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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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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
Views0See moreABSTRACT
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.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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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
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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07-10-2023
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
Metodologia 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
Views0See moreRESUMEN
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.
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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
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
Views0See moreABSTRACT
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.
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ORIGINAL ARTICLE02-10-2020
Nursing team knowledge on care for patients with fungating wounds
Revista Brasileira de Enfermagem. 2020;73(1):e20170738
Abstract
ORIGINAL ARTICLENursing team knowledge on care for patients with fungating wounds
Revista Brasileira de Enfermagem. 2020;73(1):e20170738
DOI 10.1590/0034-7167-2017-0738
Views0See moreABSTRACT
Objective:
to evaluate the nursing team knowledge of a cancer hospital on care for patients with Malignant Fungating Wounds (MFW) and to analyze associated sociodemographic and educational factors.
Method:
an observational and cross-sectional study, conducted between September and October 2015, after approval by the Research Ethics Committee. A questionnaire was applied containing sociodemographic, educational and related components to the accomplishment of dressings, dressings choice and orientation. Data were analyzed by using Chi-square, Fisher’s exact test, Student’s t-Test and Pearson’s correlation.
Results:
37 professionals participated in the study, most of whom were technicians (56.8%), women (91.9%) and with a mean age of 32 years. The professionals presented 56.5% of correct answers. There were no statistically significant associations between sociodemographic/educational variables and number of correct answers.
Conclusion:
there was a lack of important knowledge about care for patients with MFW, which should guide strategies for the oncology staff training.
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REVIEW01-29-2021
Epidemiological profile of children and adolescents with COVID-19: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200624
Abstract
REVIEWEpidemiological profile of children and adolescents with COVID-19: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200624
DOI 10.1590/0034-7167-2020-0624
Views0See moreABSTRACT
Objective:
to map the epidemiological profile of children and adolescents with COVID-19 in the world literature.
Methods:
a scoping review systematized by the Joanna Briggs Institute protocol in the PubMed/MEDLINE, CINAHL, Web of Science, Scopus, Science direct and Google Scholar databases. Articles with children and/or adolescents with laboratory diagnosis of COVID-19 were used.
Results:
thirty-two articles were included in the review. Most children and adolescents were male, with contamination by family transmission. The most frequent clinical manifestations were fever, cough and diarrhea. Ten studies cited pre-existing condition/disease, and hospital length ranged from one to twenty days. Three deaths were reported and no study presented race/color, education and socioeconomic conditions.
Conclusion:
it was possible to screen the epidemiological profile with information about age group, sex, probable contamination of the disease, clinical manifestations, presence of pre-existing disease/condition, hospitalization and deaths among children and adolescents with COVID-19.
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ORIGINAL ARTICLE06-18-2021
Why does your pain never get better? Stigma and coping mechanism in people with sickle cell disease
Revista Brasileira de Enfermagem. 2021;74(3):e20200831
Abstract
ORIGINAL ARTICLEWhy does your pain never get better? Stigma and coping mechanism in people with sickle cell disease
Revista Brasileira de Enfermagem. 2021;74(3):e20200831
DOI 10.1590/0034-7167-2020-0831
Views0See moreABSTRACT
Objectives:
to analyze the characteristics of stigma in the interactions of people with pain and sickle cell disease and the coping strategies adopted.
Methods:
qualitative study, conducted in Bahia’s reference units between January and July 2018. In-depth interviews were applied to 25 adults, followed by content analysis and interpretation in light of the Sociological Theory of Stigma.
Results:
four categories emerged from the data: Stigma in interactions with family members; Stigma in interactions with people in the general public; Stigma in interactions with health workers; and Strategies for coping with stigma.
Final Considerations:
in the participants’ interactions, stigma produced discrediting pain reports, labeling and stereotyping, blaming patients for not improving their health, discrimination, racism, inadequate pain assessment, and delay in care. Coping included silencing, covering up, aggressive behavior, exposure to risk, reading religious texts and praises, and church attendance.
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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 ARTICLE10-21-2019
Mental health in primary health care: health-disease according to health professionals
Revista Brasileira de Enfermagem. 2019;72(6):1609-1617
Abstract
ORIGINAL ARTICLEMental health in primary health care: health-disease according to health professionals
Revista Brasileira de Enfermagem. 2019;72(6):1609-1617
DOI 10.1590/0034-7167-2018-0743
Views0See moreABSTRACT
Objective:
to analyze perceptions of the Family Health Strategy (FHS) professional team about mental health-disorder and to identify health actions developed by the team for people with mental disorders.
Method:
a qualitative study of a Marxist theoretical framework and a dialectical method. 99 FHS middle and higher level professionals from São Paulo participated. Semi-structured interviews were conducted. Data were submitted to ALCESTE software and Thematic Content Analysis.
Results:
there were three empirical categories: Training in Mental Health; Perception of the FHS professional about mental health-disorder; and Health actions developed by the FHS team with people with mental disorders. Actions that converge and diverge from the psychosocial care model were identified.
Final considerations:
there is an effort from professionals to work according to the psychosocial care model, but it is necessary to invest in the Permanent Education in Health of these professionals to overcome barriers and foster successful territorial actions.
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ORIGINAL ARTICLE06-01-2020
Factors associated with depressive symptoms in older adults in context of social vulnerability
Revista Brasileira de Enfermagem. 2020;73:e20190107
Abstract
ORIGINAL ARTICLEFactors associated with depressive symptoms in older adults in context of social vulnerability
Revista Brasileira de Enfermagem. 2020;73:e20190107
DOI 10.1590/0034-7167-2019-0107
Views0See moreABSTRACT
Objective:
To identify factors associated with depressive symptoms in the elderly inserted in a context of high social vulnerability.
Methods:
A cross-sectional study was carried out with 302 elderly people enrolled in Primary Care. We used a sociodemographic questionnaire, Geriatric Depression Scale, Mini Nutritional Assessment, Shor-form-6D Quality of Life Questionnaire and Medical Outcome Study Scale. For data analysis, a logistic regression was performed considering two groups, with and without depressive symptoms.
Results:
A good perception of the quality of life (OR: 0.21) and receiving emotional support (OR: 0.98) were presented as protective factors for depression, have risks of malnutrition (OR: 4.87), belong to the female sex OR: 1.88) and living alone (OR: 2.34), indicated a predictor factor for depression.
Conclusion:
Quality of life and social support were identified as protective factors for depressive symptoms while being at risk of malnutrition, living alone, reporting pain and being female are predictors.
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ORIGINAL ARTICLE03-24-2021
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
Abstract
ORIGINAL ARTICLECosts of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
DOI 10.1590/0034-7167-2020-0275
Views1See moreABSTRACT
Objectives:
to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.
Methods:
a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.
Results:
a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).
Conclusions:
hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.
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ORIGINAL ARTICLE05-21-2021
Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
Abstract
ORIGINAL ARTICLEMusic in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
DOI 10.1590/0034-7167-2019-0838
Views0See moreABSTRACT
Objectives:
to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.
Methods:
quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.
Results:
the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.
Conclusions:
the use of music diminishes the stress and the distress of cancer patients.
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