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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
Views0ABSTRACT
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.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
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
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
ORIGINAL ARTICLEMetodologia 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
Views0RESUMEN
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.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
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
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
Views0ABSTRACT
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.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee 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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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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ORIGINAL ARTICLE08-30-2024
Fatores determinantes para à hesitação vacinal contra a COVID-19 em brasileiros: estudo utilizando modelagem de equações estruturais
Revista Brasileira de Enfermagem. 2024;77:e20240112
Abstract
ORIGINAL ARTICLEFatores determinantes para à hesitação vacinal contra a COVID-19 em brasileiros: estudo utilizando modelagem de equações estruturais
Revista Brasileira de Enfermagem. 2024;77:e20240112
DOI 10.1590/0034-7167-2024-0112
Views0See moreRESUMEN
Objetivos:
investigar los factores que influyen en la vacilación ante la vacuna contra la COVID-19 entre los brasileños.
Métodos:
esta investigación empleó un enfoque observacional y analítico, utilizando una encuesta en línea. La recolección de datos se llevó a cabo en 2020 y el análisis de los datos se realizó utilizando el modelado de ecuaciones estructurales.
Resultados:
la prevalencia de la vacilación ante la vacuna fue del 27,5% (1182 individuos). Existe una correlación negativa entre la creencia en teorías de conspiración y la influencia social. Entre las diversas creencias asociadas con las intenciones de vacunación, solo las creencias en conspiraciones mostraron un valor predictivo significativo. Así, los resultados sugieren que las creencias personales impactan significativamente la vacilación ante la vacunación y también indican que la confianza en los órganos gubernamentales está inversamente relacionada con la vacilación.
Conclusiones:
la vacilación ante la vacuna emerge como un fenómeno multifacético influenciado por una amplia gama de factores, incluyendo las creencias personales, la confianza en los órganos gubernamentales y los sistemas de salud.
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ORIGINAL ARTICLE08-30-2024
Determining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling
Revista Brasileira de Enfermagem. 2024;77:e20240112
Abstract
ORIGINAL ARTICLEDetermining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling
Revista Brasileira de Enfermagem. 2024;77:e20240112
DOI 10.1590/0034-7167-2024-0112
Views0See moreABSTRACT
Objectives:
to investigate the factors influencing vaccine hesitancy against COVID-19 among Brazilians.
Methods:
this research employed an observational and analytical approach, utilizing a web-based survey. Data collection took place in 2020, and data analysis was conducted using structural equation modeling.
Results:
the prevalence of vaccine hesitancy was found to be 27.5% (1182 individuals). There is a negative correlation between belief in conspiracy theories and social influence. Among the various beliefs associated with vaccination intentions, only conspiracy beliefs exhibited significant predictive value. Thus, the findings suggest that personal beliefs significantly impact hesitancy towards vaccination, and also indicate that trust in governmental bodies is inversely related to hesitancy.
Conclusions:
vaccine hesitancy emerges as a multifaceted phenomenon influenced by a complex array of factors, including personal beliefs, trust in governmental bodies, and healthcare systems.
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ORIGINAL ARTICLE08-30-2024
Factors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis
Revista Brasileira de Enfermagem. 2024;77:e20240092
Abstract
ORIGINAL ARTICLEFactors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis
Revista Brasileira de Enfermagem. 2024;77:e20240092
DOI 10.1590/0034-7167-2024-0092
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis.
Methods:
a cross-sectional study was conducted with 503 university students from a southern state in Brazil; data were collected using a characterization tool and a questionnaire containing 16 statements about the topic; descriptive measures and Poisson regression models with robust variance were used for analysis.
Results:
the prevalence of adequate knowledge (i.e., scoring more than 12 correct answers) was 27.83%; students older than 24 years, enrolled in health-related courses, who had not engaged in sexual relations in the last quarter, with a history of rapid HIV testing, and who knew or had heard about the prophylaxes showed a higher likelihood of scoring more than 12 correct answers.
Conclusions:
generally, the knowledge of young people about HIV and its prophylaxes was found to be inadequate and influenced by sociodemographic, educational, and behavioral factors.
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ORIGINAL ARTICLE08-30-2024
Accessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20240090
Abstract
ORIGINAL ARTICLEAccessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20240090
DOI 10.1590/0034-7167-2024-0090
Views0See moreABSTRACT
Objectives:
to understand nurse perspectives regarding homeless pregnant women’s accessibility to prenatal care.
Methods:
a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil.
Results:
nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses’ work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women.
Final Considerations:
the Street Outreach Office’s work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.
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ORIGINAL ARTICLE08-30-2024
Risk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
Abstract
ORIGINAL ARTICLERisk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
DOI 10.1590/0034-7167-2023-0537
Views0See moreABSTRACT
Objectives:
to evaluate the relative risk of smoking cessation treatment dropout during its intensive phase.
Methods:
a retrospective and quantitative cohort study was developed from the electronic medical records of individuals who started smoking cessation treatment between 2015 and 2019 at a specialty clinic in a city in the interior of São Paulo, Brazil. The relative risk of dropping out of treatment was calculated using the Poisson regression model.
Results:
it was observed that out of the 396 (100.0%) individuals who started the treatment, 109 (27.5%) abandoned it before the end of the intensive phase. For each one-year increase in age, the risk of dropping out of smoking cessation treatment decreased by an average of 2%.
Conclusions:
the risk of dropping out of smoking cessation treatment is higher among younger individuals. It is necessary to rethink the care offered to younger adults to promote the continuity of treatment.
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REVIEW08-30-2024
Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
Abstract
REVIEWImpact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
DOI 10.1590/0034-7167-2024-0078
Views0See moreABSTRACT
Objectives:
to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic.
Methods:
an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023.
Results:
out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative.
Conclusions:
the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients’ lives.
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ORIGINAL ARTICLE08-30-2024
Negative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
Abstract
ORIGINAL ARTICLENegative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
DOI 10.1590/0034-7167-2024-0040
Views0See moreABSTRACT
Objectives:
to evaluate the prevalence of negative affectivity in university students in the post-COVID-19 pandemic context and its relationship with academic performance and professional outlook.
Methods:
a cross-sectional study was conducted with undergraduate students from a public university in Minas Gerais between September 2022 and September 2023. Data were collected using a sociodemographic and psychosocial characterization questionnaire and the Depression, Anxiety, and Stress Scale 21. The relationships between negative affectivity, academic performance, and professional outlook were verified using the Kruskal-Wallis test, with a significance level of 5%.
Results:
a total of 585 students participated in the study. A high prevalence of depression, anxiety, and stress was found among university students in the post-COVID-19 context, with a notable severity of anxiety. A negative association was detected between the investigated negative affectivity, academic performance, and professional outlook.
Conclusions:
the results indicate an emotional vulnerability in university students, with a relationship between negative affectivity and a decline in academic performance and professional outlook.
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REVIEW08-30-2024
Educational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
Abstract
REVIEWEducational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
DOI 10.1590/0034-7167-2023-0352
Views0See moreABSTRACT
Objectives:
to map the educational actions conducted with primary health care professionals during the COVID-19 pandemic.
Methods:
a scoping review conducted in August 2023, which covered databases such as CINAHL, Medline, LILACS, IBECS, BDENF, and Web of Science. In total, 32 publications were analyzed through content analysis.
Results:
the primary beneficiaries of the educational actions included 69% physicians, 56% nurses, 25% pharmacists, 13% social workers and dentists, 9% psychologists, community health agents, and laboratory professionals, and 6% nursing technicians, nutritionists, and physical educators. The predominant educational interventions were training sessions (mentioned in 19 publications), followed by Continuing Health Education (10 publications) and Continuing Education (three publications).
Final Considerations:
the educational interventions demonstrated positive impacts on professional practice, particularly the Continuing Health Education actions, which were notable for stimulating critical problem-solving among professionals.
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