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EXPERIENCE REPORT10-25-2022
Patients who experience systemic lupus erythematosus and leg ulcer: phenomenological approach
Revista Brasileira de Enfermagem. 2022;75(2):e20200081
Abstract
EXPERIENCE REPORTPatients who experience systemic lupus erythematosus and leg ulcer: phenomenological approach
Revista Brasileira de Enfermagem. 2022;75(2):e20200081
DOI 10.1590/0034-7167-2020-0081
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Objective:
To understand the experience of a woman with systemic lupus erythematosus and leg ulcers with cutaneous calcinosis.
Methods:
An experience report based on the social phenomenology of Alfred Schutz, conducted with a young woman undergoing treatment in an outpatient service.
Results:
The disease manifested itself in adolescence and brought emotional instability associated with body image concern and social isolation. The discontinuation of the studies triggered financial limitations with implications for treatment. The presence of ulcers aggravated by skin calcification makes the process of getting sick tiring and painful. Interpersonal relationships are resources for coping with situations experienced.
Final considerations:
Patients with lupus may have social, affective, and family life, even in the face of the limitations imposed by the disease. However, the emergence of leg ulcer with calcinosis changes this situation.
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ORIGINAL ARTICLE10-25-2022
COVID-19 pandemic and nursing week: analysis from software Iramuteq
Revista Brasileira de Enfermagem. 2022;75:e20200690
Abstract
ORIGINAL ARTICLECOVID-19 pandemic and nursing week: analysis from software Iramuteq
Revista Brasileira de Enfermagem. 2022;75:e20200690
DOI 10.1590/0034-7167-2020-0690
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Objective:
to analyze the themes of publications on the Federal Council of Nursing (Cofen) website during Nursing Week 2020.
Method:
documentary, qualitative research, whose data sources were publications on the Cofen website from May 12 to 20, 2020. Data were processed by software IRAMUTEQ®, through the Descending Hierarchical Classification and analyzed under the historical materialism framework.
Results:
thirty publications were analyzed, giving rise to five classes.
Final considerations:
the themes published in the period investigated pointed to the grief experienced by the category, due to the death of its members, and the fight for better working conditions. Overcoming the pandemic involves recognizing science and the Unified Health System, protecting nursing workers’ health and fighting misinformation and fake news.
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ORIGINAL ARTICLE10-25-2022
Online mental health care during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20210554
Abstract
ORIGINAL ARTICLEOnline mental health care during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20210554
DOI 10.1590/0034-7167-2021-0554
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Objective:
Identify users, services, and reasons for seeking online mental health care during the COVID-19 pandemic.
Methods:
A descriptive, retrospective study, with documentary analysis of medical records of users served between April and July 2020.
Results:
Of the 258 accesses, 159 were complete, and 99 were offline messages. Although there were 61 (38.36%) consultations in May, in April, there were 49 (30.82%) in 18 days of reception. More than 89% of accesses were women between 40 and 59 years. Among the motivations in the search for care, anxiety, fear, depression, sadness, crying, stress, and suicidal ideation stand out.
Final considerations:
Chat is a quick, early and short-wait intervention opportunity for people in need of mental health care. Therefore, the study emphasizes the importance of investing in the training of nursing professionals to act in mental health.
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ORIGINAL ARTICLE10-25-2022
Planned home birth assistance: challenges during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20210083
Abstract
ORIGINAL ARTICLEPlanned home birth assistance: challenges during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20210083
DOI 10.1590/0034-7167-2021-0083
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Objective:
To understand the challenges faced by urban midwives in assisting planned home births during the COVID-19 pandemic.
Methods:
Qualitative study, based on the Collective Subject Discourse methodological framework, carried out with eight professionals, members of a birth care collective from the northeast region of Brazil. Data was collected between September and October of 2020 using the focus group technique.
Results:
The collective discourses revealed five central ideas: Changing assistance strategy; Dealing with frustration; Facing the fear of contamination; Avoiding exposure to the virus; and Keeping distance during the care process.
Final considerations:
The challenging condition the pandemic brings to the care of planned home births is made evident, being marked by the need for collective protection and the pressure of following health recommendations. The study also points out the need for official protocols and good quality information based on scientific evidence and humanizing principles to guide health care.
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ORIGINAL ARTICLE10-25-2022
Brazilian nursing in pandemic times and the bicentennial of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75:e20210081
Abstract
ORIGINAL ARTICLEBrazilian nursing in pandemic times and the bicentennial of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75:e20210081
DOI 10.1590/0034-7167-2021-0081
Views0See moreABSTRACT
Objective:
To reflect on the role of Brazilian nursing during the COVID-19 pandemic, considering as a historical landmark the bicentenary of the birth of Florence Nightingale, a precursor of modern nursing, celebrated in 2020.
Method:
Theoretical-reflective study, based on Florence Nightingale’s environmental theory through a literature review, carried out in international and national virtual news from different sources and added to the authors’ experiences related to the pandemic.
Results:
It was possible to identify the weaknesses experienced by nurse practitioners as to contagion by COVID-19, the routine of exposure to risks, the lack of adequate protection in many scenarios, the high rates of illness, and also deaths that occurred in this profession.
Final considerations:
Florence Nightingale’s Environmental Theory describes the importance of the adequacy of the work environment. It also emphasizes the value of this professional for contemporary nursing and the redefinition of this professional category during the COVID-19 pandemic.
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ORIGINAL ARTICLE10-24-2022
Avoidable deaths in the first 24 hours of life: health care reflexes
Revista Brasileira de Enfermagem. 2022;75(1):e20220027
Abstract
ORIGINAL ARTICLEAvoidable deaths in the first 24 hours of life: health care reflexes
Revista Brasileira de Enfermagem. 2022;75(1):e20220027
DOI 10.1590/0034-7167-2022-0027
Views0See moreABSTRACT
Objectives:
to analyze the risks of deaths in the first 24 hours of life and their preventable causes.
Methods:
cross-sectional study carried out in Pernambuco, Northeast of Brazil, between 2000-2019, with mortality and live birth data. The avoidability was analyzed through the Brazilian List of Avoidable Causes of Deaths due to Interventions of the Unified Health System. For the statistical analyses, Pearson’s chi-squared test and relative and attributable risks were used.
Results:
13,601 deaths were registered, of which 10,497 (77.19%) were from preventable causes. Of the total, 5,513 (40.53%) were reducible through adequate care for women during pregnancy. The lower the gestational age, birth weight and education level, the higher the relative and attributable risk of death in the first 24 hours of life.
Conclusions:
most of the deaths were considered avoidable and with high relative and attributable risks. These early deaths suggest care failures and the need to reinforce prevention and treatment measures.
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ORIGINAL ARTICLE10-24-2022
Factors associated with symptoms of physical and emotional burden in informal caregivers of the elderly
Revista Brasileira de Enfermagem. 2022;75:e20210927
Abstract
ORIGINAL ARTICLEFactors associated with symptoms of physical and emotional burden in informal caregivers of the elderly
Revista Brasileira de Enfermagem. 2022;75:e20210927
DOI 10.1590/0034-7167-2021-0927
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Objectives:
to analyze the personal and work-related burden factors associated with physical and emotional symptoms of informal caregivers of the elderly.
Methods:
cross-sectional study conducted with 121 informal caregivers and 121 seniors who received care, assessed individually for the risk of: physical overload, musculoskeletal symptoms, Self-Reporting Questionnaire, effort perception, and Katz index.
Results:
a greater perception of effort raises up to 3.3 times the chances of presenting symptoms of pain in the spine region (p=0.01), and lower functional capacity of the elderly increases up to 1.3 times the chances of presenting pain symptoms in the spine region (p=0.02). The symptoms of emotional overload were associated with the caregiver’s low income (p=0.02).
Conclusions:
the perception of effort, dependence of the elderly, caregiver’s age, and symptoms of emotional overload are involved with caregivers’ symptoms of physical overload, and low income, with emotional overload.
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ORIGINAL ARTICLE10-24-2022
Development and testing of the Prev’Quedas game for older adults in the community: a descriptive study
Revista Brasileira de Enfermagem. 2022;75:e20220098
Abstract
ORIGINAL ARTICLEDevelopment and testing of the Prev’Quedas game for older adults in the community: a descriptive study
Revista Brasileira de Enfermagem. 2022;75:e20220098
DOI 10.1590/0034-7167-2022-0098
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Objectives:
to develop and test a board game for fall prevention in older adults in the community.
Methods:
a descriptive study, carried out through the use of game design elements (narrative, mechanics, aesthetics and technology), the Health Promotion Model, assessment by experts and testing with older adults. For assessment, the Concordance Index was used, considering it greater than 80%.
Results:
three prototypes and the final version were developed. The game’s narrative was based on promotion model, comprising individual aspects, benefits and barriers in behavior to prevent falls. The mechanics outlined goals and rules. Aesthetics encompassed layout and illustrations. The technology involved board, cards, pin, roulette and instruction manual. The game was assessed by 36 experts and 31 older women from the community, with a Concordance Index of 93.22% and 99%, respectively.
Conclusions:
the game developed and tested was considered an adequate educational strategy for fall prevention.
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ORIGINAL ARTICLE09-23-2022
Brain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
Abstract
ORIGINAL ARTICLEBrain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
DOI 10.1590/0034-7167-2021-0943
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Objectives:
to identify care strategies developed by professionals from critically ill patients’ units in communicating BD with parents of children and adolescents.
Methods:
an exploratory and descriptive research with a qualitative approach, carried out in two health institutions between October and December 2019, through semi-structured interviews. Data analysis took place through content analysis.
Results:
twenty-one professionals participated. Three care strategies were identified: actual clinical situation in suspected brain death; sensitizing families to the real clinical situation after brain death diagnosis; and time to assimilate the death information.
Final Considerations:
the care strategies for communicating brain death to families identified in this study present the possibility of subsidizing health managers in training and support promotion for professionals in care practice. Moreover, they can be incorporated and validated in the care practice of the studied context.
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ORIGINAL ARTICLE03-30-2022
Nursing diagnoses of newborns in rooming-in care using ICNP®
Revista Brasileira de Enfermagem. 2022;75(4):e20200672
Abstract
ORIGINAL ARTICLENursing diagnoses of newborns in rooming-in care using ICNP®
Revista Brasileira de Enfermagem. 2022;75(4):e20200672
DOI 10.1590/0034-7167-2020-0672
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Objectives:
to create nursing diagnosis definitions for newborns in rooming-in care, using the International Classification for Nursing Practice (ICNP).
Methods:
methodological study following the steps for the identification and validation of relevant terms to care for clients; cross-mapping of the terms identified with the terms of the ICNP® 2019; elaboration and validation of the nursing diagnostic definitions of ICNP® and later classification according with the Basic Human Needs described by Wanda Horta.
Results:
from the terms extracted, 168 were validated through specialist consensus, subsidizing the elaboration of 27 diagnosis definitions.
Conclusions:
the most common diagnoses for the clients studied were: “Effective Feeding Behaviour”, “Effective Urination”, “Normal Respiration Rhythm”, “Effective Swallowing”, “Effective Peripheral Intravenous Access”, and “Effective Parent Child Attachment”. It was confirmed that the records of psychobiological needs are mainly made by nurses, which were responsible for 23 of the diagnoses in this study.
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ORIGINAL ARTICLE10-07-2022
Nursing workload associated with neonatal mortality risk: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(4):e20200965
Abstract
ORIGINAL ARTICLENursing workload associated with neonatal mortality risk: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(4):e20200965
DOI 10.1590/0034-7167-2020-0965
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Objectives:
to analyze the association between nursing workload and neonatal mortality risk in newborns admitted to the Neonatal Intensive Care Unit.
Methods:
this is an observational, cross-sectional study conducted from January 2019 to January 2020.
Results:
the sample consisted of 399 newborns, 55.4% male, Nursing Activities Score mean of 67.5%, and Score for Neonatal Acute Physiology Perinatal Extension mean of 17.7, revealed itself as a predictor of the risk of death, while gestational age, length of hospitalization, and the first-minute Apgar established a protective relationship. The correlation between workload and neonatal mortality was low (r= 0.23, p=0.0009).
Conclusions:
the workload of the nursing team is not associated with the risk of mortality in the Neonatal Intensive Care Unit, as measured by the Nursing Activities Score.
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ORIGINAL ARTICLE04-15-2022
Risk factors for infiltration in children and adolescents with peripheral intravenous catheters
Revista Brasileira de Enfermagem. 2022;75(4):e20210176
Abstract
ORIGINAL ARTICLERisk factors for infiltration in children and adolescents with peripheral intravenous catheters
Revista Brasileira de Enfermagem. 2022;75(4):e20210176
DOI 10.1590/0034-7167-2021-0176
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Objectives:
to estimate the incidence of infiltration and the factors associated with its occurrence in children and adolescents in the operative period and with peripheral intravenous catheters.
Methods:
a longitudinal and prospective study with children and adolescents using peripheral intravenous catheters, conducted at the surgical clinic unit of a pediatric hospital in Feira de Santana, State of Bahia, from April 2015 to December 2016. The study used Pearson’s chi-square and Fisher’s exact test for the analysis. It also applied multiple analyses using Poisson regression with robust variance.
Results:
the incidence of infiltration was 31.2% and was associated with female sex (RR=0.53; CI=[0.30-0.96]), non-eutrophic children (RR=2.27; CI=[1.25-4.20]), who used non-irritating and non-vesicant drugs (RR=1.72; CI=[1.03-2.87]), vesicant drugs (RR=1.84; CI=[1.05-3.22]) and irritating/vesicant electrolytes (RR=2.35; CI=[1.38-3.97]).
Conclusions:
the study suggests the development of strategies that will help in the prevention of this adverse event through the knowledge of the associated factors.
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ORIGINAL ARTICLE02-25-2022
Death of children by domestic accidents: unveiling the maternal experience
Revista Brasileira de Enfermagem. 2022;75(4):e20210435
Abstract
ORIGINAL ARTICLEDeath of children by domestic accidents: unveiling the maternal experience
Revista Brasileira de Enfermagem. 2022;75(4):e20210435
DOI 10.1590/0034-7167-2021-0435
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Objectives:
to unveil the meanings of mothers whose children died as a result of domestic accidents in childhood.
Methods:
a qualitative research, in the light of Heideggerian phenomenology, with ten mothers whose children died from domestic accidents. It was carried out in a municipality of the Northeast Region of Brazil through phenomenological interviews between May and June 2017. The existential analytic was constituted by the comprehensive moments of the Heideggerian method.
Results:
the meanings unveiled pointed out that, to understand the sudden death of her child, the mother oscillates between feeling guilty, pointing and denying guilt. She reports emptiness, permanent pain, non-acceptance of her child’s death, and the desire to keep him in her life. In this journey, the fear that brings limitations to her life and that of her other children is revealed. Final Considerations: it was revealed that the death of the child in infancy compromises the integrality of being a mother, indicating the need for systematic and continuous care for the adequate management of the emotional and social effects.
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ORIGINAL ARTICLE04-15-2022
Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory
Revista Brasileira de Enfermagem. 2022;75(4):e20210463
Abstract
ORIGINAL ARTICLEMeanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory
Revista Brasileira de Enfermagem. 2022;75(4):e20210463
DOI 10.1590/0034-7167-2021-0463
Views0See moreABSTRACT
Objectives:
to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity.
Methods:
this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework.
Results:
two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon “Re-signifying life after bariatric surgery” was constructed.
Final Considerations:
bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.
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ORIGINAL ARTICLE04-15-2022
Correlation between fatigue and quality of life self-reported by adolescents with cerebral palsy
Revista Brasileira de Enfermagem. 2022;75(4):e20210716
Abstract
ORIGINAL ARTICLECorrelation between fatigue and quality of life self-reported by adolescents with cerebral palsy
Revista Brasileira de Enfermagem. 2022;75(4):e20210716
DOI 10.1590/0034-7167-2021-0716
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Objectives:
to investigate the correlation between fatigue and quality of life in adolescents with cerebral palsy who are susceptible to more significant fatigue and lower quality of life.
Methods:
cross-sectional study conducted with 101 adolescents with cerebral palsy. Instruments such as the Pediatric Quality of Life Inventory and Gross Motor Function Classification System were used, and Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests were applied.
Results:
older adolescents self-reported higher fatigue levels, and female adolescents, quadriplegic, with worse motor function, older, and not attending school had lower quality of life scores. Higher fatigue levels correlated with lower quality of life in all domains (p<0.01), especially in tiredness (general and mental) and functioning (social, academic, and psychosocial).
Conclusions:
fatigue correlated negatively with the quality of life of adolescents with cerebral palsy, showing that the higher the level of fatigue, the more compromised is the adolescents’ life.
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ORIGINAL ARTICLE05-09-2022
Factors associated with the skills of informal caregivers in home care
Revista Brasileira de Enfermagem. 2022;75(4):e20210744
Abstract
ORIGINAL ARTICLEFactors associated with the skills of informal caregivers in home care
Revista Brasileira de Enfermagem. 2022;75(4):e20210744
DOI 10.1590/0034-7167-2021-0744
Views0See moreABSTRACT
Objective:
To identify factors associated with cognitive, emotional, psychomotor, and relational skills of informal caregivers in home care.
Methods:
A cross-sectional study carried out with a sample of 216 informal caregivers residing in a municipality in the state of Paraná. Data collection took place between February and July 2019, with an instrument developed and validated to assess the skills of informal caregivers. Descriptive and inferential analyses were used.
Results:
The factors associated with a greater competence of informal caregivers were being female, having training in the field, and having more than five years home care experience. The lowest competence was observed in caregivers who had health problems and belonged to the lowest strata of family purchasing power. Participants had lower scores in psychomotor competence and had better results in cognitive competence.
Conclusion:
It was found that women with experience in care had higher levels of competence to provide quality care at home assistance services.
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