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Nurses and primary care service users: bioethics contribution to modify this professional relation
Zoboli, Elma Lourdes Campos Pavone;
Acta Paulista de Enfermagem , 2007, DOI: 10.1590/S0103-21002007000300012
Abstract: objective: to identify ethical issues experienced by nurses during their clinical practice in primary care settings and to explore ways to improve the nurse-patient ethical relationship. methods: this qualitative descriptive study was conducted through semi-structured interviews with 17 registered nurses from a family health program in s?o paulo city, brazil. data were analyzed through content analysis. results: ethical issues in primary care settings are not serious and do not demand immediate attention. ethical issues in these settings can be easily resolved through good nurse-patient relationship. conclusion: the main ethical principles of autonomy, justice, and beneficence may contribute to better citizenship and health promotion.
A redescoberta da ética do cuidado: o foco e a ênfase nas rela??es
Zoboli, Elma Lourdes Campos Pavone;
Revista da Escola de Enfermagem da USP , 2004, DOI: 10.1590/S0080-62342004000100003
Abstract: the author presents a discussion of the meanings, the historical aspects and the different explanatory frameworks for the ethics of care. the main purpose is to contribute to the debate concerning the core role of care in nursing and nursing ethics. it also addresses the opposition between feminine and feminist ethics as an explanation for the secondary role of the ethics of care.
Bioética e saúde: novos tempos para mulheres e crian as?
Zoboli Elma Lourdes Campos Pavone
Cadernos de Saúde Pública , 2006,
Abstract:
Bioética e aten??o básica: um perfil dos problemas éticos vividos por enfermeiros e médicos do Programa Saúde da Família, S?o Paulo, Brasil
Zoboli, Elma Lourdes Campos Pavone;Fortes, Paulo Antonio de Carvalho;
Cadernos de Saúde Pública , 2004, DOI: 10.1590/S0102-311X2004000600028
Abstract: this is a qualitative empirical study of descriptive ethics conducted with nurses and physicians working in the family health program (fhp) in the city of s?o paulo, brazil. the objective was to identify ethical problems experienced by these professionals, who were asked to record ethical problems they had faced through a short written description of such events. the results revealed ethical problems involving patients and their families, the health team, organization, and the health system. the study addresses ethical issues permeating daily health care practice and requiring immediate solutions, rather than the classical dilemmas usually found in bioethics literature. the peculiarity of ethical problems in primary care may hinder their identification as such and jeopardize the relationships upon which the fhp is built.
Bioética e saúde coletiva: convergências epistemológicas
Junges,Jose Roque; Zoboli,Elma Lourdes Campos Pavone;
Ciência & Saúde Coletiva , 2012, DOI: 10.1590/S1413-81232012000400026
Abstract: this is a theoretical discussion about the epistemological statute of bioethics based on its convergences with public health, linked as scientific areas that came from the context of the second epistemological rupture, which questioned the critique to common sense inherent in modern science. the reapproximation with common sense in the second rupture means considering the determinants of environment and subjectivity in the methodology. emerging from the second rupture, public health and bioethics include the social and subjective determinants in their analysis, with an enlarged and complex vision of human health and human actions involving environment, life and health. this requires a transdisciplinary focus in their approaches. what is the meaning of these premises for the epistemological statute of bioethics in its convergence with public health? as ethics, bioethics needs to be critical, but not aprioristic. the criticism of bioethics needs to come from the facticity of the social determinants expressed by the health iniquities. the only way to integrate criticism and facticity is hermeneutics, interpreting the significances constructed in the reality and become critical therefrom. this is the epistemological statute appropriate to bioethics in its convergence with public health.
Descri??o e análise do acolhimento: uma contribui??o para o Programa de Saúde da Família
Fracolli, Lislaine Aparecida;Zoboli, Elma Lourdes Campos Pavone;
Revista da Escola de Enfermagem da USP , 2004, DOI: 10.1590/S0080-62342004000200004
Abstract: the humanist and efficient healthcare required by the family health program makes the "embracement" essential. this study aimed to identify how the "embracement" was developed at family healthcare services in sao paulo, sp. brazil. the authors observed several "embracement" links and interviewed healthcare professionals. the results pointed out the clinical and biological focuses of the "embracement". they also showed that "embracement" resolution is limited and does not entail bounding. to make the healthcare services more accessible, according to the proposal of the national health system, the theoretical and practical perspectives of the "embracement" must be reviewed.
Capacita o em bioética para profissionais da Saúde da Família do município de Santo André, SP Capacitación en bioética para profesionales de la salud de la familia del municipio de Santo André-SP A training course on bioethics for family health strategy professionals in Santo André, SP
Elma Lourdes Campos Pavone Zoboli,Fátima Aparecida Cotrim Soares
Revista da Escola de Enfermagem da USP , 2012, DOI: 10.1590/s0080-62342012000500029
Abstract: Relato de experiência da capacita o em bioética para enfermeiros e médicos da Estratégia Saúde da Família, Santo André, SP. Trata-se de trabalho calcado na problematiza o e bioética deliberativa, que objetivou apresentar o procedimento da delibera o para subsidiar o manejo de problemas éticos. Trabalharam-se os conteúdos transversalmente em cinco sequências de atividades, em dois momentos de concentra o, intercalados por um de dispers o. Na primeira concentra o, desenvolveram-se conceitos chaves e conteúdos da bioética deliberativa. Na segunda, houve sess es de delibera o para situa es de conflito moral, selecionadas e preparadas durante a dispers o. Os participantes avaliaram a delibera o como um instrumental adequado para lidar com as quest es éticas que vivem. A problematiza o mostrou-se efetiva como estratégia educativa na forma o contínua em bioética deliberativa. Relato de experiencia sobre la capacitación en bioética para enfermeros y médicos de la Estrategia Salud de la Familia, Santo André-SP. Enfocada en la problematización y bioética deliberativa, objetivó presentar el procedimiento de deliberación para coadyuvar el manejo de problemas éticos. Se trabajaron transversalmente los contenidos en cinco secuencias de actividades, en dos momentos de concentración, intercalados por uno de dispersión. En la primera concentración, se desarrollaron conceptos llave y contenidos de la bioética deliberativa. En la segunda, hubo sesiones de deliberación para situaciones de conflictos morales seleccionados y preparados durante la dispersión. Los participantes evaluaron la deliberación como un instrumental adecuado para lidiar con las cuestiones éticas que viven. La problematización se mostró efectiva como estrategia educativa en la capacitación permanente en bioética deliberativa. This case report presents the experience of a training course on bioethics for nurses and physicians of the Family Health Strategy in Santo André, SP. This study is based on problem-based learning and deliberative bioethics, and aimed at presenting the deliberation procedure as a means of handling ethical issues. Contents were addressed in a cross-section manner through five sequential activity sessions at two different moments of concentration with one dispersion interval. In the first moment of concentration, key concepts and deliberative bioethics contents were developed. The second involved deliberation sessions on moral conflicts, which were selected and prepared during the dispersion interval. Participants evaluated the deliberation as an appropriate instrument to d
Dignity in care: where next for nursing ethics scholarship and research? Dignidad del cuidado: qué se plantea como futuro para estudios e investigaciones de ética en enfermería? Dignidade no cuidado: como prosseguir nos estudos e na pesquisa sobre ética em enfermagem?
Ann Gallagher,Elma Lourdes Campos Pavone Zoboli,Carla Ventura
Revista da Escola de Enfermagem da USP , 2012, DOI: 10.1590/s0080-62342012000700008
Abstract: Dignity is recognised as both a central and also a contested value in bioethics discourse. The aim of this manuscript is to examine some of the key strands of the extensive body of dignity scholarship and research literature as it relates to nursing ethics and practice. The method is a critical appraisal of selected articles published in Nursing Ethics and other key manuscripts and texts identified by researchers in the UK and Brazil as influential. The results suggest a wide and rather confusing range of perspectives and findings albeit with some overall themes relating to objective and subjective features of dignity. In conclusion, the authors point to the need for more sustained philosophical engagement contextualising human dignity within a plurality of professional values. Future empirical work should explore what matters to patients, families, professionals and citizens in different cultural contexts rather than foregrounding qualitative research with such a contested concept. La dignidad es reconocida como un valor fundamental y, también, controvertido en el discurso bioético. El propósito del artículo es examinar algunos de los aspectos principales de la producción académica y bibliográfica sobre el tema en la ética y práctica de enfermería. El método es una evaluación crítica de una selección de artículos del Nursing Ethics y de otros textos identificados como influyentes por investigadores del Reino Unido y Brasil. Los resultados plantean la amplitud y confusión de perspectivas y conclusiones, aunque hay temas generales relacionados con características objetivas y subjetivas de la dignidad. En conclusión, los autores se alan la necesidad de sólidos estudios filosóficos a fin de contextualizar la dignidad humana en la pluralidad de valores profesionales. Los futuros estudios empíricos deben explorar lo importante para pacientes, familias, profesionales y ciudadanos en diferentes contextos culturales, en lugar de seguir desarrollando investigaciones cualitativas basadas en un concepto impreciso y controvertido. A Dignidade é reconhecida como valor central e, também, controverso no discurso bioético. O objetivo deste artigo é examinar algumas das vertentes principais da extensa produ o acadêmica e de literatura sobre o tema, na ética e prática da enfermagem. O método é a avalia o crítica de uma sele o de artigos publicados na Nursing Ethics e de outros manuscritos e textos identificados como influentes por pesquisadores do Reino Unido e Brasil. Os resultados sugerem um leque amplo e confuso de perspectivas e achados, embora haja temas gerais r
Conflitos morais e aten??o à saúde em Aids: aportes conceituais para uma ética discursiva do cuidado
Oliveira, Luzia Aparecida;Ayres, José Ricardo de Carvalho Mesquita;Zoboli, Elma Lourdes Campos Pavone;
Interface - Comunica??o, Saúde, Educa??o , 2011, DOI: 10.1590/S1414-32832011000200004
Abstract: this paper presents a theoretical underpinning of a discourse ethics of care, as used in a study that examined the moral conflicts in assisting people living with hiv/aids. based on deliberative bioethics, it defines moral conflict as a conflict of duties. it used discourse ethics and the propositions of care assuming that health work is highly relational and communicational. it concludes that discourse ethics of care recognizes rationality in decisions that involve moral issues in everyday care. the search for conflict resolution, in this perspective, suggests a dialectical process in which the reasons for the arguments are considered. the action of evidencing different arguments, including those that are contradictory, but defensible, enables prudent decision making.
Como tornar os termos de consentimento mais fáceis de ler?
Araujo, Diego Vinicius Pacheco de;Zoboli, Elma Lourdes Campos Pavone;Massad, Eduardo;
Revista da Associa??o Médica Brasileira , 2010, DOI: 10.1590/S0104-42302010000200011
Abstract: objective: define the literacy level of hospital das clínicas da faculdade de medicina da universidade de s?o paulo (hcmfusp) outpatients, for the purpose of identifying recommendations to adapt writing of the informed consent form to the outpatients literacy level, since these can become the subject of research. methods: quantitative cross sectional study with 399 subjects. the sample was intentional, selected from different outpatient care units of hcfmusp. data collection used an instrument that contained a text with prose compatible for assessment of reading skills needed for comprehension of the consent form. results. more than 46.6% of the interviewees were classified as functionally illiterate, of these, 12.7% were even unable to understand the proposed task in the text they read . nevertheless , nearly 50% of the interviewees reported having at least started high school . conclusion: the results and the orientations for the text writing centered on the reader allowed us to make recommendations to render the consent form easier to read . we recommend that the researcher modifies the text to a structural narrative, addressed to the reader, using terms that are familiar., in other words, with terms common to the subjects' and to the medical language. in addition to improving the relationship between the subject and researcher, it is believed that these recommendations may reduce the time taken for the proceeding of research projects, since problems in the wording of consent forms contribute significantly to project delays.
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