RCAAP Repository

ABSTRACT Objectives: to analyze the microbiological profile of leg ulcers of patients treated at outpatient clinics and hospitals regarding the type of microorganism, microbiological selection of antibiotics, and techniques for the collection of culture material. Methods: literature review performed on LILACS, IBECS, MEDLINE, and CINAHL databases, resulting in a descriptive analysis of 27 studies. Results: 35.7% of the studies occurred in an outpatient care scenario; and 64.2% in hospitals. There was a predominance of swab (100%) in outpatient care and biopsy (55.5%) in the hospital. Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were more common at both levels of assistance. Methicillin-resistant Staphylococcus aureus was isolated in both. Conclusions: the microbiological profile of infections was similar, with the presence of resistant bacteria in both environments. This fact causes concern and raises the need for research to elucidate it. The studies did not compare the effectiveness between biopsy and swab.

ABSTRACT Objectives: to analyze the impact of social protection programs on adults diagnosed with Tuberculosis. Methods: systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors “Social Protection” and “Tuberculosis”, in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included. Results: social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty. Conclusions: social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.

ABSTRACT Objectives: to identify vulnerabilities of nurses who work in an intensive care unit. Methods: an integrative review was held from 2006 to 2019, with searches on the platforms/databases LILACS, BDENF, SciELO, MEDLINE, Scopus, CINAHL, and Web of Science. The theoretical framework of ergology, by Schwartz, was used and the guiding question “What are the main vulnerabilities of nurses who work in an intensive care unit”? Results: eleven articles were included. Five topics of vulnerabilities emerged: physical, emotional, communication process, care process, and organizational. We observed that the organizational vulnerability was kept as a common and intersection factor in developing the other four. Conclusions: vulnerabilities found have a relationship to the physical, emotional, communication, care process, and institution organization elements. The organization aspect intersected with the others, configuring itself as the core in this context.

ABSTRACT Objectives: to analyze evidence on the quality of life of people with tuberculosis/HIV coinfection. Methods: review that followed steps of the Cochrane Collaboration, with the search of publications in the bases Embase, LILACS, PubMed, and Cochrane, through the descriptors “HIV,” “Tuberculosis,” and “Quality of Life,” without a temporal cut. Results: the results include 15 studies, published between 2009 and 2019, with the level of evidence V, in its majority. It was observed that there is no uniformity in the instrument used. Psychological support to this group and strengthening of actions to manage both infections are necessary. This segment’s quality of life is associated with social factors and scientific production on the subject concentrated in underdeveloped countries. Conclusions: the articles found have a low level of scientific evidence and indicate that people who experience coinfection have a more compromised quality of life when compared to those who experience tuberculosis or HIV separately.

ABSTRACT Objectives: to identify the factors related to the use of religious coping in informal caregivers. Methods: integrative literature review carried out through a search in the databases LILACS, PubMed, Scopus, Web of Science, and CINAHL, in addition to the Virtual Health Library and SciELO. The study selected primary articles in English, Portuguese, and Spanish, using the descriptors Coping Behavior, Caregivers, Spirituality, and Religion, which were combined with each other and with synonyms. There was no time limit for the publications. Results: nine articles were selected. Factors related to the use of religious coping in informal caregivers included: having an advanced age, experiencing traumatic situations, being under overload, being a spouse or mother, caring for hospitalized individuals, or for those with chronic diseases and high degrees of dependence. Conclusions: the factors related to the use of religious coping are multifaceted and involve physical, psychological, psychosocial, and situational aspects.

ABSTRACT Objectives: to analyze the available evidence on the nursing care provided to patients after hematopoietic stem cell transplantation. Methods: integrative review with the search for primary studies in four databases and a virtual health library. A broad search strategy was used, including research published in English, Brazilian Portuguese, or Spanish, between 2008 and 2018, totaling a sample of 42 studies. Results: the studies were grouped into three categories: multiple nursing care (n=19), first-line care (n=18), and self-management of care (n=5). Conclusions: nursing care is critical, comprising patients’ physical, psychological and social aspects. It occurs in hospital and home contexts, mainly involving technical actions and health guidance. The evidence identified provide subsidies for decision-making; however, most studies are of the non-experimental type, indicating the need for conducting intervention research.

ABSTRACT Objectives: to analyze care strategies for breast cancer screening in Primary Health Care in Brazil. Methods: this is a systematic review following the Cochrane Collaboration recommendations. Results: among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women’s health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%. Conclusions: Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.

ABSTRACT Objectives: to describe the available evidence on indications, complications, care and alternative strategies in the use of physical restraint in adult patients in Intensive Care Units. Methods: an integrative review conducted in the LILACS, Nursing Database, Índice Bibliográfico Español en Ciencias de la Salud, Scopus and CINAHL databases and the PubMed portal, in the period from June to August 2018. Results: the final selection was of 19 articles, from which the indications, complications, care and alternative strategies were extracted. The studies were conducted between the years 2003 and 2018, with a predominance of the United States; they were mostly classified (58%) in level 6 evidence, being performed by nurses, with multi-professional participation of psychologists, pharmacists, physicians, and nurses. Conclusions: the most common practices regarding physical restriction were described, and the need for the elaboration and implementation of protocols on intervention to support decision making was observed.

ABSTRACT Objectives: to identify publications about the applicability of the Symptom Management Theory in nursing care to pediatric, adolescent, adult and elderly patients. Methods: scoping review following the steps: definition of the objective, research question and inclusion criteria; search, selection and analysis of publications; synthesis of results. The search occurred in the VHL, SciELO, CAPES and PubMed Journals Portal bases, contemplating publications between 1994 and July 2020. Results: out of 3,286 studies, ten were selected, published between 2008 and 2019. They described the relationships between the participants and the domains (person, environment, health and disease), components (symptom experience, management strategies, results) and presented strategies for symptom management. Conclusions: the Symptom Management Theory was considered applicable to the participants of the studies and to nursing care. It was concluded that understanding the interaction of these elements is essential to plan actions aimed at controlling symptoms effectively.

ABSTRACT Objectives: to analyze ethically, aesthetically and politically the cine-debate of the movie “Human”, reflecting on training of researchers in qualitative research. Methods: the debate about moral questions as the essence of humanity was based on Narrative Bioethics; the comprehensive, relational and reflective character of qualitative methods; and the ethical and social sense of qualitative researches. Results: the narratives of the experiences of morality, loaded with facts and valuations, highlighting the importance of reflexivity in all phases of the qualitative research process, from thinking about themes and research questions to fieldwork, from data analysis to the production of reports, fostering the researcher’s responsibility both in the intervention for understanding and narrating the world, and in its possible transformation. Final Considerations: cinematographic art becomes an instrument of reflexivity capable of affecting and mobilizing students, in a fusion of horizons of understanding of different universes that dialogue.

ABSTRACT Objectives: to analyze the process of permanent professional training of Primary Health Care nurse managers from the perspective of reflective practice theory, built by Donald Schön. Methods: this is a theoretical-reflective study. Results: the findings apply to nurse managers’ practice to deal with the dilemmas that present themselves in the professional routine according to their knowledge, skills and attitudes, anchored in the reflection-in-action movement, which unites the process of permanent and practical training reflective, favoring the development of skills relevant to management. Final Considerations: nursing health managers, during their ongoing training process, can develop skills to act effectively in Primary Care, reflecting in practice and on practice, deciding on the need to remain in training to address the issues arising from that same practice.

ABSTRACT Objective: To reflect on autonomy in health care, its perspective on the lives of the elderly, and its meaning for the practice of nursing care. Methods: Theoretical essay on the practice of nursing care to promote autonomy and self-care for the elderly. Results: It is necessary to qualify the practice of nursing care to consider the aging process and maintain the autonomy of the elderly. Three parts emerged: “The autonomy of the elderly and the care plan”, “Nursing in the self-care process”, and “Challenges to the practice of caring for the elderly in nursing”. Final considerations: There is still a deficiency in promoting autonomy for the elderly due to the need for a review of the practice of nursing care, which, considering aging in Brazil, needs to undertake new actions in order to encourage self-care and autonomy in this population.

ABSTRACT Objectives: to report the experience using ludic strategies for the teaching-learning in the elaboration of the genogram and ecomap; and the use of these instruments by Nursing students in the Primary Health Care services. Methods: an experience report of the discipline Integrity of Care I (Integralidade do Cuidado I), of the Nursing School of Ribeirao Preto. Problems scenarios were created to approach the genogram and ecomap, comprising different family arrangements, represented by pedagogic puppets. Results: students actively participated, held collective discussions, elaborated genogram, and ecomap, identified the type of family, and the stages of the vital cycle, providing increased dynamics and interactivity. Subsequently, in supervised activities in Primary Health Care services, students elaborated the genogram and ecomap to monitor a family. Final Considerations: the use of ludic strategies propitiates the teamwork, active interaction of the group, and the creativity. The articulation between theory and practice resulted in a significant learning.

ABSTRACT Objective: to describe characteristics of pregnant women at risk and analyze the relationship with type of delivery and complications during pregnancy and puerperium. Methods: a retrospective study with secondary data of 1,574 at-risk pregnant women followed up in an educational intervention by telemedicine. Results: pregnant women with an average age of 35 years and high educational level participated. Preference for normal delivery was 43.1%, but only 17.3% had normal delivery. During pregnancy, 43.5% sought emergency care. In the postpartum period, 2.0% needed an ICU. Emergency room search was associated with age and contacts with the intervention. Cesarean delivery was associated with age, physical inactivity and overweight/obesity. ICU admission was associated with age and BMI. Conclusion: pregnant women were of high age and education, the younger and who had more contacts with the intervention sought more the emergency room. Older age, physical inactivity and overweight/obesity were factors associated with cesarean delivery.

ABSTRACT Objective: Evaluate the association between early pregnant hospitalization and the use of obstetric interventions and cesarean delivery route. Methods: Cross-sectional study, with 758 women selected at the time of childbirth. It was assumed as early hospitalization when the woman was admitted to the hospital having less than 6 cm of cervical dilation. Logistic regression models were constructed in order to estimate the odds ratio for each obstetric intervention, adjusted by sociodemographic and obstetric variables. Results: 73.22% of women were early hospitalized. On average, they had 1.97 times the chance to undergo Kristeller’s maneuver, 2.59 and 1.80 times the chance to receive oxytocin infusion and analgesia, respectively, and 8 times more chances to having their children by cesarean delivery when compared to women that had timely hospitalization. Conclusion: Early hospitalized women were submitted to a higher number of obstetric intervention and had increased chances of undergoing cesarean sections.

ABSTRACT Objective: To understand how information about Planned Home Birth motivates or discourages women’s decisions on this location of birth. Method: Descriptive exploratory study, qualitative approach. Data collection carried out from February to April 2019, through semi-structured interviews with 14 women and documentary sources. The data were analyzed using Bardin’s content analysis process, with the help of ATLAS.ti 8.0. Results: The motivations for choosing Planned Home Birth are: respect for the autonomy and natural process of childbirth and delivery, support from a partner and trust in professionals. Aspects that discourage this choice are fear of complications, the need for a hospital medical structure, opinions that value risk. Conclusion: Women’s choices are based not only on information, but also on how that information is processed. This study demonstrated that the perception pertaining to the safety of Planned Home Birth is essential for making this decision.

ABSTRACT Objective: to outline the profile and understand the expectations and needs of family members who seek compulsory hospitalization for drug-using members. Method: Mixed research; data collected involving 101 medical records and semi-structured interviews with 26 family members. SPSS software and content analysis was used. Results: The sample was characterized predominantly by women. Most users had other treatment modalities. Significant associations were observed between the request for hospitalization, the presence of aggressiveness, and other behaviors typical of harmful drug use for requesting compulsory hospitalization. The categories were: The difficult coexistence with the user; the journey of family members to “bring the user back to life”; Expectations and needs regarding compulsory hospitalization. Conclusion: The study provided a broader view of the complexity and inter-subjectivities of family systems in the face of the drug cycle, promoting discussions and strategies for multidisciplinary services in the comprehensive care of these families.

ABSTRACT Objective: to identify the perceptions of teamwork according to professionals of an oncohematology unit. Methods: this is an exploratory study/qualitative approach. Nineteen health professionals from the oncohematology unit of a public teaching hospital participated. Data collection took place through semi-structured interviews, from September to December 2018. Data analysis followed Content Analysis, thematic modality, and the work process theoretical framework. Results: two categories emerged: Cooperative behavior of professionals from an oncohematology unit, revealing meanings of teamwork and its facilitating/hindering factors in the unit, and Composition, characteristics and management of the unit, presenting teamwork in the perspective of organization/dynamics of work at the unit, material instruments, qualification/training, team composition and organizational management. Final considerations: there is a need for management to know and better understand the work of workers and their difficulties, providing psychological support to the team.

ABSTRACT Objective: To analyze the theoretical-practical articulation of the continuous learning of leadership in undergraduate Nursing. Methods: Case study carried out at a Northeast federal public university. For data collection, semi-structured interview techniques, workshops, and document analysis were applied. Forty Nursing students participated in the interviews, and 26 in the workshops. The data were submitted to Minayo’s operative analysis using the Nvivo software. Peter Senge’s concepts were adopted. Results: The students demonstrated a greater understanding of the theme throughout the course and recognized contributing elements to the continuous learning of leadership, such as behavioral characteristics and the use of methodological approaches integrated with theoretical and practical spaces. Final considerations: The teaching of leadership is relevant in Nursing education, and this has been recognized by students, but still requires changes for it to become operational, with an improvement and a theoretical-practical integration of the cultivated experiences, suitable to the reality of the craft.

ABSTRACT Objective: to understand the perceptions of hope for people with depression in the context of a therapy group. Methods: using a qualitative case study approach, a semi-structured in-depth interview and a self-report questionnaire were conducted with seven women with depression integrated in a therapy group at a Portuguese day-care psychiatric unit. Data collection and analysis used triangulation of sources. Results: the participants evidenced hope founded on the positive experiences of the past with a strong affiliation component. Hope management is done fundamentally through the interpersonal relationships established between the members of the group, based on communicational patterns that are established on a regular basis, mediated by the group therapist. Conclusion: the therapy group functioned towards the reinforcement of hope in people who experience depression, and it works as a motivation to manage the implications of illness in the participants’ life and health project.