RCAAP Repository

ABSTRACT Objectives: to analyze the burden and the social support of the informal caregivers of people undergoing kidney dialysis. Methods: mixed study, based on the Theory of Stress and Overload, using instruments of sociodemographic characterization, the Social Support Survey from the Medical Outcomes Study, Zarit’s Burden Scale, and guiding questions. Analysis of data used statistical and thematic inferences. Results: 55 caregivers were evaluated, most were women, from 31 to 50 years old, married, and having worked in care for more than three years. A high level of affective and material support was observed, with a light overload on the caregiver. The central theme of the discourses was: “Experiences of the caregiver: between the burden of responsibility and the search for meaning”. Conclusions: a small overload was found in the participants, with a high median in the dimensions of affective and emotional support, in the relations between positive social interactions and the burden of the caregivers, in addition to the duality or responsibility and the meaning of care.

ABSTRACT Objectives: to analyze the scientific productions about the history of graduate studies in Brazilian nursing in the light of Eliot Freidson’s Sociology of the Professions. Methods: an integrative review, carried out in the databases indexed in Virtual Health Library. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. Thematic content analysis and Eliot Freidson’s concepts were adopted. Results: two categories emerged: “Institutionalization of graduate courses in Brazilian nursing”, highlighting the historical process of professionalization in nursing through transition from empirical to professional care, subsidized by the monopoly of the construction of one’s own knowledge; “The scientific production of graduate nursing in Brazil”, showing the strengthening of a new generation of nurse researchers, given the greater scientificity in teaching due to implementation of graduate studies. Final Considerations: the analyzes present the historicity of graduate studies’ institutionalization, supporting the understanding of professionalization outlines of Brazilian nursing.

ABSTRACT Objectives: to analyze the applicability of Root Cause Analysis and Failure Mode and Effect Analysis tools, aiming to improve care in pediatric units. Methods: this is a scoping review carried out according to the Joanna Briggs Institute guidelines, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes extension for Scoping Reviews. Search took place in May 2018 on 15 data sources. Results: search totaled 8,254 studies. After using the relevant inclusion and exclusion criteria, 15 articles were included in the review. Of these, nine were published between 2013 and 2018, 12 used Failure Mode and Effect Analysis and 11 carried out interventions to improve the quality of the processes addressed, showing good post-intervention results. Final Considerations: the application of the tools indicated significant changes and improvements in the services that implemented them, proving to be satisfactory for detecting opportunities for improvement, employing specific methodologies for harm reduction in pediatrics.

ABSTRACT Objectives: to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture. Methods: this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020. Results: thirty-six studies were identified. Nine studies identified strengthened areas such as: “teamwork within the units”, “expectations of supervisor/boss and actions promoting safety”, “organizational learning”, “support of hospital management for patient safety” and “frequency of report of events”. As a critical area, the dimension “non-punitive response to error” was evidenced in 30 of 36 studies. Conclusions: the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.

ABSTRACT Objective: to report an experience using the Team-Based Learning methodology for the development of a standard model for Birth Plans by health professionals. Methods: experience report on the use of Team-Based Learning to develop care technology, with the participation of 120 professionals from two municipalities located in the Midwest Region. Results: the use of Team-Based Learning in this experience enabled the construction of a Child Delivery Plan model based on the theoretical approach to the theme, a critical reflection exercise, an in-depth discussion, decision-making, after what a consensus was reached. The methodology enabled the (co) construction of knowledge in small groups, teamwork, accountability, and satisfaction among the participants. Final Considerations: the use of the TeamBased Learning methodology proved to be effective as a discussion strategy, building consensus and syntheses for the elaboration of a care technology aimed at the pregnancy-parturition period.

ABSTRACT Objective: to analyze YouTube videos with information about COVID-19 in Brazilian sign language. Methods: a cross-sectional study conducted with 402 videos from the YouTube sharing platform. Chi-square, Fisher’s exact, Mann-Whitney and Spearman’s correlation tests were used. Results: the videos mainly covered COVID-19 prevention (20.6%). There was a positive correlation between video length and number of views (p<0.001). The length of more than 20 minutes was associated with narration only in BSL (p=0.37) and in BSL with audio (p<0.001), while videos with less than 20 minutes were associated with simultaneous narration in BSL, audio and subtitles. Those with narration only in BSL had a similar number of views to those narrated with subtitles and/or audio (p=0.998). Conclusion: the videos were mostly short and included COVID-19 prevention. The longer the video, the greater the number of views. Regardless the presentation of narrations, the videos had a similar number of views.

ABSTRACT Objective: to know the strategies to cope with domestic violence against women disseminated by digital media at the beginning of the COVID-19 pandemic. Methods: a documentary study with a qualitative approach. The search took place from March 11 to April 30, 2020, from four sources: newspapers and online portals, social network, official government pages and third sector portals. Thematic content analysis of the findings was performed. Results: seventy-seven strategies were identified in the journalistic press, 93 in the social network, 45 in government portals and 40 in third sector organizations. From analysis, three empirical categories emerged: Strategies for communication with women; Strategies adopted by customer service; Strategies to inform the population. Final considerations: most of strategies were adaptations of existing services, centered on the reporting of violence by women

ABSTRACT Objective: to characterize the content of Youtube™ videos related to nursing professionals during the COVID-19 pandemic. Method: a qualitative study that examined 47 videos on Youtube™ posted between 11/03 and 11/04 2020, which were subjected to thematic analysis. Results: four categories emerged: “the role of nurses in care production during the pandemic”, which addresses the management of services and individual care; “Overview of the pandemic from the perspective of nurses in different countries”, presenting experiences and encouraging physical distance; “Tributes and motivation to mobilize the category”, in addition to targeted tributes, calls for nurses to claim their rights; “Criticisms and demands to improve working conditions”, which highlights the insecurity of care provision settings. Final considerations: nursing work conditions in different countries, recognition of the importance of professionals during the pandemic, and claims of the category to improve working conditions were the main content found on Youtube™.

ABSTRACT Objective: To analyze the change in the clinical-epidemiological profile of patients attended at the specialized triage service for COVID-19 (COVID-19 tent) in the first three months of operation. Methods: Cross-sectional study, with users attended from March 2020 to May 2020 (n=379) at the COVID-19 tent in the city of Ponta Grossa, Paraná. Data collection was retrieved from an electronic form fed by tent professionals, which included sociodemographic characteristics, symptoms, risk factors of exposure, means of search and clinical conduct. Trend tests and chi-square tests were performed. Results: March showed a greater demand (n=197), motivated by mild symptoms and direct search (p<0.05). In the following months, there was a decrease in demand (n=93; n=89), however the search for referrals, ambulances and conditions that required medical attention, observation and hospitalization increased (p<0.05). The search resulting from exposure to risk factors has not changed (p>0.05). Conclusion: the profile has changed over time, reflecting, in the end, severe and critical symptoms, requiring intervention.

ABSTRACT Objective: To analyze potential triggers of moral suffering experiences of health professionals, reported in the media, during the COVID-19 pandemic and to propose a theoretical construct of analysis. Methods: Study with qualitative approach whose data source were 50 reports published online, collected passively and actively, submitted to Content Analysis with the help of ATLAS.ti software. Results: The potential moral problems that trigger moral suffering are related to the threat to moral integrity, infrastructure/logistics and teamwork problems, and emotional aspects, revealing their articulation with damage to the foundations of a healthy work environment, which generated the proposal of a construct. Final considerations: The articulation between the experiences of moral suffering and the commitment of the fundamentals of a healthy work environment has brought important contributions to the adoption of strategies to protect and stimulate moral deliberation by professionals in favor of practice and society.

ABSTRACT Objective: To analyze nurses’ experiences in the front line of the fight against the COVID-19 pandemic regarding the performance of emotional labor (EL), aiming at its characterization and identification of support strategies and development opportunities of nurses and practices. Methods: Qualitative, descriptive, and exploratory study, with content analysis of eleven written narratives and reports from a focus group composed of nurses with experience in caring for patients with COVID-19 from different Hospital Centers in Lisbon, Portugal. Results: Five themes were extracted: 1) Challenges experienced by nurses in the frontline; 2) Emotions experienced by nurses in service care; 3) Emotional responses of nurses and patients: impact on care; 4) EL of nurses in the patient care process; 5) Opportunities for development in the face of the emotional challenge required of nurses in combating COVID-19. Final considerations: The nurses demonstrated the ability to transform this profoundly emotional experience positively.

ABSTRACT Objective: To create specialized nursing terminology for the care of people with COVID-19. Methods: Methodological study, carried out based on the identification of concepts related to the care of the person with the infection, present in the official guidelines of the Brazilian Ministry of Health; the concepts were validated by three specialist nurses; and a cross-mapping of the extracted concepts was done with CIPE® 2019 primitive concepts. Results: Out of 436 unique concepts, being 399 of these validated; of these, 70.9% were in the Classification and referred to the nursing care of people with COVID-19. In the Axis, the concepts related to Focus, Action, and Environment stood out. As for the non-validated concepts, 78.4% were not included in the 2019 version of CIPE®. Conclusion: We were able to structure a specialized CIPE® terminology, with the potential to generate nursing care indicators for people with COVID-19.

ABSTRACT Objective: To describe the daily activities performed by children from 6 to 12 years of age incomplete and analyze children’s behavior during social distancing in the face of the COVID-19 pandemic. Methods: Cross-sectional study with children in a learning stage living in Brazil. The data were collected via online form. Fisher’s exact test was applied to analyze the association of categorical variables with child behavior; when significant, it was used the odds ratio. It was considered results considered statistically significant those presenting values of p < 0.05. Results: Data from 530 children were analyzed: 50.3% female, 71.3% from the Southeast Region, 73% in fulltime social distancing, 52% presented anxiety, which was significantly associated with changes in sleep and appetite. Conclusion: The results indicate the need for parents/caretakers to stimulate moments for the child to express themselves, not minimizing their feelings and providing emotional support to mitigate the negative impact of these feelings on the child’s mental and physical health.

ABSTRACT Objective: Estimate the burden of SARS-CoV-2 infection among nursing professionals in Brazil. Method: Ecological study using data from the Nursing Observatory. The weight attributed to diseases was based on the Global Disease Burden Study 2017, considering the lower respiratory infection as moderate. Results: 7,201 records were analyzed; and, 190 deaths were recorded. The total number of years of life adjusted for disability was 5,825.35 years, with an average of 2,912.76 (95% CI 2,876.49-2,948.86). The adjusted rate per thousand professionals was 1,475.94 years for men and 674.23 years for women. Conclusion SARS-CoV-2 infection in Brazil follows an upward trend in nursing and has a major impact among women, nursing technicians and younger professionals.

ABSTRACT Objective: To analyze the way of life of the unhoused people to enhance health care in the pandemic. Methods: A qualitative, interdisciplinary research, with participant observation and 24 interviews with the unhoused people. Empirical categories and bibliographic search on this population and COVID-19 guided simple actions aimed at care. Results: The group at greatest risk for COVID-19 use drugs compulsively; starves constantly; discontinues drug treatment for tuberculosis, HIV, and diabetes; has underdiagnosis of Depression; has difficulty sheltering and uses inhaled drugs. This way of life increases the risk of worsening COVID-19 and brings great challenges to health services. Several proposals to guide care considered these results and the new routine caused by the pandemic. Final considerations: The way of life of the studied population increased their vulnerability in the pandemic, as well as the perception of risk of disease transmission by the population in general.

ABSTRACT Objective: to describe the implementation and management of a restructured nursing service to cope with the COVID-19 pandemic. Methods: a descriptive study, carried out at Piquet Carneiro Polyclinic, a university ambulatory unit, which became a reference for testing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the city of Rio de Janeiro. Results: dimensioning of human resources for nursing was carried out; flows for serving users of the unit and for testing SARS-CoV-2; professional training on prevention practices. From March 18 to July 3, a total of 31214 services were made by the nursing team, 25424 for testing and 453 health professionals received professional training. Final considerations: nursing represents an important workforce, planning and management for restructuring health services in an emergency, due to its broad managerial, educative and direct care to the population.

ABSTRACT Objectives: to analyze how the nurse-midwives of maternity wards that were fields of practice for an improvement course in obstetrics have reorganized care in the context of labor and birth amidst the COVID-19 pandemic. Methods: this is a descriptive, exploratory and qualitative study carried out with nine nurse-midwives who are preceptors and collaborators in maternity wards that were fields of practice for an improvement course, between February and April 2020, through a semi-structured interview through WhatsApp®. Content analysis was used to treat the information. Results: the pandemic brought the need to reorganize work, with a focus on service training and maintenance of good practices in labor and birth, whose movement was intensely experienced, interfering in nurse-midwives’ mental health. Conclusion: nurse-midwives have faced the pandemic with concerns about maintaining safe care, focused on practices based on updated scientific evidence.

ABSTRACT Objective: To estimate the prevalence and factors associated with anxiety among multiprofessional health residents during the COVID-19 pandemic. Methods: Cross-sectional study, conducted in July 2020 with multiprofessional health residents (n = 67) from a university hospital. We used the Beck Anxiety Inventory to assess anxiety. Analyzing data through the chi-square test, likelihood ratio, and multiple analysis using Poisson regression with robust variance. Results: The proportion of moderate/severe anxiety was 31.3%, which showed significant association with working in sectors involving COVID-19 and directly with suspected/confirmed cases of COVID-19. During the multiple analysis, we found prevalence of anxiety in participants who needed psychological support after entering their residence and those who used psychotropic meds. Conclusion: The results seem to indicate that residents had their mental health impaired during the pandemic, but the maintenance of the variables in the model also suggests that they sought help to control anxiety.

ABSTRACT Objective: To analyze online information available on the internet about COVID-19 and childhood cancer and discuss its reach potential with regard to supporting family functioning. Method: Documentary research supported by thematic analysis and the concept of family functioning and support. A total of 27 publications available on the websites of reference institutions in pediatric oncology, from March 1 to May 31, 2020, were analyzed. Results: Two themes guided the presentation of results with emphasis on language and sustainability assumptions to content, and to conveyed meanings and intentionality. The publications prospect families/people with basic knowledge about COVID-19 and have little information specific to the relationship with childhood cancer. Final considerations: Threatening circumstances require informational support. This study revealed incipient of specificity and a prescriptive tone in the online information available in early times of the pandemic, questioning the scope of support for family functioning.

ABSTRACT Objective: to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position. Method: this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid. Results: all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested. Conclusions: the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.