A structured questionnaire containing Likert scale was used for data collection, previously validated by specialists. The questionnaire was applied to 21 nursing professionals. The team has a reasonable understanding about the subject, but pointed out that professional education does not prepare them for performing NCS in primary care. Institutional interest in NCS is necessary to enable implementation.
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Nursing education for prevention of cervical cancer. Data were generated through interviews, processed on Alceste 4. Results were presented in three semantic classes: nursing care in the prevention of cervical cancer; continuing education of nurses for prevention of cervical cancer; and nursing education at the undergraduate and expertise levels for prevention of cervical cancer. Nurses are trained for prevention of cervical cancer in the family health strategy, through undergraduation, specialization, and continuing education.
However, such training must be based on meaningful learning so that professional practice can change around organization of health services. Keywords: Nurse; prevention; uterine cervical neoplasms; family health strategy.
Cancer of the cervix is the second most common type among women in the world and represents a serious public health problem in Brazil. Prevention is important for the early detection of cancer-initiating cells and determines the possibility of a cure in the primary care.
In Brazil, cervical cancer is the third most common malignant neoplasm and the fourth leading cause of cancer death among women, even with the possible prevention and early diagnosis in this pathology 1.
The early detection of cervical cancer becomes a more effective action and is done by the implementation of the preventive examination, for tracking of the disease in its initial phase, which provides the woman the opportunity to treat and cure offered by primary health care in the Family Health Strategy FHS.
Thus, professionals must feel prepared to provide assistance that will bring positive results to reduce the deaths resulting from this pathology.
Women represent the prevention of cervical cancer and ways to prevent the disease as well as the possibility of early detection through Pap smears. Recognize the importance of the exam for health maintenance when incorporating it as a duty to be fulfilled with periodicity 2. In health, training should be different from the reproduction of conservative teaching models, focusing on pathophysiology in support diagnosis and therapeutic equipment and limited learning to university hospitals, providing safety to professionals in the care which they perform 3.
The quality of health services and the degree of satisfaction of users are affected by professional education. In this sense, a low quality training provides a service lack professionals with skills, knowledge and skills needed to perform in the public health system SUS. Therefore, nursing, through specific actions need to reorganize themselves according to the principles of SUS and take new approach on the actions, taking responsibility for solving problems, breaking theold ways of working and dealing with health -disease in the society 4.
In this professional education, the highlight is the nurse who, by having specific duties to perform work in a humane and integral must be able to identify the health needs of the population, a capacity that must be acquired throughout their student day and offered by the institution in which they graduated 5. Faced With this problem, this study aimed to analyze the training of nurses for the prevention of cervical cancer, in the context of the family health strategy, and discuss the aspects that interfere in the nurse's educational process.
Typically, the training of a professional to meet the profile, which labor market demands, could be related to the method adopted in the educational course. The nurse training process was regulated by resolution no. The ways to teach are based on two components: a banking education and problem-based education. The banking education is based on the experience of the teacher and in the transmission of knowledge, configuring it as the more traditional method of education in which the student is a passive agent, a mere receiver of what is transmitted by the professor.
There is a concern in developing the critical sense of the student. This type of education is purely technical and skill enhancing the student and is very dependent on the teacher 7. In the problem-based education, professors and students actively participate in the teaching-learning process. The student is a critical agent, participant and constructor of knowledge in which the teacher is the facilitator of the learning. The adoption of problem-based education in teaching is defended by various scholars.
A precursor of this type of education was a pedagogue, who spoke about the knowledge necessary for educational practice citing events that were part of the teaching experience, discussing the question of the formation of this side of the reflection on progressive-educational practice in favor the autonomy of the being of the students 8.
In this sense, nurses with training based in this education are able to develop actions from the problems that arise. Therefore, in the prevention of cervical cancer it is necessary to seek alternative in order to resolve the barriers surrounding this issue. Therefore, this presents a professional approach grounded a permanent reflection process making them able to develop quality care, holistically according to the individual need of each patient.
The subjects were 30 nurses, identified in the study as E1, E2, E For the data production, interview technique were used, by means of a semi-structured questionnaire, which, in addition to characterize the subjects by means of fixed variables, also raised issues such as: training for the prevention of cervical cancer, contribution of training for prevention of cervical cancer, aspects that interfere in training for prevention of cervical cancer.
Through the descending hierarchical classification, the training of nurses for prevention of cervical cancer, it was revealed in 3 semantic classes, as shown in Figure Class 1, directly associated to classes 2 and 3, consisting of 46 ECUs, concentrates The nurses from the study revealed that there are aspects, which interfere with the training for the implementation of quality care to women in the prevention of cervical cancer.
It is what can be observed in the following UCEs:. I know how important it is for me as a professional to give assistance in which the patient will be able to understand all my orientations [ Many feel unable to carry out the collection, perhaps due to the lack of constant training [ In the earlier UCEs if they observe the concern to provide a good service to patients, however, the nurses feel insecure on the completion of the examination, by the lack of training or a protocol that route and facilitate actions to be provided.
The nurse's field is complex and requires the development of skills, translated into knowledge, attitudes and skills that provide their role in health promotion. Defining the expectedcompetencies of a professional provides advantages that can be described as, the chance to even think about the nature of their work as part of a broader framework of what has been done; establish that members of a profession are entitled to do and what the public can expect from them, set more clear than those that exist for education institutions and programs of continuing education, make it clear to the student what is expected to achieve as a recent graduate or someone seeking a more advanced skill With a sense of social responsibility and commitment to corporate citizenship, as a promoter of the integral health of the human being, i.
The nurse is the professional most active in pursuit of uterine cancer screening in the multidisciplinary team, because, at the time of the examination is he who provides information to the woman, is who creates reception spaces and privacy in the nursing consultation In this context, they must be enabled to plan assistance, healthcare methodology based on nursing care systematization of NCS.
This activity promotes effective quality care, contributing to professional autonomy, improving communication, preventing errors and omissions The Ministry of Health recommends the adoption of a care protocol for women in the prevention of cervical cancer to serve as guidance in the implementation of the gynecological exam, thus, this protocol can be followed with the aim of improving the nurse's skills female care.
In this class, the contents of the 17 UCE's which corresponds to The words cancer, training, cervix, prevention, uterine, update grouped, which are shown in Figure 1 and associated elements to greater prominence in ECUs, strengthen the training of nurses in providing quality care and greater security in the exam. These professionals recognize that strengthening of knowledge to guide and identify possible cases, preventing disease progression, is what can be evidenced in the following ECUs:.
I went through training and update courses for prevention of cervical cancer [ It was observed in these UCEs that professionals studied skills for care to women in relation to the prevention of cervical cancer. It is striking that the knowledge and experiences acquired in courses have proved to be as facilitators for improvement in quality of care and safety in carrying out the examination. In accordance with the national policy of continuing education 15 , in training, even though in some cases, to achieve individual learning, they do not always, translate into organizational learning.
Considering the focus of this policy, which represents a change in the design and in the practices of empowerment of service workers and incorporates the teaching and learning the daily life of organizations and labor practices and social, within the actual context in which they occur.
Changes in the training of healthcare professionals were requested from the idea of organizing a healthcare network, having the primary attention as port of entry and established on the basis of attention to family, because these are the basis for the feasibility and implementation of actions and projects directed to the proposals by SUS.
Thus, the qualification of healthcare workers contributes decisively to the realization of the national health policy, which directs to an assistance in adequacy to doctrinal principles of SUS The nurse FHS plan your care differently and has a need to enhance their knowledge through continuing education for better serve the population, therefore, the lack of adequate and specific qualification can lead to difficulties in carrying out a targeted assistance and directly affect the quality of this care.
Nursing education at the undergraduate and specialization level for the prevention of cervical cancer. Class 3, directly associated with class 2, consisting of 20 ECUs, grouped the words specialization, family, graduation, health, training, prevention, cancer, cervix , shown in Figure 1.
It became evident that there are nurses who recognize training for the prevention of cervical cancer was contemplated in the undergraduate program.
Revealed from these UCEs, is a dichotomy between the learning and doing and superficiality or insufficiency in academic training for a better support for the activities in basic care, which makes impossible the subjects to carry out actions with safety. Thus, the higher education institutions are responsible for the training of scientific and social learners, which should play a relevant role as the subject of this action, for a satisfactory skill in carrying out the prevention of cervical cancer, which requires a differentiated know-how The completion of a graduate course in the family health area is important for the nurse who works in this area, when they do not acquire sufficient knowledge in graduation for an adequate actuation, which favors great contribution to professional practice When observing the distancing between academia and the provision of assistance in the health services and with a focus on the training of critical-reflective subjects committed to health.
With the objective of bringing the formation of graduate at Country the demands of basic attention, that if conducted in Brazil by the family health strategy FHS and as main goal contribute to the replacement of the traditional model of organization of health care through the integration between teaching and service This is regulated by Inter-ministerial Ordinance no.
This proposes to develop tutorial learning groups training as a way of developing activities directed towards strategic areas of the Unified Health System SUS. In order tostrengthen the integration between teaching, service and community, as well as the implementation of DCN in undergraduate courses in the area of health, characterizing it as an instrument for qualification in the service of healthcare professionals With this reorientation training of health professionals, there is a challenge for IES in relation to education policy, which is to overcome the traditional pedagogical practices.
It starts with the belief that students should have greater participation in the teaching-learning process, and teachers for the challenge becomes creating educational practices that foster more meaningful participation of the student in their own professional education. Nurses need to direct their actions to seek coherence to operate and develop critical-reflexive construction of their own work process.
It is from the reality of this that builds the knowledge and the necessary changes to situations experienced in everyday life are achieved 21, In the UCEs below, the nurses agree that training in undergraduate and specialization contributes positively, thus improving the performance in the completion of the preventive examination of cervical cancer, as follows:.
In the undergraduate program and the specialization in family health, this training contributes greatly, because it has been studied theoretically and put into practice actions for the prevention of cervical cancer [ The training interferes positively in the cervical cancer prevention activities [ Theinternship practice in women's health and for the specialization, gave opportunity to conduct cervical cancer prevention in the community.
Thus, the professional education should incorporate strategies that integrate theoretical and practical teaching and service to develop critical and reflective attitude from the context in which the professional is inserted. Study on critical education of Nurses, with the objective of discussing the areas of knowledge, issues and political pedagogical principles disclosed in scientific publications done by faculty of a nursing program, revealed that the subjects are among others related to women's health It is perceived that the woman's health was one of the areas of knowledge cited in publications for teachers.
Therefore, the training institutions need to worry about training professionals who will be able to perform their role in their reality for the promotion of quality in care and achieving the goals of health care services to women, especially in the prevention of cervical cancer.
As the design of problem-posing education 9 , the student must be structured from the questioning of the work process and explore its ability to host and care to the various dimensions and health needs of individuals, collectives and individuals. With this foundation, it is possible to offer a humanized, of high quality, considering the reality of the individual and performing environment.
The study showed that in the nurse's performance is important to the development and implementation of the policy of permanent education aiming to meaningful learning and the possibility of transforming the professional practices. The nurses recognize that skills to the care of women and the knowledge acquired in the courses, has contributed to the improvement of quality of care and safety in performing gynecological exams. It is necessary to implement a policy of continuing education well defined to provide security to nurses in the development of activities restricted to it, aimed at health promotion, disease prevention, especially in relation to the scope of this study is that of women's health.
In this sense,the incentive for managers of health institutions is necessary for continuing education through the implementation of educational programs with strategies that allow nurses to acquire an efficientposture for the development practices that ensure safe service and good results in these actions.
This study has limitations, in the sense of not allowing the analysis of actions following the educational intervention for nurses related to the prevention of cervical cancer in the health services. Thus, it is expected that this study can contribute to the debate on the training of nurses and collaborate to overcome the difficulties experienced by them, encouraging them to adopt a critical and reflective posture, and arouse interest in other studies, so that a better quality of care can be achieved.
Revenferm UERJ. Revista Nursing. Freire P. Reinert M. Ribeiro ASM. Jorge AAF. Conselho Federal de Enfermagem Br. Investeducenferm; Portaria Interministerial n.
Resolução COFEN 358/2009
Use of this Web site signifies your agreement to the terms and conditions. Special Issues. Contact Us. American Journal of Nursing Science. The systematization of nursing care, is a action private of nurses, ensuring better planning of nursing actions and processes. The data collection for the interview and a focus group, analysis of results in light of the theory of studies related to the subject. Three themes were identified: Potentials and perspectives in the application of the Systematization of Nursing Assistance in Primary Care; Expected difficulties and difficulties encountered; The use of the Systematization of Nursing Assistance in Primary Care: before and after a practical experience.
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