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ORIGINAL ARTICLE
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
07-31-2023
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
07-31-2023DOI 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 ARTICLE
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
07-10-2023
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
07-10-2023DOI 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 ARTICLE
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
07-10-2023
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
07-10-2023DOI 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 ARTICLE
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
07-10-2023
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
07-10-2023DOI 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 -
ORIGINAL ARTICLE
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
07-10-2023
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
07-10-2023DOI 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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REVIEW
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
07-10-2023
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
07-10-2023DOI 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 -
REVIEW
Barriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
Revista Brasileira de Enfermagem. 2023;76(3):e20210963
06-26-2023
Abstract
REVIEWBarriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
Revista Brasileira de Enfermagem. 2023;76(3):e20210963
06-26-2023DOI 10.1590/0034-7167-2021-0963
Views0ABSTRACT
Objectives:
to identify and synthesize scientific evidence on the barriers and difficulties for Pre-exposure Prophylaxis (PrEP) use and compliance for HIV.
Methods:
an integrative literature review, using the MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier and Scopus (Elsevier) databases.
Results:
all (100%) the articles included identified that PrEP users experience some type of structural barrier related to health services such as long distance from the units, suboptimal logistics for taking pills and professional resistance to prescribing PrEP. Furthermore, 63.21% identified social barriers, such as stigma about sexuality and HIV, in addition to individual barriers such as alcohol use, adverse effects, and concerns about long-term toxicity.
Conclusions:
the barriers to PrEP use are multifactorial. Effective interventions are needed to support PrEP users in accessing, complying with, and retaining health services.
Keywords:Access to Health ServicesAnti-HIV AgentsPre-Exposure ProphylaxisPrevention and ControlSexual HealthSee more
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ORIGINAL ARTICLE
Validation of educational booklet: an educational technology in dengue prevention
Revista Brasileira de Enfermagem. 2019;72(5):1318-1325
09-16-2019
Abstract
ORIGINAL ARTICLEValidation of educational booklet: an educational technology in dengue prevention
Revista Brasileira de Enfermagem. 2019;72(5):1318-1325
09-16-2019DOI 10.1590/0034-7167-2018-0771
Views0See moreABSTRACT
Objective:
to validate a booklet on dengue prevention in order to make it an educational technology to be used with the population.
Method:
methodological study, carried out with two groups of judges specialized in health and other areas. For data analysis, the calculation of Content Validity Index was carried out.
Results:
the booklet, in general, was considered valid by the expert judges, since it obtained an overall CVI of 70%. However, it has undergone a textual and aesthetic re-elaboration. The changes were based on the substitution of expressions, phrases, information additions and language adequacy. The illustrations were redone, adding clarity, expressiveness, movement, interaction and contextualization.
Conclusion:
the booklet is valid to be used for the population, with the purpose of informing, in a playful way, the forms of prevention and combat to mosquito transmitting dengue.
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REVIEW
Mental health of healthcare professionals in China during the new coronavirus pandemic: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200338
09-18-2020
Abstract
REVIEWMental health of healthcare professionals in China during the new coronavirus pandemic: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200338
09-18-2020DOI 10.1590/0034-7167-2020-0338
Views0See moreABSTRACT
Objective:
to identify publishing related to the mental health of health professionals working in the front line of the COVID-19 pandemic.
Methods:
an integrative review that included primary articles indexed in the Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Science Direct databases and US National Library of Medicine databases. The result analysis was performed descriptively, in four analytical categories.
Results:
The publishing involved aspects related to insufficient personal protective equipment, feelings of fear and stigma, the need for psychological and psychiatric support and the possibility of post-outbreak mental disorders.
Conclusion:
All mentioned aspects have a direct impact on the mental health of professionals, demanding the creation of strategies that minimize the emotional burnout of workers, considering that each country and culture reacts differently to the disease.
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ORIGINAL ARTICLE
Religious/spiritual coping and level of hope in patients with cancer in chemotherapy
Revista Brasileira de Enfermagem. 2019;72(3):640-645
06-27-2019
Abstract
ORIGINAL ARTICLEReligious/spiritual coping and level of hope in patients with cancer in chemotherapy
Revista Brasileira de Enfermagem. 2019;72(3):640-645
06-27-2019DOI 10.1590/0034-7167-2018-0358
Views0See moreABSTRACT
Aim:
To demonstrate the relationship between religious/spiritual coping and hope in cancer patients undergoing chemotherapy.
Method:
This is a cross-sectional, descriptive study with a quantitative approach performed in a reference outpatient clinic in Caruaru, PE, between August and October 2017. A total of 82 cancer patients undergoing chemotherapy were included in the study, using the brief religious/spiritual coping scale (RCOPE-Brief) and the Herth Hope Scale (HHS).
Results:
The sample presented mean positive RCOPE scores (3.03 ± 0.41) and the level of hope was considered high (42.7 points ± 3.67). Patients who had a high RCOPE score were found to have a higher mean of Herth’s level of hope (44.12 points).
Conclusion:
This study becomes relevant to nursing professionals by encouraging care that takes into account the patient’s spiritual dimension in order to stimulate positive mechanisms of religious coping and, consequently, raise the levels of hope.
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ORIGINAL ARTICLE
Construction and validation of an educational booklet on care for children with gastrostomy
Revista Brasileira de Enfermagem. 2020;73(3):e20190108
04-22-2020
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational booklet on care for children with gastrostomy
Revista Brasileira de Enfermagem. 2020;73(3):e20190108
04-22-2020DOI 10.1590/0034-7167-2019-0108
Views0See moreABSTRACT
Objectives:
to describe the process of construction and validation of an educational booklet on care for children with gastrostomy, directed to caregivers.
Methods:
a methodological study developed in five stages: bibliographic survey; situational diagnosis; illustration, layout, design and text construction; expert validation and Flesch-Kincaid Readability calculation; validation with the target audience. Content Validity Index and Suitability Assessment of Materials were applied for expert analysis.
Results:
the Content Validity Index obtained overall score of 0.93. In the Suitability Assessment of Materials score, the booklet scored 85.2%. It presented a satisfactory readability percentage, with an overall score of 72%, and was consistent with caregivers’ assessment in the validation with the target audience, considering the explanatory technology, important and adequate.
Conclusions:
the developed educational booklet was considered valid for use by caregivers, thus contributing to the maintenance of best practices in care for children with gastrostomy.
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REVIEW
Hospital transition care for the elderly: an integrative review
Revista Brasileira de Enfermagem. 2019;72:294-301
12-05-2019
Abstract
REVIEWHospital transition care for the elderly: an integrative review
Revista Brasileira de Enfermagem. 2019;72:294-301
12-05-2019DOI 10.1590/0034-7167-2018-0286
Views0See moreABSTRACT
Objective:
to identify evidence of scientific production on hospital transition care provided to the elderly.
Method:
an integrative review, with publications search in the MEDLINE, PubMed, LILACS, BDENF, Index Psychology and SciELO databases, with keywords and Mesh terms: elderly, hospitalization, patient discharge, health of the elderly, and transitional care, between 2013 and 2017 in English, Portuguese and Spanish. The 14 selected articles analysis was carried out through exploratory and critical reading of titles, abstracts and results of the researches.
Results:
transitional care can prevent re-hospitalizations as they enable rehabilitation, promotion and cure of illnesses in the elderly.
Final considerations:
transitional care implies the improvement of the quality of life of the elderly person, requiring skilled health professionals who involve the family through accessible communication.
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ORIGINAL ARTICLE
Development of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020
Abstract
ORIGINAL ARTICLEDevelopment of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020DOI 10.1590/0034-7167-2019-0559
Views1ABSTRACT
Objectives:
to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health.
Methods:
methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity.
Results:
the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style.
Conclusions:
the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.
Keywords:Educational TechnologyHealth EducationMethodological Research in NursingTechnological DevelopmentValidation StudiesSee more -
ORIGINAL ARTICLE
Burnout among nursing students: predictors and association with empathy and self-efficacy
Revista Brasileira de Enfermagem. 2020;73(1):e20180280
02-10-2020
Abstract
ORIGINAL ARTICLEBurnout among nursing students: predictors and association with empathy and self-efficacy
Revista Brasileira de Enfermagem. 2020;73(1):e20180280
02-10-2020DOI 10.1590/0034-7167-2018-0280
Views0See moreABSTRACT
Objective:
to analyze burnout, its predictors and association with empathy and self-efficacy among nursing students.
Method:
cross-sectional analytical study with 284 students from five state universities in the state of Parana, Brazil. The instruments applied were: social and academic questionnaire, Maslach Burnout Inventory, Interpersonal Reactivity Index and Occupational Self-Efficacy Scale (Short Form). Spearman’s correlation and univariate and multivariate logistic analysis were used.
Results:
6.0% of the students presented high burnout, 36.3% presented high emotional exhaustion, 37.7% presented high depersonalization and 28.2% presented low personal accomplishment. The burnout predictors were: absence of physical activity; weekly workload >24 hours; low empathic concern. There were negative correlations between empathy (empathic concern and perspective taking) and depersonalization; self-efficacy and emotional exhaustion; and positive correlations between personal accomplishment and empathy and self-efficacy.
Conclusion:
Personal factors and an academic variable were burnout predictors among nursing students. The correlations suggest that self-efficacy and empathy can prevent burnout.
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REVIEW
Positive aspects of authentic leadership in nursing work: integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190118
08-07-2020
Abstract
REVIEWPositive aspects of authentic leadership in nursing work: integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190118
08-07-2020DOI 10.1590/0034-7167-2019-0118
Views0See moreABSTRACT
Objective:
To identify and analyze the existing scientific production on the positive aspects of authentic leadership in the nurse’s work process.
Method:
This is an integrative literature review. The databases used were Scientific Electronic Library Online; Latin American and Caribbean Literature on Health Sciences; and National Library of Medicine – National Institutes of Health.
Results:
In this study, 17 articles were selected for analysis; 1 study (6%) was published in a national journal, and 16 (94%) were international studies. Of the 17 (100%) articles studied, 11 (65%) were developed in Canada. The hospital environment was present in the 17 (100%) articles.
Final considerations:
Authentic leadership has several positive aspects that significantly influence the nurse’s work process, such as engagement and job satisfaction, retention of new nurses, organizational commitment, among others.
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