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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
Views0See moreABSTRACT
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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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
Views0See moreABSTRACT
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 ARTICLE08-26-2024
Leadership styles and personal values of professors at a school of nursing
Revista Brasileira de Enfermagem. 2024;77(5):e20230333
Abstract
ORIGINAL ARTICLELeadership styles and personal values of professors at a school of nursing
Revista Brasileira de Enfermagem. 2024;77(5):e20230333
DOI 10.1590/0034-7167-2023-0333
Views0See moreABSTRACT
Objectives:
to identify professors’ leadership styles and personal values.
Methods:
a quantitative, descriptive-exploratory study. Population was made up of professors in doctoral category 1 at a public university in the state of São Paulo. Data collection took place from June to August 2021. Sociodemographic characterization was extracted, and the Leadership Team Values Assessment was applied. Data were analyzed using measures of central tendency.
Results:
population included 13 professors. The level that represents authentic leadership was the most prevalent. The commitment, positive attitude and trust values stood out. The level portrayed by visionary leadership was the least identified.
Conclusions:
professors’ personal values provide a theoretical basis for guiding and analyzing professors’ leadership styles. Leadership in the educational context must be recognized and studied to promote a more comprehensive and effective approach to developing and improving educational leaders.
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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
Views0See moreABSTRACT
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
Factors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(5):e20230172
Abstract
ORIGINAL ARTICLEFactors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(5):e20230172
DOI 10.1590/0034-7167-2023-0172
Views0See moreABSTRACT
Objectives:
to evaluate the factors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units in Brazil.
Methods:
this ecological study was conducted using secondary data from Brazilian pregnant women with COVID-19 hospitalized in Intensive Care Units between March 2020 and March 2022. Univariate analysis and logistic regression were employed.
Results:
out of 3,547 pregnant women with COVID-19 hospitalized in Intensive Care Units, 811 died (22.8%). It was found that lack of COVID-19 vaccination (OR: 2.73; 95% CI: 1.83; 4.04), dyspnea (OR: 1.73; 95% CI: 1.17; 2.56), obesity (OR: 1.51; 95% CI: 1.05; 2.17), chronic cardiovascular disease (OR: 1.65; 95% CI: 1.14; 2.38), and non-white race/color (OR: 1.29; 95% CI: 1.00; 1.66) were independently and significantly associated with death.
Conclusions:
it is concluded that vaccination status, presence of comorbidities, and clinical and ethnic-racial characteristics are associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units in Brazil.
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08-26-2024
Habilitação, uso de capacete e gravidade dos acidentes de trânsito envolvendo motociclistas
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
Abstract
Habilitação, uso de capacete e gravidade dos acidentes de trânsito envolvendo motociclistas
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
DOI 10.1590/0034-7167-2023-0153
Views0See moreRESUMEN
Objetivos:
describir los accidentes de tránsito con los motociclistas y evaluar la asociación entre el permiso para conducir motocicletas y el uso del casco con la gravedad de los accidentes.
Métodos:
estudio transversal, realizado a los pacientes hospitalizados en el sector de Traumatología y Ortopedia de un hospital público de referencia de la región Nordeste de Brasil.
Resultados:
participaron 170 pacientes; la mayoría de ellos del sexo masculino (95,9%), de edad entre 18 y 67 años. Los encuestados eran negros o pardos (52,3%), tenían estudios primarios (58,9%), ingresos mensuales inferiores a dos salarios mínimos (56,5%). Se encontró una asociación entre tener el permiso de conducir y llevar casco. Entre los que sufrieron accidentes moderados, esta asociación fue OR=5,66(1,85-17,23), y entre los que sufrieron accidentes graves fue OR=13,57(2,82-65,14).
Conclusiones:
las personas con permiso para conducir motocicletas que utilizaron casco como equipo de protección sufrieron lesiones menos graves en los accidentes.
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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
Views0See moreABSTRACT
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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EDITORIAL08-19-2024
Sexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
Abstract
EDITORIALSexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401
Views0Here is an academic-political editorial that aims to call on the scientific field to reflect on the dangers of decisions regarding the right to abortion under moral rules, since there is no evidence that such a perspective translates into practices of care, protection of childhood and gender equity – elements that are so urgent and […]See more
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01-01-2016
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
Abstract
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
DOI 10.1590/0034-7167.2016690424i
Views0See moreABSTRACT
Objective:
to analyze the scientific production on “breast cancer” in the period from 2002 to 2013 and determine the public policies for screening and early diagnosis of breast cancer.
Method:
this is an integrative literature review conducted in the databases MEDLINE, LILACS, SciELO and Google Scholar. Inclusion criteria: year and period of publication; availability of the full article; publication in Brazil; and the cross-check of the keywords Breast Cancer, Primary Health Care, Screening Programs, and Early Detection of Cancer.
Results:
after analysis, four thematic categories were obtained: breast self-examination, clinical examination of breast, mammography, and factors that hinder the adherence to the screening.
Conclusion:
health professionals have deficits of knowledge on the area, indicating the need for other studies on the subject addressed and greater investment in continuing education of professionals.
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01-01-2016
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
Abstract
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
DOI 10.1590/0034-7167.2016690423i
Views0See moreABSTRACT
Objective:
to verify the nursing diagnoses in patients affected by CVAs.
Method:
this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: “Enfermagem”, “Acidente Vascular Cerebral”, “Diagnóstico de Enfermagem”; and “Nursing”, “Stroke”, and “Nursing Diagnosis”.
Results:
we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: “Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs” and “Application of the nursing process on subjects affected by CVAs”.
Conclusion:
we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.
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01-01-2016
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
Abstract
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
DOI 10.1590/0034-7167.2016690422i
Views0See moreABSTRACT
Objective:
To identify in the literature evidence of the effectiveness and efficacy of educational interventions in reducing metabolic and/or vascular complications in adults with diabetes mellitus.
Method:
A systematic review performed in LILACS, IBECS, CUMED, CINAHL and Medline databases and in the online library SciELO with studies published from 2004 to 2014.
Results:
Eleven studies were included (5 randomized clinical trials and 6 quasi-experimental). We only identified studies that analyzed vascular complications.
Conclusion:
Two clinical trials demonstrated efficacy in reducing cardiovascular complications, of cataract or retinopathy and nephropathy and all the quasi-experimental studies showed effectiveness in reducing feet ulcers, peripheral neuropathy and vasculopathy, and maintenance of kidney function.
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01-01-2016
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
Abstract
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
DOI 10.1590/0034-7167.2016690421i
Views0See moreABSTRACT
Objective:
to identify scientific evidence about the communication process in Telenursing and analyze them.
Method:
integrative review performed in March 2014. The search strategy, structured with the descriptors “telenursing” and “communication”, was implemented in the databases Medline, Bireme, Cinahl, Scopus, Web of Science, Scielo, and Cochrane.
Results:
ten studies were selected after inclusion and exclusion criteria. The main challenges were: the clinical condition of patients, the possibility for inadequate communication to cause misconduct, the absence of visual references in interactions without video, and difficulty understanding nonverbal communication.
Conclusion:
distance imposes communicative barriers in all elements: sender, recipient and message; and in both ways of transmission, verbal and nonverbal. The main difficulty is to understand nonverbal communication. To properly behave in this context, nurses must receive specific training to develop abilities and communication skills.
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01-01-2016
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
Abstract
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
DOI 10.1590/0034-7167.2016690420i
Views0See moreABSTRACT
Objective:
to assess in-hospital care for patients with Acute Coronary Syndrome according to quality indicators.
Method:
a longitudinal quantitative study was performed between November 2012 and March 2013 with 94 patients, including interviews and medical records.
Results:
a total of 39.4% of patients had unstable angina and 60.6% had myocardial infarction, of which 34% had ST segment elevation. Patients with TIMI and GRACE scores higher than four and 140 (p<0.05) respectively died. Admission to the intensive care unit totaled 2.1%; assessment of left ventricular (LV) ejection fraction, 83.0%; ASA within 24 hours of admission, 77.8%; statins, 72.7%; angiotensin-converting enzyme inhibitor, 62.8%; anti-smoking counseling, 53.3%; and timely reperfusion, 62.5%. Of all participants, 12.0% underwent an invasive strategy in 24h and 50.0% in 72h. Door-to-ECG time was 68.3±104.3 min and door-to-balloon time, 122±54.5 min.
Conclusions:
health care protocols are required to standardize practice and improve these indicators.
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01-01-2016
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
Abstract
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
DOI 10.1590/0034-7167.2016690419i
Views0See moreABSTRACT
Objective:
to analyze the profile and quality of working life (QWL) of call-center workers.
Method:
quantitative research, conducted in one call-center of the city of São José do Rio Preto – SP, using the QVP-35 questionnaire.
Results:
profile was composed by: 80.2% women; 66.3% were single, with high school diploma and 6 hours of daily working hours; mean age of 28 years; 92.9% had only one job with mean working experience of 3 years. Positive aspects of QWL: intrinsic motivation, working ability, available resources and social support. Negative aspects of QWL: workload and organizational support.
Conclusion:
the data obtained indicate the need for better organization of call-center working processes in the company and suggests other researches in this context.
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01-01-2016
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
Abstract
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
DOI 10.1590/0034-7167.2016690418i
Views0See moreABSTRACT
Objective:
to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics.
Method:
a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The “Environmental Stressor Questionnaire” adapted to Portuguese was used.
Results:
105 patients participated in the study. The item “being thirsty” was evaluated as the most stressful and “the nursing staff member does not introduce himself/herself by the name” as the least stressful. Among sociodemographic and clinical variables (gender, age, type and time of surgery, pain, intubation time, use of psychotropic medications and length of stay in the intensive care unit), only pain presented a significant association with the stressors.
Conclusion:
knowing stressors can help implement practices associated with their reduction, favoring patients’ recovery.
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01-01-2016
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
Abstract
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
DOI 10.1590/0034-7167.2016690417i
Views0See moreABSTRACT
Objective:
to identify, describe and analyze characteristics of leadership, head nurses and participants in the teaching-learning process of leadership in Nursing, according to nurse professors who performed studies on this theme and taught such content between 1972 and 1994 in nursing schools of the state of São Paulo, southeastern Brazil.
Methods:
Thematic Oral History was used. A total of four nurse professors were interviewed, whose reports were submitted to content analysis.
Results:
the following aspects were approached in this study: the context in which students developed leadership, the influence of previous experiences on leadership qualification, its attributes, the importance of leadership, the value of teaching it, the possibilities of emancipation of a head nurse, the repercussions of teaching leadership for one’s professional life, the relationships between qualification and job market, the aspects of teaching qualification and students’ characteristics.
Conclusion:
although not essential for nursing qualification, leadership had a symbolic capital.
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06-01-2015
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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06-01-2015
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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06-01-2015
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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06-01-2015
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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06-01-2015
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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06-01-2015
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
Abstract
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
DOI 10.1590/0034-7167.2015680314i
Views1See moreABSTRACT
Objective:
to identify the reasons and motivations why family members search treatment for the drug addicted.
Method:
descriptive qualitative research, developed in 2012 and 2013, in a Drug Addicts Rehabilitation Unit of Parana State, Brazil. A total of 19 semi-structured interviews were conducted with the drug addicts’ family members in treatment. The results were analyzed based on the Transtheoretical Model of Behavior Change and organized in thematic categories according with qualitative data analysis.
Results:
the search for treatment for drug addicts occurred: in the pre-contemplation stage infl uenced by external factors; in the contemplation stage both for ambivalence and behavioral changes needs; in the action stage by awareness of drug addiction and also professional help needs; and in the maintenance stage because of the non-conservation of behavioral changes.
Conclusion:
an evaluation of motivational stages in the beginning of treatment is required for expansion of success possibilities in the rehabilitation process.
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06-01-2015
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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