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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023DOI 10.1590/0034-7167-2022-0759
Views0See moreABSTRACT
Objectives:
to reflect on the ethical dilemmas involved in the care of patients at the end of their lives.
Methods:
this is a theoretical-reflective study based on the ethics of care proposed by Luigina Mortari.
Results:
discussing care involves addressing the ways of being inherent to human existence and understanding the unique characteristics of this condition. Ethical care constitutes an action driven by interest in the other and by the perception of their need. Ethical dilemmas are a part of end-of-life care, making it essential to maintain respectful assistance that considers the patient’s autonomy, using strategies for expressing their wishes, and ensuring continuous clear and empathetic communication among all those involved in providing care.
Final Considerations:
issues related to being, stemming from one’s reality of dependency and vulnerability, contribute to the emergence of ethical dilemmas present in care actions.
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ORIGINAL ARTICLE
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023DOI 10.1590/0034-7167-2022-0684
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Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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ORIGINAL ARTICLE
Working conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023
Abstract
ORIGINAL ARTICLEWorking conditions in nursing in the face of Covid-19 from the perspective of precariousness
Revista Brasileira de Enfermagem. 2023;76:e20220679
12-04-2023DOI 10.1590/0034-7167-2022-0679
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Objective:
To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work.
Methods:
Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used.
Results:
among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410).
Conclusions:
The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.
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ORIGINAL ARTICLE
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
12-04-2023DOI 10.1590/0034-7167-2022-0553
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
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ORIGINAL ARTICLE
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023DOI 10.1590/0034-7167-2022-0586
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
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ORIGINAL ARTICLE
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023DOI 10.1590/0034-7167-2022-0597
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Objective:
The study aimed to analyze the factors that affect the community’s attitude towards COVID-19 vaccination in Tangerang District.
Methods:
A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval.
Results:
Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094).
Conclusions:
Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
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ORIGINAL ARTICLE
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023
Abstract
ORIGINAL ARTICLEAssessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
12-04-2023DOI 10.1590/0034-7167-2023-0068
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Objective:
to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic.
Methods:
A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods.
Results:
A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029).
Conclusion:
The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.
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Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023
Abstract
Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance
Revista Brasileira de Enfermagem. 2023;76:e20220803
12-04-2023DOI 10.1590/0034-7167-2022-0803
Views0ABSTRACT
Objective:
To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB).
Methods:
A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software.
Results:
Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities.
Conclusions:
This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.
Keywords:COVID-19Extensively Drug-Resistant TuberculosisMicrobial Drug ResistanceMultidrug-Resistant TuberculosisTuberculosisSee more
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Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
Revista Brasileira de Enfermagem. 2021;74:e20200915
05-21-2021
Abstract
Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
Revista Brasileira de Enfermagem. 2021;74:e20200915
05-21-2021DOI 10.1590/0034-7167-2020-0915
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Objective:
to understand how the COVID-19 pandemic mobilizes masculinities in relation to mental health.
Methods:
qualitative study conducted with 400 men, in a virtual environment, in all regions of Brazil. The data were analyzed by the Discourse of the Collective Subject and based on Symbolic Interactionism.
Results:
the mobilization of masculinities emerged from men towards the recognition of weaknesses and psycho-emotional vulnerabilities, with narratives that reveal the expression of feelings, pain, discomfort and psychological suffering, and showed themselves to be sensitive and engaged in performing practices, including autonomous ones, of health care mental.
Final considerations:
the pandemic mobilizes masculinities as men print meanings and senses, in their interaction and interpretation of mental health, and is a marker for the nursing clinic conduct.
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ORIGINAL ARTICLE
Health promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
03-24-2021
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
03-24-2021DOI 10.1590/0034-7167-2019-0769
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Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
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REVIEW
Influence of burnout syndrome on the quality of life of nursing professionals: quantitative study
Revista Brasileira de Enfermagem. 2021;74:e20200298
03-19-2021
Abstract
REVIEWInfluence of burnout syndrome on the quality of life of nursing professionals: quantitative study
Revista Brasileira de Enfermagem. 2021;74:e20200298
03-19-2021DOI 10.1590/0034-7167-2020-0298
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Objective:
To estimate the prevalence and factors associated with the burnout syndrome and quality of life among nursing professionals.
Methods:
Cross-sectional, analytical study, developed with 83 professionals in emergency care units in the city of Campina Grande-PB. A questionnaire was used to characterize the sample, the Maslach Burnout Inventory scale and the SF-36. Data was analyzed using descriptive and inferential statistics.
Results:
Most professionals showed low professional effectiveness (78.3; n=65), average depersonalization (53.0%; n=44) and average emotional exhaustion (55.4%; n=46). There was a statistical difference between the scores of the syndrome and the pain (p=0.03), vitality (p=0.04) and social aspect (p=0.03); significant correlation between the syndrome and vitality (p<0.001), mental health (p=0.01) and general quality of life (p=0.04).
Conclusion:
The burnout syndrome has an influence on the outcome of quality of life of nursing professionals, being more prevalent among professionals with older age, high income and among nurses.
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ORIGINAL ARTICLE
Medical device-related pressure injury prevention in critically ill patients: nursing care
Revista Brasileira de Enfermagem. 2021;74(2):e20200062
05-03-2021
Abstract
ORIGINAL ARTICLEMedical device-related pressure injury prevention in critically ill patients: nursing care
Revista Brasileira de Enfermagem. 2021;74(2):e20200062
05-03-2021DOI 10.1590/0034-7167-2020-0062
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Objectives:
to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients.
Methods:
this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used.
Results:
six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible.
Final Considerations:
nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.
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ORIGINAL ARTICLE
Factors associated with presenteeism in nursing workers
Revista Brasileira de Enfermagem. 2022;75(1):e20201290
10-01-2022
Abstract
ORIGINAL ARTICLEFactors associated with presenteeism in nursing workers
Revista Brasileira de Enfermagem. 2022;75(1):e20201290
10-01-2022DOI 10.1590/0034-7167-2020-1290
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Objective:
to analyze factors associated with presenteeism in nursing workers with sociodemographic variables, health and work conditions, productivity and musculoskeletal symptoms.
Methods:
this is a cross-sectional, descriptive and analytical study, with 306 nursing workers from a hospital and municipal emergency room in a Brazilian capital. The Stanford Presenteeism Scale, the Work Limitations Questionnaire, the Nordic Musculoskeletal Questionnaire and a demographic questionnaire on nursing professionals’ working conditions and health were used. Bivariate and multivariate analyzes were performed, respecting a significance level of 5%.
Results:
presenteeism was found in 43.8% of professionals and significant associations with CLT work (p=0.002), workplace – Intensive Care Units (p=0.008), physical exercise twice a week (p=0.008), presence of musculoskeletal symptoms, with low back pain being representative (p=0.001). The productivity loss was 8.8.
Conclusions:
the study confirms a high rate of presenteeism among nursing workers.
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EXPERIENCE REPORT
Humanitude in the humanization of elderly care: experience reports in a health service
Revista Brasileira de Enfermagem. 2019;72(3):825-829
06-07-2019
Abstract
EXPERIENCE REPORTHumanitude in the humanization of elderly care: experience reports in a health service
Revista Brasileira de Enfermagem. 2019;72(3):825-829
06-07-2019DOI 10.1590/0034-7167-2017-0363
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Objective:
To describe the experience in the implementation of the Humanitude Care Methodology (MCH) in the humanization of care for the elderly.
Methodology:
This is an experience report about the implementation of the MCH, in a Health Service in Portugal, with capacity for 30 elderly people, most of them having cognitive alterations.
Results:
The implementation of the MCH has shown positive results in the humanization of care for the elderly, namely in the reduction of agitation behaviors and better acceptance of care. There was a change in organizational culture, more focused on the person and on the humanization of care.
Conclusion:
The results reflect the need to introduce innovative care methodologies in the training of health professionals, with a focus on interaction, for a professionalized relational care that dignifies the person cared for and the care giver.
Keywords:Evidence-based NursingHumanization of CareNeurocognitive DisordersNurse-Patient RelationsOrganizational InnovationPatient-Centered CareSee more -
ORIGINAL ARTICLE
Factors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
08-19-2019
Abstract
ORIGINAL ARTICLEFactors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
08-19-2019DOI 10.1590/0034-7167-2018-0120
Views0See moreABSTRACT
Objective:
to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis.
Method:
this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis.
Results:
the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis.
Conclusions:
sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.
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