RCAAP Repository

ABSTRACT Objectives: to map the available evidence about nursing care aimed at adult patients using external ventricular drain. Methods: this is a review using the scoping review method. Results: Initially, 965 studies were identified and, after the eligibility criteria, a sample of 54 publications was obtained. Each of them was assessed according to GRADE, resulting in three studies with high quality; 14 with moderate quality; 32 with low quality; and five with very low quality. It was highlighted 20 nursing care subdivided into nine categories, namely: drainage system; bed positioning and mobilization; catheter care; monitoring of intracranial pressure; and medication administration. Conclusions: the scoping review made it possible to identify the main nursing care directed to adult patients undergoing placement of external ventricular drain from the evidence available to date.

ABSTRACT Objective: to evidence the clinical outcomes of navigation performed by nurses in cancer patients. Methods: this is an integrative literature review with collection in MEDLINE via PUBMED, LILACS, Web of Science, Scopus, and CINAHL databases. The final sample consisted of seven studies. The data were analyzed and presented descriptively. Data related to clinical outcomes were compiled and described in full. The Agency for Healthcare Research and Quality categorization was used to assess the level of evidence. Results: the clinical outcomes demonstrated were decreased distress, anxiety and depression, improved control and management of symptoms, improved physical conditioning, improved quality and continuity of care, improved quality of life, reduced time to start treatment. Final considerations: there is research that shows better clinical outcomes in cancer patients through navigation by nurses across the continuum of health care.

ABSTRACT Objectives: to characterize publications about palliative care and communication, with an emphasis on the approaches addressed, disseminated in online journals. Methods: it is a scope review, in which the mnemonic strategy Problem, Concept and Context was used, based on database research. The sample consisted of 86 publications. Results: most publications were written in the English language, published in the journal BMC Palliative Care, and with level of evidence IV. As for the approaches approached, the following stand out: Importance of communication in palliative care; Breaking the bad news in palliative care; Training professionals/staff to communicate in palliative care; and Communication strategies in palliative care. Final Considerations: the review made it possible to map a significant number of publications on palliative care and communication. It is recommended to produce new studies with better scientific evidence that guide the assistance of health professionals.

ABSTRACT Objective: to investigate the biological activities of interest to the health of Jatropha multifida plant species in published scientific literature. Methods: this is an integrative review, with searches between May and June 2019, using the descriptors, combined through the Boolean operator AND, Jatropha multifida, anti-infective agents, wound healing, cytotoxicity and antioxidants, in LILACS, BDENF, MEDLINE, SciFinder, Web of Science and Scopus databases and in the virtual libraries SciELO and ScienceDirect. Results: twelve publications were retrieved that showed nine biological activities. The antioxidant activity was reported in 04 (33.33%) studies; antimicrobial and anticancer, addressed by 03 (25%) and 02 (16.66%); anti-inflammatory, anti-melanin deposition, healing, antiophidic, purgative and anti-influenza, seen in 01 (8.33%) each. Final considerations: although scarce, the published scientific production highlights the biological potential of J. multifida and supports the need for further studies.

ABSTRACT Objectives: to identify the socio-spatial determinants associated with the incidence of infection by the human immunodeficiency virus (HIV) described in national and international literature. Methods: integrative literature review that included original articles indexed in the LILACS, PUBMED, CINAHL, and Scopus databases, from 2015 to 2019. The synthesis of the articles was done in a descriptive manner in two categories according to the type of approach. Results: 13 articles were selected, with a predominance of ecological studies. Regions with deficient access to health services, high population density, higher rates of poverty, intense migratory flow, border areas, as well as precarious socioeconomic conditions, and risk behaviors are associated with higher rates of infection. Final Considerations: the influence of regional inequalities on the incidence of HIV infection is revealed, confirming the relevance of spatial analysis techniques for mapping the distribution of diseases and identifying risk areas.

ABSTRACT Objectives: to analyze scientific evidence on evaluation strategies for active learning methods in health undergraduate programs. Methods: integrative literature review in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases. Results: different evaluation strategies are used: Presentation of seminars, Self-evaluation, Evaluation of student performance in Tutotest-Lite tutoring, Peer Evaluation, Active Learning and Critical Thinking Self-evaluation Scale, Objective and Structured Clinical Exam, Portfolio, Progressive Disclosure Questions, Modified Dissertation Questions, Progression Test, Dissertation Test, Objective Test, Immediate Learning Checks, Clinical Case Resolution and Cumulative Test. Final Considerations: evaluation strategies in active learning are used in combination, aiming at the affective, cognitive and psychomotor development of the student. However, studies with greater power of scientific evidence would be needed.

ABSTRACT Objectives: to analyze the scientific evidence available in literature on hospital indicators after implementation of bed regulation strategies. Methods: this is an integrative review conducted with studies available in five databases and in the reference database of the Center for Study and Research in Nursing Services Management in October 2019. Articles on hospital bed management, available in full in English, Spanish or Portuguese, without temporal delimitation were included. Results: 1,118 eligible articles were found, of which 37 were duplicated. Among 1,081 pre-selected studies, 112 studies were eligible and 11 articles were included. Six studies addressed the emergency services. Three addressed hospital indicators in general, another focused on a psychiatric ward and one analyzed the indicators of two hospitals administered differently. Conclusions: the studies focused on emergency services, demonstrating the importance of organizing these services for health institutions.

ABSTRACT Objective: to reflect on Florence Nightingale’s legacy and describe her contributions to critical holistic thinking in nursing. Methods: this is a theoretical reflection, for which scientific productions on Florence Nightingale’s environmental theory, as published in national and international journals, were based. Results: Florence Nightingale’s philosophy and teachings emphasize that the nurse must use her brain, heart and hands to create healing environments to care for the patient’s body, mind and spirit. Nursing, since the time of Nightingale, has been building the holistic paradigm, in all schools of thought, with a view to a humanistic approach to the human being in their indivisible relationship with the environment. Final considerations: Florence’s contributions to holistic critical thinking in nursing are evident, constituting nurses’ differential in clinical practice.

ABSTRACT Objective: Report the implementation of integrative and complementary practices in a Nursing course at a federal university in the fields of teaching, research and extension. Method: As a reference, the concept of nursing care anchored in the integrality and the avant-garde legacy of Florence Nightingale was used. The report is structured in two topics: the first describes the experience itself, and the second brings a critical reflection about the limits, achievements and challenges. Results: The interaction of integrative practices in nursing and its insertion in teaching, research and extension corroborate holistic care, favor the construction of scientific knowledge in the area and potentially requalify professional training. Final considerations: The insertion of integrative and complementary practices in nursing education can contribute to the consolidation of an integral model of care in SUS towards access and comprehensiveness.

ABSTRACT Objectives: to classify the degree of dependence on nursing care required by children with Congenital Zika Syndrome during hospitalization and to analyze their complexity. Methods: this is a descriptive, observational and quantitative study carried out in a pediatric ward of a public hospital in Rio de Janeiro. Data were collected from hospitalization records between June 2017 and April 2018. Results: 54% of the population studied showed a degree of dependence equivalent to semi-intensive care. On 37.5% of hospitalization days, patients required non-invasive or invasive mechanical ventilation; 31.5% had spontaneous breathing requiring airway clearance by aspiration and/or oxygen therapy. Conclusion: Congenital Zika Syndrome represents a challenge for health professionals due to its uniqueness. In this study, it is expressed by demands for complex and continuous care in hospitalization and in preparation for discharge, requiring semi-intensive nursing care.

ABSTRACT Objective: To analyze outcomes in fetuses and newborns exposed to infections during pregnancy. Methods: Cross-sectional, quantitative study, carried out in a public maternity hospital in Maceió, Alagoas, Brazil. The sample consisted of 145 medical records of pregnant women admitted between 2015 and 2018 with possible vertically transmitted infections. Incomplete medical records or those that did not make it possible to describe fetal/neonatal exposure were excluded. The chi-squared test was used to verify the association between variables. Results: A greater occurrence of congenital syphilis was observed (28.8%). There was more than one outcome in the same individual, such as low birth weight (39%), respiratory distress (20.5%), oligohydramnios (20%), congenital malformation and small size for gestational age (10.8%). Maternal infections and the number of prenatal visits revealed an association with fetal/neonatal outcome (p ≤ 0.05). Conclusion: The data obtained indicate the occurrence of unfavorable fetal/neonatal outcomes when related to neonatal infections and indicate the need for strategies that strengthen the coping with vertical transmissions.

ABSTRACT Objective: to understand professional care for maternal grief in the puerperium of stillbirth. Methods: a clinical-qualitative study with all the women who had stillbirths living in Maringá (Brazil) and participating in the Center d’Études et de Recherche in Family Intervention at the University of Quebec in Outaouais in Gatineau (Canada). Semi-structured interviews were carried out and the relevant aspects were categorized into themes. Results: the identified categories were: Assistance received in the puerperium with a focus on grief: hospital and outpatient environment, and Professional support in coping with maternal grief after fetal loss: with contact and memories, without contact and without memories and impossibilities of contact with the baby. Final considerations: the need for a multidisciplinary support and monitoring network for women who experienced fetal loss was evident. From this study, a routine of care for grief can be implemented in Brazil based on experiences in Canada.

ABSTRACT Objectives: To analyze the abstracts that relate nursing to the Theory of Culture Care Diversity and Universality, published in the annals of the main national scientific events in the category, over a 12-year period. Methods: documental research carried out in the annals of the Brazilian Nursing Congress and the National Nursing Research Seminar. Data collection took place from July/2018 to June/2019 using a form. Data was analyzed using descriptive statistics and content analysis. Results: 99 studies were analyzed, and three categories emerged: Cultural diversity, emic perspective, and cultural context: possibilities for applying the theory; Incongruencies and peculiarities of the care sectors: limitations of the application of the theory; Knowledge production to improve care: implications for professional nursing practice. Final Considerations: the investigated scientific production enabled the construction of knowledge of cultural aspects related to nursing care and showed similarities and variations in care practices.

ABSTRACT Objectives: to build and validate a data collection instrument for onco-hematological patients undergoing outpatient chemotherapy. Methods: methodological study that aimed to build a scientifically consistent data collection instrument to evaluate hematological patients. There were five stages: identification of empirical indicators, evaluation of empirical indicators by focus group, construction of the instrument, content validation by judges and clinical validation. Built based on the Theory of Basic Human Needs of Horta, adjusted by Garcias and Cubas. Results: the built instrument contains data on patient identification, perception and expectations related to the disease, assessment of psychobiological, psychosocial and psychospiritual needs. It reached 95% CVI, ensuring the instrument’s content validity and Cronbach’s alpha test with a reliability of 0.93. Conclusions: the instrument is a valid technology to assist nurses in data collection and may serve as a tool for onco-hematological nursing care, teaching and research.

ABSTRACT Objectives: to describe a medium-range nursing theory for the cardiovascular rehabilitation process. Methods: theoretical development study, addressing the elaboration of medium-range theory, based on Roy’s Adaptation Model, which combined theoretical deduction with induction strategies, based on literature review and concept analysis. Results: the Medium-Range Theory for Nursing in Cardiovascular Rehabilitation presents eleven concepts and respective definitions, organized in relationships that represent elements, through modeling and image representation. Theoretical assumptions and propositions are presented. Final Considerations: the theory presented aims to contribute to the description of the cardiovascular rehabilitation process from the perspective of the adaptation of the person, family and groups, as well as to impact the nursing care implemented to patients in the process. The procedures advanced from conceptualization to operationalization, through the production of theoretical propositions that will guide future theoretical testing.

ABSTRACT Objectives: to analyze the predictors of moral harassment in nursing work in critical care units. Methods: a cross-sectional study conducted in a public hospital in Fortaleza, Ceará, with 167 nursing professionals in 2016. Sociodemographic/occupational questionnaire and Negative Acts Questionnaire Revised were applied. The analysis included descriptive statistics, measures of central tendency and dispersion, as well as Mann-Whitney, Kruskal-Wallis and Conover Inman U-tests for multiple comparisons. Results: there was a 33% prevalence of self-perception of moral harassment, highlighting personal/professional disqualification and work-related harassment. The predictors of moral harassment included age, time working in the job and time in the unit, employment relationship and sector. Conclusions: young professionals (< 30 years), cooperative, crowded in intensive care or emergency units, with less time working in the job (< 5 years) or greater time in the unit (above 10 years) are the biggest victims of moral harassment in the work of nursing in critical environments.

ABSTRACT Objective: To identify the pattern of medication consumption among the elderly assisted in Primary Health Care. Methods: Descriptive, quantitative, cross-sectional study, with a sample of 315 elderly people, in a city in rural Rio Grande do Norte. Results: The average age was 72.41 years, with an average consumption of 3.15 medications per day, ranging from 1 to 16 medications daily. There was a prevalence of antihypertensives, antidiabetics, hypolipidemic and psychotropic drugs. 238 different drugs were mentioned, 15 of which were “potentially inappropriate drugs” for the elderly. Most of these patients follow treatment according to medical prescription, with low self-medication. Most elderly people buy their drugs, although many are available for free. Conclusion: The most consumed drugs are consistent with the most reported diseases (hypertension and diabetes). The daily use of inappropriate medications for the elderly is worrying, especially psychotropics, given the risks of dependence or health complications of these users.

ABSTRACT Objective: to verify the association between social network and functional disability in elderly Brazilians. Methods: a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics’ website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used. Results: disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women. Conclusion: there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

ABSTRACT Objective: to describe the therapeutic itinerary of elderly people with diabetes mellitus registered at Family Health Strategy units. Methods: qualitative and descriptive study carried out with 15 elderly people with diabetes mellitus between February and April 2019 by applying semi-structured interviews with the participants. Data were submitted to analysis of Minayo’s operational proposal. Results: in the folk care subsystem, the use of medicinal herbs, healers, and faith was emphasized by the participants. In the professional care subsystem, Family Health Strategy units were the services with the strongest bond to elderly people, but these patients still had to resort to the private healthcare network. Family proved to be the main source of support in the popular care subsystem. Final considerations: nursing must acknowledge the different types of knowledge, coping strategies, beliefs, and the culture of elderly people with diabetes mellitus to guarantee the delivery of comprehensive care.

ABSTRACT Objectives: to analyze the characteristics of stigma in the interactions of people with pain and sickle cell disease and the coping strategies adopted. Methods: qualitative study, conducted in Bahia’s reference units between January and July 2018. In-depth interviews were applied to 25 adults, followed by content analysis and interpretation in light of the Sociological Theory of Stigma. Results: four categories emerged from the data: Stigma in interactions with family members; Stigma in interactions with people in the general public; Stigma in interactions with health workers; and Strategies for coping with stigma. Final Considerations: in the participants’ interactions, stigma produced discrediting pain reports, labeling and stereotyping, blaming patients for not improving their health, discrimination, racism, inadequate pain assessment, and delay in care. Coping included silencing, covering up, aggressive behavior, exposure to risk, reading religious texts and praises, and church attendance.