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ORIGINAL ARTICLE09-24-2022
Spatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
Abstract
ORIGINAL ARTICLESpatial analysis of AIDS in the state of Maranhão: an ecological study 2011-2018
Revista Brasileira de Enfermagem. 2022;75(1):e20210131
DOI 10.1590/0034-7167-2021-0131
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Objective:
Analyze the spatio-temporal distribution of AIDS cases in Maranhão.
Methods:
Ecological study of AIDS cases in the Notifiable Diseases Information System, 2011-2018. Gross and adjusted incidences were calculated using the Baysean method; then, the Moran Global and Local Indices to observe the existence of spatial autocorrelation of the cases and for the delimitation of high and low risk clusters.
Results:
6,349 cases were reported, which were distributed heterogeneously. There was an advance of cases to new areas and persistence in old areas, such as in the capital São Luís and its surroundings. The dissemination did not occur at random, with positive spatial autocorrelation, with evidence of the formation of clusters in the municipalities of São Luís, São José de Ribamar and Paço do Lumiar.
Conclusion:
High-risk areas have been identified and should be considered a priority for investment in health, management, and organization of health services.
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TECHNOLOGICAL INNOVATION09-24-2022
Transitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
Abstract
TECHNOLOGICAL INNOVATIONTransitional care from the hospital to the home in heart failure: implementation of best practices
Revista Brasileira de Enfermagem. 2022;75(1):e20210123
DOI 10.1590/0034-7167-2021-0123
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Objectives:
Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home.
Methods:
Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits.
Results:
In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria.
Conclusion:
The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.
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ORIGINAL ARTICLE09-24-2022
Characterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
Abstract
ORIGINAL ARTICLECharacterization of obstetric care developed in teaching hospitals in a capital of northeast Brazil
Revista Brasileira de Enfermagem. 2022;75(1):e20200896
DOI 10.1590/0034-7167-2020-0896
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Objective:
to describe the obstetric care developed in teaching hospitals (TH) in the city of Maceió-AL, intended for high-risk pregnancies.
Methods:
Retrospective cohort study performed between June and November 2018 with 291 women who received assistance with vaginal delivery, cesarean section, or abortion process in teaching hospitals selected as settings for this research. Data collection allowed the characterization of the interviewees as well as the assistance received and its relationship with obstetric violence. The analysis was performed using descriptive and analytical statistics with the aid of the Epi Info software (version 7.2.0.1) and measures that allowed the comparison of means and proportions.
Results:
All women reported at least one violent situation, contrary to recommendations based on scientific evidence.
Conclusion:
It becomes necessary to optimize professional training to deconstruct obstetric care based on medicalization and pathologization of pregnancy and strengthen science-based care.
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ORIGINAL ARTICLE09-24-2022
Risk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
Abstract
ORIGINAL ARTICLERisk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
DOI 10.1590/0034-7167-2021-0022
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Objectives:
to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.
Methods:
a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.
Results:
we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.
Conclusions:
the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.
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ORIGINAL ARTICLE09-23-2022
Peripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
Abstract
ORIGINAL ARTICLEPeripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates
Revista Brasileira de Enfermagem. 2022;75(4):e20210967
DOI 10.1590/0034-7167-2021-0967
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Objectives:
to estimate incidence and free time of peripherally inserted central catheter obstruction in newborns undergoing red blood cell transfusion in the first 24 hours after the procedure.
Methods:
a longitudinal study, carried out with neonates in Neonatal Intensive Care Unit at a teaching hospital in Paraná, between January and July 2019. The sample consisted of 46 transfusion events performed in neonates through a peripherally inserted central catheter. Analysis performed according to descriptive statistics.
Results:
thirty-one catheters were analyzed, inserted in 24 neonates, through which 46 red blood cell transfusions were performed. Most neonates were male, gestational age <32 weeks, weight <1,500 grams, hospitalized mainly for prematurity. Among the 31 catheters, one (3.2%) presented obstruction after transfusion.
Conclusions:
The occurrence of obstructions immediately after transfusion was low and the catheters remained complication free for the next 24 hours.
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ORIGINAL ARTICLE09-23-2022
Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
Abstract
ORIGINAL ARTICLEValidation of the Informal Caregiver Burden Assessment Questionnaire for Brazil – short version
Revista Brasileira de Enfermagem. 2022;75(4):e20210862
DOI 10.1590/0034-7167-2021-0862
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Objectives:
to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties.
Methods:
the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity.
Results:
inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain “Perception of Efficacy and Control Mechanisms” showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70).
Conclusions:
the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.
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ORIGINAL ARTICLE09-23-2022
Analysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
Abstract
ORIGINAL ARTICLEAnalysis of the concept of cardiovascular risk: contributions to nursing practice
Revista Brasileira de Enfermagem. 2022;75(4):e20210803
DOI 10.1590/0034-7167-2021-0803
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Objectives:
to analyze the concept of cardiovascular risk to support nursing practice.
Methods:
this is an analysis to define the concept of cardiovascular risk, through the use of eight steps of Walker’s and Avant’s framework, using a literature review in indexed scientific journals.
Results:
cardiovascular risk is defined in a broad and original way as a context of health and nursing care that makes it possible to identify modifiable (cardiometabolic, behavioral, psychosocial, cultural and occupational) and non-modifiable (biological) risk factors for cardiovascular diseases that act as early and interrelated markers, of multiple and heterogeneous etiology, predisposing to cardiovascular vulnerability.
Conclusions:
with the analysis and definition of the concept of cardiovascular risk, we realized that it will be possible to base nursing practice, with implications in clinical practice for identifying and reducing risk factors for cardiovascular diseases, with nursing relevance in the care of these subjects.
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ORIGINAL ARTICLE09-23-2022
Brain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
Abstract
ORIGINAL ARTICLEBrain death communication with parents of children and adolescents: care strategies
Revista Brasileira de Enfermagem. 2022;75(3):e20210943
DOI 10.1590/0034-7167-2021-0943
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Objectives:
to identify care strategies developed by professionals from critically ill patients’ units in communicating BD with parents of children and adolescents.
Methods:
an exploratory and descriptive research with a qualitative approach, carried out in two health institutions between October and December 2019, through semi-structured interviews. Data analysis took place through content analysis.
Results:
twenty-one professionals participated. Three care strategies were identified: actual clinical situation in suspected brain death; sensitizing families to the real clinical situation after brain death diagnosis; and time to assimilate the death information.
Final Considerations:
the care strategies for communicating brain death to families identified in this study present the possibility of subsidizing health managers in training and support promotion for professionals in care practice. Moreover, they can be incorporated and validated in the care practice of the studied context.
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07-05-2021
Selenium concentrations in elderly people with Alzheimer’s disease: a cross-sectional study with control group
Revista Brasileira de Enfermagem. 2021;74:e20200984
Abstract
Selenium concentrations in elderly people with Alzheimer’s disease: a cross-sectional study with control group
Revista Brasileira de Enfermagem. 2021;74:e20200984
DOI 10.1590/0034-7167-2020-0984
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Objective:
To investigate possible differences in plasma and erythrocyte concentrations of selenium among elderly with and without a diagnosis of Alzheimer’s disease (AD).
Methods:
Cross-sectional study, performed with an elderly group with Alzheimer’s disease, diagnosed by a geriatric doctor, and compared to an elderly group without the disease, equaling gender, education, and age. Atomic absorption spectrophotometry determined plasma and erythrocyte concentrations of total selenium (Set).
Results:
The mean age was 74.41±7.1 years in the Alzheimer’s disease group and 71.46±5.1 years among the control group. The Alzheimer’s disease group presented lower plasma concentrations (mean of 45.29±14.51 µg/dL vs. 55.14±14.01 µg/dL; p=0.004), and erythrocyte Set (median of 56.36 µg/L vs. 76.96 µg/L; p<0.001). The logistic regression model indicated an association between erythrocyte Set concentrations and diagnosis of Alzheimer’s disease (p=0.028).
Conclusion:
Elderly with Alzheimer’s disease present lower selenium concentrations in the evaluated organic compartments.
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ORIGINAL ARTICLE12-13-2019
Hammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
Abstract
ORIGINAL ARTICLEHammock and nesting in preterm infants: randomized controlled trial
Revista Brasileira de Enfermagem. 2019;72:96-102
DOI 10.1590/0034-7167-2018-0099
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Objective:
To compare the physiological variables and the sleep-wake pattern presented by preterm in nesting and hammock positions after diaper change.
Method:
This is a crossover randomized controlled trial. It was conducted with 20 preterm infants who, after diaper change, were placed in nests or hammocks. These preterm infants were evaluated for physiological variables (heart rate and oxygen saturation) and behavioral variables (sleep and wakefulness).
Results:
There was no statistically significant difference in the studied variables between nesting and hammock positions. However, regarding the categorical variable sleep, the comparison between the research phases for the hammock position showed differences between the baseline phase and the immediate recovery (p=0.00), baseline and late recovery (p=0.00), response and immediate recovery (p=0.00), response and late recovery (p=0.00).
Conclusion:
No differences were identified between the nest and the hammock; however, the use of the hammock favored the sleep of preterm infants compared to its non-use.
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12-05-2019
Hospital care and urinary incontinence in the elderly
Revista Brasileira de Enfermagem. 2019;72:284-293
Abstract
Hospital care and urinary incontinence in the elderly
Revista Brasileira de Enfermagem. 2019;72:284-293
DOI 10.1590/0034-7167-2018-0273
Views0See moreABSTRACT
Objective:
to identify factors inherent in hospital care that favor urinary incontinence in the elderly.
Method:
an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model.
Results:
13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly.
Conclusion:
modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.
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04-14-2021
Child behavior during the social distancing in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200762
Abstract
Child behavior during the social distancing in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200762
DOI 10.1590/0034-7167-2020-0762
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Objective:
To describe the daily activities performed by children from 6 to 12 years of age incomplete and analyze children’s behavior during social distancing in the face of the COVID-19 pandemic.
Methods:
Cross-sectional study with children in a learning stage living in Brazil. The data were collected via online form. Fisher’s exact test was applied to analyze the association of categorical variables with child behavior; when significant, it was used the odds ratio. It was considered results considered statistically significant those presenting values of p < 0.05.
Results:
Data from 530 children were analyzed: 50.3% female, 71.3% from the Southeast Region, 73% in fulltime social distancing, 52% presented anxiety, which was significantly associated with changes in sleep and appetite.
Conclusion:
The results indicate the need for parents/caretakers to stimulate moments for the child to express themselves, not minimizing their feelings and providing emotional support to mitigate the negative impact of these feelings on the child’s mental and physical health.
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ORIGINAL ARTICLE09-21-2020
Prevalence of xerostomia in women during breast cancer chemotherapy
Revista Brasileira de Enfermagem. 2020;73:e20190785
Abstract
ORIGINAL ARTICLEPrevalence of xerostomia in women during breast cancer chemotherapy
Revista Brasileira de Enfermagem. 2020;73:e20190785
DOI 10.1590/0034-7167-2019-0785
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Objective:
To identify the prevalence of xerostomia in women undergoing chemotherapy for breast cancer.
Method:
Prospective cohort with 27 women who underwent up to 16 sessions of intravenous chemotherapy. Data collection was performed at the outpatient clinic of a university hospital in the city of São Paulo, where two forms were applied before the start of treatment and the Xerostomia Inventory before and after each chemotherapy session.
Results:
Complaints of dry mouth were present in 48.1% of women before chemotherapy, and they were approximately 28 times more likely to develop dry mouth during treatment. It was observed that the use of antiemetics contributed to the occurrence of xerostomia, and the anti-ulcerous were presented as a protective factor.
Conclusion:
The study identified both a high prevalence of xerostomia regardless of the chemotherapy used and the need to create protocols to improve the quality of life of these patients.
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ORIGINAL ARTICLE10-21-2019
Educational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
Abstract
ORIGINAL ARTICLEEducational hypermedia in nursing assistance at birth: building and validation of content and appearance
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
DOI 10.1590/0034-7167/2018-0163
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Objective:
to build an educational hypermedia about nursing care at usual risk birth and to perform validation of content and appearance.
Method:
methodological research carried out following the following stages: content and planning of modules; media production and organization of tutorial units; organization of student space, tutor and communication between them; availability of hypermedia; assessment by experts in nursing and informatics; and implementation of proposed suggestions.
Results:
educational hypermedia showed to be a validated material, since it presented an optimum index of global content of 0.97 and statistical significance in the binomial test for the content and appearance.
Conclusion:
it is believed that the use of this material with undergraduate students in nursing will contribute to the quality of obstetric care, considering that it is an illustrated technology capable of favoring teaching-learning about normal humanized childbirth.
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REFLECTION06-29-2020
Recommendations in covid-19 times: a view for home care
Revista Brasileira de Enfermagem. 2020;73:e20200310
Abstract
REFLECTIONRecommendations in covid-19 times: a view for home care
Revista Brasileira de Enfermagem. 2020;73:e20200310
DOI 10.1590/0034-7167-2020-0310
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Objective:
To suggest recommendations for the practice of Home Nursing in the context of COVID-19.
Method:
Reflective study, originated from readings associated with the theme, available in current guidelines from the Pan American Health Organization, World Health Organization and the Ministry of Health.
Results:
Recommendations were developed from current scientific evidence for prevention of infections, control of epidemics and pandemics in the Brazilian home scenario.
Final considerations:
the reflections achieved contribute to guiding actions for better assistance to the patient, family caregivers and the community in the perspective of safe home care with COVID-19, and it is characterized as an introductory discussion on the theme, encouraging new studies to be carried out from the unfolding of the current scenario.
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04-14-2021
Emotional labor of nurses in the front line against the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200660
Abstract
Emotional labor of nurses in the front line against the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200660
DOI 10.1590/0034-7167-2020-0660
Views1See moreABSTRACT
Objective:
To analyze nurses’ experiences in the front line of the fight against the COVID-19 pandemic regarding the performance of emotional labor (EL), aiming at its characterization and identification of support strategies and development opportunities of nurses and practices.
Methods:
Qualitative, descriptive, and exploratory study, with content analysis of eleven written narratives and reports from a focus group composed of nurses with experience in caring for patients with COVID-19 from different Hospital Centers in Lisbon, Portugal.
Results:
Five themes were extracted: 1) Challenges experienced by nurses in the frontline; 2) Emotions experienced by nurses in service care; 3) Emotional responses of nurses and patients: impact on care; 4) EL of nurses in the patient care process; 5) Opportunities for development in the face of the emotional challenge required of nurses in combating COVID-19.
Final considerations:
The nurses demonstrated the ability to transform this profoundly emotional experience positively.
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