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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 ARTICLE10-21-2019
Child and adolescent violence: oral story of women who attempted suicide
Revista Brasileira de Enfermagem. 2019;72(6):1450-1456
Abstract
ORIGINAL ARTICLEChild and adolescent violence: oral story of women who attempted suicide
Revista Brasileira de Enfermagem. 2019;72(6):1450-1456
DOI 10.1590/0034-7167-2017-0814
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Objective:
To unveil expressions of intrafamily violence experienced in childhood and/or adolescence by women who attempted suicide.
Method:
This is a study with a qualitative approach based on Oral Story. Participants were ten women with a history of suicide attempt, who experienced intrafamily violence in childhood and/or adolescence. The research was carried out at the Center for the Study and Prevention of Suicide, linked to a Toxicological Information Center in the city of Salvador, Bahia, Brazil.
Results:
From the orality of women, the study allowed the emergence of the following representative categories of intrafamily abuse experienced in childhood and/or adolescence: psychological violence, rejection, neglect, physical violence and sexual violence.
Final considerations:
The study alerts to intrafamily violence as an aggravation related to suicidal behavior, offering elements that help in the identification of their expressions, which will raise awareness to suicidal behavior and consequently suicide prevention.
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ORIGINAL ARTICLE07-08-2020
Cognition and quality of life relationship among the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20190030
Abstract
ORIGINAL ARTICLECognition and quality of life relationship among the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20190030
DOI 10.1590/0034-7167-2019-0030
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Objective:
to assess cognitive functions and their association with quality of life among elderly people enrolled in a Family Health Unit (FHU) of Primary Health Care in Recife-PE.
Methods:
a quantitative, descriptive, cross-sectional study in which elderly aged 60 years and over were studied.
Results:
76.7% of the elderly were women and the age group was less than or equal to 70 years. 68.6% had cognitive impairment, and in the quality of life assessment it was found that the social participation facet had the highest mean score among the elderly (14.25), while the lowest was observed in the sensory functioning facet (9.10). There was an association between cognitive decline and quality of life.
Conclusion:
most of the elderly had good quality of life rates, but low cognitive level. Using screening tools allows early detection of health problems, guiding the nursing staff in the construction of preventive measures.
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ORIGINAL ARTICLE03-30-2020
Meanings assigned by families about children’s chronic disease diagnosis
Revista Brasileira de Enfermagem. 2020;73(2):e20180742
Abstract
ORIGINAL ARTICLEMeanings assigned by families about children’s chronic disease diagnosis
Revista Brasileira de Enfermagem. 2020;73(2):e20180742
DOI 10.1590/0034-7167-2018-0742
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Objectives:
to understand the meanings assigned by family caregivers about children’s chronic disease diagnosis.
Methods:
qualitative study, which used as theoretical framework the Symbolic Interactionism, and methodological, the Grounded Theory. It was held in a pediatric unit in Southern Brazil, in 2016, through interviews submitted to open and axial analysis, with the participation of 20 family caregivers of hospitalized children.
Results:
relatives, interacting with the nursing/health staff, perceive children’s disease at birth. They are diagnosed with chronic disease by the physician and deny it. Subsequently, they accept and seek information on care.
Conclusions:
the results pointed out the stages that relatives experience by assigning meanings to about children’s chronic disease diagnosis. These meanings provide subsidies for nurses’ actions, which need to be aware of children’s and family’s needs in order to offer comprehensive and humanized care.
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ORIGINAL ARTICLE04-03-2020
Nurse as an integrator in healthcare management of children with chronic condition
Revista Brasileira de Enfermagem. 2020;73(3):e20180453
Abstract
ORIGINAL ARTICLENurse as an integrator in healthcare management of children with chronic condition
Revista Brasileira de Enfermagem. 2020;73(3):e20180453
DOI 10.1590/0034-7167-2018-0453
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Objectives:
to understand the practice of the nurse in healthcare management of children with chronic condition in the hospital setting.
Methods:
analytical study of qualitative approach with theoretical and methodological reference of institutional ethnography. Developed in the pediatric unit of a university hospital, in a municipality in Northeastern Brazil. Data collections techniques were: participant observation, documentary analysis and semi-structured interview. Participants of the study totaled twenty professionals, including nurses, social workers, psychologists, pharmacists, nutritionists, physiotherapists, and doctors. For data analysis, it was used the Bardin’s Content Analysis with interface of the Atlas.ti software.
Results:
categories of analysis were “Nurse as mediator of healthcare management”; “Nursing process as a mechanism of healthcare management”.
Final
considerations: the nurse proved to be essential for healthcare management of the child with chronic condition, acting as mediator of the relationship between the doctor, the members of the health team, the user and their family.
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ORIGINAL ARTICLE09-18-2020
Nursing recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes
Revista Brasileira de Enfermagem. 2020;73:e20200260
Abstract
ORIGINAL ARTICLENursing recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes
Revista Brasileira de Enfermagem. 2020;73:e20200260
DOI 10.1590/0034-7167-2020-0260
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Objective:
to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes.
Method:
a study of experts’ recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem)
Results:
the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions.
Final considerations:
the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.
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REVIEW12-21-2020
Skill acquisition of safe medication administration through realistic simulation: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190880
Abstract
REVIEWSkill acquisition of safe medication administration through realistic simulation: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190880
DOI 10.1590/0034-7167-2019-0880
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Objective:
to investigate evidence that indicates the contribution of realistic high, medium or low fidelity simulation to acquire knowledge, skills and attitudes in safe medication administration by nursing students.
Methods:
an integrative review of experimental studies from MEDLINE, LILACS, Web of Science, Scopus and Science Direct. The descriptors “nursing students”, “simulation”, “high fidelity simulation training”, “medication errors” and “pharmacology” were used to identify 14 studies that answered the research question, and were assessed for accuracy methodological level and level of evidence.
Results:
there was a sample of quasi-experimental studies, (level 3 of evidence; 78.6%) and randomized clinical trials (level 2 of evidence; 21.4%), whose expressive majority showed superiority of the simulation strategy over the traditional methodology (71.4%).
Conclusion:
using low and high fidelity simulators, standardized patients and virtual simulation can promote acquisition of essential skills for patient safety.
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ORIGINAL ARTICLE12-07-2020
Sarcopenia screening in elderly in primary health care: nurse knowledge and practices
Revista Brasileira de Enfermagem. 2020;73:e20200421
Abstract
ORIGINAL ARTICLESarcopenia screening in elderly in primary health care: nurse knowledge and practices
Revista Brasileira de Enfermagem. 2020;73:e20200421
DOI 10.1590/0034-7167-2020-0421
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Objective:
Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly.
Methods:
Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference.
Results:
The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference.
Final Considerations:
The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.
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ORIGINAL ARTICLE10-21-2019
Inclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
Abstract
ORIGINAL ARTICLEInclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
DOI 10.1590/0034-7167-2018-0806
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Objective:
To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers.
Method:
Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis.
Results:
The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users’ access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy.
Final considerations:
The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.
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