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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
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Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023DOI 10.1590/0034-7167-2022-0553
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
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ORIGINAL ARTICLE
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023DOI 10.1590/0034-7167-2022-0586
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
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ORIGINAL ARTICLE
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023DOI 10.1590/0034-7167-2022-0597
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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ORIGINAL ARTICLE
Tuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
09-16-2019
Abstract
ORIGINAL ARTICLETuberculosis: health care and surveillance in prisons
Revista Brasileira de Enfermagem. 2019;72(5):1304-1310
09-16-2019DOI 10.1590/0034-7167-2018-0260
Views0ABSTRACT
Objective:
To identify tuberculosis-related health care and surveillance actions in Prison Health Units.
Method:
Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials.
Results:
Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units.
Conclusion:
Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.
Keywords:Cross-Sectional StudiesDelivery of Health CarePrisonsPublic Health SurveillanceTuberculosisSee more -
ORIGINAL ARTICLE
Patient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
06-27-2019
Abstract
ORIGINAL ARTICLEPatient safety incidents identified by the caregivers of hospitalized children
Revista Brasileira de Enfermagem. 2019;72(3):707-714
06-27-2019DOI 10.1590/0034-7167-2018-0484
Views0See moreABSTRACT
Objective:
to analyze patient safety incidents identified by caregivers of hospitalized children.
Method:
a qualitative, exploratory-descriptive study was carried out with 40 caregivers of children hospitalized in three hospital institutions in the city of Porto Alegre, Rio Grande do Sul State, Brazil, from April to December 2016. Semi-structured, recorded and transcribed interviews were carried out in their entirety, submitted to a thematic analysis using the NVivo 11.0 software.
Results:
reports related to falls, infant feeding, patient/caregiver identification, medication process, communication, hand hygiene and hygiene of the hospital environment, spread of diseases, relations between caregivers and professionals and care processes/procedures were all cited.
Final considerations:
communication and the relations among caregivers and professionals are the main contributory factors for patient safety incidents, interfering with the quality of care. The participation of caregivers and engagement in child care may be strategies to be developed to promote a safety culture.
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ORIGINAL ARTICLE
Maternal and child health care: adequacy index in public health services
Revista Brasileira de Enfermagem. 2020;73:e20170757
07-31-2020
Abstract
ORIGINAL ARTICLEMaternal and child health care: adequacy index in public health services
Revista Brasileira de Enfermagem. 2020;73:e20170757
07-31-2020DOI 10.1590/0034-7167-2017-0757
Views0See moreABSTRACT
Objectives:
to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service.
Methods:
longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 – Prenatal, 2 – Maternity, 3 – Immediate puerperal return, 4 – Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior.
Results:
lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3.
Conclusions:
in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.
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ORIGINAL ARTICLE
Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
09-16-2019
Abstract
ORIGINAL ARTICLETemporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
09-16-2019DOI 10.1590/0034-7167-2018-0682
Views0See moreABSTRACT
Objective:
to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016.
Method:
a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model.
Results:
There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126).
Final considerations:
leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services
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ORIGINAL ARTICLE
Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
09-30-2020
Abstract
ORIGINAL ARTICLEOrganizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
09-30-2020DOI 10.1590/0034-7167-2019-0732
Views0See moreABSTRACT
Objective:
To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities.
Method:
Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman’s correlation coefficient and Chi-squared test (p<0.05).
Results:
Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices.
Conclusion:
This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.
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COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
04-14-2021
Abstract
COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention
Revista Brasileira de Enfermagem. 2021;74:e20201185
04-14-2021DOI 10.1590/0034-7167-2020-1185
Views0See moreABSTRACT
Objective:
to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position.
Method:
this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid.
Results:
all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested.
Conclusions:
the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.
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Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
03-19-2021
Abstract
Production and validation of educational technology on nursing care for syphilis prevention
Revista Brasileira de Enfermagem. 2021;74:e20190694
03-19-2021DOI 10.1590/0034-7167-2019-0694
Views0See moreABSTRACT
Objectives:
Validate script and storyboard of a video for educational intervention on nursing care for the prevention and management of syphilis.
Methods:
Methodological design study, with quantitative analysis approach. The content and appearance of the educational video script and storyboard was validated by a committee of experts on the subject and video. They were considered validated from the agreement of 78%, calculated by means of the Content Validity Index.
Results:
There were suggestions, which were analyzed; and, where relevant, the script and storyboard were changed. The degree of agreement among the expert judges on the subject obtained a Content Validity Index (CVI) of 100%, while, with the technical experts in video, all the questions in the educational material obtained the percentage above the recommended minimum of 78%.
Conclusion:
The validated video is an important technological production and could be used in the context of health care.
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REVIEW
Singular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
03-09-2020
Abstract
REVIEWSingular therapeutic project in mental health: an integrative review
Revista Brasileira de Enfermagem. 2020;73(2):e20180508
03-09-2020DOI 10.1590/0034-7167-2018-0508
Views0ABSTRACT
Objectives:
to analyze the Singular Therapeutic Projects’ characteristics in mental health care used to assist the subject with psychological distress.
Methods:
it is an Integrative Literature Review study conducted in July 2017. The following databases used to collect the data were LILACS, MEDLINE and BDENF. After applying the inclusion and exclusion criteria, 12 articles were selected.
Results:
there was divergence between what was recommended by the Ministry of Health for PTS elaboration with that described in the studies analyzed. Emphasis is placed on the low participation and co-responsibility between team/user in PTS elaboration, excessive referrals to specialized mental health services, fragmentation of knowledge within the multidisciplinary team, and difficulty sharing and discussing information about cases.
Final considerations:
it is pointed out the need to adapt PTS elaboration, and its respective steps, to the needs of each individual.
Keywords:Integrality in HealthMental HealthMental Health ServicesPatient Care PlanningPrimary Health CareSee more
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Aged (144) Atenção Primária à Saúde (239) COVID-19 (104) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Estudos de Validação (131) Health Education (144) Idoso (208) Mental Health (149) Nursing (987) Nursing Care (306) Patient Safety (151) Primary Health Care (284) Qualidade de Vida (104) Quality of Life (106) Saúde Mental (145) Segurança do Paciente (150) Validation Studies (108)