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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0ABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
ORIGINAL ARTICLEMetodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0RESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0ABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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RESEARCH01-01-2016
Prevalence and factors associated with traffic accidents involving motorcycle taxis
Revista Brasileira de Enfermagem. 2016;69(2):382-388
Abstract
RESEARCHPrevalence and factors associated with traffic accidents involving motorcycle taxis
Revista Brasileira de Enfermagem. 2016;69(2):382-388
DOI 10.1590/0034-7167.2016690223i
Views0See moreABSTRACT
Objective:
to determine the prevalence of motorcycle accidents involving motorcycle taxi drivers and associated factors.
Method:
this is a cross-sectional and exploratory study, with application of questionnaires to motorcycle taxi drivers of 32 regions of Caicó, Rio Grande do Norte, Brazil (N=420).
Results:
motorcycle taxi drivers have a high level of daily working hours (12 hours on average), and it was found that 63.6% were involved in at least one motorcycling accident. The occurence of motorcycling accidents was significantly associated only to level of education (p<0.001), with no significant association with the other variables, such as age (p=0.132), time of service (p=0.744) and working hours (p=0.830).
Conclusion:
it is necessary to implement preventive and educational actions with motorcycle taxi drivers and users of this service concerning accidents and emergency measures, due to constant exposure to accidents during work routine.
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RESEARCH01-01-2016
Characterization of undergraduate nursing courses according to the National Student Performance Exam
Revista Brasileira de Enfermagem. 2016;69(2):375-381
Abstract
RESEARCHCharacterization of undergraduate nursing courses according to the National Student Performance Exam
Revista Brasileira de Enfermagem. 2016;69(2):375-381
DOI 10.1590/0034-7167.2016690222i
Views0See moreABSTRACT
Objective:
to characterize undergraduate nursing courses according to Enade (National Student Performance Exam) in 2010 and 2013.
Method:
a quantitative documental study was performed and descriptive statistics was used for data organization and analysis.
Results:
Enade report analysis enabled the identification of a reduction in the total number of institutions providing undergraduate nursing courses that passed the evaluation process. The Southeastern, Northeastern and Southern regions of Brazil included the highest numbers of courses assessed and showed the best results in the two evaluation cycles. Additionally, the courses characterized as “without a ranking” were mainly held at private institutions.
Conclusion:
the results of these evaluation cycles are important to support investigative and intervention processes about and with undergraduate nursing courses.
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RESEARCH01-01-2016
Teaching airway management with laryngeal mask: randomized controlled trial
Revista Brasileira de Enfermagem. 2016;69(2):368-374
Abstract
RESEARCHTeaching airway management with laryngeal mask: randomized controlled trial
Revista Brasileira de Enfermagem. 2016;69(2):368-374
DOI 10.1590/0034-7167.2016690221i
Views0See moreABSTRACT
Objective:
to teach airway management with laryngeal mask to nursing students through dialogic lectures along with laboratory activities or exclusively through simulation class.
Method:
randomized controlled trial. Population: eighth semester bachelor’s degree students. Sample: 17 students randomized in the intervention group (IG: simulation class) or control group (CG: dialogic lecture along with laboratory activities). Elaborated and validated instruments: written test, simulation scenario, objective structured clinical examination (checklist). Data collected from workshop. Structured clinical examination in simulation scenario filmed and evaluated by 3 experts, and written tests were applied.
Results:
24.4±4.2 years old. Right answers percentage: CG: pre-test 66±10%; post-test 84±8%. IG: pre-test 65±5%; post-test 86±11%. Scenario: CG 78±5.2%; IG 84±8.9%.
Conclusion:
strategies allowed the development of knowledge, skills and decision-making, which are essential to achieve the scenario objectives. Knowledge was incorporated in airway management with laryngeal mask, shown by the increase in the scenario and written tests scores.
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RESEARCH01-01-2016
Influence of the São Paulo State innovative models on Brazil’s mental health policy
Revista Brasileira de Enfermagem. 2016;69(2):360-367
Abstract
RESEARCHInfluence of the São Paulo State innovative models on Brazil’s mental health policy
Revista Brasileira de Enfermagem. 2016;69(2):360-367
DOI 10.1590/0034-7167.2016690220i
Views0See moreABSTRACT
Objective:
to analyze the influence of two São Paulo State experiences in the choice of psychosocial care centers as guiding service providers for the national mental health policy.
Method:
qualitative, exploratory, and descriptive study using oral history as a methodology and theoretical reference.
Results:
eight professionals involved in the deployment of the mental health policy in the cities of Santos and São Paulo between the years 1989 and 1992 were interviewed. Data were analyzed after treating the narratives and grouping the most significant content. Two central themes emerged: development of the local-regional model, and the model’s influence on the choice of the psychosocial care center.
Conclusion:
due to greater insertion of the Santos experience group in the spheres of the federal government, its influence on the choice of the substitute model was higher in ideological terms, whereas the São Paulo model had its influence restricted for political reasons.
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RESEARCH01-01-2016
Stress and cardiovascular risk: multi-professional intervention in health education
Revista Brasileira de Enfermagem. 2016;69(2):351-359
Abstract
RESEARCHStress and cardiovascular risk: multi-professional intervention in health education
Revista Brasileira de Enfermagem. 2016;69(2):351-359
DOI 10.1590/0034-7167.2016690219i
Views0See moreABSTRACT
Objective:
to identify cardiovascular risk in educators (administrators and teachers) from the South region of Brazil, evaluated before and after intervention with stress management activities and health education.
Method:
longitudinal study of the before and after type. The sample consisted of 49 participants. Variables studied were socio-demographic, morbidity antecedents and lifestyle habits. Measured risk factors for cardiovascular disease were arterial blood pressure, body mass index, ratio of waist to hip size, lipid profile and capillary blood glucose. Stress levels were evaluated using the Lipp Stress Symptoms Inventory (LSSI). The study ran for four months, with weekly meetings of a multidisciplinary team.
Results:
after intervention, the study observed a statistically significant reduction of the investigated variables, except for blood glucose levels in the administrators group.
Conclusion:
stress management activities are potential tools in the identification and control of the risk factors studied, particularly in those involving multi- and trans-disciplinary focus.
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RESEARCH01-01-2016
Social representations of nursing students about hospital assistance and primary health care
Revista Brasileira de Enfermagem. 2016;69(2):343-350
Abstract
RESEARCHSocial representations of nursing students about hospital assistance and primary health care
Revista Brasileira de Enfermagem. 2016;69(2):343-350
DOI 10.1590/0034-7167.2016690218i
Views0ABSTRACT
Objective:
To analyze how social representations of hospital and community care are structured in two groups of nursing students – 1st and 4th years.
Method:
Qualitative research oriented by the Theory of Social Representations. We used a questionnaire with Free Association of Words. Data were analyzed in the Software IRaMuTeQ 0.6 alpha 3.
Results:
We applied the method of Descending Hierarchical Classification and obtained four classes. Class 4 has the largest social representation (30.41%) within the corpus. The two organizational axes are nurse and disease/patient in the central core. On the periphery are the care and help related to the nurse and the treatment and prevention associated with the disease.
Conclusion:
Social representations focus on disease/patient and on the role of nurses in the treatment, prevention, and care. Health promotion and the social determinants of health are absent from the social representations of students.
Keywords:Hospital AssistanceNursing EducationNursing StudentsPrimary Health CareSkills-Based EducationSee more -
RESEARCH01-01-2016
Prevalence of medication therapy adherence in the elderly and related factors
Revista Brasileira de Enfermagem. 2016;69(2):335-342
Abstract
RESEARCHPrevalence of medication therapy adherence in the elderly and related factors
Revista Brasileira de Enfermagem. 2016;69(2):335-342
DOI 10.1590/0034-7167.2016690217i
Views0See moreABSTRACT
Objective:
to determine the prevalence of adherence to medication therapy in elderly outpatients; to verify whether there is an association between medication therapy adherence and demographic and socioeconomic factors, health conditions.
Method:
a quantitative, exploratory, descriptive, cross-sectional study, performed in outpatient clinics of a university hospital in Rio Grande do Sul, Brazil. Three data collection instruments were answered by a convenience sample of 107 elders. A descriptive and inferential statistical analysis was conducted.
Results:
the prevalence of adherence was 86.9%. A statistically significant association was identified between the adherence variable and receiving medical guidelines on how to take medications, and having adverse reactions. Conclusion: Nurses must know the prevalence of medication adherence and related factors in order to plan interventions that promote therapeutic success.
Conclusion:
Nurses must know the prevalence of medication adherence and related factors in order to plan interventions that promote therapeutic success.
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RESEARCH01-01-2016
Family farming and human and environmental health conservation
Revista Brasileira de Enfermagem. 2016;69(2):326-334
Abstract
RESEARCHFamily farming and human and environmental health conservation
Revista Brasileira de Enfermagem. 2016;69(2):326-334
DOI 10.1590/0034-7167.2016690216i
Views0See moreABSTRACT
Objective:
understand how farmers identify positive and negative impacts of family farming work on the environment and conserve the environmental health.
Method:
a qualitative study with 129 farmers from Ilha dos Marinheiros, Rio Grande, Brazil. Secondary data and recorded interviews were used in this study, with subsequent analysis performed by Bardin and NVivo10, both based on Enrique Leff’s cultural rationality.
Results:
the positive impacts included food production with responsibility, work appreciation, and the correct, minimum or inexistent insertion of agrochemicals. The negative aspects included excessive and incorrect use of agrochemicals and absent farming knowledge.
Conclusion:
environmental conservation consisted in reducing impacts that could have a negative effect on health, while performing work activities.
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