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ARTÍCULO ORIGINAL08/12/2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Resumen
ARTÍCULO ORIGINALInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
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Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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ARTÍCULO ORIGINAL08/12/2024
Safe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
Resumen
ARTÍCULO ORIGINALSafe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
DOI 10.1590/0034-7167-2023-0135
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Objective:
To validate a checklist for safe bathing in critically ill patients.
Methods:
This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.
Results:
In the apparent and content validation, adjustments were made according to the judges’ suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).
Conclusion:
The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.
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ARTÍCULO DE REVISIÓN29/11/2024
Assessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
Resumen
ARTÍCULO DE REVISIÓNAssessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
DOI 10.1590/0034-7167-2023-0532
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Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
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ARTÍCULO ORIGINAL29/11/2024
Sleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
Resumen
ARTÍCULO ORIGINALSleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
DOI 10.1590/0034-7167-2023-0283
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Objective:
To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.
Method:
Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.
Results:
The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).
Conclusion:
Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.
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ARTÍCULO DE REVISIÓN22/11/2024
Transition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
Resumen
ARTÍCULO DE REVISIÓNTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
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Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
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22/11/2024
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
Resumen
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
DOI 10.1590/0034-7167-2023-0298
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Objective:
To report the development of a technological innovation in the form of a documentary, aimed at disseminating actions for preventing violence against adolescents within the context of Primary Health Care.
Methods:
The documentary was developed through action research and interventions with adolescents in the territory of a Health Unit, conducted between 2020 and 2022, using Social Technology as both an action strategy and a conceptual reference.
Results:
The Social Technology proposal, created through workshops and seminars, resulted in a documentary focusing on violence prevention, involving 48 adolescents. The documentary’s script, collectively developed, portrays a soccer match between teams symbolizing peace and violence, with peace ultimately prevailing. The documentary is six minutes long.
Final Considerations:
The documentary has proven to be an effective Social Technology tool among adolescents, as it fosters critical thinking, is accessible, has potential for digital dissemination, and appeals to the target audience.
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ARTÍCULO ORIGINAL22/11/2024
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
Resumen
ARTÍCULO ORIGINALPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
DOI 10.1590/0034-7167-2023-0327
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Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
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ARTÍCULO ORIGINAL07/08/2023
Workload assessment: cross-cultural adaptation, content validity and instrument reliability
Revista Brasileira de Enfermagem. 2023;76(3):e20220556
Resumen
ARTÍCULO ORIGINALWorkload assessment: cross-cultural adaptation, content validity and instrument reliability
Revista Brasileira de Enfermagem. 2023;76(3):e20220556
DOI 10.1590/0034-7167-2022-0556
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Objectives:
to adapt, validate the content and assess the reliability of the instrument National Aeronautics and Space Administration – Task Load Index, translated into Brazilian Portuguese.
Methods:
a methodological study, divided into five steps: translation; synthesis; back-translation; assessment of the Portuguese version by an expert committee; pre-test and content validity of the final version by health professionals working in inpatient units. The Content Validity Index (CVI) (minimum 0.80) and Cronbach’s alpha (minimum 0.70) were calculated.
Results:
in the first round, in the agreement analysis of the translated version, three items did not reach the minimum CVI value. It was decided to remove the statement. The instrument title and items “performance” and “effort” were changed. There was consensus and approval of the final version in the pre-test step.
Conclusions:
the NASA Task Load Index instrument, adapted to Brazilian Portuguese, presents reliability and content validity evidence.
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ARTÍCULO ORIGINAL04/09/2023
Financial toxicity in people with chronic kidney disease undergoing hemodialysis treatment
Revista Brasileira de Enfermagem. 2023;76(4):e20220671
Resumen
ARTÍCULO ORIGINALFinancial toxicity in people with chronic kidney disease undergoing hemodialysis treatment
Revista Brasileira de Enfermagem. 2023;76(4):e20220671
DOI 10.1590/0034-7167-2022-0671
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Objective:
to assess the financial toxicity of people with chronic kidney disease undergoing hemodialysis treatment.
Method:
a descriptive analytical cross-sectional study, carried out with 214 people, between February and May 2022. For data collection, a sociodemographic and clinical instrument and the COmprehensive Score for financial Toxicity were used. For analysis, the Odds Ratio, ANOVA and Cronbach’s alpha tests were used.
Results:
the mean financial toxicity score was 20.30. Women with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (Odds Ratio: 0.85; 0.76).
Conclusion:
financial toxicity was identified to different degrees and varied according to sociodemographic and clinical characteristics. Measuring financial toxicity can help nurses plan care and develop strategies to avoid interrupting treatment.
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ARTÍCULO ORIGINAL27/11/2023
Prevalence of risk factors for primary postpartum hemorrhage in a university hospital
Revista Brasileira de Enfermagem. 2023;76(5):e20220134
Resumen
ARTÍCULO ORIGINALPrevalence of risk factors for primary postpartum hemorrhage in a university hospital
Revista Brasileira de Enfermagem. 2023;76(5):e20220134
DOI 10.1590/0034-7167-2022-0134
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Objectives:
to identify the risk factors associated with primary postpartum hemorrhage in a university hospital.
Methods:
a cross-sectional study was conducted with 277 postpartum women who received care during childbirth or cesarean section between June and August 2020. Data were collected using a pre-structured questionnaire administered 24 hours after delivery. Poisson Regression was employed to analyze the factors associated with postpartum hemorrhage.
Results:
postpartum hemorrhage was observed in 30% of the study sample. Shock Index and uterine distension were found to be statistically associated with postpartum hemorrhage. Postpartum women with a Shock Index ≥ 0.9 had a 61% higher prevalence of postpartum hemorrhage (PR=1.61, 95% CI: 1.07 – 2.43), while those with uterine distension had a 134% higher prevalence (PR=2.34, 95% CI: 1.63 – 3.36).
Conclusions:
recognizing these factors contributes to improvements in clinical practice, as they enable the prediction of their occurrence and call for appropriate management, thereby preventing unfavorable outcomes.
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ARTÍCULO ORIGINAL27/11/2023
Incidents in the context of pre-hospital care by ambulances: contributions to patient safety
Revista Brasileira de Enfermagem. 2023;76(5):e20220657
Resumen
ARTÍCULO ORIGINALIncidents in the context of pre-hospital care by ambulances: contributions to patient safety
Revista Brasileira de Enfermagem. 2023;76(5):e20220657
DOI 10.1590/0034-7167-2022-0657
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Objectives:
to analyze the occurrence of incidents in the context of mobile terrestrial pre-hospital care.
Methods:
a descriptive research was carried out through the observation of 239 treatments performed by 22 healthcare professionals at the Mobile Emergency Care Service, located in Baixada Fluminense, Rio de Janeiro, Brazil. Fisher’s exact test and chi-square test were used for data analysis.
Results:
the total time dedicated to patient care was 439.5 hours, during which 2386 security incidents were observed. The most notable ones were related to written communication (235), patient identification through bracelets (238), and safety in medication preparation (81).
Conclusions:
the need to promote and implement initiatives aimed at patient safety is evident, with special focus on international safety goals within the scope of mobile pre-hospital care services.
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31/07/2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Resumen
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
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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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ARTÍCULO ORIGINAL28/11/2023
Remote consultation with people with eating disorders during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220197
Resumen
ARTÍCULO ORIGINALRemote consultation with people with eating disorders during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220197
DOI 10.1590/0034-7167-2022-0197
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Objectives:
to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic.
Methods:
a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence.
Results:
the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations.
Final Considerations:
the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.
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INFORME DE EXPERIENCIA03/02/2023
Gestão da qualidade na pandemia de COVID-19: plano de ação da enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220272
Resumen
INFORME DE EXPERIENCIAGestão da qualidade na pandemia de COVID-19: plano de ação da enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220272
DOI 10.1590/0034-7167-2022-0272pt
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Objetivos:
descrever a implementação de um plano de ação da enfermagem para enfrentamento da pandemia de COVID-19 em um hospital universitário do estado do Rio de Janeiro.
Métodos:
trata se de um relato de experiência, no qual foram utilizadas duas ferramentas de gestão: o Diagrama de Ishikawa, para o levantamento dos problemas; e a planilha 5W2H, para traçar as ações de acordo com as situações apresentadas.
Resultados:
foram elencadas quatro categorias em dois grupos: 1) Atuação do enfermeiro gestor na organização de logística, infraestrutura e assistência: materiais e meio ambiente; e 2) Gerenciamento dos recursos humanos de enfermagem e educação permanente: método e recursos humanos.
Considerações Finais:
o plano elaborado evidenciou o protagonismo da gestão de enfermagem, com busca pelas melhores práticas assistenciais, elaboração de protocolos, realização de treinamentos multiprofissionais e gestão de insumos.
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ARTÍCULO ORIGINAL03/02/2023
Factors associated with the safety culture of patients under dialysis in the context of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220280
Resumen
ARTÍCULO ORIGINALFactors associated with the safety culture of patients under dialysis in the context of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220280
DOI 10.1590/0034-7167-2022-0280
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Objectives:
to assess the factors associated with the safety culture of patients under dialysis in the context of the COVID-19 pandemic.
Methods:
a cross-sectional and analytical study, carried out in Minas Gerais, with 134 professionals from three dialysis services. The Hospital Survey on Patient Safety Culture, adapted for Brazil, was used.
Results:
only variable type of management was associated with the highest percentage of positive response in public and private services. Patient safety was rated as good by 55.7% of respondents. In dimension assessment, the public service presented one strength and five weaknesses, the private service did not present weak areas, and the philanthropic service presented a weakness. The priority areas for improvement actions are represented by dimensions “Nonpunitive response to error” and “Staffing”.
Conclusions:
interventions should consider the type of service management, as it is a factor associated with safety culture.
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