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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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ORIGINAL ARTICLE09-09-2022
Palliative care management by caregivers in home care: theoretical validation in a conversation circle
Revista Brasileira de Enfermagem. 2022;75(6):e20210737
Abstract
ORIGINAL ARTICLEPalliative care management by caregivers in home care: theoretical validation in a conversation circle
Revista Brasileira de Enfermagem. 2022;75(6):e20210737
DOI 10.1590/0034-7167-2021-0737
Views0See moreABSTRACT
Objectives:
to present the validation process of a Grounded Theory on the management of palliative care at home by a caregiver of a family member who experiences a death/dying process.
Methods:
a qualitative, explanatory research, which validated a theoretical matrix through a conversation circle containing 15 family caregivers and nine healthcare professionals, in December 2018.
Results:
forty-six propositions were validated regarding family caregivers’ contextual, causal, intervening conditions, consequences and action strategies to deal with the dying and death process of a family member. Conversation circles encouraged dialogue and (re)signification of the senses and knowledge of those involved, proving to be a way of educating and promoting the exercise of citizenship by participants.
Final Considerations:
the conversation circle made it possible for participants to interact and share information and experiences regarding home care for palliative patients and their families.
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EXPERIENCE REPORT06-24-2022
Step-by-step approach to reopening a Brazilian higher education institution during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(6):e20210807
Abstract
EXPERIENCE REPORTStep-by-step approach to reopening a Brazilian higher education institution during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(6):e20210807
DOI 10.1590/0034-7167-2021-0807
Views0See moreABSTRACT
Objectives:
to describe the experience of reopening a Brazilian higher education institution during the COVID-19 pandemic.
Methods:
experience report of a step-by-set approach to reopening a nursing higher education institution in São Paulo, Brazil, from May 2020 to May 2021.
Results:
the plan was created and operated by a group including students, professors, and technical-administrative workers. Weekly or by-weekly meetings occurred according to changes in the epidemiological situation and the needs to review the local technical and political agreements.
Conclusions:
we suggest that reopening plans during the COVID-19 pandemic should be politically and technically legitimated by all members of the community of a higher education institution so that they can take place quickly and sustainably. The early identification of COVID-19 cases and the adoption of local administrative measures are necessary to reduce the risk of outbreaks.
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ORIGINAL ARTICLE10-03-2022
Instrument validity: HIV and other sexually transmitted infections in homeless people
Revista Brasileira de Enfermagem. 2022;75(6):e20210863
Abstract
ORIGINAL ARTICLEInstrument validity: HIV and other sexually transmitted infections in homeless people
Revista Brasileira de Enfermagem. 2022;75(6):e20210863
DOI 10.1590/0034-7167-2021-0863
Views0See moreABSTRACT
Objectives:
to validate, through the Item Response Theory, an instrument on vulnerability to HIV and other sexually transmitted infections in homeless people.
Methods:
a cross-sectional study carried out between February and May 2018 with 100 homeless people in a municipality in northeastern Brazil. A sociodemographic questionnaire was applied, and another with items referring to behaviors vulnerable to HIV and sexually transmitted infections (STIs). Subsequently, it was assessed through the Item Response Theory.
Results:
the items previous diagnosis of STIs (F=0.473), partner with STI symptoms (F=0.518), drug use (F=0.509), sex for money (F=0.552), STI symptoms (F=0.448), number of sexual partners (F=0.616), sharps sharing (F=0.398) and being a victim of sexual violence (F=0.347) were validated.
Conclusions:
the instrument proved to be validated, being able to identify vulnerability to HIV and other sexually transmitted infections in homeless people.
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ORIGINAL ARTICLE08-22-2022
Temporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, 2007-2019
Revista Brasileira de Enfermagem. 2022;75(6):e20220046
Abstract
ORIGINAL ARTICLETemporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, 2007-2019
Revista Brasileira de Enfermagem. 2022;75(6):e20220046
DOI 10.1590/0034-7167-2022-0046
Views0See moreABSTRACT
Objectives:
to analyze the temporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, between 2007 and 2019, according to sociodemographic and professional characteristics.
Methods:
analysis of time series of accidents due to percutaneous exposure that occurred in health workers. Sociodemographic and professional variables, accident profile, post-accident behavior and accident incidence rates were evaluated. The Prais Winsten regression was used for trend analysis and calculation of the annual percentage change, with a significance level of 5%.
Results:
761 occupational accidents were recorded. There was a downward trend in the rate of percutaneous injuries among female workers (-0.012%; p=0.009), who had secondary education (-0.011%; p=0.035) and among all health professional categories (-0.010%; p =0.019). There was an increasing trend (0.018%; p= 0.050) among workers with ≥ 61 months of professional experience.
Conclusions:
the analysis showed a decreasing incidence of percutaneous accidents, which can be explained by multiple factors.
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ORIGINAL ARTICLE11-26-2022
Health beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75:e20201190
Abstract
ORIGINAL ARTICLEHealth beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75:e20201190
DOI 10.1590/0034-7167-2020-1190
Views0See moreABSTRACT
Objective:
To evaluate the effect of an educational intervention on health beliefs and adherence of elderly people to fall prevention measures.
Methods:
This is a quasi-experimental study, carried out at the Senior Citizens’ Center. Sixty-eight elderly completed the intervention. The intervention consisted of four meetings focused on beliefs about falls and prevention, and the evaluation occurred at baseline and 30 days after completion.
Results:
The elderly were predominantly women (83.82%), with one to four years of schooling (36.76%), with health problems (95.59%), and 48.53% had fallen. There was a significant increase in perceived susceptibility, severity, benefits, barriers, and total health belief score post educational intervention. By adding total to partial adherence, there was a significant increase in the adherence of the elderly to fall prevention measures after the educational intervention.
Conclusion:
Educational intervention was able to improve the beliefs and adherence of the elderly to fall prevention measures.
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ORIGINAL ARTICLE11-26-2022
Transitional care of nurses to older adults with artificial pacemaker
Revista Brasileira de Enfermagem. 2022;75:e20210192
Abstract
ORIGINAL ARTICLETransitional care of nurses to older adults with artificial pacemaker
Revista Brasileira de Enfermagem. 2022;75:e20210192
DOI 10.1590/0034-7167-2021-0192
Views0See moreABSTRACT
Objective:
to understand how the transitional care of nurses to olde adults with artificial pacemaker occurs.
Method:
a qualitative research, carried out in a philanthropic hospital in the city of Salvador, Bahia, Brazil. Fourteen nurses working in surgical and cardiac inpatient units participated. Data were collected between August and November 2020, through semi-structured interviews, and analyzed using the methodological framework Discourse of the Collective Subject and discussed in the light of Afaf Meleis’ theory of transitions.
Results:
nurses’ incipient knowledge about transitional care was identified. It was observed that the nursing discharge report is a facilitating instrument for transitional care.
Final considerations:
the study pointed out that the transitional care of nurses to older adults with artificial pacemakers does not have a theoretical foundation, reporting as a priority the care with the pacemaker identification card and with the surgical wound.
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REVIEW02-25-2022
COVID-19 and the occupational stress experienced by health professionals in the hospital context: integrative review
Revista Brasileira de Enfermagem. 2022;75:e20200859
Abstract
REVIEWCOVID-19 and the occupational stress experienced by health professionals in the hospital context: integrative review
Revista Brasileira de Enfermagem. 2022;75:e20200859
DOI 10.1590/0034-7167-2020-0859
Views1See moreABSTRACT
Objective:
To analyze Brazilian and international scientific publications about the stress experienced by health professionals in the hospital context during the COVID-19 pandemic.
Methods:
Integrative literature review carried out on the SciELO, ScienceDirect, and LILACS databases, and sources of official Brazilian institutions, with documents published by May 2020.
Results:
Of the 26 selected references, 19 (73.08%) were indexed articles, and 7 (26.92 %) were obtained from official institutions. The study found that stress is mainly due to the overload of hospital services, the removal of professionals, the insufficiency of personal protective equipment and strict biosecurity measures, challenges in the allocation of available resources, and the risk of contamination by COVID-19.
Final considerations:
The stress experienced by health professionals in hospital institutions during the pandemic can trigger occupational and psychological problems.
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ORIGINAL ARTICLE09-29-2022
Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
Abstract
ORIGINAL ARTICLENeither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
DOI 10.1590/0034-7167-2020-1329
Views1See moreABSTRACT
Objective:
to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of “angels and heroes” given by society during the pandemic of COVID-19.
Methods:
a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault.
Results:
they were organized into two thematic categories: “Angels and heroes? The (not) heroic reality of nursing during the pandemic” and “The search for recognition of the professional work of nursing: between what is said and what is not said”.
Final considerations:
the nurses’ speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.
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