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ORIGINAL ARTICLE07-29-2024
Adaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
Abstract
ORIGINAL ARTICLEAdaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
DOI 10.1590/0034-7167-2023-0159
Views0See moreABSTRACT
Objectives:
to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women.
Methods:
a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo’s methodology and Roy’s Adaptation Model.
Results:
various types of stimuli – focal, contextual, and residual – were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women’s adaptation, offering significant support and generating positive feedback for childbirth preparation.
Final Considerations:
the importance of pregnant women’s groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.
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ORIGINAL ARTICLE07-29-2024
Profile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
Abstract
ORIGINAL ARTICLEProfile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
DOI 10.1590/0034-7167-2023-0146
Views0See moreABSTRACT
Objectives:
to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
Methods:
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
Results:
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
Conclusions:
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.
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ORIGINAL ARTICLE07-29-2024
Impact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
Abstract
ORIGINAL ARTICLEImpact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
DOI 10.1590/0034-7167-2023-0132
Views0See moreABSTRACT
Objectives:
to evaluate the impact of educational intervention on understanding health recommendations after liver transplantation.
Methods:
randomized and prospective clinical trial, with 68 liver transplant recipients in two institutions. The level of understanding was assessed using a statement agreement scale and the understanding score was classified. Chi-square test was used to compare groups.
Results:
the level of understanding was reasonable in 77.9% of patients, 73.5% in the Control Group and 82.3% in the Intervention Group (p=0.399). For topics covered after educational action, there were more than 80% correct answers regarding nutrition, frequent hydration, usage and function of immunosuppressants. However, there were less than 10% correct answers regarding hand hygiene, contact with animals and crowds of people. The use of the patient’s audio, visual and tactile resources led to improved understanding of skin care (p=0.014).
Conclusions:
the level of understanding acquired regarding health recommendations was only reasonable.
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ORIGINAL ARTICLE07-29-2024
Trends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
Abstract
ORIGINAL ARTICLETrends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
DOI 10.1590/0034-7167-2023-0099
Views0See moreABSTRACT
Objectives:
to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification.
Methods:
this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression.
Results:
higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5).
Conclusions:
although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.
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ORIGINAL ARTICLE07-29-2024
Healthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
Abstract
ORIGINAL ARTICLEHealthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
DOI 10.1590/0034-7167-2022-0413
Views0See moreABSTRACT
Objectives:
to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020.
Methods:
the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined.
Results:
676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system.
Conclusions:
characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.
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ORIGINAL ARTICLE07-19-2024
Nursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
Abstract
ORIGINAL ARTICLENursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
DOI 10.1590/0034-7167-2023-0414
Views0See moreABSTRACT
Objectives:
to understand nursing students’ perception regarding Escape Room use to develop leadership skills.
Methods:
a qualitative exploratory-descriptive study, with 97 nursing students. Escape Room game sessions were held, totaling ten. Subsequently, a debriefing and analysis was carried out using the Discourse of the Collective Subject method, through the focus group technique. Ethical procedures were respected.
Results:
students’ perceptions about using this methodology to develop leadership skills were positive and significant. The effectiveness of the game in teaching and developing these skills in nursing practice stands out.
Final Considerations:
the game was an effective active methodology in approaching the proposed content, promoting satisfaction and easy assimilation.
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
Abstract
ORIGINAL ARTICLEValidation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
DOI 10.1590/0034-7167-2023-0401
Views0See moreABSTRACT
Objectives:
to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.
Methods:
a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.
Results:
an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.
Conclusions:
the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
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ORIGINAL ARTICLE07-19-2024
The use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
Abstract
ORIGINAL ARTICLEThe use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
DOI 10.1590/0034-7167-2023-0383
Views0See moreABSTRACT
Objectives:
to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer.
Methods:
a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0.
Results:
participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned.
Final Considerations:
spirituality and religiosity are dimensions that guide oncology nurse residents’ attitudes.
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06-14-2024
Duração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
Abstract
Duração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
DOI 10.1590/0034-7167-2023-0167
Views0See moreRESUMEN
Objetivo:
analizar la duración y calidad del sueño en profesionales de enfermería que trabajan por turnos.
Método:
investigación analítica, transversal, realizada entre septiembre de 2017 y abril de 2018, en un hospital público del sur de Brasil, con el equipo de enfermería. Se utilizó el cuestionario sociolaboral y de síntomas de salud, la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh. Los datos se presentan como estadística descriptiva e inferencial, análisis bivariado y regresión logística binaria.
Resultados:
participaron 308 profesionales de enfermería, con predominio de sueño prolongado, ausencia de somnolencia y mala calidad del sueño. La duración corta del sueño (<6 h) se asoció con turnos de día y mala calidad del sueño. La calidad del sueño se asoció con la presencia de somnolencia diurna excesiva y con el trabajo diurno.
Conclusión:
los turnos de trabajo, el insomnio y la cefalea fueron los principales factores relacionados con la falta de sueño de los profesionales de enfermería. Los resultados pueden justificar el desarrollo de investigaciones de intervención para la salud de los trabajadores.
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ORIGINAL ARTICLE06-14-2024
Sleep duration and quality of Brazilian nursing staff who work in shifts
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
Abstract
ORIGINAL ARTICLESleep duration and quality of Brazilian nursing staff who work in shifts
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
DOI 10.1590/0034-7167-2023-0167
Views0See moreABSTRACT
Objective:
to analyze sleep duration and sleep quality in nursing professionals who work in shifts.
Method:
this is a cross-sectional, analytical research, carried out between September 2017 and April 2018, at a public hospital in southern Brazil, with the nursing team. A socio-occupational and health symptoms questionnaire, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index were used. Data are presented as descriptive and inferential statistics, bivariate analysis, and binary logistic regression.
Results:
participants were 308 nursing professionals with a predominance of long-term sleep, absence of drowsiness, and poor sleep quality. Short-term sleep (<6h) was associated with day shift and poor sleep quality. Sleep quality was associated with presence excessive daytime sleepiness and work day shift.
Conclusion:
work shift, insomnia and headache were the main factors related short-term sleep for nursing professionals. The results may justify the development of intervention research for workers’ health.
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ORIGINAL ARTICLE06-14-2024
Translation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230137
Abstract
ORIGINAL ARTICLETranslation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230137
DOI 10.1590/0034-7167-2023-0137
Views0See moreABSTRACT
Objective:
The aim of this study is to cross-culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire Lymphoedema (LYMPH-ICF) instrument into Brazilian Portuguese and conduct a pilot application (n = 10), without psychometric pretensions.
Method:
Methodological research was conducted, following the steps of translation, synthesis, back-translation, and evaluation by the expert committee. Two translators, two back-translators, and twelve professionals participated in the expert committee. A pretest was carried out with 10 patients with secondary lymphedema due to breast cancer. The degree of agreement was determined by the content validity coefficient.
Results:
It was necessary to modify 8 out of the 29 questions comprising the questionnaire, which exhibited idiomatic disagreement. However, despite these changes, there were no indications of impairments, as content reliability was achieved through a validity coefficient of 0.90.
Final Considerations:
The instrument was successfully translated and cross-culturally adapted for Brazil with a high level of agreement.
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ORIGINAL ARTICLE05-27-2024
Fall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
Abstract
ORIGINAL ARTICLEFall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
DOI 10.1590/0034-7167-2023-0348
Views0See moreABSTRACT
Objectives:
to present the theoretical model, logic model, and the analysis and judgment matrix of the Fall TIPS Brazil Program.
Methods:
a qualitative, participatory research approach, in the form of an evaluability study, encompassing the phases (1) problem analysis; (2) program design, development, and adaptation to the Brazilian context; (3) program dissemination. Data were collected through document analysis and workshops.
Results:
through document analysis, workshops with stakeholders from the participating institution, and validation with key informants, it was possible to identify the program’s objectives, expected outcomes, and the target audience. This allowed the construction of theoretical and logic models and, through evaluative questions, the identification of indicators for the evaluation of the Fall TIPS Brazil Program.
Final Considerations:
this study has provided insights into the Fall TIPS program, the topic of hospital fall prevention, and the proposed models and indicators can be employed in the implementation and future evaluative processes of the program.
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ORIGINAL ARTICLE05-27-2024
Nursing care protocol for critical users with tracheostomy under mechanical ventilation
Revista Brasileira de Enfermagem. 2024;77(2):e20230337
Abstract
ORIGINAL ARTICLENursing care protocol for critical users with tracheostomy under mechanical ventilation
Revista Brasileira de Enfermagem. 2024;77(2):e20230337
DOI 10.1590/0034-7167-2023-0337
Views0See moreABSTRACT
Objectives:
to develop and assess a nursing care protocol for critically ill users with tracheostomy under mechanical ventilation.
Methods:
a methodological study, developed through two phases, guided by the 5W2H management tool: I) target audience characterization and II) technology development.
Results:
thirty-four nursing professionals participated in this study, who presented educational demands in relation to care for critical users with tracheostomy, with an emphasis on standardizing care through a protocol and carrying out continuing education.
Final Considerations:
the creation and validity of new technologies aimed at this purpose enhanced the participation of nursing professionals and their empowerment in the health institution’s microsectoral actions and in macrosectoral actions, highlighting the need for public policies that guarantee the conduct of a line of care for users with tracheostomy.
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ORIGINAL ARTICLE05-27-2024
Assessment of educational technology in lactation physiology by health students
Revista Brasileira de Enfermagem. 2024;77(2):e20230252
Abstract
ORIGINAL ARTICLEAssessment of educational technology in lactation physiology by health students
Revista Brasileira de Enfermagem. 2024;77(2):e20230252
DOI 10.1590/0034-7167-2023-0252
Views0See moreABSTRACT
Objectives:
to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students.
Methods:
a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students.
Results:
the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music’s speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72.
Conclusions:
the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.
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ORIGINAL ARTICLE05-27-2024
Technology for nursing care in a Maternal Intensive Care Unit: a methodological study
Revista Brasileira de Enfermagem. 2024;77(2):e20230202
Abstract
ORIGINAL ARTICLETechnology for nursing care in a Maternal Intensive Care Unit: a methodological study
Revista Brasileira de Enfermagem. 2024;77(2):e20230202
DOI 10.1590/0034-7167-2023-0202
Views0See moreABSTRACT
Objectives:
to develop and validate a nursing care plan in a Maternal Intensive Care Unit.
Methods:
a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges.
Results:
the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated.
Conclusions:
the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.
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05-13-2024
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301pt
Views0A investigação qualitativa em saúde permite a compreensão aprofundada de como a pessoa experiencia as diferentes transições de saúde, a relação com os profissionais de saúde e a passagem pelos diferentes ambientes de prática clínica. Concomitantemente, tem o potencial de suportar a tomada de decisão clínica dos profissionais e de empoderar o cidadão na sua […]See more
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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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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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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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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
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 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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