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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
Views0See moreABSTRACT
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
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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 ARTICLE12-05-2019
Elderly caregiver: knowledge, attitudes and practices about falls and its prevention
Revista Brasileira de Enfermagem. 2019;72:119-126
Abstract
ORIGINAL ARTICLEElderly caregiver: knowledge, attitudes and practices about falls and its prevention
Revista Brasileira de Enfermagem. 2019;72:119-126
DOI 10.1590/0034-7167-2018-0276
Views0ABSTRACT
Objective:
investigate the knowledge, attitudes and practices of informal elderly caregivers about falls and its prevention.
Method:
this is a descriptive cross-sectional study conducted with 97 informal elderly caregivers residents in areas covered by five Health Strategy Units (ESF) in Cuiabá.
Results:
more than half of the participants are aware of falls and identify them as a problem, as well as they identify some risk factors and prevention measures. Regarding attitudes, more than half of the caregivers do not seem to act effectively to prevent falls. Most of them report adopting practices to prevent falls of the elderly, supervising the activities of their daily lives.
Conclusion:
caregivers know about falls and its prevention, but in a superficial way, and it seems to influence their attitudes and practices regarding the prevention of this event.
Keywords:Accidental FallsAgedCaregiversHealth Knowledge, Attitudes, PracticeHealth Services for the AgedSee more -
ORIGINAL ARTICLE09-21-2020
The care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory
Revista Brasileira de Enfermagem. 2020;73:e20190644
Abstract
ORIGINAL ARTICLEThe care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory
Revista Brasileira de Enfermagem. 2020;73:e20190644
DOI 10.1590/0034-7167-2019-0644
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Objective:
To analyze the care practices of family members of premature infants admitted to a Neonatal Intensive Care Unit in the light of Leininger’s transcultural theory.
Methods:
Qualitative, descriptive and exploratory study. Participant observation and semi-structured interviews were conducted with 16 family members of newborns, admitted to the neonatal unit of a public maternity hospital, during the months of May and June 2019. The software called Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire® and the Bardin Content Analysis technique.
Results:
Two thematic categories emerged: Family care in the neonatal unit; (in)effective support for shared care.
Conclusion:
The participation of families in the care of babies is still unstable, but it must be an inseparable element of culturally congruent care, thus collaborating with the full recovery of the premature.
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EXPERIENCE REPORT07-13-2020
Military Nursing in “Operation Return to Brazil”: aeromedical evacuation in the coronavirus pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200297
Abstract
EXPERIENCE REPORTMilitary Nursing in “Operation Return to Brazil”: aeromedical evacuation in the coronavirus pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200297
DOI 10.1590/0034-7167-2020-0297
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Objective:
to describe the experience of military nursing in “Operation Return to Brazil” in an aeromedical evacuation.
Method:
this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus.
Results:
the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers.
Final considerations:
nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.
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ORIGINAL ARTICLE09-21-2020
Adolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
Revista Brasileira de Enfermagem. 2020;73:e20190242
Abstract
ORIGINAL ARTICLEAdolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
Revista Brasileira de Enfermagem. 2020;73:e20190242
DOI 10.1590/0034-7167-2019-0242
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Objective:
To analyze the association between vulnerabilities to Sexually Transmitted Infections (STIs/HIV/AIDS) of adolescents in poverty and their level of resilience.
Method:
Cross-sectional study with 287 students between 11 and 17 years old in a school in the outskirts of Fortaleza-Ce. The study was conducted from August to October 2016. Three instruments related to characterization, vulnerability to STIs/HIV/AIDS and resilience were used. The association between the instruments was calculated using the Mann-Whitney and Kruskal-Wallis tests. Association between vulnerability to STIs/HIV/AIDS and resilience was assessed through the Spearman’s correlation coefficient. Statistical significance was set at p<0.05.
Results:
There was a significant association between the factors “housing” (p=0.022), “family income” (p=0.037) and vulnerability to STIs/HIV/AIDS. Adolescents whose father has completed high school (p=0.043) have moderately high resilience.
Conclusion:
Adolescents with low socioeconomic status and who live on less than a minimum wage tends to be more susceptible to vulnerabilities to STIs/HIV/AIDS and to have low resilience.
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REFLECTION06-04-2021
Care in pediatric nursing from the perspective of emotions: from Nightingale to the present
Revista Brasileira de Enfermagem. 2021;74(4):e20200377
Abstract
REFLECTIONCare in pediatric nursing from the perspective of emotions: from Nightingale to the present
Revista Brasileira de Enfermagem. 2021;74(4):e20200377
DOI 10.1590/0034-7167-2020-0377
Views0See moreABSTRACT
Objective:
Reflect on the evolution of pediatric nursing care from the perspective of emotions, from the conceptions of Florence Nightingale to the present.
Method:
Reflective study based on theoretical and experiential aspects of emotional care in pediatric nursing.
Results:
From Nightingale, there were many definitions regarding the nursing care in an integrative and humanist logic; and with certain bond to emotional dimension. That time, nursing care was based on the religious conceptions of charity and love of our neighbor and, despite the conceptualization that shapes nursing science today, such conceptions have not ceased to be its attribute, mainly in the care of pediatric nurses.
Final considerations:
In pediatric nursing, nurture care with affection and facilitate emotions management in each interaction nurse-child-family is crucial for caring. This emotional care should evolve into a competence that recognizes the expertise and merit of professional action.
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EXPERIENCE REPORT09-29-2022
Mobile pre-hospital care reorganization during the COVID-19 pandemic: experience report
Revista Brasileira de Enfermagem. 2022;75:e20200826
Abstract
EXPERIENCE REPORTMobile pre-hospital care reorganization during the COVID-19 pandemic: experience report
Revista Brasileira de Enfermagem. 2022;75:e20200826
DOI 10.1590/0034-7167-2020-0826
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Objective:
To describe the reorganization of Belo Horizonte’s Mobile Emergency Care Service during the new coronavirus pandemic using the Plan Do-Check-Act quality tool.
Methods:
Descriptive study, of the experience report type, on the reorganization of care in a mobile pre-hospital care service during the new coronavirus pandemic, from March to July 2020. The Plan-Do-Check-Act quality tool was applied for the process.
Results:
Preparation of care protocol, meetings, training, addition of ambulances, hiring of professionals, and other actions were carried out, with subsequent evaluation and monitoring. When failures or new needs were identified, actions and changes were implemented while keeping monitoring and evaluation during the work routine.
Final considerations:
The reorganization of the service through the construction of a protocol and using the Plan-Do-Check-Act as a management tool was essential to promote safe care for professionals and patients.
Keywords:AmbulancesCoronavirus InfectionsEmergency Medical ServicesHealth Services AdministrationPandemicsSee more -
ORIGINAL ARTICLE12-13-2019
Factors associated with low Apgar in newborns in birth center
Revista Brasileira de Enfermagem. 2019;72:297-304
Abstract
ORIGINAL ARTICLEFactors associated with low Apgar in newborns in birth center
Revista Brasileira de Enfermagem. 2019;72:297-304
DOI 10.1590/0034-7167-2018-0924
Views0See moreABSTRACT
Objective:
to analyze factors associated with Apgar of 5 minutes less than 7 of newborns of women selected for care at the Center for Normal Birth (ANC).
Method:
a descriptive cross-sectional study with data from 9,135 newborns collected between July 2001 and December 2012. The analysis used absolute and relative frequency frequencies and bivariate analysis using Pearson’s chi-square test or the exact Fisher.
Results:
fifty-three newborns (0.6%) had Apgar less than 7 in the 5th minute. The multivariate analysis found a positive association between low Apgar and gestational age less than 37 weeks, gestational pathologies and intercurrences in labor. The presence of the companion was a protective factor.
Conclusion:
the Normal Birth Center is a viable option for newborns of low risk women as long as the protocol for screening low-risk women is followed.
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ORIGINAL ARTICLE07-31-2020
Factors associated with normal and cesarean delivery in public and private maternity hospitals: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20180996
Abstract
ORIGINAL ARTICLEFactors associated with normal and cesarean delivery in public and private maternity hospitals: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20180996
DOI 10.1590/0034-7167-2018-0996
Views0See moreABSTRACT
Objectives:
to investigate the factors associated with the mode of delivery in pregnant women in the city of Belo Horizonte.
Methods:
cross-sectional study developed with data from the study “Being born in Belo Horizonte: survey on childbirth and birth” carried out in seven maternity hospitals in Belo Horizonte – Minas Gerais. The final sample consisted of 1088 pregnant/postpartum women. In this study, to verify the magnitude of the association between the outcome variable and its possible determinants (exposure variables) logistic regression models were constructed to estimate the Odds Ratio.
Results:
increasing age, the lack of companionship, the hospital’s private financing for performing delivery and being a first-time pregnant woman increased the chance of delivery by cesarean section.
Final Considerations:
the knowledge of factors associated with the prevalence of cesarean sections can support reflections among health professionals about this surgical procedure in certain situations, especially when there are no precise clinical indications.
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