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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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ORIGINAL ARTICLE07-29-2024
Mental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
Abstract
ORIGINAL ARTICLEMental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
DOI 10.1590/0034-7167-2023-0457
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Objective:
To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health.
Methods:
exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis.
Results:
parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression.
Final considerations:
It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.
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07-29-2024
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
Views0See moreABSTRACT
Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
Views0See moreABSTRACT
Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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ORIGINAL ARTICLE07-29-2024
Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
Abstract
ORIGINAL ARTICLEDisrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
DOI 10.1590/0034-7167-2023-0464
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Objectives:
to develop and evaluate a Middle-Range Theory for the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” in high-risk pregnancies.
Methods:
this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem’s General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80.
Results:
the theory identified 20 elements of the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80.
Conclusions:
the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon “Disrupted Mother-Fetus Dyad Risk,” which aids in nurses’ diagnostic reasoning.
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
Views0See moreABSTRACT
Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
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ORIGINAL ARTICLE07-29-2024
Primary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
Abstract
ORIGINAL ARTICLEPrimary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
DOI 10.1590/0034-7167-2024-0468
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Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final Considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
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ORIGINAL ARTICLE07-29-2024
Completeness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
Abstract
ORIGINAL ARTICLECompleteness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
DOI 10.1590/0034-7167-2023-0467
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Objectives:
to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.
Methods:
an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.
Results:
there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables “family history of cancer” (p<0.001), “alcoholism” (p<0.001), “smoking” (p<0.001), “TNM staging” (p<0.001) had a decreasing trend, while “clinical start of treatment” (p<0.001), “origin” (p=0.008) and “occupation” (p<0.001) indicated an increasing trend.
Conclusions:
most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.
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ORIGINAL ARTICLE09-29-2022
Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
Abstract
ORIGINAL ARTICLENeither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
DOI 10.1590/0034-7167-2020-1329
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Objective:
to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of “angels and heroes” given by society during the pandemic of COVID-19.
Methods:
a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault.
Results:
they were organized into two thematic categories: “Angels and heroes? The (not) heroic reality of nursing during the pandemic” and “The search for recognition of the professional work of nursing: between what is said and what is not said”.
Final considerations:
the nurses’ speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.
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REVIEW10-18-2022
Decision making by health professionals during COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2022;75:e20210067
Abstract
REVIEWDecision making by health professionals during COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2022;75:e20210067
DOI 10.1590/0034-7167-2021-0067
Views1See moreABSTRACT
Objective:
To analyze the scientific production on the decision making of health workers during the COVID-19 pandemic.
Methods:
Integrative review in the databases CINAHL, MEDLINE, Scopus, ScienceDirect, WoS, and BVS. Inclusion criteria: original articles available in full, in any language, related to the object investigated.
Results:
During this pandemic, health workers have been making decisions based on ethical/bioethical principles (utility, beneficence, non-maleficence, autonomy, justice, proportionality, flexibility, clinical prognosis, duration of the need, and fair health attention), values (solidarity, equality, equity, utilitarianism, relational autonomy, reliability, reciprocity, maximization of the benefits and resources, and prioritization of those in worse conditions), beliefs and personal motivation, protocols, directives, tools, algorithms, recommendations, and criteria.
Final considerations:
Decision making has never been so necessary as in this pandemic. This article is not a recipe for the professionals, since decision making is based on numerous factors. However, it provides them with a foundation that can be helpful in this difficult process.
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ORIGINAL ARTICLE07-18-2022
Child and adolescent victims of sexual violence: aspects of physical and emotional development
Revista Brasileira de Enfermagem. 2022;75:e20200584
Abstract
ORIGINAL ARTICLEChild and adolescent victims of sexual violence: aspects of physical and emotional development
Revista Brasileira de Enfermagem. 2022;75:e20200584
DOI 10.1590/0034-7167-2020-0584
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Objective:
to identify the multidisciplinary health team’s perception on aspects of the physical and emotional development of children and adolescents who have suffered sexual violence.
Methods:
a qualitative study, carried out with 30 health professionals in a hospital in Bahia, Brazil, between June and July 2019. Data were collected from an interview guided by a semi-structured questionnaire. The results were interpreted according to Symbolic Interactionism.
Results:
some sexually violated children were under five years old and healthy, others had physical/mental disabilities. Victimized adolescents were in the pre-pubertal phase, with fragile body structure, not emotionally mature and unaware of sexuality.
Final considerations:
children’s physical and emotional aspects make children vulnerable to sexual victimization, as they facilitate the control and dominion that offenders need to have over them. As a protection strategy, it is recommended using sexual and health education linked to greater surveillance of family members, multidisciplinary team and educators.
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ORIGINAL ARTICLE11-10-2022
Home care for children with gastrostomy
Revista Brasileira de Enfermagem. 2022;75:e20200699
Abstract
ORIGINAL ARTICLEHome care for children with gastrostomy
Revista Brasileira de Enfermagem. 2022;75:e20200699
DOI 10.1590/0034-7167-2020-0699
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Objectives:
to describe home care practices performed by family members for maintaining the life of children with gastrostomy.
Methods:
qualitative research using the Sensitive Creative method, with the Criatividade e Sensibilidade Corpo Saber [Corpo Saber Creativity and Sensitivity] dynamics. The participation included ten family caregivers of children with gastrostomy. The outpatient clinic of a federal hospital in Rio de Janeiro was the setting. Lexical analysis was used through the IRaMuTeQ® software.
Results:
Theme 1, entitled “The care for maintaining life performed by family members of children with gastrostomy at home”, was analyzed, comprising three classes: “The gastrostomy tube home care routine”; “The care with the gastrostomy/stoma”; and “Food and medication home care routine of children with gastrostomy”.
Final Considerations:
family caregivers used strategies to maintain the device and acquired new knowledge in this field, and in nursing competence, regarding stoma care, food administration, medication, and syringes.
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ORIGINAL ARTICLE01-14-2022
Hospital structure elements demarcating (in)visibilities of institutional violence against children
Revista Brasileira de Enfermagem. 2022;75:e20200785
Abstract
ORIGINAL ARTICLEHospital structure elements demarcating (in)visibilities of institutional violence against children
Revista Brasileira de Enfermagem. 2022;75:e20200785
DOI 10.1590/0034-7167-2020-0785
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Objectives:
to analyze the hospital structure elements that demarcate (in)visibilities of institutional violence in hospitalized children.
Methods:
this is a descriptive-exploratory qualitative study that used approaches with Foucault’s thinking. Ten companions and 39 healthcare professionals from a university hospital in Salvador, Bahia participated. Data collection took place from November 2018 to June 2019 through semi-structured interviews. The discourse analysis method was used. The study was approved by the Institutional Review Board.
Results:
institutional violence was understood in the violations and invisibilities of the structure of health services through the problems: in infrastructure (physical structure, lack of human and material resources, scrapping of equipment); administrative and management; pilgrimage.
Final Considerations:
it is necessary to realize the invisibilities of the infrastructure to act in confronting institutional violence to hospitalized children.
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ORIGINAL ARTICLE03-07-2022
The family of the child with special health care needs and their social relationships
Revista Brasileira de Enfermagem. 2022;75:e20210031
Abstract
ORIGINAL ARTICLEThe family of the child with special health care needs and their social relationships
Revista Brasileira de Enfermagem. 2022;75:e20210031
DOI 10.1590/0034-7167-2021-0031
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Objectives:
to identify aspects that can influence the types of bonds developed in the social support network of family members of children with special health care needs.
Methods:
qualitative research conducted through interviews with 15 family members/guardians in the city of Rio de Janeiro, from January to February 2020. Sanicola’s theoretical-methodological framework and Bardin’s thematic analysis technique were used.
Results:
social distancing, lack of responsibility for coordinating care, lack of supplies and lack of individualized care were weaknesses found in the families’ social relationships. However, the bonds were strengthened by the relationship of familiarity and availability of professionals in the care of children with special health needs.
Final Considerations:
understanding the configuration of primary and secondary social networks and the types of support offered can improve the care of children and strengthen bonds that provide security for families.
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ORIGINAL ARTICLE07-18-2022
Prevalence of non-communicable chronic diseases and associated factors in deaf people
Revista Brasileira de Enfermagem. 2022;75:e20210205
Abstract
ORIGINAL ARTICLEPrevalence of non-communicable chronic diseases and associated factors in deaf people
Revista Brasileira de Enfermagem. 2022;75:e20210205
DOI 10.1590/0034-7167-2021-0205
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Objective:
To analyze the prevalence and factors associated with non-communicable chronic diseases in deaf people.
Methods:
Cross-sectional study with 110 deaf people in Maringá-Paraná, selected using the snowball sampling technique. Data were collected from February to August 2019, using a structured instrument; and, in the analysis, multiple logistic regression was used.
Results:
The self-reported prevalence of chronic diseases was 43.6%, the most frequent being: arterial hypertension (12.7%), depression (6.4%), diabetes mellitus (5.4%), respiratory disease (5.4%) and hypothyroidism (4.5%). Using health services for routine consultations was significantly associated with being bimodal bilingual. The only risk behavior significantly associated with chronic disease was excessive consumption of sweet foods.
Conclusion:
The prevalence of chronic diseases in this population may be higher than that found, as there is a possibility of underdiagnosis due to the low demand for routine consultations and the difficulty of communication with health professionals.
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ORIGINAL ARTICLE06-03-2022
Sociodiscursive representations about leprosy in educational campaigns: implications on stigma reduction
Revista Brasileira de Enfermagem. 2022;75:e20210410
Abstract
ORIGINAL ARTICLESociodiscursive representations about leprosy in educational campaigns: implications on stigma reduction
Revista Brasileira de Enfermagem. 2022;75:e20210410
DOI 10.1590/0034-7167-2021-0410
Views0See moreABSTRACT
Objectives:
to analyze the socio-discursive representations about leprosy produced in posters of educational campaigns of the Brazilian Ministry of Health.
Methods:
a documentary and discursive research about posters of campaigns about leprosy produced by the Brazilian Ministry of Health and available on Google Search Images. For the analysis, we used the Critical Discourse Analysis approach and the Grammar of Visual Design.
Results:
the socio-discursive representations of leprosy are based on the biomedical ideology, through a normative-curative discourse that focuses on the dermatological manifestations of the disease. Regarding the construction of the compositional space, there are posters that emphasize the meaning that the disease does not prevent affectionate relationships, and others highlight as “new” the clinical manifestations of the disease.
Final Considerations:
the normative-curative discourse produced in the campaigns is not enough to face stigma related to the disease. For leprosy to be understood as a common chronic disease, it is first necessary to fight the “social leprosy”: the stigma.
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