RCAAP Repository

ABSTRACT Objective: to analyze the Health Care Network (dis)articulation of late and moderate premature infants in the first year of life. Method: a qualitative study with semi-structured interview, which addressed the care network constitution in a municipality in southern Brazil. Fifteen mothers of infants participated. Thematic content analysis and flowchart were used to describe networks and services. Results: first contact in Primary Health Care is a decisive factor for the recognition and articulation of neonates/infants in the network and enables resolution, especially in childcare demands. Secondary and hospital care services support isolated acute events or chronic conditions, without articulation between levels of care and in a uniprofessional way. Final considerations: attention to health conditions is organized and structured in a uniprofessional, fragmented and disjointed way, which makes it impossible to form a Health Care Network premature infants’ perspective.

ABSTRACT Objective: to identify the sociodemographic profile of nursing students who suffered gender violence and to know the characteristics of the violence that occurred in this population. Method: a cross-sectional study with 91 nursing students from a public university in southeastern Brazil, between September 2019 and January 2020. A sociodemographic questionnaire and the World Health Organization Violence Against Women, section 10 were used. Results: approximately 65% suffered some form of gender violence during their lifetime, mainly perpetrated by family members. 41.7% were victims of physical aggression, 23% suffered sexual harassment, 30.8% suffered sexual abuse. There was a pattern of intergenerational violence (p<0.001), vulnerability of self-declared lesbians and/or bisexuals (p=0.705), Christian or evangelical (p<0.001). Conclusion: gender violence was high among those surveyed. The experience of forms of violence can damage students’ lives. There is a need for attention from teaching institutions and professors in addressing the theme.

ABSTRACT Objective: to identify the information demands of families of children with Autism Spectrum Disorder. Method: this is a qualitative study conducted through semi-structured and audio-recorded interviews with 55 family members, in the states of Paraná, Ceará, and Macapá, between September 2018 and September 2019. Thematic category analysis and Qualitative Data Analysis Software resources were used for data organization. Results: it was identified that families need information regarding the characteristics of Autism Spectrum Disorder (definition, cause, possibility of cure, prognosis and the probability of having another child with Autism Spectrum Disorder); child’s routine and behavior; future rights and expectations. Final considerations: information demands are relevant to support professionals, health managers and other services in health care organization to support families of children with autism.

ABSTRACT Objective: to analyze the sociodemographic and clinical profile of women with gynecological cancer in brachytherapy. Method: a cross-sectional study including records of 1,930 visits of women in brachytherapy assisted between 2006-2016 in Santa Catarina (Brazil). Collection was performed in 2019, in an institutional bank, submitted to frequency measurements, chi-square test, 95% confidence intervals, significance level of 0.05. Results: women aged 40-59 years (47.2%), white (93.3%); with elementary school (65%); cervical cancer (78.5%); stages II-III (73.3%) figured prominently. In the comparison of staging proportions in the topography variable, a higher proportion of malignant neoplasm of cervix uteri unspecified in the grouped III-IV staging (84.6%). Conclusion: the profile analysis shows the need for screening and health education for prevention and/or early detection of gynecological cancers and training of nurses specialized in radiotherapy to care for women’s health.

ABSTRACT Objective: To develop and test the content validity of the “Knowledge and Attitudes on Assessing Degrees of Physical Disability in Leprosy” instrument. Methods: Methodological study carried out between January and May 2019 in three stages: item generation, analysis of aggregated redundancy to the composition, and content validation, using the Delphi technique. Results: In the first evaluation, a relevance of ≥ 0.80 stood out for all items, except for 2.8, which was excluded. To make the instrument clearer, the sequence was renumbered from one to 32; 2.6, 3.1, and 15 were reformulated, and the others underwent modifications, except for ten and 13. After the second evaluation, all items obtained Content Validity Index > 0.90 and Kappa = 1.00. Conclusion: The instrument has an excellent content validity; it is inferred that it is adequate to measure the knowledge and attitudes of professionals in the assessment of physical disabilities in leprosy.

ABSTRACT Objective: To correlate nine facial anthropometric measurements with the readiness for oral feeding of late preterm newborns using an orogastric tube. Methods: Observational study, carried out in two institutions in Maceió, Alagoas. Fifty-two newborns participated. A single measuring of nine facial measurements and daily measuring of the interface area for fixing the tube was performed. For readiness assessment, the Premature Oral Feeding Readiness Assessment Scale was used. Results: An average readiness of 28.81 (± 3.18) was observed in the first evaluation and 30.65 (± 3.23) in the second. Most facial measurements are correlated with weight. There was a positive and slight correlation between glabella-subnasale distance and readiness. No correlation was observed between the area of the tube fixation interface and facial measurements. Conclusion: It is concluded that the glabella-subnasale measurement is positively correlated with the readiness for oral feeding in late preterm newborns who used an orogastric tube for feeding.

ABSTRACT Objective: To understand the role of grandparents of hospitalized children with cancer. Methods: In a qualitative study, we interviewed eleven grandparents of children with cancer hospitalized at a referral center for pediatric oncology in São Paulo. The data were analyzed using the Hybrid Framework of Thematic Analysis. Results: Six themes were found to describe the role of grandparents in this context: Being the family’s support, Sharing love to my child and my grandchild, Being there for my child and my grandchild, Offering spiritual support to my child and my grandchild, Making an effort to be able to manage my own feelings and Balancing the demands of hospitalization with available resources. Final considerations: The findings show the significance of the grandparents’ role in this experience and emphasize the value of being considered, by health professionals, as part of the family and care.

ABSTRACT Objective: To analyze the knowledge and practices of education of Family Health Strategy professionals regarding child intoxication for the autonomy and empowering of the families. Methods: Qualitative research, carried out through semistructured interviews with 50 professionals from the Family Health Strategy of a city in the Northwest of Paraná. Data was problematized using Paulo Freire’s sociocultural approach and its concepts of dialogism and autonomy. Results: The statements showed the many ways in which the care for child intoxication is perceived and their relations with educational action, but these were traditional educational practices, with elements focused on the dissemination of information about health-disease, probably because the dialogic approach is still abstract and has no interface with the concrete practices. Final considerations: The education knowledge and practices of the professionals for the autonomy and empowering of families suggested that there is a transition stage between the biomedical model, focused on a cure, and the dialogical one.

ABSTRACT Objective: to analyze the perspectives that affect the transition to exclusive palliative care for women with breast cancer. Methods: qualitative, descriptive study, carried out in a public health institution in Rio de Janeiro, Brazil, between December 2018 and May 2019. 28 health professionals were interviewed. Content analysis was used in the thematic modality. Results: the operational difficulties were linked to the fragmented physical structure, the late and unplanned nature of the referral, the ineffective communication, and the deficit of human resources. In general, women and family members resist referral because they do not know palliative care. There is no consensus among oncologists on the most appropriate time to stop systemic therapy for disease control. Final considerations: the perceived difficulties configure an abrupt referral, accompanied by false hopes and, often, limited to end-of-life care.

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.