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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023DOI 10.1590/0034-7167-2022-0759
Views0See moreABSTRACT
Objectives:
to reflect on the ethical dilemmas involved in the care of patients at the end of their lives.
Methods:
this is a theoretical-reflective study based on the ethics of care proposed by Luigina Mortari.
Results:
discussing care involves addressing the ways of being inherent to human existence and understanding the unique characteristics of this condition. Ethical care constitutes an action driven by interest in the other and by the perception of their need. Ethical dilemmas are a part of end-of-life care, making it essential to maintain respectful assistance that considers the patient’s autonomy, using strategies for expressing their wishes, and ensuring continuous clear and empathetic communication among all those involved in providing care.
Final Considerations:
issues related to being, stemming from one’s reality of dependency and vulnerability, contribute to the emergence of ethical dilemmas present in care actions.
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ORIGINAL ARTICLE
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023DOI 10.1590/0034-7167-2022-0684
Views0See moreABSTRACT
Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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ORIGINAL ARTICLE
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023DOI 10.1590/0034-7167-2022-0679
Views0See moreABSTRACT
Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023DOI 10.1590/0034-7167-2022-0553
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
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ORIGINAL ARTICLE
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023DOI 10.1590/0034-7167-2022-0586
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
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ORIGINAL ARTICLE
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023DOI 10.1590/0034-7167-2022-0597
Views0See moreABSTRACT
Objective:
The study aimed to analyze the factors that affect the community’s attitude towards COVID-19 vaccination in Tangerang District.
Methods:
A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval.
Results:
Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094).
Conclusions:
Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
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ORIGINAL ARTICLE
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023
Abstract
ORIGINAL ARTICLEAssessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023DOI 10.1590/0034-7167-2023-0068
Views0See moreABSTRACT
Objective:
to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic.
Methods:
A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods.
Results:
A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029).
Conclusion:
The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.
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Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023
Abstract
Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023DOI 10.1590/0034-7167-2022-0803
Views0ABSTRACT
Objective:
To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB).
Methods:
A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software.
Results:
Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities.
Conclusions:
This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.
Keywords:COVID-19Extensively Drug-Resistant TuberculosisMicrobial Drug ResistanceMultidrug-Resistant TuberculosisTuberculosisSee more
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ORIGINAL ARTICLE
Hammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
12-13-2019
Abstract
ORIGINAL ARTICLEHammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
12-13-2019DOI 10.1590/0034-7167-2018-0099
Views0See moreABSTRACT
Objective:
To compare the physiological variables and the sleep-wake pattern presented by preterm in nesting and hammock positions after diaper change.
Method:
This is a crossover randomized controlled trial. It was conducted with 20 preterm infants who, after diaper change, were placed in nests or hammocks. These preterm infants were evaluated for physiological variables (heart rate and oxygen saturation) and behavioral variables (sleep and wakefulness).
Results:
There was no statistically significant difference in the studied variables between nesting and hammock positions. However, regarding the categorical variable sleep, the comparison between the research phases for the hammock position showed differences between the baseline phase and the immediate recovery (p=0.00), baseline and late recovery (p=0.00), response and immediate recovery (p=0.00), response and late recovery (p=0.00).
Conclusion:
No differences were identified between the nest and the hammock; however, the use of the hammock favored the sleep of preterm infants compared to its non-use.
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ORIGINAL ARTICLE
Educational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
10-21-2019
Abstract
ORIGINAL ARTICLEEducational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
10-21-2019DOI 10.1590/0034-7167/2018-0163
Views0See moreABSTRACT
Objective:
to build an educational hypermedia about nursing care at usual risk birth and to perform validation of content and appearance.
Method:
methodological research carried out following the following stages: content and planning of modules; media production and organization of tutorial units; organization of student space, tutor and communication between them; availability of hypermedia; assessment by experts in nursing and informatics; and implementation of proposed suggestions.
Results:
educational hypermedia showed to be a validated material, since it presented an optimum index of global content of 0.97 and statistical significance in the binomial test for the content and appearance.
Conclusion:
it is believed that the use of this material with undergraduate students in nursing will contribute to the quality of obstetric care, considering that it is an illustrated technology capable of favoring teaching-learning about normal humanized childbirth.
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REVIEW
Nursing care in mental health based on the TIDAL MODEL: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180177
03-30-2020
Abstract
REVIEWNursing care in mental health based on the TIDAL MODEL: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180177
03-30-2020DOI 10.1590/0034-7167-2018-0177
Views0See moreABSTRACT
Objectives:
to identify the applicability of the Phil Barker’s Tidal Model in mental health nursing care.
Methods:
an integrative literature review carried out by LILACS, MEDLINE, Scopus and Web of Science. Data were collected from December 2017 to March 2018. After selecting the studies, the sample totaled 24 articles.
Results:
the articles are in English (91.7%), were published in nursing journals (87.5%), are reflective and/or theoretical (50%) and have level of evidence VII (79.2%). The model brings contributions to nursing science, enabling person-centered care, with an emphasis on interdisciplinary work, nurses’ protagonism and the empowerment of subjects in mental suffering.
Final considerations:
the use of the Tidal Model enables changes in nurses practice working in the context of mental health. Its application by nurses who work in mental health services in Brazil is recommended.
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ORIGINAL ARTICLE
Cervical cancer: knowledge, attitude and practice on the prevention examination
Revista Brasileira de Enfermagem. 2019;72:25-31
12-13-2019
Abstract
ORIGINAL ARTICLECervical cancer: knowledge, attitude and practice on the prevention examination
Revista Brasileira de Enfermagem. 2019;72:25-31
12-13-2019DOI 10.1590/0034-7167-2017-0645
Views0ABSTRACT
Objective:
to evaluate the knowledge, attitude and practice of women on the cervical-uterine cancer screening and to investigate their association with sociodemographic variables.
Method:
a cross-sectional study, carried out from July to September 2015, with 500 women enrolled in the Basic Health Units of the Health District V, of the city of Recife-PE. For data collection, a semi-structured form was used. In statistical analysis, the Chi-square test and Fisher’s Exact Test were applied and, in the multivariate analysis, the Poisson model and Wald statistic.
Results:
the prevalence of adequate knowledge, attitude and practice was 35.2%, 98% and 70.6%, respectively. Adequate knowledge was associated with having no children, having a family income of two minimum wages and Spiritist/Afro-Brazilian religion.
Conclusion:
women carry out the examination, deem it necessary, but do not have adequate knowledge, which demonstrates the need for educational actions by nurses and other health professionals.
Keywords:Knowledge, Attitudes and Practice in HealthNursingPapanicolaou TestUterine Cervical NeoplasmsWomen's HealthSee more -
REVIEW
Nursing students’ learning from involvement in research projects: an integrative literature review
Revista Brasileira de Enfermagem. 2022;75(1):e20210053
09-29-2022
Abstract
REVIEWNursing students’ learning from involvement in research projects: an integrative literature review
Revista Brasileira de Enfermagem. 2022;75(1):e20210053
09-29-2022DOI 10.1590/0034-7167-2021-0053
Views0See moreABSTRACT
Objective:
To identify the learning outcomes and skills obtained of undergraduate nursing students involved in research projects.
Methods:
This was an integrative literature review, based on a research protocol in the CINAHL Complete databases; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; MedicLatina; MEDLINE, Scopus and JBI, including primary and secondary studies, published between 2015 and 2020.
Results:
A total of five heterogeneous articles were included, which were categorized using Kirkpatrick’s (adapted) model. Seventeen learning outcomes acquired through participation in research projects were identified, from the learning of new knowledge and skills to the development of new attitudes and behaviors.
Final considerations:
The involvement of nursing students in research projects is important to their professional development. Future investment in research on this topic can help cement the potential of this type of student involvement.
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ORIGINAL ARTICLE
Quality of life related to health for heart failure patients
Revista Brasileira de Enfermagem. 2019;72:140-146
12-05-2019
Abstract
ORIGINAL ARTICLEQuality of life related to health for heart failure patients
Revista Brasileira de Enfermagem. 2019;72:140-146
12-05-2019DOI 10.1590/0034-7167-2018-0368
Views0See moreABSTRACT
Objective:
To assess the quality of life related to health for heart failure patients and to relate sociodemographic and clinical data.
Method:
It is an observational and transversal study, with quantitative approach, carried out in a heart failure ambulatory in the state of Pernambuco.
Results:
In the sample (n=101), there was prevalence of men older than 60 years old, married and professionally inactive. The quality of life related to health, based on the Minnesota Living With Heart Failure Questionnaire, was considered moderate (34.3±21.6), being significantly related to age (p=0.004), functional class (p<0.001), and patients with chagasic cardiopathy (p=0.02).
Conclusion:
The quality of life in the HF group of chagasic etiology was more compromised, specially in the emotional dimension. It is suggested that studies on the hypothesis that longer ambulatory follow-up improves quality of life and that having Chagas disease interferes negatively with the quality of life of heart failure patients.
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