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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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ORIGINAL ARTICLE07-29-2024
Mental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
Abstract
ORIGINAL ARTICLEMental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
DOI 10.1590/0034-7167-2023-0457
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Objective:
To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health.
Methods:
exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis.
Results:
parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression.
Final considerations:
It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.
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07-29-2024
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
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Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
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Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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ORIGINAL ARTICLE07-29-2024
Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
Abstract
ORIGINAL ARTICLEDisrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
DOI 10.1590/0034-7167-2023-0464
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Objectives:
to develop and evaluate a Middle-Range Theory for the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” in high-risk pregnancies.
Methods:
this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem’s General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80.
Results:
the theory identified 20 elements of the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80.
Conclusions:
the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon “Disrupted Mother-Fetus Dyad Risk,” which aids in nurses’ diagnostic reasoning.
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
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Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
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ORIGINAL ARTICLE07-29-2024
Primary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
Abstract
ORIGINAL ARTICLEPrimary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
DOI 10.1590/0034-7167-2024-0468
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Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final Considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
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ORIGINAL ARTICLE07-29-2024
Completeness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
Abstract
ORIGINAL ARTICLECompleteness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
DOI 10.1590/0034-7167-2023-0467
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Objectives:
to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.
Methods:
an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.
Results:
there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables “family history of cancer” (p<0.001), “alcoholism” (p<0.001), “smoking” (p<0.001), “TNM staging” (p<0.001) had a decreasing trend, while “clinical start of treatment” (p<0.001), “origin” (p=0.008) and “occupation” (p<0.001) indicated an increasing trend.
Conclusions:
most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.
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ORIGINAL ARTICLE01-30-2023
Adverse dermatoneurological events and impacts on daily activities of patients with gastrointestinal neoplasms undergoing chemotherapy
Revista Brasileira de Enfermagem. 2023;76(1):e20220161
Abstract
ORIGINAL ARTICLEAdverse dermatoneurological events and impacts on daily activities of patients with gastrointestinal neoplasms undergoing chemotherapy
Revista Brasileira de Enfermagem. 2023;76(1):e20220161
DOI 10.1590/0034-7167-2022-0161
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Objective:
to associate the presence and grading of adverse dermatoneurological events (peripheral neuropathy and hand-foot syndrome) and the interference in the activities of daily living of patients with gastrointestinal neoplasms undergoing systemic antineoplastic treatment.
Method:
this is a longitudinal, prospective study, using instruments to assess hand-foot syndrome and peripheral neuropathy.
Results:
there were 36 patients: 66.7% diagnosed with colon cancer and 83.2% on combination therapy. From cycle 5 onwards, all of them had hand-foot syndrome, with a majority of grade 1, unrelated to interference in activities of daily living. Regarding peripheral neuropathy, there was a moderate to strong correlation from cycle 1 of treatment.
Conclusion:
peripheral neuropathy negatively affects activities of daily living. The monitoring of dermatoneurological events by oncology nurses contributes to the clinical practice of nursing and subsidizes the development of advanced practice in the country.
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ORIGINAL ARTICLE12-16-2023
Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District
Revista Brasileira de Enfermagem. 2023;76(1):e20220170
Abstract
ORIGINAL ARTICLEElderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District
Revista Brasileira de Enfermagem. 2023;76(1):e20220170
DOI 10.1590/0034-7167-2022-0170
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Objectives:
To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District.
Methods:
Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%.
Results:
There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999).
Conclusions:
Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.
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ORIGINAL ARTICLE11-28-2023
Syphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
Abstract
ORIGINAL ARTICLESyphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism
Revista Brasileira de Enfermagem. 2023;76(1):e20220210
DOI 10.1590/0034-7167-2022-0210
Views1See moreABSTRACT
Objectives:
to understand the meanings attributed by women to the diagnosis and treatment of syphilis and congenital syphilis, and to outpatient follow-up of their children.
Methods:
this is a qualitative study conducted with 30 mothers of children with congenital syphilis using audio-recorded semi-structured interviews, which were submitted to inductive thematic analysis. Symbolic interactionism was the theoretical framework considered in this study.
Results:
two themes were identified, showing the maternal diagnosis involved shock, guilt, and fear of social exclusion, in addition to frustration due to failure to prevent vertical transmission. Moreover, the painful clinical procedures for the child’s treatment enhanced maternal guilt, and the symbolic process of re-signification of the disease/treatment took place with the child’s healing.
Final Considerations:
understanding the intersubjective aspects involved in this experience helps nurses rethink their care practice and contributes to their critical role in the context of syphilis.
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ORIGINAL ARTICLE11-28-2023
Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
Abstract
ORIGINAL ARTICLEBrazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(1):e20220315
DOI 10.1590/0034-7167-2022-0315
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Objectives:
to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains.
Methods:
in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient.
Results:
the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001).
Conclusions:
poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.
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ORIGINAL ARTICLE02-06-2023
Teaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal
Revista Brasileira de Enfermagem. 2023;76(2):e20210244
Abstract
ORIGINAL ARTICLETeaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal
Revista Brasileira de Enfermagem. 2023;76(2):e20210244
DOI 10.1590/0034-7167-2021-0244
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Objective:
To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning.
Methods:
Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher’s exact tests, with differences considered statistically significant if p < 0.05.
Results:
Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods.
Conclusions:
The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.
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ORIGINAL ARTICLE03-06-2023
Medication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
Abstract
ORIGINAL ARTICLEMedication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
DOI 10.1590/0034-7167-2021-0755
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Objectives:
to develop and validate the content of two instruments for promoting medication reconciliation for the transition of care of hospitalized children.
Methods:
methodological study, conducted in five stages: scope review for conceptual structure; elaboration of the initial version; content validation with five specialists using the Delphi technique; reassessment; and construction of the final version of the instruments. A content validity index of at least 0.80 was adopted.
Results:
three rounds of evaluation were carried out to reach the validity index of the proposed contents, whereas a new analysis of 50% of the 20 items of the instrument aimed at families, and 28.5% of the 21 items aimed at professionals was necessary. The instrument aimed at families reached an index of 0.93, and the instrument for professionals, 0.90.
Conclusions:
the proposed instruments were validated. It is now possible to proceed with practical implementation studies to identify their influence on safety during medication reconciliation at transition of care.
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ORIGINAL ARTICLE05-08-2023
Precarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
Abstract
ORIGINAL ARTICLEPrecarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
DOI 10.1590/0034-7167-2022-0120
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Objectives:
to analyze the implications of precarious work for the organization of work and for the health of nursing professionals in a surgical center.
Methods:
qualitative, descriptive study in which the interview technique was applied on 30 nursing professionals from a surgical center in a university hospital located in the Southeast region of Brazil. The project was approved by the research ethics committee. Thematic content analysis was applied in the categorization of speeches.
Results:
precarious work in the surgical center negatively affects the organization of work due to staff turnover, loss of skilled talent, and the need for continuous training of temporary workers. It also affects the quality of care, leading to risks to patient safety and workers’ health.Final Considerations: it is important to make work conditions less precarious in order to minimize staff turnover and promote the quality of the service offered and the health of the worker.
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ORIGINAL ARTICLE04-07-2023
Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
Abstract
ORIGINAL ARTICLESuicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
DOI 10.1590/0034-7167-2022-0137
Views1See moreABSTRACT
Objectives:
to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt.
Methods:
an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis.
Results:
eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified.
Conclusions:
adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
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