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ORIGINAL ARTICLE04-14-2023
Validity study of educational technology on gynecological high dose rate (HDR) brachytherapy
- Meiriane Lopes Ximenes
, - Mariana Alves Firmeza ,
- Andrea Bezerra Rodrigues ,
- Maria Isis Freire de Aguiar ,
- Gabriela Lacerda Souza , [ … ],
- Patrícia Peres de Oliveira
Abstract
ORIGINAL ARTICLEValidity study of educational technology on gynecological high dose rate (HDR) brachytherapy
Revista Brasileira de Enfermagem. 2023;76:e20220232
DOI 10.1590/0034-7167-2022-0232
- Meiriane Lopes Ximenes ,
- Mariana Alves Firmeza ,
- Andrea Bezerra Rodrigues ,
- Maria Isis Freire de Aguiar ,
- Gabriela Lacerda Souza ,
- Georgia de Sousa Serpa ,
- Patrícia Peres de Oliveira
Views0See moreABSTRACT
Objective:
to construct and validate an educational booklet on high dose rate gynecological brachytherapy (HDR) for women with gynecologic cancer.
Methods:
a methodological study, with the construction and validity of a booklet based on the Doak, Doak and Root theoretical-methodological framework. Content and appearance validity was guided by the Delphi technique, by 11 judges, selected using Jasper’s criteria. Afterwards, clinical validity was carried out with the target population.
Results:
the booklet, built from evidence from an integrative review, validated with judges, obtained an overall CVI of 0.98. After clinical validity with 27 women, it presents 24 sheets with illustrations produced by a graphic designer, subdivided into topics: gynecological system anatomy and gynecological cancer epidemiology, gynecological brachytherapy definition, therapeutic steps, approach to side effects and management, and two pages for notes.
Conclusions:
the booklet has validity for use in HDR gynecological brachytherapy treatment.
- Meiriane Lopes Ximenes
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EXPERIENCE REPORT04-14-2023
Construction of educational technology on non-violent communication between health professionals: an experience report
Revista Brasileira de Enfermagem. 2023;76:e20220414
Abstract
EXPERIENCE REPORTConstruction of educational technology on non-violent communication between health professionals: an experience report
Revista Brasileira de Enfermagem. 2023;76:e20220414
DOI 10.1590/0034-7167-2022-0414
Views0ABSTRACT
Objective:
to report the construction of an educational technology to promote non-violent communication for health professionals.
Methods:
an experience report on the development of an educational technology on non-violent communication for health professionals, prepared by members of a social university extension project. The Plan-Do-Study-Act cycle was used as a process or product management procedure.
Results:
two complete management method cycles were performed. A mini almanac was generated as a final product, which addressed the main elements of non-violent communication, an example of its use in everyday life, hobbies and interspersed activities.
Conclusion:
educational technology construction (mini almanac) by members of a university extension project was facilitated using the Plan-Do-Study-Act cycle, proving to be a resource for disseminating non-violent communication in health work and promoting a culture of peace.
Keywords:Educational TechnologyHealth CommunicationHealth PersonnelInterpersonal RelationsWorkplace violenceSee more
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ORIGINAL ARTICLE04-07-2023
Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study
- Vanessa Dias Fogaça ,
- Danton Mateus de Souza ,
- Lucía Silva ,
- Danila Maria Batista Guedes ,
- Flavia Domingues , [ … ],
- Lisabelle Mariano Rossato
Abstract
ORIGINAL ARTICLESuicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
DOI 10.1590/0034-7167-2022-0137
- Vanessa Dias Fogaça ,
- Danton Mateus de Souza ,
- Lucía Silva ,
- Danila Maria Batista Guedes ,
- Flavia Domingues ,
- Isadora Trinquinato ,
- Lisabelle Mariano Rossato
Views0See moreABSTRACT
Objectives:
to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt.
Methods:
an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis.
Results:
eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified.
Conclusions:
adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
- Vanessa Dias Fogaça
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ORIGINAL ARTICLE04-07-2023
Implications of the pandemic for the construction of nurses’ identity based on the journalistic media
Revista Brasileira de Enfermagem. 2023;76(2):e20220245
Abstract
ORIGINAL ARTICLEImplications of the pandemic for the construction of nurses’ identity based on the journalistic media
Revista Brasileira de Enfermagem. 2023;76(2):e20220245
DOI 10.1590/0034-7167-2022-0245
Views0See moreABSTRACT
Objectives:
to analyze the work of nurses portrayed in the journalistic media and its impact on the construction of professional nursing identity.
Methods:
this is qualitative, retrospective, descriptive and documentary research, with 51 reports from Folha de São Paulo. Time frame from March to December 2020. Thematic Content Analysis carried out from Claude Dubar’s theoretical perspective. Organization and coding of data performed with the help of ATLAS.ti®.
Results:
three categories emerged: Working conditions in the pandemic – a problem that worsened; Impacts of the pandemic on daily work; Feelings generated by the pandemic.
Conclusions:
despite adversities, such as the precariousness of health institutions, inadequate working conditions for nurses, lack of basic items of individual protection, negative feelings and hopelessness, these professionals used their knowledge, skills and innovations in the act of caring, which contributed to reconstructing their professional identity.
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ORIGINAL ARTICLE04-07-2023
Spiritual well-being, symptoms and performance of patients under palliative care
- Bárbara Vitória Mendes ,
- Suzana Cristina Teixeira Donato ,
- Thaina Lúcio da Silva ,
- Ramon Moraes Penha ,
- Paula Jaman-Mewes , [ … ],
- Marina de Góes Salvetti
Abstract
ORIGINAL ARTICLESpiritual well-being, symptoms and performance of patients under palliative care
Revista Brasileira de Enfermagem. 2023;76(2):e20220007
DOI 10.1590/0034-7167-2022-0007
- Bárbara Vitória Mendes ,
- Suzana Cristina Teixeira Donato ,
- Thaina Lúcio da Silva ,
- Ramon Moraes Penha ,
- Paula Jaman-Mewes ,
- Marina de Góes Salvetti
Views0See moreABSTRACT
Objectives:
to assess the relationship between spiritual well-being, symptoms and performance of patients under palliative care.
Methods:
this is a descriptive correlational study, conducted with 135 patients seen in palliative care outpatient clinics. Karnofsky Performance Status Scale, Edmonton Symptom Assessment Scale, Spirituality Scale and Hospital Anxiety and Depression Scale were used. Data were submitted to descriptive statistical analysis and Spearman’s correlation.
Results:
among participants, 68.2% were cancer patients. The most prevalent symptoms were changes in well-being (65.2%), anxiety (63.7%), sadness (63%) and fatigue (63%). Sadness, dyspnea, sleepiness, anxiety and depression presented weak to moderate correlation with spiritual well-being. Symptom overload showed weak negative correlation with performance.
Conclusions:
symptom intensification was correlated with worsening in spiritual well-being perception. The reduction in performance was related to increased number of symptoms, especially depression and anxiety.
- Bárbara Vitória Mendes
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ORIGINAL ARTICLE04-07-2023
The use of toys by nursing as a therapeutic resource in the care of hospitalized children
- Lia Leão Ciuffo ,
- Tania Vignuda de Souza ,
- Thais Mello de Freitas ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Keila Cristina Oliveira dos Santos , [ … ],
- Roberta de Oliveira Jaime Ferreira Lima dos Santos
Abstract
ORIGINAL ARTICLEThe use of toys by nursing as a therapeutic resource in the care of hospitalized children
Revista Brasileira de Enfermagem. 2023;76(2):e20220433
DOI 10.1590/0034-7167-2022-0433
- Lia Leão Ciuffo ,
- Tania Vignuda de Souza ,
- Thais Mello de Freitas ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Keila Cristina Oliveira dos Santos ,
- Roberta de Oliveira Jaime Ferreira Lima dos Santos
Views0See moreABSTRACT
Objectives:
to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children.
Methods:
qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure.
Results:
the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children’s toys, hospital materials, cartoons, and children’s videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource.
Final Considerations:
although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.
- Lia Leão Ciuffo
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REVIEW04-07-2023
Analysis of moral courage and related factors among undergraduate nursing students: a scoping review
- Romario Daniel Jantara ,
- Jamila Geri Tomaschewski Barlem ,
- Adrieli Jantara ,
- Laurelize Pereira Rocha ,
- Sabrina Santos da Rocha , [ … ],
- Danubia Andressa da Silva Stigger
Abstract
REVIEWAnalysis of moral courage and related factors among undergraduate nursing students: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220225
DOI 10.1590/0034-7167-2022-0225
- Romario Daniel Jantara ,
- Jamila Geri Tomaschewski Barlem ,
- Adrieli Jantara ,
- Laurelize Pereira Rocha ,
- Sabrina Santos da Rocha ,
- Danubia Andressa da Silva Stigger
Views0See moreABSTRACT
Objective:
to analyze scientific evidence on moral courage and related factors among nursing undergraduate students.
Method:
the protocol of this scoping review was registered on Open Science Framework. A search was performed in five databases, according to the method provided by Joanna Briggs Institute Reviewers, the mnemonic strategy Population, Concept and Context, and a specific checklist.
Results:
a total of 2,812 results were identified, but only nine studies were eligible and presented three thematic approaches: Moral courage from the perspective of nursing students; Moral courage and related factors; and The teaching of moral courage in the training of nursing students. The factors related to moral courage include moral distress, moral sensitivity, age, and having a previous degree in the health field.
Final Considerations:
few studies were found with a low evidence level. Most were performed in developed countries, indicating some gaps that need to be addressed in the future.
- Romario Daniel Jantara
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ORIGINAL ARTICLE03-27-2023
Prevalence of characteristics associated with sarcopenia in elders: a cross-sectional study
- Caroline Ribeiro de Sousa ,
- Janaína Fonseca Victor Coutinho ,
- Marília Braga Marques ,
- Rachel Gabriel Bastos Barbosa ,
- Jarbas de Sá Roriz Filho , [ … ],
- Rodrigo Lopes de Paula Souza
Abstract
ORIGINAL ARTICLEPrevalence of characteristics associated with sarcopenia in elders: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220209
DOI 10.1590/0034-7167-2022-0209
- Caroline Ribeiro de Sousa ,
- Janaína Fonseca Victor Coutinho ,
- Marília Braga Marques ,
- Rachel Gabriel Bastos Barbosa ,
- Jarbas de Sá Roriz Filho ,
- Edson Silva Soares ,
- Charlys Barbosa Nogueira ,
- Rodrigo Lopes de Paula Souza
Views0See moreABSTRACT
Objectives:
to identify the prevalence and characteristics associated with sarcopenia in elders in Primary Health Care Units.
Methods:
cross-sectional study with 384 elders. To evaluate sarcopenia, we measured: strength and muscle mass, and physical performance. The elderly were classified as having: probable sarcopenia; sarcopenia; or severe sarcopenia. The chi-squared test and the multinomial logistic regression method were used.
Results:
the prevalence of probable sarcopenia was 25.52%; of sarcopenia, 11.98%; and of severe sarcopenia, 9.90%. Probable sarcopenia is 1.75 times more prevalent in men; osteoporosis is 2.16 times more prevalent in people with severe sarcopenia; polypharmacy is 1.57 times more likely in individuals with probable sarcopenia; and calf circumference below 31 cm is 2.24 times more likely in patients with sarcopenia and 2.19 times more likely in patients with severe sarcopenia.
Conclusions:
the highest prevalence was of probable sarcopenia, and the characteristics associated with sarcopenia were sex, osteoporosis, polypharmacy, overweight, obesity, and calf circumference.
- Caroline Ribeiro de Sousa
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ORIGINAL ARTICLE07-13-2020
Mental health of nursing in coping with COVID-19 at a regional university hospital
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins , [ … ],
- Aline Cristina Correa Anselmo
Abstract
ORIGINAL ARTICLEMental health of nursing in coping with COVID-19 at a regional university hospital
Revista Brasileira de Enfermagem. 2020;73:e20200434
DOI 10.1590/0034-7167-2020-0434
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins ,
- Aline Cristina Correa Anselmo
Views0See moreABSTRACT
Objective:
to identify prevalence and factors associated with anxiety and depression in nursing professionals who work to cope with COVID-19 at a university hospital.
Methods:
a cross-sectional observational study using a sociodemographic questionnaire and Hospital Anxiety and Depression Scale, with 88 nursing professionals. Data were analyzed using absolute and relative frequency and Statistical Package for the Social Sciences.
Results:
there was prevalence of anxiety (48.9%) and depression (25%). The majority of the sample consisted of women over 40 years old, married or in a common-law marriage, white, with higher education or graduate degree, with an income above 3,000.00 reais, public servants, working 40 hours a week and working in the hospital from 1 to 5 years.
Conclusion:
we must consider the impact on mental health nursing caused by COVID-19 and intervene with coping strategies to minimize the suffering of professionals.
- Eduardo Bassani Dal’Bosco
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REFLECTION04-22-2020
Thematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
Abstract
REFLECTIONThematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
DOI 10.1590/0034-7167-2019-0250
Views0See moreABSTRACT
Objective:
to describe the most important tools of ATLAS.ti Software and to associate them with the procedures of Thematic Content Analysis.
Method:
It is a theoretical reflection of the Content Analysis phases of Laurence Bardin, associating them with software tools Atlas.ti and showing its usefulness for data analysis in qualitative research.
Results:
historical contextualization and the available resources of Atlas.ti software with presentation of health research involving the phases of thematic content analysis.
Final considerations:
The Atlas.ti software assists in the accomplishment of the thematic content analysis being this promising association in health research.
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REFLECTION10-26-2020
Nursing education: challenges and perspectives in times of the COVID-19 pandemic
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Abstract
REFLECTIONNursing education: challenges and perspectives in times of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200683
DOI 10.1590/0034-7167-2020-0683
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Views0See moreABSTRACT
Objective:
To discuss the challenges and perspectives of nursing education in times of the COVID-19 pandemic.
Methods:
Reflection study, with theoretical approach based on national and international publications, allied to the experience of researchers in the area of nursing education.
Results:
Four sections are identified: Nursing education: current affairs and perspectives; Education and technologies in time of pandemic: acceleration, alteration and paralysis; Difference between emergency, intentional and remote teaching; the return to the “new normality”: new structuring axes and legal norms.
Final considerations:
The conclusion is that longstanding challenges have emerged with the pandemic, and the processes of acceleration, change and paralysis have marked education in these times. Moreover, epidemiological, technological and psychological aspects should be more valued in the return to activities.
- Ana Luisa Brandão de Carvalho Lira
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ORIGINAL ARTICLE11-13-2020
Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García , [ … ],
- Antonio Daponte
Abstract
ORIGINAL ARTICLESocial determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200673
DOI 10.1590/0034-7167-2020-0673
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García ,
- Rodrigo Pinheiro de Toledo Vianna ,
- Antonio Daponte
Views0See moreABSTRACT
Objective:
To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil.
Methods:
Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman’s correlation coefficient and multiple regression analysis.
Results:
In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country’s variations in federal units.
Conclusion:
Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.
- Alexandre Medeiros de Figueiredo
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ORIGINAL ARTICLE06-27-2019
Validation of a booklet on self-care with the diabetic foot
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Abstract
ORIGINAL ARTICLEValidation of a booklet on self-care with the diabetic foot
Revista Brasileira de Enfermagem. 2019;72(3):780-787
DOI 10.1590/0034-7167-2017-0900
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Views0ABSTRACT
Objective:
to describe the validation of the booklet on self-care with the feet of people with diabetes.
Method:
methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus.
Results:
the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%.
Conclusion:
the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.
Keywords:Diabetes Mellitus Type 2Diabetic FootEducational TechnologyTeaching MaterialsValidation StudiesSee more
- Yara Lanne Santiago Galdino
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ORIGINAL ARTICLE08-10-2020
Braden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
Abstract
ORIGINAL ARTICLEBraden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
DOI 10.1590/0034-7167-2019-0413
Views0See moreABSTRACT
Objective:
To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU).
Methods:
A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale.
Results:
The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it.
Conclusion:
The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.
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ORIGINAL ARTICLE02-27-2020
Prevalence of symptoms and quality of life of cancer patients
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Abstract
ORIGINAL ARTICLEPrevalence of symptoms and quality of life of cancer patients
Revista Brasileira de Enfermagem. 2020;73(2):e20180287
DOI 10.1590/0034-7167-2018-0287
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Views0See moreABSTRACT
Objectives:
to analyze the prevalence of symptoms and their relationship with the quality of life of cancer patients.
Methods:
this is a cross-sectional study with 107 patients evaluated using a sociodemographic instrument, the hospital anxiety and depression scale (HADS) and the quality of life scale (EORTC-QLQ-C30). Pearson’s correlation test was used to evaluate the relationship between symptoms and quality of life.
Results:
prevalence of female patients (56.1%), 55 years as the mean age and 10 years of schooling. Fatigue (76.6%), insomnia (47.7%), pain (42.1%), loss of appetite (37.4%), anxiety (31.8%) and depression (21.5%) were identified. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
Conclusions:
fatigue, insomnia, pain and loss of appetite were the most common and most intense symptoms. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
- Marina de Góes Salvetti
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REVIEW03-24-2021
Strategies of active learning methodologies in nursing education: an integrative literature review
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Abstract
REVIEWStrategies of active learning methodologies in nursing education: an integrative literature review
Revista Brasileira de Enfermagem. 2021;74(1):e20200130
DOI 10.1590/0034-7167-2020-0130
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objectives:
to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training.
Methods:
integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases.
Results:
among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students.
Final Considerations:
the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.
- Joyce Fernanda Soares Albino Ghezzi
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