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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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ORIGINAL ARTICLE06-27-2019
Patient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
Abstract
ORIGINAL ARTICLEPatient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
DOI 10.1590/0034-7167-2018-0484
Views0See moreABSTRACT
Objective:
to analyze patient safety incidents identified by caregivers of hospitalized children.
Method:
a qualitative, exploratory-descriptive study was carried out with 40 caregivers of children hospitalized in three hospital institutions in the city of Porto Alegre, Rio Grande do Sul State, Brazil, from April to December 2016. Semi-structured, recorded and transcribed interviews were carried out in their entirety, submitted to a thematic analysis using the NVivo 11.0 software.
Results:
reports related to falls, infant feeding, patient/caregiver identification, medication process, communication, hand hygiene and hygiene of the hospital environment, spread of diseases, relations between caregivers and professionals and care processes/procedures were all cited.
Final considerations:
communication and the relations among caregivers and professionals are the main contributory factors for patient safety incidents, interfering with the quality of care. The participation of caregivers and engagement in child care may be strategies to be developed to promote a safety culture.
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ORIGINAL ARTICLE09-16-2019
Tuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
Abstract
ORIGINAL ARTICLETuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
DOI 10.1590/0034-7167-2018-0260
Views0See moreABSTRACT
Objective:
To identify tuberculosis-related health care and surveillance actions in Prison Health Units.
Method:
Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials.
Results:
Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units.
Conclusion:
Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.
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ORIGINAL ARTICLE03-07-2022
Adaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
Revista Brasileira de Enfermagem. 2022;75(5):e20210582
Abstract
ORIGINAL ARTICLEAdaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
Revista Brasileira de Enfermagem. 2022;75(5):e20210582
DOI 10.1590/0034-7167-2021-0582
Views0See moreABSTRACT
Objective:
To adapt and validate the content of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) to Brazilian culture.
Methods:
This is a methodological study that followed the stages of translation, synthesis, back translation, evaluation by a committee of five specialists, pre-test with 31 nurses, and evaluation by the author of the original instrument. The Content Validity Index (minimum 0.90) and the modified Kappa (minimum 0.74) were calculated to evaluate the content.
Result:
In the first round of content evaluation, 18 items had to be altered because they did not reach the minimum values established. Three items have not reached a consensus in the second round and had to be sent to the author of the original version. In the pre-test, 13 items were returned to the specialists because they suffered content changes.
Conclusion:
The Advanced Practice Nursing Competency Assessment Instrument (APNCAI) – Brazilian version was cross-culturally adapted, and its content was validated.
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REVIEW07-29-2020
Frailty syndrome in the elderly: conceptual analysis according to Walker and Avant
Revista Brasileira de Enfermagem. 2020;73:e20190601
Abstract
REVIEWFrailty syndrome in the elderly: conceptual analysis according to Walker and Avant
Revista Brasileira de Enfermagem. 2020;73:e20190601
DOI 10.1590/0034-7167-2019-0601
Views0See moreABSTRACT
Objective:
To analyze the concept of “frailty syndrome” in the literature, according to the method proposed by Walker and Avant.
Methods:
It is a concept analysis, guided by the method proposed by Walker and Avant, made operational through an integrative literature review. The search in a scientific database was carried out using the descriptors: Frail elderly, syndrome, phenotype, geriatric assessment, and aging. The literary corpus comprised 66 studies. Results: The study found the antecedents and attributes (categorized as physical, sociodemographic, and behavioral/environmental) that integrate the signs and symptoms evidenced in the “frailty syndrome,” as well as the consequences of this concept. The variables were analyzed with emphasis on the conceptions that influence the frailty process of the elderly.
Conclusion:
The study demonstrated the complexity arising from the multifactorial genesis of the referred syndrome, emphasizing the specificities of the elderly’s frailty. However, we recommend conducting further research involving the phenomenon in question to understand the construct better.
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09-16-2019
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
Abstract
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
DOI 10.1590/0034-7167-2018-0734
Views0See moreABSTRACT
Objective:
To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care.
Method:
A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility.
Results:
The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997.
Conclusions:
The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
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02-10-2020
Development of middle-range theories in nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20170893
Abstract
Development of middle-range theories in nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20170893
DOI 10.1590/0034-7167-2017-0893
Views0See moreABSTRACT
Objective:
To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing.
Method:
Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles.
Results:
All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews.
Final considerations:
The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.
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REVIEW08-20-2021
Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review
Revista Brasileira de Enfermagem. 2021;74(6):e20201315
Abstract
REVIEWAssessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review
Revista Brasileira de Enfermagem. 2021;74(6):e20201315
DOI 10.1590/0034-7167-2020-1315
Views0See moreABSTRACT
Objectives:
to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture.
Methods:
this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020.
Results:
thirty-six studies were identified. Nine studies identified strengthened areas such as: “teamwork within the units”, “expectations of supervisor/boss and actions promoting safety”, “organizational learning”, “support of hospital management for patient safety” and “frequency of report of events”. As a critical area, the dimension “non-punitive response to error” was evidenced in 30 of 36 studies.
Conclusions:
the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.
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ORIGINAL ARTICLE11-12-2022
Low-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
Abstract
ORIGINAL ARTICLELow-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
DOI 10.1590/0034-7167-2021-0396
Views0See moreABSTRACT
Objectives:
to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing.
Methods:
this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC.
Results:
groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators.
Conclusions:
low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.
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