Nevin Manimala

Rev Bras Enferm. 2021 Jun 11;74(suppl 4):e20200138. doi: 10.1590/0034-7167-2020-0138. eCollection 2021.

ABSTRACT

OBJECTIVE: to analyze the association of skin-to-skin contact and social determinants of health.

METHODS: this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval.

RESULTS: 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines.

CONCLUSION: skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.

PMID:34133704 | DOI:10.1590/0034-7167-2020-0138

Rev Assoc Med Bras (1992). 2021 Jun 9:S0104-42302021005002206. doi: 10.1590/1806-9282.67.01.20200487. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to demonstrate the clinical utility of CHA2DS2-VASc and anticoagulation and risk factors in atrial fibrillation risk scores in the assessment of one year mortality in patients with abdominal aortic aneurysm.

METHODS: We designed a retrospective cohort study using data from Suleyman Demirel University Hospital for the diagnosis of abdominal aortic aneurysm. The study included 120 patients with abdominal aortic aneurysm who underwent aortic computed tomography. Patients were divided into two groups according to presence of abdominal aortic aneurysm and the development of mortality. Predictors of mortality were determined by multiple logistic regression analysis.

RESULTS: Multivariate regression analysis showed that CHA2DS2-VASc score, advanced age, female gender and elevated white blood cell counts were independent predictors of abdominal aortic aneurysm development while CHA2DS2-VASc score and elevated glucose levels were independent predictors of one year mortality in patients with abdominal aortic aneurysm. The concordance statistics for anticoagulation and risk factors in atrial fibrillation risk Score and CHA2DS2-VASc risk score respectively were 0.96 and 0.97 and could significantly predict one year mortality in patients with abdominal aortic aneurysm (p<0.001, and p<0.001, respectively).

CONCLUSIONS: CHA2DS2-VASc and anticoagulation and risk factors in atrial fibrillation risk scores are easily obtained in an emergency setting and can accurately predict one year mortality as a noninvasive follow-up in patients with abdominal aortic aneurysm. These simple scores could be used as a point of care decision aid to help the clinician in counseling patients presenting with abdominal aortic aneurysm and their families on treatment protocols.

PMID:34133696 | DOI:10.1590/1806-9282.67.01.20200487

Rev Bras Enferm. 2021 Jun 9;74(3):e20200732. doi: 10.1590/0034-7167-2020-0732. eCollection 2021.

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.

PMID:34133681 | DOI:10.1590/0034-7167-2020-0732

Rev Bras Enferm. 2021 Jun 11;74(2):e20190803. doi: 10.1590/0034-7167-2019-0803. eCollection 2021.

ABSTRACT

OBJECTIVES: to assess the risks of pathogenic suffering related to the experience of nursing workers in the operating room of a university hospital.

METHODS: cross-sectional, quantitative study, carried out from 11/2017 to 01/2018 in a university hospital in the South of Brazil. The sample was composed by 159 nursing workers of the units of a surgical center, that answered to the Scale of Evaluation of Pathogenic Suffering at Work. Data was submitted to statistical analysis.

RESULTS: the workers present low risk of pathogenic suffering related to the experiences at work, being the results of its factors: Uselessness (1.47±0.761) – low risk; Indignity (2.372±1.035) – medium risk; and Disqualification (1.74±0.903) – low risk.

CONCLUSIONS: the evaluation of Pathogenic Suffering at Work Scale was positive, predominating low risk for pathogenic suffering of surgical center workers related to professional experiences, because they feel useful, valued and are not indignant about their work, feelings that reflect on the quality of care provided.

PMID:34133672 | DOI:10.1590/0034-7167-2019-0803

Rev Bras Enferm. 2021 Jun 14;74(6):e20200725. doi: 10.1590/0034-7167-2020-0725. eCollection 2021.

ABSTRACT

OBJECTIVE: Identify the knowledge of family members of children and adolescents with cancer about their legal rights, difficulties, and concessions to ensure them.

METHOD: Quantitative study, survey type, of intersectional design. A questionnaire drawn up by the researchers was applied in order to characterize the minor and their family and also to identify the family’s knowledge about legal rights. Descriptive statistics were used to analyze data.

RESULTS: 61 family members who participated know some more rights to the detriment of others and are especially motivated to search for information when negative impacts on the financial life increase, with repercussions beyond family health.

CONCLUSION: the studied population requires more information and demands knowledge about some rights guaranteed by law. Guidance on rights empowers the family and guarantees the necessary care, searching to have an intersectoral action qualify care and assist in restructuring family dynamics to deal with chronic conditions.

PMID:34133671 | DOI:10.1590/0034-7167-2020-0725

Rev Bras Enferm. 2021 Jun 14;74(6):e20200445. doi: 10.1590/0034-7167-2020-0445. eCollection 2021.

ABSTRACT

OBJECTIVE: to develop and validate a scenario for clinical simulation in nursing education on the management of severe preeclampsia in the puerperium.

METHOD: methodological study in five stages (overview, scenario, scenario design progression, debriefing and assessment), developed from March to December 2019, involving 10 volunteers (one professor, five actors and four judges). Data were analyzed using descriptive statistics and Content Validation Index.

RESULTS: the scenario was built from the definition of learning objectives that meet the needs of nursing education. From the completion of a Likert scale, by the judges in on-site validation, a Content Validity Index of 1.0 was reached, which indicates 100% agreement in the assessed items.

CONCLUSION: the scenario was validated. It is expected that teaching by simulation will be expanded and that new studies of scenario validation will contribute to the preparation of future nurses, based on the most recent scientific evidence.

PMID:34133668 | DOI:10.1590/0034-7167-2020-0445

Clinics (Sao Paulo). 2021 Jun 11;76:e2659. doi: 10.6061/clinics/2021/e2659. eCollection 2021.

ABSTRACT

This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.

PMID:34133659 | DOI:10.6061/clinics/2021/e2659

Rev Esc Enferm USP. 2021 Jun 9;55:e03713. doi: 10.1590/S1980-220X2020002003713. eCollection 2021.

ABSTRACT

OBJECTIVE: To verify the prevalence of burnout and its relationship with the academic satisfaction of nursing students in traditional and integrated curricula.

METHOD: Quantitative, observational, cross-sectional, and analytical descriptive study with nursing undergraduates in two public universities. The data were collected in the classroom through a characterization survey, Maslach Burnout Inventory, and the Nursing Student Satisfaction Scale, and analyzed through inferential and descriptive statistics.

RESULTS: The participants included 301 undergraduate students. The prevalence of burnout in the traditional curriculum was 30.2%; in the integrated one, this was 16.2%. Academic efficacy (p=0.004), satisfaction with curriculum and teaching (p=0.011), and professional and social integration (p<0.001) were higher for students in the integrated curriculum. Satisfaction with the educational environment was higher in the traditional curriculum (p=0.012). Burnout was statistically associated with low academic satisfaction in all dimensions.

CONCLUSION: The prevalence of burnout has differed significantly among students in the analyzed curriculum models and is directly associated with academic satisfaction or lack thereof. Educators should develop preventive actions against burnout in future nurses focusing on the promotion of academic satisfaction.

PMID:34133648 | DOI:10.1590/S1980-220X2020002003713

Cien Saude Colet. 2021 Jun 14;26(suppl 1):2497-2506. doi: 10.1590/1413-81232021266.1.40892020. eCollection 2021.

ABSTRACT

This study diagnosed the situation regarding the physical accessibility of the resident population to primary health care, based on the characteristics of the population served, their spatial distribution in the territory, based on space-time analysis. Thus, bearing the different means of transport available and the specific features of a low-density territory, we considered several mobility profiles under analysis, and selected the Baixo Alentejo as the study area. In methodological terms, besides using the location of primary health facilities and their areas of influence, the use of the road network and its restrictions, we selected the use the new 1×1 km grid, recently implemented throughout the EU (European Union), instead of using the statistical units or administrative boundaries. Its advantages allow overcoming some of the issues of the usual base cartography. The final results can be divided into two groups: conclusions related to the methodologies used and conclusions related to the accessibility of primary health care equipment in the study area.

PMID:34133629 | DOI:10.1590/1413-81232021266.1.40892020

Rev Saude Publica. 2021 Jun 14;55:34. doi: 10.11606/s1518-8787.2021055002534. eCollection 2021.

ABSTRACT

OBJECTIVE: To analyze the effect of a multifaceted intervention in the care of pregnant women with syphilis in primary health care.

METHODS: This is a quality improvement project performed in 26 basic care units in the municipality of Rio de Janeiro, between January and December 2017. It has a quasi-experimental mixed design, with previous, later and time series analyses. We evaluated the care provided to all pregnant women with syphilis whose prenatal care that ended during the studied period, using ten quality criteria and one indicator. The intervention was multifaceted, covering permanent education, improvement of records and information systems, audit and feedback, patient education, organizational changes and work processes. We estimated absolute and relative improvements of the criteria and their statistical significance (α = 5%). The facilitators and hinders of the intervention were analyzed according to the Model for Understanding Success in Quality.

RESULTS: After the intervention, there was a total absolute improvement of 6.7% (64.4% versus 71.0%) and relative of 28.8% (p > 0.05). Eight of the ten quality criteria had an improvement, which was significant in four of them (p < 0.05). The monthly indicator of adequate treatment also improved (p < 0.05), but maintained low performance throughout the project. The increase in the compliance of the treatment scheme with the protocol (91.4% versus 99.1%) positively stood out, but the main opportunities for improvement were testing (42.8% versus 48.5%) and treatment of sexual partnerships (42.8% versus 44.2%). Regulatory pressures to improve the monthly indicator and the political-economic crisis experienced by the municipality modulated the effect of the intervention.

CONCLUSION: The project was useful to identify priorities and guide interventions to improve the quality of care for syphilis, although there is still ample room for improvement. The identified problems, as well as the contextual modulators of the effect, should be considered in future interventions.

PMID:34133619 | DOI:10.11606/s1518-8787.2021055002534