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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0ABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
ORIGINAL ARTICLEMetodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0RESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0ABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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ORIGINAL ARTICLE06-28-2024
Quality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
Abstract
ORIGINAL ARTICLEQuality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20230402
DOI 10.1590/0034-7167-2023-0402
Views0See moreABSTRACT
Objective:
To assess the quality of care transition from hospital to home for COVID-19 patients.
Method:
A cross-sectional study conducted at a University Hospital in Southern Brazil, involving 78 patients discharged after COVID-19 hospitalization. Data collection was performed via telephone using the Brazilian version of the Care Transitions Measure (CTM-15). Data were analyzed using descriptive and analytical statistics.
Results:
The mean quality of care transition was 70.8 on a scale ranging from zero to 100, indicating moderate quality of care transition. The highest score was attributed to factor 1, “Preparation for self-management,” and the lowest to factor 4, “Care Plan.”
Conclusions:
It is important to enhance communication and support provided to patients during the transition process, especially regarding understanding prescribed medications and the development of clear care plans.
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REVIEW06-28-2024
Desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa
Revista Brasileira de Enfermagem. 2024;77:e20230400
Abstract
REVIEWDesfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa
Revista Brasileira de Enfermagem. 2024;77:e20230400
DOI 10.1590/0034-7167-2023-0400
Views0See moreRESUMEN
Objetivos:
analizar los desenlaces clínicos en recién nacidos de mujeres embarazadas con COVID-19.
Métodos:
revisión integradora realizada en PubMed, Web of Knowledge, SCOPUS, CINHAL; se obtuvieron 2.111 estudios y 8 artículos conformaron la muestra final.
Resultados:
los desenlaces clínicos en neonatos de mujeres embarazadas positivas para COVID-19 se clasificaron según las siguientes categorías: a) contaminación por COVID-19, reportada en el 62,5% de los estudios; b) alta hospitalaria debido a mejoría, mencionada en el 37,5% de los artículos; c) fallecimiento, representando casos raros en el 25% de la muestra. La complicación gestacional más prevalente fue la prematuridad, mencionada en el 75% de los estudios. Esta complicación se observó debido a casos de rotura prematura de membranas y desprendimiento de placenta.
Conclusiones:
a pesar del conocimiento del comportamiento asintomático y levemente sintomático en los recién nacidos, es importante continuar la búsqueda de nuevos datos clínicos, ya que este público presenta reacciones inciertas a la infección por el SARS-CoV-2.
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REVIEW06-28-2024
Clinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
Abstract
REVIEWClinical outcomes in newborns of pregnant women with COVID-19: integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230400
DOI 10.1590/0034-7167-2023-0400
Views0See moreABSTRACT
Objectives:
to analyze clinical outcomes in newborns of pregnant women with COVID-19.
Methods:
integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample.
Results:
clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption.
Conclusions:
despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.
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ORIGINAL ARTICLE06-28-2024
Nursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
Abstract
ORIGINAL ARTICLENursing leadership strategies in addressing COVID-19 in light of John Kotter’s framework
Revista Brasileira de Enfermagem. 2024;77:e20230289
DOI 10.1590/0034-7167-2023-0289
Views0See moreABSTRACT
Objective:
To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter’s insights.
Methods:
This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin’s content analysis and the webQDA software.
Results:
The primary category identified was “Nursing Leadership Strategies in the Battle Against COVID-19,” encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals.
Final Considerations:
The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter’s theoretical framework and his model of change.
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ORIGINAL ARTICLE06-28-2024
Palliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study
Revista Brasileira de Enfermagem. 2024;77:e20230218
Abstract
ORIGINAL ARTICLEPalliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study
Revista Brasileira de Enfermagem. 2024;77:e20230218
DOI 10.1590/0034-7167-2023-0218
Views0See moreABSTRACT
Objective:
To comprehend the multiprofessional actions regarding palliative care for patients in the Intensive Care Unit affected by SARS-CoV-2.
Methods:
A comprehensive qualitative study conducted with 31 professionals from the Intensive Care Units of a university hospital, based on the Theory of Peaceful End of Life.
Results:
The analysis of the discourse led to the identification of two categories: “Multidisciplinary actions to promote comfort at the end of life” and “Palliative care during the pandemic period and the promotion of emotional and spiritual comfort.”
Final Considerations:
It became evident that local administration needs to invest in measures that reduce barriers to the implementation of palliative care during times of crisis. Understanding the discourse highlighted that non-specialized professionals can provide basic palliative care appropriately, without diminishing the importance and necessity of the presence of palliative care specialists in various hospital areas.
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ORIGINAL ARTICLE06-28-2024
Uncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
Revista Brasileira de Enfermagem. 2024;77:e20230142
Abstract
ORIGINAL ARTICLEUncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human
Revista Brasileira de Enfermagem. 2024;77:e20230142
DOI 10.1590/0034-7167-2023-0142
Views0See moreABSTRACT
Objective:
To analyze the uncertainties experienced by nursing professionals who contracted COVID-19.
Methods:
This qualitative research was conducted with 20 nursing professionals who fell ill from COVID-19. Data collection was carried out through semi-structured interviews; the data were then organized using thematic analysis and discussed in the context of Merle Mishel’s Reconceptualized of Uncertainty in Illness Theory.
Results:
The antecedents of the disease had a strong influence on how nursing professionals who contracted COVID-19 perceived uncertainty. The media coverage of the increasing number of cases, the collapse of the healthcare system, and the high mortality rate contributed to associating the disease with fear and panic.
Final Considerations:
Viewing it from the perspective of the disease’s antecedents, the illness of a nursing professional from COVID-19 underscores that before being professionals, they are human beings just like anyone else, undergoing adversities and facing the possibilities associated with being ill.
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ORIGINAL ARTICLE06-28-2024
COVID-19 pandemic: what factors compromised the mental capacity to work of nursing technicians?
Revista Brasileira de Enfermagem. 2024;77:e20220783
Abstract
ORIGINAL ARTICLECOVID-19 pandemic: what factors compromised the mental capacity to work of nursing technicians?
Revista Brasileira de Enfermagem. 2024;77:e20220783
DOI 10.1590/0034-7167-2022-0783
Views0See moreABSTRACT
Objectives:
to identify the factors that influenced the mental capacity to work of nursing technicians during the COVID-19 pandemic.
Methods:
a cross-sectional study, carried out at two reference hospitals in assisting the population during the COVID-19 pandemic. A total of 237 professionals from Intensive Care Units participated and answered a questionnaire. Multiple linear regression models were used to assess the correlation between mental capacity to work and variables related to risks of contamination, institutional support and health.
Results:
lack of COVID-19 tests, lack of knowledge of routine, absences in 2021 and mental illness contributed to worse mental capacity to work. Management embracement and physical capacity were considered protective factors.
Conclusions:
reduced work capacity in relation to mental demands can affect professional performance and quality of care, with implications for patients and health institutions.
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ORIGINAL ARTICLE06-17-2024
Website for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
Abstract
ORIGINAL ARTICLEWebsite for families of non-breastfed children: development and validation of content and interface
Revista Brasileira de Enfermagem. 2024;77(3):e20230490
DOI 10.1590/0034-7167-2023-0490
Views0See moreABSTRACT
Objectives:
to develop and validate the content and interface of a guidance website to support families in promoting Food and Nutrition Security for children under six months who are not breastfed.
Methods:
methodological study, Knowledge Translation, in two stages of creation: 1) content and validation on the criterion of accuracy in a panel of experts; 2) interface and validation on the criteria of content, language, illustrations, layout, motivation, culture and applicability.
Results:
the “Milky Way” website is freely available: . The content was structured in a decision tree made up of types of milk: milk formula, whole cow’s milk and powdered milk; and utensils: bottle, cup and measuring spoon. There were 46 illustrations to elucidate the content, facilitate understanding and engage the target population. The Content Validity Index was 0.91.
Conclusions:
the website is a validated technology with evidence-based written and pictorial content translated for use with families.
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