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ORIGINAL ARTICLE08-30-2024
Meanings attributed to changes experienced by individuals after COVID-19 hospitalization
Revista Brasileira de Enfermagem. 2024;77:e20230122
Abstract
ORIGINAL ARTICLEMeanings attributed to changes experienced by individuals after COVID-19 hospitalization
Revista Brasileira de Enfermagem. 2024;77:e20230122
DOI 10.1590/0034-7167-2023-0122
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Objectives:
to understand the meanings attributed to the experiences of individuals after hospitalization for COVID-19.
Methods:
qualitative study, with a theoretical framework based on Symbolic Interactionism and a methodological approach grounded in Grounded Theory. Nineteen participants who had moderate and severe forms of COVID-19 after hospitalization were interviewed. Data collection took place between April and November 2021 through online interviews, and the data were analyzed using initial and focused coding in the MAXQDA software.
Results:
the data illustrate new meanings attributed to different aspects of life after hospitalization, including relationships with others, the environment, physical and mental health, finances, identity, and interactions with a new social reality.
Conclusions:
the meanings are intrinsically linked to the value of interpersonal relationships, the perception of their impact, and the consequences after hospitalization. This allows professionals to understand the importance of this information to improve care and prepare for future epidemics.
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ORIGINAL ARTICLE08-30-2024
Patient safety culture in times of the COVID-19 pandemic: a cross-sectional study in a hospital
Revista Brasileira de Enfermagem. 2024;77:e20230187
Abstract
ORIGINAL ARTICLEPatient safety culture in times of the COVID-19 pandemic: a cross-sectional study in a hospital
Revista Brasileira de Enfermagem. 2024;77:e20230187
DOI 10.1590/0034-7167-2023-0187
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Objectives:
to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture.
Methods:
a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened.
Results:
all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors.
Conclusions:
with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution’s leaders.
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REVIEW08-30-2024
Educational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
Abstract
REVIEWEducational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
DOI 10.1590/0034-7167-2023-0352
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Objectives:
to map the educational actions conducted with primary health care professionals during the COVID-19 pandemic.
Methods:
a scoping review conducted in August 2023, which covered databases such as CINAHL, Medline, LILACS, IBECS, BDENF, and Web of Science. In total, 32 publications were analyzed through content analysis.
Results:
the primary beneficiaries of the educational actions included 69% physicians, 56% nurses, 25% pharmacists, 13% social workers and dentists, 9% psychologists, community health agents, and laboratory professionals, and 6% nursing technicians, nutritionists, and physical educators. The predominant educational interventions were training sessions (mentioned in 19 publications), followed by Continuing Health Education (10 publications) and Continuing Education (three publications).
Final Considerations:
the educational interventions demonstrated positive impacts on professional practice, particularly the Continuing Health Education actions, which were notable for stimulating critical problem-solving among professionals.
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ORIGINAL ARTICLE08-30-2024
Negative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
Abstract
ORIGINAL ARTICLENegative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
DOI 10.1590/0034-7167-2024-0040
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Objectives:
to evaluate the prevalence of negative affectivity in university students in the post-COVID-19 pandemic context and its relationship with academic performance and professional outlook.
Methods:
a cross-sectional study was conducted with undergraduate students from a public university in Minas Gerais between September 2022 and September 2023. Data were collected using a sociodemographic and psychosocial characterization questionnaire and the Depression, Anxiety, and Stress Scale 21. The relationships between negative affectivity, academic performance, and professional outlook were verified using the Kruskal-Wallis test, with a significance level of 5%.
Results:
a total of 585 students participated in the study. A high prevalence of depression, anxiety, and stress was found among university students in the post-COVID-19 context, with a notable severity of anxiety. A negative association was detected between the investigated negative affectivity, academic performance, and professional outlook.
Conclusions:
the results indicate an emotional vulnerability in university students, with a relationship between negative affectivity and a decline in academic performance and professional outlook.
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REVIEW08-30-2024
Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
Abstract
REVIEWImpact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
DOI 10.1590/0034-7167-2024-0078
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Objectives:
to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic.
Methods:
an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023.
Results:
out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative.
Conclusions:
the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients’ lives.
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ORIGINAL ARTICLE08-30-2024
Risk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
Abstract
ORIGINAL ARTICLERisk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
DOI 10.1590/0034-7167-2023-0537
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Objectives:
to evaluate the relative risk of smoking cessation treatment dropout during its intensive phase.
Methods:
a retrospective and quantitative cohort study was developed from the electronic medical records of individuals who started smoking cessation treatment between 2015 and 2019 at a specialty clinic in a city in the interior of São Paulo, Brazil. The relative risk of dropping out of treatment was calculated using the Poisson regression model.
Results:
it was observed that out of the 396 (100.0%) individuals who started the treatment, 109 (27.5%) abandoned it before the end of the intensive phase. For each one-year increase in age, the risk of dropping out of smoking cessation treatment decreased by an average of 2%.
Conclusions:
the risk of dropping out of smoking cessation treatment is higher among younger individuals. It is necessary to rethink the care offered to younger adults to promote the continuity of treatment.
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ORIGINAL ARTICLE08-26-2024
Influence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
Revista Brasileira de Enfermagem. 2024;77(5):e20230293
Abstract
ORIGINAL ARTICLEInfluence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
Revista Brasileira de Enfermagem. 2024;77(5):e20230293
DOI 10.1590/0034-7167-2023-0293
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Objectives:
to investigate the influence of the leukoreduction moment (preor post-storage) of blood components on the clinical outcomes of patients transfused in the emergency department.
Methods:
retrospective cohort study of patients aged 18 years or older who received preor post-storage leukoreduced red blood cell or platelet concentrate in the emergency department and remained in the institution for more than 24 hours. A generalized mixed-effects model was applied in the analyses.
Results:
in a sample of 373 patients (63.27% male, mean age 54.83) and 643 transfusions (69.98% red blood cell), it was identified that the leukoreduction moment influenced the length of hospital stay (p<0.009), but was not dependent on the transfused blood component (p=0.124). The leukoreduction moment had no effect (p>0.050) on transfusion reactions, healthcare-associated infections, or mortality.
Conclusions:
patients who received pre-storage leukoreduced blood components in the emergency department had a shorter length of hospital stay.
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ORIGINAL ARTICLE08-26-2024
Driver’s license, head protection devices and severity of motorcyclists’ injuries in traffic accidents
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
Abstract
ORIGINAL ARTICLEDriver’s license, head protection devices and severity of motorcyclists’ injuries in traffic accidents
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
DOI 10.1590/0034-7167-2023-0153
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Objectives:
to describe traffic accidents involving motorcyclists and analyze the association between possession of a motorcycle driver’s license and use of helmets according to the severity of injuries.
Methods:
a cross-sectional study was conducted among all patients hospitalized in the traumatology and orthopedics sector of a public reference hospital in northeastern Brazil.
Results:
170 patients were surveyed, the majority were male (95.9%). Their ages ranged from 18 to 67 years. Most were black or brown (52.3%), had completed elementary school (58.9%) and had monthly income smaller than two minimum wages (56.5%). An association was found between being licensed to drive a motorcycle and wearing a helmet. Among those who suffered moderate injuries, this association was OR=5.66(1.85-17.23) and among those who suffered severe injuries it was OR=13.57(2.82-65.14).
Conclusions:
people who were licensed to drive motorcycles used a helmet as protective equipment more often and, in accidents, suffered fewer injuries.
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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
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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
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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
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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
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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
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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
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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
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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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