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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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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
Views0See moreABSTRACT
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.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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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
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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07-10-2023
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
Metodologia 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
Views0See moreRESUMEN
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.
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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
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
Views0See moreABSTRACT
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.
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REVIEW07-06-2020
Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health
Revista Brasileira de Enfermagem. 2020;73(5):e20190370
Abstract
REVIEWMiddle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health
Revista Brasileira de Enfermagem. 2020;73(5):e20190370
DOI 10.1590/0034-7167-2019-0370
Views0See moreABSTRACT
Objectives:
theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct.
Methods:
construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles.
Results:
eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health.
Conclusions:
the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.
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ORIGINAL ARTICLE05-24-2021
Critical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
Abstract
ORIGINAL ARTICLECritical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
DOI 10.1590/0034-7167-2020-0979
Views0See moreABSTRACT
Objective:
To analyze the constitution of critical thinking in nursing training in the approach by competence and the integrated curriculum, considering the evaluation process by capturing its challenges, and proposing overcoming strategies.
Methods:
Qualitative. In the first phase of data collection, interviews were conducted with twenty-four professors, nine preceptors, and fifteen students to reconstruct the profile of competence, and in the second phase, a workshop to validate the profile identified challenges and proposals. The Collective Subject Discourse was used to analyze the interviews and the holistic competence reference in reconstructing the profile.
Results:
The critical thinking is built based on experiences in the world of work, and evaluation is the conductor of reflections towards emancipation.
Final considerations:
It signals the importance of professor training in the learning evaluation and working with the collective construction of subjects to overcome challenges that happen in the changes of training.
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07-26-2021
Impact of clinical supervision on job satisfaction and emotional competence of nurses
Revista Brasileira de Enfermagem. 2021;74(6):e20210125
Abstract
Impact of clinical supervision on job satisfaction and emotional competence of nurses
Revista Brasileira de Enfermagem. 2021;74(6):e20210125
DOI 10.1590/0034-7167-2021-0125
Views0See moreABSTRACT
Objective:
To evaluate the impact of implementing the SafeCare clinical supervision model on nurses’ job satisfaction and emotional competence profile.
Methods:
This is a quasi-experimental study, with a sample of 28 nurses from a hospital in northern Portugal. A self-administered questionnaire was applied, used as pre and post-test, which included: sociodemographic and professional characterization; “Job Satisfaction Scale”; and “Veiga Emotional Competence Scale”. We conducted descriptive statistical analysis and the Wilcoxon Test.
Results:
A significant decrease in the nurses’ satisfaction with hierarchical superior was observed in the post-test. No significant differences were found in the nurses’ job satisfaction and emotional competence after the implementation of the SafeCare Model.
Conclusion:
The SafeCare Model needs improvement, suggesting increasing the amount of training time administered to nurses and strengthening the healthcare institution’s link to the Model.
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ORIGINAL ARTICLE07-10-2020
Working conditions and depression in hospital emergency service nurses
Revista Brasileira de Enfermagem. 2020;73:e20180952
Abstract
ORIGINAL ARTICLEWorking conditions and depression in hospital emergency service nurses
Revista Brasileira de Enfermagem. 2020;73:e20180952
DOI 10.1590/0034-7167-2018-0952
Views0See moreABSTRACT
Objective:
to analyze the presence, intensity and factors related to working conditions for depressive symptoms in hospital emergency nurses in the east of São Paulo.
Methods:
a descriptive, exploratory, quantitative and qualitative study, which applied psychometric scales and interview script.
Results:
nurses (95.24%) had depressive symptoms by the assessment scales by the observer, most with mild and moderate intensity. Inadequate working conditions led to suffering. Factors that trigger depressive symptoms were: disorganized work; harmful relationship with immediate management; inappropriate physician behavior; aggressions; lack of inputs, infrastructure and human resources; professional devaluation. Identified professionals with depressive symptoms who, because they were unaware of being affected by the disorder, did not seek treatment, continued to perform activities that compromised their physical and mental health, promoting damage to the assistance provided.
Final considerations:
high frequency of depressive symptoms. The precarious work environment negatively influenced the care and development of depressive symptoms.
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ORIGINAL ARTICLE06-27-2019
Safety of the patient in an emergency situation: perceptions of the nursing team
Revista Brasileira de Enfermagem. 2019;72(3):753-759
Abstract
ORIGINAL ARTICLESafety of the patient in an emergency situation: perceptions of the nursing team
Revista Brasileira de Enfermagem. 2019;72(3):753-759
DOI 10.1590/0034-7167-2018-0544
Views0See moreABSTRACT
Objective:
To know the perception of nursing professionals about the essential aspects to provide safe care to polytraumatized patients in emergency services.
Method:
Descriptive and mixed study, performed with a focus group and projective techniques. The sample was made of seven nursing professionals. Data analysis took place through the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires and SPSS 22.0 softwares.
Results:
Based on the analysis of participants’ speeches, three content partitions emerged in the Descending Hierarchical Classification. 1) Structure: need for changes; 2) The process: safe actions by the nursing team; and 3) Care free from damage as the sought result.
Conclusion:
Patient safety in emergency situations must rely on a proper environment and an organized sector, good conditions to transport patients, use of routines and protocols, identification and organization of the beds.
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ORIGINAL ARTICLE06-24-2020
Practice of breastfeeding in quilombola communities in the light of transcultural theory
Revista Brasileira de Enfermagem. 2020;73(4):e20190191
Abstract
ORIGINAL ARTICLEPractice of breastfeeding in quilombola communities in the light of transcultural theory
Revista Brasileira de Enfermagem. 2020;73(4):e20190191
DOI 10.1590/0034-7167-2019-0191
Views0See moreABSTRACT
Objectives:
to identify factors that interfere with the practice of exclusive breastfeeding in quilombola communities.
Methods:
qualitative research based on the Transcultural Theory proposed by Madeleine Leininger, performed with quilombola mothers. For data collection, we used the semi-structured interview, conducted from June 2018 to January 2019. Content analysis was guided by the interactive model of Miles and Huberman.
Results:
it was revealed that intergenerational cultural myths and customs interfere with breastfeeding practice, and identified the influence of professional nurses on best breastfeeding practices.
Final Considerations:
cultural and intergenerational factors favor early weaning and expose the child to illness.
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REVIEW10-28-2020
Health care of sexual and gender minorities: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20190192
Abstract
REVIEWHealth care of sexual and gender minorities: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20190192
DOI 10.1590/0034-7167-2019-0192
Views0See moreABSTRACT
Objectives:
to describe health care practices aimed at lesbians, gays, bisexuals, transvestites, and transsexuals.
Methods:
an integrative literature review based on systematic steps, in MEDLINE, LILACS AND SciELO databases and/or electronic libraries. It was held from September to November 2018, with articles published between 2012 and 2017, available in full in Portuguese, English, and Spanish, addressing health care to that population group.
Results:
fourteen articles were included. Most of the articles were about the trajectory of individuals within health services and showed limitations and obstacles in the use of these services.
Final Considerations:
there is evidence that factors related to organization of services, attitude of professionals, stigma, and discrimination experienced undermine health care practices. Therefore, it is essential to carry out educational activities in health services and educational institutions.
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ORIGINAL ARTICLE06-01-2020
Nursing knowledge patterns: nurses’ image and role in society perceived by students
Revista Brasileira de Enfermagem. 2020;73(4):e20180959
Abstract
ORIGINAL ARTICLENursing knowledge patterns: nurses’ image and role in society perceived by students
Revista Brasileira de Enfermagem. 2020;73(4):e20180959
DOI 10.1590/0034-7167-2018-0959
Views0See moreABSTRACT
Objectives:
to understand high school students’ perception about the nurse’s image and role in society, from nursing knowledge patterns.
Methods:
phenomenographic qualitative study, developed between October 2017 and January 2018, in a public university in the countryside of the state of São Paulo, with eight Interdisciplinary Higher Education Program (Programa de Formação Interdisciplinar Superior) students. The findings were collected through semi-structured interviews and analyzed by the phenomenography framework, supported by rereading nursing knowledge patterns.
Results:
two categories emerged: Perception of nurses’ image, which contemplates their positive and negative characteristics, attributes and place where they operate; and Nurses’ role in society, in which their work is compared with physicians’.
Final Considerations:
despite their essential role in care, subordination to medical knowledge and lack of knowledge of nurses’ functions still reflect their image.
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