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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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Psychiatric nursing and mental health teaching in relation to Brazilian curriculum
Revista Brasileira de Enfermagem. 2020;73(2):e20180200
03-09-2020
Abstract
Psychiatric nursing and mental health teaching in relation to Brazilian curriculum
Revista Brasileira de Enfermagem. 2020;73(2):e20180200
03-09-2020DOI 10.1590/0034-7167-2018-0200
Views0See moreABSTRACT
Objectives:
to know the scientific production on psychiatric nursing and mental health teaching in relation to Brazilian nursing curriculum.
Methods:
an Integrative Literature Review with no temporal delineation, whose data collection took place in ten Brazilian and international databases, adding to the total 35 objects of analysis.
Results:
a priori categories were adopted, consisting of the psychiatric nursing and mental health teaching in Brazil according to the 1923, 1949, 1962, 1972, 1994 and 2001 nursing curriculum, presented in the light of the dimensions: thought model; places of practice; methods or contents used; and profile or skills of the student.
Final considerations:
the study made it possible to observe psychiatric nursing and mental health teaching historical evolution, indicating that teaching transformations involved changes in curriculum, Psychiatric Reform and the way nursing undergraduate courses and schools take these determinants.
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ORIGINAL ARTICLE
Nurse as an integrator in healthcare management of children with chronic condition
Revista Brasileira de Enfermagem. 2020;73(3):e20180453
04-03-2020
Abstract
ORIGINAL ARTICLENurse as an integrator in healthcare management of children with chronic condition
Revista Brasileira de Enfermagem. 2020;73(3):e20180453
04-03-2020DOI 10.1590/0034-7167-2018-0453
Views0See moreABSTRACT
Objectives:
to understand the practice of the nurse in healthcare management of children with chronic condition in the hospital setting.
Methods:
analytical study of qualitative approach with theoretical and methodological reference of institutional ethnography. Developed in the pediatric unit of a university hospital, in a municipality in Northeastern Brazil. Data collections techniques were: participant observation, documentary analysis and semi-structured interview. Participants of the study totaled twenty professionals, including nurses, social workers, psychologists, pharmacists, nutritionists, physiotherapists, and doctors. For data analysis, it was used the Bardin’s Content Analysis with interface of the Atlas.ti software.
Results:
categories of analysis were “Nurse as mediator of healthcare management”; “Nursing process as a mechanism of healthcare management”.
Final
considerations: the nurse proved to be essential for healthcare management of the child with chronic condition, acting as mediator of the relationship between the doctor, the members of the health team, the user and their family.
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REVIEW
Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190815
10-19-2020
Abstract
REVIEWEffectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190815
10-19-2020DOI 10.1590/0034-7167-2019-0815
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Objective:
to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis.
Method:
an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out.
Results:
the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis.
Conclusion:
data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.
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ORIGINAL ARTICLE
Cognition and quality of life relationship among the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20190030
07-08-2020
Abstract
ORIGINAL ARTICLECognition and quality of life relationship among the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73:e20190030
07-08-2020DOI 10.1590/0034-7167-2019-0030
Views0See moreABSTRACT
Objective:
to assess cognitive functions and their association with quality of life among elderly people enrolled in a Family Health Unit (FHU) of Primary Health Care in Recife-PE.
Methods:
a quantitative, descriptive, cross-sectional study in which elderly aged 60 years and over were studied.
Results:
76.7% of the elderly were women and the age group was less than or equal to 70 years. 68.6% had cognitive impairment, and in the quality of life assessment it was found that the social participation facet had the highest mean score among the elderly (14.25), while the lowest was observed in the sensory functioning facet (9.10). There was an association between cognitive decline and quality of life.
Conclusion:
most of the elderly had good quality of life rates, but low cognitive level. Using screening tools allows early detection of health problems, guiding the nursing staff in the construction of preventive measures.
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ORIGINAL ARTICLE
Expert assessment of the “Neonatal Pain Assessment Program” online course
Revista Brasileira de Enfermagem. 2020;73(4):e20180392
05-18-2020
Abstract
ORIGINAL ARTICLEExpert assessment of the “Neonatal Pain Assessment Program” online course
Revista Brasileira de Enfermagem. 2020;73(4):e20180392
05-18-2020DOI 10.1590/0034-7167-2018-0392
Views0See moreABSTRACT
Objectives:
to assess layout quality, visual identity and content of the “Neonatal Pain Assessment Program” (Programa de Avaliação da Dor Neonatal) online course.
Methods:
a descriptive exploratory study. The course was assessed by 24 experts in pain, neonatology and education. A form containing 20 questions on technical, interface and educational aspects was used. For each item, the score ranged from 0 to 1. Mean scores above 0.7 were considered indicative of high quality of the items. Descriptive statistics were used for data analysis.
Results:
navigation, clarity, ease of localization, content relevance, contextualization, content correction, multiple windows, ease of use, ease of return, ergonomics, esthetics, special brands, audiovisual resources, information and portability were assessed. All aspects obtained a mean ≥ 0.70 and no changes were required.
Conclusions:
the Neonatal Pain Assessment Program is considered as quality educational technology and promising strategy for health education.
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Are symptoms of depression and anxiety in nursing students associated with their sociodemographic characteristics?
Revista Brasileira de Enfermagem. 2021;74:e20200503
05-28-2021
Abstract
Are symptoms of depression and anxiety in nursing students associated with their sociodemographic characteristics?
Revista Brasileira de Enfermagem. 2021;74:e20200503
05-28-2021DOI 10.1590/0034-7167-2020-0503
Views0See moreABSTRACT
Objective:
to investigate symptoms of depression and anxiety and their association with the sociodemographic characteristics of undergraduate nursing students.
Methods:
a cross-sectional analytical study carried out with students from the Faculty of Nursing at Universidade Federal de Juiz de Fora from June to July 019. Data were collected through a sociodemographic questionnaire and the Beck Depression and Anxiety Inventories.
Results:
192 students participated, with a mean age of 21.44 (±3.56) years. 85.93% of participants were female. The mean depression score was 22.40 (±12.35), and anxiety was 17.56 (±11.98). There was a difference in the mean of the scales for sex and psychotropic drugs (p<0.05). Women presented moderate and severe classification for both scales. Severe symptoms prevailed among students from the 6th to the 10th semester (18.22%).
Conclusion:
there was an association between depression and anxiety symptoms related to gender and psychotropic drugs.
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Humanization practices in the parturitive course from the perspective of puerperae and nurse-midwives
Revista Brasileira de Enfermagem. 2021;74:e20190743
01-22-2021
Abstract
Humanization practices in the parturitive course from the perspective of puerperae and nurse-midwives
Revista Brasileira de Enfermagem. 2021;74:e20190743
01-22-2021DOI 10.1590/0034-7167-2019-0743
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Objective:
to understand humanization practices in the parturitive course from the point of view of purperae and nurse-midwives.
Methods:
an exploratory, descriptive, qualitative research carried out in a maternity hospital in Bahia State. Semi-structured interviews were carried out, with a structured script applied to 11 mothers and 5 nurse-midwives from March to June 2019. Analysis followed Bardin’s content structure.
Results:
this study unveiled the importance of using soft care technologies, respect for female role, active participation and women’s autonomy as a positive impact on the parturition process.
Final considerations:
nurse-midwives are qualified professionals to assist women in labor and birth. They can favor the implantation and implementation of care with humanization practices, respect for women’s choices and incentive to the normal way of delivery with an expanded view of individual and multidisciplinary needs.
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Moral suffering in health professionals: portrait of the work environment in times of COVID-19
Revista Brasileira de Enfermagem. 2021;74:e20200653
03-05-2021
Abstract
Moral suffering in health professionals: portrait of the work environment in times of COVID-19
Revista Brasileira de Enfermagem. 2021;74:e20200653
03-05-2021DOI 10.1590/0034-7167-2020-0653
Views0See moreABSTRACT
Objective:
To analyze potential triggers of moral suffering experiences of health professionals, reported in the media, during the COVID-19 pandemic and to propose a theoretical construct of analysis.
Methods:
Study with qualitative approach whose data source were 50 reports published online, collected passively and actively, submitted to Content Analysis with the help of ATLAS.ti software.
Results:
The potential moral problems that trigger moral suffering are related to the threat to moral integrity, infrastructure/logistics and teamwork problems, and emotional aspects, revealing their articulation with damage to the foundations of a healthy work environment, which generated the proposal of a construct.
Final considerations:
The articulation between the experiences of moral suffering and the commitment of the fundamentals of a healthy work environment has brought important contributions to the adoption of strategies to protect and stimulate moral deliberation by professionals in favor of practice and society.
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