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ORIGINAL ARTICLE06-28-2024
Quality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
Abstract
ORIGINAL ARTICLEQuality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
DOI 10.1590/0034-7167-2023-0402
Views0See moreABSTRACT
Objective:
To assess the quality of care transition from hospital to home for COVID-19 patients.
Method:
A cross-sectional study conducted at a University Hospital in Southern Brazil, involving 78 patients discharged after COVID-19 hospitalization. Data collection was performed via telephone using the Brazilian version of the Care Transitions Measure (CTM-15). Data were analyzed using descriptive and analytical statistics.
Results:
The mean quality of care transition was 70.8 on a scale ranging from zero to 100, indicating moderate quality of care transition. The highest score was attributed to factor 1, “Preparation for self-management,” and the lowest to factor 4, “Care Plan.”
Conclusions:
It is important to enhance communication and support provided to patients during the transition process, especially regarding understanding prescribed medications and the development of clear care plans.
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Desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa
Revista Brasileira de Enfermagem. 2024;77:e20230400
Abstract
Desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa
Revista Brasileira de Enfermagem. 2024;77:e20230400
DOI 10.1590/0034-7167-2023-0400
Views0See moreRESUMEN
Objetivos:
analizar los desenlaces clínicos en recién nacidos de mujeres embarazadas con COVID-19.
Métodos:
revisión integradora realizada en PubMed, Web of Knowledge, SCOPUS, CINHAL; se obtuvieron 2.111 estudios y 8 artículos conformaron la muestra final.
Resultados:
los desenlaces clínicos en neonatos de mujeres embarazadas positivas para COVID-19 se clasificaron según las siguientes categorías: a) contaminación por COVID-19, reportada en el 62,5% de los estudios; b) alta hospitalaria debido a mejoría, mencionada en el 37,5% de los artículos; c) fallecimiento, representando casos raros en el 25% de la muestra. La complicación gestacional más prevalente fue la prematuridad, mencionada en el 75% de los estudios. Esta complicación se observó debido a casos de rotura prematura de membranas y desprendimiento de placenta.
Conclusiones:
a pesar del conocimiento del comportamiento asintomático y levemente sintomático en los recién nacidos, es importante continuar la búsqueda de nuevos datos clínicos, ya que este público presenta reacciones inciertas a la infección por el SARS-CoV-2.
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REVIEW06-28-2024
Clinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
Abstract
REVIEWClinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
DOI 10.1590/0034-7167-2023-0400
Views0See moreABSTRACT
Objectives:
to analyze clinical outcomes in newborns of pregnant women with COVID-19.
Methods:
integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample.
Results:
clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption.
Conclusions:
despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.
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ORIGINAL ARTICLE06-28-2024
Nursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
Abstract
ORIGINAL ARTICLENursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
DOI 10.1590/0034-7167-2023-0289
Views0See moreABSTRACT
Objective:
To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter’s insights.
Methods:
This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin’s content analysis and the webQDA software.
Results:
The primary category identified was “Nursing Leadership Strategies in the Battle Against COVID-19,” encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals.
Final Considerations:
The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter’s theoretical framework and his model of change.
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ORIGINAL ARTICLE06-28-2024
Palliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study
Revista Brasileira de Enfermagem. 2024;77:e20230218
Abstract
ORIGINAL ARTICLEPalliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study
Revista Brasileira de Enfermagem. 2024;77:e20230218
DOI 10.1590/0034-7167-2023-0218
Views0See moreABSTRACT
Objective:
To comprehend the multiprofessional actions regarding palliative care for patients in the Intensive Care Unit affected by SARS-CoV-2.
Methods:
A comprehensive qualitative study conducted with 31 professionals from the Intensive Care Units of a university hospital, based on the Theory of Peaceful End of Life.
Results:
The analysis of the discourse led to the identification of two categories: “Multidisciplinary actions to promote comfort at the end of life” and “Palliative care during the pandemic period and the promotion of emotional and spiritual comfort.”
Final Considerations:
It became evident that local administration needs to invest in measures that reduce barriers to the implementation of palliative care during times of crisis. Understanding the discourse highlighted that non-specialized professionals can provide basic palliative care appropriately, without diminishing the importance and necessity of the presence of palliative care specialists in various hospital areas.
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ORIGINAL ARTICLE06-28-2024
Uncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
Revista Brasileira de Enfermagem. 2024;77:e20230142
Abstract
ORIGINAL ARTICLEUncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
Revista Brasileira de Enfermagem. 2024;77:e20230142
DOI 10.1590/0034-7167-2023-0142
Views0See moreABSTRACT
Objective:
To analyze the uncertainties experienced by nursing professionals who contracted COVID-19.
Methods:
This qualitative research was conducted with 20 nursing professionals who fell ill from COVID-19. Data collection was carried out through semi-structured interviews; the data were then organized using thematic analysis and discussed in the context of Merle Mishel’s Reconceptualized of Uncertainty in Illness Theory.
Results:
The antecedents of the disease had a strong influence on how nursing professionals who contracted COVID-19 perceived uncertainty. The media coverage of the increasing number of cases, the collapse of the healthcare system, and the high mortality rate contributed to associating the disease with fear and panic.
Final Considerations:
Viewing it from the perspective of the disease’s antecedents, the illness of a nursing professional from COVID-19 underscores that before being professionals, they are human beings just like anyone else, undergoing adversities and facing the possibilities associated with being ill.
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ORIGINAL ARTICLE06-28-2024
COVID-19 pandemic: what factors compromised the mental capacity to work of nursing technicians?
Revista Brasileira de Enfermagem. 2024;77:e20220783
Abstract
ORIGINAL ARTICLECOVID-19 pandemic: what factors compromised the mental capacity to work of nursing technicians?
Revista Brasileira de Enfermagem. 2024;77:e20220783
DOI 10.1590/0034-7167-2022-0783
Views1See moreABSTRACT
Objectives:
to identify the factors that influenced the mental capacity to work of nursing technicians during the COVID-19 pandemic.
Methods:
a cross-sectional study, carried out at two reference hospitals in assisting the population during the COVID-19 pandemic. A total of 237 professionals from Intensive Care Units participated and answered a questionnaire. Multiple linear regression models were used to assess the correlation between mental capacity to work and variables related to risks of contamination, institutional support and health.
Results:
lack of COVID-19 tests, lack of knowledge of routine, absences in 2021 and mental illness contributed to worse mental capacity to work. Management embracement and physical capacity were considered protective factors.
Conclusions:
reduced work capacity in relation to mental demands can affect professional performance and quality of care, with implications for patients and health institutions.
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ORIGINAL ARTICLE06-17-2024
Website for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
Abstract
ORIGINAL ARTICLEWebsite for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
DOI 10.1590/0034-7167-2023-0490
Views0See moreABSTRACT
Objectives:
to develop and validate the content and interface of a guidance website to support families in promoting Food and Nutrition Security for children under six months who are not breastfed.
Methods:
methodological study, Knowledge Translation, in two stages of creation: 1) content and validation on the criterion of accuracy in a panel of experts; 2) interface and validation on the criteria of content, language, illustrations, layout, motivation, culture and applicability.
Results:
the “Milky Way” website is freely available: . The content was structured in a decision tree made up of types of milk: milk formula, whole cow’s milk and powdered milk; and utensils: bottle, cup and measuring spoon. There were 46 illustrations to elucidate the content, facilitate understanding and engage the target population. The Content Validity Index was 0.91.
Conclusions:
the website is a validated technology with evidence-based written and pictorial content translated for use with families.
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ORIGINAL ARTICLE12-04-2023
Sepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
Abstract
ORIGINAL ARTICLESepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
DOI 10.1590/0034-7167-2023-0037
Views0See moreABSTRACT
Objective:
to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables.
Methods:
a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records.
Results:
sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis.
Conclusions:
there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.
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ORIGINAL ARTICLE12-04-2023
Clinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
Abstract
ORIGINAL ARTICLEClinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
DOI 10.1590/0034-7167-2023-0019
Views0ABSTRACT
Objective:
to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses.
Methods:
methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74.
Conclusion:
two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.
Keywords:Educational MeasurementNursing EducationPatient Care PlanningSimulation TrainingVascular Access DevicesSee more -
Sleep quality of nurses who worked in coping with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2023;76(6):e20230007
Abstract
Sleep quality of nurses who worked in coping with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2023;76(6):e20230007
DOI 10.1590/0034-7167-2023-0007
Views0See moreABSTRACT
Objective:
to analyze sleep quality of nurses who worked coping with COVID-19 in scientific evidence.
Methods:
an integrative review, carried out in seven databases, including studies between December 2021 and June 2022, without language restrictions. The sample consisted of 15 primary studies.
Results:
nurses working in hospital, intensive care, outpatient care and teaching institutions constitute a vulnerable group for sleep disorders: latency, duration, efficiency and quality. The disorders identified involved insomnia at varying levels of severity: daytime dysfunction and morning sleepiness. Night work and low capacity for self-care were determinants of impaired sleep patterns.
Final considerations:
the COVID-19 pandemic contributed to greater vulnerability of nurses to changes in sleep, requiring strategies for risk management and well-being promotion.
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ORIGINAL ARTICLE12-04-2023
Work and Mental Distress among Nurses in the Amazon Region of Brazil during the COVID-19 Pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220792
Abstract
ORIGINAL ARTICLEWork and Mental Distress among Nurses in the Amazon Region of Brazil during the COVID-19 Pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220792
DOI 10.1590/0034-7167-2022-0792
Views0See moreABSTRACT
Objective:
To assess the relationship between psychopathological symptoms and the social, clinical, and occupational profile of nurses in the Amazon region of Brazil during the COVID-19 pandemic.
Methods:
A descriptive cross-sectional online study was conducted in 2020 with 261 nurses. The Symptom Assessment Scale-40 was utilized.
Results:
The presence of pre-existing conditions before the pandemic was associated with psychotism (p=0.044). Experiencing constraints and/or violence at work during the pandemic was associated with somatization (p=0.025), and working hours were associated with anxiety (p=0.025). Nurses predominantly exhibited symptoms related to fear (33.7%), tension (34.5%), and a sense that something is wrong in the mind (22.6%).
Conclusions:
A significant association was observed between working hours and anxiety symptoms, the experience of constraints and/or violence at work during the COVID-19 pandemic and somatization symptoms, as well as between pre-existing conditions and psychotism symptoms related to COVID-19.
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ORIGINAL ARTICLE12-04-2023
Sexual behavior according to undergraduate students: perspective of cross-cultural nursing and intersectional framing
Revista Brasileira de Enfermagem. 2023;76(6):e20220786
Abstract
ORIGINAL ARTICLESexual behavior according to undergraduate students: perspective of cross-cultural nursing and intersectional framing
Revista Brasileira de Enfermagem. 2023;76(6):e20220786
DOI 10.1590/0034-7167-2022-0786
Views0ABSTRACT
Objective:
to discuss undergraduate students’ sexual behavior from the perspective of social markers and cross-cultural care proposed by Madeleine Leininger.
Methods:
descriptive-exploratory qualitative research, with a theoretical-philosophical foundation in the Transcultural Theory. Convenience sample was composed of 57 young people from two universities in Rio de Janeiro. The focus groups’ content were analyzed lexically using the IRAMUTEQ software.
Results:
four classes emerged: Young people’s sexual scripts: between the fear of an unplanned pregnancy and the risk of exposure to sexually transmitted infections; Affective relationships: trust in steady sexual partners, apparent sense of security and disuse of condoms; Sexual practices, gender and cultural determinants: distinction in men’s and women’s role; Sexual partnerships, negotiation of condom use and vulnerability to sexually transmitted infections.
Final considerations:
challenges are perceived for the attention to undergraduate students’ sexual health, who verbalized risky sexual behaviors due to sociocultural vulnerabilities.
Keywords:Cross-Cultural NursingIntersectional FramingSexual BehaviorSexually Transmitted InfectionsYoung AdultSee more -
ORIGINAL ARTICLE12-04-2023
Hospital discharge planning in care transition of patients with chronic noncommunicable diseases
Revista Brasileira de Enfermagem. 2023;76(6):e20220772
Abstract
ORIGINAL ARTICLEHospital discharge planning in care transition of patients with chronic noncommunicable diseases
Revista Brasileira de Enfermagem. 2023;76(6):e20220772
DOI 10.1590/0034-7167-2022-0772
Views0ABSTRACT
Objective:
to analyze care transition in hospital discharge planning for patients with chronic noncommunicable diseases.
Method:
a qualitative study, based on the Care Transitions Intervention theoretical model, with four pillars of intervention, to ensure a safe transition. Twelve professionals participated in a public hospital in the countryside of São Paulo. Data were collected through observation, document analysis and semi-structured interviews.
Results:
there was a commitment of a multidisciplinary team to comprehensive care and involvement of family members in patient care. The documents facilitated communication between professionals and/or levels of care. However, the lack of time to prepare for discharge can lead to fragmented care, impairing communication and jeopardizing a safe transition.
Final considerations:
they were shown to be important elements in discharge planning composition, aiming to ensure a safe care transition, team participation with nurses as main actors, early discharge planning and family involvement.
Keywords:Continuity of Patient CareNurse's RolePatient DischargePatient-Centered CareProcess AssessmentTransitional CareSee more -
ORIGINAL ARTICLE12-04-2023
Psychometric Properties of an Instrument for Assessing University Administrators’ Knowledge on Gender-Based Violence
Revista Brasileira de Enfermagem. 2023;76(6):e20220770
Abstract
ORIGINAL ARTICLEPsychometric Properties of an Instrument for Assessing University Administrators’ Knowledge on Gender-Based Violence
Revista Brasileira de Enfermagem. 2023;76(6):e20220770
DOI 10.1590/0034-7167-2022-0770
Views0ABSTRACT
Objective:
To evaluate the factorial structure of the instrument measuring university administrators’ knowledge of gender-based violence.
Methods:
This cross-sectional methodological study was conducted from August to November 2020 with 101 university administrators. Data on demographic and functional characteristics were collected, and the “QUEST VBG UNIV” instrument was applied. Descriptive analysis was performed, the structure of the questionnaire was assessed using exploratory factor analysis (EFA), and the stability of the factors was verified through ORION and FDI tests.
Results:
Of the original 38 items across the 4 sections of the questionnaire, 19 were retained within 2 factors, with appropriate factor loadings. Factor 1 had an explained variance of 15.69%, and Factor 2 had an explained variance of 9.10%. The reliability was deemed satisfactory (ORION > 0.900, FDI > 0.900).
Conclusions:
The questionnaire presented a valid and reliable factorial structure for measuring knowledge about gender-based violence, thereby representing a suitable option for situational assessments in universities.
Keywords:Factor AnalysisGender-Based ViolencePsychometricsStatisticalValidation StudyWorkplace violenceSee more
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Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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