Revista Brasileira De Enfermagem最新文献

Objectives: to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification.

Methods: this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression.

Results: higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5).

Conclusions: although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.

Objective: To describe the possibility of applying Fuzzy Logic in analyzing the vulnerability of Women Who Have Sex with Women to Sexually Transmitted Infections/HIV/AIDS.

Methods: We developed a Fuzzy Logic system with 17 input variables and one output variable, using data related to vulnerability in a municipality located in the Midwest region of the State of São Paulo, Brazil.

Results: The factor with the greatest positive impact was the confirmation that a low understanding of Sexually Transmitted Infections/HIV/AIDS is associated with higher vulnerability. Conversely, the statement "Not disclosing sexual activity to healthcare professionals," where individuals do not admit to having sex with women, had the least impact.

Conclusions: Fuzzy Logic facilitates the identification of vulnerability, expressed through the analysis of interaction between variables in each dimension. This makes it a promising method to assist in analyzing the vulnerability of specific populations.

Objectives: to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020.

Methods: the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined.

Results: 676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system.

Conclusions: characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.

Objectives: to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.

Methods: an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.

Results: there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables "family history of cancer" (p<0.001), "alcoholism" (p<0.001), "smoking" (p<0.001), "TNM staging" (p<0.001) had a decreasing trend, while "clinical start of treatment" (p<0.001), "origin" (p=0.008) and "occupation" (p<0.001) indicated an increasing trend.

Conclusions: most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.

Objectives: to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.

Methods: a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers' contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman's correlation.

Results: the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.

Conclusions: informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.

Objectives: to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.

Methods: single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.

Results: the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.

Final considerations: the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.

Objective: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients.

Methods: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023.

Results: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure.

Final considerations: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

Objectives: To analyze nurses' perspectives on nurses' work methods in the hospital context.

Methods: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software.

Results: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions."

Final considerations: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.

Objective: To analyze the knowledge of professionals working in a Nursing Home about the Nursing Process before and after the awareness workshop.

Methods: This is strategic action research, developed with nursing professionals and managers of a Nursing Home in Rio Grande do Sul, Brazil. Data were collected between January and June 2023, through semi-structured interviews before and after an awareness workshop. Discursive textual analysis of the data was carried out.

Results: The central category "Understanding about the Nursing Process in Nursing Homes" emerged, which was unitized into two units of meaning and three categories of analysis.

Conclusion: Data revealed non-use and lack of knowledge of the Nursing Process before awareness raising. Afterwards, a deeper understanding of the topic and its importance was identified. Awareness-raising workshops contribute to transformation of knowledge.

Objectives: to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.

Methods: this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.

Results: the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.

Conclusions: patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.