Articles - Revista Brasileira de Enfermagem

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RESEARCH01-01-2017

Promoting oral care in the preschool child: effects of a playful learning intervention
Revista Brasileira de Enfermagem. 2017;70(3):519-525

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Abstract
RESEARCH
Promoting oral care in the preschool child: effects of a playful learning intervention
Revista Brasileira de Enfermagem. 2017;70(3):519-525
DOI 10.1590/0034-7167-2016-0237
Cecília Helena de Siqueira Sigaud,
Bruna Rodrigues dos Santos,
Priscila Costa,
Aurea Tamami Minagawa Toriyama
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ABSTRACT

Objective:

To compare the number of appropriate behaviors for tooth brushing before and after a playful learning intervention with preschool children.

Method:

A quasi-experimental, quantitative, before and after study design was conducted in an early childhood educational institution, with children between three and five years of age. The intervention consisted of three meetings with educational activities about tooth brushing, whose outcome was evaluated by means of observation of ten behaviors suitable for tooth brushing.

Results:

Forty-four children participated in the study. The mean of adequate behaviors was 4.4 before the intervention, and 8.5 after the intervention. A significant increase in the adoption of appropriate behaviors for tooth brushing (p <0.01) was identified.

Conclusion:

Nurses can enhance oral health promotion actions with preschoolers in preschool institution using playful learning interventions

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RESEARCH01-01-2017

Violence against children and adolescents: the perspective of Primary Health Care
Revista Brasileira de Enfermagem. 2017;70(3):511-518

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Abstract
RESEARCH
Violence against children and adolescents: the perspective of Primary Health Care
Revista Brasileira de Enfermagem. 2017;70(3):511-518
DOI 10.1590/0034-7167-2016-0471
Diene Monique Carlos,
Elisabete Matallo Marchesini de Pádua,
Maria das Graças Carvalho Ferriani
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ABSTRACT

Objective:

To analyze the care provided by Basic Health Units (BHU) to families involved in domestic intrafamily violence against children and adolescents.

Method:

Qualitative research, based on the Paradigm of Complexity. Data collection was performed with 41 professionals through focus groups and semi-structured interviews.

Results:

The following categories emerged from data analysis: ‘Everything comes here’, which reflects the legitimate place of BHUs for the population and the actions taken to build care for families; and ‘We only do what is really necessary’, which brings the look to violence still based on the positivist and biomedical paradigm.

Final considerations:

The model of understanding and construction of work processes in the BHU is structured in the aforementioned paradigm. Nurses have the possibility to become agents of change, both in professionals’ training and in the care thought and provided to communities.

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RESEARCH01-01-2017

Integrality of care: challenges for the nurse practice
Revista Brasileira de Enfermagem. 2017;70(3):504-510

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Integrality of care: challenges for the nurse practice
Revista Brasileira de Enfermagem. 2017;70(3):504-510
DOI 10.1590/0034-7167-2016-0380
Solange Meira de Sousa,
Elizabeth Bernardino,
Karla Crozeta,
Aida Maris Peres,
Maria Ribeiro Lacerda
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ABSTRACT

Objective:

to understand the role of the nurse in the collegiate management model of a teaching hospital, in the integrality of care perspective.

Method:

a single case study with multiple units of analysis, with the theoretical proposition “integrality of care is a result of the care offered to the user by multiple professionals, including the nurse”. Data were obtained in a functional unit of a teaching hospital through interviews with 13 nurses in a non-participant observation and document analysis.

Results:

from the analytical categories emerged subcategories that allowed understanding that the nurse promotes integrality of care through nursing management, team work and integration of services.

Final considerations:

the theoretical proposition was confirmed and it was verified that the nursing management focus on attending to health care needs and is a strategy to provide integrality of care.

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RESEARCH01-01-2017

Low completion rate of hepatitis B vaccination in female sex workers
Revista Brasileira de Enfermagem. 2017;70(3):489-494

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Low completion rate of hepatitis B vaccination in female sex workers
Revista Brasileira de Enfermagem. 2017;70(3):489-494
DOI 10.1590/0034-7167-2016-0567
Rosilane de Lima Brito Magalhães,
Sheila Araújo Teles,
Renata Karina Reis,
Marli Teresinha Gimeniz Galvão,
Elucir Gir
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ABSTRACT

Objective:

to assess predictive factors for noncompletion of the hepatitis B vaccination schedule in female sex workers in the city of Teresina, Northeastern Brazil.

Method:

402 women were interviewed and, for those who did not wish to visit specialized sites, or did not know their hepatitis B vaccination status, the vaccine was offered at their workplaces. Bi- and multivariate analyses were performed to identify potential predictors for noncompletion of the vaccination schedule.

Results:

of the 284 women eligible for vaccination, 258 (90.8%) received the second dose, 157/258 (60.8%) and 68/258 (26.3%) received the second and third doses, respectively. Working at clubs and consuming illicit drugs were predictors for noncompletion of the vaccination schedule.

Conclusion:

the high acceptability of the vaccine’s first dose, associated with low completion rates of the vaccination schedule in sex workers, shows the need for more persuasive strategies that go beyond offering the vaccine at their workplaces.

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RESEARCH01-01-2017

Cost of nursing most frequent procedures performed on severely burned patients
- Talita de Oliveira Melo,
- Antônio Fernandes Costa Lima
Revista Brasileira de Enfermagem. 2017;70(3):481-488

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Cost of nursing most frequent procedures performed on severely burned patients
Revista Brasileira de Enfermagem. 2017;70(3):481-488
DOI 10.1590/0034-7167-2015-0034
Talita de Oliveira Melo,
Antônio Fernandes Costa Lima
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ABSTRACT

Objective:

to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit.

Method:

exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions.

Results:

a MDC of US$ 0.65 (SD=0.36) was obtained for “vital signs monitoring”; US$ 10.00 (SD=24.23) for “intravenous drug administration”; US$ 5.90 (SD=2.75) for “measurement of diuresis”; US$ 0.93 (SD=0.42) for “capillary blood glucose monitoring”; and US$ 99.75 (SD=129.55) for “bandaging”.

Conclusion:

the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care.

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RESEARCH01-01-2017

Nursing Activities Score and Acute Kidney Injury
Revista Brasileira de Enfermagem. 2017;70(3):475-480

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Nursing Activities Score and Acute Kidney Injury
Revista Brasileira de Enfermagem. 2017;70(3):475-480
DOI 10.1590/0034-7167-2016-0266
Filipe Utuari de Andrade Coelho,
Mirian Watanabe,
Cassiane Dezoti da Fonseca,
Katia Grillo Padilha,
Maria de Fátima Fernandes Vattimo
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ABSTRACT

Objective:

to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI).

Method:

A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively.

Results:

A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001).

Conclusion:

The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

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RESEARCH01-01-2017

Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial
Revista Brasileira de Enfermagem. 2017;70(3):468-474

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial
Revista Brasileira de Enfermagem. 2017;70(3):468-474
DOI 10.1590/0034-7167-2016-0352
Elen Ferraz Teston,
Guilherme Oliveira de Arruda,
Catarina Aparecida Sales,
Deise Serafim,
Sonia Silva Marcon
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ABSTRACT

Objective:

to verify the effect of nursing appointment on cardiometabolic profile of people with Diabetes Mellitus type 2.

Method:

randomized controlled trial, developed with 134 individuals chosen for two groups: intervention and control. The intervention consisted of three nursing appointments alternated bimonthly, with two phone calls, over five months. The control group received usual care offered by the Health Unit. Data were collected through semi-structured interviews before and after the intervention, in addition to conducting laboratory tests.

Results:

after the intervention, a significant difference was shown in the amount of glycated hemoglobin (p = 0.006) and in the systolic blood pressure (p = 0.031), which were higher in the control group.

Conclusion:

besides being low-cost and easy to develop on the monitoring routine of people with diabetes, the intervention performed influenced positively the biochemical profile.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RESEARCH01-01-2017

Terms of the specialized nursing language for the care of ostomates
Revista Brasileira de Enfermagem. 2017;70(3):461-467

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
RESEARCH
Terms of the specialized nursing language for the care of ostomates
Revista Brasileira de Enfermagem. 2017;70(3):461-467
DOI 10.1590/0034-7167-2015-0058
Carina Maris Gaspar Carvalho,
Marcia Regina Cubas,
Maria Miriam Lima da Nóbrega
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ABSTRACT

Objectives:

to identify terms of the specialized nursing language for the care of ostomates from the literature of the area, and to map the identified terms with terms of the International Classification for Nursing Practice (ICNP^®).

Method:

descriptive study of quantitative approach guided by the guidelines for the elaboration of terminology subsets of the ICNP^®. The terms were collected in 49 scientific articles, extracted using a computational tool, selected according to the relevance for the theme, and normalized and mapped with the ICNP^®.

Results:

20,668 terms were extracted. The standardization process resulted in 425 relevant terms (151 were constant in ICNP^® and 274 were not contained in ICNP^®), of which 154 were similar, 19 were more comprehensive, 50 were more restricted, and 51 were not in concordance.

Conclusion:

the use of standardized language can minimize the ambiguities and redundancies identified in the mapping. The existence of terms not in concordance with the ICNP^® reinforces the need for constant updating of this classification.

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ORIGINAL ARTICLE03-24-2021

Costs of healthcare-associated infections in an Intensive Care Unit
- Michelle Araujo Leal ,
- Ana Amélia de Freitas-Vilela
Revista Brasileira de Enfermagem. 2021;74(1):e20200275

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
DOI 10.1590/0034-7167-2020-0275
Michelle Araujo Leal ,
Ana Amélia de Freitas-Vilela
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ABSTRACT

Objectives:

to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.

Methods:

a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.

Results:

a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).

Conclusions:

hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL ARTICLE03-24-2021

Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392
DOI 10.1590/0034-7167-2020-0392
Maria de Nazaré de Souza Ribeiro ,
Fátima Helena do Espírito Santo ,
Bruna da Silva Simões ,
Cleisiane Xavier Diniz ,
Helen Cristine Albuquerque Bezerra ,
Luiz dos Santos
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ABSTRACT

Objectives:

to identify feelings, experiences, and expectations of kidney transplant patients, generated from the diagnosis of chronic renal disease until the post-transplant period, highlighting the challenges for nurses to incorporate individualized care to cope throughout the disease process.

Methods:

qualitative, descriptive research, carried with seven kidney transplant patients, in the city of Manaus, State of Amazonas. The data analysis followed the methodological referential of Bardin’s content analysis.

Results:

the diagnosis of the disease was experienced negatively, and hemodialysis was described as an imprisonment and health decline. The transplant meant an improvement in quality of life. The main difficulties were lack of a specialized hospital and low immunity.

Conclusions:

the nurses’ approach of chronic renal patient and with the renal transplantation favored the discovery of solutions facing the demands of the disease and allowed greater capacity to implement individualized care, surrounding a relationship of trust and respect.

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ORIGINAL ARTICLE06-11-2021

Work at the surgical center: risks of the pathogenic suffering of the nursing team
- Rosane Lima de Araujo ,
- Cecília Helena Glanzner
Revista Brasileira de Enfermagem. 2021;74(2):e20190803

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Abstract
ORIGINAL ARTICLE
Work at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
DOI 10.1590/0034-7167-2019-0803
Rosane Lima de Araujo ,
Cecília Helena Glanzner
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ABSTRACT

Objectives:

to assess the risks of pathogenic suffering related to the experience of nursing workers in the operating room of a university hospital.

Methods:

cross-sectional, quantitative study, carried out from 11/2017 to 01/2018 in a university hospital in the South of Brazil. The sample was composed by 159 nursing workers of the units of a surgical center, that answered to the Scale of Evaluation of Pathogenic Suffering at Work. Data was submitted to statistical analysis.

Results:

the workers present low risk of pathogenic suffering related to the experiences at work, being the results of its factors: Uselessness (1.47±0.761) – low risk; Indignity (2.372±1.035) – medium risk; and Disqualification (1.74±0.903) – low risk.

Conclusions:

the evaluation of Pathogenic Suffering at Work Scale was positive, predominating low risk for pathogenic suffering of surgical center workers related to professional experiences, because they feel useful, valued and are not indignant about their work, feelings that reflect on the quality of care provided.

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ORIGINAL ARTICLE05-21-2021

Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838

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Abstract
ORIGINAL ARTICLE
Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
DOI 10.1590/0034-7167-2019-0838
Mariana Scheidegger dos Santos ,
Filipe de Moraes Thomaz ,
Rafael Tavares Jomar ,
Angela Maria Mendes Abreu ,
Gunnar Glauco De Cunto Carelli Taets
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ABSTRACT

Objectives:

to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.

Methods:

quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.

Results:

the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.

Conclusions:

the use of music diminishes the stress and the distress of cancer patients.

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ORIGINAL ARTICLE05-21-2021

Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089
DOI 10.1590/0034-7167-2020-0089
Tatiane Henrique ,
Fábio Luiz Banhara ,
Natiele Favarão da Silva ,
Francely Tineli Farinha ,
Maila Meryellen Ferreira Garcia Manso ,
Armando dos Santos Trettene
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ABSTRACT

Objectives:

to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery.

Methods:

cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject.

Results:

48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%).

Conclusions:

the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.

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ORIGINAL ARTICLE05-28-2021

The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
DOI 10.1590/0034-7167-2020-0116
Jair da Silva Melo ,
Noélle de Oliveira Freitas ,
Maíra Rosa Apostolico
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ABSTRACT

Objective:

To identify the potential and the limits of the actions of the nursing team in the Primary Health Care for the Health of the Indigenous.

Methods:

This is a quantitative study guided by the Theory of Practical Intervention of Nursing and Collective Health. 230 nursing professionals participated, responding to an instrument about the frequency of the actions carried out in assistance, management, teaching, and research.

Results:

168 nursing technicians and 62 nurses participated. As strengths, 80% participated in the assistance most of the time. Stand out: 90.3% and 71% of nurses carried out nursing consultations and house visits, respectively. As a limitation, the involvement in education and research is small. Only 2% of the interviewees carried out scientific researches, reflecting the need to broaden and qualify care and improve the use of traditional practices, overcoming the biomedical model.

Final considerations:

Nursing assistance is essential in the modification and monitoring of the epidemiological profile of indigenous populations, and its results allow for the planning of quality actions.

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ORIGINAL ARTICLE05-28-2021

Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
Camila Brito Borguezam ,
Caroline Tolentino Sanches ,
Silvia Paulino Ribeiro Albaneser ,
Uiara Rodrigues de Oliveira Moraes ,
Cintia Magalhães Carvalho Grion ,
Gilselena Kerbauy
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ABSTRACT

Objectives:

to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.

Methods:

an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi Info^TM.

Results:

the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).

Conclusions:

this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.

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ORIGINAL ARTICLE06-16-2021

The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
- Emanuelle Caires Dias Araújo Nunes ,
- Regina Szylit
Revista Brasileira de Enfermagem. 2021;74(2):e20200364

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
DOI 10.1590/0034-7167-2020-0364
Emanuelle Caires Dias Araújo Nunes ,
Regina Szylit
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ABSTRACT

Objectives:

to know the meaning of contemporary nursing from the experience of intensive care nurses.

Methods:

qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential.

Results:

the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills – besides the scientific ones, such as empathy, creativity, spirituality and compassion.

Final Considerations:

the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.

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