RCAAP Repository

ABSTRACT Objective: to identify the factors associated with pregnancy that influence constant glycemic variability. Method: a case-control study with random sampling. The medical records of 417 pregnant women were divided into case group (200 pregnant women with constant glycemic variability) and control group (217 pregnant women without constant glycemic variability). Data were collected from 2009 to 2015. Results: pregnant women aged 25 years and over, with family history of diabetes mellitus, with systemic arterial hypertension, overweightness or obesity, sedentarism and polycystic ovarian syndrome are more likely to present changes in blood glucose. Conclusion: The study demonstrated that risk factors associated with pregnancy increase the risk of constant glycemic variability. The findings will allow reassessment of the interventions during pregnancy, providing an increase in nursing care quality.

ABSTRACT Objective: to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables. Method: prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables. Results: the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006. Conclusion: there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.

ABSTRACT Objective: to analyze the quality of life of high-risk pregnant women. Methods: an observational and cross-sectional study, carried out in a tertiary maternity hospital located in Fortaleza, with 276 high-risk pregnant women. A questionnaire was applied containing socioddemographic, clinical and obstetric data and The Mother-Generated Index. Descriptive analyzes were performed using the Jamovi statistical program®, version 0.9. Results: most areas were negatively influenced by pregnancy. “Satisfaction with pregnancy”, “family relationship” and “relationship with the partner” obtained the highest means of primary score, while “physical condition/disposition” and “financing” obtained the lowest means. The highest secondary scores were in “satisfaction with pregnancy”, “family relationship” and “relationship with the partner”, while the lowest were in “financing” and “psychological/emotional”. Conclusion: the total primary score mean was 6.03, suggesting a good quality of life. The Mother Generated Index made it possible to identify aspects of life that go beyond pre-formulated assessments of the construct.

ABSTRACT Objective: to identify evidence of nursing patterns of knowing disseminated by the Brazilian press before the implementation of Florence Nightingale’s model in Brazil and categorize topics of journalistic articles according to Carper’s and White’s patterns of knowing. Methods: categorical content analysis of materials related to Florence Nightingale, published in Brazil between 1850 and 1919, collected at Hemeroteca Digital. Four analysts identified themes of journalistic article, performing classification in patterns of knowing. Results: there was a predominance of evidence of the sociopolitical pattern followed by the empirical pattern. In the analyses per decade, ethical and aesthetic patterns showed predominance between 1860 and 1870, respectively. Conclusion: White’s classification by nursing patterns of knowing was useful in understanding precursor themes of professional/disciplinary knowledge that spread in Brazil, linked to Nightingale’s character, in addition to the repercussions of her actions and her expanded sociopolitical perspective.

ABSTRACT Objective: To assess the safety climate from the perspective of health professionals in the inpatient and intensive care units of a public hospital specialized in cardiology, in the city of Rio de Janeiro. Methods: Quantitative, exploratory, descriptive study, using the Safety Attitudes Questionnaire. The findings were analyzed according to descriptive and inferential statistics, with a significance level of 5%. Results: The general safety climate had a mean of 66.6; the best score corresponded to the Job satisfaction (80.8) domain and the lowest to Hospital management perception (52.5). The means of the scores were statistically significant regarding the employment relationship, gender and professional category. Conclusion: There are weaknesses in the safety climate related to management and having a state job bond, belonging to the male gender and to the nursing team.

ABSTRACT Objective: To know the experiences and perceptions of nurses who care for dying cancer patients. Method: A descriptive, qualitative study, developed in a private hospital in Sao Paulo, with a total of nine nurses, aged between 24 and 46 years old, who participated in a semi-structured interview. Results: Through Bardin's Content Analysis, three categories were highlighted: Death as a natural process and the final stage of the life cycle; Although it is difficult, it is important to get emotionally involved with dying patients and their family; and Reflecting on their experiences in the care of dying patients and their family. Final Considerations: The nurses' experiences and perceptions of the death of cancer patients showed the professional's involvement and feelings of anxiety and anguish. Adopting effective strategies to address people who are suffering, in the context of the study, can provide subsidies that will guide clinical practice in health.

ABSTRACT Objective: To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities. Method: Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman's correlation coefficient and Chi-squared test (p<0.05). Results: Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices. Conclusion: This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.

ABSTRACT Objective: To verify the age, nutritional status, and gait speed in hospitalized individuals, and their association with the quality of life of their caregivers. Methods: Observational cross-sectional study with 54 patients and their respective caretakers in a university hospital in the Brazilian Midwest. The analyses were carried out using the SPSS software, with p < 0.05. Results: The Social Relations domain had the highest mean score (71.45±18.64). The lowest score was in the Physical domain (57.80±12.01). According to a subjective nutritional evaluation, 72.2% presented some degree of malnutrition. Most were classified with low gait speeds (82%). There was a significant correlation between age and the Physical and General Quality of Life domains. The Environment domain was significantly correlated to the gait speed. Conclusion: The age and the gait speed of the patient were related to the quality of life of the caregiver, but the nutritional state was not affected.

ABSTRACT Objective: to develop and validate an application for cellphones structured in self-care to encourage adherence to antiretroviral prophylaxis after occupational exposure to biological material. Methods: phase 1 - descriptive study to identify characteristics of occupational exposure; phase 2 - methodological study to construct and validate an application content aiming to increase adherence to antiretrovirals. Results: phase 1 - 55 occupational exposures were recorded; 32 (58.2%) antiretroviral indication. Blood was present in 96.9% of exposures; most professionals have insufficient knowledge about exposure risks. A statistical relationship was identified between self-care and adherence (p<0.001). Phase 2 - application was constructed, validated by 11 experts, and considered appropriate to encourage health professionals for self-care and adherence to antiretrovirals. Conclusion: the application “Exposição Ocupacional ao HIV” was considered adequate to expand self-care and adherence of professionals to prophylactic treatment to occupational infections arising from biological risks.

ABSTRACT Objective: To analyze the spatial pattern of AIDS mortality and social factors associated with its occurrence. Methods: An ecological study that considered 955 AIDS deaths of residents in Piauí, reported in the Mortality Information System (MIS) from 2007 to 2015. Non-spatial and spatial regression models were used to identify social determinants of AIDS mortality, with a significance of 5%. Results: The predictors of AIDS mortality were illiteracy rate in males (p = 0.020), proportion of households with water supply (p = 0.015), percentage of people in households with inadequate walls (p = 0.022), percentage of people in households vulnerable to poverty and in whom no one has completed primary education (p = 0.000) and percentage of people in households vulnerable to poverty and dependent on the elderly (p = 0.009). Conclusion: Social indicators related to education, job and income generation and housing were associated with AIDS mortality.

ABSTRACT Objective: Analyze the results of knowledge production from a graduate program for master’s degree in nursing. Method: This is a qualitative retrospective documentary study. Data were collected from the university library repository and the program website. In total, 83 dissertations were found, analyzed and arranged into five groups: worker’s health, care management, systematization of nursing care, health education, and nursing care. Results: The results indicate good practices such as manuals, guides, protocols, software, and products for systematization of care. They indicate concern about changing the reality with care practices and interventions, health education and continuing education. Final considerations: This study showed student commitment to the fields of practice when choosing the project theme. Students presented an intention to improve care, management, education and research, in the various dimensions of the profession.

ABSTRACT Objective: Correlate the cases of multidrug-resistant tuberculosis and its spatial patterns with the type of notification and sociodemographic variables. Method: Ecological study carried out in the municipality of Belém, with 77 cases of multidrug-resistant tuberculosis registered in the Special Treatment Information System for Tuberculosis, between 2012 and 2016. For analysis, the data was debugged followed by geo-referencing in ArcGis 10.3 and Terra View 4.2.2. To relate the cases with the type of notification, the BioEstat 5.4 software was used, with a significance level of 95%. Results: Of the total, 40 (52%) were new cases; 27 (35%), relapses; and ten (13%) were re-enrolled after leaving. Multidrug-resistant tuberculosis was randomly distributed and related to income, household, territorial cluster and water supply. There was a concentration of cases in two administrative districts, corresponding to 28.5% and 27.3% of the total, with a median Sociodemographic Index. Conclusion: Behavior of multidrug-resistant tuberculosis influenced by sociodemographic indicators.

ABSTRACT Objective: to verify mercury exposure prevalence and identify its possible associated factors in two riverside communities in the Madeira River basin of the Western Brazilian Amazon. Method: a cross-sectional study comprising 95 children and adolescents. Age cycle, school attendance, Bolsa Família, number of siblings, meals, fish consumption, height by age were measured. Binary logistic regression was used to verify relationships between mercury exposure and its possible associated factors. Results: the general prevalence of mercury exposure was 46.3%; children, 35.4%; and adolescents, 57.4%. Associated factors were fish consumption (aOR=1.84; 95%CI 1.56-2.16), age cycle (aOR=2.50; 95%CI 1.09-5.7), parasites (aOR=1.22; 95%CI 1.02-2.71), and short stature (aOR=1.32; 95%CI 1.05-2.02). Conclusion: mercury exposure prevalence in riverside children and adolescents was considered worrying, with association with fish consumption, adolescence, parasites, and short stature.

ABSTRACT Objective: Analyze the agreement of nurses, who work in hospital institutions, about Florence Nightingale’s conceptions about nursing, people, health and the environment. Method: Quantitative, observational and cross-sectional study, with the participation of 3,451 nurses from 36 Portuguese hospitals. Data collection took place from July 2015 to March 2016, using a questionnaire. For analysis, descriptive and analytical statistics were used. Results: It was evident that 60% to 70% of participating nurses considered that Florence Nightingale’s conceptions of nursing, person, health and environment were partly in agreement or totally in agreement with their practice. The variables that influenced agreement were: service, condition in which they practice the profession, length of professional practice, academic degree and region of the country. Conclusion: Florence Nightingale’s conceptions continue to contribute to professional nursing practice, with the region and the service significantly influencing this continuity.

ABSTRACT Objective: to understand the experiences of relatives of critically ill children before bad news report. Method: a phenomenological study based on Heidegger’s philosophical framework. Data collection was carried out from October 2018 to March 2019, through phenomenological interviews with 15 relatives of children hospitalized in a Pediatric Intensive Care Unit. Results: relatives, in their existentiality, experience the facticity thrown into unpredictable situations, regardless of their choices and are faced with feelings of shock, despair and fear before bad news. After emotional impact, especially regarding the possibility of death, relatives reveal hope as a mechanism for coping with the situation. Final considerations: solidarity and sensitivity by health professionals, especially nurses, are essential in understanding the existential dimension of relatives who experience such an experience, understanding the several facets of their existence and offering them opportunities to project themselves.

ABSTRACT Objective: To build and validate an educational booklet for preventing complications in intestinal ostomy and peristomy skin. Methods: Methodological study developed in: 1. Survey of the clinical profile of patients; 2. Integrative review; 3. Construction of technology; 4. Validation of educational material. The Delphi technique was used, with 18 judges with expertise in the field of stomatherapy. For data treatment, the Collective Subject Discourse (CSD), descriptive analysis, Kappa Index (K), binomial test and Content Validity Index (CVI) were used. Results: The agreement rate between judges was higher than 0.61, for K p> 0.05, a proportion of 80% for the binomial test and 80% for the CVI. . The booklet showed an excellent index for K, binomial test and global content validity, becoming validated. Final Considerations: The booklet was validated in appearance and content, being an instrument that can favor communication between professionals and people with ostomies.

ABSTRACT Objective: To evaluate factors associated with health dissatisfaction of public elementary school teachers. Methods: Cross-sectional study conducted among teachers from a Midwest capital, in 2017. A self-administered questionnaire composed of a collection of validated instruments and additional questions was used. Poisson Regression was performed, considering significance p <0.05. Results: sample composed of 326 teachers, with an average age of 43 years, 87.1% female. Concerning health conditions, 19.5% were dissatisfied and 31.5% were indifferent. In a simultaneous analysis of the factors of interest, a statistically significant association was found among teacher’s health dissatisfaction and the presence of symptoms of common mental disorders (PRa= 2.28), musculoskeletal symptoms in the last 12 months (PRa= 1.71), voice disorders (PRa= 1.29), never/rarely waking up rested (PRa= 1.45), never/rarely engage in physical activity/sports (PRa= 1.57), among other factors. Conclusion: never/rarely waking up rested and engaging in physical activity/sports, the presence of common mental disorders, musculoskeletal symptoms and voice disorders were associated with health dissatisfaction.

ABSTRACT Objective: To validate the content of the indicators of the nursing outcome Dry eye severity, of the Nursing Outcomes Classification, in adult patients admitted to the intensive care unit. Methods: Methodological study of content validity, developed in two stages: the first, consisting of 23 specialists; and the second, of a consensus group formed by ten nurses. For analyzing the data in the first stage, we used the content validity index and binomial test for each indicator; in the second stage, the discussions of each meeting were transcripted, and the indicators that achieved 100% consensus were validated. Results: Of the 14 indicators evaluated by the specialists, 7 presented a cut-off point below 0.80, but did not show statistical significance in the binomial test. In the consensus group’s validation, six indicators were reformulated. Conclusion: This study considered the 14 indicators valid for evaluating patients admitted to the intensive care unit.

ABSTRACT Objective: to analyze the characteristics, related factors, and consequences of physical violence and verbal abuse against nurses working with risk stratification. Methods: a cross-sectional, descriptive and quantitative study carried out with 80 nurses who work with risk stratification in emergency services. Data were collected using an adapted instrument and analyzed using (uni)bivariate inferential statistics. Results: companions were the main perpetrators of verbal abuse (86.1%); and patients inflicted physical violence (100%). Professionals with up to five years of experience are 74% less likely to suffer physical violence (p=0.029). Women suffer 5.83 times more verbal abuse than men (p=0.026). Sadness (15.8%) and fear of the aggressor (15.3%) were the main consequences of verbal abuse; and fear of the aggressor (22.2%) and stress (22.2%) were results of physical violence. Conclusion: violence is influenced by institutional, professional and client aspects. Therefore, coping with it requires multidimensional strategies.

ABSTRACT Objective: to understand what are the strategies used by nurses to mediate conflicts. Method: a qualitative and descriptive study that used oral history, carried out in the organ transplant unit of a university hospital located in the city of São Paulo, SP, Brazil. The population consisted of seven nurses with one year or more of experience in the unit. Data collection took place with semi-structured interviews. The reports were transcribed, and their content was analyzed according to Minayo’s model. Results: three categories have emerged: Conflict-generating sources; Strategies for conflict mediation such as collaboration, dialogue, standardization, and expressive action by nurses to mediate conflicts; Consequences of conflicts. Conclusion: there is a need to invest in the training of nurses to mediate conflicts, and it is important to develop skills such as interpersonal relationships and communication for the success of their professional performance.