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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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Humor intervention in the nurse-patient interaction
Revista Brasileira de Enfermagem. 2019;72(4):1078-1085
08-19-2019
Abstract
Humor intervention in the nurse-patient interaction
Revista Brasileira de Enfermagem. 2019;72(4):1078-1085
08-19-2019DOI 10.1590/0034-7167-2018-0609
Views0ABSTRACT
Objective:
To describe the factors influencing the use of humor in nursing care, its applicability and benefits.
Method:
A scoping review was performed using the Arksey and O’Mally methodology. A search for articles published between 2008 and 2018 was performed using the platforms EBSCO Host, Virtual Health Library and Google Scholar.
Results:
From the initial 465 articles found, 17 were included for final revision. Data allowed to retrieve information on humor definition; its applicability as a nursing intervention; humor as a tool to improve nurse-patient communication and relationship; influence factors; type of humor interventions; humor benefits in health care context and; limitations and precautions of humor intervention.
Conclusion:
The use of humor promotes both communication and human interaction; it promotes well-being; helps deal/cope with difficult and unpleasant situations, reduces tension, discomfort and stress; and strengthens the immune system. This intervention should be used with caution.
Keywords:CommunicationNurse-Patient RelationsNursingPatient Outcome AssessmentWit and Humor as SubjectSee more -
ORIGINAL ARTICLE
Workloads and burnout of nursing workers
Revista Brasileira de Enfermagem. 2019;72(6):1435-1441
10-21-2019
Abstract
ORIGINAL ARTICLEWorkloads and burnout of nursing workers
Revista Brasileira de Enfermagem. 2019;72(6):1435-1441
10-21-2019DOI 10.1590/0034-7167-2017-0659
Views0See moreABSTRACT
Objective:
to identify workloads in nursing work and its association with nursing worker burnout.
Method:
a cross-sectional study, including 211 nursing workers from a university hospital, between July and August 2016. For the analysis, the descriptive statistics, Chi-Square Test, Fisher’s Exact Test and Mann Whitney U-Test were used.
Results:
the most evidenced loads were biological. A significant association was found between workloads and workers’ occupation, as well as a significant association between workloads and worker burnout. Burnout caused upper limb pain, neck and lumbar pain, lower limb pain, muscle spasm, lower limb edema, mental fatigue, headache, nervousness, and forgetfulness.
Conclusion:
workloads identification is a subsidy for the promotion of interventions that minimize the burnout generated to the health of the nursing worker.
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ORIGINAL ARTICLE
Nursing care systematization: perceptions and knowledge of the Brazilian nursing
Revista Brasileira de Enfermagem. 2019;72(6):1547-1553
10-21-2019
Abstract
ORIGINAL ARTICLENursing care systematization: perceptions and knowledge of the Brazilian nursing
Revista Brasileira de Enfermagem. 2019;72(6):1547-1553
10-21-2019DOI 10.1590/0034-7167-2018-0606
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Objective:
to present the perception and knowledge of Brazilian nursing nurses and academics regarding Nursing Care Systematization.
Method:
a descriptive study, carried out in the first half of 2018.
Results:
of the 596 respondents, 86% perceived Nursing Care Systematization as very important, but only 60.9% used it in their care practice. Its use was statistically associated with a higher level of training. Non-utilization was associated with the perception that it is irrelevant and with little knowledge on the Nursing Process, even in the face of recognition of its obligation. Among professionals who wish to learn more about the subject, understanding the application of the process, especially the planning step, is perceived as a necessity.
Conclusion:
the relevance perception of systematization and levels of knowledge of the professional/academic are directly related to the use or not of Nursing Care Systematization principles.
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Burnout Syndrome and Associated Factors in Intensive Care Unit Nurses
Revista Brasileira de Enfermagem. 2021;74:e20190535
01-20-2021
Abstract
Burnout Syndrome and Associated Factors in Intensive Care Unit Nurses
Revista Brasileira de Enfermagem. 2021;74:e20190535
01-20-2021DOI 10.1590/0034-7167-2019-0535
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Objective:
to estimate prevalence and factors associated with Burnout Syndrome in intensive care nurses in a city in the state of Bahia.
Methods:
a cross-sectional, population-based study carried out with 65 intensive care nurses through a self-administered questionnaire, from July to November 2016, containing sociodemographic data, lifestyle, work characteristics. To define burnout syndrome, the Maslach Burnout Inventory was used.
Results:
Burnout Syndrome prevalence was 53.6%, an association was observed with age, tobacco consumption, alcohol use, weekly night shift hours, employment relationship, having an intensive care specialist title, number of patients on duty, monthly income and considering active or high-strain job.
Conclusion:
the results of this study can contribute to expanding the discussion on stressful working conditions in Intensive Care Units.
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ORIGINAL ARTICLE
Elderly caregivers of the elderly: frailty, loneliness and depressive symptoms
Revista Brasileira de Enfermagem. 2019;72:88-96
12-05-2019
Abstract
ORIGINAL ARTICLEElderly caregivers of the elderly: frailty, loneliness and depressive symptoms
Revista Brasileira de Enfermagem. 2019;72:88-96
12-05-2019DOI 10.1590/0034-7167-2018-0137
Views0See moreABSTRACT
Objective:
to investigate the association between frailty, loneliness and depressive symptoms of elderly caregivers.
Method:
a cross – sectional study carried out with 341 elderly caregivers enrolled in Family Health Units of a city in the countryside of São Paulo State. The interviews were domiciliary and included questionnaire for characterization of the caregiver, Fried’s frailty phenotype, family APGAR (family functionality), Geriatric Depression Scale (depressive symptoms) and item 3 of the Herth Hope Scale (loneliness). Logistic regression was used to analyze the association between depressive symptoms and solitude (independent variables), and frailty and pre-frailty (dependent variables).
Results:
there was an association between frailty, loneliness and depressive symptoms. Elderly caregivers had increased odds of 158% presenting pre-frailty, and 360% of frailty. Elderly caregivers with depressive symptoms had an increased chance of 242% of presenting fragility.
Conclusion:
elderly and lonely caregivers with depressive symptoms are more likely to be frail and pre-frail.
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Clinical simulation in nursing education in intensive therapy: an integrative review
Revista Brasileira de Enfermagem. 2019;72(4):1061-1070
08-19-2019
Abstract
Clinical simulation in nursing education in intensive therapy: an integrative review
Revista Brasileira de Enfermagem. 2019;72(4):1061-1070
08-19-2019DOI 10.1590/0034-7167-2018-0217
Views0See moreABSTRACT
Objective:
to analyze the publications on clinical simulation practices for education in Nursing in Intensive Care.
Method:
an integrative review carried out through LILACS, PubMed, Cochrane Library, CINAHL and SciELO databases, of articles published from 2008 to 2017.
Results:
29 articles were selected, of which 76% discuss the use of simulation in continuing education of nursing professionals, while the others describe their use for student education. There is a higher prevalence of studies with a level of evidence 6 (17), with 28 international publications. There was an increase in scientific production, with 16 articles published in the last three years.
Conclusion:
variables after simulation use, such as confidence, communication skills, efficiency in the identification of clinical worsening of patients, development of technical skills, teamwork and clinical decision-making, presented a significant improvement, demonstrating that this tool is effective in qualifying care for critical patients.
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ORIGINAL ARTICLE
Usability of a mobile application on diabetic foot self-care
Revista Brasileira de Enfermagem. 2020;73(4):e20180862
06-08-2020
Abstract
ORIGINAL ARTICLEUsability of a mobile application on diabetic foot self-care
Revista Brasileira de Enfermagem. 2020;73(4):e20180862
06-08-2020DOI 10.1590/0034-7167-2018-0862
Views0See moreABSTRACT
Objectives:
to assess the usability of an app prototype for diabetic foot self-care by an end user.
Methods:
a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied.
Results:
the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype.
Conclusions:
the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.
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