Online Brazilian Journal of Nursing

Surgical site infection and nurse telemonitoring in the postoperative period: a scoping review

Janessa Vieira Santos — 2024-01-02

Objective: The aim of this study is to map scientific evidence regarding the prevention and early management of surgical site infection through telemonitoring in surgical patients after discharge from the hospital. Method: A scoping review was conducted following the guidelines proposed by the Joanna Briggs Institute (JBI). The search was performed across PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Collaboration, Scopus, CINAHL, MEDLINE, Web of Science, and Embase databases. The identified studies were collected using Endnote Basic and Rayyan by three independent researchers. Results: A total of 1,386 studies were identified, of which 31 were included in the analysis. These selected studies demonstrated significance in terms of early and late warning signs of surgical site infection, complications, risk factors, prevention strategies, and the utilization of telemonitoring. Conclusion: While the studies address surgical site infection and telemonitoring, it is imperative to formulate the instruments employed in telephonic consultations, incorporating a more specific consideration of essential criteria to be addressed.

The use of simulators for health education of people with diabetes: A scoping review

Maria Verônica Gomes de Oliveira — 2024-08-02

Objective: To map the simulators used as a health education strategy for people with diabetes mellitus. Method: This is a scoping review based on the recommendations of the Joanna Briggs Institute, conducted through a literature search strategy in PubMed Central, Web of Science, Scopus, ERIC, BDTD, and RCAAP databases. The analysis of the identified studies was performed by two independent review authors. Data were analyzed descriptively, resulting in the preparation of tables and statistics of absolute and relative frequencies. Results: A total of 226 studies were identified, of which nine formed the final sample. The use of the Human Patient Simulator was identified in 78% of the studies, followed by low-cost simulator and simulation tool (11% each). All strategies showed positive results. Conclusions: The simulators used include the Human Patient Simulator, the low-cost simulator, and the simulation tool, all of which show equally satisfactory results.

Health care in the process of parturition of immigrant women: a review of scope

Isabella Zerbeto dos Santos — 2024-08-05

Objective: to identify what has been published in Brazil about immigrant women in the process of parturition. Method: structured scope review, according to the PRISMA-SCR flowchart and following the steps of the method proposed by the Joanna Briggs Institute .Publications in English, Spanish and Portuguese were included between 2011 and 2023 and addressed the theme process of parturition of immigrant women in Brazil. The search was carried out in four databases and in the gray literature. Results: seven articles were included and it was observed that the difficulties existing during the delivery assistance of immigrants in Brazil involve communication barriers and difficulties of cultural manifestation of women. Strategies such as interpreters, material preparation and training of professionals were identified. Conclusion: strategies need to be raised and implemented by health institutions and professionals to improve care.

Telemedicine for diagnosis or treatment during Covid-19: systematic review

Jéssyca Maria França de Oliveira Melo — 2024-01-06

Objective: To describe the use of telemedicine by health professionals for diagnosis or treatment of patients during the Covid-19 pandemic. Method: This is a systematic literature review of observational studies. Five databases were used. The assessment of the studies methodological quality occurred individually among the revisors and the Joanna Briggs Institute tool was used. Results: The reviewers selected 22 articles from 6,180 works. The services provided through telemedicine were consultation/screening, consultation/follow-up or monitoring, test reports, medication prescriptions and case discussions. The technological resources used were platforms using video and telephone (audio and video). The use of telemedicine made it possible to reduce their exposure to Covid-19, reduce social panic and anxiety, quickly medical specialties access and the possibility of access to diagnosis and treatment of patients with chronic and acute diseases. Conclusion: Telemedicine can be an important tool in healthcare, keeping patients and healthcare professionals safe during the Covid-19 pandemic.

Educational Apps to Support Patient Safety in Hospitals: A Technology Perspective

Léia Arcanjo Mendes — 2024-01-03

Objective: To examine mobile applications developed to guide healthcare professionals, patients, and their caregivers regarding patient safety interventions in the context of hospitalization. Methods: A technological prospection was conducted in the virtual stores App Store® and Google Play® and through the Google search tool. Inclusion criteria included applications focused on patient safety in the context of hospitalization without temporal limitations. Results: 25 applications were included in the study and analyzed. The majority of the applications were mobile, developed in English, and focused on healthcare professionals. In addition, they had limitations and weaknesses related to design and playful features. Conclusions: The study may contribute to the development of new patient safety education applications that promote increased engagement in error prevention interventions

Child Sexual Abuse in the Context of Nursing: A Concept Analysis

Tamires Paula Gomes Medeiros — 2024-02-11

Objective: To conduct a conceptual analysis of child sexual abuse to identify possible attributes, antecedents, and consequents. Method: A concept analysis was conducted using a scoping review methodology. Searches were conducted in 6 databases, resulting in a total of 17 articles after analysis. Results: Antecedents included children older than 8 years, female gender, the perpetrator often being a relative of the victim or even the biological father. Psychological changes, sexually transmitted diseases, and unwanted pregnancies were identified. The consequents observed were mainly psychological, including depression and suicidal behavior. Conclusions: A total of nine antecedents were grouped as factors contributing to vulnerability to abuse. In addition, 11 attributes were identified that correspond to characteristic signs indicating that a child is a victim of maltreatment. Finally, 12 consequents of child sexual violence were observed.

The Impact of the COVID-19 Pandemic on the Management of Acute Coronary Syndrome: A Retrospective Cohort Study

Alexandra Nogueira Mello Lopes — 2024-03-20

Objective: To assess the impact of the COVID-19 pandemic on response times and clinical outcomes of acute coronary syndrome admissions. Methods: Retrospective cohort study. Data were analyzed using SPSS® version 20.0 with parametric and non-parametric tests for group comparisons. Generalized linear modeling was used for multivariate analysis. Results: 434 patients were included in the pre-pandemic period and 430 during the pandemic period. Delta-t was higher during the pandemic period (p=0.003). There were no differences in response times and mortality. Admission during the pandemic period (RR 1.56; 95% CI: 1.30-1.87) and a previous diagnosis of ischemic heart disease (RR 1.82; 95% CI: 1.50-2.20) were associated with an increase in delta-t. Conclusions: There was no difference in the number of patients presenting to the emergency department with acute coronary syndrome during the periods analyzed. Despite longer Delta-t during the pandemic, no worse clinical outcomes were observed.

Childbirth from the male perspective: qualitative research on the fathers’ experience at birth

Lorena Lopes Carvalho Bellas — 2024-09-28

Objective: to reveal how the experience was of childbirth for men who participated in the birth of their children. Method: descriptive study, of qualitative and field nature, having as a technique of data collection the focal group, in the virtual format, called the childbirth report circle. The data were analyzed using the IRAMUTEQ ®software. Results: five (05) deponents participated in data collection, generating ten (10) reports. From the analyzes, six classes of words were generated, represented by a phylogram of which some relevant terms stood out for the study such as “participate”, “will”, “possibility”, “fear”,” hospital “, “decision”, among others. Conclusion: the participation of the paternal figure at the time of birth, as well as in the whole gravidic process resignifies masculinity and inserts the father into a position of protagonism in the experience of paternity.

Men’s Experiences and Perspectives on their Involvement in Pregnancy: A Qualitative Approach Study

Thalita Rocha Oliveira — 2024-01-07

Objective: To understand men’s experiences and perceptions of their involvement in pregnancy. Method: A descriptive, qualitative research approach was used. Information was collected through semi-structured interviews with ten male partners of postpartum women in a shared accommodation setting and subjected to thematic analysis. Results: Overall, men’s involvement in prenatal care included attending medical appointments, being present during examinations, and assisting with household tasks. Some limitations included work routines and legal aspects related to work issues. Respondents suggested ways to encourage greater involvement and inclusion in the experience of pregnancy and prenatal care. Conclusion: Health professionals should give fathers a voice and include them as targets of health initiatives, making them active participants during this period and reinforcing good health practices set by government policies.

Evaluation by Community Health Agents of the attributes of Primary Health Care for fighting leprosy

Natacha Bolorino — 2024-05-01

Objective: To evaluate whether the attributes of Primary Healthcare are present in leprosy control actions in Londrina from Community Health Workers (CHW) perspectives. Methods: Observational and evaluative study. Data collection took place between January and March 2020 in Londrina, Paraná, using the questionnaire "Primary Care Assessment Tool (PCATool) - Hansen's disease - CHW version" and a population-based census of 246 CHWs from 52 Primary Healthcare Units. The analyses used a cutoff point (≥ 6.6), central tendency, and dispersion measures. One-way ANOVA and Tukey's post hoc tests were used to analyze differences. Results: The general performance towards the primary healthcare attributes were evaluated as strong (mean = 6.95 / SD = 1.08) and the essential score (mean = 7.39 / SD = 1.0). On the other hand, the derived score was evaluated as poor (mean = 6.07 / sd = 1.06). Concerning the Access attribute, the rural zone had a lower score than the urban (mean = 4.47 / SD = 1.63). As for the Comprehensiveness attribute of services provided to leprosy patients, the central region had a lower mean (mean = 4.87 / SD = 3.44) than the south region (mean = 6.76 / SD = 2, 24). Concerning the Integrality, the rural region presented a higher score (mean = 8.15 / SD = 1.22) than the western (mean = 6.16 / SD = 2.91) and central regions (mean = 6.13 / SD = 3.27). As for Community Orientation, the western region had a lower mean than the others (mean = 5.04 / SD = 2.44). The vocational guidance attribute had a higher average in the rural region (mean = 4.14 / SD = 2.62). Final Considerations: The study highlights issues that can be improved, such as first contact access, catalog of services offered to leprosy patients, information provided to the community, professional training, and differences in PHC performance between urban and rural regions.

Events supposedly attributable to vaccination or immunization recommended for pregnant women: time series analysis

Thales Philipe Rodrigues da Silva — 2024-10-05

Objective: To analyze the events supposedly attributable to vaccination or immunization (ESAVI) associated with the Diphtheria-Tetanus Vaccine, Adult Diphtheria-Tetanus-Pertussis Vaccine (Tdap), Hepatitis B, and Influenza vaccines and their severity in pregnant women in Minas Gerais. Methods: Epidemiological, time series study on ESAVI registered in the Information System of the Brazilian National Immunization Program from 2015 to 2020. Four hundred and nine ESAVI were analyzed in pregnant women according to the kind of event, need for medical care, and evolution of the case. Results: The Tdap vaccine showed a higher proportion of ESAVI in this period (56.86%), followed by the Hepatitis B vaccine (29.41%), Influenza vaccine (20.04%), and adult Diphtheria-Tetanus Vaccine (16.00%). Local manifestations were more prevalent, and pain at the injection site was mostly reported. Notably, pregnant women vaccinated with the Adult Diphtheria-Tetanus-Pertussis Vaccine (Tdap) and / or with Hepatitis B vaccine had a higher proportion of events classified as Immunization Error. There was a significant trend towards an increase in the rate of ESAVI because of the Diphtheria-Tetanus Vaccine (p=0.024). Conclusion: The ESAVI incidence rate during pregnancy was low and there was no increase in the risk of pregnant women presenting any serious adverse event after the administration of the recommended vaccines during pregnancy.

Mobile applications on the safety of elderly patients in the surgical environment: a technological prospecting

Juliana Martins Ferreira — 2024-03-15

Purpose: To describe applications focused on the safety of elderly surgical patients in the pre- and postoperative periods. Method: Technology prospecting with a qualitative approach in the Apple Store®, Google Play® virtual stores and web application. As search strategy the following terms were used: ‘elderly self-care’, ‘preoperative’, ‘postoperative’, ‘patient safety’, ‘elderly patient safety’. Results: 12 applications were identified in the Apple Store, 17 in Google Play, and a web app, which focused on the gamification of health and population professionals; educational applications to health professionals and health system users; related applications as a work tool for health professionals; applications as a self-care tool for health system users; and, post-operative applications for health system users. Conclusion: Technologies aimed at self-care and the safety of elderly patients were not found in the pre- and postoperative periods.

Breastfeeding and the adjustment process in the family context: a qualitative approach

Patrícia Alves Paiva de Oliveira — 2024-01-02

Objective: To understand women's adaptation to the breastfeeding process and the support provided by family and health services. Method: A qualitative study based on the methodological framework of Ethnonursing, following Leininger's Transcultural Nursing Theory. A semi-structured interview guide was used. Results: Three thematic categories were identified: "Facing something unexpected, changing, and challenging"; "Dealing with doubts, uncertainties, and disorientation"; and "Identifying sources of support for breastfeeding maintenance". Conclusion: The breastfeeding adjustment process is characterized by doubts, uncertainties, and challenges. Women rely on and are directly influenced by their past experiences and family culture. The role of primary health care is crucial in this context.

Clinical and epidemiological characteristics of pediatric hospitalizations due to COVID-19 in the Brazilian Amazon: an observational study

Janaina Corrêa dos Santos — 2024-03-20

Objective: To determine the clinical and epidemiologic aspects of children hospitalized for COVID-19 in a public hospital located in a state in the Brazilian Amazon. Methods: Observational, descriptive, retrospective and documentary study with a quantitative approach to pediatric hospitalization cases due to COVID-19. Results: In the Hospital for Children and Adolescents, a total of 5016 suspected cases of COVID-19 in children were recorded. Of these, 666 were confirmed with the disease and resulted in 140 hospitalizations. We analyzed 136 reports of children hospitalized for COVID-19. Most patients were infants (39%) and preschool children (36%), with a prevalence of males (67.6%) and black/brown race/color (86%). In addition, 83.1% live in urban areas. Regarding the outcome, 96.67% were cured and 3.33% resulted in death. Conclusion: In the Amazonian context, the analysis of the clinical and epidemiologic characteristics of this age group is essential to guide clinical care, predict the severity of the disease and determine the prognosis.

Psychological distress of mental health workers in a pandemic context and associated factors: a cross-sectional study

Ana Luisa Camachi Stander — 2024-04-23

Objective: To analyze the psychological distress of mental health workers in a pandemic context and identify associated factors. Method: A cross-sectional study was conducted with 108 workers from four mental health services in a municipality in the interior of São Paulo. Data collection was conducted online between October and December 2020 through a sociodemographic questionnaire and the Self Report Questionnaire-20 (SRQ-20) scale. The data were analyzed using descriptive statistics and multiple linear regression of ordinary least squares, intending to analyze the factors associated with the variation in the scale score. Results: The workers had a high average on the SRQ-20 scale (15.07), indicating significant psychological distress. Receiving psychological and/or psychiatric support during the COVID-19 pandemic was associated with reducing this distress, with an average reduction of three symptoms assessed by the scale. Conclusion: Mental health support for workers in the pandemic context can be an important coping strategy associated with reducing psychological distress

Elaboration of the standard operational protocol for performing bladder catheterization in children : applied research

Thayse Nunes da Silva — 2024-10-28

Objective: to develop a standard operational protocol for guidance of family members of children with neurogenic dysfunction in performing clean intermittent vesical catheterization. Method: This is an Applied Research for the elaboration of the standard operational protocol as an instrument for intervention in health care and education to family members of children with dysfunctions in the lower urinary tract, for use at home. The study took place between August 2022 and July 2023. Results: The protocol was elaborated with the description of the actions for application before, during and after the procedure of vesical catheterization, as well as the list of materials . The Protocol and Flowchart of Health Care was used as theoretical reference in the care of the user with the need for intermittent vesical catheterization, both of the Health Department of the Federal District, critical reading of scientific articles on the subject and Resolution n. 546/2017, Federal Council of Nursing. Conclusion: It is concluded that the elaboration of the protocol as a tool of health education can provide clarification of doubts to the family members, contributes to comprehensive care and safety at home, increase the autonomy of the family member.

Repercussions of the COVID-19 pandemic on the configuration of Nursing interpersonal relationships: qualitative approach

Carla Aparecida Spagnol — 2024-10-05

Objective: to identify the repercussions of the COVID-19 pandemic on interpersonal relationships in the workplace, reported by nursing professionals at a university hospital in the state of Minas Gerais. Method: descriptive study of qualitative approach with semi-structured interview conducted with the Nursing Team of a university hospital in Belo Horizonte. The data were organized a posteriori from the thematic Content Analysis. Results: the responses showed fear of the unknown and vulnerability of nursing professionals; work overload and stress that interfere paradoxically in work relationships; impersonality and power relationships, in addition to institutional standards versus affective relationships that permeate the work. Conclusion: the repercussions of the pandemic in the configuration of interpersonal relationships of nursing professionals in the work environment can stimulate reflections on the more horizontal and dialogical relationships, based on interprofessionality for the provision of integral, affective and humanized care.

“De boa com o intestino neurogênico”: A report on technological innovation based on design thinking

Thayane de Souza Xavier — 2024-03-21

Objective: To describe the processes used to develop the prototype of a program for support and assistance to parents (entitled “De boa com o intestino neurogênico”) applicable to intestinal rehabilitation in the pediatric population using transanal irrigation. Methods: This is a report on technological innovation using the design thinking approach to develop a prototype digital educational technology for neurogenic bowel management. This represents both a process and a product created as part of a Master’s in Nursing program. Results: The development of the prototype followed the stages of design thinking: empathy, immersion, ideation, and prototyping. A toolkit was developed to support parents of children with neurogenic bowel dysfunction using transanal irrigation. Conclusion: The design thinking approach and methodology enabled an expansion of the horizon of care interventions by focusing on families. An innovative solution based on empathy, collaboration, and experimentation was proposed.

The effectiveness of nonpharmacological interventions compared with usual care and other therapies in improving sleep quality of oncology patients: A systematic review protocol

Maria José Dias Gonzaga — 2024-10-16

Objective: To identify and compare the effectiveness of nonpharmacologic interventions for managing sleep disturbances in cancer patients across the continuum of care. Methods: This is a systematic review protocol conducted according to Joanna Briggs Institute (JBI) guidelines. Study selection, critical appraisal, and data extraction were performed by two independent review authors, with disagreements resolved by consensus or third reviewer decision. The Grading of Recommendations, Assessment, Development, and Evaluations will be used to assess the certainty of evidence, and meta-analysis calculations will be performed using the JBI SUMARI. Dichotomous outcomes will be analyzed by odds ratio or risk ratio, continuous outcomes by mean difference with corresponding 95% confidence intervals, statistical significance (p < 0.05), and heterogeneity by Cochran Q-test and I2. Where statistical pooling is not feasible, a narrative synthesis will be presented.

Digital story based on the experience of bladder and bowel symptoms in childhood: A methodological study of technological production

Lilhian Cristine Fernandes da Fonseca — 2024-05-12

Aim: To describe the production of a prototype digital story based on the experience of bladder and bowel symptoms in children. Method: This is an applied research with a multimethod approach, divided into two phases: Phase 1 consisted of a systematic review of mixed methods and a mixed methods study (quantitative phase based on retrospective documentary analysis of medical records, and qualitative phase based on interviews with health professionals, caregivers, and children with bladder and bowel symptoms of school age). Phase 2 consisted of a methodological study of the technological production of the digital story prototype. Results: Based on the triangulation of data obtained in the two phases of the multimethod research, the developed story brought representative characters of the profile of children with the studied symptoms and a narrative with elements of the experience of these symptoms. Conclusion: The story sought to give protagonism and encourage children with such symptoms for treatment and self-care.

The health of LGBT+ people in nursing and health training, research and care

Bruno Pereira da Silva — 2024-09-28

The Lesbians, Gays, Bisexuals, Transvestites, Transsexuals, Intersexuals and other gender identities and/or sexual orientations (LGBT+) movement has achieved rights in various areas of society. In the political and social spheres, the increase in the representation of LGBT+ people in political positions, the recognition of homoaffective unions as a family nucleus by the Federal Supreme Court in 2011, and the criminalization of homophobia in 2019 are just a few examples. In culture and the media, the representativeness and plurality of these people are becoming more present with efforts to deconstruct caricaturing and stigmatization.

The search for the therapeutic environment: contemporary challenges in the age of technology

Ana Carla Dantas Cavalcanti — 2024-10-06

At 5:53 a.m., I started writing this editorial while I was in a private hospital accompanying my mother, who had been diagnosed with dementia and pneumonia. Perplexed at the loss of the much-prized "therapeutic environment" advocated by Florence Nightingale, I felt the urgency to address this topic before dawn, fearing that I would lose the motivational impetus that drove me forward.

Intensive care unit - past, present and future: an invitation to reflect

Kely Regina da Luz — 2024-09-28

Objective: To provide a comprehensive overview of the evolution of critical care, highlighting its historical origins, identifying important milestones in its development, and examining technological advances over time. It also aims to address the current challenges facing intensive care as a specialty, contributing to an in-depth understanding of its complexity and relevance in the healthcare context. Method: This is a theoretical-reflective essay based on historical research and the knowledge of the authors, who analyze, reflect and contextualize the construction of intensive care units, their current guidelines and future prospects. Results: The manuscript deepens the theoretical framework described and brings concrete elements that generate concerns in order to elicit more pertinent behavior in the care of critically ill patients. This means combining the use of available technology with more humanized care practices. Conclusion: We believe that accurate knowledge of legal regulations and resolutions promotes and sustains the necessary improvements in the care process, ensuring safe and effective care for critically ill patients. It also provides planned and organized working conditions.