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ORIGINAL ARTICLE12-04-2023
Sepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
Abstract
ORIGINAL ARTICLESepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
DOI 10.1590/0034-7167-2023-0037
Views0See moreABSTRACT
Objective:
to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables.
Methods:
a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records.
Results:
sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis.
Conclusions:
there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.
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ORIGINAL ARTICLE12-04-2023
Changes in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
Abstract
ORIGINAL ARTICLEChanges in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
DOI 10.1590/0034-7167-2023-0039
Views0See moreABSTRACT
Objective:
To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma.
Methods:
a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student’s t test.
Results:
the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005).
Conclusion:
metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.
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ORIGINAL ARTICLE12-04-2023
Clinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
Abstract
ORIGINAL ARTICLEClinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
DOI 10.1590/0034-7167-2023-0019
Views0ABSTRACT
Objective:
to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses.
Methods:
methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74.
Conclusion:
two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.
Keywords:Educational MeasurementNursing EducationPatient Care PlanningSimulation TrainingVascular Access DevicesSee more -
ORIGINAL ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 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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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
DOI 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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EDITORIAL12-04-2023
Chronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
Abstract
EDITORIALChronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
DOI 10.1590/0034-7167.202376suppl301
Views0The relationship between chronicity and work has been a growing concern in contemporary society. As the number of chronic illnesses increases around the world, it is critical to understand how these conditions impact workers’ health(). In this editorial, we will explore the impacts of chronicity on workers’ health, highlighting data from the Global Burden of […]See more -
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
Abstract
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
DOI 10.1590/0034-7167-2023-0126
Views0See moreABSTRACT
Objectives:
to reflect on the impacts of the General Personal Data Protection Law on Nursing practice.
Methods:
reflection article, through the intentional collection of materials relating to the topic.
Results:
legislation regulates confidentiality, processing and data sharing, requiring institutional protection measures. The nursing team is responsible for acting preventively, both in care and in the management role, in order to avoid the misuse of the patient’s personal data. The law allows academic research to be carried out as long as the purpose is clear, data collection occurs with an explicit purpose and data is anonymized.
Final Considerations:
although the General Personal Data Protection Law requires greater care in relation to data processing, it is established on precepts of good faith and respect for the rights of the individual, concepts aligned with the nursing code of ethics.
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ORIGINAL ARTICLE04-14-2023
Guide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
Abstract
ORIGINAL ARTICLEGuide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
DOI 10.1590/0034-7167-2021-0975
Views1ABSTRACT
Objective:
to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process.
Methods:
applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout.
Results:
the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges.
Final considerations:
the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.
Keywords:Educational TechnologyNursing ProcessNursing RecordsProfessional PracticeStandardized Nursing TerminologySee more -
ORIGINAL ARTICLE03-27-2023
Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
Abstract
ORIGINAL ARTICLEAdaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
DOI 10.1590/0034-7167-2022-0530
Views1ABSTRACT
Objectives:
to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care.
Methods:
methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients.
Results:
in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7.
Conclusions:
the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Keywords:Factor AnalysisFamilyHospital Organization and AdministrationPatient-Centered CareValidation StudiesSee more -
ORIGINAL ARTICLE09-24-2022
Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
Abstract
ORIGINAL ARTICLENurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
DOI 10.1590/0034-7167-2021-0029
Views1See moreABSTRACT
Objectives:
to analyze nurses’ role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring.
Methods:
this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis.
Results:
the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension.
Final Considerations:
nurses have attitudes consistent with Jean Watson’s Theory and apply the Caritas Process elements during assistance to patients’ spiritual dimension in palliative care.
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ORIGINAL ARTICLE10-01-2022
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
DOI 10.1590/0034-7167-2020-1257
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more -
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
Views1See moreABSTRACT
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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EXPERIENCE REPORT08-19-2019
Hypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
Revista Brasileira de Enfermagem. 2019;72(4):1114-1118
Abstract
EXPERIENCE REPORTHypothermia post-cardiopulmonary resuscitation with low inputs: an experience report
Revista Brasileira de Enfermagem. 2019;72(4):1114-1118
DOI 10.1590/0034-7167-2017-0771
Views1ABSTRACT
Objective:
to report the experience of conducting directed temperature control of a post-cardiopulmonary resuscitation patient, with reduced and basic inputs available at the institution.
Method:
an experience report of directed temperature control in patient (age 15 years), after four hours of cardiopulmonary resuscitation in an Intensive Care Unit of a hospital in São Paulo State countryside in 2016, according to the protocol suggested by the American Heart Association, in 2015. There were applications of cold compresses, plastic bags with crushed ice and rectal temperature control.
Results:
after eight hours, temperature had reached 93.2 ºF. Body cooling was maintained for 24 hours. However, bags with crushed ice were used in the first 6 hours.
Conclusion:
conduct of nurses to obtain the body cooling with reduced and basic inputs was effective during the stay at the Intensive Care Unit.
Keywords:Body Temperature RegulationCardiopulmonary ResuscitationHeart ArrestHypothermia InducedIntensive Care UnitsSee more -
Overview of clinical trial protocols for behavioral insomnia in infants
Revista Brasileira de Enfermagem. 2021;74:e20200769
Abstract
Overview of clinical trial protocols for behavioral insomnia in infants
Revista Brasileira de Enfermagem. 2021;74:e20200769
DOI 10.1590/0034-7167-2020-0769
Views1See moreABSTRACT
Objective:
to describe the overview of clinical trial protocols for behavioral insomnia in infants.
Methods:
an analytical study that reviewed protocols registered with the International Clinical Trials Registry Platform between August and September 2019, aiming to identify the interventions for behavioral insomnia in infants, the comparators, the main primary, secondary outcomes and their respective measurements.
Results:
eleven protocols registered between 2004 and 2018 were included. Nurses were the main coordinators of protocols (45.5%), with proposals using educational technologies, one-to-one and online follow-up consultations. The main outcome was improvement of infant and maternal sleep patterns. Secondary outcomes were anxiety, depression, and parental sexual satisfaction. To measure them, the following were used: sleep diary (54.5%), actigraphy (45.4%), and the Pittsburgh Sleep Quality Interview (36.3%) and Extended Brief Infant Sleep Questionnaire (27.2%) were used.
Conclusion:
the protocols proposed interventions for independent sleep, aiming at quality of sleep for the whole family.
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ORIGINAL ARTICLE07-30-2021
Curricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
Abstract
ORIGINAL ARTICLECurricular reforms in the transformation of nursing teaching in a federal university
Revista Brasileira de Enfermagem. 2021;74(4):e20201242
DOI 10.1590/0034-7167-2020-1242
Views1See moreABSTRACT
Objectives:
to discuss the curricular reforms adopted for nursing teaching in Brazil, from 1969 to 2019.
Methods:
historical, qualitative approach using the thematic oral history and document research. 13 interviews were carried out with graduation nursing professors from a federal university in the South of Brazil. The document sources were the political-pedagogical projects of the course and their associated documents. Minayo’s thematic analysis was used.
Results:
nursing curricula delineates the profile of the professional that must be formed and are reviewed in order to be adapted to social and educational changes, showing the scientific and professional potential of the nurse. Curricular reforms consider the quality of nursing formation.
Final Considerations:
the structure of the curriculum and the reforms that took place emerged according to the historical, political, epidemiological and social context demanded from the profession, to attend to the demands of society and to the work market.
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ORIGINAL ARTICLE03-24-2021
Development, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
Abstract
ORIGINAL ARTICLEDevelopment, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
DOI 10.1590/0034-7167-2020-0360
Views0ABSTRACT
Objectives:
to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy.
Methods:
methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application.
Results:
scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations.
Conclusions:
scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.
Keywords:Educational AssessmentNursing EducationPatient SimulationSimulation TrainingValidation StudiesSee more -
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
Abstract
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
DOI 10.1590/0034-7167-2020-0863
Views0See moreABSTRACT
Objectives:
to analyze how the nurse-midwives of maternity wards that were fields of practice for an improvement course in obstetrics have reorganized care in the context of labor and birth amidst the COVID-19 pandemic.
Methods:
this is a descriptive, exploratory and qualitative study carried out with nine nurse-midwives who are preceptors and collaborators in maternity wards that were fields of practice for an improvement course, between February and April 2020, through a semi-structured interview through WhatsApp®. Content analysis was used to treat the information.
Results:
the pandemic brought the need to reorganize work, with a focus on service training and maintenance of good practices in labor and birth, whose movement was intensely experienced, interfering in nurse-midwives’ mental health.
Conclusion:
nurse-midwives have faced the pandemic with concerns about maintaining safe care, focused on practices based on updated scientific evidence.
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Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
Abstract
Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
DOI 10.1590/0034-7167-2020-0400
Views0ABSTRACT
Objective:
to assess elderly people’s quality of life, understanding the social representations of falls.
Methods:
a convergent mixed methods research carried out at homes, with a sample of 134 elderly people. A structured questionnaire was used, covering sociodemographic variables and factors that indicated frailty and risk of falling. For quality of life assessment, Medical Outcomes Study Short-Form 36 and Theory of Social Representations, Abric’s structural approach were used, with data treated by dictionary of equivalent terms, processed in Evoc 2000, converging analytically according to Neuman.
Results:
quality of life impairment was identified in terms of physical, emotional and functional capacity. The elements of the possible central nucleus were fall, fear, and bruised-broken-bone.
Final considerations:
quality of life impairment can contribute to increase the number of falls, which has been shown to be an event present in elderly people’s lives through evocations. Understanding elderly people’s individual demands allows planning actions.
Keywords:Accident PreventionAccidental FallsCommunity Health NursingHealth Services for the AgedQuality of LifeSee more -
ORIGINAL ARTICLE07-06-2020
Knowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
Abstract
ORIGINAL ARTICLEKnowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
DOI 10.1590/0034-7167-2019-0362
Views0See moreABSTRACT
Objectives:
to analyze the knowledge and health promotion practice carried out by Family Health Strategy nurses.
Methods:
a descriptive study and qualitative approach. The study was conducted with 18 Family Health Strategy nurses from the city of São Carlos. Data were collected through semi-structured interviews and analyzed through thematic analysis. The study was approved by the Research Ethics Committee.
Results:
the data revealed that nurses had difficulties to conceptualize health promotion, and it is common to describe the definition of disease prevention. Nurses also reported developing group activities for health promotion; however, individual actions and consultations were still predominant.
Final Considerations:
it is necessary to develop sustainable strategies for collective health-promoting activities, in addition to strengthening multidisciplinary work and Continuing Education actions.
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EDITORIAL07-28-2021
The era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
Abstract
EDITORIALThe era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
DOI 10.1590/0034-7167.2021740501
Views0INTRODUCTIONThe large investment and development of research in genomics and molecular biology in the last two decades, especially after the conclusion of the Human Genome Project (HGP), has generated many expectations regarding its impact on the transformation from the conventional medicine paradigm to the precision medicine paradigm(–). The term precision medicine (PM) was used for […]See more -
REFLECTION02-25-2022
Art in evidence-based nursing practice from the perspective of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75(4):e20210664
Abstract
REFLECTIONArt in evidence-based nursing practice from the perspective of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75(4):e20210664
DOI 10.1590/0034-7167-2021-0664
Views0See moreABSTRACT
Objectives:
to discuss, in the light of Florence Nightingale, the historical position of art as a constituent device of evidence-based nursing practice.
Methods:
reflective study anchored in the writings of Nightingale and other researchers with whom it is possible to have a profound dialogue on the theme “art in nursing”.
Results:
art is related to two essential elements in the practice of nursing: knowledge and skill. Understanding science as knowledge and art as skill leads to the idea that both make it possible to combine technical competence, compassion, ethics, and individualization of care. Final Considerations: the art of nursing is the continuous exercise of detailed perception, so that the subjective aspect becomes the center to which the nurse’s gaze converges, that which will allow them to unveil the “truth” posed by the patient, resulting in the best intervention for him.
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ORIGINAL ARTICLE06-16-2021
Family interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
Abstract
ORIGINAL ARTICLEFamily interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
DOI 10.1590/0034-7167-2019-0206
Views0See moreABSTRACT
Objectives:
to identify information that can support creating good practice assumptions to develop family interview for organ and tissue donation.
Methods:
this scoping study, conducted in two Brazilian hospitals in the southern, between April and December 2017, included integrative review and consultation with 15 families who experienced interview for organ donation. For data analysis, thematic content analysis was used.
Results:
three categories emerged: communication of death, which shows the need to know the history of hospitalization of patients; emotional support, the team must have mastery of the stages of mourning; information about donation, professionals need to know the stages of the donation process and respect families’ time.
Final Considerations:
good practice assumptions point to the need for team training, respect for family time and the use of simple language.
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