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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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ORIGINAL ARTICLE06-16-2021
Patient participation in care safety: Primary Health Care professionals’ perception
Revista Brasileira de Enfermagem. 2021;74(2):e20200773
Abstract
ORIGINAL ARTICLEPatient participation in care safety: Primary Health Care professionals’ perception
Revista Brasileira de Enfermagem. 2021;74(2):e20200773
DOI 10.1590/0034-7167-2020-0773
Views0See moreABSTRACT
Objectives:
to analyze health professionals’ perception about the meaning and practice of patient involvement in care safety in Primary Health Care.
Methods:
this is an exploratory, qualitative study, developed with 22 professionals in the Federal District, Brazil. A semi-structured interview was conducted between October and November/2018. Content analysis was carried out according to Bardin.
Results:
nurses, physicians, dentists, among others, participated. The following categories emerged: Meaning of patient involvement in care safety; Factors intervening in patient involvement in care safety; Strategies for patient involvement in care safety; Qualification for patient involvement in care safety.
Final Considerations:
the meaning of patient involvement for care safety was associated with co-responsibility and patient-centered care. Professionals’ practice revealed intervening factors and the use of involvement strategies. A gap was identified in training on patient involvement in care safety.
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REVIEW03-30-2020
Internet influence on the biopsychosocial health of adolescents: an integratitive review
Revista Brasileira de Enfermagem. 2020;73(2):e20180766
Abstract
REVIEWInternet influence on the biopsychosocial health of adolescents: an integratitive review
Revista Brasileira de Enfermagem. 2020;73(2):e20180766
DOI 10.1590/0034-7167-2018-0766
Views0See moreABSTRACT
Objectives:
To identify scientific evidence on the influence of internet use on adolescents’ biopsychosocial health.
Methods:
Integrative review, with database search, using the descriptors “internet”, “adolescent health” and “adolescent behavior”. After applying the inclusion and exclusion criteria, 16 articles were selected.
Results:
Knowledge convergence produced for three main themes was demonstrated: “Internet exposure time and possible damages to adolescent health”; “Internet, adolescent and cyberbullying”; and “Internet as a source of information for adolescent health”.
Final considerations:
The network involves an intricate network of interactions, providing varied behaviors and attitudes that reflect on adolescent health. Therefore, it is important to articulate nursing actions with the school community and the family, in order to carry out health education.
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REFLECTION07-10-2020
Psychosocial risks and the health of health workers: reflections on Brazilian labor reform
Revista Brasileira de Enfermagem. 2020;73:e20190092
Abstract
REFLECTIONPsychosocial risks and the health of health workers: reflections on Brazilian labor reform
Revista Brasileira de Enfermagem. 2020;73:e20190092
DOI 10.1590/0034-7167-2019-0092
Views0See moreABSTRACT
Objective:
to reflect on the psychosocial risks and their impacts on the health of health workers in light of the Brazilian economic context and Labor Reform.
Method:
reflective study on the Brazilian Labor Reform and its impacts on health of health workers.
Results:
although the changes observed in the labor sphere have contributed to improvements in health and safety policies for, these changes have also contributed to the emergence of new risks arising from work activities, including psychosocial risks, which affect all occupational categories.
Final considerations:
we understand that the Brazilian Labor Reform carried out in 2017 leads to the weakening of labor relations, increases workers’ exposure to risks in the workplace, increases the risk of illness, and opposes the global movement of international organizations aimed at the prevention of aggravation in workers’ health and also at preserving their health.
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REVIEW06-17-2020
The role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
Abstract
REVIEWThe role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
DOI 10.1590/0034-7167-2019-0031
Views0See moreABSTRACT
Objectives:
to know the nursing interventions in the identification, prevention and control of sepsis in critical patients.
Methods:
integrative review of the literature, with two parallel researches using different MesH terms, using the EBSCO database and Google Scholar. Nine studies were included in the sample.
Results:
nursing interventions are centered on the creation/implementation of protocols for the early recognition of sepsis, the training of teams to ensure a safe and effective approach and the adoption of measures for infection prevention and control as a way to prevent sepsis.
Final Considerations:
the evidence shows that nurses are fundamental in the early identification, control and prevention of sepsis, preventing disease progression and contributing to decreased morbidity and mortality.
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ORIGINAL ARTICLE05-15-2020
Configuration of power relations in physicians and nurses’ professional practices
Revista Brasileira de Enfermagem. 2020;73:e20180629
Abstract
ORIGINAL ARTICLEConfiguration of power relations in physicians and nurses’ professional practices
Revista Brasileira de Enfermagem. 2020;73:e20180629
DOI 10.1590/0034-7167-2018-0629
Views0See moreABSTRACT
Objective:
to analyze the configuration of power relations constituted in and by the knowledge and daily practices of physicians and nurses in an Intensive Care Unit (ICU).
Method:
qualitative study in which data were collected through interviews with physicians and nurses from an ICU of a hospital in Belo Horizonte, Minas Gerais. A semi-structured script was used. Data were analyzed through discourse analysis in a Foucaultian perspective.
Results:
three categories were developed – Professional Identity: self-recognition in the profession; Discipline: individualizing attitudes or collective need?; and Circularity of knowledge and power in the constitution of daily practices.
Final considerations:
the identity, discipline and circulation of power are connected in a continuous movement of subjectivation of the subject, which, in turn, uses discourse as a persuasion strategy to modify the position taken over in different situations thereby causing the circulation of power.
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ORIGINAL ARTICLE02-10-2020
Theater of the Oppressed and bullying: nursing performance in school adolescent health
Revista Brasileira de Enfermagem. 2020;73(1):e20170910
Abstract
ORIGINAL ARTICLETheater of the Oppressed and bullying: nursing performance in school adolescent health
Revista Brasileira de Enfermagem. 2020;73(1):e20170910
DOI 10.1590/0034-7167-2017-0910
Views0See moreABSTRACT
Objective:
to assess the effects of an intervention based on the Theater of the Oppressed in reducing school bullying.
Method:
a quasi-experimental study with 232 first-year high school students from two public schools in the city of Cuiabá, Mato Grosso State, Brazil. An intervention was performed with the Theater of the Oppressed, a theatrical methodology created by Augusto Boal and inspired by Paulo Freire’s “Pedagogy of the Oppressed”, in which one school composed the intervention group, and another school, the comparison group. Both groups were assessed for involvement in bullying situations before and after intervention. For data analysis, Poisson Regression models with random effect were used.
Results:
intervention group presented a significant decrease in direct victimization (physical and verbal aggression).
Conclusion:
the Theater of the Oppressed represents an important strategy in reducing bullying victimization among school adolescents.
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ORIGINAL ARTICLE02-10-2020
Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort
Revista Brasileira de Enfermagem. 2020;73(1):e20180162
Abstract
ORIGINAL ARTICLECommon Mental Disorders and Contemporary Factors: 1982 Birth Cohort
Revista Brasileira de Enfermagem. 2020;73(1):e20180162
DOI 10.1590/0034-7167-2018-0162
Views0See moreABSTRACT
Objective:
To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort.
Method:
Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations.
Results:
Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD.
Conclusion:
It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.
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REVIEW12-21-2020
Lean Six Sigma methodology application in health care settings: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190861
Abstract
REVIEWLean Six Sigma methodology application in health care settings: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190861
DOI 10.1590/0034-7167-2019-0861
Views0See moreABSTRACT
Objective:
to analyze the scientific production on the results of Lean Six Sigma methodology in health care institutions.
Methods:
an integrative literature review, with the following question: what are the results in health institutions using Lean Six Sigma and Six Sigma methodology? The search was carried out at MEDLINE, LILACS, BDENF, CINAHL, Web of Science, and Scopus, with no time frame.
Results:
thirty-four articles were included, published between 2005 and 2019, of which 52.9% came from the United States of America. The most commonly found improvements were in hospital institutions and from the perspective of customers and internal processes.
Conclusion:
using Lean Six Sigma methodology proved to be effective in the different health care settings, evidencing a gap in its application regarding people engagement and training.
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