintaining empathy and validating the painful affect patients often experience.