Revista Cuidarte最新文献

Introduction: Prenatal care is essential for maternal and neonatal health. Nursing professionals play a key role in providing comprehensive care.

Objective: To analyze the concept of prenatal caring in the context of maternal-perinatal care from the perspective of nursing professionals and pregnant women.

Materials and methods: The concept was developed using the hybrid model by Schwartz-Barcott and Kim, which comprises theoretical, fieldwork, and analytical phases. The first step included a review of 23 articles published between 2012 and 2022, sourced from various databases. Then, five interviews were conducted with low-risk pregnant women and five with nursing professionals, followed by inductive content analysis using ATLAS Ti® software. Finally, a general definition was formulated.

Results: Prenatal caring is defined as a humanized interaction between the pregnant woman, her family, and nursing professionals, grounded in kindness, respect, and commitment. It requires empathy, attentiveness to individual needs, and a focus that goes beyond technical procedures to emphasize holistic well-being.

Discussion: A distinction is drawn between prenatal care and prenatal caring, the latter being understood as a woman- and family-centered process. Operational and time constraints hinder the delivery of this care, highlighting the need to strengthen nursing leadership and foster care models that prioritize maternal and infant well-being.

Conclusion: Prenatal caring in nursing addresses the emotional and relational needs of pregnant women and their families. It enhances adherence to prenatal checkups, contributes to the reduction of mortality, and supports preparation for childbirth. It reaffirms an approach centered on the woman, her unborn child, her partner, and the family.

Introduction: Facing a chronic disease such as colorectal cancer with a colostomy is a process that represents changes in people's quality of life. Addressing this experience is an enriching process that strengthens self-management interventions.

Objective: To describe the self-management experience of adults with colostomy due to colorectal cancer.

Materials and methods: A qualitative study with a descriptive phenomenological approach was conducted. Ten people over 18 years of age with colorectal cancer with temporary or permanent colostomies of at least 6 months' evolution participated voluntarily in semi-structured interviews. Data were analyzed using the Colaizzi analysis method.

Results: Eight categories are associated with the phenomenon, and thirty nominal codes represent the experience. The spiritual dimension, social support, coping with colostomy-related difficulties, and experiencing psychosocial changes were identified as factors that influence self-management, as well as practices and behaviors, such as self-management skills, living a new reality, adapting to the colostomy, and support and learning from the healthcare team and system.

Discussion: The difficulties experienced, family and social support, social effects, and spiritual support are consistent with the literature. This research highlights the difficulties with access to supplies, helping others, nicknaming the stoma, and the interactions with the health system.

Conclusion: Knowing the self-management experience, influencing factors, and practices contributes to implementing interventions with a better impact aimed at improving the quality of life and the new life experience of having a colostomy.

Introduction: Transcendence is a metaphysical phenomenon of the self that is reflected in caregivers by transforming their attitudes, perceptions, and caregiving meanings about the care recipient and themselves.

Objective: To develop and validate the content of the "Transcend" instrument through expert judgment and to determine its preliminary reliability.

Materials and methods: This methodological study focused on the design and content validation, via expert judgment, of an instrument to measure family caregiver transcendence called "Transcend," following the methodology proposed by Waltz. The judges assessed instrument's clarity, coherence, and relevance. After validation, the instrument was administered to 30 caregivers to assess its clarity in the population and its preliminary reliability.

Results: Fifteen judges participated in the validation process, and a significant level of agreement was found (p < 0.001) in assessing clarity, coherence, and relevance. The content validity index, both individual and global, was 1.00. All items obtained an Aiken's V value ≥ 0.69, with values falling within the confidence intervals. Preliminary reliability in the pilot testing yielded a Cronbach's alpha of 0.90.

Discussion: Validity and concordance indices should be interpreted together to determine the level of content validity based on expert judgment.

Conclusion: The Transcend instrument shows adequate content validity and high preliminary reliability, supporting its progression to a second phase of validation, which will be crucial to determining its potential as a tool for assessing transcendence in family caregivers.

Introduction: Humanization of care is a need demanded by users, and it is necessary to generate evidence that identifies both strengths and shortcomings in nurse-patient care.

Objective: To determine the perception of adult patients regarding the humanized care provided by nursing professionals in a hospital in the Southern Zone of Chile.

Materials and methods: A cross-sectional and analytical study was conducted using a sociodemographic survey and the third version of the Perception of Behavior Related to Humanized Nursing Care (PCHE) instrument, which reports an internal consistency determined by Cronbach's alpha of 0.96. A non-probabilistic convenience sampling method was applied, and the ethical principles proposed by Ezekiel J. Emanuel were upheld.

Results: Overall, most patients perceived that nurses always delivered humanized care. When comparing the mean scores of the PCHE dimensions with sociodemographic variables, significant differences were found in relation to sex and educational level: men with secondary education reported higher scores.

Discussion: The perception of humanized care among hospitalized adult patients was more favorable than in a Mexican study but lower than the findings of a Chilean study conducted in a Hemato-Oncology Unit.

Conclusion: As the lowest scores were observed in the openness to nurse-patient communication dimension, developing strategies to strengthen this bond is essential.

Introduction: Hospital-at-home programs rely on vascular access devices for secure administration of parenteral antimicrobials. While guidelines recommend peripherally inserted central catheters (PICC) for treatments ≥14 days, short peripheral catheters (SPC) are often used instead. Cost-effectiveness studies comparing these devices and their complications are limited.

Objective: This study conducted an economic evaluation comparing PICC and SPC for patient outpatient parenteral antibiotic therapy.

Materials and methods: A literature review of catheter complication frequencies yielded 1053 papers, narrowed to 18 after independent peer review. Experts were consulted, and a list of items required for catheter use was compiled to determine costs. A decision tree model was developed based on complication frequencies and costs. Results were analyzed using incremental cost-effectiveness ratios (ICER), univariate sensitivity analysis (tornado diagram), and multivariate sensitivity analysis (Monte Carlo simulation).

Results: Major complications were similar between devices, but minor complications were more frequent with SPC. The PICC reference case assumed 50%-50% radiologist/nurse insertion, catheter cost ($74,7), ≤15-day treatment, and complication prevalence. Higher costs associated with PICC were linked to catheter material and radiologist insertion. Multivariate analysis showed ICERs of $49,2 with 90% nurse-led insertion and $24,3 with 100% nurse-led insertions, assuming a 50% PICC price reduction.

Discussion: PICC was more effective in reducing minor complications. Costs decreased with nurse-led insertions and lower catheter material costs.

Conclusion: Increasing PICC use for extended treatments could reduce overall costs and lower ICERs, highlighting their potential economic advantage despite higher initial expenses.

Introduction: One of the attributes that attest to the effectiveness of postpartum care is the longitudinality of health care, which must be offered by Primary Health Care, an entity responsible for offering support and attention to maternal demands or women's health conditions.

Objective: To investigate the frequency of postpartum consultations and the factors associated with low adherence to follow-up among postpartum women living in a municipality in the interior of the Northeast.

Materials and methods: Cross-sectional study, developed in the urban area of the municipality of Senhor do Bonfim, Bahia, Brazil, between June 2019 and January 2020. 97 women were surveyed, based on semi-structured interviews. The Chi-square/Fisher's Exact and Multiple Logistic Regression tests were used to perform data analysis.

Results: There was 67% attendance at the postpartum consultation. Furthermore, an association was found between not having attended a postpartum consultation and the following variables: having attended prenatal care at the Basic Health Unit (OR: 0.08; p=0.002) and not having received guidance during prenatal care about the importance of returning for postpartum follow-up (OR: 0.22; p=0.004).

Discussion: It is important to highlight that even with the existence of national protocols, states and municipalities can implement measures to improve postpartum care based on their respective realities.

Conclusion: A low frequency of postpartum consultations was observed among the women surveyed, and the main reason for non-attendance was the difficulty in going to the consultation due to lack of time. In addition, the lack of continuity of care after childbirth among women who attended prenatal care at the SUS stands out.

Introduction: According to the World Health Organization, stroke is a clinical condition characterized by the sudden development of focal or global signs and symptoms in cerebral functions and is the second leading cause of death and the third leading cause of disability worldwide.

Objective: This study aimed to determine the levels of illness acceptance, health perception, and hopelessness of stroke survivors and to examine the relationship between these variables.

Materials and methods: This study was conducted with 170 stroke survivors. Data were collected with the "Descriptive Information Form," "Modified Barthel Index," "Acceptance of Illness Scale," "Perception of Health Scale," and "Beck Hopelessness Scale." The data were analyzed using SPSS 21.0 software.

Results: Participants showed moderate levels of illness acceptance and mild levels of hopelessness. The mean health perception score was 50.30±0.59. A significant relationship was found between age, education, employment status, living arrangements, illness duration, post-stroke deficits, independence level, illness acceptance, health perception, and hopelessness levels. The health perception and hopelessness levels of the participants decreased as their level of illness acceptance increased. Increasing health perception levels were also found to increase hopelessness levels.

Discussion: When the literature is reviewed, there are studies that support our findings in stroke and other chronic illnesses, but there are also studies with different results.

Conclusion: The study results draw attention to the levels of illness acceptance, health perception, and hope, which have not been discussed much but have important effects on the illness and rehabilitation process.

Introduction: In Chile, the International Migrant Health Policy (PSMI in Spanish) mandates the inclusion of topics such as migration, interculturality, human rights, social determinants of health, and gender in higher education curricula. However, it is unknown whether this effectively happens.

Objective: To understand the materialization of the PSMI in health sciences curricula.

Materials and methods: This interpretative/hermeneutic study included semi-structured interviews with program directors, academic faculty, clinical professors, and students. It also involved a document analysis across different health sciences degree programs at three regional universities in Chile. Data analysis included open, axial, and selective coding with ATLAS.ti version 24.

Results: A total of 179 informants participated. Three main categories emerged: Health Institution Setting, University Institution Setting, and Degree Program Setting, each comprising facilitating or hindering subcategories for materializing policy materialization. The hermeneutic analysis made it possible to interrelate these subcategories, producing a semantic network to understand the phenomenon. Facilitators were scarce and isolated from the network core, while hindrances were more numerous, cohesive, and robust, reinforcing an ethnocentric model of professional education validated by ethnocentric healthcare practices in clinical settings.

Discussion: The concept of "cultural blinders" is proposed in place of "cultural blindness" as there is awareness of the cultural influences on healthcare that are nonetheless not integrated.

Conclusion: Current curricula do not align with the PSMI. Coordinated policies between the Ministry of Education and the Ministry of Health are imperative to reverse the existing healthcare status quo.

Introduction: Water is an essential resource for survival, and therefore, its quality and safety must be a priority, especially for susceptible population groups.

Objective: To determine the presence of mesophilic aerobes, coliforms, and Pseudomonas in drinking water in schools from three municipalities of Norte de Santander.

Materials and methods: Maintenance personnel were inquired about water storage. Samples from different sources were collected and processed using the membrane filtration method to identify aerobic mesophilic bacteria, E. coli, coliforms, Pseudomonas spp., and Salmonella spp. following the technical standards established for each microorganism.

Results: Mesophilic bacteria growth was identified in 77.50% of the samples, total coliforms in 84.00%, fecal coliforms in 72.00%, and Escherichia coli in 21%. Pseudomonas spp. was also identified in 73.00% of the samples and Salmonella spp. in 10.50%.

Discussion: These findings reflect non-compliance with current regulations due to the presence of indicator organisms such as mesophiles and the indicator par excellence in water quality: coliforms, a fact that is ratified by the presence of Pseudomonas spp. and Salmonella spp.

Conclusion: The presence of these microorganisms is associated with failures in the water purification process, which allows us to expose the need for corrective actions to guarantee the microbiological quality of water and ensure health.