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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
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Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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ORIGINAL ARTICLE07-29-2024
Mental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
Abstract
ORIGINAL ARTICLEMental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
DOI 10.1590/0034-7167-2023-0457
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Objective:
To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health.
Methods:
exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis.
Results:
parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression.
Final considerations:
It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.
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07-29-2024
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
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Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
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Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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ORIGINAL ARTICLE07-29-2024
Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
Abstract
ORIGINAL ARTICLEDisrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
DOI 10.1590/0034-7167-2023-0464
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Objectives:
to develop and evaluate a Middle-Range Theory for the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” in high-risk pregnancies.
Methods:
this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem’s General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80.
Results:
the theory identified 20 elements of the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80.
Conclusions:
the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon “Disrupted Mother-Fetus Dyad Risk,” which aids in nurses’ diagnostic reasoning.
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
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Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
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ORIGINAL ARTICLE07-29-2024
Primary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
Abstract
ORIGINAL ARTICLEPrimary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
DOI 10.1590/0034-7167-2024-0468
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Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final Considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
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ORIGINAL ARTICLE07-29-2024
Completeness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
Abstract
ORIGINAL ARTICLECompleteness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
DOI 10.1590/0034-7167-2023-0467
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Objectives:
to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.
Methods:
an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.
Results:
there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables “family history of cancer” (p<0.001), “alcoholism” (p<0.001), “smoking” (p<0.001), “TNM staging” (p<0.001) had a decreasing trend, while “clinical start of treatment” (p<0.001), “origin” (p=0.008) and “occupation” (p<0.001) indicated an increasing trend.
Conclusions:
most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.
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ORIGINAL ARTICLE05-18-2020
Women in situations of sexual violence: potentialities and weaknesses of the intersectoral network
Revista Brasileira de Enfermagem. 2020;73(4):e20190856
Abstract
ORIGINAL ARTICLEWomen in situations of sexual violence: potentialities and weaknesses of the intersectoral network
Revista Brasileira de Enfermagem. 2020;73(4):e20190856
DOI 10.1590/0034-7167-2018-0856
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Objectives:
to identify potentialities and weaknesses of the intersectoral network for women in situations of sexual violence, from the perspective of Intervention Bioethics and the Universal Declaration on Bioethics and Human Rights.
Methods:
qualitative study conducted with multidisciplinary team members who work in intersectoral care services for women subject to sexual violence. It was held in a municipality in southern Brazil. An intentional sample, totaling 30 professionals. Semi-structured interview was used from January to April 2016. Interviews were analyzed by Thematic Analysis.
Results:
two categories emerged: potentialities and weaknesses related to the intersectoral network. Potentialities confirm the importance of the articulated intersectoral network; weaknesses such as lack of organized flow and disarticulation of services result in women revictimization and care fragmentation.
Final Considerations:
it is necessary to articulate services and qualify professionals. The Intervention Bioethics and the Universal Declaration on Bioethics and Human Rights foster discussions that contribute to how to organize and sustain the intersectoral network.
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REVIEW07-17-2020
Approaches to workload in psychiatric and mental health nursing
Revista Brasileira de Enfermagem. 2020;73:e20190620
Abstract
REVIEWApproaches to workload in psychiatric and mental health nursing
Revista Brasileira de Enfermagem. 2020;73:e20190620
DOI 10.1590/0034-7167-2019-0620
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Objective:
to investigate approaches to workload in psychiatric and mental health nursing in Brazilian and international production of knowledge
Methods:
integrative literature review using six databases, covering January 2005 to March 2019. Articles in full in English, Spanish and Portuguese were included.
Results:
the sample consisted of 23 original articles classified as quantitative or emotional. The quantitative dimension was addressed in 12 articles and included: assessing patient care needs, identifying activities performed by the team, measuring time spent and developing and validating a measurement instrument. The emotional dimension included 11 articles the focus of which was on identifying stressors in the workplace, psychosocial risks and coping strategies.
Conclusion:
strategies were found for measuring workload and assessing the impact of stressors on nursing teams.
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ORIGINAL ARTICLE06-24-2020
Interprofessional relationships of a patient assistance team in critical care
Revista Brasileira de Enfermagem. 2020;73(4):e20190420
Abstract
ORIGINAL ARTICLEInterprofessional relationships of a patient assistance team in critical care
Revista Brasileira de Enfermagem. 2020;73(4):e20190420
DOI 10.1590/0034-7167-2019-0420
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Objectives:
to identify perceptions of teamwork according to the professionals of an Adult Intensive Care Unit.
Methods:
descriptive research with qualitative approach. The methodological framework was thematic content analysis. The theoretical framework of the work process was used to guide the interpretation of the data. Data collection: A semi-structured interview was conducted with 38 professionals in a public teaching hospital in the state of Minas Gerais. Results: three thematic categories emerged from the interviews: Work Organization, which is related to work performed through tasks/routines, with or without coordinated actions; Non-material Work Instruments, which reveal that teamwork is based on communication/collaboration; Insufficient Material Resources, which indicate that lack of material creates conflicts between professionals.
Conclusions:
Teamwork requires effective communication and collaboration, integrated work and appropriate professional training. On the other hand, fragmentation and rigidity at work, poor collaboration/communication and lack of material make teamwork difficult. We emphasize the need to revise the curriculum of health courses, with a view to including and/or improving discussions about teamwork in order to train professionals for a more integrated and perhaps even sympathetic health practice.
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ORIGINAL ARTICLE04-09-2020
Nursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
Abstract
ORIGINAL ARTICLENursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
DOI 10.1590/0034-7167-2018-0775
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Objetives:
to analyze the ingredients of the competence that the nurses use in the performance of their work in hemotherapy.
Methods:
qualitative study with 22 nurses, accomplished through documentary study, observation and semi-structured interview, with resources of Atlas.ti software based on the foundations of Historical Materialism Dialectic and Ergology. Performed Content Analysis.
Results:
the domain of specific knowledge of hemotherapy and the time of experience in the area, allied to the motivation of the worker and the ability to work in a team favor the competent action in the work activities. On the other hand, the lack of adequate work conditions, especially in relation to adequate materials, equipment and structure, impairs the work of the nurse in hemotherapy.
Final Considerations:
experience gained is critical to successful decision making. In addition, adequate working conditions, updating of knowledge and ability in teamwork favor a scenario of safe practices.
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ORIGINAL ARTICLE08-30-2021
Historical aspects in pain management in palliative care in an oncological reference unit
Revista Brasileira de Enfermagem. 2021;74(5):e20200761
Abstract
ORIGINAL ARTICLEHistorical aspects in pain management in palliative care in an oncological reference unit
Revista Brasileira de Enfermagem. 2021;74(5):e20200761
DOI 10.1590/0034-7167-2020-0761
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Objective:
Describe the actions implemented for pain management in palliative care oncology and analyze the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute.
Methods:
Study of the history of the present time, whose sources were written documents and interviews with five participants. The collection took place from February to June 2018. The analysis of the written sources took place through internal and external criticism of the documents, considering their chronology and theme.
Results:
Professionals contributed with actions for pain management in palliative oncology care: in discussions and final drafting of ordinances, as rapporteurs at national and international events, in the elaboration of humanization conducts and systematization of assistance in addressing pain.
Final considerations:
These actions favored assistance in palliative oncology care at various levels of health care for patients and families, with greater technical and scientific recognition for all.
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06-28-2021
Validation of an instrument for systematizing nursing care in pediatrics
Revista Brasileira de Enfermagem. 2021;74:e20200222
Abstract
Validation of an instrument for systematizing nursing care in pediatrics
Revista Brasileira de Enfermagem. 2021;74:e20200222
DOI 10.1590/0034-7167-2020-0222
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Objective:
to verify the validity of indicators’ content referring to the instrument for data collection in children aged 0 to 5 years hospitalized in a pediatric clinic.
Method:
a cross-sectional methodological study was carried out with 11 experts between January and May 2018. For data collection, the steps for validating the instrument’s content were respected. For data analysis, Content Validity Index and Kappa agreement analysis were used.
Results:
after content analysis, a Content Validity Index of 0.94 and Kappa 0.71 was issued according to the experts’ suggestions 81.9%. Therefore, the instrument was suitable for applicability.
Conclusion:
the instrument proved to be valid in terms of content for pediatric care, contributing significantly to improving care for hospitalized children aged 0 to 5 years.
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06-11-2021
Severe acute postoperative pain self-reported by children after ambulatory surgeries: a cohort study
Revista Brasileira de Enfermagem. 2021;74:e20200151
Abstract
Severe acute postoperative pain self-reported by children after ambulatory surgeries: a cohort study
Revista Brasileira de Enfermagem. 2021;74:e20200151
DOI 10.1590/0034-7167-2020-0151
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Objectives:
to estimate the incidence and the risk factors for severe acute postoperative pain self-reported on the first day after hospital discharge.
Methods:
cohort study with 279 children from both sexes (5-12 years old), indicated for ambulatory surgery in two Brazilian hospitals. Children were assessed at the pre-surgery, immediate postoperative and first postoperative day. Faces Pain Scale-Revised and Yale Preoperative Anxiety Scale Modified were used. Severe postoperative pain was defined as score ≥6. Cox regression analyses were used.
Results:
the incidence of severe postoperative pain was 15.8% (95%CI:10.7%-20.4%) on the first postoperative day. Preoperative anxiety (HR=2.23; p=0.049), severe preoperative pain (HR=2.78; p=0.031) and having undergone two surgical procedures (HR=2.91; p=0.002) were associated with severe postoperative pain.
Conclusions
the incidence of severe postoperative pain self-reported after hospital discharge was high. Anxiety and severe preoperative pain, in addition to performing two surgical procedures at the same time were confirmed as risk factors.
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REFLECTION09-07-2020
Public health nursing: regulation and public health policies
Revista Brasileira de Enfermagem. 2020;73(6):e20190550
Abstract
REFLECTIONPublic health nursing: regulation and public health policies
Revista Brasileira de Enfermagem. 2020;73(6):e20190550
DOI 10.1590/0034-7167-2019-0550
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Objective:
To analyze regulation and public policies related to nursing and the specialist nurse in community and public health nursing.
Methods:
Analysis of the legal and normative framework of community and public health nursing in Portugal, as well as current public health policies, regarding the competences and intervention of this nurse, articulated with the attributions of the Public Health Unit.
Results:
The intervention of this nurse deserves a broad reflection, in the sense of maximizing the activities of community and public health, essential for the implementation of public policies and obtaining health gains.
Final considerations:
This nurse has competences foreseen in the regulations and standards for public health interventions, in line with the attributions of the Public Health Unit, of the National Health Service, in which specialties are identified for their performance in the current structure.
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