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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
Views0ABSTRACT
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.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
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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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
Views0RESUMEN
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.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
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
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
Views0ABSTRACT
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.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee 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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Nursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
Abstract
Nursing actions in primary care and the control of diseases preventable through vaccines
Revista Brasileira de Enfermagem. 2015;68(5):803-809
DOI 10.1590/0034-7167.2015680506i
Views0See moreABSTRACT
Objective:
to discuss the actions performed by nurses in the control and eradication of diseases preventable with vaccines in healthcare setting, according to the National Primary Health Care Policy.
Method:
qualitative research supported by the social phenomenology of Schutz. It had as its setting a Family Health Clinic, located in the city of Rio de Janeiro (Brazil), with ten nurses. The data collection occurred through interviews.
Results:
nurses’ actions aimed at the control and eradication of preventable diseases mainly involve updating a vaccination card, administering the vaccine, and guiding the user of the Health Unit, with the purpose of preventing diseases. The National Primary Care Policy and all manuals from the Ministry of Health recognize the importance of focusing on the service user.
Conclusion:
the user’s lifestyle must be considered, and his access to services aiming at the expansion of the control of diseases preventable with vaccines should be promoted.
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Children with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
Abstract
Children with neuropsychomotor development delay: music therapy promoting quality of life
Revista Brasileira de Enfermagem. 2015;68(5):797-802
DOI 10.1590/0034-7167.2015680505i
Views0See moreABSTRACT
Objective:
to identify the influence of music therapy on the behavior and quality of life of children with neuropsychomotor development delay (NPMDD).
Method:
experimental research, with applications of music therapy (in a group of children) held in the specialized association in Cruz das Almas – Bahia, composed of 17 children with NPMDD aged 5 to 12 years. The behavior of children involving emotional, physical, social and school aspects was observed.
Results:
there was an evolution in all aspects, being this improvement significant to Emotional Capacity and School Capacity domains, showing the beneficial effects of music therapy.
Conclusion:
music therapy becomes a treatment option for children with NPMDD, improving their quality of life.
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Spirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
Abstract
Spirituality, religion and personal beliefs of adolescents with cancer
Revista Brasileira de Enfermagem. 2015;68(5):791-796
DOI 10.1590/0034-7167.2015680504i
Views0See moreABSTRACT
Objective:
to examine adolescents’ perception about spirituality, religion and personal beliefs in their lives due to cancer and a possible strategy for coping with the disease.
Method:
qualitative research, both descriptive and exploratory. The data were collected by means of a personal semi-structured interview, and the categories were analyzed by content analyzes.
Results:
nine adolescents who were undergoing cancer treatment at one of the two institutions located Uberaba, Brazil, participated in the study. Based on the analysis and interpretation of results, it was possible to systematize them according to four categories: spiritual history of the individual; faith and belief; importance of spirituality in their lives, and the community acting as a spiritual supporter. Most adolescents referred to spirituality as being an important tool for dealing with the disease, especially concerning religious rituals and community support.
Conclusion:
spirituality creates hope for adolescents, which helps them to cope with cancer-related diffi culties and contribute to the search for the meaning of life.
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Coping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
Abstract
Coping strategies of nursing students for dealing with university stress
Revista Brasileira de Enfermagem. 2015;68(5):783-790
DOI 10.1590/0034-7167.2015680503i
Views0See moreABSTRACT
Objective:
to identify the coping strategies used by nursing students in a university in southern Brazil, establishing the relationship between the sociodemographic and academic variables examined.
Method:
an exploratory, descriptive, quantitative study, carried out with 146 nursing students, through application of the Coping Strategies Inventory. For the data analysis, descriptive statistics, analysis of variance and regression analysis were used.
Results:
it was found that the coping strategy most used by nursing students is escape. A connection was also detected between the academic dissatisfaction variable and the use of negative coping strategies.
Conclusion:
it was noted that students satisfi ed with the course used positive coping strategies targeting the problem, whereas dissatisfi ed students used negative strategies focusing on the emotion.
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Unemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
Abstract
Unemployment and psychological distress in nurses
Revista Brasileira de Enfermagem. 2015;68(5):775-782
DOI 10.1590/0034-7167.2015680502i
Views0See moreABSTRACT
Objective:
to assess psychological distress in nurses searching for their first job, especially symptoms of depression, and identify the factors that caused mental suffering, and how these nurses cope with the situation.
Method:
this was a qualitative study carried out with unemployed nurses who had graduated less than two years before the time of the study, and were residents of the town of Assis in the Brazilian state of São Paulo. Data were gathered by means of semi-structured interviews, content analysis, and application of the Beck Depression Inventory psychometric scale.
Results:
of the 14 nurses that participated, three had scores on the psychometric scale indicative of depression. Participants reported psychological distress related to unemployment, poor university education, and surplus labor due to the large number of graduates and lack of jobs, as well as a culture of employment centered on professionals’ social networks. The unemployed nurses did not have effective ways of coping.
Conclusion:
unemployment promoted psychological distress among the new nurses, especially symptoms of depression, without effective means of coping.
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Newborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
Newborn blood spot screening: to expand or not to expand?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“The principal constraint on what we can detect in newborn screening is fast becoming what we choose to detect: rather than what is limited for us by technical feasibility or cost”().Technological advances are providing the medical world an opportunity to extend the number of conditions newborn babies are screened for. Tandem mass spectrometry (TMS, also […]See more -
Teste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
Abstract
Teste de triagem neonatal: expandir ou não expandir?
Revista Brasileira de Enfermagem. 2015;68(5):771-772
DOI 10.1590/0034-7167.2015680501i
Views0“A principal restrição sobre o que podemos detectar no teste de triagem neonatal está rapidamente se tornando o que escolhemos detectar em vez daquilo que nos é limitado por razão de viabilidade técnica ou custo”().Os avanços tecnológicos estão conferindo ao mundo médico uma oportunidade de aumentar o número de patologias para as quais os recém-nascidos […]See more -
REVIEW01-01-2015
International Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
Abstract
REVIEWInternational Classification for Nursing Practice – ICNP®: application to the Brazilian reality
Revista Brasileira de Enfermagem. 2015;68(4):730-731
DOI 10.1590/0034-7167.2015680422i
Views0The author and organizer, Telma Ribeiro Garcia, added her theoretical and practical knowledge to those of a dozen other authors for the creation of the book “International Classification for Nursing Practice – ICNP®: application to the Brazilian reality”. She is a retired professor of the Department of Public Health Nursing and Psychiatry at the Federal […]See more
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
Abstract
ORIGINAL ARTICLEValidation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
DOI 10.1590/0034-7167-2023-0344
Views0See moreABSTRACT
Objectives:
to validate the content of an instrument for assessing leprosy care in individuals under 15 years old in the context of Primary Health Care.
Methods:
methodological study of content validation, based on the evaluation of essential and derived attributes in primary care, in the professional version. For data analysis, the Content Validation Index (CVI ≥ 0.8) and Cronbach’s Alpha were calculated.
Results:
a higher percentage of judges among nurses (61.5%) was observed; with a doctorate (46.2%), and engaged in teaching and research (77%). The overall Content Validation Index of the instrument was 0.98. In the analysis of Cronbach’s Alpha of the instrument, the assigned value was 0.717.
Conclusions:
the instrument represents an advancement in the measurement of health evaluation policies and can significantly contribute to improving the quality of care provided to children and adolescents with leprosy.
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ORIGINAL ARTICLE07-19-2024
Validation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
Abstract
ORIGINAL ARTICLEValidation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
DOI 10.1590/0034-7167-2023-0211
Views0See moreABSTRACT
Objectives:
to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles.
Methods:
this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach’s alpha test, and z-test for proportion comparison were used.
Results:
the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership.
Conclusions:
the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.
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REVIEW07-19-2024
Nursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
Abstract
REVIEWNursing care for hospitalized older adults – fall accidents versus safe mobility: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230180
DOI 10.1590/0034-7167-2023-0180
Views0See moreABSTRACT
Objectives:
to map the constituent elements of the safe mobility concept present in hospital care for older adults.
Methods:
a scoping review of 35 articles searched in databases and gray literature – BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Theses and Dissertations Catalog. No time or language cut-off was established.
Results:
none of the studies presented a clear safe mobility concept, however its constituent elements involve factors related to patient (behavioral factors, conditions, diseases, signs and symptoms, nutritional status, age, balance, strength, gait quality, sleep), the institution (environment, treatment devices, guidelines, medications and polypharmacy, material and human resources and clothing/shoes) and the nature of the interventions (related to the patient, institution and family).
Final Considerations:
the constituent elements of safe mobility express hospital units’ capacity to guarantee care and protection from fall accidents for hospitalized older adults.
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REVIEW07-19-2024
Drug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
Abstract
REVIEWDrug-resistant tuberculosis: integrative review of nursing care in primary health care
Revista Brasileira de Enfermagem. 2024;77(2):e20230097
DOI 10.1590/0034-7167-2023-0097
Views0See moreABSTRACT
Objectives:
to identify, in the scientific literature, the care that should be provided to individuals with drug-resistant tuberculosis by nurses in primary health care.
Methods:
integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses study selection flowchart. Data collection was conducted in November 2022, across ten databases.
Results:
six studies emphasized that nurses should perform directly observed treatment; two highlighted the importance of integrated care management between tuberculosis and human immunodeficiency virus; two demonstrated comprehensive nursing consultation using the nursing process; one emphasized person-centered care, with discharge planning and improved hospital communication with primary health care services.
Final Considerations:
the care that nurses should provide to individuals with drug-resistant tuberculosis in primary health care, for care resolution, is evidence-based.
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ORIGINAL ARTICLE07-19-2024
Translation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
Abstract
ORIGINAL ARTICLETranslation and cross-cultural adaptation of the MISSCARE Survey-Ped into Brazilian Portuguese
Revista Brasileira de Enfermagem. 2024;77(2):e20230060
DOI 10.1590/0034-7167-2023-0060
Views0See moreABSTRACT
Objectives:
to translate and cross-culturally adapt the MISSCARE Survey-Ped for use in Brazil.
Methods:
a methodological study proposed by translation, synthesis of translations, back-translation, assessment by a committee of experts and pre-testing with the target population.
Results:
two direct translations of the instrument were carried out, followed by a consensual version between them. This synthetic version was back-translated and analyzed by a committee of five experts in pediatric nursing and patient safety, obtaining a Content Validity Index (CVI) of 0.95 and Cronbach’s alpha of 0.804. The final version was sent for pre-testing with 254 Brazilian pediatric nurses, with 44 (17.3%) analyzing the instrument for understanding (CVI 0.866; Content Validity Ratio (CVR) 0.773), relevance (CVI 0.931; CVR 0.864) and relevance (CVI 0.977; CVR 0.955).
Conclusions:
the MISSCARE Survey-Ped Brasil was considered suitable for application in pediatric nurses’ clinical practice in the country.
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Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301pt
Views0Na concepção comum, o trabalho é comumente associado a uma atividade remunerada em uma sociedade mercantil e de direito, refletindo a visão moderna que o limita ao tempo trocado por salário. Essa perspectiva, influenciada pelos princípios da Revolução Industrial, estabelece uma dicotomia entre o trabalho e o tempo fora dele, segmentando a vida em esferas […]See more -
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301
Views0In the common conception, work is commonly associated with a paid activity in a commercial and legal society, reflecting the modern view that limits it to time exchanged for wage. This perspective, influenced by Industrial Revolution principles, establishes a dichotomy between work and time outside of work, segmenting life into professional and private spheres. However, […]See more
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