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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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ORIGINAL ARTICLE07-29-2024
Mental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
Abstract
ORIGINAL ARTICLEMental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
DOI 10.1590/0034-7167-2023-0457
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Objective:
To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health.
Methods:
exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis.
Results:
parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression.
Final considerations:
It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.
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07-29-2024
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
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Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
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Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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ORIGINAL ARTICLE07-29-2024
Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
Abstract
ORIGINAL ARTICLEDisrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
DOI 10.1590/0034-7167-2023-0464
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Objectives:
to develop and evaluate a Middle-Range Theory for the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” in high-risk pregnancies.
Methods:
this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem’s General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80.
Results:
the theory identified 20 elements of the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80.
Conclusions:
the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon “Disrupted Mother-Fetus Dyad Risk,” which aids in nurses’ diagnostic reasoning.
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
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Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
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ORIGINAL ARTICLE07-29-2024
Primary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
Abstract
ORIGINAL ARTICLEPrimary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
DOI 10.1590/0034-7167-2024-0468
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Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final Considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
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ORIGINAL ARTICLE07-29-2024
Completeness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
Abstract
ORIGINAL ARTICLECompleteness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
DOI 10.1590/0034-7167-2023-0467
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Objectives:
to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.
Methods:
an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.
Results:
there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables “family history of cancer” (p<0.001), “alcoholism” (p<0.001), “smoking” (p<0.001), “TNM staging” (p<0.001) had a decreasing trend, while “clinical start of treatment” (p<0.001), “origin” (p=0.008) and “occupation” (p<0.001) indicated an increasing trend.
Conclusions:
most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.
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ORIGINAL ARTICLE10-01-2022
Factors associated with vulnerability and fragility in the elderly: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20200399
Abstract
ORIGINAL ARTICLEFactors associated with vulnerability and fragility in the elderly: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20200399
DOI 10.1590/0034-7167-2020-0399
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Objectives:
to assess factors associated with vulnerability and fragility in the elderly.
Methods:
crosssectional study with 384 elderly people in Fortaleza, Ceará. The Vulnerable Elders Survey and Clinical-Functional Vulnerability Index – 20 were used. Chi-square and Fisher’s exact tests were used for associations. In the analysis of the combined influence of risk factors, the stepwise logistic regression and multinomial regression methods were adopted.
Results:
251 (65.4%) non-vulnerable and 133 (34.6%) vulnerable elders. From the vulnerable elders analyzed, 42 (30.9%) are at high risk for frailty. Factors associated with vulnerability: age, gender, presence of comorbidities, hypertension, diabetes, osteoporosis and use of polypharmacy. There is a 30% increase in the chance of vulnerability for each additional drug. Physical activity reduces the chance of vulnerability by 60%. Factors associated with frailty: educational level; self-perception of health; comorbidities; polypharmacy.
Conclusions:
it is important to pay attention to the presence of arterial hypertension, osteoporosis, polypharmacy, and encourage the practice of physical activity.
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ORIGINAL ARTICLE10-18-2022
Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians
Revista Brasileira de Enfermagem. 2022;75(2):e20200611
Abstract
ORIGINAL ARTICLECare related to peripheral intravenous catheterism in pediatrics performed by nursing technicians
Revista Brasileira de Enfermagem. 2022;75(2):e20200611
DOI 10.1590/0034-7167-2020-0611
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Objectives:
to evaluate the care practice adopted by nursing technicians before, during and after peripheral intravenous catheterization performed in hospitalized children.
Methods:
cross-sectional and descriptive research, carried out in a pediatric hospital in Bahia through non-participatory observation of peripheral intravenous catheterizations performed in children by nursing technicians. Data was collected through an instrument containing care related to the moments before, during and after insertion of the catheter, calculating absolute and relative frequencies, measures of central tendency and dispersion.
Results:
there were 31 nursing technicians, who performed care mainly before intravenous catheterization. Nonconformities were identified regarding hand hygiene, use of a disposable mask, selection of the catheter insertion site, antisepsis, stabilization and catheter coverage.
Conclusions:
most of the precautions observed regarding peripheral intravenous catheterization are not in accordance with the standards of practice recommended by the national and international literature.
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ORIGINAL ARTICLE10-01-2022
Frailty in the elderly: screening possibilities in Primary Health Care
Revista Brasileira de Enfermagem. 2022;75(2):e20200973
Abstract
ORIGINAL ARTICLEFrailty in the elderly: screening possibilities in Primary Health Care
Revista Brasileira de Enfermagem. 2022;75(2):e20200973
DOI 10.1590/0034-7167-2020-0973
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Objectives:
to evaluate two instruments for screening frailty in the elderly in Primary Health Care.
Methods:
this is an observational, cross-sectional study, with a quantitative approach, with 396 elderly people. SPSS software helped to perform the statistical analyses. The study used the kappa coefficient and Spearman’s correlation.
Results:
the kappa coefficient between the Clinical-Functional Vulnerability Index 20 and the Edmonton Frailty Scale was 0.496, considered moderate. There was a positive and significant correlation (r = 0.77; p < 0.001) between the frailty conditions and the total score of the two instruments.
Conclusions:
when this article assessed fragility through the kappa coefficient, both instruments presented positive correlation and agreement. However, the identification of frailty was higher when it used the Edmonton Frailty Scale.
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10-01-2022
Kangaroo Method: potentialities, barriers and difficulties in humanized care for newborns in the Neonatal ICU
Revista Brasileira de Enfermagem. 2022;75(2):e20201121
Abstract
Kangaroo Method: potentialities, barriers and difficulties in humanized care for newborns in the Neonatal ICU
Revista Brasileira de Enfermagem. 2022;75(2):e20201121
DOI 10.1590/0034-7167-2020-1121
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Objective:
To identify the potentialities, barriers and difficulties for the implementation of humanized care from the perspective of the Kangaroo Method.
Methods:
Integrative literature review with a time cut from 02/01/2015 to 06/01/2019, totaling ten articles in the final sample.
Results:
The findings were categorized into two categories: Potentialities for humanized care from the perspective of the Kangaroo Method; Barriers or difficulties to the implementation of the Kangaroo Method. Several potentialities for humanized care allied to technology and continuing education were identified, as well as several barriers to the implementation of the Kangaroo Method, such as lack of physical space, lack of professionals and team training, lack of knowledge, lack of adherence and professional demotivation.
Final considerations:
There are still few studies that address the potentialities, barriers and difficulties for the implementation of humanized care from the perspective of the Kangaroo Method, and most of those included in this review were conducted in Brazil and present a qualitative approach.
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10-18-2022
Clinical progression of COVID-19 coinfection in people living with the human immunodeficiency virus: scoping review
Revista Brasileira de Enfermagem. 2022;75(2):e20201380
Abstract
Clinical progression of COVID-19 coinfection in people living with the human immunodeficiency virus: scoping review
Revista Brasileira de Enfermagem. 2022;75(2):e20201380
DOI 10.1590/0034-7167-2020-1380
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Objectives:
to map the production of scientific knowledge on the clinical progression of COVID-19 coinfection in people living with the human immunodeficiency virus (HIV).
Methods:
scoping review, with search strategies in MEDLINE, Scopus, Embase, Web of Science, and LILACS. Dual independent data extraction and analysis of the material with similarity compilation and narrative synthesis.
Results:
sample consisted of 35 articles. Fever, cough, and dyspnea were the most prevalent signs/symptoms. Recurrent complications involved desaturation/worsening of oxygen desaturation and pneumonia. No standard pharmacological treatment was identified, and the main interventions involved the provision of supplemental oxygen and mechanical ventilation. The studies recommended preventive, care, and pharmacological practices.
Conclusions:
the clinical manifestations, complications, and treatments/assistance care for people coinfected with SARS CoV-2/HIV are similar to those of the general population. Coinfection, overall, does not infer a worse prognosis.
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ORIGINAL ARTICLE10-25-2022
Relationship between power and knowledge in choosing a cesarean section: women’s perspectives
Revista Brasileira de Enfermagem. 2022;75(2):e20201389
Abstract
ORIGINAL ARTICLERelationship between power and knowledge in choosing a cesarean section: women’s perspectives
Revista Brasileira de Enfermagem. 2022;75(2):e20201389
DOI 10.1590/0034-7167-2020-1389
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Objectives:
to analyze the reasons and motives that initiates the decision to choose a cesarean section, by describing the plots, power relationships, struggles, and systems of truths regarding this method of childbirth.
Methods:
a qualitative study, inserted into a poststructuralist perspective, and conducted in a city in southern Rio Grande do Sul state. The settings were a teaching hospital and home residences. Thirteen postpartum women who had a cesarean section participated. The analysis consisted of questions based on the information produced and articulated with Foucauldian theories.
Results:
two categories were developed: “I wanted a vaginal delivery, but it was a cesarean section”, and, “Are you sure you want a vaginal delivery: paths and detours in the choice of cesarean section”.
Final Considerations:
the study allowed us to identify problems in the choice for a cesarean section, which is associated with the circulation of “truths” that occur via discourses on society.
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ORIGINAL ARTICLE10-25-2022
Prevention of domestic accidents in childhood: knowledge of caregivers at a health care facility
Revista Brasileira de Enfermagem. 2022;75(2):e20210006
Abstract
ORIGINAL ARTICLEPrevention of domestic accidents in childhood: knowledge of caregivers at a health care facility
Revista Brasileira de Enfermagem. 2022;75(2):e20210006
DOI 10.1590/0034-7167-2021-0006
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Objective:
To analyze caregivers’ knowledge about prevention of domestic accidents in early childhood and its association with education level.
Methods:
This is a cross-sectional study conducted in a Primary Care Unit in Niterói with caregivers (convenience sample) of children under 6 years old. To classify the knowledge, we adopted the Positivity Index; to verify the association between the variable “schooling” and knowledge, the chi square test was used; statistically significant results: p < 0.05.
Results:
A total of 256 caregivers participated; 93.5% showed adequate knowledge. In the individual items, the knowledge (100%) about prevention of accidents with sharp toys, firearms, intoxication by products stood out; and less frequently (64.5%), the knowledge of the information contained in the Child’s Health Booklet. There was no statistically significant association (p = 0.237) between education and knowledge. Conclusion: The caregivers presented knowledge about the prevention of domestic accidents, and this was not associated with the level of education.
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ORIGINAL ARTICLE10-18-2022
Adherence to antiretroviral therapy by adults living with HIV/aids: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20210019
Abstract
ORIGINAL ARTICLEAdherence to antiretroviral therapy by adults living with HIV/aids: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20210019
DOI 10.1590/0034-7167-2021-0019
Views0See moreABSTRACT
Objective:
To verify the association between adherence to antiretroviral treatment by adults with HIV/AIDS and sociodemographic factors, social and clinical support.
Methods:
Cross-sectional study, with a quantitative approach. Participation of 230 patients. Questionnaires of sociodemographic characterization, social and clinical support, and assessment of adherence to antiretroviral treatment were used. Descriptive and inferential statistics were performed.
Results:
Adherence was classified as good/adequate. An association with sex, income, employment, and level of education was noted. In social support: having access to health services; communication with health professionals; health education; having support to allow venting/talking about issues; information on HIV/AIDS; and company for leisure. In the clinical profile: non-interruption of the drug treatment due to absence from the service or due to changes in the medical prescription.
Conclusion:
Adherence was classified as good/adequate and especially associated with social support factors, which should be enhanced in clinical practice.
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