Logo UAB
2021/2022

Nursing Care in Complex Situations

Code: 101790 ECTS Credits: 3
Degree Type Year Semester
2500891 Nursing OB 3 2
The proposed teaching and assessment methodology that appear in the guide may be subject to changes as a result of the restrictions to face-to-face class attendance imposed by the health authorities.

Contact

Name:
Rebeca Gomez Ibaņez
Email:
Rebeca.Gomez@uab.cat

Use of Languages

Principal working language:
spanish (spa)
Some groups entirely in English:
No
Some groups entirely in Catalan:
Yes
Some groups entirely in Spanish:
Yes

Prerequisites

There are no requirements, although it is recommended the previous realization of the subjects included in the subject Clinical Nursing.

Objectives and Contextualisation

Nursing professionals often face death or complex health situations. This can generate fear and anxiety, making the patient's attention in this situation not adequate. This subject aims to train students to cope with the care of patients in complex situations and in the end-of-life phases. The objectives of the subject are that the students are able to:

  • Analyze the concept of palliative care from a nurse model.
  • Identify actions that help to guarantee comfort, well-being and quality of life of people in complex and / or terminal situations.
  • Select the most appropriate care plans that allow to intervene.

Competences

  • "Demonstrate an understanding of people without prejudice: consider physical, psychological and social aspects, as independent individuals; ensure that their opinions, values and beliefs are respected and guarantee their right to privacy, through trust and professional secrecy."
  • Analyse and synthesise complex phenomena.
  • Base nursing interventions on scientific evidence and the available media.
  • Demonstrate knowledge of strategies to adopt measures of comfort and care of symptoms, the patient and family run, in the application of palliative care that will contribute to alleviate the situation of advanced and terminal patients.
  • Design systems for curing aimed at people, families or groups and evaluate their impact, making any necessary changes.
  • Develop critical thinking and reasoning and communicate ideas effectively, both in the mother tongue and in other languages.
  • Develop independent learning strategies.
  • Identify, analyse and choose the most suitable option to respond efficiently and effectively to problems in the professional context.
  • Identify, analyse and solve ethical problems in complex situations.
  • Offer technical and professional health care and that this adequate for the health needs of the person being attended, in accordance with the current state of scientific knowledge at any time and levels of quality and safety established under the applicable legal and deontological rules.
  • Plan and carry out nursing care aimed at people, families and groups orientated to health results and evaluate the impact of them using clinical and care practice guides describing the processes for the diagnosis, treatment or cure of a health problem.
  • Promote healthy life styles, self-treatment, giving support to the maintenance of preventative and therapeutic conducts.
  • Respect diversity in ideas, people and situations.

Learning Outcomes

  1. Analyse and synthesise complex phenomena.
  2. Argue with scientific evidence selecting those most suitable nursing care for adequate professional attention to the health needs of people.
  3. Arguing nursing interventions with scientific evidence.
  4. Design strategies that consider the cultural aspects and guarantee respect for opinions, beliefs and values as well as the right to privacy and professional secrecy.
  5. Develop independent learning strategies.
  6. Establish a relationship between theory and practice.
  7. Examine the care needs and nursing strategies for people in situations of advanced and terminal illness and their families.
  8. Explain the risk factors involved in the health and illness process.
  9. Identify and explain practical clinical and care guides related to attending to health demands of people during their entire life cycle and the changes that may occur, and to offer the necessary care at each stage.
  10. Identify and prioritise the different measures of physical, emotional and spiritual comfort in advanced stages of illness and at the end of life.
  11. Identify health needs during the different stages of the life cycle, from the moment of birth to the end of life.
  12. Identify strategies aimed at the readaptation of daily life through resources of proximity and support.
  13. Identify the psychosocial components of individuals and their beliefs which identify them as autonomous and independent individuals throughout their life cycles.
  14. Identify the risk factors in the health-illness process on a physical, emotional and social level.
  15. Identify the strategies and bases of nursing care in controlling the symptoms of terminal illness.
  16. Identify, analyse and solve ethical problems in complex situations.
  17. Identify, analyze and make the right choice paragraphs to address problems professionally, efficiently and effectively.
  18. Interpret the cultural aspects and values that determine health behaviour.
  19. Justify nursing actions with physiopathological processes.
  20. Justify quality nursing care that is adequate for health needs.
  21. Justifying analyze nursing interventions with scientific evidence and / or expert contributions sustain.
  22. Plan nursing cures aimed at people, families or groups.
  23. Plan proposals for scientifically-based analysis in accordance with resources.
  24. Propose protocols for care aimed at people at risk of becoming ill.
  25. Respect diversity in ideas, people and situations.
  26. Select the basic aspects related to a healthy life, self-care and preventative and therapeutic actions in relation to health needs, directing the actions to the person as well as the families or responsible carers.

Content

The complexity in the field of health refers to those situations that imply an added difficulty in the management, control and process of the health problem. This causes the need to adjust therapeutic and specific attention plan for the patient, taking into account physiopathological, psychological, familiar and social aspects.

The selected contents will provide the tools to value and prioritize the care of the patients and relatives facing these complex situations.

The following contents will be worked:

PALLIATIVE CARES. PEOPLE AT THE END OF LIFE

These are those treatments focused on alleviating or preventing the suffering of patients with a bad illness prognosis and without cure. It is important to study:

  • How are these patients addressed? What concrete needs they present?
  • Individualized care plans. Attention to the relative and the patient.
  • Pain management
  • Emotional support facing the process of dying.

COMPLEX CHRONIC PROCESSES

The complex chronic patient is a person who has comorbidiity, pluripatology, polimedication and a hard-going family and social support environment. Therefore, it will be studied:

  • Take care of patients with severe physical and emotional condition.
  • Tackling the fragility, vulnerability and dependence.
  • Social and institutional aids.
  • Importance of the caregiver role. Overload.

ONCOLOGICAL PROCESSES

Cancer is a very frequent and devastating disease, being one of the first causes of death worldwide. It is important to dig deeply in:

  • Physical, social and family affliction.
  • Confrontation of the disease.
  • Approaching their needs.

NEURODEGENERATIVE PROCESSES

Neurodegenerative diseases are incurable and limiting processes, which are produced by a progressive degeneration and neuronal death. In this context, it will be analyzed:

  • Physical, social and family impact.
  • Types of affectations: balance, movement, speech, breathing and cardiac functions.
  • Institutional resources.
  • Experimental studies in this field.
  • Caregivers importance.

Methodology

The content of the subject will be done in 6 sessions of 4 hours.

There will be different teaching-learning activities:

  • Theoretical sessions with audiovisual support given by the teacher.
  • Group work activities:
    • Critical reflection on original articles or publications / current news.
      Exposure of the main ideas.

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.

Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
THEORY (TE) 25 1 1, 21, 2, 3, 5, 4, 6, 7, 8, 14, 12, 9, 10, 15, 11, 13, 17, 16, 18, 20, 19, 22, 23, 24, 25, 26
Type: Autonomous      
PREPARATION OF WRITTEN WORKS / SELF-STUDY / READING ARTICLES / REPORTS OF INTEREST 47.25 1.89 1, 21, 2, 3, 5, 4, 6, 7, 8, 14, 12, 9, 10, 15, 11, 13, 17, 16, 18, 20, 19, 22, 23, 24, 25, 26

Assessment

The system of evaluation activities consists of three phases:

- Written test (50%): this evaluation will be carried out through the written answer to open and / or closed questions related to the theoretical contents.

- Oral defense of written works (10%): group defense of the work done, through computer support.

- Delivery of reports (40%): delivery of the group work done. It will be delivered the day of oral defense.

The evaluation activities will be carried out in three different moments according to the calendar.

OBTAINING THE FINAL QUALIFICATION:

The following will be considered:

  • Merit. The student has achieved the competencies evaluated and carried out in an autonomous way doing its justifications with evidences.
  • Good. The student has attained the competencies evaluated and carries out them autonomously with some evidences.
  • Pass. The student can achieve the skills evaluated with supervision.
  • Fail. The student has not achieved the competencies evaluated.
  • Not evaluable. The student has not performed the programmed activities in order to achieve the competencies.

1- The final grade of the subject will be the weighted average of each of the assessment activities. According to agreement 4.4 of the Governing Council 17/11/2010 of the regulations of evaluation, the qualifications will be:

From 0 to 4.9 = Grade F  (Fail)

From 5.0 to 6.9 = Grade E  (Pass)

From 7.0 to 8.9 = Grade B  (Good)

From 9.0 to 10 = Grade A  (Merit)

From 9.0 to 10 = Grade A+  (Honour distinction)

 

2.- The requirement to obtain the final grade is to have been presented to all the evaluation parts and to have obtained a minimum score of 4 on each one of them.

3.- It will be considered non-evaluable and will be scored as zero, when the student has not submitted to one of the evaluation tests.

4.- The student has the right to review the evaluation tests. For this purpose, the dates will be specified on the Campus Virtual.

5. The valuation of special and particular situations will be valued by an evaluating commission set up to this end, in order to design, if applicable, a final recovery test. Students who have not passed the subject can submit to a final exam or a final recovery test. To have right to the final recovery test the student must have submitted to all the evaluation tests.

 

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Delivery of reports / written works 40% 0.25 0.01 1, 21, 2, 3, 5, 6, 17, 16, 20, 23, 25
Oral defense of written works 10% 0.5 0.02 1, 2, 3, 5, 6, 9, 20, 19, 23
Written evaluation: Objective tests 50% 2 0.08 1, 21, 2, 3, 5, 4, 6, 7, 8, 14, 12, 9, 10, 15, 11, 13, 17, 16, 18, 20, 19, 22, 23, 24, 26

Bibliography

  • Jiménez López R, Román López P, Díaz Cortés, M. Cuidados de enfermería en situaciones complejas de salud. TEXD Documentos: Almería; 2017.  ISBN: 978-84-16642-87-8

  • Granados Gámez, G. Aplicación de las Ciencias Psicosociales al ámbito del cuidar. Colección cuidados de salud avanzados. 1ª ed. Barcelona: Elsevier; 2014.
  • Martínez Cruz B, Monleón Just M, Carretero Lanchas Y, García-Baquero Merino MT. Enfermería en cuidados paliativos y al final de la vida. 1ª ed. Barcelona: Elsevier; 2012.
  • Programa de prevenció a l'atenció a la cronicitat de Catalunya. https://salutweb.gencat.cat/web/.content/_ambits-actuacio/Linies-dactuacio/Estrategies-de-salut/Cronicitat/Documentacio-cronicitat/arxius/Programa.pdf
  • Malalties neurodegeneratives. Neuroalianza. Alianza Española de Enfermerdades Neurodegenerativas. http://neuroalianza.org/las-enfermedades-neurodegenerativas/
  • Asociación Española contra el cáncer. Conceptos importantes. https://www.aecc.es/es/todo-sobre-cancer/glosario
  • Canal salut "cures pal.liatives".http://canalsalut.gencat.cat/ca/salut-az/c/cures-palliatives/cures-palliatives 
  • Walsh D. Medicina Paliativa. 1ª ed. Barcelona: Elsevier; 2010.
  • González Otero J, Stablé Duharte M. Cuidados Paliativos. Recomendaciones terapéuticas para Atención Primaria. 1ª ed. Barcelona: Editorial Médica Panamericana; 2014.
  • González Barón M. Compendio del tratado de medicina paliativa. 1ª ed. Barcelona: Editorial Médica Panamericana; 2007
  • Cruz Aquaroni, M cruz. Compendio de patologías. Barcelona: Ediciones Dae grupoParadigma; 2016.

Software