Repositório RCAAP

ABSTRACT Objective: To identify relational and organizational barriers related to the production of care and to map strategies and tools that favor comprehensive care. Methods: Scoping review of Brazilian publications from 2008 to 2018, related to the production of care in Primary Health Care. From the 348 studies found in the Virtual Health Library, 30 made up the final sample. Three book chapters were added, totaling 33 documents. Results: Three thematic categories were organized: Relational dimension between health professionals and users; Interactive dimension of the teamwork process; Organizational dimension and articulation in networks. Challenges of health practices out of context of the users’ needs; inflexible and bureaucratic work processes; and organizational barriers to the access are highlighted. The potentials of mapped tools involved embracement, interprofessional actions and instituting care networks. Final considerations: The overview of challenges and processes that induce good practices facilitate a decision-making that is committed with comprehensive care.

ABSTRACT Objectives: to identify the current state of knowledge on compassion fatigue in the work context of healthcare professionals; and how coping strategies are established in this scenario. Method: a scoping review with search applied to the databases: MEDLINE, LILACS, CINAHL, Scopus. Temporal limit: 2009 to 2019. The data was analyzed and synthesized in narrative form Results: thirty articles were selected, synthesized into two categories: a) Health work and compassion fatigue: conceptual analysis, context, and manifestations; b) Coping strategies for compassion fatigue. Conclusions: this study presented: a descriptive and general panorama about compassion fatigue in healthcare professionals, identifying a greater consolidation of the concept between 2015 and 2018; and some coping strategies. The association between health and spirituality is highlighted as one of the strategies in this scenario, enabling new research to be conducted in view of the importance of the theme in life, health work.

ABSTRACT Objective: to identify products/technologies for treating patients with pressure ulcers with an evidence level 1. Method: this is an integrative literature review. A survey of studies was carried out using the United States National Library of Medicine Portal, Scientific Electronic Library Online, Virtual Health Library, National Library of Medicine(®), The Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean in Health Sciences, Nursing Database. Results: sixteen articles were selected with level of evidence 1. The findings were categorized into five categories: Topical therapy to promote healing; Alternative therapy to promote healing; Topical therapy to promote debridement; Topical therapy to minimize lesion contamination; Topical therapy to reduce lesion size. Final considerations: the 17 products/technologies identified favor/fast healing, debridement, minimize contamination and reduce lesion size to accelerate healing.

ABSTRACT Objective: To reflect on the environment of the Pediatric Intensive Care Unit in the light of the Florence Nightingale’s Environmental Theory. Methods: A theoretical-reflexive essay of constructs originated from the final work of a discipline related to the Florence Nightingale’s Environmental Theory and the current legislation regarding the environment of the unit. Results: The elements “lighting,” “noise,” “colors, and varieties of objects,” “location of nursing units,” and “odors” follow Florence Nightingale’s assumptions while the elements “ventilation,” “spacing between beds,” “furniture” underwent adaptations to suit the current structure of the unit. Final considerations: The environmental theory is a milestone in the history of nursing. Despite the transformations, such as the emergence of intensive care units and the permanence of the family in these units, the nursing team must maintain Florence Nightingale’s concern about the environment influencing the health/disease process and promoting an adequate environment for the care of the child and his family.

ABSTRACT Objective: to develop and validate a scenario for clinical simulation in nursing education on the management of severe preeclampsia in the puerperium. Method: methodological study in five stages (overview, scenario, scenario design progression, debriefing and assessment), developed from March to December 2019, involving 10 volunteers (one professor, five actors and four judges). Data were analyzed using descriptive statistics and Content Validation Index. Results: the scenario was built from the definition of learning objectives that meet the needs of nursing education. From the completion of a Likert scale, by the judges in on-site validation, a Content Validity Index of 1.0 was reached, which indicates 100% agreement in the assessed items. Conclusion: the scenario was validated. It is expected that teaching by simulation will be expanded and that new studies of scenario validation will contribute to the preparation of future nurses, based on the most recent scientific evidence.

ABSTRACT Objective: Understand the continuity of stimulation of neuro-psychomotor development in children with congenital Zika syndrome. Method: Descriptive-exploratory study with theoretical support in symbolic interactionism. Between August and November 2019, 12 health professionals were interviewed in depth; and to the focus group, seven caregivers of children with the syndrome. The analysis was thematic inductive. Results: The continuation of neuro-psychomotor stimulation of children with Zika syndrome goes through: organizational difficulties (lack of doctors, professional unpreparedness, dissatisfaction and search for other services); socioenvironmental aspects (low maternal education, low socioeconomic level, difficulty in moving and lack of support); and conditions inherent to children (hospitalizations for respiratory crises, seizures, hypoactivity and social stigma). Final considerations: A strengthened support network with qualified human resources is necessary in order to provide comprehensive care and avoid the discontinuity of neuro-psychomotor stimulation of children with congenital Zika syndrome.

ABSTRACT Objective: to identify mothers’ knowledge about premature newborn care and application of Kangaroo Mother Care at home. Methods: a descriptive, qualitative study carried out with 15 mothers of premature newborns in a reference Maternal and Child Hospital in northern Brazil using two semi-structured interviews with open- and closed-ended questions. The testimonies were analyzed using thematic analysis technique, proposed by Bardin. Results: two thematic categories originated: “Caring for a premature newborn at home: strengths and weaknesses” and “Applying Kangaroo Mother Care at home: new knowledge acquired during hospitalization”. Final considerations: the speeches of the interviewed mothers pointed out their knowledge about home care of premature NBs and understanding the importance of Kangaroo Mother Care, mainly acquired and improved with the guidance of professionals during hospitalization and application of the method, in addition to fears, possible difficulties in home care and the need to be better informed at hospital discharge.

ABSTRACT Objective: Identify the knowledge of family members of children and adolescents with cancer about their legal rights, difficulties, and concessions to ensure them. Method: Quantitative study, survey type, of intersectional design. A questionnaire drawn up by the researchers was applied in order to characterize the minor and their family and also to identify the family’s knowledge about legal rights. Descriptive statistics were used to analyze data. Results: 61 family members who participated know some more rights to the detriment of others and are especially motivated to search for information when negative impacts on the financial life increase, with repercussions beyond family health. Conclusion: the studied population requires more information and demands knowledge about some rights guaranteed by law. Guidance on rights empowers the family and guarantees the necessary care, searching to have an intersectoral action qualify care and assist in restructuring family dynamics to deal with chronic conditions.

ABSTRACT Objective: to understand the representations about sexuality of people diagnosed late with HIV infection and its implications in the delayed search for diagnosis. Methods: this is a qualitative study, whose theoretical and methodological framework was Social Representation Theory. The research was carried out with 18 people diagnosed late with HIV infection through an open interview. For data analysis, Structural Narration Analysis was used, with support from MAXQDA 12®. Results: representations about sexuality contributed to delayed diagnosis, such as trust in a fixed partnership, sexual intercourse is natural, sexuality as a taboo, search for pleasure in sexual intercourse, regardless of risks, denial of risk for HIV infection. Final considerations: representations about sexuality participate in a web of stereotypes and riskier ways of living, which contribute to delayed diagnosis. Sexual health education remains necessary and essential throughout people’s lives.

ABSTRACT Objective: to analyze the relationship between exposure to workloads and presenteeism among nursing workers in the socio-environmental context of university hospitals. Method: this is a quantitative, cross-sectional and analytical study with 355 nursing workers from two university hospitals in southern Brazil. Data were collected from November 2019 to February 2020. The Workload Scale in Nursing Activities and the Work Limitations Questionnaire were used. Descriptive statistics, variance analysis and Pearson’s correlation test were used. Results: there was a significant correlation between chemical loads and time management; biological loads and time management, physical demand and productivity loss; physiological loads and mental and interpersonal demand, production demand and loss of productivity; psychological loads and production demand. Conclusions: there is a relationship between workloads and nursing presenteeism, verified by limitations and loss of productivity.

ABSTRACT Objective: To analyze the factors associated with sex without the use of condoms in consumers of sexually explicit media (SEM). Methods: Cross-sectional study, with a sample of 172 participants selected and collected through social media. To assess the predictors of unprotected sexual practices, the Poisson regression model was used. Values were expressed as a robust prevalence ratio (PR) with their respective confidence intervals. Results: There was a statistically significant association between, the use of condoms and the type of scenes that the participants prefer (p = 0.03), the preference for films with scenes involving unprotected sex or even those that do not care about protection (p = 0.02), the type of pornography watched influencing sexual relations (p = 0.017), and the number of scenes seen per week (p = 0.05). Conclusions: The lack of condom use was associated with the access to erotic scenes.

ABSTRACT Objective: To evaluate the impact of implementing the SafeCare clinical supervision model on nurses’ job satisfaction and emotional competence profile. Methods: This is a quasi-experimental study, with a sample of 28 nurses from a hospital in northern Portugal. A self-administered questionnaire was applied, used as pre and post-test, which included: sociodemographic and professional characterization; “Job Satisfaction Scale”; and “Veiga Emotional Competence Scale”. We conducted descriptive statistical analysis and the Wilcoxon Test. Results: A significant decrease in the nurses’ satisfaction with hierarchical superior was observed in the post-test. No significant differences were found in the nurses’ job satisfaction and emotional competence after the implementation of the SafeCare Model. Conclusion: The SafeCare Model needs improvement, suggesting increasing the amount of training time administered to nurses and strengthening the healthcare institution’s link to the Model.

ABSTRACT Objective: to understand the perception of alumni from a nursing course which uses active learning methods about their insertion in the job market. Methods: descriptive and exploratory study with a qualitative approach, carried out through 17 interviews with alumni from 2012 and 2014. The analysis took place using Dialectic Hermeneutics, as subsidized by the theoretical framework of the Theory of Complexity. Results: the statements of the alumni showed aspects related to safety to act in the job market, to stimulating proactivity and initiative for learning as proposed by the active method, to difficulties in teamwork, and to the lack of experience in certain specialized fields. Final Considerations: there are advances and challenges marked by contradictions in the way the alumni act and think as they enter the job market, which is an inherent condition to processes of change, from the perspective of complex thinking.

ABSTRACT Objectives: to analyze quality of sleep among students of technical courses in nursing according to the exercise of work activity. Methods: a cross-sectional and analytical research, with 213 students from Paraná. Characterization data and the Pittsburg Sleep Quality Index were collected between March and June 2020 and analyzed descriptively and inferentially. Results: quality of poor sleep was 76.5% among those who work and 75.3% among those who do not work. Difficulty in reconciling personal and academic life (p=0.016;adjOR:3.450) and indicating anxiety due to school activities (p=0.017;adjOR:3.236) increased the chances of poor sleep quality among working students. Satisfaction with health reduced the chances of poor sleep quality, regardless of exercising work activity (p=0.002;adjOR:0.210) or not (p=0.008;adjOR:0.215). Conclusions: students who performed work activities have worse sleep quality due to anxiety and the multiple activities to be reconciled with the study.

ABSTRACT Objectives: to identify the socio-emotional competencies in teachers who work in a Nursing technical course. Method: qualitative study in the action research modality. Inclusion criteria: being a teacher in a Nursing technical course. Data collection: December 2018 to June 2019, with the realization of five focus group meetings. Data analyzed using the Content Analysis technique, according to Bardin. Results: data classification into two categories: 1) Teacher socio-emotional competencies in a conceptual and experiential perspective; 2) Teacher socio-emotional competencies in a conscious perspective of lived experiences. Final Considerations: five socio-emotional competencies were listed for teaching practice: self-control, creativity, empathy, respect, and knowing how to listen. There was a strong awareness of the theme among teachers, impacting their teaching practice.

ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.

ABSTRACT Objectives: to identify the prevalence of psychotropic drug use according to their Anatomical Therapeutic Chemical classification among Psychosocial Care Center users and assess their prescription compliance based on the recommended therapeutic dose. Methods: this is an analytical study, based on documents, from the study of 389 records between September 2017 and May 2018. Associations between the presence of underdose or overdose and participants’ characteristics were assessed using the chi-square test, adopting a significant value of p <0.05. Results: the most used drugs were antipsychotics (74.7%), 16.0% of users with at least one medication with a dose below the therapeutic level and another 3.6% above the recommended therapeutic dose. Conclusions: greater nonconformities in the prescribed dose were related to antihistamines, antipsychotics and antidepressants, with underdosage associated with females and overdose with the report of hearing voices.

ABSTRACT Objectives: to develop and validate a scale for assessing the quality of life of women with Human Papillomavirus infection. Methods: a methodological study to develop the stages of item elaboration, apparent and content validation, semantic validation, pre-test, item allocation in domains, and reliability. Results: 98 items were elaborated and submitted to apparent and content validation (version 2; n=05). In semantic validation, 90.9% of women considered all items clear and understandable (version 3; n=11). In pre-test, the best applicability was in the form of a self-administered questionnaire in relation to the interview (version 4; n=38). The Exploratory Factor Analysis allocated 58 items in 6 domains; (version 5; n=351). For reliability, the general Cronbach’s alpha value was 0.883. Conclusions: the instrument proved to be valid and reliable for assessing the quality of life of women with Human Papillomavirus infection, consisting of 54 items allocated in 6 domains.

ABSTRACT Objectives: to know the therapeutic itinerary and to show the implications of breast cancer for women in a border town in southern Brazil. Methods: a qualitative research conducted based on the complexity paradigm, through interviews with 13 women with breast cancer undergoing outpatient treatment and data analyzed by thematic analysis. Results: the first signs and symptoms of breast cancer were noticed unexpectedly, in everyday moments and during routine visits. There was family support in the search for assistance in primary care services, but organizational barriers led this itinerary to private health services, including Paraguay. Coping with the disease and treatment was anchored in the family subsystem. Final Considerations: the paths for breast cancer diagnosis and treatment included families, primary care services and private health services, including from the neighboring country, considering the vulnerability of border regions to guarantee health care.

ABSTRACT Objectives: to compare the parameters of the activity/rest cycle of early postpartum breastfeeding women under a controlled and uncontrolled long wavelength ray light regimen. Methods: quasi-experimental study with breastfeeding women and their babies during postnatal rooming-in, São Paulo, Brazil. Participants were allocated to either an experimental (intervention) or a comparison group. The intervention involved exposure of the woman in a controlled room with artificial long wavelength ray light at night. Each woman’s level of 6-sulfatoxymelatonin at 24 hours and activity/rest times was analyzed. Results: the mean activity/rest times of women in the experimental and comparison groups were similar. The mean percentages of total load of 6-sulfatoxymelatonin during the day and night were similar (p=0.09). At 24 hours, the experimental group presented a significantly lower mean percentage of total load compared to the comparison group (p=0.04). Conclusions: women who stayed in the room with long-wavelength artificial light showed no difference in activity/rest and 6-sulfatoxymelatonin levels in the early postpartum period.