RCAAP Repository

ABSTRACT Objective: to reflect on social control in health and the contributions that nursing can make to cope with the COVID-19 pandemic. Methods: this is a theoretical reflection, elaborated from discussions based on literature and the experience of authors’ performance in social control and in Primary Care. It is divided into two topics: the first, related to aspects of institutionalized social control; the second, related to the perspectives for nursing in this space. Results: limits and relevant aspects for nurses’ role in social control are presented, contributing to a perspective of praxis in health based on their ethical-political commitment and their technical competence in the coordination and management of care to face the pandemic. Final considerations: nurses’ role in social control favors the strengthening of the struggle for the right to life above profits, especially through popular participation in the community context in Primary Care.

ABSTRACT Objective: to report the experience of a health team in restructuring service at a mastology outpatient clinic. Methods: an experience report in a public university service mastology outpatient in Ceará between March and April 2020. Service in this outpatient clinic is exclusively for women and who have breast changes for surgical treatments ranging from nodulectomies to mastectomies with oncoplastic. Results: increased COVID-19 cases brought the need to restructure healthcare services. The following steps were followed: identification of scheduled patients, reading of clinical developments in electronic medical records, individual assessment to define whether or not appointment would remain, telephone contact to inform about unscheduling. Among the 555 consultations scheduled for March and April 2020, 316 (56.9%) were maintained. Final considerations: restructuring consultations at a mastology outpatient clinic optimized the waiting time for consultations and avoided crowds at service, providing patient safety.

ABSTRACT Objective: to report the experience of professors and students of a graduate course on nursing care in coping with the new coronavirus (COVID-19) based on Self-Care Theory. Method: the active methodologies used were a literature search and seminar presentations, with an understanding of Orem's theoretical concepts: health; man; self-care; universal, developmental and health deviation requirements; self-care activities; self-care deficits; the required therapeutic demand; nursing systems. The pandemic was considered a health deviation that requires critical thinking and nursing care planning. Methodological frameworks to classify nursing diagnoses, interventions, and outcomes were used. Results: for each health deviation, nursing systems were identified; self-care deficits, diagnoses; actions, interventions; and the form of assessment, outcomes. Final considerations: theoretical-practical reflections of the academic context support nursing care planning.

ABSTRACT Objective: To report the experience of a Virtual Culture Circle with Brazilian families about coping with COVID-19, as a space that promotes health during the pandemic. Method: Experience resulting from an extension action, the Virtual Culture Circle was held based on Paulo Freire's Research Itinerary. It counted with the participation of seven families from different locations in Brazil. During the dialogues, a house was built: the foundation represented the thematic research; walls and roof, coding and decoding; doors and windows, the critical unveiling. Results: The action-reflection-action process favored the approach and integration of the participants of the Culture Circle; despite the geographical distance, it is an innovative strategy for empowerment and health promotion. Final considerations: The Virtual Culture Circle constituted a soft technology for health care and can be explored as a tool for promoting health, especially in scenarios where face-to-face meetings are an impossibility.

ABSTRACT Objective: To report the experience of a quaternary care center on the implementation of a care program for patients with severe hypoxemic respiratory failure due to SARS-CoV-2 requiring an extracorporeal oxygenation membrane. Method: This is an experience report with a descriptive approach, analyzing the use of the extracorporeal oxygenation membrane in a quaternary care center in the city of Rio de Janeiro. Results: The planning for the use of the extracorporeal oxygenation membrane included training with the professionals and use of the components related to the adaptation of the protocol, equipment, facilities, quality and safety. Final Considerations: Planning, resource allocation and regular training of the team to offer complex interventions, in line with recommendations for good practices in the care for patients with pulmonary complications related to the new coronavirus were essential for the development of the action plan for the use of extracorporeal oxygenation membrane in this pandemic period.

ABSTRACT Objective: to describe the experience of a private outpatient network for hematology and oncology treatment in the adoption of management tools to face the risk of contamination by SARS-CoV-2. Method: an experience report on the use of a root cause analysis method to identify potential risks of contamination by COVID-19 among patients and employees. Through the risks identified through the Ishikawa Diagram, we built an action plan, linked to the 5W2H tool, for planning and decision-making implemented. Results: the number of attendances in person and people circulating in the units was reduced, protective distance measures and new protection barriers were fundamental to control the risks of spreading COVID-19 in patients and employees. Final considerations: the management tools served as a valuable tool in the construction of measures, making the measures in question more clearly and applicable.

ABSTRACT Objective: to report the experience of implementing care management strategies in coping with the COVID-19 pandemic in a teaching hospital. Method: this is an experience report of the managers who work at the largest public hospital in Paraná with functions as Head of the Care Management Division, Head of the Care Lines Management Sector, Head of the Infectiology Unit and support team. Results: care management strategies were structured based on the service dynamics; physical structure; human Resources; professional and user safety. Final considerations: preparing for a pandemic involves measures that include modifying infrastructure and processes, managing employees and users, infection prevention strategies, and clinical recommendations. These measures are necessary to optimize the quality of care provided to users with COVID-19 and to reduce the risk of viral transmission to other users or health professionals.

ABSTRACT Objective: to describe the experience of building the technology "Care for the prevention of COVID-19 in post-hematopoietic stem cell transplant patients". Methods: experience report conducted in a hematopoietic stem cell transplant outpatient clinic that supported the construction of an educational technology in the form of a booklet for the prevention of COVID-19. In May 2020, a literature review in scientific databases and guidelines of health organizations were used for its development. Results: printed booklet with information on the definition of coronavirus, hand hygiene, use of the mask by the patient and caregiver, isolation and social distancing and general hygiene care. Final Considerations: the use of technologies is characterized as a tool for educational actions therefore, nurses, patients and caregivers benefit from guidance processes for health care. The developed technology has the potential to minimize the impact and spread of SARS-CoV-2 among high-risk populations.

ABSTRACT Objective: to analyze the spatial distribution of elder abuse in Ribeirão Preto-SP, according to victims’ place of residence and event. Method: an ecological study that analyzed 1,153 elder abuse police reports (2009 to 2013). Local gross and empirical Bayesian rates and Local Moran’s I were calculated. Results: there was a heterogeneous distribution of concentration of sectors with a high incidence rate surrounded by neighbors with also high rates, considering place of residence. In contrast, analysis by place of occurrence showed a greater concentration in the central areas of the municipality. More than 80% of cases of violence occurred at their own homes and with spatial dependence on distribution by occurrence up to a 5,000 m distance from their places of residence. Conclusion: data reinforce that violence is a complex phenomenon, affecting several social strata, including in central urban areas and in elderly people families’ own context.

ABSTRACT Objective: to analyze the actions and suggestions of Primary Care professionals in relation to elder abuse. Method: this is a research with a qualitative approach based on the realization of focus groups with professionals from Primary Health Care in a city in the interior of São Paulo. The methodological stance of Hermeneutic-Dialectic thinking (HD) was adopted. Results: two themes were listed: Actions taken by health professionals and Suggestions for improving care for elderly victims of violence. Final considerations: professionals emphasized the need to implement new resources and improve the functioning of existing ones, so that comprehensive care is possible, in order to prevent and intervene in the important social and public health problem that violence represents.

ABSTRACT Objective: to assess the results of a training program focused on the well-being of elderly individuals from the perspective of users, through the opinion on the program impact on their active aging. Methods: a qualitative research, carried out from an intentional sample, consisting of 10 elderly women. Interview conducted by focus group, recorded and transcribed, which constituted the corpus of analysis. Lexical analysis of textual data was performed using the Alceste software. Results: from the analysis, three classes emerged: 1) Health-Activity; 2) Activity-Expectation; 3) Mind-Body Unit. The Activity-Expectation class stands out. Conclusions: the research revealed that elderly individuals consider it important to have expectation, which results in satisfaction and involvement with life as well as the ability to remain active in a perspective of mind-body unit. Future projects should focus on enhancing mental and physical functions to promote active and healthy aging.

ABSTRACT Objective: to identify the association between the characteristics of the support network and cognitive performance of older caregivers and compare characteristics between caregivers and non-caregivers. Methods: we evaluated 85 older caregivers and 84 older non-caregivers registered with primary care units regarding sociodemographic characteristics, cognition, and social support. Multiple linear regression analysis was performed. Results: among non-caregivers, significant associations were found between a better cognitive performance and receiving emotional/affectionate support; each one-point increase in the emotional support score and affectionate support score was related to a 0.43-point and 0.39-point increase in cognitive assessment, respectively. Among older caregivers, each one-point increase in the emotional support score was related to a 0.55-point increase in cognitive assessment. Conclusion: strengthening the support networks of older caregivers and encouraging satisfactory exchanges of social support can assist in improving cognitive performance, which can have a positive impact on caregivers’ health.

ABSTRACT Objective: To validate the defining characteristics of the nursing diagnoses, impaired memory and chronic confusion for older adults, by testing diagnostic concept definitions among expert nurses. Methods: We used a Diagnostic content validation using an online survey of expert clinical nurses. Results: 195 expert nurses performed the diagnostic validations. Findings provided validity of impaired memory with 11 major defining characteristics and chronic confusion, with 11 major and one minor defining characteristics. In both diagnoses, content validity index was 0.85. Factor analysis provided four and five supported factors for impaired memory and chronic confusion, respectively. Conclusion: The study provided evidence of validity of the two diagnoses and made them clearer. Using these updated nursing diagnoses, nurses have the potential to improve accuracy and quality of care for elderly patients, contributing to more accurate nursing gerontological care.

ABSTRACT Objective: to analyze the oral hygiene care for hospitalized elderly patients provided by the nursing staff. Method: this is a qualitative, exploratory-descriptive study carried out in a university hospital, with the participation of 35 professionals from the nursing staff. Data collection was carried out through semi-structured interviews, explored through thematic content analysis. Results: two categories emerged: The oral hygiene of hospitalized elderly patients as an extension of body care and Barriers in (lack of) care with the oral hygiene of hospitalized elderly patients, with two subcategories: The oral hygiene and dental prosthesis technique performed divergently; Care hampered by deficit of materials and human resources. Final considerations: this study showed weaknesses in the oral hygiene care of hospitalized elderly patients, promoting reflections on the practice informed in data and management actions, allowing recommendations of care standards for the nursing staff.

ABSTRACT Objective: to understand elderly people’s experiences in emergencies through access to other levels of health care. Methods: a phenomenological study in the light of Heidegger, conducted with 19 elderly patients admitted to an Emergency Care Unit of the city of Salvador, between April and October 2019. Results: ontic primacy: Disposition of the experience of elderly people waiting for regulation; Constitutional anguish and fear in the willingness to be an elderly person waiting for regulation in an Emergency Care Unit; Inappropriate elderly being suppressed while waiting for regulation; Being an elderly person unveiled in the existential modality of being for death. Ontological primacy: Heal how to be the presence of elderly people waiting for regulation. Final considerations: elderly people being anguished and afraid, feelings that allow the questioning of their own being, who want a healing and seeks ways that allows an active and proper participation in care.

ABSTRACT Objective: to identify sociodemographic and health characteristics according to age groups and to analyze the association between self-assessed health status and satisfaction with regular/bad life with sociodemographic characteristics, global functioning and falls of older adults linked to home care within the primary health care network. Method: cross-sectional study with 124 older adults, conducted using home interviews. A sociodemographic data and health status questionnaire was used, together with Barthel Index, Lawton Instrumental Activities of Daily Living Scale (IADL), the Mini-Mental State Examination, the Geriatric Depression Scale and the Timed Up and Go Test. Bivariate and multivariate analyses (Poisson regression) were applied. Results: there was a predominance of female octogenarians. Self-assessment of regular/bad health was associated with mild (p=0.002) and severe (p<0.001) depressive symptoms. Satisfaction with regular/bad life was associated with fear of falling (p=0.019) and with mild (p<0.001) and severe (p<0.001) depressive symptoms. Conclusion: depressive symptoms were associated with a worse life satisfaction and health self-assessment.

ABSTRACT Objective: to verify the validity and reliability of the Psychological Distress Scale for screening mental distress. Methods: a cross-sectional study with 75 elderly people. Psychological Distress scale and Self Reporting Questionnaire were used. Criterion validity was verified using Spearman’s correlation and diagnostic accuracy measures. Cronbach’s alpha coefficient was used to investigate reliability. Results: the total internal consistency of the Psychological Distress Scale was α=0.844. Concurrent validity between this instrument and the Self Reporting Questionnaire was ρ=0.722 (p<0.001). The best cut-off point for screening mental distress among elderly people was a total score greater than 14, with sensitivity equal to 75.47% and specificity equal to 85.0%. Conclusions: the scale was robust for screening mental distress, given its high reliability, in terms of homogeneity, and adequate criterion validity, whose best cut-off point for screening was a score greater than 14.

ABSTRACT Objective: to know the perception of nurses, undergraduate students, and professors about the competencies for professional nurses in elder care. Methods: this is a qualitative analytical study developed with six professors, four nurses, and 12 nursing students. Data were collected through semi-structured interviews and analyzed using Fiorin’s Discourse technique, with support from the MAXQDA software. Results: the competencies identified included knowledge of theories and general concepts of gerontology, communication, listening, leadership, teamwork, proactivity, respect, and empathy. Final considerations: knowing the competencies contributes to understanding the aging process and qualifying nurses for elder care.

ABSTRACT Objective: to assess elderly people’s quality of life, understanding the social representations of falls. Methods: a convergent mixed methods research carried out at homes, with a sample of 134 elderly people. A structured questionnaire was used, covering sociodemographic variables and factors that indicated frailty and risk of falling. For quality of life assessment, Medical Outcomes Study Short-Form 36 and Theory of Social Representations, Abric’s structural approach were used, with data treated by dictionary of equivalent terms, processed in Evoc 2000, converging analytically according to Neuman. Results: quality of life impairment was identified in terms of physical, emotional and functional capacity. The elements of the possible central nucleus were fall, fear, and bruised-broken-bone. Final considerations: quality of life impairment can contribute to increase the number of falls, which has been shown to be an event present in elderly people’s lives through evocations. Understanding elderly people’s individual demands allows planning actions.

ABSTRACT Objective: to compare cognitive performance of elderly caregivers with and without chronic pain over four years and verify the effect of pain intensity on cognitive performance of elderly caregivers with chronic pain. Method: a longitudinal study with data collected in 2014 and 2018. Community-dwelling elderly caregivers of a Brazilian city participated in the study. Cognition was assessed using the Addenbrooke’s Cognitive Examination instrument. Pain was assessed by an 11-point scale. For data analysis, a mixed linear model and ANCOVA with a 5% significance level were used. Results: they were divided into two groups. A cognitive decline over four years was found in elderly people with pain (p=0.02; 95%CI=0.32-4.25), while those without pain did not show a significant change. Conclusion: the results show that elderly caregivers with pain had a worse cognitive performance, but when comparing groups with the ANCOVA test for intergroup analysis, there was no difference in cognitive performance.