Repositório RCAAP

ABSTRACT Objective: To analyze the temporal trends in the fertility rate, proportion of antenatal consultations and caesarean sections in Brazilian adolescents aged 15 to 19, between 2000 and 2015. Methods: The fertility rate, proportion of prenatal consultations and proportion of routes of birth were calculated using data from DATASUS. The trend analysis was performed using the Prais-Winsten regression model and the annual percentage change. Results: There was a trend of reduction of 3.5% per year in the fertility rate among adolescents (p<0.05), in addition to an increasing trend of 6% per year in the proportion of more than six antenatal consultations (p <0.0001) and an increasing trend of 6.8% per year in the proportion of caesarean sections (p<0.0001). Conclusion: Despite the decreasing trend in fertility rates among Brazilian adolescents, they remain high. Also noteworthy is the growing trend for caesarean sections, even with improved access to antenatal care.

ABSTRACT Objective: to assess breastfeeding support practices for preterm infants at two Baby-Friendly hospitals in southeastern Brazil, comparing the effect of implementing the guidelines for Baby-Friendly Hospital Initiative for Neonatal wards. Methods: a quasi-experimental study, pre- and post-intervention with control. Implementation of this initiative in the intervention hospital using Knowledge Translation. Data collection on compliance with the adapted Ten Steps, Three Guiding Principles and the Code before and after the intervention was carried out via interviews with mothers of preterm babies and professionals, unit observation and documentary analysis in the intervention and control hospitals. Intra-intergroup comparison was performed. Results: increases in global compliance with the Three Principles, Ten Steps, the Code, partial compliance with each Principle and in most Steps was greater in the intervention hospital. Conclusion: this initiative improved practices related to breastfeeding in the intervention hospital, demonstrating the potential to improve care and breastfeeding in neonatal wards.

ABSTRACT Objectives: to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals. Methods: Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration. Results: the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff. Final Considerations: obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.

ABSTRACT Objectives: to validate the content and appearance of the booklet “Going home after a child’s cardiac surgery” and assess family members’ cognitive learning regarding its use. Methods: a methodological and quasi-experimental study of before and after type, with semi-structured interview, pre-test and reading of the booklet in a hospital; post-test and validation occurred after hospital discharge. Wilcoxon non-parametric statistics were used. Results: nineteen family members of children with heart disease participated. The average of correct answers increased 14 percentage points from pre- to post-test; most were medication errors. There was a significant difference (p <0.0001) in the comparison between cognitive knowledge prior to using the booklet and learning acquired from its use. All items received a positive rating, except font size. Conclusions: the booklet helps family members to understand a child’s needs after cardiac surgery, and can be used to prevent unwanted occurrences and enable safe care at home.

ABSTRACT Objectives: to describe the contribution of pregnant women to the construction and evaluation of educational technology. Methods: a participatory study developed in three stages, which occurred between March 2018 and June 2019 for identifying the content, construction, and evaluation of the comic. Non-directive interviews were conducted in educational groups with 34 pregnant women. After the comic was built by a team, including a designer, an instrument was applied to 41 pregnant women to evaluate the items Objectives, Organization, Writing style, Appearance, and Motivation. Results: the comic contains 40 pages of contents, illustrations, and quizzes (word search, cross-puzzle, seven mistakes, etc). The pregnant women evaluated it as easy to understand, self-explanatory, aesthetically attractive, and capable of motivating good care practices during pregnancy, obtaining a minimum agreement of 92.1%. Final Considerations: the innovation of the educational technology consisted of incorporating the voices of pregnant women in prenatal care, with the potential to stimulate reflections and the learning process of this target audience.

ABSTRACT Objective: to identify actions to prevent adolescent sexual violence. Method: an integrative literature review of five databases, Medline/Pubmed, Scopus, Lilacs, Bdenf, Cinahl using the following descriptors “adolescent” “adolescence” “youth” “primary prevention” “prevention” “primary” “sexual violence”, plus the Boolean operators AND and OR, with a final sample of 24 articles; the evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation Results: the review identifies different structures of the study object, classified in the categories “Interventions with programs created by authors” and “Interventions with standard programs”. Conclusion: there are actions to prevent sexual violence against adolescents; the participants’ knowledge was assessed immediately after the intervention, but the assessment of the participants’ acquisition of habits and behavioral changes was to a lesser extent; health prevention is crucial for society’s healthy development, which demonstrates that its applicability in the environment directly favors human health.

ABSTRACT Objective: To analyze the scientific literature on the application of management tools in the postoperative period of pediatric cardiac surgery. Methods: integrative review including studies published between 2004 and 2018 in the following databases: LILACS, BDENF, coleciona SUS, MEDLINE/PUBMED, CINAHL and SCOPUS, via Portal de Periódicos da Capes, Scientific Electronic Library Online (SciELO) and Academic Google research. Results: Twelve articles that met the inclusion criteria were analyzed. The studies demonstrated that strategies such as extracorporeal membrane oxygenation, renal replacement therapy and the risk scores for Risk Adjustment for Congenital Heart Surgery 1 and Aristotle Basic Score favored the stratification the demand for care and predicted the risk for mortality. Final considerations: The applicability of risk scores and emerging strategies for the management of childcare in the postoperative period of cardiac surgery was described by the evaluation of possibilities of performance and/or efficiency of the treatments developed.

ABSTRACT Objective: to describe the overview of clinical trial protocols for behavioral insomnia in infants. Methods: an analytical study that reviewed protocols registered with the International Clinical Trials Registry Platform between August and September 2019, aiming to identify the interventions for behavioral insomnia in infants, the comparators, the main primary, secondary outcomes and their respective measurements. Results: eleven protocols registered between 2004 and 2018 were included. Nurses were the main coordinators of protocols (45.5%), with proposals using educational technologies, one-to-one and online follow-up consultations. The main outcome was improvement of infant and maternal sleep patterns. Secondary outcomes were anxiety, depression, and parental sexual satisfaction. To measure them, the following were used: sleep diary (54.5%), actigraphy (45.4%), and the Pittsburgh Sleep Quality Interview (36.3%) and Extended Brief Infant Sleep Questionnaire (27.2%) were used. Conclusion: the protocols proposed interventions for independent sleep, aiming at quality of sleep for the whole family.

ABSTRACT Objective: To reflect on the repercussions of premature babies’ oral ability concerning breastfeeding, under the light of the theory of causation. Methods: Theoretical production of reflections based on Hobbes’s theory of causation. Results: The study addresses the understanding of oral abilities as the main accident regarding the capacity of the premature newborn, which, coupled with other accidents that make up the other domains, concerning breastfeeding, is an integral cause of the phenomenon. Final considerations: Although there are protocols, even if some of them are inconsistent or incomplete, the use of criteria such as weight and gestational age as standards to understand this readiness can still be observed. However, the effect manifests itself even in the absence of these accidents, showing them as partial causes of the phenomenon, while oral ability is, by itself, a necessary cause for this event to take place.

ABSTRACT Objective: To report the results of a dissertation developed with nurses who perform childcare consultations in Family Health Units in a Health District of João Pessoa, Paraíba, Brazil. Methods: Experience report of the presentation and interpretation of the research results, in 2018, with 42 nurses, using the conversation strategy with two focus groups. Results: The nurses showed disappointment with the negative results evidenced in the study’s feedback, but they highlighted the importance of this moment for discussion and reflection of their practices, thus arousing the interest in qualifying the child’s health care. Final considerations: This study achieved the objective of promoting the dissemination of the findings of a research, coupled with the social and ethical commitment to return to the nurses and participating services with the feedback of the research results to improve the reality in which they work.

ABSTRACT Objective: to evaluate the effectiveness of a mobile application for cell phones in the adherence of pregnant women to prenatal consultations. Method: a randomized controlled clinical trial, simple-blind with two parallel groups, conducted from January to December 2018. Data collection was carried out through a structured interview at the end of the third trimester of pregnancy. For analysis, Chi-Square and Mann-Whitney tests were used. The sample consisted of 88 pregnant women from 2 Family Health Strategies in Northeast Brazil. Participants were randomized into two groups: intervention (IG), who used the application, and control (CG), who attended prenatal consultations. Results: pregnant women who used the application (IG) attended a greater number of consultations when compared to participants in the CG, identifying a statistical difference between the groups (p<0.05). Conclusion: the application showed to be an effective health technology to improve adherence to prenatal care. Brazilian Registry of Clinical Trials: RBR-74SNST.

ABSTRACT Objective: Evaluate a three-dimensional educational gerontotechnology for the prevention of falls in the elderly at home. Methods: Cross-sectional, descriptive study, involving the Development of gerontotechnology; Evaluation by specialists and target audience, took place in Fortaleza, State of Ceara, Brazil, from June 2017 to October 2018. For the development, it was used the steps adopted in a booklet and the Casa Segura project for the elderly. 16 specialists and 30 elderly participated in the evaluation, using the Health Promotion Model, by Nola Pende. Results: The scale model has an area of 160 cm2, with four rooms made of Medium Density Fiberboard . Specialists consider technology adequate, with a level of compliance of 87.7% IC95% [87,71-88,42]. All the elderly related that the scale model looked their homes, and 13 of them (43.3%) suggested the construction of a backyard, a possible second floor, corridors, and stairs. Conclusion: Gerontotechnology was considered fit to be used in the prevention of falls in the elderly.

ABSTRACT Objective: to describe the process of developing a software for emergency bed management. Methods: a participatory research based on User-Centered Design in four stages: 1) definition of requirements and structure elaboration; 2) generation of alternatives and prototyping; 3) tests; 4) implementation. Seminars were held with health professionals between May 21, 2018 and May 31, 2019 for the preparation and assessment of software content. Results: the software CuidarTech KRONOS was developed for emergency bed management using the kanban methodology. Final considerations: this software will assist professionals' and managers' decision-making providing more reliable data to enable the improvement of work processes and the quality of patient care. Developing a bed management software is innovative in the health field, and no articles were found describing this methodology.

ABSTRACT Objective: To develop and evaluate an educational primer to promote healthy lifestyles in people with HIV. Methods: Study of technological development in three stages: Development of the booklet, with bibliographical review, illustrations, layout, diagramming, adopting as reference the trans-theoretical model of behavior change; Analysis of content and appearance by 22 judges; Semantic analysis by 22 people with HIV. The proportion of positive evaluations of the items was measured, considering a percentage equal to or greater than 85%. Results: My motivational booklet for change! Practices for promoting a healthy lifestyle" had six areas: Body weight control; Healthy eating; Exercise practice; Smoking, alcohol and other drugs; Stress control; and Drug treatment. Most of the items evaluated agreed with an overall average of 92.4% by the judges and 98.9% by the target audience. Conclusion: The booklet had evidence of adequate validity to be used by people with HIV.

ABSTRACT Objectives: Validate script and storyboard of a video for educational intervention on nursing care for the prevention and management of syphilis. Methods: Methodological design study, with quantitative analysis approach. The content and appearance of the educational video script and storyboard was validated by a committee of experts on the subject and video. They were considered validated from the agreement of 78%, calculated by means of the Content Validity Index. Results: There were suggestions, which were analyzed; and, where relevant, the script and storyboard were changed. The degree of agreement among the expert judges on the subject obtained a Content Validity Index (CVI) of 100%, while, with the technical experts in video, all the questions in the educational material obtained the percentage above the recommended minimum of 78%. Conclusion: The validated video is an important technological production and could be used in the context of health care.

ABSTRACT Objective: to evaluate the impact of an educational intervention, on nurses’ self-perception, about knowledge and skills for initial care for burn victims. Methods: a quasi-experimental study of the type before and after, with 18 nurses who assist burn victims. The intervention was carried out for 11 days in face-to-face meetings and online activities, and comprised active case-based learning strategies, simulation training, concept maps and digital portfolio. A structured instrument was used to collect sociodemographic data, and another one related to the knowledge and essential skills to the initial care for burn victims. Results: The average scores found before the intervention ranged from 2.78 to 3.33 and, after the intervention, they ranged from 3.89 to 4.72. Relevant statistical differences (p <0.005) were found in all questions addressed. Conclusion: this educational intervention, based on innovative teaching methods, showed a positive impact on nurses’ knowledge and skills on initial care for people with burns.

ABSTRACT Objective: to describe the development of a mobile application for the International Classification Terminology Subset for Nursing Practice for Coping with Domestic Violence Against Children. Methods: an applied research of technological development, based on the Analysis, Design, Development, Implementation and Evaluation model and on the terminological subset based on the Theory of Nursing Praxis Intervention in Collective Health framework. Results: the application is divided into: 1) “Definition”: characterizes the phenomenon of violence against children; 2) “Assistance”: electronic record of nursing care; 3) “Diagnosis Consultation”; 4) “Intervention Consultation”: nursing diagnoses, outcomes, and interventions related to children and their families, subdivided into Strengthening and Weariness group. Final considerations: built from scientific research, the application has the potential to support nursing care, presenting, in an organized and systematic manner, nursing diagnoses, outcomes, and interventions, in addition to enabling the registration of cases under monitoring.

ABSTRACT Objective: to develop and validate a distance learning course aimed at the pillars of care management of diabetes mellitus people’s feet. Method: a technological production research using Moodle Virtual Learning Environment, based on Andragogy, Constructionism and Instructional Design. Content is based on consensus guidelines on diabetic foot. Validation was carried out by distance education, diabetes and/or diabetic foot experts. Results: the course’s content is based on diabetic foot guidelines, and is structured in units with didactic material, videos, forums and questionnaires to assess the participants’ learning. The judges considered it appropriate to meet nurses’ needs in clinical practice. Conclusion: the virtual learning course has been validated, being a promising strategy for training nurses on care management of diabetes mellitus people’s feet.

ABSTRACT Objective: to validate the content and appearance of the educational booklet “You can control your child’s asthma - let’s learn together?” with parents and caregivers of children with asthma. Methods: this is a methodological study, carried out with 34 mothers and caregivers of children, from two to 10 years old, diagnosed with asthma. The educational booklet validation was performed using Content Validity Index (CVI) and assessment of comprehension, attractiveness, self-efficacy, persuasion, and cultural acceptance domains. Results: the booklet was considered clear (99.8%) and relevant (100%), with a global CVI of 0.99. Domain assessment proved to be an easy-to-understand tool, culturally appropriate, attractive, with persuasive power and promoting self-efficacy. Conclusion: the booklet is valid and adequate for promoting the self-efficacy of parents and caregivers in childhood asthma control and management, potentially scalable to other realities of outpatient care.

ABSTRACT Objective: To describe the processes of producing messages and interacting with the media by professional nursing associations. Methods: Qualitative, descriptive study based on semi-structured interviews with managers of five professional nursing associations in Portugal. The data were subjected to thematic content analysis. Results: Regulatory and union associations use public relations services and refer more strategies for interacting with journalists. Professional specialization associations interact less frequently and prefer social media for publishing their messages. Voluntary work and the reduced professionalization of the communication of specialized associations favors a nursing retraction stance towards the media. Final considerations: Organizational and cultural factors may help to explain nursing’s limited access to the media. The use of renewal, cooperation, and education strategies will help overcome some of the limitations experienced by these associations.