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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
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
DOI 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 ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 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 ARTICLE12-04-2023
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
DOI 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 ARTICLE12-04-2023
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
DOI 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 ARTICLE12-04-2023
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
DOI 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 ARTICLE12-04-2023
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
DOI 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 ARTICLE12-04-2023
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
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
DOI 10.1590/0034-7167-2023-0068
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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
Abstract
Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
DOI 10.1590/0034-7167-2022-0803
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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 ARTICLE08-19-2019
Psychosocial risks related to the nurse in the psychiatric hospital and management strategies
Revista Brasileira de Enfermagem. 2019;72(4):834-840
Abstract
ORIGINAL ARTICLEPsychosocial risks related to the nurse in the psychiatric hospital and management strategies
Revista Brasileira de Enfermagem. 2019;72(4):834-840
DOI 10.1590/0034-7167-2017-0311
Views0See moreABSTRACT
Objective:
To characterize the presence of psychosocial risks related to the work of the nurse in a psychiatric hospital and the strategies for managing these risks.
Methods:
Qualitative, in which 25 nurses from a psychiatric hospital participated using semi-structured interviews from November 2014 to January 2015. Data analysis was performed using the thematic method.
Results:
The results showed psychosocial risks related to the work of psychiatric nurses, such as: insufficient academic training; lack of preparation and maintenance of equipment; poor relationship with colleagues; shortage of human resources and lack of capacity building; conflict between the demands of the home and work, as well as strategies for managing psychosocial risks such as family, cinema, music, reading, among others.
Final considerations:
This study should provoke the reflection of managers and future nurses regarding the working conditions in a psychiatric hospital and possible psychosocial risks to which they are exposed.
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ORIGINAL ARTICLE06-01-2020
Structural and procedural conditions in National Immunization Program Information System establishment
Revista Brasileira de Enfermagem. 2020;73(4):e20180939
Abstract
ORIGINAL ARTICLEStructural and procedural conditions in National Immunization Program Information System establishment
Revista Brasileira de Enfermagem. 2020;73(4):e20180939
DOI 10.1590/0034-7167-2018-0939
Views0ABSTRACT
Objectives:
to analyze structural and process conditions in National Immunization Program Information System establishment.
Methods:
a cross-sectional study conducted in 307 vaccination rooms in the state of Minas Gerais in 2017. For data collection, a multidimensional questionnaire was used. Descriptive data analysis was performed.
Results:
vaccination rooms have basic inputs necessary for System establishment. The greatest problems relate to professional practice. Low enrollment of population, failures in the active search for absentees, vaccine scheduling and absence of reports to monitor vaccination coverage were identified. Training was considered insufficient and ineffective.
Conclusions:
Immunization Information System is an essential technological innovation for the management of immunization actions. However, the production of timely records and the use of information are still challenges. Investments in training are required to ensure System’s management and operationalization activities.
Keywords:Evaluation StudiesHealth Information SystemsImmunization ProgramsInformation TechnologyNursingSee more -
Trends in fertility rates, proportion of antenatal consultations and caesarean sections among Brazilian adolescents
Revista Brasileira de Enfermagem. 2021;74:e20200884
Abstract
Trends in fertility rates, proportion of antenatal consultations and caesarean sections among Brazilian adolescents
Revista Brasileira de Enfermagem. 2021;74:e20200884
DOI 10.1590/0034-7167-2020-0884
Views0ABSTRACT
Objective:
To analyze the temporal trends in the fertility rate, proportion of antenatal consultations and caesarean sections in Brazilian adolescents aged 15 to 19, between 2000 and 2015. Methods: The fertility rate, proportion of prenatal consultations and proportion of routes of birth were calculated using data from DATASUS. The trend analysis was performed using the Prais-Winsten regression model and the annual percentage change.
Results:
There was a trend of reduction of 3.5% per year in the fertility rate among adolescents (p<0.05), in addition to an increasing trend of 6% per year in the proportion of more than six antenatal consultations (p <0.0001) and an increasing trend of 6.8% per year in the proportion of caesarean sections (p<0.0001).
Conclusion:
Despite the decreasing trend in fertility rates among Brazilian adolescents, they remain high. Also noteworthy is the growing trend for caesarean sections, even with improved access to antenatal care.
Keywords:Birth RateCaesarean SectionDescriptors:Pregnancy in adolescencePrenatal CareTime Serie StudiesSee more -
ORIGINAL ARTICLE10-21-2019
Nursing protocol in vascular trauma prevention: peripheral catheterization bundle in urgency
Revista Brasileira de Enfermagem. 2019;72(6):1512-1518
Abstract
ORIGINAL ARTICLENursing protocol in vascular trauma prevention: peripheral catheterization bundle in urgency
Revista Brasileira de Enfermagem. 2019;72(6):1512-1518
DOI 10.1590/0034-7167-2018-0457
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Objective:
to create, apply and analyze in clinical practice the effectiveness of a bundle to prevent peripheral vascular trauma to approach the peripheral venous puncture process.
Method:
action research with 435 adult participants in an emergency service from 2011 to 2013. Creation of the bundle for prevention of vascular trauma based on scientific evidence, ease of operation, observation and measurement with implantation through an educational intervention of the team of nursing. Effectiveness analyzed by descriptive and inferential statistics using chi-square. Consecutive sample with 95% confidence interval.
Results:
Five stages of the bundle were related to the catheter fixation, permanence and removal process. The incidence of vascular traumas due to vein punctures reduced by 46.41% after implantation of the bundle to prevent vascular trauma associated with emergency peripheral catheterization.
Conclusion:
The bundle in clinical practice reduced vascular traumas by venipuncture.
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ORIGINAL ARTICLE09-21-2020
Autonomy in the reproductive health of quilombolas women and associated factors
Revista Brasileira de Enfermagem. 2020;73:e20190786
Abstract
ORIGINAL ARTICLEAutonomy in the reproductive health of quilombolas women and associated factors
Revista Brasileira de Enfermagem. 2020;73:e20190786
DOI 10.1590/0034-7167-2019-0786
Views0ABSTRACT
Objective:
Identify the level of reproductive autonomy of quilombola women and associate it with sociodemographic characteristics and aspects of sexual and reproductive health.
Methods:
Cross-sectional census study carried out in quilombola communities in a municipality in Bahia. Data was collected through questionnaires from the National Health Survey and the Reproductive Autonomy Scale, applied to quilombola women who agreed to participate. Descriptive statistics procedures were used and associations were made between reproductive autonomy scores and sociodemographic and reproductive characteristics.
Results:
The average total score for reproductive autonomy was 2.06. An association was found between the “decision-making” score and marital status. The score for “total reproductive autonomy” was associated with the use of contraceptive method.
Conclusion:
The reality of the study participants converges with the literature regarding the interference of sociodemographic and reproductive factors in the reproductive autonomy of black women.
Keywords:African Continental Ancestry GroupPersonal AutonomyReproductive HealthSocioeconomic FactorsWomenSee more -
ORIGINAL ARTICLE09-16-2019
Playful educational intervention with schoolchildren on intestinal parasitosis
Revista Brasileira de Enfermagem. 2019;72(5):1203-1210
Abstract
ORIGINAL ARTICLEPlayful educational intervention with schoolchildren on intestinal parasitosis
Revista Brasileira de Enfermagem. 2019;72(5):1203-1210
DOI 10.1590/0034-7167-2017-0551
Views0See moreABSTRACT
Objective:
To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis.
Method:
This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test.
Results:
Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students’ knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention.
Conclusion:
Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.
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ORIGINAL ARTICLE02-10-2020
Group Brief Intervention: effectiveness in motivation to change alcohol intake
Revista Brasileira de Enfermagem. 2020;73(1):e20180138
Abstract
ORIGINAL ARTICLEGroup Brief Intervention: effectiveness in motivation to change alcohol intake
Revista Brasileira de Enfermagem. 2020;73(1):e20180138
DOI 10.1590/0034-7167-2018-0138
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Objective:
To verify the effectiveness of the group brief intervention (GBI), performed by nurses in motivational stages to change the pattern of alcohol intake.
Method:
Randomized controlled trial with 3-month follow-up. The ruler of readiness for change was applied in 180 individuals with risk or harmful alcohol intake pattern in basic health unit. Only the experimental group (EG) was submitted to the intervention. Both groups (experimental and control [CG]) participated in the follow-up.
Results:
EG had a mean score before GBI=6.55 (SD=3.41) points (preparation). After GBI=8.00 (SD=2.88) points (action) and in the follow-up 7.92 (SD=3.06) points (action). CG presented a mean score before GBI=5.42 (SD=3.26) points (preparation); after GBI=6.67 (SD=3.05) points (preparation) and in the follow up had a mean score of 4.80 (SD=2.86) points (contemplation). There was a statistically significant difference between the two groups at the motivational stages (p≤ 0,03).
Conclusion:
It was evidenced that GBI was effective in increasing the motivation to change harmful alcohol intake.
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EXPERIENCE REPORT11-13-2020
Pedagogical mediations for non-formal nursing teaching during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200499
Abstract
EXPERIENCE REPORTPedagogical mediations for non-formal nursing teaching during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200499
DOI 10.1590/0034-7167-2020-0499
Views0See moreABSTRACT
Objective:
to report the experience of developing pedagogical mediations in a Virtual Learning Environment implemented in a nursing faculty during the COVID-19 pandemic.
Methods:
an experience report on the construction of a distance course aimed at graduates and residents of a nursing faculty at a public university located in the city of Rio de Janeiro.
Results:
the course’s conception, operationalization and implementation were the result of a collective work that culminated in a non-formal, virtual and problematic teaching process, which reached a participation rate of 82% of enrolled students.
Final considerations:
even in times of social isolation, the course promoted collaborative learning of knowledge about COVID-19 and strengthened the relationship between professors and students. The possibility of carrying out distance activities based on solid methodological proposals that contradict the content logic often observed in distance learning is emphasized.
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