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RESEARCH01-01-2018
Factors associated to the dependence of older adults with diabetes mellitus type 2
Revista Brasileira de Enfermagem. 2018;71:868-875
Abstract
RESEARCHFactors associated to the dependence of older adults with diabetes mellitus type 2
Revista Brasileira de Enfermagem. 2018;71:868-875
DOI 10.1590/0034-7167-2017-0285
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Objective:
to identify factors associated to the dependence of older adults with Diabetes Mellitus, Type 2
Method:
analytical and epidemiological study with 99 older adults. The Brazilian Multidimensional Functional Assessment Questionnaire and a questionnaire composed by socio-demographic and clinical variables were used. The independent variables were described and compared to the level of dependence obtained by the chi-square test or the Fisher test, the strength of association was estimated by Odds Ratio and multiple regression.
Results:
the level of dependence prevailed in 79.8% of the sample. Higher chances of dependence were associated to: cutting toenails; performing household chores; presenting geriatric problems; urinary incontinence; time of diagnosis of diabetes; falls in the past year; and physical inactivity.
Conclusion:
considering the positive association of diabetes mellitus to the increased chance of dependence among older adults, there is need for direction and adoption of effective measures to ensure the functionality and quality of life of older adults with diabetes mellitus in a fair and democratic way.
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RESEARCH01-01-2018
Self-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais
Revista Brasileira de Enfermagem. 2018;71:860-867
Abstract
RESEARCHSelf-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais
Revista Brasileira de Enfermagem. 2018;71:860-867
DOI 10.1590/0034-7167-2017-0135
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Objective:
To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument.
Method:
This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson’s Chi-square test and Poisson regression models.
Results:
The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization.
Conclusion:
Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.
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RESEARCH01-01-2018
Social representation of elderly people on falls: structural analysis and in the light of Neuman
Revista Brasileira de Enfermagem. 2018;71:851-859
Abstract
RESEARCHSocial representation of elderly people on falls: structural analysis and in the light of Neuman
Revista Brasileira de Enfermagem. 2018;71:851-859
DOI 10.1590/0034-7167-2017-0258
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Objective:
To understand the symbolic elements and the hierarchical system of representations of elderly people on falls, according to Abric’s structural analysis and Neuman’s theory.
Method:
Abric structural approach developed at the home of primary care users in a city of Minas Gerais. A free evocation technique of images triggered by images was performed in 2016 with elderly individuals (≥65 years old). Data treated by dictionary of equivalent terms; processed in Evoc 2000 software converging, analytically, according to Neuman. Ethical/legal criteria were met.
Results:
195 people participated, 78.5% were women, and 45.1% were aged ≥75 years. Summarized 897 words; 155 different ones. Central nucleus containing cognates: dizziness-vertigo-labyrinthitis and slipper-shoes (behavioral and objective dimension). The word disease integrated the area of contrast. Environmental and personal stressors were identified according to Neuman.
Final considerations:
Objects and risk behaviors for falls integrated the representations, although environmental and personal stressors indicate the need for preventive interventions in the environment and in the intrapersonal dimension.
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RESEARCH01-01-2018
Elderly and caregiver demand: proposal for a care need classification
Revista Brasileira de Enfermagem. 2018;71:844-850
Abstract
RESEARCHElderly and caregiver demand: proposal for a care need classification
Revista Brasileira de Enfermagem. 2018;71:844-850
DOI 10.1590/0034-7167-2017-0123
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Objective:
To propose a care need classification for elderly people by identifying their functional demands.
Method:
Cross-sectional study carried out in São Paulo, in 2006, with 1,413 elderly (≥ 60 years old), participants in the Health, Well-being and Aging study (SABE – Saúde, Bem Estar e Envelhecimento). For the care need classification, we used the Guttman Scaling method e the frequency of assistance required by the elderly.
Results:
The hierarchy of activities of daily living had good internal consistency (α = 0.92) and satisfactory coefficients of reproducibility (98%), scalability (84%) and minimum marginal reproducibility (87%). Care need was categorized into: no need (requires no caregiver), minimum need (requires caregiver sporadically), moderate need (requires caregiver intermittently) and maximum need (requires full-time caregiver).
Conclusion:
This classification will allow identifying elderly that need assistance in everyday activities and will orientante health professionals in the development of a line of care.
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RESEARCH01-01-2018
Elderly people with mental disorders: experiencing the use of psychotropic medicines
Revista Brasileira de Enfermagem. 2018;71:835-843
Abstract
RESEARCHElderly people with mental disorders: experiencing the use of psychotropic medicines
Revista Brasileira de Enfermagem. 2018;71:835-843
DOI 10.1590/0034-7167-2016-0159
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Objective:
To interpret the experience of the elderly with mental disorder in the use of psychotropic medicines.
Method:
Qualitative study in the interpretative modality, supported by the Grounded Theory. It was carried out from interviews with 16 elderly people with mental disorder and six relatives, totaling 22 participants.
Results:
In the experience of the use of psychotropic medicines, the elderly with mental disorders become aware of their condition, attribute meaning and establish strategies for the correct use. On the other hand, they express their dissatisfaction with being dependent on psychotropic medicines to live without symptoms, face their side effects and do not always use them correctly.
Conclusion:
The use of psychotropic medicines is a priority in the life of the elderly and, in view of the fragilities found, it is necessary a continuous monitoring of health professionals.
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RESEARCH01-01-2018
Validity and reliability of the Brazilian version of the Caregiver Reaction Assessment
Revista Brasileira de Enfermagem. 2018;71:827-834
Abstract
RESEARCHValidity and reliability of the Brazilian version of the Caregiver Reaction Assessment
Revista Brasileira de Enfermagem. 2018;71:827-834
DOI 10.1590/0034-7167-2017-0153
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Objective:
To analyze the validity based on the internal structure and reliability of the Brazilian version of the Caregiver Reaction Assessment (CRA) applied to informal caregivers of dependent elderly.
Method:
A methodological study with 120 informal caregivers of the elderly. Validity based on the internal structure evaluated by exploratory factorial analysis, with extraction of main factorial axes, varimax orthogonal rotation and retention of factors by parallel analysis. Reliability assessed by Cronbach’s alpha.
Results:
The instrument revealed a factorial structure different from the original version: three factors were identified, equivalent to subscales, self-esteem, daily activities and family support, with explained variance of 42%. The values of the Cronbach alpha for the items belonging to each subscale were, respectively: 0.71, 0.81 and 0.83.
Conclusion:
The Brazilian version of CRA presents good evidence of validity based on internal structure and is reliable, and can be used to assess the overload of informal caregivers of dependent elderly.
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RESEARCH01-01-2018
Board games: gerotechnology in nursing care practice
Revista Brasileira de Enfermagem. 2018;71:818-826
Abstract
RESEARCHBoard games: gerotechnology in nursing care practice
Revista Brasileira de Enfermagem. 2018;71:818-826
DOI 10.1590/0034-7167-2017-0365
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Objective:
To create a board game as a form of gerotechnology to promote active and healthy aging.
Method:
This was a qualitative, convergent care study conducted with 32 older adults. Individual interviews, creativity and sensitivity techniques, group discussions, and participant observations guided by Paulo Freire’s theoretical framework of problematization were used to produce data. The participants and researchers assessed the entire production process at the end of the study, after the gerotechnology was implemented in the groups. French discourse analysis was adopted.
Results:
Patented under registration no. BR 1020160107725, the game was created as a technological product based on the discussions with older adults, considering the conceptions, knowledge and practices shared by them about aging.
Final considerations:
The gerotechnology implemented in clinical nursing practices functioned as a playful resource to exercise self-determination and independence among older adults, boosting memory, self-esteem, socialization processes, exchanging experiences and shared learning.
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RESEARCH01-01-2018
Emergency care units and dimensions of accessibility to health care for the elderly
Revista Brasileira de Enfermagem. 2018;71:811-817
Abstract
RESEARCHEmergency care units and dimensions of accessibility to health care for the elderly
Revista Brasileira de Enfermagem. 2018;71:811-817
DOI 10.1590/0034-7167-2017-0440
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Objective:
to understand the conception of the elderly and their caregivers about the accessibility to health mediated by the service in Emergency Care Units.
Methodo:
a qualitative study conducted with 25 elderly patients and caregivers at Emergency Care Units in a city of Paraná, using Grounded Theory as a methodological reference.
Results:
According to the participants, the resources available in these services guarantee medical consultation and provide access to exams and medicines. Such resources have attracted patients and caused excess demand, which implies a set of compromising factors for the quality of care in these services.
Final considerations:
Investments in the restructuring of the care network, especially in primary care, with an increase in the number of consultations and the creation of a bond, can contribute to the emergency care units achieving the goal of access to qualified assistance to the elderly population.
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ORIGINAL ARTICLE01-30-2023
Adverse dermatoneurological events and impacts on daily activities of patients with gastrointestinal neoplasms undergoing chemotherapy
Revista Brasileira de Enfermagem. 2023;76(1):e20220161
Abstract
ORIGINAL ARTICLEAdverse dermatoneurological events and impacts on daily activities of patients with gastrointestinal neoplasms undergoing chemotherapy
Revista Brasileira de Enfermagem. 2023;76(1):e20220161
DOI 10.1590/0034-7167-2022-0161
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Objective:
to associate the presence and grading of adverse dermatoneurological events (peripheral neuropathy and hand-foot syndrome) and the interference in the activities of daily living of patients with gastrointestinal neoplasms undergoing systemic antineoplastic treatment.
Method:
this is a longitudinal, prospective study, using instruments to assess hand-foot syndrome and peripheral neuropathy.
Results:
there were 36 patients: 66.7% diagnosed with colon cancer and 83.2% on combination therapy. From cycle 5 onwards, all of them had hand-foot syndrome, with a majority of grade 1, unrelated to interference in activities of daily living. Regarding peripheral neuropathy, there was a moderate to strong correlation from cycle 1 of treatment.
Conclusion:
peripheral neuropathy negatively affects activities of daily living. The monitoring of dermatoneurological events by oncology nurses contributes to the clinical practice of nursing and subsidizes the development of advanced practice in the country.
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ORIGINAL ARTICLE12-16-2023
Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District
Revista Brasileira de Enfermagem. 2023;76(1):e20220170
Abstract
ORIGINAL ARTICLEElderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District
Revista Brasileira de Enfermagem. 2023;76(1):e20220170
DOI 10.1590/0034-7167-2022-0170
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Objectives:
To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District.
Methods:
Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%.
Results:
There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999).
Conclusions:
Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.
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ORIGINAL ARTICLE11-28-2023
Syphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
Abstract
ORIGINAL ARTICLESyphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
DOI 10.1590/0034-7167-2022-0210
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Objectives:
to understand the meanings attributed by women to the diagnosis and treatment of syphilis and congenital syphilis, and to outpatient follow-up of their children.
Methods:
this is a qualitative study conducted with 30 mothers of children with congenital syphilis using audio-recorded semi-structured interviews, which were submitted to inductive thematic analysis. Symbolic interactionism was the theoretical framework considered in this study.
Results:
two themes were identified, showing the maternal diagnosis involved shock, guilt, and fear of social exclusion, in addition to frustration due to failure to prevent vertical transmission. Moreover, the painful clinical procedures for the child’s treatment enhanced maternal guilt, and the symbolic process of re-signification of the disease/treatment took place with the child’s healing.
Final Considerations:
understanding the intersubjective aspects involved in this experience helps nurses rethink their care practice and contributes to their critical role in the context of syphilis.
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ORIGINAL ARTICLE11-28-2023
Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
Abstract
ORIGINAL ARTICLEBrazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
DOI 10.1590/0034-7167-2022-0315
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Objectives:
to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains.
Methods:
in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient.
Results:
the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001).
Conclusions:
poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.
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ORIGINAL ARTICLE02-06-2023
Teaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal
Revista Brasileira de Enfermagem. 2023;76(2):e20210244
Abstract
ORIGINAL ARTICLETeaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal
Revista Brasileira de Enfermagem. 2023;76(2):e20210244
DOI 10.1590/0034-7167-2021-0244
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Objective:
To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning.
Methods:
Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher’s exact tests, with differences considered statistically significant if p < 0.05.
Results:
Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods.
Conclusions:
The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.
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ORIGINAL ARTICLE03-06-2023
Medication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
Abstract
ORIGINAL ARTICLEMedication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
DOI 10.1590/0034-7167-2021-0755
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Objectives:
to develop and validate the content of two instruments for promoting medication reconciliation for the transition of care of hospitalized children.
Methods:
methodological study, conducted in five stages: scope review for conceptual structure; elaboration of the initial version; content validation with five specialists using the Delphi technique; reassessment; and construction of the final version of the instruments. A content validity index of at least 0.80 was adopted.
Results:
three rounds of evaluation were carried out to reach the validity index of the proposed contents, whereas a new analysis of 50% of the 20 items of the instrument aimed at families, and 28.5% of the 21 items aimed at professionals was necessary. The instrument aimed at families reached an index of 0.93, and the instrument for professionals, 0.90.
Conclusions:
the proposed instruments were validated. It is now possible to proceed with practical implementation studies to identify their influence on safety during medication reconciliation at transition of care.
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ORIGINAL ARTICLE05-08-2023
Precarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
Abstract
ORIGINAL ARTICLEPrecarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
DOI 10.1590/0034-7167-2022-0120
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Objectives:
to analyze the implications of precarious work for the organization of work and for the health of nursing professionals in a surgical center.
Methods:
qualitative, descriptive study in which the interview technique was applied on 30 nursing professionals from a surgical center in a university hospital located in the Southeast region of Brazil. The project was approved by the research ethics committee. Thematic content analysis was applied in the categorization of speeches.
Results:
precarious work in the surgical center negatively affects the organization of work due to staff turnover, loss of skilled talent, and the need for continuous training of temporary workers. It also affects the quality of care, leading to risks to patient safety and workers’ health.Final Considerations: it is important to make work conditions less precarious in order to minimize staff turnover and promote the quality of the service offered and the health of the worker.
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ORIGINAL ARTICLE04-07-2023
Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
Abstract
ORIGINAL ARTICLESuicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
DOI 10.1590/0034-7167-2022-0137
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Objectives:
to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt.
Methods:
an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis.
Results:
eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified.
Conclusions:
adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
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