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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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REVIEW07-29-2020
Frailty syndrome in the elderly: conceptual analysis according to Walker and Avant
Revista Brasileira de Enfermagem. 2020;73:e20190601
Abstract
REVIEWFrailty syndrome in the elderly: conceptual analysis according to Walker and Avant
Revista Brasileira de Enfermagem. 2020;73:e20190601
DOI 10.1590/0034-7167-2019-0601
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Objective:
To analyze the concept of “frailty syndrome” in the literature, according to the method proposed by Walker and Avant.
Methods:
It is a concept analysis, guided by the method proposed by Walker and Avant, made operational through an integrative literature review. The search in a scientific database was carried out using the descriptors: Frail elderly, syndrome, phenotype, geriatric assessment, and aging. The literary corpus comprised 66 studies. Results: The study found the antecedents and attributes (categorized as physical, sociodemographic, and behavioral/environmental) that integrate the signs and symptoms evidenced in the “frailty syndrome,” as well as the consequences of this concept. The variables were analyzed with emphasis on the conceptions that influence the frailty process of the elderly.
Conclusion:
The study demonstrated the complexity arising from the multifactorial genesis of the referred syndrome, emphasizing the specificities of the elderly’s frailty. However, we recommend conducting further research involving the phenomenon in question to understand the construct better.
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ORIGINAL ARTICLE09-16-2019
Tuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
Abstract
ORIGINAL ARTICLETuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
DOI 10.1590/0034-7167-2018-0260
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Objective:
To identify tuberculosis-related health care and surveillance actions in Prison Health Units.
Method:
Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials.
Results:
Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units.
Conclusion:
Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.
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04-14-2021
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
Abstract
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
DOI 10.1590/0034-7167-2020-1185
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Objective:
to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position.
Method:
this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid.
Results:
all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested.
Conclusions:
the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.
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02-10-2020
Development of middle-range theories in nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20170893
Abstract
Development of middle-range theories in nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20170893
DOI 10.1590/0034-7167-2017-0893
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Objective:
To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing.
Method:
Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles.
Results:
All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews.
Final considerations:
The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.
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09-16-2019
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
Abstract
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
DOI 10.1590/0034-7167-2018-0734
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Objective:
To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care.
Method:
A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility.
Results:
The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997.
Conclusions:
The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
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ORIGINAL ARTICLE02-10-2020
Stress and health risk behaviors among university students
Revista Brasileira de Enfermagem. 2020;73(1):e20180035
Abstract
ORIGINAL ARTICLEStress and health risk behaviors among university students
Revista Brasileira de Enfermagem. 2020;73(1):e20180035
DOI 10.1590/0034-7167-2018-0035
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Objective:
To analyze the level of stress and its relationship with health risk behaviors among university students.
Method:
Cross-sectional analytical study carried out at a higher education institution in Picos-PI. A total of 377 students were evaluated for socio-demographic and academic variables, stress profile, sleep quality, alcohol use, smoking habits and level of physical activity. The Statistical Package for the Social Sciences (SPSS), version 20.0 was used for data processing and analysis.
Results:
Sleep quality was poor for 65.3% of the subjects, and sleep disturbances were found in 17.0%. Stress was observed in 68.7% of the sample. Stress was associated with the following variables: gender, time in the institution, poor sleep quality.
Conclusion:
Most of the students evaluated present some level of stress associated with poor sleep quality, which is a risk to the quality of life of these individuals.
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ORIGINAL ARTICLE03-24-2021
Self-care of people with intestinal ostomy: beyond the procedural towards rehabilitation
Revista Brasileira de Enfermagem. 2021;74(1):e20200088
Abstract
ORIGINAL ARTICLESelf-care of people with intestinal ostomy: beyond the procedural towards rehabilitation
Revista Brasileira de Enfermagem. 2021;74(1):e20200088
DOI 10.1590/0034-7167-2020-0088
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Objectives:
to interpret the self-care experience of people with intestinal ostomy registered in an ostomy program, based on the framework of the Social Model of Disability.
Methods:
qualitative exploratory research, with the participation of nine people with intestinal ostomy, based on the Social Model of Disability.
Results:
majority were elderly, married, male with colostomy due to colorectal neoplasia. The self-care of these people was analyzed in two thematic groups: “Interdisciplinary assistance needed for people with intestinal ostomy” and “Self-care for the rehabilitation of the person with intestinal ostomy”. It was proved that there was a need for a specialized health team, offering information on disabilities, teaching self-care and perioperative follow-up.
Final Considerations:
when the social barriers of physical disabilities are overcome in the context of assistance for health and life, self-care will go beyond the reductionist vision of procedural care, towards comprehensive care, favoring the achievement of rehabilitation and the quality of survival.
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03-19-2021
Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
Abstract
Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
DOI 10.1590/0034-7167-2019-0694
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Objectives:
Validate script and storyboard of a video for educational intervention on nursing care for the prevention and management of syphilis.
Methods:
Methodological design study, with quantitative analysis approach. The content and appearance of the educational video script and storyboard was validated by a committee of experts on the subject and video. They were considered validated from the agreement of 78%, calculated by means of the Content Validity Index.
Results:
There were suggestions, which were analyzed; and, where relevant, the script and storyboard were changed. The degree of agreement among the expert judges on the subject obtained a Content Validity Index (CVI) of 100%, while, with the technical experts in video, all the questions in the educational material obtained the percentage above the recommended minimum of 78%.
Conclusion:
The validated video is an important technological production and could be used in the context of health care.
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