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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
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 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
Views0See moreABSTRACT
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
Views0See moreABSTRACT
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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REVIEW
Mental health interventions implemented in the COVID-19 pandemic: what is the evidence?
Revista Brasileira de Enfermagem. 2021;74:e20200635
06-11-2021
Abstract
REVIEWMental health interventions implemented in the COVID-19 pandemic: what is the evidence?
Revista Brasileira de Enfermagem. 2021;74:e20200635
06-11-2021DOI 10.1590/0034-7167-2020-0635
Views0See moreABSTRACT
Objective:
to map the evidence on mental health interventions implemented during the COVID-19 pandemic.
Method:
this scoping review was carried out in the MEDLINE/PubMed, SCOPUS, Web of Science, PsycINFO, and Science Direct databases and in the medRxiv, bioRxiv, and PsyArXiv preprints servers using the descriptors “Covid-19”, “coronavirus infection”, “coronavirus”, “2019-nCoV”, “2019 novel coronavirus disease”, “SARS-CoV-2”, “health personnel”, “general public”, and “mental health”.
Results:
eight articles were selected and categorized into mental health interventions for the population, among which mental health interventions were for people diagnosed with suspicion/confirmed COVID-19 and mental health interventions for health professionals.
Conclusion:
telemonitoring, virtual games and strategies focused on social support and muscle relaxation techniques, characterized as non-pharmacological and low-cost, were shown as interventions, which, since they are effective, need to be encouraged and included in mental health care practices.
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Nursing performance in robotic surgeries: integrative review
Revista Brasileira de Enfermagem. 2019;72(3):795-800
06-07-2019
Abstract
Nursing performance in robotic surgeries: integrative review
Revista Brasileira de Enfermagem. 2019;72(3):795-800
06-07-2019DOI 10.1590/0034-7167-2018-0426
Views0ABSTRACT
Objective:
To know the scientific production on the performance of the nursing staff in robotic surgeries, identifying the role of the nurse in the three perioperative periods.
Methods:
Integrative review, search in the databases National Library of Medicine, National Institutes of Health, Scientific Electronic Library Online and Biblioteca Virtual em Saúde, performed from June to September, 2017; 17 selected articles met the inclusion criteria.
Results:
Most articles were published in foreign journals in English, nine in the United States, classified with evidence level of 4 and 5. The role of nursing in the perioperative period was identified, related mainly to patient safety. The most mentioned perioperative period in the articles was the intraoperative, with greater concern in the positioning of the patient.
Conclusion:
The nursing performance and patient safety in robotic surgeries are similar to the ones in major surgeries, requiring from the patient a specific knowledge on the setting and preparation of the robot.
Keywords:Nurse's RolePerioperative NursingRoboticsSurgical Procedures, OperativeTechnological DevelopmentSee more -
ORIGINAL ARTICLE
“Waiting for a miracle”: Spirituality/Religiosity in coping with sickle cell disease
Revista Brasileira de Enfermagem. 2019;72(6):1554-1561
10-21-2019
Abstract
ORIGINAL ARTICLE“Waiting for a miracle”: Spirituality/Religiosity in coping with sickle cell disease
Revista Brasileira de Enfermagem. 2019;72(6):1554-1561
10-21-2019DOI 10.1590/0034-7167-2018-0635
Views0See moreABSTRACT
Objective:
To understand spirituality/religiosity as experienced by people with sickle cell disease, and its influence on coping with the disease.
Method:
A qualitative, descriptive, and exploratory study conducted in the State of Bahia. Twenty-nine respondents participated in semi-structured interviews. Content analysis was used to analyze the empirical material.
Results:
Individuals with sickle cell disease experience spirituality/religiosity motivated by their hope for a miracle, and fear of death; among their rites are: reading religious materials, individual and group prayer, and attendance at worship services. The effects on their health include: comfort by means of coping by comparing two evils, anxiety relief, social support, and lifestyle changes; however, spirituality/religiosity may be impaired.
Final considerations:
This study demonstrates the need to qualify health professionals to address spiritual issues of these individuals during illness, with the aims of diagnosing suffering and anguish, and providing care, comfort and strengthening of the spiritual bonds of these individuals.
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ORIGINAL ARTICLE
Construction and validation of a mobile application for development of nursing history and diagnosis
Revista Brasileira de Enfermagem. 2020;73:e20190674
12-21-2020
Abstract
ORIGINAL ARTICLEConstruction and validation of a mobile application for development of nursing history and diagnosis
Revista Brasileira de Enfermagem. 2020;73:e20190674
12-21-2020DOI 10.1590/0034-7167-2019-0674
Views0ABSTRACT
Objectives:
to describe the construction and validation process for a mobile application for development of the nursing history and diagnosis.
Methods:
methodological study conducted in 2018 in three stages: content creation, based on the Basic Human Needs categories and nursing diagnoses; content assessment by nine nursing judges, with calculation of the content validity index; and construction of the application, which included definition of the requirements, a conceptual map, implementation and prototyping options, tests and implementation.
Results:
the application was organized by sections: Grouped Basic Human Needs, Cranial pair tests, Clinical assessment scales and Additional tests. Two section were adjusted according to the judges’ suggestions.
Final Considerations:
it is the first application produced in Brazil based on the Basic Human Need categories, which enables quick access to information, concepts and typical nomenclatures of semiology, recording of clinical data and definition of nursing diagnoses.
Keywords:Educational TechnologyMobile ApplicationsNursing InformaticsNursing ProcessPhysical ExaminationSmartphoneSee more -
ORIGINAL ARTICLE
Factors associated with vulnerability and fragility in the elderly: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20200399
10-01-2022
Abstract
ORIGINAL ARTICLEFactors associated with vulnerability and fragility in the elderly: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(2):e20200399
10-01-2022DOI 10.1590/0034-7167-2020-0399
Views0See moreABSTRACT
Objectives:
to assess factors associated with vulnerability and fragility in the elderly.
Methods:
crosssectional study with 384 elderly people in Fortaleza, Ceará. The Vulnerable Elders Survey and Clinical-Functional Vulnerability Index – 20 were used. Chi-square and Fisher’s exact tests were used for associations. In the analysis of the combined influence of risk factors, the stepwise logistic regression and multinomial regression methods were adopted.
Results:
251 (65.4%) non-vulnerable and 133 (34.6%) vulnerable elders. From the vulnerable elders analyzed, 42 (30.9%) are at high risk for frailty. Factors associated with vulnerability: age, gender, presence of comorbidities, hypertension, diabetes, osteoporosis and use of polypharmacy. There is a 30% increase in the chance of vulnerability for each additional drug. Physical activity reduces the chance of vulnerability by 60%. Factors associated with frailty: educational level; self-perception of health; comorbidities; polypharmacy.
Conclusions:
it is important to pay attention to the presence of arterial hypertension, osteoporosis, polypharmacy, and encourage the practice of physical activity.
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ORIGINAL ARTICLE
Caring ability, burden, stress and coping of family caregivers of people in cancer treatment
Revista Brasileira de Enfermagem. 2019;72(6):1541-1546
10-21-2019
Abstract
ORIGINAL ARTICLECaring ability, burden, stress and coping of family caregivers of people in cancer treatment
Revista Brasileira de Enfermagem. 2019;72(6):1541-1546
10-21-2019DOI 10.1590/0034-7167-2018-0605
Views0See moreABSTRACT
Objective:
To analyze the association between the caring ability and the burden, stress and coping of family caregivers of people in cancer treatment.
Method:
A cross-sectional study with 132 family caregivers. The following instruments were applied: a characterization instrument, the Caring Ability Inventory, the Zarit Burden Interview, the Perceived Stress Scale, and the Brief COPE. The Spearman Correlation was used with significance ≤5%.
Results:
There were significant and positive correlations between total caring ability and: burden – interpersonal relationship (p=0.03); stress (p=0.02) and maladaptive coping (p=0.00); and inversely proportional correlations with problem-focused coping (p=0.03). The courage had inversely proportional correlation with: self-efficacy (p=0.03), interpersonal relationship (p=0.00), stress (p=0.04) and maladaptive coping (p=0.00). The knowledge had significant and positive correlation with problem-focused coping (p=0.00), adaptive coping (p=0.01), and inverse correlation with stress (p=0.02).
Conclusion:
The level of caring ability correlates with levels of stress and burden, and with the type of coping strategy used by family caregivers.
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ORIGINAL ARTICLE
Clinical simulation as a Nursing Fundamentals teaching method: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75(2):e20201155
10-18-2022
Abstract
ORIGINAL ARTICLEClinical simulation as a Nursing Fundamentals teaching method: a quasi-experimental study
Revista Brasileira de Enfermagem. 2022;75(2):e20201155
10-18-2022DOI 10.1590/0034-7167-2020-1155
Views0See moreABSTRACT
Objectives:
to evaluate students’ knowledge gain after the implementation of clinical simulation in Nursing Fundamentals disciplines.
Methods:
a quasi-experimental intervention was carried out with 60 students, distributed in comparison and intervention groups, who underwent traditional teaching and traditional teaching associated with simulated teaching, respectively. Pre-test and post-test instruments were applied to both groups.
Results:
after analyzing the students’ performance through the applied instruments, both groups had a cognitive evolution along with the taught content, however, when compared, the intervention group obtained a higher knowledge gain than the comparison group (p = 0.016), demonstrating progressive and increasing improvement with the use of the methodology.
Conclusions:
simulated teaching significantly helps students in gaining technical-cognitive knowledge. Therefore, it is recommended to adhere to the use of this methodology for teaching Nursing Fundamentals.
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ORIGINAL ARTICLE
Eliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
08-10-2020
Abstract
ORIGINAL ARTICLEEliot Freidson’s sociology of professions: an interpretation for Health and Nursing
Revista Brasileira de Enfermagem. 2020;73(6):e20180950
08-10-2020DOI 10.1590/0034-7167-2018-0950
Views0See moreABSTRACT
Objectives:
to analyze theoretical conceptions of Eliot Freidson’s Sociology of Professions scoped on health and nursing professions.
Methods:
Eight nurses were interviewed, all involved in the development of the professional Council on the timeframe from 1975 to 1986. Documental resources were Laws, Ordinances, Resolutions, Reports, Meeting Minutes and Public Deeds. Information was organized as from literature and Eliot Freidson’s conceptions, and thematic content analysis was carried out.
Results:
the concepts authored by Eliot Freidson allowed for the development of a concept chart that portrays the nursing profession and that may be expanded for the other occupations in the health field, in consonance with professional organization in the country.
Final Considerations:
Eliot Freidson’s framework, in interpretation for nursing, consolidates the profession with relative autonomy, expertise by Nursing Care Systematization and credentialism by professional normalizations.
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