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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
- Paula dos Santos Brito
, - Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo , [ … ],
- Floriacy Stabnow Santos
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
- Paula dos Santos Brito ,
- Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo ,
- Marcelino Santos Neto ,
- Francisca Elisângela Teixeira Lima ,
- Floriacy Stabnow Santos
Views0ABSTRACT
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.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more
- Paula dos Santos Brito
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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
- Ricardo Barros Gurgel ,
- Juliane Lima Pereira Da Silva ,
- Estela Maria Leite Meirelles Monteiro ,
- Suzana Lins da Silva ,
- Tereza Rebecca de Melo e Lima , [ … ],
- Maria Wanderleya de Lavor Coriolano-Marinus
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
- Ricardo Barros Gurgel ,
- Juliane Lima Pereira Da Silva ,
- Estela Maria Leite Meirelles Monteiro ,
- Suzana Lins da Silva ,
- Tereza Rebecca de Melo e Lima ,
- Maria Wanderleya de Lavor Coriolano-Marinus
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
- Ricardo Barros Gurgel
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
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
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
Views0ABSTRACT
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.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more - Geórgia Silva Marques
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ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi , [ … ],
- Carmen Silvia Gabriel
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
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi ,
- Carmen Silvia Gabriel
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.
- Antônio José de Lima Júnior
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ORIGINAL ARTICLE07-10-2023
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
ORIGINAL ARTICLEMetodologia 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
Views0RESUMEN
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.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva , [ … ],
- Kátia Neyla de Freitas Macedo Costa
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
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva ,
- Kaisy Martins de Albuquerque Madruga ,
- Patrícia Serpa de Souza Batista ,
- Kátia Neyla de Freitas Macedo Costa
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.
- Maria Cristina Lins Oliveira Frazão
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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
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REVIEW06-26-2023
Barriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
- Marcela Antonini ,
- Ingred Evangelista da Silva ,
- Henrique Ciabotti Elias ,
- Larissa Gerin ,
- Aliete Cunha Oliveira , [ … ],
- Renata Karina Reis
Abstract
REVIEWBarriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
Revista Brasileira de Enfermagem. 2023;76(3):e20210963
DOI 10.1590/0034-7167-2021-0963
- Marcela Antonini ,
- Ingred Evangelista da Silva ,
- Henrique Ciabotti Elias ,
- Larissa Gerin ,
- Aliete Cunha Oliveira ,
- Renata Karina Reis
Views0ABSTRACT
Objectives:
to identify and synthesize scientific evidence on the barriers and difficulties for Pre-exposure Prophylaxis (PrEP) use and compliance for HIV.
Methods:
an integrative literature review, using the MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier and Scopus (Elsevier) databases.
Results:
all (100%) the articles included identified that PrEP users experience some type of structural barrier related to health services such as long distance from the units, suboptimal logistics for taking pills and professional resistance to prescribing PrEP. Furthermore, 63.21% identified social barriers, such as stigma about sexuality and HIV, in addition to individual barriers such as alcohol use, adverse effects, and concerns about long-term toxicity.
Conclusions:
the barriers to PrEP use are multifactorial. Effective interventions are needed to support PrEP users in accessing, complying with, and retaining health services.
Keywords:Access to Health ServicesAnti-HIV AgentsPre-Exposure ProphylaxisPrevention and ControlSexual HealthSee more
- Marcela Antonini
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ORIGINAL ARTICLE03-09-2020
Quality of life at work in a central sterile processing department
- Gliccia Morguethe Vieira Rego ,
- Isaura Letícia Tavares Palmeira Rolim ,
- Aurean D’Eça Júnior ,
- Ana Hélia de Lima Sardinha ,
- Geysa Santos Góis Lopes , [ … ],
- Nair Portela Silva Coutinho
Abstract
ORIGINAL ARTICLEQuality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
DOI 10.1590/0034-7167-2018-0792
- Gliccia Morguethe Vieira Rego ,
- Isaura Letícia Tavares Palmeira Rolim ,
- Aurean D’Eça Júnior ,
- Ana Hélia de Lima Sardinha ,
- Geysa Santos Góis Lopes ,
- Nair Portela Silva Coutinho
Views1See moreABSTRACT
Objectives:
to evaluate the quality of life of nursing professionals who work in a central sterile processing department.
Methods:
a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire “Medical Outcomes Study Short-Form 36” were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects.
Conclusions:
This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.
- Gliccia Morguethe Vieira Rego
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ORIGINAL ARTICLE12-05-2019
Care complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
Abstract
ORIGINAL ARTICLECare complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
DOI 10.1590/0034-7167-2018-0357
Views1See moreABSTRACT
Objective:
to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline.
Method:
quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP.
Results:
cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain.
Conclusion:
the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.
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ORIGINAL ARTICLE10-21-2019
Nurses defending the autonomy of the elderly at the end of life
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
DOI 10.1590/0034-7167-2018-0768
- Rafael Barroso Gaspar ,
- Marcelle Miranda da Silva ,
- Karen Gisela Moraes Zepeda ,
- Ítalo Rodolfo Silva
Views1See moreABSTRACT
Objective:
to understand how nurses deal with the elderly’s autonomy at the end of life.
Method:
qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil.
Results:
nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team.
Final considerations:
the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.
- Rafael Barroso Gaspar
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ORIGINAL ARTICLE09-16-2019
Spatial analysis on tuberculosis and the network of primary health care
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira , [ … ],
- Rosinelle Janayna Coelho Caldas
Abstract
ORIGINAL ARTICLESpatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
DOI 10.1590/0034-7167-2017-0897
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira ,
- Rosinelle Janayna Coelho Caldas
Views1See moreABSTRACT
Objective:
to analyze the spatial distribution of new cases of tuberculosis compared to the location of the Primary Healthcare Units that performed the compulsory notification.
Method:
ecological study conducted in Belém, Pará, with 5,294 new cases of tuberculosis notified to Sistema de Informação de Agravos de Notificação for the period from 2010 to 2014. The cases were georeferenced using the software applications ArcGis 10.2 and TerraView 4.2.2. The techniques of Kernel density and global Moran geostatistics were used.
Results:
the incidence of tuberculosis cases did not vary significantly between the years studied, however there was a variation in incidence between neighborhoods. Health units that exhibited higher number of notifications can suffer great influence of migration from nearby neighborhoods.
Conclusion:
the spatial dynamics of tuberculosis associated with health services allows to know the areas with increased risk of tuberculosis and the density of notifications of health units.
- Beatriz do Nascimento Leal
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