Repositório RCAAP

ABSTRACT Objective: to describe the factors related to psychological impairment and quality of life (QoL) of patients with schizophrenia. Method: a cross-sectional, descriptive and correlational study, carried out with 119 schizophrenics. A questionnaire of sociodemographic and clinical variables was applied, plus BPRS-A and QLS-BR scales. Chi-square test and Spearman’s correlation were used, Results: seventy-seven were male and 44 were using typical medications. The “Number of times they were hospitalized” related to “Time of illness” that patients live with schizophrenia showed significance (p=0.266); 91.7% had a severe occupational level (n=109); 34.5% (n=41) had moderate impairment. Conclusion: the greater the degree of psychological impairment, the worse the QoL, this worsening may be related to several factors, as well as disease symptoms.

ABSTRACT Objective: to analyze the cognitive capacity and functional development of the elderly with and without diabetes. Methods: case-control study, comparing elderly people with and without diabetes. 218 patients interviewed in outpatient clinics: geriatrics and endocrinology. Validated instruments were used for cognitive and functional assessment. Results: people with diabetes had low scores on cognitive tests. HbA1c and education were related to memory loss, compromising the basic and instrumental activities of daily life. Conclusion: this study evaluated that high glycemic values affect the autonomy of the elderly, compromising cognition and functional performance in activities of daily living.

ABSTRACT Objective: Evaluate the effects of clown activities on quality of life, depression, stress, anxiety, aid, and social support in patients eligible for palliative care (PC) attended in Primary Health Care (PHC). Method: A quasi-experimental study, with pre-intervention and post-intervention evaluation, carried out with 16 patients eligible for early PC in PHC in a Midwestern city. Patients received 24 visits with home-based clown activities. Results: The interventions evidenced improved quality of life and social support, with significant results for the Social Activities dimension (p = 0.023). Increased scores for Anxiety (p = 0.007) and Depression (p = 0.023) were also observed. Conclusion: Clown activities can bring positive results for the quality of life and social support of patients eligible for PC at home. They should be encouraged to interact with family knowledge and enhance humanized care, integral and centered on human relationships in PHC.

ABSTRACT Objective: To analyze pelvic floor muscular strength (PFMS), urinary (UI) and anal (AI) incontinence and dyspareunia in primiparous women up to 6 months after normal or cesarean delivery. Methods: this is a prospective cohort with 169 women (128 normal births, 41 cesarean sections), followed between 50-70 and 170-190 days postpartum, when PFMS was measured using perineometry, and UI and AI and dyspareunia, through interview. Results: PFMS, UI and dyspareunia were similar between types of delivery. The difference was significant only for the time elapsed, with improvement in the studied period (2 and 6 months postpartum). Regarding AI, there was a significant difference between 2 and 6 months postpartum, with an interaction between type of delivery and time (p=0.022). Conclusion: the type of delivery did not show any influence on pelvic floor dysfunctions, except for AI. For all outcomes, there was an improvement in the period studied.

ABSTRACT Objectives: to identify factors associated with homicides in women who had prior notification of violence in the state of Pernambuco, 2011 to 2016. Methods: a transversal, quantitative and observational study, guided by the STROBE tool, with data of homicides of women obtained from the Mortality Information System; and of violence against women, from the Grievance Notification Information System. The logistic regression model was used to verify the factors associated with the homicides. Results: there were 32,308 cases of violence against women and 1,162 homicides. The chances of homicide were higher for women: victims of physical violence (2.39 times more), aggression by object of court (2.32 times more), aggression by firearm (6 times more), and when there was a recurrence of violence (3.82 times more). Conclusions: association of physical violence, agression by object of court, aggression by firearm, recurrence of violence with homicides of women in the state of Pernambuco was found.

ABSTRACT Objectives: to understand the challenges of introducing gender debate in nursing training from undergraduate students’ perspective. Methods: a qualitative, exploratory-explanatory study. Data were collected through a semi-structured interview applied to 12 undergraduate nursing students at a public university in São Paulo. For data treatment and analysis, the Discourse of the Collective Subject was used in light of Boaventura de Sousa Santos’ knowledge production paradigm theoretical framework. Results: nursing education remains centered on the traditional scientific model, neglecting gender and strengthening stereotypes aimed at the feminization of the profession. Final Considerations: nursing training has a challenge of implementing actions that deepen the gender theme. Therefore, some strategies are suggested, such as improving professor training and appropriating emancipatory pedagogical practices; reviewing pedagogical political projects; curriculum theorization and restructuring; problematizing gender issues for nursing leadership.

ABSTRACT Objectives: to evaluate undergraduate nursing students’ knowledge about intestinal ostomies before and after an educational intervention via an online platform. Methods: before and after one-group type quasi-experimental research, carried out with 90 undergraduate nursing students from two higher education institutions in Piauí, from July to October 2014. For knowledge assessment, an instrument validated in Brazil was used. Nonparametric inferential statistics was used to compare the pre-test and post-test averages. Results: there was an increase in the average number of correct answers for undergraduate students after intervention in the online educational platform, from 23.67 (SD = 5.9) in the pre-test to 32.01 (SD = 2.72) in the post-test, and this difference was statistically significant (p = 0.000). Conclusions: intervention via online educational platform is considered applicable for teaching undergraduate nursing students on intestinal ostomies.

ABSTRACT Objective: Describe the actions implemented for pain management in palliative care oncology and analyze the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute. Methods: Study of the history of the present time, whose sources were written documents and interviews with five participants. The collection took place from February to June 2018. The analysis of the written sources took place through internal and external criticism of the documents, considering their chronology and theme. Results: Professionals contributed with actions for pain management in palliative oncology care: in discussions and final drafting of ordinances, as rapporteurs at national and international events, in the elaboration of humanization conducts and systematization of assistance in addressing pain. Final considerations: These actions favored assistance in palliative oncology care at various levels of health care for patients and families, with greater technical and scientific recognition for all.

ABSTRACT Objective: to build and validate the appearance of a digital educational technology to promote the mental health of school adolescents. Methods: methodological study, which included the elaboration and validation of the “Conect@dos com a S@ude” online course based on the Galvis-Panqueva methodological framework. The elaboration was based on a literature review and followed the Theory of Meaningful Learning. The validation was performed by a total of 21 adolescent students, using an instrument adapted for the study. A quantitative analysis was performed from the Content Validity Index and descriptive of the suggestions pointed out by the target audience. Results: the analysis of the Content Validity index ranged from 0.8 to 1 in all evaluated items. The adolescents presented some suggestions for improvement for the course, most of them were accepted. Conclusion: the course was validated by the target audience.

ABSTRACT Objective: to verify the difference of mean or median in the scores of family functionality and burden of family caregivers of people with mental disorders. Methods: cross-sectional study carried out in a Psychosocial Care Center with 61 family caregivers. Instruments were used for sociodemographic characterization, care process, Family Apgar Index and Family Burden Interview Schedule. Mean/median difference tests were adopted. Results: women with mental disorders and the presence of children in the home decreased the median of the family Apgar score. Difficulty in the relationship between caregiver/user, nervousness/tension, physical aggression and agitation of patients increased the global average of subjective burden. Conclusions: nursing interventions to reduce burden and promote family functionality should prioritize caregivers of women with mental disorders, assist them in managing troublesome behaviors and raising awareness of family nucleus to co-responsibility for caring for sick people, especially in families with children who demand daily care.

ABSTRACT Objective: To compare the mean time of orotracheal intubation and insertion of supraglottic airway devices, considering healthcare providers wearing waterproof overall, gloves, boots, eye protection and mask at the Chemical, Biological, Radiological and Nuclear context in simulation setting. Methods: Six databases were searched. The selected studies were put in a pool of results using a random-effects meta-analysis, with standardized mean differences and calculation of 95% confidence intervals. Results: Nine observational studies were included. Regarding reducing time to provide ventilatory support, subgroup analyses were made. The emergency setting subgroup: -12.97 [-16.11; -9.83]; I2 = 64%. The surgery setting subgroup: -14.96 [-18.65; -11.27]; I2 = 75%. Another analysis was made by reproductive methodology subgroups. Ophir’s subgroup: -15.70 [-17.04; -14.37]; I2 = 0%. All meta-analyses had orotracheal tube as comparator. Conclusion: Moderate level of evidence was in favor of insertion of supraglottic devices because of fast application.

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.