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ORIGINAL ARTICLE09-24-2022
Spatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
Abstract
ORIGINAL ARTICLESpatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
DOI 10.1590/0034-7167-2021-0131
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Objective:
Analyze the spatio-temporal distribution of AIDS cases in Maranhão.
Methods:
Ecological study of AIDS cases in the Notifiable Diseases Information System, 2011-2018. Gross and adjusted incidences were calculated using the Baysean method; then, the Moran Global and Local Indices to observe the existence of spatial autocorrelation of the cases and for the delimitation of high and low risk clusters.
Results:
6,349 cases were reported, which were distributed heterogeneously. There was an advance of cases to new areas and persistence in old areas, such as in the capital São Luís and its surroundings. The dissemination did not occur at random, with positive spatial autocorrelation, with evidence of the formation of clusters in the municipalities of São Luís, São José de Ribamar and Paço do Lumiar.
Conclusion:
High-risk areas have been identified and should be considered a priority for investment in health, management, and organization of health services.
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TECHNOLOGICAL INNOVATION09-24-2022
Transitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
Abstract
TECHNOLOGICAL INNOVATIONTransitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
DOI 10.1590/0034-7167-2021-0123
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Objectives:
Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home.
Methods:
Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits.
Results:
In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria.
Conclusion:
The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.
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ORIGINAL ARTICLE09-24-2022
Characterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
Abstract
ORIGINAL ARTICLECharacterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
DOI 10.1590/0034-7167-2020-0896
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Objective:
to describe the obstetric care developed in teaching hospitals (TH) in the city of Maceió-AL, intended for high-risk pregnancies.
Methods:
Retrospective cohort study performed between June and November 2018 with 291 women who received assistance with vaginal delivery, cesarean section, or abortion process in teaching hospitals selected as settings for this research. Data collection allowed the characterization of the interviewees as well as the assistance received and its relationship with obstetric violence. The analysis was performed using descriptive and analytical statistics with the aid of the Epi Info software (version 7.2.0.1) and measures that allowed the comparison of means and proportions.
Results:
All women reported at least one violent situation, contrary to recommendations based on scientific evidence.
Conclusion:
It becomes necessary to optimize professional training to deconstruct obstetric care based on medicalization and pathologization of pregnancy and strengthen science-based care.
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ORIGINAL ARTICLE09-24-2022
Risk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
Abstract
ORIGINAL ARTICLERisk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
DOI 10.1590/0034-7167-2021-0022
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Objectives:
to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.
Methods:
a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.
Results:
we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.
Conclusions:
the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.
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ORIGINAL ARTICLE09-23-2022
Peripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
Abstract
ORIGINAL ARTICLEPeripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
DOI 10.1590/0034-7167-2021-0967
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Objectives:
to estimate incidence and free time of peripherally inserted central catheter obstruction in newborns undergoing red blood cell transfusion in the first 24 hours after the procedure.
Methods:
a longitudinal study, carried out with neonates in Neonatal Intensive Care Unit at a teaching hospital in Paraná, between January and July 2019. The sample consisted of 46 transfusion events performed in neonates through a peripherally inserted central catheter. Analysis performed according to descriptive statistics.
Results:
thirty-one catheters were analyzed, inserted in 24 neonates, through which 46 red blood cell transfusions were performed. Most neonates were male, gestational age <32 weeks, weight <1,500 grams, hospitalized mainly for prematurity. Among the 31 catheters, one (3.2%) presented obstruction after transfusion.
Conclusions:
The occurrence of obstructions immediately after transfusion was low and the catheters remained complication free for the next 24 hours.
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ORIGINAL ARTICLE09-23-2022
Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
Abstract
ORIGINAL ARTICLEValidation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
DOI 10.1590/0034-7167-2021-0862
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Objectives:
to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties.
Methods:
the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity.
Results:
inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain “Perception of Efficacy and Control Mechanisms” showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70).
Conclusions:
the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.
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ORIGINAL ARTICLE09-23-2022
Analysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
Abstract
ORIGINAL ARTICLEAnalysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
DOI 10.1590/0034-7167-2021-0803
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Objectives:
to analyze the concept of cardiovascular risk to support nursing practice.
Methods:
this is an analysis to define the concept of cardiovascular risk, through the use of eight steps of Walker’s and Avant’s framework, using a literature review in indexed scientific journals.
Results:
cardiovascular risk is defined in a broad and original way as a context of health and nursing care that makes it possible to identify modifiable (cardiometabolic, behavioral, psychosocial, cultural and occupational) and non-modifiable (biological) risk factors for cardiovascular diseases that act as early and interrelated markers, of multiple and heterogeneous etiology, predisposing to cardiovascular vulnerability.
Conclusions:
with the analysis and definition of the concept of cardiovascular risk, we realized that it will be possible to base nursing practice, with implications in clinical practice for identifying and reducing risk factors for cardiovascular diseases, with nursing relevance in the care of these subjects.
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ORIGINAL ARTICLE09-23-2022
Brain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
Abstract
ORIGINAL ARTICLEBrain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
DOI 10.1590/0034-7167-2021-0943
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Objectives:
to identify care strategies developed by professionals from critically ill patients’ units in communicating BD with parents of children and adolescents.
Methods:
an exploratory and descriptive research with a qualitative approach, carried out in two health institutions between October and December 2019, through semi-structured interviews. Data analysis took place through content analysis.
Results:
twenty-one professionals participated. Three care strategies were identified: actual clinical situation in suspected brain death; sensitizing families to the real clinical situation after brain death diagnosis; and time to assimilate the death information.
Final Considerations:
the care strategies for communicating brain death to families identified in this study present the possibility of subsidizing health managers in training and support promotion for professionals in care practice. Moreover, they can be incorporated and validated in the care practice of the studied context.
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ORIGINAL ARTICLE02-10-2020
Stress and health risk behaviors among university students
Revista Brasileira de Enfermagem. 2020;73(1):e20180035
Abstract
ORIGINAL ARTICLEStress and health risk behaviors among university students
Revista Brasileira de Enfermagem. 2020;73(1):e20180035
DOI 10.1590/0034-7167-2018-0035
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Objective:
To analyze the level of stress and its relationship with health risk behaviors among university students.
Method:
Cross-sectional analytical study carried out at a higher education institution in Picos-PI. A total of 377 students were evaluated for socio-demographic and academic variables, stress profile, sleep quality, alcohol use, smoking habits and level of physical activity. The Statistical Package for the Social Sciences (SPSS), version 20.0 was used for data processing and analysis.
Results:
Sleep quality was poor for 65.3% of the subjects, and sleep disturbances were found in 17.0%. Stress was observed in 68.7% of the sample. Stress was associated with the following variables: gender, time in the institution, poor sleep quality.
Conclusion:
Most of the students evaluated present some level of stress associated with poor sleep quality, which is a risk to the quality of life of these individuals.
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09-16-2019
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
Abstract
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
DOI 10.1590/0034-7167-2018-0734
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Objective:
To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care.
Method:
A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility.
Results:
The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997.
Conclusions:
The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
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ORIGINAL ARTICLE11-12-2022
Low-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
Abstract
ORIGINAL ARTICLELow-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
DOI 10.1590/0034-7167-2021-0396
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Objectives:
to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing.
Methods:
this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC.
Results:
groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators.
Conclusions:
low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.
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05-21-2021
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
DOI 10.1590/0034-7167-2020-0422
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Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
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ORIGINAL ARTICLE09-30-2020
Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
Abstract
ORIGINAL ARTICLEOrganizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
DOI 10.1590/0034-7167-2019-0732
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Objective:
To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities.
Method:
Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman’s correlation coefficient and Chi-squared test (p<0.05).
Results:
Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices.
Conclusion:
This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.
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ORIGINAL ARTICLE09-16-2019
Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
Abstract
ORIGINAL ARTICLETemporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
DOI 10.1590/0034-7167-2018-0682
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Objective:
to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016.
Method:
a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model.
Results:
There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126).
Final considerations:
leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services
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ORIGINAL ARTICLE03-07-2022
Adaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
Revista Brasileira de Enfermagem. 2022;75(5):e20210582
Abstract
ORIGINAL ARTICLEAdaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
Revista Brasileira de Enfermagem. 2022;75(5):e20210582
DOI 10.1590/0034-7167-2021-0582
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Objective:
To adapt and validate the content of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) to Brazilian culture.
Methods:
This is a methodological study that followed the stages of translation, synthesis, back translation, evaluation by a committee of five specialists, pre-test with 31 nurses, and evaluation by the author of the original instrument. The Content Validity Index (minimum 0.90) and the modified Kappa (minimum 0.74) were calculated to evaluate the content.
Result:
In the first round of content evaluation, 18 items had to be altered because they did not reach the minimum values established. Three items have not reached a consensus in the second round and had to be sent to the author of the original version. In the pre-test, 13 items were returned to the specialists because they suffered content changes.
Conclusion:
The Advanced Practice Nursing Competency Assessment Instrument (APNCAI) – Brazilian version was cross-culturally adapted, and its content was validated.
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ORIGINAL ARTICLE08-19-2019
Factors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
Abstract
ORIGINAL ARTICLEFactors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
DOI 10.1590/0034-7167-2018-0120
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Objective:
to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis.
Method:
this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis.
Results:
the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis.
Conclusions:
sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.
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