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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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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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ORIGINAL ARTICLE12-04-2023
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
DOI 10.1590/0034-7167-2022-0679
Views0See moreABSTRACT
Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE12-04-2023
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
DOI 10.1590/0034-7167-2022-0553
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
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ORIGINAL ARTICLE12-04-2023
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
DOI 10.1590/0034-7167-2022-0586
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
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ORIGINAL ARTICLE12-04-2023
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
DOI 10.1590/0034-7167-2022-0597
Views0See moreABSTRACT
Objective:
The study aimed to analyze the factors that affect the community’s attitude towards COVID-19 vaccination in Tangerang District.
Methods:
A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval.
Results:
Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094).
Conclusions:
Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
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ORIGINAL ARTICLE12-04-2023
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
Abstract
ORIGINAL ARTICLEAssessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
DOI 10.1590/0034-7167-2023-0068
Views0See moreABSTRACT
Objective:
to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic.
Methods:
A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods.
Results:
A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029).
Conclusion:
The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.
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Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
Abstract
Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
DOI 10.1590/0034-7167-2022-0803
Views0ABSTRACT
Objective:
To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB).
Methods:
A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software.
Results:
Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities.
Conclusions:
This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.
Keywords:COVID-19Extensively Drug-Resistant TuberculosisMicrobial Drug ResistanceMultidrug-Resistant TuberculosisTuberculosisSee more
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ORIGINAL ARTICLE07-29-2022
Effects of guided imagery relaxation in hematopoietic stem-cell transplantation patients: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75(5):e20220114
Abstract
ORIGINAL ARTICLEEffects of guided imagery relaxation in hematopoietic stem-cell transplantation patients: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75(5):e20220114
DOI 10.1590/0034-7167-2022-0114
Views1ABSTRACT
Objective:
To analyze the effects of the technique of virtual reality guided imagery in the vital signs of hematopoietic stem-cell transplantation patients.
Method:
Quasi-experimental study with 35 participants who received an intervention using virtual reality guided imagery with progressive muscle relaxation, applied three times a week for four weeks in a referral hospital for transplants in the south of Brazil. Data collected included: temperature, arterial pressure, respiratory rate, heart rate, pain, and oxygen saturation, before and after each intervention. The comparisons were analyzed using Wilcoxon’s test.
Results:
There was a clinical significance between the mean measurements before and after for respiratory rate (p=0.00) in all stages, and for the variables Heart rate, Temperature, and Oxygen saturation from the 1st to the 12th measurements (p=0.05).
Conclusion:
The intervention was low cost, easy to apply, and showed positive effects, presenting itself as an option for patient-focused care.
Keywords:Bone Marrow TransplantationHematopoietic Stem Cell TransplantationImageryPsychotherapyRelaxation TherapyVital SignsSee more -
ORIGINAL ARTICLE10-17-2022
Ethics, COVID-19 and nursing vulnerability: analysis of photographs released by the media
Revista Brasileira de Enfermagem. 2022;75:e20210960
Abstract
ORIGINAL ARTICLEEthics, COVID-19 and nursing vulnerability: analysis of photographs released by the media
Revista Brasileira de Enfermagem. 2022;75:e20210960
DOI 10.1590/0034-7167-2021-0960
Views1See moreABSTRACT
Objectives:
to analyze nursing vulnerability through photos released by the media amidst the COVID-19 pandemic.
Methods:
a documentary study, with a qualitative approach. The object of analysis were photographic images selected between January 2020 and March 2021, published by the main news portals in countries such as Brazil, the United States, France, Spain, England and Germany. Thematic categorical analysis was the method of analysis used.
Results:
we found 74 photographs that portrayed nursing professionals in different work situations. It was possible to identify stigma and social devaluation about this class’s representation and professional attribution. Moreover, we found an underrepresentation of black professionals in Brazilian portals and the man as the prominent figure in the spaces of claims.
Final Considerations:
the photographs represented an important tool for the social analysis of nursing vulnerability, favoring the unveiling of situations that may go unnoticed by nursing and society.
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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 -
REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
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ORIGINAL ARTICLE12-16-2024
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
Abstract
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
DOI 10.1590/0034-7167-2023-0315
Views1See moreABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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REVIEW11-22-2024
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
Abstract
REVIEWTelenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
DOI 10.1590/0034-7167-2024-0093
Views1See moreABSTRACT
Objective:
to identify telenursing contributions in Primary Health Care during the COVID-19 pandemic.
Methods:
an integrative literature review, conducted between January and August 2022 in the PubMed, CINAHL, LILACS, BDENF, Scopus, WoS, EMBASE and SciELO databases. A total of 493 studies was found, 62 were read in full, and of these, 16 were selected. For analysis, a dynamic reading of the studies and synthesis of the main results were carried out.
Results:
the main results highlighted telenursing practice as a challenge for professionals and the population. Among the contributions and positive points and aspects that require improvement, practice showed promise when considered in a post-pandemic scenario.
Final considerations:
through telenursing, the population’s access to Primary Health Care was guaranteed in the face of the COVID-19 pandemic. However, a critical look at current technological advances in healthcare is necessary.
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EDITORIAL03-08-2024
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
EDITORIALNursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101
Views1Since the 1970s, the Brazilian Ministry of Health established the Brazilian National Immunization Program (PNI – Programa Nacional de Imunização), which preceded the Brazilian Health System and which was incorporated and strengthened due to the decentralized model to municipalities, but under single command at central level. Its objective was and still is to coordinate vaccination […]See more
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