Revista gaucha de enfermagem / EENFUFRGS最新文献

Objective: To uncover the factors that deteriorate the work environment during shift exchanges.

Method: This is a qualitative, descriptive-analytical study using the phenomenological method, based on Elton Mayo's human relations theory. The setting was a second-level hospital. A total of thirty-two participants were included. The social actors included were general nurses, specialists, and service managers. Data collection was carried out using interviews and non-participant observation techniques, conducted in September-October 2021. Data analysis was performed in three stages: epoché, description, and horizontalization. The chromatic technique was used for analysis.

Results: The main findings converge into three categories: workload, as it affects the quality of care; absenteeism, which increases handover time; and interpersonal relationships, which influence the handover process. Observations allowed for the creation of a shift exchange model represented by a flowchart and a patient reception instrument.

Final considerations: Workload and interpersonal relationships directly influence the work environment.

Objective: To describe the obstetric racism suffered by black women as from their perceptions and experiences in prenatal and childbirth care.

Method: A descriptive qualitative study was conducted from February to May 2021. The participants were 22 black women who lived in the municipalities of Rio de Janeiro, São Paulo, Porto Alegre, and Salvador, who had a natural birth or cesarean section during the first year of the COVID-19. The semi-structured interviews were conducted via video conference and/or video call. These women were recruited through social networks. Thematic Analysis and references on racism in obstetric care guided the analytical process.

Results: the participants suffered violence, mistreatment, negligence, racial discrimination, and prejudice during prenatal and childbirth care, causing negative experiences with attendance in public and private services. The black women adopted strategies in the face of obstetric racism: seeking maternity hospitals other than the reference units, changing the health professional and/or service of private health insurance, and hiring professionals for childbirth.

Conclusion: obstetric racism manifests itself as violence, discrimination, and prejudice suffered by black women during prenatal, childbirth, and postpartum care. The confrontation of racism requires collective and collaborative actions from political, healthcare, professional, and educational health.

Objective: To develop an educational WebQuest to prevent incidents related to medication administration.

Method: Methodological study of construction and evaluation, developed in two stages: Construction of technology with identification of domains and generation of items for the Assessment Instrument. The technology assessment involved three phases: Content Assessment by Experts; Review and Reformulation; Pilot test. 15 experts participated in the content evaluation, and 35 nursing professionals participated in the pilot test. In data analysis, the Content Validity Ratio was applied, considered valid when the index reached > 0.600 in the first round and > 0.778 in the second.

Results: The WebQuest presented adequate indexes regarding technical aspects (> 0.87) and pedagogical aspects (1.0) in the first round of evaluation, while the Instrument was considered adequate (> 0.78) after the second round. The proportion of correct answers was significantly higher after browsing the WebQuest (p-value <0.001), increasing from 31.63% in the pre-test to 87.76% in the post-test.

Conclusion: The WebQuest and the Knowledge Verification Instrument had their contents considered adequate by experts. The WebQuest proved to be an effective educational tool to expand the nursing team's knowledge on preventing incidents in medication administration.

Objective: To assess the quality of the transition from hospital to home care and the quality of life of people with stomas.

Method: A cross-sectional study conducted with 84 patients from the Hospital de Clínicas of the Universidade Estadual de Campinas, after surgery for a stoma. The Care Transitions Measure and Stoma-QoL instruments were applied by telephone between April 2022 and August 2023. Descriptive and analytical statistical analysis was performed.

Results: The total score of the Care Transitions Measure was 65.18±9.18. "Care plan" had the highest score (66.97±12.27) and "Understanding of medications" the lowest (63.82±10.45). The Stoma-QoL instrument score was 50.43±11.50. The domain "Social relationships outside family and close friends" had the highest mean score, while "Need for rest during the day" had the lowest mean score.

Conclusion: The transition of care was assessed as moderate, suggesting potential implications for quality of life, especially regarding social aspects, perceived safety in the use of devices and willingness to carry out daily activities.

Objective: To assess the level of satisfaction among the companions of children awaiting elective medical care due to their participation in a Musical Visit project.

Method: A quasi-experimental study with independent samples, conducted with companions of children awaiting outpatient care at a university hospital in Maranhão, Brazil, between January and April 2022. The participants were divided into two groups: exposed to the project (n=163) and control (n=163). All participants completed a Likert-type questionnaire assessing satisfaction regarding structure, comfort, hygiene, organization, waiting time for consultations and exams, and trust in the service. The exposed group also evaluated the Musical Visit project. Descriptive statistical analysis was performed, and the groups were compared using Chi-square and Fisher's exact tests.

Results: Satisfaction did not differ between groups for most of the items evaluated; however, waiting time for consultation and comfort in the office showed lower satisfaction in the exposed group (p<0.05). The ratings for the project were high (9.6±1.2).

Conclusion: Both groups showed positive levels of satisfaction; however, regarding participation in the project, there was no difference in most of the evaluated items. Waiting time and comfort in the environment are aspects that require attention and improvement.

Objective: Identify the incidence of exclusive breastfeeding in the sixth month of life and associated factors according to care received during hospitalization for birth.

Method: A prospective cohort study was conducted in two hospitals (A and B) in Guarapuava, Paraná, Brazil, with 291 pregnant women/puerperal women. Data collection was performed in four moments through interviews and the completion of questionnaires. The outcome variable was the duration of exclusive breastfeeding, while the independent variables were the characteristics of the care received during hospitalization for birth. The proportion difference test was used, with presentation of relative risk.

Results: The incidence of exclusive breastfeeding in the sixth month of the newborn in hospital A and B was 13.8% and 13.0%, respectively. The absence of formula supplementation to the newborn showed a significant association of protection to exclusive breastfeeding. The lack of guidance on breastfeeding techniques and late initiation of breastfeeding showed a significant association for the interruption of exclusive breastfeeding.

Conclusion: The care received during hospitalization for birth was associated with the duration of exclusive breastfeeding. It reinforces the implementation of intra-hospital strategies that promote exclusive breastfeeding, aiming at increasing its rates and favoring maternal and child health.

Objective: To assess the compliance with the Nutrition Therapy Quality Indicator "prescribed versus infused volume".

Method: Secondary data analysis, performed in four adult wards (clinical and surgical) of a Brazilian university hospital. Data were prospectively collected in two sequential periods - between June and November 2017 (cohort 1) and from May 2018 to May 2019 (cohort 2). The difference between the prescribed and infused diet volume was assessed using the Wilcoxon test; and to measure the relationship between the difference and the mean difference of the prescribed and infused volumes, the method suggested by Bland and Altman was applied.

Results: A total of 494 patients were included. It was observed that patients received, on average, less enteral nutrition than prescribed (-601.3±430ml/day), which represented approximately 46% less diet; only 17.7% of patients were able to reach the target for this indicator (infusion of ≥80% of the prescribed volume). Furthermore, no patients received the entire prescribed volume during the established period.

Conclusion: The volume of diet infused was substantially lower than that prescribed, resulting in low compliance of the indicator monitored in the wards.

Objective: To verify the effectiveness of AccuVeinAV300® in the success of peripheral intravenous catheterization in adults with difficult intravenous access, compared to the traditional clinical method.

Method: This is a description of the protocol for a randomized controlled clinical trial in a parallel, non-blinded group. It will be carried out with patients from the medical and surgical clinics of a university hospital. The sample will be determined after a pilot study with 60 patients. Inclusion criteria will be age 18 or above, difficult intravenous access and no clinical deterioration. Participants in the intervention group will undergo peripheral intravenous catheterization with the AccuVeinAV300®, which is a vein viewer with a near-infrared light emitter. For patients in the control group, the procedure will take place using the traditional clinical method, using inspection and palpation. The procedure will be considered successful when the catheter is inserted on the first attempt with blood reflux, as long as it is possible to infuse 10 ml of saline solution without complications. Data collected will include observation of peripheral intravenous catheterization, information collected from the patient, and from medical records. Data analysis will be descriptive, univariate and multiple. RBR-6jm5zht.

Objective: To generate evidence regarding the validity of the internal structure and consistency of the Self-Care of Chronic Illness Inventory - Brazilian Version and its relationship with health-related quality of life.

Method: A psychometric study of instrument validation was carried out with 227 adults (female=74.89%; mean age= 58.03±13.2 years) with chronic illnesses who answered the instrument adapted for Brazil. Internal structural validity was studied by confirmatory factor analysis, the relationship with health-related quality of life was analyzed by correlation with health-related quality of life, and internal consistency by the omega coefficient.

Results: The theoretical structure of the instrument was confirmed with three domains and good fit indexes and 18 of the 20 items had factorial loadings above 0.3; the omega coefficient was 0.929; and participants with better self-care scores had better quality of life scores.

Conclusion: The Self-Care of Chronic Illness Inventory - Brazilian Version provides good evidence of internal validity and consistency for studying self-care in chronic diseases in Brazil.

Objective: To explore the available evidence on the cultural competence of health professionals in the care of cancer patients.

Methods: Scoping review carried out between April and May 2024. The databases Scopus, Medline (via Pubmed) and BVS (Lilacs) were used as sources. The sample included articles from the last ten years, resulting from primary research, literature reviews and systematic reviews in English, Portuguese and Spanish. Data were manually extracted and analyzed using an inductive thematic construction process.

Results: 31 studies were included, mostly quantitative research produced in North America. Four themes emerged from the synthesis: 1) Barriers to culturally competent care in oncology settings; 2) Strategies for implementing cultural practices; 3) Intervention measures to improve the cultural competence of oncology care providers; and 4) Outcomes of cultural competence on patient satisfaction and professional development.

Conclusion: Evidence reveals that cultural barriers limit effective cancer care. However, strategies and interventions to improve cultural competence increase patient satisfaction and benefit providers' professional development in oncology care.