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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023DOI 10.1590/0034-7167-2022-0759
Views0See moreABSTRACT
Objectives:
to reflect on the ethical dilemmas involved in the care of patients at the end of their lives.
Methods:
this is a theoretical-reflective study based on the ethics of care proposed by Luigina Mortari.
Results:
discussing care involves addressing the ways of being inherent to human existence and understanding the unique characteristics of this condition. Ethical care constitutes an action driven by interest in the other and by the perception of their need. Ethical dilemmas are a part of end-of-life care, making it essential to maintain respectful assistance that considers the patient’s autonomy, using strategies for expressing their wishes, and ensuring continuous clear and empathetic communication among all those involved in providing care.
Final Considerations:
issues related to being, stemming from one’s reality of dependency and vulnerability, contribute to the emergence of ethical dilemmas present in care actions.
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ORIGINAL ARTICLE
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023DOI 10.1590/0034-7167-2022-0684
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Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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ORIGINAL ARTICLE
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023DOI 10.1590/0034-7167-2022-0679
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Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023DOI 10.1590/0034-7167-2022-0553
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
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ORIGINAL ARTICLE
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023DOI 10.1590/0034-7167-2022-0586
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
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ORIGINAL ARTICLE
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023DOI 10.1590/0034-7167-2022-0597
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Objective:
The study aimed to analyze the factors that affect the community’s attitude towards COVID-19 vaccination in Tangerang District.
Methods:
A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval.
Results:
Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094).
Conclusions:
Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
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ORIGINAL ARTICLE
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023
Abstract
ORIGINAL ARTICLEAssessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023DOI 10.1590/0034-7167-2023-0068
Views0See moreABSTRACT
Objective:
to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic.
Methods:
A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods.
Results:
A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029).
Conclusion:
The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.
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Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023
Abstract
Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023DOI 10.1590/0034-7167-2022-0803
Views0ABSTRACT
Objective:
To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB).
Methods:
A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software.
Results:
Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities.
Conclusions:
This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.
Keywords:COVID-19Extensively Drug-Resistant TuberculosisMicrobial Drug ResistanceMultidrug-Resistant TuberculosisTuberculosisSee more
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ORIGINAL ARTICLE
Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
05-21-2021
Abstract
ORIGINAL ARTICLEMusic in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
05-21-2021DOI 10.1590/0034-7167-2019-0838
Views0See moreABSTRACT
Objectives:
to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.
Methods:
quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.
Results:
the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.
Conclusions:
the use of music diminishes the stress and the distress of cancer patients.
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ORIGINAL ARTICLE
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
03-24-2021
Abstract
ORIGINAL ARTICLECosts of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
03-24-2021DOI 10.1590/0034-7167-2020-0275
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Objectives:
to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.
Methods:
a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.
Results:
a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).
Conclusions:
hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.
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ORIGINAL ARTICLE
Factors associated with depressive symptoms in older adults in context of social vulnerability
Revista Brasileira de Enfermagem. 2020;73:e20190107
06-01-2020
Abstract
ORIGINAL ARTICLEFactors associated with depressive symptoms in older adults in context of social vulnerability
Revista Brasileira de Enfermagem. 2020;73:e20190107
06-01-2020DOI 10.1590/0034-7167-2019-0107
Views0See moreABSTRACT
Objective:
To identify factors associated with depressive symptoms in the elderly inserted in a context of high social vulnerability.
Methods:
A cross-sectional study was carried out with 302 elderly people enrolled in Primary Care. We used a sociodemographic questionnaire, Geriatric Depression Scale, Mini Nutritional Assessment, Shor-form-6D Quality of Life Questionnaire and Medical Outcome Study Scale. For data analysis, a logistic regression was performed considering two groups, with and without depressive symptoms.
Results:
A good perception of the quality of life (OR: 0.21) and receiving emotional support (OR: 0.98) were presented as protective factors for depression, have risks of malnutrition (OR: 4.87), belong to the female sex OR: 1.88) and living alone (OR: 2.34), indicated a predictor factor for depression.
Conclusion:
Quality of life and social support were identified as protective factors for depressive symptoms while being at risk of malnutrition, living alone, reporting pain and being female are predictors.
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Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2019;72(5):1389-1396
09-16-2019
Abstract
Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2019;72(5):1389-1396
09-16-2019DOI 10.1590/0034-7167-2018-0285
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Objective:
to ascertain the epidemiological profile of TB/HIV co-infection in Brazilian scenarios.
Method:
this is a systematic review conducted via electronic search in databases PubMed, EMBASE, LILACS and SciELO, having as inclusion criterion articles based on the Brazilian scenario of TB/HIV co-infection.
Results:
of the total 174 studies, 15 were selected, revealing the epidemiological profile of the co-infection in different scenarios: male, economically active age, low education level, brown/black ethnicity, low income, heterosexual, pulmonary clinical form, alcoholism and Directly Observed Therapy.
Conclusion:
the sociodemographic and epidemiological profile of people with TB/HIV co-infection has an expected occurrence pattern, which corroborates articles found in the literature, either at national level or by grouping the studies according to region or state.
Keywords:Acquired Immunodeficiency SyndromeCo-infectionCommunity Health NursingPublic HealthTuberculosisSee more -
ORIGINAL ARTICLE
Gerontotechnology for fall prevention of the elderly with Parkinson
Revista Brasileira de Enfermagem. 2019;72:243-250
12-05-2019
Abstract
ORIGINAL ARTICLEGerontotechnology for fall prevention of the elderly with Parkinson
Revista Brasileira de Enfermagem. 2019;72:243-250
12-05-2019DOI 10.1590/0034-7167-2018-0704
Views0See moreABSTRACT
Objective:
to develop the gerontological nursing care process among the elderly with Parkinson’s disease, aiming at the promotion of health through the creation of gerontotechnologies for fall prevention.
Method:
Convergent Care Research was used as a methodological route. Data were collected from February to October 2017, with the participation of nine elderly people with Parkinson’s disease. An educational booklet, a memory game called “não cai istepô”, a memory game called “caiu de maduro” were developed through clinical evaluation through scales, recorded semi-structured interview and workshops.
Results:
the application of gerontotechnology resulted from the elderly in self-care, empowerment and knowledge through play, revealing interest in behavior change, independence and learning, as well as serving as a facilitator of care.
Conclusion:
the gerontotechnologies presented as a playful and innovative instrument for the nursing gerontological care process.
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ORIGINAL ARTICLE
Self-confidence in the care of critically ill patients: before and after a simulated intervention
Revista Brasileira de Enfermagem. 2019;72(6):1618-1623
10-21-2019
Abstract
ORIGINAL ARTICLESelf-confidence in the care of critically ill patients: before and after a simulated intervention
Revista Brasileira de Enfermagem. 2019;72(6):1618-1623
10-21-2019DOI 10.1590/0034-7167-2018-0758
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Objective:
To evaluate the self-confidence of nurses in the care of critically ill patients, before and after a simulated intervention.
Method:
A quasi-experimental study was carried out with 103 nurses who participated in a workshop on the care of critically ill patients in the first semester of 2016. A clinical simulation pedagogical instrument was used throughout the event, and self-confidence was assessed by the Portuguese version of the Self-confidence Scale (SCSvp).
Results:
Most participants reported not being prepared to provide first care to critically ill patients, which was carried out during care practice. The participants presented a significant increase in self-confidence after the simulated intervention (p<0.001) in the cardiac, neurological, and respiratory dimensions.
Conclusion:
Simulation has proved to be an effective strategy for the development of individuals’ self-confidence, which contributes to the improvement of skills required for professional practice.
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ORIGINAL ARTICLE
Effect of first aid training on teams from special education schools
Revista Brasileira de Enfermagem. 2020;73(2):e20180288
02-17-2020
Abstract
ORIGINAL ARTICLEEffect of first aid training on teams from special education schools
Revista Brasileira de Enfermagem. 2020;73(2):e20180288
02-17-2020DOI 10.1590/0034-7167-2018-0288
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Objectives:
Analyze the effect of first aid training on the knowledge of multidisciplinary teams from special education schools, in school accidents.
Methods:
A quasi-experimental, before-and-after study with a single comparison group. Descriptive statistics and McNemar’s test were used to evaluate the effect of the intervention.
Results:
This study had the participation of 162 higher education professionals, predominantly teachers (82.1%), female (97.5%), aged over 40 (69.2%). An increase in correct answers was observed, with statistical significance (≤0.05), especially in proper handling in case of fall with traumatic brain injury, electric shock, and burn due to hot liquid (98.1%, 98.1% and 96.9% of proper response, respectively).
Conclusions:
First aid training for child accidents, through content exhibition, in a dialogical and practical way, proved to be efficient for multidisciplinary teams from special education schools for people with disabilities.
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ORIGINAL ARTICLE
Permanent education and matrix support in primary health care: family health routine
Revista Brasileira de Enfermagem. 2020;73(6):e20190076
08-07-2020
Abstract
ORIGINAL ARTICLEPermanent education and matrix support in primary health care: family health routine
Revista Brasileira de Enfermagem. 2020;73(6):e20190076
08-07-2020DOI 10.1590/0034-7167-2019-0076
Views0See moreABSTRACT
Objective:
To analyze the understanding of the professionals working on the Family Health Support by about permanent education and matrix support in the daily routine of primary health care.
Methods:
Descriptive research with a qualitative approach. Data were collected through semi-structured interviews with the participation of 19 professionals from different backgrounds. The results were organized based on Thematic Content Analysis.
Results:
Thematic categories emerged from the analysis: Permanent Health Education: knowledge and daily activities; Matrix support as a premise of Permanent Health Education; The principle of integrality as the foundation of the supporting teams; Conditions of praxis in the promotion of Permanent Health Education.
Final Considerations:
The study evidenced that professionals experience their routines within the service and that the sharing of knowledge to transform the reality of users and the territory is based on matrix support and integrality. However, they face structural difficulties in carrying out actions.
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Aged (144) Atenção Primária à Saúde (239) COVID-19 (104) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Estudos de Validação (131) Health Education (144) Idoso (208) Mental Health (149) Nursing (987) Nursing Care (306) Patient Safety (151) Primary Health Care (284) Qualidade de Vida (104) Quality of Life (106) Saúde Mental (145) Segurança do Paciente (150) Validation Studies (108)