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Prevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
Abstract
Prevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
DOI 10.1590/0034-7167.2016690416i
Views0See moreABSTRACT
Objective:
to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients.
Method:
this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil.
Results:
ten problems regarding nursing practices for prevention and monitoring of delirium were identified. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported significant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation.
Conclusion:
the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments.
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Technology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
Abstract
Technology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
DOI 10.1590/0034-7167.2016690415i
Views0See moreABSTRACT
Objective:
to understand the experience of mothers of technology-dependent children as regards pharmaceutical care.
Method:
this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis.
Results:
this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks.
Conclusion:
pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.
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Fasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
Abstract
Fasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
DOI 10.1590/0034-7167.2016690414i
Views0See moreABSTRACT
Objective:
to verify the occurrence of intraoperative and postoperative complications in patients undergoing urgent and emergency surgical procedures between January and December 2012, with fasting time of less than 8 hours.
Method:
a quantitative study was conducted, of the retrospective cohort type, through the analysis of medical records.
Results:
we included 181 records of patients undergoing surgical procedures with average duration of 59.4 minutes. Fractures correction surgeries stood out, totalling 32% of cases. We observed complications in 36 patients (19.9%), vomiting being the most prevalent (47.2%); followed by nausea (16.7%); need for blood transfusion (13.9%); surgical site infection (11.1%); and death (11.1%). The average fasting time was 133.5 minutes. The fasting time showed no statistically significant correlation with the complications investigated.
Conclusion:
intraoperative and postoperative complications were associated with the clinical conditions of the patients and not with the fasting time.
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Validation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
Abstract
Validation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
DOI 10.1590/0034-7167.2016690413i
Views1See moreABSTRACT
Objective:
to translate and validate to Portuguese the Debriefing Experience Scale jointly with individuals that used high-fidelity simulation in learning.
Method:
methodological and exploratory study for an instrument translation and validation. For the validation process, the event “III Workshop Brazil – Portugal: Care Delivery to Critical Patients” was created.
Results:
103 nurses attended. Validity and reliability of the scale, the correlation pattern among variables, the sampling adequacy test, and the sphericity test showed good results. Since there was no relationship among the groups established in the exploratory factor analysis, the option was to follow the division established by the original version.
Conclusion:
the version of the instrument was called Escala de Experiência com o Debriefing. The results showed good psychometric properties and a good potential for use. However, further studies will contribute to consolidate the validity of the scale and strengthen its potential use.
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Factor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
Abstract
Factor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
DOI 10.1590/0034-7167.2016690412i
Views0See moreABSTRACT
Objective:
to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients.
Method:
the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach’s alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance.
Conclusion:
future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.
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RESEARCH01-01-2016
Associação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
RESEARCHAssociação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreRESUMEN
Objetivo:
investigar la asociación entre la fragilidad y la internación e institucionalización, en un estudio de acompañamiento de residentes ancianos.
Método:
el estudio de acompañamiento fue realizado en 2008 y 2013, con ancianos de ambos sexos, de 65 años o más, los cuales vivían en la comunidad. El procedimiento de muestreo realizado fue probabilístico, con agrupamiento en dos etapas. Fueron entrevistados 512 ancianos en 2008 y 262 en 2013. Datos socioeconómicos y demográficos, morbilidad relatada por los mismos y datos específicos de internación e institucionalización han sido utilizados. La fragilidad fue medida por la escala Edmond Frail Scale (EFS) y la capacidad funcional por la escala Functional Independence Measure (FIM).
Resultados:
El promedio de la puntuación EFS fue mayor entre los residentes ancianos que fueron internados y hospitalizados, siendo estadísticamente significativa en los dos años investigados.
Conclusión:
La confirmación de la asociación entre la fragilidad y la internación e institucionalización refuerza la importancia del tema y enfatiza la fragilidad como un instrumento importante en la evaluación de los riesgos para estos eventos adversos.
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Association of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
Association of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreABSTRACT
Objective:
to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents.
Method:
the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure.
Results:
we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years.
Conclusion:
the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.
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Analysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
Abstract
Analysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
DOI 10.1590/0034-7167.2016690410i
Views0ABSTRACT
Objective:
analyze healthcare and managerial indicators after nursing personnel upsizing.
Method:
a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed.
Results:
increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed.
Conclusion:
nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.
Keywords:AbsenteeismHealth Care Quality IndicatorsHospital Nursing StaffHospital Personnel AdministrationPatient SafetySee more
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Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Research lines in nursing: phylosophical and epistemological highlights
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMEN
Objetivo:
elucidar destaques filosóficos y epistemológicos mediante consideraciones en favor de la casualidad de cuestiones en el interés de la Enfermería.
Método:
es fundamentado en las proposiciones teóricas de Johannes Hessen y de otros autores consagrados.
Resultados:
clareamiento de aspectos sustantivo e implicaciones adjetivas no sólo el interés de la investigación, resaltando los significados esenciales del asunto coincidido con las elaboraciones de disertaciones y tesis (Maestría y Doctorado de Enfermería).
Conclusión:
texto representa una contribución valiosa para esclarecer mejor detalles de la construcción del conocimiento en la temática y problemática del asunto puesto en causa.
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Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
Abstract
Linhas de pesquisa em enfermagem: destaques filosóficos e epistemológicos
Revista Brasileira de Enfermagem. 2015;68(4):723-729
DOI 10.1590/0034-7167.2015680421p
Views0See moreRESUMO
Objetivo:
elucidar destaques filosóficos e epistemológicos mediante considerações significativas, essenciais, em favor da causalidade de questões no interesse da Enfermagem.
Método:
abordagem fundamentada nas proposições teóricas de Johannes Hessen, com referência a outros autores expertos no tema.
Resultados:
esclarecimento de aspectos substantivos e implicações adjetivas não só no interesse da investigação, ressaltando os significados essenciais do assunto, condizente com as elaborações de dissertações de mestrado e teses de doutorado de Enfermagem.
Conclusão:
trata-se de uma contribuição valiosa para esclarecer melhor detalhes da construção do conhecimento na temática e problemática do assunto posto em causa, as linhas de pesquisa em enfermagem.
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Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
Abstract
Using the theory of meaningful learning in nursing education
Revista Brasileira de Enfermagem. 2015;68(4):713-722
DOI 10.1590/0034-7167.2015680420i
Views0See moreABSTRACT
Objective:
to synthesize the scientific literature about the Theory of Meaningful Learning in the process of teaching and learning in nursing.
Method:
this is an integrative review conducted in the databases MEDLINE, LILACS, SciELO, BDENF and CINAHL with studies addressing the subject or aspects of the theory of meaningful learning of David Ausubel. Ten studies were included, from which six were written in Portuguese and four in English, published from 1998 to 2013.
Results:
five studies used the theory of meaningful learning, four studies cited Ausubel as the author of this theory and only two studies followed the framework for the application of the theory completely. There are only a few studies on this subject and those which explore it are not correlated with Ausubel’s theory.
Conclusion:
it is necessary to break with the dichotomy between theory and practice and promote the articulation of content with action, introducing the student as the author of their own knowledge.
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Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
Abstract
Nursing scientific production on health promotion, chronic condition, and aging
Revista Brasileira de Enfermagem. 2015;68(4):705-712
DOI 10.1590/0034-7167.2015680419i
Views1See moreABSTRACT
Objective:
to characterize the scientific production of Postgraduate Programs Nursing in Brazil on health promotion with a focus on elderly people with chronic conditions in the period from 2006 to 2010.
Method:
integrative research developed by searching for dissertations and theses in the database of the Center for Nursing Studies and Research of the Brazilian Nursing Association published in the period from 2006 to 2010 and which focused on health promotion for elderly people with chronic conditions.
Results:
five themes emerged: “Living with the disease”; “Technologies of care”, “Potential for self-care” “Psycho-spiritual dimension”, and “Family caregiver”.
Conclusion:
it was possible to identify nursing care as a key element to promote the health of elderly people and make them more independent in their care so as to live with their limitations or disabilities, even when affected by chronic diseases.
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Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
Abstract
Longevity according to life histories of the oldest-old
Revista Brasileira de Enfermagem. 2015;68(4):697-704
DOI 10.1590/0034-7167.2015680418i
Views0See moreABSTRACT
Objective:
to interpret life histories of the oldest-old in a community, grounded on the perspective of the Active Aging and Life Course.
Method:
this is a qualitative research. Participants included twenty seniors 80 years and older, users of a Basic Health Unit. Life histories were collected and analyzed according to the proposition of the Autobiographical Narrative Interview.
Results:
during the analytic process, elements found in the elders’ present and past arose, contributing to the development of a theoretical model: “Building longevity along the life course.”
Conclusion:
longevity is rooted in the past, strongly infl uenced by the family culture and life course; assumptions of the Active Aging are more meaningful in the informants’ present trajectory. The content of the narratives pointed to new possibilities of Gerontology Nursing intervention in Primary Care, aiming at health promotion and intervention, specially grounded on the respect to the oldest-elders’ culture.
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Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
Abstract
Accuracy in inference of nursing diagnoses in heart failure patients
Revista Brasileira de Enfermagem. 2015;68(4):690-696
DOI 10.1590/0034-7167.2015680417i
Views0See moreABSTRACT
Objective:
to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients.
Method:
descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating effi cacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected.
Results:
the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identifi ed by the nursing evaluators.
Discussion:
the search for improving diagnostic accuracy reaffi rms the need for continuous and specifi c training to improve the diagnosis capability of nurses.
Conclusion:
the training allowed the exercise of clinical judgment and better accuracy of nurses.
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Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
Abstract
Direct cost of development and documentation of the nursing process
Revista Brasileira de Enfermagem. 2015;68(4):683-689
DOI 10.1590/0034-7167.2015680416i
Views0See moreABSTRACT
Objective:
identify the average direct cost (ADC) of the activities performed by nursing professionals in the nursing process development and documentation at the medical clinic of a teaching hospital.
Method:
1040 activities were observed and the ADC was calculated by multiplying the time spent by professionals by the unit cost of direct labor.
Results:
the ADC of patient admission was R$ 55.57 (SD=19.44); among the activities of patient follow-up, the assessment phase documentation had the most significant ADC (R$ 17.70 – SD=14.60); the ADC of descriptive records corresponded to R$ 1.21 (SD=1.21) and the ADC of the nursing team for shift change was R$ 54.23 (SD=28.95).
Conclusion:
the study promotes visibility of the work performed by nursing professionals in the development of the nursing process, providing financial data to ensure consistent arguments for proper resources to its feasibility.
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Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
Abstract
Health status and mental health in patients after percutaneous coronary intervention
Revista Brasileira de Enfermagem. 2015;68(4):676-682
DOI 10.1590/0034-7167.2015680415i
Views0See moreABSTRACT
Objective:
to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge.
Method:
a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains.
Results:
There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3.
Conclusion:
Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
Abstract
Leads for potentializing groups in Primary Health Care
Revista Brasileira de Enfermagem. 2016;69(5):964-971
DOI 10.1590/0034-7167-2015-0102
Views0ABSTRACT
Objective:
to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants.
Method:
This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis.
Results:
the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership.
Conclusion:
the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.
Keywords:Group ProcessesGroup StructureHealth PromotionNursing in Community HealthPrimary Health CareSee more -
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
Abstract
Intimate partner violence in adolescence: an analysis of gender and generation
Revista Brasileira de Enfermagem. 2016;69(5):946-955
DOI 10.1590/0034-7167-2016-0408
Views0ABSTRACT
Objective:
to analyze the intimate partner violence in adolescence from the perspective of gender and generation.
Method:
Quantitative, descriptive, and exploratory research. 111 adolescents participated in this study, with ages from 15 to 19 years old.
Results:
We found that 91% of participants have perpetrated and 90.1% have undergone at least one of the natures of violence. The intimate partner violence in adolescence constitutes a form of gender violence, and gender constructions have determined the suffered and perpetrated aggressions, possibly also determining the naturalization and legitimization of such aggressions. The inequality of power between generations may determine greater vulnerability of youngsters to the phenomenon.
Conclusion:
The historical and social construction of masculinity and femininity and the power inequalities set by these constructions converge with the power inequality between generations. Thus, gender and generation are determinants of intimate partner violence in adolescence, as well as of the vulnerability of adolescents to this phenomenon.
Keywords:AdolescentAdolescent HealthGender and HealthIntimate Partner ViolenceViolence Against WomenSee more -
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
Abstract
Hospitalization anxiety in children: conceptual analysis
Revista Brasileira de Enfermagem. 2016;69(5):940-945
DOI 10.1590/0034-7167-2015-0116
Views0See moreABSTRACT
Objective:
to analyze the concept “hospitalization anxiety in children”, identifying its antecedents, attributes, and consequences, with the objective of clarifying its meaning.
Method:
we used a conceptual analysis model, whose objective is to clarify the meaning of terms.
Results:
we identified the concept antecedents and its attributes, classified as biological and psychological needs, which are essential characteristics of “hospitalization anxiety in children”. This process consequences have also been identified. We proceeded to the analysis of the characteristics with emphasis on the impacts of the hospitalization process on the child and on the family.
Conclusion:
based on the conceptual analysis of the phenomenon, it was possible to identify the antecedents, attributes, and consequences of Hospitalization Anxiety in children. We recommend the continuation of the study validating the essential characteristics presently identified as a way to join knowledge gathered and professional practice.
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Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
Abstract
Stroke: patient characteristics and quality of life of caregivers
Revista Brasileira de Enfermagem. 2016;69(5):933-939
DOI 10.1590/0034-7167-2015-0064
Views0See moreABSTRACT
Objective:
to investigate the association between the domains of health-related quality of life of family caregivers and sociodemographic characteristics of individuals with stroke sequelae.
Method:
descriptive, cross-sectional, quantitative research, conducted with 136 family caregivers of individuals with stroke sequelae by means of home interviews from April to June 2013.
Results:
we found that caregivers of individuals aged under 65 years, married, with 10 to 12 years of formal education, presented higher scores, respectively, in the domains ‘Social aspects’, ‘Emotional aspects’, and ‘Mental health’. However, caregivers of patients with higher degree of disability obtained lower score in the ‘Mental Health’ domain.
Conclusion:
the results foster reflection on the need of including the family caregivers of individuals with stroke sequelae in the planning of care provided by health professionals.
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A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
Abstract
A quasi-experimental nursing study on pain in comatose patients
Revista Brasileira de Enfermagem. 2016;69(5):927-932
DOI 10.1590/0034-7167-2015-0121
Views0See moreABSTRACT
Objective:
to verify whether comatose patients feel pain during the bed bath nursing procedure.
Method:
nineteen patients aged 61 ± 17.39 years participated in the study. A quantitative analysis was conducted on the P substance (PS) in the saliva collected before and during a bed bath, using the ELISA method. Program Graph Pad Prisma 6 was used to analyze the data. The verification of normality was made through the Shapiro Wilk test, which determined the choice for the Wilcoxon nonparametric test.
Results:
the study showed a statistically significant increase (∆= 5.62%, p<0.001) in the PS level of the patients studied during the nursing procedure.
Conclusion:
when caring for comatose patients during a bed bath, professionals cause or add painful stimuli; therefore, they feel pain.
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Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
Abstract
Quality of nursing care: instrument development and validation
Revista Brasileira de Enfermagem. 2016;69(5):920-926
DOI 10.1590/0034-7167-2015-0151
Views0See moreABSTRACT
Objectives:
to describe the development and validation process of a scale to measure the nurses’ perception of the activities that contribute to nursing care quality.
Method:
methodological study based on a literature review, the opinion of experts and the experience of study investigators. An instrument was designed containing six dimensions and 25 items, applied as a questionnaire to 775 nurses from a hospital in northern Portugal, from May to July 2014. The instrument validation used an exploratory factor analysis and an internal consistency assessment of each factor/dimension.
Results:
the factor analysis indicated the need to adjust the original composition of the scale, which then received one more dimension, totaling seven dimensions and the same 25 items, and presented a high internal consistency (Cronbach’s alpha of 0.940).
Conclusion:
the final version of the scale presents adequate psychometric properties, with potential use in future studies.
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