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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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ORIGINAL ARTICLE08-18-2021
Mapping of advanced practice nursing actions in the Family Health Strategy
Revista Brasileira de Enfermagem. 2021;74:e20210228
Abstract
ORIGINAL ARTICLEMapping of advanced practice nursing actions in the Family Health Strategy
Revista Brasileira de Enfermagem. 2021;74:e20210228
DOI 10.1590/0034-7167-2021-0228
Views0See moreABSTRACT
Objectives:
to map advanced practice nursing actions implemented in the Family Health Strategy context.
Methods:
cross-sectional exploratory study carried out with Family Health Strategy nurses. Data obtained in the mapping were compared to the characteristics that define advanced practice nurses and are adopted internationally by using a checklist based on the International Council of Nurses Guidelines.
Results:
the mapping allowed to identify advanced practice nursing actions, such as advanced assessment, judgement, decision-making, and diagnostic reasoning skills and authority to diagnose and prescribe medications, diagnostic testing, and therapeutic treatments. However, evidence found in the educational preparation domain indicated evident fragility, expressed as the low percentage of nurses credentialed with a professional master’s degree.
Conclusions:
the present study showed that nurses in the Family Health Strategy carry out advanced practice nursing actions without the professional master’s degree recommended for credentialing, with pertinent legislation, which requires initiatives to be taken by nursing leaders to overcome this deficiency.
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REVIEW07-09-2021
Nursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
Revista Brasileira de Enfermagem. 2021;74(3):e20200097
Abstract
REVIEWNursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
Revista Brasileira de Enfermagem. 2021;74(3):e20200097
DOI 10.1590/0034-7167-2020-0097
Views0See moreABSTRACT
Objectives:
to analyze the available evidence on the nursing care provided to patients after hematopoietic stem cell transplantation.
Methods:
integrative review with the search for primary studies in four databases and a virtual health library. A broad search strategy was used, including research published in English, Brazilian Portuguese, or Spanish, between 2008 and 2018, totaling a sample of 42 studies.
Results:
the studies were grouped into three categories: multiple nursing care (n=19), first-line care (n=18), and self-management of care (n=5).
Conclusions:
nursing care is critical, comprising patients’ physical, psychological and social aspects. It occurs in hospital and home contexts, mainly involving technical actions and health guidance. The evidence identified provide subsidies for decision-making; however, most studies are of the non-experimental type, indicating the need for conducting intervention research.
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09-16-2019
Nursing practices centered on individuals with tuberculosis: an interface with democracy
Revista Brasileira de Enfermagem. 2019;72(5):1219-1225
Abstract
Nursing practices centered on individuals with tuberculosis: an interface with democracy
Revista Brasileira de Enfermagem. 2019;72(5):1219-1225
DOI 10.1590/0034-7167-2017-0380
Views0See moreABSTRACT
Objective:
To analyze whether user-centered nursing practices in TB DOT are being carried out and are contributing to democracy.
Method:
A cross-sectional, exploratory, descriptive study with 123 nurses in three capital cities with high incidence of TB (Manaus-AM, João Pessoa-PB, Porto Alegre-RS) in Brazil. Data were collected from January to June 2014. Descriptive and multiple correspondence analyzes were used.
Results:
It was identified that the most user-centered care actions had scores below 50%, considered unfavorable to the exercise of democracy. In the analysis of the general user-centered practice score per municipality, Manaus and João Pessoa presented unfavorable results, and the municipality of Porto Alegre was partially favorable.
Conclusion:
The three municipalities need to advance in the implementation of user-centered practices in DOT, because their health system still has difficulties and challenges to overcome.
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ORIGINAL ARTICLE10-21-2022
Self-care deficit among older men in the COVID-19 pandemic: implications for nursing
Revista Brasileira de Enfermagem. 2022;75:e20210933
Abstract
ORIGINAL ARTICLESelf-care deficit among older men in the COVID-19 pandemic: implications for nursing
Revista Brasileira de Enfermagem. 2022;75:e20210933
DOI 10.1590/0034-7167-2021-0933
Views0See moreABSTRACT
Objectives:
to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice.
Methods:
web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem’s Self-Care Deficit Theory, was used.
Results:
temporally, the self-care of older men was manifested in the self-care requirements – affective bonds, self-care for development – meditation and self-care with health deviations – remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care.
Final Considerations:
as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.
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ORIGINAL ARTICLE07-18-2022
Nursing in Primary Health Care: association between leadership, psychological capital, and burnout implications
Revista Brasileira de Enfermagem. 2022;75:e20210942
Abstract
ORIGINAL ARTICLENursing in Primary Health Care: association between leadership, psychological capital, and burnout implications
Revista Brasileira de Enfermagem. 2022;75:e20210942
DOI 10.1590/0034-7167-2021-0942
Views0See moreABSTRACT
Objectives:
to verify the association between authentic leadership and burnout syndrome in Primary Health Care nursing professionals and analyze the relationship between positive psychological capital and burnout syndrome in subordinate nursing professionals.
Methods:
a field, descriptive-exploratory, cross-sectional study with a quantitative approach, developed with the nursing team, in Basic Health Units in the city of São Paulo, with the application of the sociodemographic questionnaires, Burnout Characterization Scale [Escala de Caracterização do Burnout], Authentic Leadership Questionnaire and Psychological Capital Questionnaire.
Results:
in leaders’ perception, there was no evidence of significant associations between burnout and authentic leadership scales. There was a significant negative association of the burnout scale dimensions with the leadership dimensions regarding the subordinates. There was evidence of significant negative associations in the burnout scores with the scores of the psychological questionnaire dimensions.
Conclusions:
in nursing, burnout is associated with authentic leadership and psychological capital.
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09-16-2019
Leprosy educational practices with adolescents: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1397-1404
Abstract
Leprosy educational practices with adolescents: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1397-1404
DOI 10.1590/0034-7167-2017-0458
Views0See moreABSTRACT
Objectives:
to identify scientific evidence in the literature regarding educational actions on leprosy developed with adolescents.
Method:
an integrative review of the literature, with the following research question: what are the leprosy educational practices currently being developed with adolescents? The search was performed in the following databases: MEDLINE, Scopus, LILACS, CINAHL, BVS Hanseníase and other sources, using “adolescent”; “leprosy”; “health education”; “public health”, and “public health practice” as keywords. Results: the sample was comprised of nine studies. Leprosy educational practices with adolescents verifiably promote change in knowledge when they are based on constructivist methodologies. The nurse is recognized as a professional with potential for developing these educational practices. Final considerations: actions for leprosy education with adolescents do lead to changes in knowledge, but new research is needed to evaluate their effectiveness in further improving this knowledge as well as changing behaviors and practices.
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ORIGINAL ARTICLE03-07-2022
Is self-esteem associated with the elderly person’s quality of life?
Revista Brasileira de Enfermagem. 2022;75:e20210388
Abstract
ORIGINAL ARTICLEIs self-esteem associated with the elderly person’s quality of life?
Revista Brasileira de Enfermagem. 2022;75:e20210388
DOI 10.1590/0034-7167-2021-0388
Views0See moreABSTRACT
Objective:
To analyze the association between self-esteem and quality of life in the elderly.
Methods:
Cross-sectional web survey developed with 519 elderly people. Participants filled out three data collection instruments developed on the Google Forms platform and widely disseminated through all of Brazil. Fisher’s exact test, Mann-Whitney, Pearson correlation, and linear regression with 95% confidence interval were used.
Results:
Self-esteem was associated with all quality-of-life facets: sensory skills [β= 1.307; p<0.001]; autonomy [β= 2.101; p<0.001]; past, present, and future activities [β= 2.486; p<0.001]; social presence [β= 2.547; p<0.001]; death and dying [β= 2.175; p<0.001]; and intimacy [β=2.378; p<0.001].
Conclusion:
There is a positive and statistically significant association between self-esteem and quality of life in the elderly. We therefore suggest the development of local policies capable of raising this age groups’ self-esteem and reaffirming aging as a new possibility for discoveries and pleasure.
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ORIGINAL ARTICLE09-29-2022
Incidence of acute radiodermatitis in women with breast cancer undergoing hypofractionated radiotherapy
Revista Brasileira de Enfermagem. 2022;75(1):e20210118
Abstract
ORIGINAL ARTICLEIncidence of acute radiodermatitis in women with breast cancer undergoing hypofractionated radiotherapy
Revista Brasileira de Enfermagem. 2022;75(1):e20210118
DOI 10.1590/0034-7167-2021-0118
Views0See moreABSTRACT
Objective:
To estimate the incidence and degree of acute radiodermatitis at the end and after the end of treatment in women with breast cancer undergoing hypofractionated radiotherapy.
Methods:
Observational, prospective, and longitudinal study, conducted between March 2019 and January 2020, in a radiotherapy outpatient clinic.
Results:
Thirty-two women participated in the study, among whom, in the last session of hypofractionated radiotherapy, 15 (46.9%) had radiodermatitis, erythema in 13 (40.6%), and wet peeling in 2 (6.3%). In the post-treatment evaluation, 27 (84.4%) had radiodermatitis, erythema in 17 (53.1%), dry peeling in 8 (25%), and wet peeling in 2 (6.3%).
Conclusion:
The general incidence of radiodermatitis after hypofractionated radiotherapy in women with breast cancer was 37.5%, erythema, 12.5%, and dry peeling, 25%. The development of care protocols for the management of radiodermatitis after treatment is of paramount importance.
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