Repositório RCAAP

ABSTRACT Objectives: to understand care for the spiritual dimension provided by caregivers in a Nursing Home. Methods: this is a qualitative research, carried out in a geriatric center of a philanthropic hospital in the city of Salvador, Bahia. Eighteen formal caregivers participated, through a semi-structured interview, between January and February 2019. The data were analyzed in the light of Jean Watson’s Theory of Transpersonal Caring. Results: formal caregivers discuss the spiritual dimension based on older adults’ religious beliefs, encourage religious practices and exercise spiritual care according to older adults’ physical, emotional and spiritual demands. Final Considerations: formal caregivers understand that older adults’ religious or spiritual experiences should be included in their work routine. Care for the spiritual dimension occurs by stimulating faith in God, encouraging religious practices and embracing their beliefs in the face of physical, emotional and spiritual demands.

ABSTRACT Objective: to describe the obstetric care developed in teaching hospitals (TH) in the city of Maceió-AL, intended for high-risk pregnancies. Methods: Retrospective cohort study performed between June and November 2018 with 291 women who received assistance with vaginal delivery, cesarean section, or abortion process in teaching hospitals selected as settings for this research. Data collection allowed the characterization of the interviewees as well as the assistance received and its relationship with obstetric violence. The analysis was performed using descriptive and analytical statistics with the aid of the Epi Info software (version 7.2.0.1) and measures that allowed the comparison of means and proportions. Results: All women reported at least one violent situation, contrary to recommendations based on scientific evidence. Conclusion: It becomes necessary to optimize professional training to deconstruct obstetric care based on medicalization and pathologization of pregnancy and strengthen science-based care.

ABSTRACT Objectives: to analyze factors associated with sepsis and septic shock in cancer patients in the Intensive Care Unit. Methods: cross-sectional, retrospective study with a quantitative approach, with a sample of 239 patients in an oncology hospital. Secondary data from medical records were used. The outcome variable was “presence of sepsis and/or septic shock”; and exposures: sex, length of stay, origin, use of invasive procedures and primary tumor site. Descriptive, bivariate analyzes and multiple logistic regression models were performed. Results: the prevalence of sepsis was 95% CI: 14.7-24.7 and septic shock of 95% CI: 37.7-50.3. In the multiple analysis, sepsis and/or septic shock were associated with hospital stay longer than seven days, being from the Emergency Department, presence of invasive procedures and hematological site. Conclusions: sepsis and/or septic shock in cancer patients were associated with clinical characteristics and health care factors.

ABSTRACT Objectives: to analyze the contents on patient safety in the training of nursing technicians. Methods: a documentary study, conducted in three technical nursing courses at a public university in northeastern Brazil, based on the Multi-Professional Patient Safety Curriculum Guide, published by the World Health Organization. Results: we found that, of the 26 subjects in each course, the tracking terms were found in 22 subjects in the A/C courses, 23 in the B course. The topics of the guide with the highest number of terms were the improvement in medication safety, with 85 terms (22.6%), and Infection prevention and control, with 75 terms (20%). The contents do not express the comprehensiveness of patient safety education; some subjects had this focus, while others did not. Conclusions: the documents revealed gaps in the contents related to patient safety and demonstrated that they are addressed only in the course syllabus and discipline plans.

ABSTRACT Objectives: to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome. Methods: a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records. Results: we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge. Conclusions: the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.

ABSTRACT Objectives: to analyze nurses’ role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring. Methods: this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis. Results: the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension. Final Considerations: nurses have attitudes consistent with Jean Watson’s Theory and apply the Caritas Process elements during assistance to patients’ spiritual dimension in palliative care.

ABSTRACT Objective: Analyze the spatio-temporal distribution of AIDS cases in Maranhão. Methods: Ecological study of AIDS cases in the Notifiable Diseases Information System, 2011-2018. Gross and adjusted incidences were calculated using the Baysean method; then, the Moran Global and Local Indices to observe the existence of spatial autocorrelation of the cases and for the delimitation of high and low risk clusters. Results: 6,349 cases were reported, which were distributed heterogeneously. There was an advance of cases to new areas and persistence in old areas, such as in the capital São Luís and its surroundings. The dissemination did not occur at random, with positive spatial autocorrelation, with evidence of the formation of clusters in the municipalities of São Luís, São José de Ribamar and Paço do Lumiar. Conclusion: High-risk areas have been identified and should be considered a priority for investment in health, management, and organization of health services.

ABSTRACT Objective: to analyze the activities developed by hospital ship SS HOPE in Natal. Method: this is a qualitative, socio-historical study, elaborated from documentary sources and 16 interviews with health professionals. Thematic Oral History was used for data treatment and analysis. Results: the empirical material identified a wide schedule of courses and lectures as well as made it possible to elaborate the following categories: Health education on hospital ship SS HOPE; Legacy of international cooperation of hospital ship SS HOPE; Statements about the season of hospital ship SS HOPE. Final considerations: the arrival and stay of this hospital ship, for ten months, is the result of negotiations between the University, the State Government and the People to People Foundation. During their stay, education and health care actions were carried out, with the joint participation of health professionals, Potiguares and Americans.

ABSTRACT Objectives: to identify undergraduate nursing students' entrepreneurial tendency at a public university. Methods: cross-sectional study, with a quantitative approach, with 135 undergraduate nursing students from a public university in the interior of the state of Rio Grande do Sul, Brazil. Data were collected using a socio-professional characterization form and a General measure of Enterprising Tendency test and analyzed using descriptive statistics. Results: among the five entrepreneurial tendencies, students presented results equal or above average in two dimensions: Drive and Determination (82.2%) and Need for Success (51.1%). The Creative tendency was the dimension with the highest percentage of participants below the average (68.9%). However, students in research or extension groups scored equal or above average in all five entrepreneurial tendencies. Conclusions: students showed low entrepreneurial tendencies, indicating the need for a broader approach to the subject in nursing education.

ABSTRACT Objectives: to analyze hand hygiene determinants of informal caregivers in a hospital environment. Methods: qualitative study conducted with 55 caregivers at a university hospital in the Northeast of Brazil. A semi-structured instrument was used, adapted from Nola Pender's Health Promotion Model, from which the deductive categories were derived. Results: the general behavior included hand hygiene before meals and after using the bathroom. Sensitivity to the requirements for hand hygiene was observed, but the barriers and self-efficacy consisted of the availability of soap or alcohol-based hand sanitizers, the lack of knowledge on the importance of and forgetfulness of the practice. The reinforcement on the importance of the practice and being in a contaminated environment were influencers, and commitment, warnings, and training were indispensable. Conclusions: benefits related to protection from infections were seen as positive determinants for hand hygiene adherence. For non-adherence, factors such as lack of sanitizing supplies, ignorance towards the importance of the activity, and forgetfulness stood out.

ABSTRACT Objectives: to analyze palliative care production developed by health professionals to home care patients. Methods: this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©. Results: actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and "listening" to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users. Final Considerations: it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.

ABSTRACT Objectives: to analyze the effects of sexuality on frailty and quality of life in the elderly. Methods: a sectional study conducted with 662 elderly people between July and October 2020. Four self-administered instruments were used to collect bio-sociodemographic variables, sexuality, frailty and quality of life. Correlation analysis and structural equation modeling were performed. Results: among the dimensions that assess sexuality, sexual intercourse had a weak, positive effect on quality of life (SC: 0.134, 95%CI: 0.153 - 0.254, p = 0.027), while affective relationships had a strong, positive effect (SC: 0.556, 95%CI: 0.442 - 0.670, p < 0.001). Frailty was only significantly related to a weak to moderate negative effect with sexual intercourse (SC: -0.216, 95%CI: -0.385 - -0.047, p = 0.012). Conclusions: two dimensions of sexuality, Sexual intercourse and Affective relationships, were found to have an effect on the quality of life and frailty of the elderly people investigated.

ABSTRACT Objectives: to construct and validate a classification of nipple and areola complex lesions resulting from breastfeeding, according to content and appearance. Methods: this is a methodological study, developed in four stages: operational definition, instrument construction, content and appearance validation. The Delphi technique and a Likert-type scale were used to validate content and appearance, through the participation of ten and sixteen judges, respectively. For analysis, Content Validity Index and Kappa Coefficient were applied. Results: Content Validity Index obtained an overall value of 0.93 and, for appearance, 0.94. Kappa values ranged between 0.46 and 1. The high rates of agreement among judges demonstrated the quality of the proposed content validity. Conclusions: the Nipple and Areola Complex Lesions Classification Instrument developed obtained acceptable values of its indexes, proving to be valid in terms of content and appearance.

ABSTRACT Objective: To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. Method: This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. Results: 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. Conclusion: The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.

ABSTRACT Objective: To develop and validate a booklet on the use of the colostomy plug as a technological support for educational intervention. Methods: Methodological study focusing on the production of soft and hard technologies for colostomized people using a plug, developed in three stages: literature review; validation with 13 experts; and with seven colostomized persons. Results: The content for the booklet was selected based on the analysis of the articles identified in Step 1. In Step 2, regarding the content, the number of pages and appearance obtained a Content Validity Index of 0.85 and 1.00 respectively. In Step 3, the minimum Content Validity Index was 0.71 in two items related to organization and 0.86 for the writing style. The other items obtained a Content Validity Index of 1.0. Conclusion: The booklet was validated among experts and colostomized persons, and the final version, containing 50 pages, was offered to health professionals and colostomized people in use of a plug.

ABSTRACT 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.

ABSTRACT Objective: To assess stigma and prejudice in the organization of the Psychosocial Care Network for drug users. Methods: this is a qualitative study, developed through Empowerment Assessment. The survey was conducted in a municipality in Rio Grande do Sul, with 42 network workers. For data collection, participant observation, semi-structured interviews and open forum were used. For data analysis, thematic analysis was used. Results: the network’s mission involved a proposal for care without prejudice and judgments for drug users. It was identified that the composition of the network with training in multidisciplinary residency and psychiatry facilitates achieving the mission, and among the difficulties, the challenges to overcome prejudice were analyzed. Strategies for continuing education, seminars, and user empowerment in the community are suggested. Final considerations: stigma and prejudice need to be problematized in the networks for the organization of more inclusive and rehabilitating psychosocial care.

ABSTRACT Objective: to discuss in the scientific literature the strategies used to prevent hypothermia in newborns undergoing surgical procedures. Methods this is an integrative literature review, with structured search in April and May 2020 in 08 databases, using the descriptors: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Four primary studies were selected and analyzed using three instruments to assess the methodological quality of the Joanna Briggs Institute and content analysis. Results: Among the strategies used, the following stand out: room temperature control; establishment of humidification and quality of air conditioning cleanliness; use of a heated incubator or cradle; use of thermal mattress; use of caps and blanket; heated fluids; temperature monitoring and abdominal organ coverage. Conclusion good hypothermia prevention strategies were identified, despite the small number of publications on this topic; thus, it points out the need for research with strong evidence.

ABSTRACT Objective: to understand how religiosity can influence the health of individuals diagnosed with mental disorders, based on comprehensive care. Methods: this is an integrative literature review, with the inclusion of articles in Portuguese, English and Spanish, between 2010 and 2018. Results: the critical analysis and qualitative synthesis of the 24 selected studies were categorized into two subtopics: The influence of religiosity in promoting comprehensive mental health care; Mental health versus religiosity: influencing conditions for effective access to comprehensive care. Final considerations: a positive influence of religiosity was identified in the lives of individuals diagnosed with mental disorders; however, evidence shows that health teams do not feel comfortable and prepared to work with religiosity as an expression of spirituality. This being one of the dimensional aspects of health, it can be inferred, on the results, the existence of this gap in the comprehensive care approach.

ABSTRACT Objective: to identify the main biosafety measures for preventing COVID-19 in healthcare professionals. Methods: this is an integrative literature review, with studies published between January and July 2020, on the MEDLINE/PubMed, Scopus, Embase, Web of Science, LILACS, SciELo, Wiley Online Library, Cochrane CINAHL databases. The selection of studies followed the PRISMA recommendations. Results: among the 2,208 publications identified, 12 studies comprised the sample, which enabled the analysis in four thematic categories: The importance of using recommendations about the use of personal protective equipment; The restructuring of new operational and clinical routines and flows in the practice of services; Monitoring professionals, especially testing; Conducting training. Conclusions: the phenomena involved are innumerable, covering operational management and the training of teams to deal with highly infectious pathogens and disease outbreaks.