Repositório RCAAP

ABSTRACT Objective: to analyze the NANDA-I taxonomy “maternal-fetal dyad” concept in high-risk pregnancy. Method: an integrative literature review based on the Conceptual Analysis model proposed by Walker and Avant. It was conducted at PUBMED, CINAHL, SCOPUS, LILACS and SciELO, with the descriptors: Complications of pregnancy, Risk Factors, and Pregnancy, High-Risk (from 2008-2020). Result: the sample consisted of 44 articles, which identified two attributes and 21 antecedents of the concept. Conclusion: concept analysis allowed to identify the attributes and antecedents of the “maternal-fetal dyad” concept in high-risk pregnancy, in addition to raising and clarifying ideas. It was possible to identify 12 antecedents that are not included in NANDA-I as well as the need to review the definition of the diagnosis proposed by the taxonomy.

ABSTRACT Objective: To identify available evidence about the self-reported experience of hospitalized children. Methods: An integrative review was carried out, and the survey occurred between September and November 2017, in the electronic sources DLTD-USP, CAPES, IBICT, MEDLINE, LILACS and BDENF. Results: Ten studies were found, prevailing samples with descriptive design and approach in qualitative and mixed methods research. The literature evidenced the experience of hospitalized children through the report of parents and health professionals; few were self-reported by the child itself. Five themes were identified: Understanding the time of hospital admission, relevance of care received, feeling of pain, importance of the patient companion, information received about hospitalization. Conclusion: It was found that experiences in childhood are able to have repercussions throughout life, and it is relevant that nursing is attentive to their clients’ perception in order to have more satisfaction and the negative impact is diminished.

ABSTRACT Objective: To know the evidence available in the literature on the effects of the zika virus in children development after fetal exposure. Methods: This is an integrative literature review with 16 scientific articles found in five databases (PubMed, LILACS, CINAHL, Web of Science and Scopus), based on the guiding question: “What are the effects in the development of children aged 0 to 6 years exposed to the zika virus in the fetal period? The STROBE statement was used for data extraction and evaluation of primary studies. Results: Exposure to the zika virus in the fetal period resulted in several congenital anomalies and/or changes in the central nervous system: microcephaly, ocular problems, neurosensorial problems, ventriculomegaly, intracranial calcification, cardiopathy, arthrogryposis, among others. Conclusion: The zika virus is neurotropic; its effect in the fetal nervous system causes irreparable damage to the child, so health professionals, especially nurses, must intensify maternal and also childcare.

ABSTRACT Objective: Reflect on the gaps in the care of Children with Special Needs in Health that demand complex clinical care with dependence on technological support for the maintenance of life, in the Unified Health System. Methods: This is a reflection study based on recent policies and literature related to the theme. Discussion: Despite the advances achieved with the Unified Health System with regard to access to health services and the expansion of Primary Care, with the aim of reorienting health, it can be said that the health care model for CSHCN in Brazil is still centered on the hospital and medical knowledge. Final considerations: There are gaps in the policies for children aimed at the new paediatric profile, and little is discussed about its implications for the Unified Health System.

ABSTRACT Objectives: to discuss the (in)visibility of children with special healthcare needs and their families in the Primary Health Care scenario. Methods: experience report about the difficulties faced by researchers from different regions of Brazil to locate children with special healthcare needs in the scope of primary care. Results: the main reason for these children and their families to be “unknown” and, therefore, not assisted in PHC, is the fact that they are followed-up by institutions/outpatient clinics and specialized and/or public rehabilitation clinics, or even because they have private health insurance. Final Considerations: transferring care responsibility to the Primary Health Care teams to specialized and rehabilitation institutions may be related to the lack of knowledge of the care demands of this group, as well as to the relevance of care centered on rehabilitation and the specialty instead of the long-term care, one of the features of primary health care.

ABSTRACT Objective: to identify the factors associated with pregnancy that influence constant glycemic variability. Method: a case-control study with random sampling. The medical records of 417 pregnant women were divided into case group (200 pregnant women with constant glycemic variability) and control group (217 pregnant women without constant glycemic variability). Data were collected from 2009 to 2015. Results: pregnant women aged 25 years and over, with family history of diabetes mellitus, with systemic arterial hypertension, overweightness or obesity, sedentarism and polycystic ovarian syndrome are more likely to present changes in blood glucose. Conclusion: The study demonstrated that risk factors associated with pregnancy increase the risk of constant glycemic variability. The findings will allow reassessment of the interventions during pregnancy, providing an increase in nursing care quality.

ABSTRACT Objective: to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables. Method: prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables. Results: the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006. Conclusion: there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.

ABSTRACT Objective: to analyze the quality of life of high-risk pregnant women. Methods: an observational and cross-sectional study, carried out in a tertiary maternity hospital located in Fortaleza, with 276 high-risk pregnant women. A questionnaire was applied containing socioddemographic, clinical and obstetric data and The Mother-Generated Index. Descriptive analyzes were performed using the Jamovi statistical program®, version 0.9. Results: most areas were negatively influenced by pregnancy. “Satisfaction with pregnancy”, “family relationship” and “relationship with the partner” obtained the highest means of primary score, while “physical condition/disposition” and “financing” obtained the lowest means. The highest secondary scores were in “satisfaction with pregnancy”, “family relationship” and “relationship with the partner”, while the lowest were in “financing” and “psychological/emotional”. Conclusion: the total primary score mean was 6.03, suggesting a good quality of life. The Mother Generated Index made it possible to identify aspects of life that go beyond pre-formulated assessments of the construct.

ABSTRACT Objective: to identify evidence of nursing patterns of knowing disseminated by the Brazilian press before the implementation of Florence Nightingale’s model in Brazil and categorize topics of journalistic articles according to Carper’s and White’s patterns of knowing. Methods: categorical content analysis of materials related to Florence Nightingale, published in Brazil between 1850 and 1919, collected at Hemeroteca Digital. Four analysts identified themes of journalistic article, performing classification in patterns of knowing. Results: there was a predominance of evidence of the sociopolitical pattern followed by the empirical pattern. In the analyses per decade, ethical and aesthetic patterns showed predominance between 1860 and 1870, respectively. Conclusion: White’s classification by nursing patterns of knowing was useful in understanding precursor themes of professional/disciplinary knowledge that spread in Brazil, linked to Nightingale’s character, in addition to the repercussions of her actions and her expanded sociopolitical perspective.

ABSTRACT Objective: To assess the safety climate from the perspective of health professionals in the inpatient and intensive care units of a public hospital specialized in cardiology, in the city of Rio de Janeiro. Methods: Quantitative, exploratory, descriptive study, using the Safety Attitudes Questionnaire. The findings were analyzed according to descriptive and inferential statistics, with a significance level of 5%. Results: The general safety climate had a mean of 66.6; the best score corresponded to the Job satisfaction (80.8) domain and the lowest to Hospital management perception (52.5). The means of the scores were statistically significant regarding the employment relationship, gender and professional category. Conclusion: There are weaknesses in the safety climate related to management and having a state job bond, belonging to the male gender and to the nursing team.

ABSTRACT Objective: To know the experiences and perceptions of nurses who care for dying cancer patients. Method: A descriptive, qualitative study, developed in a private hospital in Sao Paulo, with a total of nine nurses, aged between 24 and 46 years old, who participated in a semi-structured interview. Results: Through Bardin's Content Analysis, three categories were highlighted: Death as a natural process and the final stage of the life cycle; Although it is difficult, it is important to get emotionally involved with dying patients and their family; and Reflecting on their experiences in the care of dying patients and their family. Final Considerations: The nurses' experiences and perceptions of the death of cancer patients showed the professional's involvement and feelings of anxiety and anguish. Adopting effective strategies to address people who are suffering, in the context of the study, can provide subsidies that will guide clinical practice in health.

ABSTRACT Objective: To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities. Method: Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman's correlation coefficient and Chi-squared test (p<0.05). Results: Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices. Conclusion: This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.

ABSTRACT Objective: To verify the age, nutritional status, and gait speed in hospitalized individuals, and their association with the quality of life of their caregivers. Methods: Observational cross-sectional study with 54 patients and their respective caretakers in a university hospital in the Brazilian Midwest. The analyses were carried out using the SPSS software, with p < 0.05. Results: The Social Relations domain had the highest mean score (71.45±18.64). The lowest score was in the Physical domain (57.80±12.01). According to a subjective nutritional evaluation, 72.2% presented some degree of malnutrition. Most were classified with low gait speeds (82%). There was a significant correlation between age and the Physical and General Quality of Life domains. The Environment domain was significantly correlated to the gait speed. Conclusion: The age and the gait speed of the patient were related to the quality of life of the caregiver, but the nutritional state was not affected.

ABSTRACT Objective: to develop and validate an application for cellphones structured in self-care to encourage adherence to antiretroviral prophylaxis after occupational exposure to biological material. Methods: phase 1 - descriptive study to identify characteristics of occupational exposure; phase 2 - methodological study to construct and validate an application content aiming to increase adherence to antiretrovirals. Results: phase 1 - 55 occupational exposures were recorded; 32 (58.2%) antiretroviral indication. Blood was present in 96.9% of exposures; most professionals have insufficient knowledge about exposure risks. A statistical relationship was identified between self-care and adherence (p<0.001). Phase 2 - application was constructed, validated by 11 experts, and considered appropriate to encourage health professionals for self-care and adherence to antiretrovirals. Conclusion: the application “Exposição Ocupacional ao HIV” was considered adequate to expand self-care and adherence of professionals to prophylactic treatment to occupational infections arising from biological risks.

ABSTRACT Objective: To analyze the spatial pattern of AIDS mortality and social factors associated with its occurrence. Methods: An ecological study that considered 955 AIDS deaths of residents in Piauí, reported in the Mortality Information System (MIS) from 2007 to 2015. Non-spatial and spatial regression models were used to identify social determinants of AIDS mortality, with a significance of 5%. Results: The predictors of AIDS mortality were illiteracy rate in males (p = 0.020), proportion of households with water supply (p = 0.015), percentage of people in households with inadequate walls (p = 0.022), percentage of people in households vulnerable to poverty and in whom no one has completed primary education (p = 0.000) and percentage of people in households vulnerable to poverty and dependent on the elderly (p = 0.009). Conclusion: Social indicators related to education, job and income generation and housing were associated with AIDS mortality.

ABSTRACT Objective: Analyze the results of knowledge production from a graduate program for master’s degree in nursing. Method: This is a qualitative retrospective documentary study. Data were collected from the university library repository and the program website. In total, 83 dissertations were found, analyzed and arranged into five groups: worker’s health, care management, systematization of nursing care, health education, and nursing care. Results: The results indicate good practices such as manuals, guides, protocols, software, and products for systematization of care. They indicate concern about changing the reality with care practices and interventions, health education and continuing education. Final considerations: This study showed student commitment to the fields of practice when choosing the project theme. Students presented an intention to improve care, management, education and research, in the various dimensions of the profession.

ABSTRACT Objective: Correlate the cases of multidrug-resistant tuberculosis and its spatial patterns with the type of notification and sociodemographic variables. Method: Ecological study carried out in the municipality of Belém, with 77 cases of multidrug-resistant tuberculosis registered in the Special Treatment Information System for Tuberculosis, between 2012 and 2016. For analysis, the data was debugged followed by geo-referencing in ArcGis 10.3 and Terra View 4.2.2. To relate the cases with the type of notification, the BioEstat 5.4 software was used, with a significance level of 95%. Results: Of the total, 40 (52%) were new cases; 27 (35%), relapses; and ten (13%) were re-enrolled after leaving. Multidrug-resistant tuberculosis was randomly distributed and related to income, household, territorial cluster and water supply. There was a concentration of cases in two administrative districts, corresponding to 28.5% and 27.3% of the total, with a median Sociodemographic Index. Conclusion: Behavior of multidrug-resistant tuberculosis influenced by sociodemographic indicators.

ABSTRACT Objective: to verify mercury exposure prevalence and identify its possible associated factors in two riverside communities in the Madeira River basin of the Western Brazilian Amazon. Method: a cross-sectional study comprising 95 children and adolescents. Age cycle, school attendance, Bolsa Família, number of siblings, meals, fish consumption, height by age were measured. Binary logistic regression was used to verify relationships between mercury exposure and its possible associated factors. Results: the general prevalence of mercury exposure was 46.3%; children, 35.4%; and adolescents, 57.4%. Associated factors were fish consumption (aOR=1.84; 95%CI 1.56-2.16), age cycle (aOR=2.50; 95%CI 1.09-5.7), parasites (aOR=1.22; 95%CI 1.02-2.71), and short stature (aOR=1.32; 95%CI 1.05-2.02). Conclusion: mercury exposure prevalence in riverside children and adolescents was considered worrying, with association with fish consumption, adolescence, parasites, and short stature.

ABSTRACT Objective: Analyze the agreement of nurses, who work in hospital institutions, about Florence Nightingale’s conceptions about nursing, people, health and the environment. Method: Quantitative, observational and cross-sectional study, with the participation of 3,451 nurses from 36 Portuguese hospitals. Data collection took place from July 2015 to March 2016, using a questionnaire. For analysis, descriptive and analytical statistics were used. Results: It was evident that 60% to 70% of participating nurses considered that Florence Nightingale’s conceptions of nursing, person, health and environment were partly in agreement or totally in agreement with their practice. The variables that influenced agreement were: service, condition in which they practice the profession, length of professional practice, academic degree and region of the country. Conclusion: Florence Nightingale’s conceptions continue to contribute to professional nursing practice, with the region and the service significantly influencing this continuity.

ABSTRACT Objective: to understand the experiences of relatives of critically ill children before bad news report. Method: a phenomenological study based on Heidegger’s philosophical framework. Data collection was carried out from October 2018 to March 2019, through phenomenological interviews with 15 relatives of children hospitalized in a Pediatric Intensive Care Unit. Results: relatives, in their existentiality, experience the facticity thrown into unpredictable situations, regardless of their choices and are faced with feelings of shock, despair and fear before bad news. After emotional impact, especially regarding the possibility of death, relatives reveal hope as a mechanism for coping with the situation. Final considerations: solidarity and sensitivity by health professionals, especially nurses, are essential in understanding the existential dimension of relatives who experience such an experience, understanding the several facets of their existence and offering them opportunities to project themselves.