{"id":8017,"date":"2023-02-24T12:14:09","date_gmt":"2023-02-24T10:14:09","guid":{"rendered":"https:\/\/www.easistent.ro\/?p=8017"},"modified":"2023-03-27T10:38:47","modified_gmt":"2023-03-27T08:38:47","slug":"cercetarea-si-misiunea-asistentilor-medicali-si-a-moaselor","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=8017","title":{"rendered":"Cercetarea \u0219i misiunea asisten\u021bilor medicali \u0219i a moa\u0219elor"},"content":{"rendered":"\n<h3><em>Timp de lectur\u0103: 6 minute<\/em><\/h3>\n\n\n\n<p>\u00cen general, c\u00e2nd ne g\u00e2ndim la cercetare, avem tendin\u021ba de a spune c\u0103 <em>\u201enu este treaba noastr\u0103, a asisten\u021bilor medicali \u0219i moa\u0219elor\u201d<\/em>, deoarece singura noastr\u0103 responsabilitate este <em>\u201emunca la patul bolnavului\u201d<\/em>. \u00cens\u0103, existen\u021ba numeroaselor referin\u021be bibliografice al unor valoroase studii de cercetare conduse de asisten\u021bi medicali \u0219i moa\u0219e din \u00eentreaga lume, pare s\u0103 ne contrazic\u0103.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare.png\"><img width=\"1024\" height=\"576\" src=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare-1024x576.png\" alt=\"\" class=\"wp-image-7982\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare-1024x576.png 1024w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare-300x169.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare-768x432.png 768w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/02\/cercetare.png 1066w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure>\n\n\n\n<p>\u00cen mare m\u0103sur\u0103, s-a observat c\u0103 \u00een\u021belegerea asupra cercet\u0103rii este limitat\u0103 la urm\u0103toarele aspecte, care sunt frecvent \u00eent\u00e2lnite \u00een cercetarea efectuat\u0103 de medici:<\/p>\n\n\n\n<ul><li>Studii de caz \/ serii de caz: prezentarea evolu\u021biei clinice \u00een contextul unei afec\u021biuni;<\/li><li>Studii clinice interven\u021bionale \/ investiga\u021bii, \u00een care terapia standard este comparat\u0103 cu un alt tip de terapie nou introdus\u0103 sau deja existent\u0103 (tratament, regim alimentar sau dispozitiv medical) \u0219i<\/li><li>Studii clinice observa\u021bionale efectuate pentru evaluarea \u0219i monitorizarea s\u0103n\u0103t\u0103\u021bii unor pacien\u021bi, \u00een scopul identific\u0103rii impactului diferitelor obiceiuri cotidiene (fumatul, alimenta\u021bia inadecvat\u0103, insomnia, sedentarismul, etc.) asupra riscului de apari\u021bie al unor afec\u021biuni (cardiovasculare, pulmonare, hepatice, endocrine, etc.).<\/li><\/ul>\n\n\n\n<p>Analiz\u00e2nd sistematic bibliografia interna\u021bional\u0103, am descoperit \u00eens\u0103 c\u0103 profesiile de asistent medical \u0219i moa\u0219\u0103 au o istorie bogat\u0103 de cercetare, dovedit\u0103 de numeroasele publica\u021bii academice interna\u021bionale.<\/p>\n\n\n\n<p>Conform lui Grove et all (2013)<a href=\"#_ftn1\">[1]<\/a>, <strong>cercetarea este <em>\u201eun proces sistematic, riguros, logic \u0219i social-interpretativ care vizeaz\u0103 g\u0103sirea de r\u0103spunsuri valide la \u00eentreb\u0103ri relevante \u0219i semnificative \u00een cadrul unei anumite societ\u0103\u021bi \u0219i comunit\u0103\u021bi pentru a promova un bine general\u201d. <\/em><\/strong>\u00cen acest context, rolul cercet\u0103rii \u00een domeniul \u00eengrijirilor de s\u0103n\u0103tate este de <strong>a genera cuno\u0219tin\u021be \u0219i dovezi de cele mai bune practici care s\u0103 informeze practica profesional\u0103 a asisten\u021bilor medicali \u0219i moa\u0219elor \u0219i care s\u0103 fie aplicate \u00een practica clinic\u0103, \u00een scopul furniz\u0103rii unor \u00eengrijiri sigure \u0219i de calitate pentru pacien\u021bi.<\/strong><\/p>\n\n\n\n<p>La nivel global, \u00een cercetare este recunoscut \u0219i promovat rolul asisten\u021bilor medicali \u0219i moa\u0219elor ca profesioni\u0219ti de s\u0103n\u0103tate angaja\u021bi \u00een<a href=\"#_ftn2\">[2]<\/a><sup>,<a href=\"#_ftn3\">[3]<\/a><\/sup>:<\/p>\n\n\n\n<ul><li>Generarea de cuno\u0219tin\u021be \u0219i dovezi, sinteza \u0219i transferul acestora \u00een practica clinic\u0103 (rol de produc\u0103tor al cercet\u0103rii)<\/li><li>Implementarea practicilor bazate pe dovezi (rol de consumator al cercet\u0103rii)<\/li><li>Luarea deciziilor \u00een context clinic \u0219i organiza\u021bional (rol de lider),<\/li><li>Formarea profesional\u0103 (rol de educator).<\/li><\/ul>\n\n\n\n<p><strong>\u00cen contextul gener\u0103rii de cuno\u0219tin\u021be \u0219i dovezi de bune practici,<\/strong> <a><strong>asisten\u021bii medicali \u0219i moa\u0219ele desf\u0103\u0219oar\u0103 urm\u0103toarele activit\u0103\u021bi:<\/strong><\/a><\/p>\n\n\n\n<ol type=\"1\"><li>Dezvoltarea \u00eentreb\u0103rii de cercetare \u0219i\/sau formularea ipotezei de cercetare;<\/li><li>Stabilirea criteriilor de includere \u0219i a criteriilor de excludere;<\/li><li>Stabiliea scopului \u0219i a obiectivelor cercet\u0103rii;<\/li><li>Analiza sistematic\u0103 a literaturii de specialitate \u00een bazele de date (cercetare secundar\u0103);<\/li><li>Proiectarea, rafinarea \u0219i implementarea studiilor de cercetare pentru a genera o baz\u0103 de cuno\u0219tin\u021be pentru practic\u0103 (cercetare primar\u0103);<\/li><li>Explorarea \u0219i descrierea fenomenelor de interes; testarea interven\u021biilor, evaluarea impactului prin metode de cercetare recunoscute la nivel interna\u021bional.<\/li><\/ol>\n\n\n\n<p>Rezultatul final al acestui proces formal \u0219i riguros este reprezentat de un set de cuno\u0219tin\u021be \/ dovezi de practic\u0103 clinic\u0103 ce poate acoperi \u00eentreaga gam\u0103 de activit\u0103\u021bi de \u00eengrijire.<\/p>\n\n\n\n<p><strong><em>Ce \u00een\u021belegem prin dovezi?<\/em><\/strong> Dovezile sunt <em>cuno\u0219tin\u021be dob\u00e2ndite prin observare sau experimentare \u00een sprijinul unei concluzii; adic\u0103 fundamentarea sau confirmarea de care avem nevoie pentru a crede c\u0103 ceva este adev\u0103rat<a href=\"#_ftn4\"><strong>[4]<\/strong><\/a>.<\/em><\/p>\n\n\n\n<p>Conform metodologiei JBI<a href=\"#_ftn5\">[5]<\/a>, Facultatea de \u0218tiin\u021be ale S\u0103n\u0103t\u0103\u021bii a Universit\u0103\u021bii din Adelaide, Australia de Sud, <strong>dovezile pot fi generate prin urm\u0103toarele metode<\/strong>:<\/p>\n\n\n\n<ol type=\"1\"><li><strong>Studii de cercetare<\/strong> dezvoltate \u00een baza unor metodologii de cercetare formal\u0103, riguroas\u0103 \u0219i replicabil\u0103 (cercetare primar\u0103);<\/li><li><strong>Judecata clinic\u0103<\/strong> \u2013 Concluzii derivate din expertiza asisten\u021bilor medicali \u0219i moa\u0219elor;<\/li><li><strong>Opinii personale<\/strong> exprimate \u00een dialoguri deliberative formale, pe site-uri web profesionale, \u00een documente de politici, rapoarte, reviste de specialitate, etc.<\/li><\/ol>\n\n\n\n<p>\u00centre generarea de cuno\u0219tin\u021be \u0219i dovezi de bune practici \u0219i implementarea acestora \u00een practica clinic\u0103, exist\u0103 dou\u0103 etape intermediare care constituie parte important\u0103 din activitatea de cercetare a asisten\u021bilor medicali \u0219i moa\u0219elor:<\/p>\n\n\n\n<ol type=\"1\"><li><strong>Sinteza dovezilor<\/strong> &#8211; reprezint\u0103 evaluarea dovezilor cercet\u0103rii \u0219i a opiniei asupra unui subiect de interes pentru a ajuta la luarea deciziilor. Este alc\u0103tuit din trei componente principale: analiza sistematic\u0103 (analiz\u0103 secundar\u0103 de date), rezumatul dovezilor (analiz\u0103 sistematic\u0103 rapid\u0103) \u0219i ghiduri clinice (recomand\u0103ri pentru optimizarea \u00eengrijirii pacientului, bazate pe o revizuire sistematic\u0103 a dovezilor \u0219i o evaluare a beneficiilor \u0219i daunelor op\u021biunilor alternative de \u00eengrijire)<a href=\"#_ftn6\">[6]<\/a>.<\/li><li><strong>Transferul dovezilor<\/strong> \u2013 reprezint\u0103 un proces proactiv, participativ, pentru a promova accesul \u0219i preluarea dovezilor \u00een contextele clinice locale. Are loc prin diseminare activ\u0103 (ateliere de lucru, seminarii, conferin\u021be), integrarea sistemului \u00een context organiza\u021bional\/politic \u0219i desf\u0103\u0219urarea de programe educa\u021bionale adecvate (strategii eficiente pentru implementarea dovezilor).<\/li><\/ol>\n\n\n\n<p><strong>\u00cen contextul implement\u0103rii dovezilor \u00een practica clinic\u0103, asisten\u021bii medicali \u0219i moa\u0219ele desf\u0103\u0219oar\u0103 urm\u0103toarele activit\u0103\u021bi:<\/strong><\/p>\n\n\n\n<ol type=\"1\"><li>Stabilirea echipei de proiect;<\/li><li>Identificarea practicilor neconforme;<\/li><li>Dezvoltarea \u00eentreb\u0103rii de cercetare sau formularea ipotezei de cercetare;<\/li><li>Stabilirea grupului \u021bint\u0103;<\/li><li>Identificarea p\u0103r\u021bilor interesate;<\/li><li>Identificarea barierelor \u0219i a facilitatorilor \u00een implementarea dovezilor;<\/li><li>Elaborarea de strategii adecvate pentru implementare;<\/li><li>Conducerea auditului clinic, alc\u0103tuirea unei baze de date, analiza \u0219i interpretarea datelor;<\/li><li>Asigurarea sustenabilit\u0103\u021bii proiectului de implementare.<\/li><\/ol>\n\n\n\n<p>Rezultatul final al acestui proces formal \u0219i riguros este reprezentat de implementarea celor mai bune dovezi \u00een practica clinic\u0103 de \u00eengrijire. Desigur, clientul final este pacientul, iar proiectul reprezint\u0103 o metod\u0103 sistematic\u0103 de \u00eembun\u0103t\u0103\u021bire a calit\u0103\u021bii \u00eengrijirilor de s\u0103n\u0103tate.<\/p>\n\n\n\n<p><strong>\u00cen contextul lu\u0103rii deciziilor la nivel clinic \u0219i organiza\u021bional, asisten\u021bii medicali \u0219i moa\u0219ele desf\u0103\u0219oar\u0103 urm\u0103toarele activit\u0103\u021bi:<\/strong><\/p>\n\n\n\n<ol type=\"1\"><li>Proiectarea, rafinarea \u0219i implementarea studiilor de cercetare, inclusiv analiza contextului organiza\u021bional (c\u00e2t de preg\u0103tit\u0103 este organiza\u021bia pentru implementarea practicilor bazate pe dovezi);<\/li><li>Conducerea echipelor de proiect, inclusiv a echipelor de audit clinic;<\/li><li>Facilitarea schimb\u0103rii practicilor (identificarea barierelor \u0219i facilitatorilor pentru de-implementarea practicilor neconforme \u0219i implementarea celor mai bune dovezi de practic\u0103 clinic\u0103, elaborarea \u0219i implementarea strategiilor, monitorizarea sustenabilit\u0103\u021bii proiectului \u0219i implementarea m\u0103surilor adecvate, diseminarea rezultatelor proiectului, etc.);<\/li><li>Elaborarea sau actualizarea procedurilor \u0219i politicilor organiza\u021bionale;<\/li><li>Elaborarea politicilor de \u00eengrijiri de s\u0103n\u0103tate la nivel na\u021bional.<\/li><\/ol>\n\n\n\n<p><strong>\u00cen contextul form\u0103rii profesionale (rol de educator), asisten\u021bii medicali \u0219i moa\u0219ele desf\u0103\u0219oar\u0103 urm\u0103toarele activit\u0103\u021bi:<\/strong><\/p>\n\n\n\n<ol type=\"1\"><li>Identificarea nevoilor de formare;<\/li><li>Identificarea practicilor inadecvate;<\/li><li>Monitorizarea continu\u0103 a cuno\u0219tin\u021belor, atitudinilor \u0219i practicilor asisten\u021bilor medicali;<\/li><li>Formarea profesional\u0103 continu\u0103 \u021bintit\u0103 pe nevoile educa\u021bionale \u00een baza unui Plan de formare profesional\u0103 continu\u0103;<\/li><li>Evaluarea cuno\u0219tin\u021belor, atitudinilor \u0219i practicilor \u00een baza unui Plan de evaluare;<\/li><li>Formarea profesional\u0103 de baz\u0103 a asisten\u021bilor medicali \u0219i moa\u0219elor \u00een institu\u021bii de \u00eenv\u0103\u021b\u0103m\u00e2nt specifice.<\/li><\/ol>\n\n\n\n<p>\u00cen concluzie, cercetarea este element esen\u021bial ce st\u0103 la baza practicii clinice de \u00eengrijiri de s\u0103n\u0103tate, contribuind semnificativ la asigurarea calit\u0103\u021bii \u00eengrijirilor \u0219i dezvoltarea profesiilor de asistent medical \u0219i moa\u0219\u0103. Ea este str\u00e2ns legat\u0103 de misiunea acestor dou\u0103 profesii.<\/p>\n\n\n\n<p><em>Mariana Zazu, <\/em><em>Specialist \u00een dezvoltare organiza\u021bional\u0103, OAMGMAMR Filiala Bucure\u0219ti<\/em><em><\/em><\/p>\n\n\n\n<p><em>Director adjunct al Centrului Rom\u00e2n de Cercetare \u00een \u00cengrijiri de S\u0103n\u0103tate: Un Centru de excelen\u021b\u0103 JBI<\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p><a href=\"#_ftnref1\">[1]<\/a> Grove, S.K., Burns, N. &amp; Gray, J. (2013). The Practice of Nursing Research: Appraisal, synthesis and generation of evidence. 7th edition. St Louis, Missouri.<\/p>\n\n\n\n<p><a href=\"#_ftnref2\">[2]<\/a> Loiselle, C.G. &amp; Profetto-McGrath, J. (2011). Canadian essentials of nursing research. Third edition. Lippincott Williams &amp; Wilkins: Philadelphia, US.<\/p>\n\n\n\n<p><a href=\"#_ftnref3\">[3]<\/a> Jirojwong, S., Johnson, M. &amp; Welch, A. (eds). (2014). Research methods in nursing and midwifery: pathways to evidence-based practice. Second edition. Oxford University Press: South Melbourne, Victoria<\/p>\n\n\n\n<p><a href=\"#_ftnref4\">[4]<\/a> Pearson A, Wiechula R, Court A &amp; Lockwood C. A re-consideration of what constitutes &#8222;evidence&#8221; in the healthcare professions. Nursing Science Quarterly. 2007Jan;20(1):85-8.<\/p>\n\n\n\n<p><a href=\"#_ftnref5\">[5]<\/a> Jordan, Zoe PhD; Lockwood, Craig PhD; Munn, Zachary PhD; Aromataris, Edoardo PhD. The updated Joanna Briggs Institute Model of Evidence-Based Healthcare. International Journal of Evidence-Based Healthcare 17(1):p 58-71, March 2019. | DOI: 10.1097\/XEB.0000000000000155<\/p>\n\n\n\n<p><a href=\"#_ftnref6\">[6]<\/a> Institute of Medicine of the National Academies. Clinical practice guidelines we can trust. Washington, DC: The National Academy of Sciences; 2011.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Timp de lectur\u0103: 6 minute \u00cen general, c\u00e2nd ne g\u00e2ndim la cercetare, avem tendin\u021ba de a spune c\u0103 \u201enu este treaba noastr\u0103, a asisten\u021bilor medicali \u0219i moa\u0219elor\u201d, deoarece singura noastr\u0103 responsabilitate este \u201emunca la patul bolnavului\u201d. \u00cens\u0103, existen\u021ba numeroaselor referin\u021be bibliografice al unor valoroase studii de cercetare conduse de asisten\u021bi medicali \u0219i moa\u0219e din \u00eentreaga [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":7982,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,155],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8017"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8017"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8017\/revisions"}],"predecessor-version":[{"id":8018,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8017\/revisions\/8018"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/7982"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8017"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8017"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8017"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}