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ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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ORIGINAL ARTICLE12-08-2024
Safe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
Abstract
ORIGINAL ARTICLESafe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
DOI 10.1590/0034-7167-2023-0135
Views0See moreABSTRACT
Objective:
To validate a checklist for safe bathing in critically ill patients.
Methods:
This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.
Results:
In the apparent and content validation, adjustments were made according to the judges’ suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).
Conclusion:
The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.
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REVIEW11-29-2024
Assessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
Abstract
REVIEWAssessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
DOI 10.1590/0034-7167-2023-0532
Views0See moreABSTRACT
Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
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ORIGINAL ARTICLE11-29-2024
Sleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
Abstract
ORIGINAL ARTICLESleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
DOI 10.1590/0034-7167-2023-0283
Views0See moreABSTRACT
Objective:
To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.
Method:
Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.
Results:
The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).
Conclusion:
Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.
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REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
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11-22-2024
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
Abstract
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
DOI 10.1590/0034-7167-2023-0298
Views0See moreABSTRACT
Objective:
To report the development of a technological innovation in the form of a documentary, aimed at disseminating actions for preventing violence against adolescents within the context of Primary Health Care.
Methods:
The documentary was developed through action research and interventions with adolescents in the territory of a Health Unit, conducted between 2020 and 2022, using Social Technology as both an action strategy and a conceptual reference.
Results:
The Social Technology proposal, created through workshops and seminars, resulted in a documentary focusing on violence prevention, involving 48 adolescents. The documentary’s script, collectively developed, portrays a soccer match between teams symbolizing peace and violence, with peace ultimately prevailing. The documentary is six minutes long.
Final Considerations:
The documentary has proven to be an effective Social Technology tool among adolescents, as it fosters critical thinking, is accessible, has potential for digital dissemination, and appeals to the target audience.
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ORIGINAL ARTICLE11-22-2024
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
Abstract
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
DOI 10.1590/0034-7167-2023-0327
Views0See moreABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
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ORIGINAL ARTICLE07-28-2021
Effects of clown activities on patients eligible for palliative care in primary health care
Revista Brasileira de Enfermagem. 2021;74(5):e20200431
Abstract
ORIGINAL ARTICLEEffects of clown activities on patients eligible for palliative care in primary health care
Revista Brasileira de Enfermagem. 2021;74(5):e20200431
DOI 10.1590/0034-7167-2020-0431
Views0See moreABSTRACT
Objective:
Evaluate the effects of clown activities on quality of life, depression, stress, anxiety, aid, and social support in patients eligible for palliative care (PC) attended in Primary Health Care (PHC).
Method:
A quasi-experimental study, with pre-intervention and post-intervention evaluation, carried out with 16 patients eligible for early PC in PHC in a Midwestern city. Patients received 24 visits with home-based clown activities.
Results:
The interventions evidenced improved quality of life and social support, with significant results for the Social Activities dimension (p = 0.023). Increased scores for Anxiety (p = 0.007) and Depression (p = 0.023) were also observed.
Conclusion:
Clown activities can bring positive results for the quality of life and social support of patients eligible for PC at home. They should be encouraged to interact with family knowledge and enhance humanized care, integral and centered on human relationships in PHC.
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06-28-2021
Baby-Friendly Hospital Initiative for Neonatal Wards: impact on breastfeeding practices among preterm infants
Revista Brasileira de Enfermagem. 2021;74:e20200909
Abstract
Baby-Friendly Hospital Initiative for Neonatal Wards: impact on breastfeeding practices among preterm infants
Revista Brasileira de Enfermagem. 2021;74:e20200909
DOI 10.1590/0034-7167-2020-0909
Views0See moreABSTRACT
Objective:
to assess breastfeeding support practices for preterm infants at two Baby-Friendly hospitals in southeastern Brazil, comparing the effect of implementing the guidelines for Baby-Friendly Hospital Initiative for Neonatal wards.
Methods:
a quasi-experimental study, pre- and post-intervention with control. Implementation of this initiative in the intervention hospital using Knowledge Translation. Data collection on compliance with the adapted Ten Steps, Three Guiding Principles and the Code before and after the intervention was carried out via interviews with mothers of preterm babies and professionals, unit observation and documentary analysis in the intervention and control hospitals. Intra-intergroup comparison was performed.
Results:
increases in global compliance with the Three Principles, Ten Steps, the Code, partial compliance with each Principle and in most Steps was greater in the intervention hospital. Conclusion: this initiative improved practices related to breastfeeding in the intervention hospital, demonstrating the potential to improve care and breastfeeding in neonatal wards.
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08-16-2021
The prevalence of the technocratic model in obstetric care from the perspective of health professionals
Revista Brasileira de Enfermagem. 2021;74:e20200689
Abstract
The prevalence of the technocratic model in obstetric care from the perspective of health professionals
Revista Brasileira de Enfermagem. 2021;74:e20200689
DOI 10.1590/0034-7167-2020-0689
Views0See moreABSTRACT
Objectives:
to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals.
Methods:
Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration.
Results:
the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff.
Final Considerations:
obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.
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ORIGINAL ARTICLE07-08-2020
Older adults with physical disabilities: vulnerabilities relative to the body, the physical and social environment
Revista Brasileira de Enfermagem. 2020;73:e20190175
Abstract
ORIGINAL ARTICLEOlder adults with physical disabilities: vulnerabilities relative to the body, the physical and social environment
Revista Brasileira de Enfermagem. 2020;73:e20190175
DOI 10.1590/0034-7167-2019-0175
Views0See moreABSTRACT
Objective:
to understand the vulnerabilities of older adults with physical disabilities regarding their body, physical and social environments.
Method:
this was a qualitative study based on Alfred Schütz’ social phenomenology, with 15 older adults with physical disability from Cuiabá, state of Mato Grosso, Brazil. Open-ended questionnaires were administered to the participants in 2017. The units of meaning that emerged were organized into thematic categories.
Results:
physical decline, associated with the permanence of environmental and social barriers intensified the vulnerabilities of older adults. Gaps in health services are mitigated by informal social support networks and access to work was a form of social inclusion.
Final considerations:
vulnerabilities in the old age of persons with physical disabilities did not reside only in the body dimension, but also the physical and social environment, countering healthcare models based on the logic of reverting their dysfunctional body.
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05-28-2021
Challenges of nursing care in psychosocial rehabilitation: a study from the constructionist perspective
Revista Brasileira de Enfermagem. 2021;74:e20200408
Abstract
Challenges of nursing care in psychosocial rehabilitation: a study from the constructionist perspective
Revista Brasileira de Enfermagem. 2021;74:e20200408
DOI 10.1590/0034-7167-2020-0408
Views0See moreABSTRACT
Objective:
To identify the nursing staff’s difficulties in providing care in psychosocial rehabilitation to CAPS users.
Methods:
Qualitative study based on constructionism. Sixteen members of the CAPS nursing staff participated in the study in the city of Rio de Janeiro. The data collected in the interviews and observations were organized in Nvivo software and analyzed based on thematic content.
Results:
The difficulties identified were: the territorial violence that imposes a silence to the actions of CAPS, low user education as a barrier to protagonism, impaired family adhesion, the technical-conceptual discomfort of nursing in acting in the crisis and material and human of CAPS dismantlement.
Final considerations:
The challenges consist of overcoming staff exhaustion; however, they do not prevent nursing from betting on the possibility of protagonist care. Therefore, such care is dimensioned by the clinical-political-ethical relation in constant negotiation with the territory.
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ORIGINAL ARTICLE07-23-2021
Quality indicators of the nursing process documentation in clinical practice
Revista Brasileira de Enfermagem. 2021;74(3):e20201355
Abstract
ORIGINAL ARTICLEQuality indicators of the nursing process documentation in clinical practice
Revista Brasileira de Enfermagem. 2021;74(3):e20201355
DOI 10.1590/0034-7167-2020-1355
Views0See moreABSTRACT
Objectives:
to propose quality indicators for clinical nursing documentation
Methods:
methodological study in which literature review guided the composition of an instrument for evaluating nursing documentation. Two independent professionals evaluated 204 medical records of adult patients. The analysis of this assessment generated quality indicators for clinical nursing documentation. Inter-rater agreement was analyzed by Cohen’s kappa.
Results:
the bibliographic review, analysis by experts and pre-test resulted in 88 evaluation items distributed in seven topics; in 88.5% of the items, inter-rater agreement between strong and almost perfect (k=0.61-1.0) was observed. Analysis of the evaluations generated a global indicator and seven partial indicators of documentation quality. Compliance in the two services ranged between 62.3% and 93.4%. The global indicator showed a 2.1% difference between services.
Conclusions:
seven quality indicators of clinical nursing documentation and their method of application in hospital records have been proposed.
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ORIGINAL ARTICLE07-01-2020
Knowledge of primary health care professionals on health policies for the riverside population
Revista Brasileira de Enfermagem. 2020;73(5):e20190080
Abstract
ORIGINAL ARTICLEKnowledge of primary health care professionals on health policies for the riverside population
Revista Brasileira de Enfermagem. 2020;73(5):e20190080
DOI 10.1590/0034-7167-2019-0080
Views0See moreABSTRACT
Objectives:
to analyze the knowledge of health professionals on the health policies for the riverside population; identify how health practices with this group are developed; and discuss facilitators and barriers for the implementation of these policies.
Methods:
qualitative and descriptive study with 24 professionals from the Riverside Family Health Strategy Teams in the city of Belém-Pará. Data were collected in individual interviews and analyzed by Content Analysis.
Results:
although professionals demonstrate knowledge about public health policies, there is a need to expand and strengthen knowledge about health policies for the riverside population. The activities directed to the communities took place in the Unit itself, and some did not occur due to insufficient material and human resources.
Final Considerations:
the greatest barrier for the organization of health care is the lack of material and human resources, and the most prominent facilitator was the union and cohesion of the health team.
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REVIEW08-15-2022
State of the art on Advanced Nursing Practice: reflections for the agenda in Brazil
Revista Brasileira de Enfermagem. 2022;75(5):e20220151
Abstract
REVIEWState of the art on Advanced Nursing Practice: reflections for the agenda in Brazil
Revista Brasileira de Enfermagem. 2022;75(5):e20220151
DOI 10.1590/0034-7167-2022-0151
Views0See moreABSTRACT
Objectives:
to review the state of the art on Advanced Nursing Practices.
Methods:
a scoping review of existing publications up to 2020, in the PubMed/MEDLINE, SciELO, LILACS, BDENF, Web of Science and Scopus databases, identified by descriptors “Prática Avançada de Enfermagem” or “Advanced Practice Nursing”. A total of 184 documents were selected. The characterization of this study was carried out, followed by the construction of an overview of different regions of the world.
Results:
studies showed an increasing trend in the last decade, being present in all continents, although 43.5% correspond to opinion articles, comments, editorials and event reports. Even with similar aspects, the justifications for Advanced Nursing Practices reflect specific regional needs.
Final Considerations:
the studies still lack methodological variety and emphasis on the specificities of countries and their health systems, in addition to greater detail on labor regulation, professional training and the impacts of these practices in nursing.
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