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ORIGINAL ARTICLE09-24-2022
Spatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
Abstract
ORIGINAL ARTICLESpatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
DOI 10.1590/0034-7167-2021-0131
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Objective:
Analyze the spatio-temporal distribution of AIDS cases in Maranhão.
Methods:
Ecological study of AIDS cases in the Notifiable Diseases Information System, 2011-2018. Gross and adjusted incidences were calculated using the Baysean method; then, the Moran Global and Local Indices to observe the existence of spatial autocorrelation of the cases and for the delimitation of high and low risk clusters.
Results:
6,349 cases were reported, which were distributed heterogeneously. There was an advance of cases to new areas and persistence in old areas, such as in the capital São Luís and its surroundings. The dissemination did not occur at random, with positive spatial autocorrelation, with evidence of the formation of clusters in the municipalities of São Luís, São José de Ribamar and Paço do Lumiar.
Conclusion:
High-risk areas have been identified and should be considered a priority for investment in health, management, and organization of health services.
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TECHNOLOGICAL INNOVATION09-24-2022
Transitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
Abstract
TECHNOLOGICAL INNOVATIONTransitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
DOI 10.1590/0034-7167-2021-0123
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Objectives:
Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home.
Methods:
Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits.
Results:
In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria.
Conclusion:
The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.
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ORIGINAL ARTICLE09-24-2022
Characterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
Abstract
ORIGINAL ARTICLECharacterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
DOI 10.1590/0034-7167-2020-0896
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Objective:
to describe the obstetric care developed in teaching hospitals (TH) in the city of Maceió-AL, intended for high-risk pregnancies.
Methods:
Retrospective cohort study performed between June and November 2018 with 291 women who received assistance with vaginal delivery, cesarean section, or abortion process in teaching hospitals selected as settings for this research. Data collection allowed the characterization of the interviewees as well as the assistance received and its relationship with obstetric violence. The analysis was performed using descriptive and analytical statistics with the aid of the Epi Info software (version 7.2.0.1) and measures that allowed the comparison of means and proportions.
Results:
All women reported at least one violent situation, contrary to recommendations based on scientific evidence.
Conclusion:
It becomes necessary to optimize professional training to deconstruct obstetric care based on medicalization and pathologization of pregnancy and strengthen science-based care.
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ORIGINAL ARTICLE09-24-2022
Risk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
Abstract
ORIGINAL ARTICLERisk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
DOI 10.1590/0034-7167-2021-0022
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Objectives:
to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.
Methods:
a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.
Results:
we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.
Conclusions:
the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.
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ORIGINAL ARTICLE09-23-2022
Peripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
Abstract
ORIGINAL ARTICLEPeripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
DOI 10.1590/0034-7167-2021-0967
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Objectives:
to estimate incidence and free time of peripherally inserted central catheter obstruction in newborns undergoing red blood cell transfusion in the first 24 hours after the procedure.
Methods:
a longitudinal study, carried out with neonates in Neonatal Intensive Care Unit at a teaching hospital in Paraná, between January and July 2019. The sample consisted of 46 transfusion events performed in neonates through a peripherally inserted central catheter. Analysis performed according to descriptive statistics.
Results:
thirty-one catheters were analyzed, inserted in 24 neonates, through which 46 red blood cell transfusions were performed. Most neonates were male, gestational age <32 weeks, weight <1,500 grams, hospitalized mainly for prematurity. Among the 31 catheters, one (3.2%) presented obstruction after transfusion.
Conclusions:
The occurrence of obstructions immediately after transfusion was low and the catheters remained complication free for the next 24 hours.
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ORIGINAL ARTICLE09-23-2022
Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
Abstract
ORIGINAL ARTICLEValidation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
DOI 10.1590/0034-7167-2021-0862
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Objectives:
to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties.
Methods:
the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity.
Results:
inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain “Perception of Efficacy and Control Mechanisms” showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70).
Conclusions:
the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.
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ORIGINAL ARTICLE09-23-2022
Analysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
Abstract
ORIGINAL ARTICLEAnalysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
DOI 10.1590/0034-7167-2021-0803
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Objectives:
to analyze the concept of cardiovascular risk to support nursing practice.
Methods:
this is an analysis to define the concept of cardiovascular risk, through the use of eight steps of Walker’s and Avant’s framework, using a literature review in indexed scientific journals.
Results:
cardiovascular risk is defined in a broad and original way as a context of health and nursing care that makes it possible to identify modifiable (cardiometabolic, behavioral, psychosocial, cultural and occupational) and non-modifiable (biological) risk factors for cardiovascular diseases that act as early and interrelated markers, of multiple and heterogeneous etiology, predisposing to cardiovascular vulnerability.
Conclusions:
with the analysis and definition of the concept of cardiovascular risk, we realized that it will be possible to base nursing practice, with implications in clinical practice for identifying and reducing risk factors for cardiovascular diseases, with nursing relevance in the care of these subjects.
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ORIGINAL ARTICLE09-23-2022
Brain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
Abstract
ORIGINAL ARTICLEBrain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
DOI 10.1590/0034-7167-2021-0943
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Objectives:
to identify care strategies developed by professionals from critically ill patients’ units in communicating BD with parents of children and adolescents.
Methods:
an exploratory and descriptive research with a qualitative approach, carried out in two health institutions between October and December 2019, through semi-structured interviews. Data analysis took place through content analysis.
Results:
twenty-one professionals participated. Three care strategies were identified: actual clinical situation in suspected brain death; sensitizing families to the real clinical situation after brain death diagnosis; and time to assimilate the death information.
Final Considerations:
the care strategies for communicating brain death to families identified in this study present the possibility of subsidizing health managers in training and support promotion for professionals in care practice. Moreover, they can be incorporated and validated in the care practice of the studied context.
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RESEARCH01-01-2018
Assistance flowchart for pain management in a Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2018;71:1281-1289
Abstract
RESEARCHAssistance flowchart for pain management in a Neonatal Intensive Care Unit
Revista Brasileira de Enfermagem. 2018;71:1281-1289
DOI 10.1590/0034-7167-2017-0265
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Objective:
To describe and discuss the process of developing a flowchart collectively constructed by the health team of a Neonatal Intensive Care Unit for the management of neonatal pain.
Method:
This is a descriptive and an exploratory study with a qualitative approach that used Problem-Based Learning as a theoretical-methodological framework in the process of developing the assistance flowchart for the management of neonatal pain.
Results:
Based on this methodology, there was training in service and the discussion of key points of pain management by the health team, which served as input for the construction of the flowchart.
Final considerations:
The assistance flowchart for pain management, based on scientific evidence, provided means to facilitate the decision-making of the health team regarding the pain of the newborn. It is suggested to use the flowchart frequently to promote the permanent education of the team and identify possible points to be adjusted.
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RESEARCH01-01-2018
The adolescent and the institutionalization: understanding the phenomenon and meanings attributed to it
Revista Brasileira de Enfermagem. 2018;71:1373-1380
Abstract
RESEARCHThe adolescent and the institutionalization: understanding the phenomenon and meanings attributed to it
Revista Brasileira de Enfermagem. 2018;71:1373-1380
DOI 10.1590/0034-7167-2017-0242
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Objective:
To understand the meaning of being institutionalized and in conflict with the law for the institutionalized adolescent.
Method:
A qualitative, phenomenological-comprehensive study carried out in a Socio-educational Service Foundation in the northern region of Brazil, with 05 institutionalized adolescents. The analysis was carried out under the understanding of the content suggested by Heidgger, thus allowing the construction of analytical categories for a hermeneutical interpretation.
Results:
Conflicting with the law means something negative and bad for the institutionalized adolescents, in which they understand that although there is deprivation of liberty, the period of hospitalization is an important moment for the reflection on the need to start over.
Conclusion:
The meaning of conflicting with the law goes far beyond a simple word, act or behaviour, it is something that only those who experience the phenomenon are able to unveil, arouse deep feelings and provide reflection to the adolescent about the damages caused by the infraction.
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RESEARCH01-01-2018
Identification of post-cesarean surgical site infection: nursing consultation
Revista Brasileira de Enfermagem. 2018;71:1395-1403
Abstract
RESEARCHIdentification of post-cesarean surgical site infection: nursing consultation
Revista Brasileira de Enfermagem. 2018;71:1395-1403
DOI 10.1590/0034-7167-2017-0325
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Objective:
To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care.
Method:
Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo.
Results:
89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection.
Conclusion:
Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.
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RESEARCH01-01-2018
Nursing laboratory and critical education of nurses: approaches and distances
Revista Brasileira de Enfermagem. 2018;71:1500-1506
Abstract
RESEARCHNursing laboratory and critical education of nurses: approaches and distances
Revista Brasileira de Enfermagem. 2018;71:1500-1506
DOI 10.1590/0034-7167-2017-0339
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Objective:
to analyze the contribution of the laboratory of nursing to the critical education of nurses.
Method:
qualitative study, conducted among 18 professors of higher education institutions, being one public and the other private. Data were collected between February and November of 2016 by means of semi-structured interview. To analyze data, it was used a content analysis in the thematic modality.
Results:
it was observed the emphasis in the technical skills development by propagation of behavior and practices; the creation of bonds between professors and students happens on the limit of good interpersonal relationship; the laboratory of nursing may help the critical reflection about the practice, being a place that allows the learning of ethics.
Final considerations:
the nurse education, carried out by the laboratory of nursing, have to overcome the emphasis in the uncritical reproduction of practices and to observe the nurse’s power to think about the reality in the meaning of its modification.
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RESEARCH01-01-2018
Introduction of the School Health Program in the city of Cascavel, Paraná State: report of nurses
Revista Brasileira de Enfermagem. 2018;71:1540-1547
Abstract
RESEARCHIntroduction of the School Health Program in the city of Cascavel, Paraná State: report of nurses
Revista Brasileira de Enfermagem. 2018;71:1540-1547
DOI 10.1590/0034-7167-2017-0188
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Objective:
to understand the introduction of the School Health Program in the city of Cascavel, Paraná State, as opposed to the report of nurses.
Method:
a qualitative study with fifteen participants. The data were collected from April to August 2015, through semi-structured interviews, analyzed by content analysis and thematic modality.
Results:
the category “Introduction process” of the School Health Program integrates the subcategories “Identified health problems” and the “Challenges of intersectoriality”. The program was implemented quickly, with a fragile training of professionals to perform in the phases that compose it. Structural conditions of schools, human and material resources, and emerging intersectoral interaction were identified obstacles. The integration of the health, school, and family constitutes the program’s potentiality.
Final considerations:
it is understood that the actions of the program were based on health assessments of students, and it is necessary for professionals and managers to discuss and analyze the obstacles identified to achieve all the proposed objectives.
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RESEARCH01-01-2018
Knowledge about precautions in Primary Health Care: tool validation
Revista Brasileira de Enfermagem. 2018;71:1589-1595
Abstract
RESEARCHKnowledge about precautions in Primary Health Care: tool validation
Revista Brasileira de Enfermagem. 2018;71:1589-1595
DOI 10.1590/0034-7167-2017-0886
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Objective:
To elaborate and validate a tool to assess knowledge and behavior of nursing professionals about standards and specific precautions in the Primary Health Care.
Method:
Methodological study of the elaboration and validation of the tool by thirteen experts judges, using a Likert scale of 4 points, with Content Validity Index ≥ 0.80, on clarity, relevance and pertinence.
Results:
A tool composed of 47 dichotomous questions to assess knowledge and 12 questions, with five options of answers, for the referred behavior. In the validation, only one item was deleted, related to the “Hands Hygiene” axis and one item was reformulated, regarding “Use of Common Gloves” and another 11 changed writing. The tool as a whole was assessed for relevance, comprehensiveness and representativeness within the scope of the topic investigated.
Conclusion:
The developed tool has been validated and is now available for use in Primary Health Care.
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RESEARCH01-01-2018
Training in diabetes education: meanings attributed by primary care nurses
Revista Brasileira de Enfermagem. 2018;71:1611-1618
Abstract
RESEARCHTraining in diabetes education: meanings attributed by primary care nurses
Revista Brasileira de Enfermagem. 2018;71:1611-1618
DOI 10.1590/0034-7167-2017-0792
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Objective:
seize meanings attributed by primary care nurses to training in diabetes education.
Method:
exploratory and descriptive study, with a qualitative approach, with twenty primary care nurses; semistructured interview script, with interviews processed in the IRaMuTeQ software and analyzed through the Descending Hierarchical Classification. The results were subsidized in the Representational Theory of Meaning.
Results:
nurse training in diabetes education is insufficient for holistic action, although it allows the community to be instrumentalized in specific issues about the disease, using the limited tools available, especially lectures. Nurses find themselves in a context of challenges, improvisations, weaknesses, and limitations that determine the meaning attributed to diabetes education and subsequent actions.
Conclusion:
the meanings attributed by the nurses revealed an incipient training, which limits the quality of care provided and instigates the search for qualification.
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RESEARCH01-01-2018
Nursing international student mobility in the University of São Paulo
Revista Brasileira de Enfermagem. 2018;71:1619-1625
Abstract
RESEARCHNursing international student mobility in the University of São Paulo
Revista Brasileira de Enfermagem. 2018;71:1619-1625
DOI 10.1590/0034-7167-2017-0754
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Objective:
To characterize the experiences of undergraduate students of the School of Nursing of the University of São Paulo (EEUSP) who participated in international mobility programs between January 2011 and July 2017.
Method:
Exploratory, descriptive study with quantitative approach. Of 68 reports, only 38 (56%) were considered valid and were submitted to descriptive statistical analysis. Data were categorized in general, institutional, academic and cultural aspects and cost of living.
Results:
The main destination was Portugal and the years with most participation were 2012 and 2013. The mean stay was six months and the students took a mean of three to four courses. The main funder was the university of origin.
Conclusion:
Academic activities were limited to theoretical and practical courses, with little insertion in research. There is a need to increase investment in learning other languages and to expand partnerships with larger centers of foreign education and research.
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