Resumo Atualmente sabe-se que resultados positivos em saúde derivam de fatores como valorização e respeito, participação nas decisões, autoestima positiva e capacidade de exercer controle sobre a própria vida, indicando que a percepção do paciente sobre a própria dignidade é elemento central do cuidado. Trata-se de conceito complexo, difícil de definir por falta de clareza quanto ao que implica, mas fundamental na enfermagem. Este artigo apresenta revisão de literatura com o objetivo de discutir aspectos da dignidade no contexto da ética do cuidado.

Background: Coping is essential to manage palliative care professionals’ challenges. The focus has been on the effects of coping mechanism; however, little is known about coping itself in palliative care. Aim: To synthesise evidence of coping strategies in palliative care professionals, and how different strategies play roles over time. Design: Systematically conducted integrative review. Data sources: PubMed; CINAHL; Medline; PsycINFO and B-ON were searched (1996–2021) combining ‘coping’ AND ‘palliative care’. A predefined data extraction sheet was developed to report data. Two researchers performed constant comparative analysis using Nvivo®. Results: Thirty-one studies were included. Four main strategies with recurrent reference to time were found: (a) proactive coping, involving activities to achieve self-confidence and control situations and emotions; (b) self-care based coping, including self-protection and self-awareness activities, with behavioural disconnection; (c) self-transformation coping, involving activities to accept limits; and (d) encountering deep professional meaning, is a coping mechanism based on meaning, frequently considering the deepest meaning of work. The dynamic and influencing factors were training, team interaction, professional motivation and family. They were usually protective factors, though sometimes they represented risk factors. The emotional burden associated with healthcare and systemic stressors were always risk factors. An explanatory model describes a complex and dynamic process, in which everyday strategies and more introspective strategies are combined. Conclusions: The model showed a process of adaptation and learning to persevere in palliative care. It changes over time under factors and strategies, and evolves in a personal and professional transformation, parallel to the working life. It would be worth assessing coping in healthcare professionals who chose to leave palliative care and to investigate the reasons they did so and their coping mechanisms.

A implementação de paradigmas no Ensino Superior resultantes da introdução do Processo de Bolonha abre portas para a renovação. A qualidade passa pela revisão dos curricula, pela reorganização dos processos de ensino-aprendizagem, pela estruturação das unidades curriculares ecursos, pela qualificação e formação de docentes, pelo sucesso e resultados escolares, pela avaliação das competências atingidas e pela confiança social no Ensino Superior. Em 2010, foi delineado o Projeto "Construção da Aprendizagem" (ConstAp) com o objetivo principal de motivar as mudanças, nomeadamente ao nível das metodologias adotadas e da implementação do trabalho autónomo, para garantir uma carga de trabalho do estudante contínua ao longo do semestre. A questão central é a melhoria da qualidade no ensino ministrado. Este artigo analisa a execução do projeto implementado no IPCB, desde o ano letivo 2009/10, no âmbito do Processo de Bolonha, contextualizando os seus objetivos, implementação e condicionantes.Palavras-chaveConstAp; ECTS; Ensino-aprendizagem; Trabalho autónomo

Purpose of reviewQualitative research in the field of palliative care allows for a crucial study of the final stage of life from a social point of view and cultural perspective. This review evaluates the advantages and challenges of applying an ethnographic approach to palliative care research. Recent findingsThirteen ethnographic articles on organization or quality of care, decision-making, delirium, death, and the process of dying, were reviewed. Most studies use interviews, participant observation, and field notes as their primary data collection techniques. In ethnographic research, cultural issues, relationships and interactions of a group, the meanings and perceptions of the participants, the communication process, and the use of language in a particular and natural context were analyzed. Data collection and information analysis took an average of 14 months in the included studies.

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