Revista Cuidarte最新文献

Introduction: Patients in intensive care units often experience a decline in oral health. Systematic reports of oral findings in these patients are scarce.

Objective: To document oral cavity lesions in patients in Intensive Care Units.

Materials and methods: A systematic review was conducted, with a literature search across five databases, focusing on publications from 2018 to 2023. The identified articles were imported into the Mendeley reference manager; titles and abstracts were reviewed in pairs and under blinded conditions. Pre-selected articles were exported to the Rayyan application for eligibility assessment. Quality of the studies was assessed using the Joanna Briggs Institute (JBI) tool. This research is classified as risk-free and complies with copyright regulations by exercising citation rights (Law 1915 of 2018 and Law 1032 of 2006).

Results: A total of 1553 articles were identified. Using the PRISMA methodology, 11 studies were included, with 54% retrieved from PubMed and 91% published in English. Toothbrushing was the most frequently documented oral care procedure. Gingivitis and ulcers were the most frequent oral findings.

Discussion: The literature confirms the presence of oral findings in these patients, which are related to their systemic health status, procedures, equipment, and oral health care protocols.

Conclusion: Although oral care is provided at a high rate in critically ill patients, oral alterations and lesions are frequently observed. The involvement of a dentist is essential for the comprehensive care of these patients.

Introduction: Palliative care has recently gained importance in the context of life-threatening diseases, such as cancer, that affect the mental health of patients and their caregivers. Psychological symptoms, such as anxiety and depression, are the most prevalent in this population.

Objective: To determine the association between anxiety, depression, and quality of life of caregivers of palliative care patients with cancer.

Materials and methods: A quantitative, descriptive, and correlational design was used. A total of 190 primary caregivers recruited from Colombian hospitals and home care programs participated. The Quality of Life in Life-Threatening Illness-Family Carer (QOLLTI-FT) questionnaire, the Beck Depression Inventory-II (BDI-II), and the Beck Anxiety Inventory (BAI) were used. The analysis was performed with SPSS Statistics 26.0, using descriptive and inferential statistics.

Results: The predominant sex was female, and the level of education was high school. The mean age of the caregivers was 44.15 years, and the mean age of the patients was 64.51 years. The average time as a caregiver was 33.79 ± 64.77 months. The results show correlations between anxiety and caregiver status (p≤0.000), anxiety and Information and Communication Technology (ICT) use (p≤0.006). There were also correlations between anxiety, quality of life, and caregiver status (p≤0.000) and between depression and total quality of life (p≤0.001).

Discussion: Correlations were also found between depression and quality of life and between hours of daily care and the level of dependency of the cancer patient. This entails the need to manage the psychological symptoms as soon as the family member is diagnosed to prevent alterations in their quality of life that could affect their well-being.

Conclusion: Caregivers with moderate or severe depression were more likely to report symptoms of sadness, punishment feelings, self-dislike, suicidal thoughts or wishes, indecisiveness, irritability, changes in appetite, concentration difficulty, and tiredness or fatigue. Among caregivers with mild depression, loss of interest in sex, agitation, and past failure were identified. Strategies for psycho-emotional counseling, education, and support for caregivers are needed.

Introduction: Students and professionals' difficulty in formulating nursing diagnoses underlines the need to use tools based on expert systems.

Objective: To develop an expert system to formulate nursing diagnoses and to evaluate their attributes.

Materials and methods: This technological-descriptive study was conducted in two phases. The first phase was the design and construction of the expert system and the evaluation of its attributes (usability, functionality, reliability, and portability). In the second phase, 68 people participated, including students and nurses. Two questionnaires were applied, one to evaluate usability (validated by exploratory factor analysis, with a Cronbach's alpha reliability of 0.93) and the other to evaluate the remaining attributes (validated with Aiken's V: 0.91; with a Cronbach's alpha reliability of 0.91). The data were processed in Excel, using descriptive statistics.

Results: An expert system was designed using the NANDA International 2021-2023 as its knowledge base. Its interface allows users to input age group, characteristics, and factors, generating diagnostic labels. Most users rated the attributes of usability (79.41%), functionality (82.35%), reliability (77.94%), and portability (86.76%) as "very good."

Discussion: The DIEN Expert System Version 1 develops skills to identify characteristics and related or risk factors. It familiarizes users with the standardized nursing language and strengthens critical thinking to formulate contextualized diagnoses for the person cared for.

Conclusion: The DIEN Version 1 enables the use of standardized nursing diagnostic language, as it demonstrates the scientific and systematized work in care. The favorable opinion of its attributes by most participants predicts its acceptance in training and care settings.

Introduction: Vascular access teams often use guidelines or algorithms to determine the most appropriate vascular access device based on the patient's condition and the substance to be infused. These guidelines are intended to help identify the most qualified personnel for device insertion, but few studies collect information on the performance of these units.

Objective: This study aims to identify the evolution and complication rate of peripherally inserted central catheters (PICCs) in patients requiring vascular access.

Materials and methods: A prospective observational study was conducted over three years. Continuous variables with normal distribution were compared using Student's t-test. Nonparametrically distributed variables were analyzed with the Mann-Whitney U test. For categorical variables, the two-tailed chi-square or Fisher's exact test was used. Regression analysis was performed for the dependent variable of complications.

Results: Of the PICCs inserted, 61.99% (566) were in patients receiving oncologic treatment, with a mean dwell time of 136±127.51 days. PICCs inserted in hematologic patients had a mean dwell time of 144±141.3 days (p=0.438). The most frequent complications were accidental removal (3.50%, 32, OR 0.581), thrombosis (3%, 27, OR 0.752), and central line-associated bloodstream infection (CLABSI) (2.10%, 19, OR, 0.113).

Discussion: Complications related to PICCs were infrequent, with thrombosis being the most prevalent. Accidental removal was also frequent, a complication not thoroughly analyzed in other studies.

Conclusions: PICC insertion and management by vascular access teams enables units to achieve a low complication rate in onco-hematological patients.

Introduction: Multiple studies have associated sleep duration and quality with changes in blood pressure in the general population, considering it a related risk factor. However, there is limited information regarding hospitalized patients who tend to experience sleep disturbances.

Objective: o examine the relationship between subjective sleep duration, sleep latency, and systolic and diastolic blood pressure in hospitalized patients.

Materials and methods: A cross-sectional study included 381 Mexican adults hospitalized in a secondary-level hospital in Tampico, Tamaulipas, Mexico. Self-reported sleep duration and latency were assessed using the Pittsburgh Sleep Quality Index component. Clinical and sociodemographic data were collected. The study was approved by an ethics committee.

Results: In adjusted models, a significant negative association was found between subjective sleep hours and diastolic blood pressure (β= -0.59; 95% CI: -1.80 to -0.10). A significant positive relationship was observed between sleep latency and systolic blood pressure (β= 1.48; 95% CI: -0.49 to 2.47).

Discussion: The findings are consistent with those of previous studies. Hospitalization can impact sleep due to unfamiliar environments, noise, irregular schedules, and invasive procedures, affecting patients' health and prognosis.

Conclusion: It is essential to consider sleep as a modifiable factor in preventing and managing hypertension in hospitalized patients and to find effective interventions to improve sleep duration and quality.

Introduction: Domestic violence is a multi-causal situation that impacts women, exposing them to significant structural inequalities.

Objective: To identify patterns that perpetuate domestic violence in women through a comprehensive review of the literature, using the ecological model to understand the underlying factors.

Materials and methods: A systematic literature review was conducted in Spanish, English, and Portuguese on patterns associated with domestic violence against women, using the PubMed, Scopus, Sociological Abstracts, and JSTOR databases, following the PRISMA method. Relevant studies were identified and selected based on predefined criteria, and their quality was assessed.

Results: Twenty-two studies were selected that met the relevance and quality criteria. The review reveals that domestic violence is perpetuated through various systems: in the microsystem, patterns such as low educational level, alcohol and drug consumption, and emotional dependence; in the mesosystem, lack of life skills, inability to make decisions, and child abuse; in the exosystem, low income, poverty, unemployment, and criminal records; and in the macrosystem, husband's controlling behavior and society.

Discussion: The comprehensive analysis from different microsystemic, mesosystemic, exosystemic, and macrosystemic perspectives reveals gaps in existing knowledge and reinforces hypotheses about the underlying mechanisms, corroborating similar problems in other studies.

Conclusion: The study provides a comprehensive understanding of domestic violence by analyzing patterns from different systems. This approach guides the development of more effective and informed prevention interventions and policies.

Introduction: Across the world, multiple institutions in the health sector actively promote the adoption and expansion of health technology innovations, driven by their potential benefits in improving medical care quality. The successful integration of health technologies into healthcare settings brings significant changes to work activities and depends, in part, on their acceptance and appropriation by healthcare personnel.

Objective: To determine the content validity of a questionnaire adapted to assess perceptions and attitudes toward health technologies.

Materials and methods: Content validity was assessed through expert judgment using the model proposed by Escobar and Cuervo (2008). A 28-item questionnaire was adapted to assess health personnel's perceptions and attitudes toward technologies, and content validity was determined using Aiken's V coefficient. The Brennan and Prediger coefficient was used to assess agreement among experts.

Results: The Aiken V coefficient was 0.98 (95% CI: 0.88 - 1.00) for the entire instrument. The expert agreement was almost perfect.

Discussion: Most of the studies evaluating perceptions and attitudes toward technologies do not include validation through expert judgment before conducting statistical validation.

Conclusion: According to the criteria of the consulted experts, the questionnaire's content validity is acceptable for assessing perceptions and attitudes toward health technologies.

Introduction: The ethical climate is defined as the shared perception among healthcare professionals of what is ethically correct behavior and how to deal with ethical issues.

Objective: To evaluate the perception of the ethical climate among health professionals working in an emergency room.

Materials and methods: Cross-sectional study carried out with healthcare professionals working in the emergency room of a university hospital in southern Brazil. Collection took place in January 2024 through the Positive Ethical Climate Promotion Platform, through the Hospital Ethical Climate Survey-Brazilian Version instrument. The data was organized and analyzed on the Positive Ethical Climate Promotion Platform, applying descriptive statistics.

Results: 71 health professionals participated in the research, in which the general ethical climate was classified as positive (M=3.73; SD=0.60). The factors were evaluated as positive, except for the medical factor (M=3.23; SD=1.16), classified as negative. Descriptively, female professionals (p=0.063), with a partner (p=0.508), aged over 42 years (p=0.047) and with training time over 17 years (p=0.072) presented high averages for positive ethical climate, however, only age showed a significant association.

Discussion: Despite the positive assessment of the general ethical climate, the importance of self-reflection and self-awareness when making ethical decisions in care is understood.

Conclusion: The general ethical climate and its factors were evaluated as positive, however, the medical factor was perceived as negative.

Introduction: Empathy is an attribute that contributes to humane care of patients and increases the likelihood of successful treatment.

Objective: To measure the levels of empathy and its dimensions, and diagnose empathic behavior in medicine and nursing students.

Materials and methods: This was a non-experimental, cross-sectional study in which Colombian nursing and medicine students were evaluated using the Jefferson Scale of Empathy (JSE). A factor analysis, an analysis of invariance, and a two-way analysis of variance (ANOVA) were used, and the data were compared to specific cut-off points for each program. Effect size and power of the tests were estimated for the comparisons performed.

Results: The theoretical model for the construct 'empathy' fitted the observed data, and the invariance of the model between groups was confirmed. Differences were observed between nursing and medical students, as well as between sexes, with results favoring the women group.

Discussion: The differences found between students could be partly due to the curricular differences of the programs and the students' interests, whereas those related to sex may be due to characteristics observed in Latin American population. The identified empathy deficiencies allowed for the development of a diagnosis for nursing and medicine students.

Conclusion: Based on the findings, it is possible to diagnose the empathy levels of students of both programs by identifying the deficiencies observed in the dimensions of empathy.