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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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REVIEW12-21-2020
Strategies and competences of nurses in men’s health care: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190546
Abstract
REVIEWStrategies and competences of nurses in men’s health care: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190546
DOI 10.1590/0034-7167-2019-0546
Views0See moreABSTRACT
Objectives:
to synthesize scientific evidence on nurses’ strategies and competencies in men’s health care.
Methods:
an integrative review carried out in seven databases, with a time frame from 2009 to 2019, using the descriptors “men’s health”, “professional competence”, “nursing”, “nursing care” and “male” in Portuguese and in English.
Results:
ten articles were selected, in which it was demonstrated that nursing professionals develop their professional practices with regard to men’s health care, in convergence with the general skills of the profession. The most used are health care; decision-making; Communication; administration; management; continuing education and leadership, consecutively.
Final Considerations:
professionals’ efforts to strengthen health actions, aimed at male needs, in accordance with the general skills of the profession and the principles and guidelines of the Brazilian National Policy for Comprehensive Care to Men’s Health.
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ORIGINAL ARTICLE12-04-2020
“The pen is the blade, my skin the paper”: risk factors for self-injury in adolescents
Revista Brasileira de Enfermagem. 2020;73:e20200578
Abstract
ORIGINAL ARTICLE“The pen is the blade, my skin the paper”: risk factors for self-injury in adolescents
Revista Brasileira de Enfermagem. 2020;73:e20200578
DOI 10.1590/0034-7167-2020-0578
Views0See moreABSTRACT
Objective:
to describe the risk factors that influence the self-injury behavior of adolescents assisted at a Psychosocial Care Center for Children and Adolescents, according to subjects’ own perceptions.
Method:
a descriptive, exploratory, qualitative study carried out through medical records and a focus group with 07 adolescents. The statements were submitted to thematic content analysis.
Results:
in the risk factors category, four subcategories emerged: Family adversity factors; Social contagion; Adverse life events; Personal characteristics. Conflicts, lack of support, drug use in the family, meeting someone who cuts themselves, social networks, religiosity, history of sexual violence and bullying were identified as risk factors that influence self-injury.
Final Considerations:
adolescents pointed out the need for prejudice-free dialogues in schools, in health and family devices, configuring protective factors to avoid this practice that comes from several negative events throughout life.
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REVIEW11-25-2020
Auriculotherapy and reducing chronic musculoskeletal pain: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190394
Abstract
REVIEWAuriculotherapy and reducing chronic musculoskeletal pain: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190394
DOI 10.1590/0034-7167-2019-0394
Views0See moreABSTRACT
Objectives:
to describe the scientific evidence on the use of auriculotherapy to reduce chronic musculoskeletal pain in adults and the elderly.
Methods:
integrative literature review conducted in the Latin American and Caribbean Health Sciences, SciVerse Scopus and MEDLINE databases (via National Library of Medicine), in March 2019, with no time frame.
Results:
14 original scientific articles were analyzed, 64.3% of which were classified with level of evidence 2. All productions show the benefit of auriculotherapy in reducing chronic musculoskeletal pain, especially in the lumbar spine (42.9%). The treatment was developed in one or more sessions, using semi-permanent needles (42.9%) and electro-auriculotherapy (21.4%).
Conclusions:
auriculotherapy was effective in reducing chronic musculoskeletal pain, showing itself as an alternative to be used for the promotion and recovery of individuals’ health.
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REVIEW09-18-2020
Allocation of resources for health care in COVID-19 pandemic times: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200244
Abstract
REVIEWAllocation of resources for health care in COVID-19 pandemic times: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200244
DOI 10.1590/0034-7167-2020-0244
Views0See moreABSTRACT
Objective:
To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020.
Methods:
This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected.
Results:
It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded.
Final considerations:
The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated.
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REFLECTION07-10-2020
In defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
Abstract
REFLECTIONIn defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
DOI 10.1590/0034-7167-2020-0247
Views0See moreABSTRACT
Objective:
To discuss the political and structural conditions for establishing the Unified Health System (UHS – Sistema Único de Saúde, SUS) in coping with the SARS-CoV-2 pandemic.
Methods:
Theoretical-reflection study.
Results:
At the first moment named “The global and the local in facing the SARS-CoV-2 pandemic” is presented the health crisis that took place worldwide and the government actions to combat COVID-19. A second moment named “Between dismantling actions and resistance, the UHS is the best way to face the SARS-CoV-2 pandemic”, reflects on the neoliberal attacks on the health system and how it resists, remaining the main pandemic response strategy.
Conclusion:
The strengthening of democracy and the defense of the UHS are the way out of the crisis. It is believed that this reflection generates – in everyone who deals with caretaking – the political action, the ethical attitude, the desire for valorization and the spirit of struggle in defense of the UHS and human life.
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REVIEW05-28-2021
Scientific production about palliative care and communication in online journals: a scoping review
Revista Brasileira de Enfermagem. 2021;74(2):e20190378
Abstract
REVIEWScientific production about palliative care and communication in online journals: a scoping review
Revista Brasileira de Enfermagem. 2021;74(2):e20190378
DOI 10.1590/0034-7167-2019-0378
Views0See moreABSTRACT
Objectives:
to characterize publications about palliative care and communication, with an emphasis on the approaches addressed, disseminated in online journals.
Methods:
it is a scope review, in which the mnemonic strategy Problem, Concept and Context was used, based on database research. The sample consisted of 86 publications.
Results:
most publications were written in the English language, published in the journal BMC Palliative Care, and with level of evidence IV. As for the approaches approached, the following stand out: Importance of communication in palliative care; Breaking the bad news in palliative care; Training professionals/staff to communicate in palliative care; and Communication strategies in palliative care.
Final Considerations:
the review made it possible to map a significant number of publications on palliative care and communication. It is recommended to produce new studies with better scientific evidence that guide the assistance of health professionals.
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ORIGINAL ARTICLE12-13-2019
Quality of life in the climacteric of nurses working in primary care
Revista Brasileira de Enfermagem. 2019;72:154-161
Abstract
ORIGINAL ARTICLEQuality of life in the climacteric of nurses working in primary care
Revista Brasileira de Enfermagem. 2019;72:154-161
DOI 10.1590/0034-7167-2018-0306
Views0See moreABSTRACT
Objective:
to evaluate the quality of life of primary care nurses in the climacteric.
Method:
A cross-sectional descriptive-analytic study, performed with 98 female nurses, aged 40-65 years, using the WHOQOL-Bref questionnaire.
Results:
the worst level of quality of life was observed for professionals aged 50-59 years, non-white, specialists, divorced or widowed, with children, a lower income, with another employment relationship, a weekly workload of more than 40 hours, who consumed alcoholic beverages weekly, with chronic disease, in continuous use of medications, sedentary, who did not menstruate and did not receive hormonal treatment, and who went through menopause between the ages of 43-47 years.
Conclusion:
Although the variables “physical activity” and “age” have a statistically significant association with quality of life, other variables seem to interfere in these professionals’ lives, indicating the need for a more critical and deep reflection on these relations.
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ORIGINAL ARTICLE09-21-2020
Incontinence associated dermatitis in elderly people admitted to a university hospital
Revista Brasileira de Enfermagem. 2020;73:e20190374
Abstract
ORIGINAL ARTICLEIncontinence associated dermatitis in elderly people admitted to a university hospital
Revista Brasileira de Enfermagem. 2020;73:e20190374
DOI 10.1590/0034-7167-2019-0374
Views0See moreABSTRACT
Objective:
To identify the frequency and factors associated to incontinence associated dermatitis in elderly people.
Methods:
Cross-sectional study with 202 elderly patients admitted to a university hospital between September 2017 and January 2018. Data collection included: cognitive screening, sociodemographic and clinical questionnaire. It was performed exploratory and descriptive analysis, where prevalence and ratios (PR) were calculated.
Results:
Prevalence of injury was 9.4%, age range 70-79 years (13.5%), African American (21.4%), hospitalization period ≥ 21 days (44.4%), in use of nasogastric tube (33.3%), medical device (11.3%), restricted mobility (18.5%). It was associated with hospitalization period, use of nasogastric tube, restricted mobility, medical devices, and cognition.
Conclusion:
It was confirmed an average frequency of incontinence associated dermatitis in elderly patients and association to factors such as hospitalization period, immobility, cognition, use of nasogastric tube and devices. It must be highlighted the importance of prevention measures, early detection, assessment and monitoring of this type of injury.
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