Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 16 nº 3 - Jul/Sep - 2019

Original Article Imprimir 

Páginas 51 a 58


The scientific production of Adolescent Health Nursing residents of a university hospital in Rio de Janeiro (RJ)

La producción científica de los residentes de enfermería de salud adolescente de un hospital universitario en Río de Janeiro (RJ)

A produção científica dos residentes de Enfermagem em Saúde do Adolescente de um hospital universitário do Rio de Janeiro (RJ)

Autores: Mellina Fernanda Silva dos Santos Gualberto1; Helena Ferraz Gomes2; Dayana Carvalho Leite3; Ellen Márcia Peres4; Ariane da Silva Pires5

1. Resident at the Adolescent Health Nursing Program at Pedro Ernesto University Hospital (HUPE - UERJ). Rio de Janeiro, RJ, Brazil
2. Doctoral student in Nursing from the State University of Rio de Janeiro (UERJ). Master in Nursing from the State University of Rio de Janeiro (UERJ). Teacher at the Department of Medical-Surgical Nursing (DEMC), School of Nursing, Rio de Janeiro State University (ENF/UERJ). Rio de Janeiro, RJ, Brazil
3. Nurse at the Center for Adolescent Health Studies (NESA), Coordinator and Tutor for the Adolescent Health Nursing Residency Program at Pedro Ernesto University Hospital (HUPE - UERJ). Rio de Janeiro, RJ, Brazil
4. Doctor in Community Health from the Abel Salazar Institute of Biomedical Sciences (ICBAS). Porto, Portugal. Doctor in Collective Health - Health Policy, Planning and Administration, by the Institute of Social Medicine of the State University of Rio de Janeiro (IMS/UERJ). Teacher of the Department of Medical-Surgical Nursing (DEMC), School of Nursing, Rio de Janeiro State University (ENF/UERJ). Rio de Janeiro, RJ, Brazil
5. Doutor Student in Nursing by the State University of Rio de Janeiro (UERJ). Teacher in the Departament of Medical-Surgical Nursing (DEMC) of the Nursing College at the State University of Rio de Janeiro (ENF/UERJ). Rio de Janeiro, RJ, Brasil

Mellina Fernanda Silva dos Santos Gualberto
(mellinafernanda@hotmail.com)
Faculdade de Enfermagem da Universidade do Estado do Rio de Janeiro
Boulevard 28 de Setembro, 157, Vila Isabel
Rio de Janeiro, RJ, Brasil. CEP: 20551-030

Submitted on 12/17/2018
Approved on 09/02/2019

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How to cite this article

Keywords: Nursing, Practical; Adolescent; Monograph.
Palabra Clave: Enfermería práctica; Adolescente Monografía.
Descritores: Enfermagem Prática; Adolescente; Monografia.

Abstract:
OBJECTIVE: Analyze the scientific production of Adolescent Health Nursings residents between 2007 and 2017.
METHODS: This is a descriptive, quantitative study, conducted through documentary analysis of the Conclusion of Residence Works (CRW) of the Adolescent Health Nursing Residency Program of Pedro Ernesto University Hospital. Based on the inclusion and exclusion criteria, 18 CRW were selected for analysis. The data were collected in June and July of 2018, through search in electronic media. The data were tabulated and organized with the application of simple descriptive statistics, presented in form of charts and tables.
RESULTS: Of the analyzed studies, 44.44% (n=8) use qualitative research methods. The semi-structured interview technique was used in 39% (n=7) of the studies, with the ward scenario being 45% being on the ward (n=8), with chemotherapy 16% (n=3) and adolescent pregnancy 16% (n=3) the most addressed themes.
CONCLUSION: The study allowed to characterize the scientific production of nursing residents in Adolescent Health, serving as subsidies for a new look at the problems arising from care practice. They demonstrate to be in line with the public policies aimed at this specific population and the reality of the service.

Resumen:
OBJETIVO: Analizar la producción científica de los residentes de Enfermería en Salud del Adolescente, entre los años 2007 a 2017.
MÉTODOS: Este es un estudio descriptivo, de naturaleza cuantitativa, realizado a través del análisis documental de la Conclusión de los Trabajos de Residencia (TCR) del Programa de Residencia en Enfermería en Salud del Adolescente, Hospital Universitario Pedro Ernesto de Enfermería en Salud del Adolescente, entre 2007 y 2017. Según los criterios de inclusión y exclusión, se seleccionaron 18 artículos para su análisis. Los datos se recopilaron en junio y julio de 2018 a través de la búsqueda en medios electrónicos. Los datos se tabularon y organizaron utilizando estadísticas descriptivas simples, presentadas en tablas y gráficos.
RESULTADOS: De los estudios analizados, 44.44% (n = 8) utilizan métodos de investigación cualitativa. La técnica de entrevista semiestructurada se utilizó en el 39% (n = 7) de los estudios, con un escenario de sala del 45% (n = 8), con quimioterapia 16% (n = 3) y embarazo adolescente 16% (n = 3) los temas más abordados.
CONCLUSIÓN: El estudio permitió caracterizar la producción científica de los residentes de enfermería en Salud de los Adolescentes, sirviendo como subsidios para una nueva mirada a los problemas que surgen de la práctica de la atención. Demuestran estar en línea con las políticas públicas dirigidas a esta población específica y la realidad del servicio.

Resumo:
OBJETIVO: Analisar a produção científica dos residentes de Enfermagem em Saúde do Adolescente, entre os anos de 2007 e 2017.
MÉTODOS: Este é um estudo descritivo, de natureza quantitativa, realizado através da análise documental dos Trabalhos de Conclusão de Residência (TCR) do Programa de Residência de Enfermagem em Saúde do Adolescente, do Hospital Universitário Pedro Ernesto. A partir de critérios de inclusão e exclusão foram selecionados 18 trabalhos para análise. Os dados foram coletados nos meses de junho e julho de 2018, por meio de busca em mídia eletrônica. Os dados foram tabulados e organizados com aplicação da estatística descritiva simples, apresentados em forma de tabelas e gráfico.
RESULTADOS: Dos trabalhos analisados, 44,44% (n=8) utilizam métodos de pesquisa qualitativos. A a técnica de entrevista semiestruturada foi empregada em 39% (n=7) dos estudos, tendo por cenário a enfermaria 45% (n=8), sendo a Quimioterapia 16% (n=3) e Gravidez na adolescência 16% (n=3) as temáticas mais abordadas.
CONCLUSÃO: O estudo permitiu caracterizar a produção científica dos residentes de enfermagem em Saúde do Adolescente, servindo de subsídios para um novo olhar frente aos problemas oriundos da prática assistencial. Demonstram estar consonantes com as políticas públicas voltadas para esta população específica e com a realidade do serviço.

INTRODUCTION

The aim of this study is to map the scientific production of the Adolescent Health Nursing Residency Program of the State University of Rio de Janeiro (UERJ), linked to the Faculty of Nursing (ENF) and the University Hospital Pedro Ernesto (HUPE). It is noteworthy that scientific production refers to the modality of completion of the course work, adopting, in this research, the term Residency Completion Work (TCR).

The Nursing Residency Specialization course is a form of lato sensu postgraduate education for nurses, characterized by in-service teaching with a workload of 60 hours per week and a minimum duration of two years1.

Regarding nursing residency and the necessary requirements for specialist training in the form of in-service training, Resolution No. 3 of 4 May 2010 provides for the duration and workload of Multiprofessional Health Residency programs and Residency in Health Professional Area, as well as the need for individual presentation of a monograph or scientific article with proof of protocol for submission to publication1.

It is noteworthy that the Adolescent Health Nursing Residency Program is inserted in the clinical area of the Faculty of Nursing (ENF), offering four vacancies annually. Initiation in the research occurs in the first months of the first year of residence, where the mentor and advisor begin to delimit the theme to be developed and the necessary subsidies to conduct the research.

Mendes2 points out that nursing needs the development of research for its growth, being a fundamental requirement in the creation and validation of the knowledge necessary for its practice, besides ensuring professional status through the awareness that the autonomy of the profession depends on the art of mastering knowledge that is his own.

In addition, knowledge production is necessary for problem solving, and nursing must act in teaching, research and extension, socializing knowledge and ensuring research that can intervene in everyday reality3.

However, the development of research will involve the organization of steps defined by the researcher in conjunction with his advisor and will start with the choice of the theme to be investigated, which sometimes refer to the problems experienced by the researcher in daily practice4.

From these considerations, the authors observed the need to analyze the scientific productions of the Adolescent Health Residency Program, in relation to the main researched themes involving the adolescent being, the nursing care to these subjects, and the relationship with the scenarios of practical experience experienced by residents during their residency.

It is noteworthy that the State of Rio de Janeiro does not have specialized units in Adolescent Health focusing on different levels of health care, being the Nucleus of Study of Adolescent Health (NESA) a reference for this specialty. In addition, the nursing residency program is the only program in the country to offer vacancies for the training of the hebiatra nurse.

Aquino5 corroborates this statement by pointing out that in Brazil the units for comprehensive health care for adolescents date from 1974, but they are few and the exact number of units is unknown.

In this sense, it is essential to delineate the themes researched by specialist nurses in the area of comprehensive health care for adolescents, assessing their consonance with the reality of health services and the health-disease process of this population group.

Given the above, the following research problem was delimited: What is the scientific production of the Residency in Nursing in Adolescent Health between 2007 and 2017? The objective was to analyze the scientific production of residents of Adolescent Health Nursing between 2007 and 2017.


METHODS

This is a descriptive study, quantitative in nature, conducted through document analysis. The RCTs of the Adolescent Health Nursing Program of the Pedro Ernesto University Hospital, in Rio de Janeiro, were stored as electronic media in the CD - units at the Nursing Training and Evaluation Service (STAVE).

In the months of June and July 2018, data were collected from the TCR performed from 2007 to 2017. This time frame was defined after prior consultation with STAVE, as there were no materials prior to 2007.

The sample consisted of 18 papers selected based on the following inclusion criteria: Complete Residency Conclusion Papers, available on electronic media - CD drives, and with final approval. TCRs that did not meet the following criteria were excluded: jobs whose electronic media - CD drives were not openable and viewable, incomplete and unavailable materials.

The variables defined by the authors for the creation of the Data Collection Instrument (ICD) were: author, advisor and coordinator, year, central theme addressed, methodology (type of study, study participants, research scenario) and conclusion. The instrument was previously tested and adjusted to meet the study objective. The works were handled directly by the authors and the undergraduate researcher, with simultaneous completion of the forms, after previous training.

Data were tabulated and organized using descriptive statistics and were grouped into absolute and relative frequencies. For analysis of these data, a database was built with Microsoft Excel Office XP. After analysis, the data were presented in table and graph format.

It is noteworthy that the research does not require registration in Brazil platform because it is access data available from documentary sources.


RESULTS

It was found that 40 RCTs should have been defended between 2007 and 2017, according to the number of annual vacancies opened by the Program. However, during these years, four (4) works were not defended, as residents did not complete the course; no electronic (CD) media was found for five (5) papers, although residents successfully completed the course; and thirteen (13) vacancies were idle, that is, the approved did not register during the period analyzed. Therefore, the study sample consisted of 18 homework completion papers.

Regarding the methodological approach, 44.44% (n = 8) of the studies were qualitative, 22.22% (n = 4) were quantitative, 22.22% (n = 4) were integrative review. , and only 11.11% (n = 2) quantitative and qualitative, as shown in Table 1.




Regarding the data collection technique, 39% (n = 7) used semi-structured interviews, 22% (n = 4) performed integrative database review, 17% (n = 3) structured interviews, 17% (n = 3) phenomenological interviews, and only 5% (n = 1) documentary analysis, according to Table 2.




Regarding the distribution of works in relation to the researched scenario, of the 14 articles that were developed in the field, 57% (n = 8) were performed in the ward, 29% (n = 4) in the outpatient clinic, and only 14% (n = 2) in the Polyclinic. It is noteworthy that, during the period outlined in the research, the Adolescent Health Studies Nucleus functioned at the primary level in a polyclinic, at the secondary level in an outpatient clinic and at a tertiary level in a ward, all linked to a Rio de Janeiro State Public University, according to Table 3.




The thematic areas most addressed by the RCT, when compared to the other themes, were Chemotherapy 16% (n = 3) and Adolescent Pregnancy 16% (n = 3), as observed in Figure 1.


Figure 1. The thematic areas most addressed in the Conclusion of Residence Work analyzed.



DISCUSSION

Most studies with adolescents present qualitative research as the preferred methodological approach, and semi-structured interview as the most used data collection technique. One possible inference is that this type of research is best suited to understanding the nuances surrounding adolescence as an object of scientific investigation.

Qualitative research is appropriate for several unknown areas of knowledge, themes and problems that require appropriate answers, as the process of this type of research, collects, analyzes, and at the same time, reformulates new questions and is effective. by analyzing the social processes of human life and the social understanding of the world6.

As for the practice scenarios of residents there is a predominance of studies in the ward. However, the polyclinic, primary level unit in which residents develop nursing consultation activities, health education through waiting rooms, activities in schools, among others, had incipient scientific production.

The importance of actions focused on the promotion, prevention and care triad by the entire health team is highlighted, being the first two of greater relevance in the work process, meeting the principles and guidelines of the Unified Health System, considered to be great relevance, for co-responsibility and strengthening the bond in the nurse-adolescent relationship. Health promotion crosswise permeates all health policies, programs and actions, with the challenge of constituting integrality and equity7,8.

Still, observing the themes analyzed, we highlight some themes that emerge as social processes, such as violence, teenage pregnancy and HIV / AIDS. These themes are in line with those proposed by the National Guidelines for Comprehensive Health Care for Adolescents and Youth in promoting, protecting and restoring health. However, some structuring themes for the Comprehensive Health Care of Adolescents and Youths still need to be investigated, such as youth participation in society, gender equity, sexual rights, reproductive rights, life project, ethics and citizenship, racial equality. and ethnic, among other themes9.

Teenage pregnancy is considered a high risk pregnancy due to complications that can bring to the teenage mother and the newborn. For this reason, it is incorporated into a situation of psychosocial risk, affecting the biography of youth and the possibility of forming a stable life, being a very traumatic factor especially in socioeconomically unfavorable classes, contributing even more to the maintenance of poverty10,11.

Adolescent pregnancy includes some aspects, since adolescents are not prepared to take care of another being, besides being a population that is exposed to sexually transmitted infections, licit and illicit drug use, and various forms of violence. extremely vulnerable12.

Therefore, it has a great impact on adolescent life, and research in this area may contribute to the understanding of this phenomenon.

In addition, there is a growing concern from various sectors of society regarding teenage pregnancy, understood as a social and public health problem, corroborated by the growing number of adolescents who have become pregnant in recent years13,11.

Added to this is the fact that teenage pregnancy is one of the most worrying issues related to sexuality, due to the implications of this event, such as abortion, morbidity and maternal mortality. When pregnancy occurs in the age group of 10 to 14 years, the disorders are even greater due to unplanned, often being interrupted by abortion performed in poor technical conditions, with risk of developing serious complications, which may lead to the death of adolescents14.

It is also observed that one of the most researched themes was Chemotherapy. The survey of the hospitalization profile in the tertiary care of the Adolescent Health Studies Center points out as prevalent oncohematological and hematological pathologies, such as leukemia, lymphoma, purpura, sickle cell anemia, thalassemia, coagulation disorders, aplastic anemia, among others. The treatment of most of these conditions is based on antineoplastic therapy.

Although rare in absolute numbers compared to incidences in adults, childhood cancer has shown an increase in incidence rates. Previously, cancer was considered an acute and fatal disease and today has characteristics of chronic disease15.

There are several types of treatment and among them, chemotherapy is the most common, associated or not with other therapies. The treatment protocol is established according to the type of tumor, its biological behavior, location, disease extent, age and general conditions of the patient15.

In addition, chemotherapy treatment promotes a series of transformations in the lives of those who receive it, changes their body, emotional state and routine, as well as their families. Due to these factors, issues related to quality of life are seen as priorities, however, despite the adverse effects, chemotherapy is seen as a source of life16.

Therefore, chemotherapy impacts the lives of adolescents and their families. In this sense, research involving this theme is paramount in the context of health and adolescent care.

It is noteworthy that another issue that is poorly produced, but with a great advance at the hospital and outpatient level, is the central peripheral insertion catheter (PICC), a device that allows the administration of fluids and drugs that cannot be infused through peripheral access17. This type of catheter is widely used in patients undergoing antineoplastic chemotherapy.

As for chronic diseases, they represent a challenge for adolescents, family members and health professionals, as they imply significant changes in the adolescent's lifestyle and family environment. Nursing care should establish care in treatment and routines, as well as provide support, relief and encouragement so that adolescents and their families can live the best possible way to face their chronic disease18.

In this sense, there is a need for research involving important themes in nursing, in the context of adolescent care in the various vulnerabilities involved, such as care, the process of care, the systematization of nursing care.

Finally, there is the need to produce care according to the real health needs of these subjects. Care should be appropriate to adolescents, understanding the particularities of this phase of life, regarding biopsychosocial transformations, because the different ways of thinking and acting of these subjects, presuppose different forms of interaction with the world, resulting from actions based on subjectivity19 .

Nursing professionals need to know and understand the reality of adolescents to offer care that can make them better cope with illness and hospitalization20. For this, it is necessary to deepen the health-disease process of this population group with emphasis on nursing care through scientific investigations in the various scenarios of professional practice.


CONCLUSION

The analysis of the scientific production of the residency in Nursing in Adolescent Health, from 2007-2017, showed the tendency of residents to produce studies with a qualitative methodological approach, using semi-structured interviews technique, using the ward scenario.

The themes related to Chemotherapy and Pregnancy in adolescence was the most investigated. However, there is the absence of scientific productions focused on themes related to youth participation in society, gender equity, sexual rights, reproductive rights, life project, ethics and citizenship, racial and ethnic equality, among others.

The study allowed to characterize the scientific production of the residents of Adolescent Health Nursing, serving as subsidies for a new look at the problems arising from the care practice that require scientific investigation. Thus, they are in line with public policies aimed at this specific population and the reality of the service.

It is hoped that this study can contribute to nurses and nursing residents, signaling the gaps to be addressed in improving adolescent nursing care in the various scenarios of residency practice, from a comprehensive care perspective, through quality care.

As limitations of the study it is worth mentioning the absence of completion of residency papers prior to 2007, as well as those that were not for research in the period outlined in data collection.


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