Revista da Escola de Enfermagem da U S P最新文献

Objective: To investigate the effects of risk management plus predictive nursing on adolescents with non-suicidal self-injury (NSSI) behavior.

Method: Totally 122 adolescents with NSSI behavior hospitalized during February 2021 and May 2023 were included and categorized into an observation group (n = 61) and a control group (n = 61) according to the type of nursing care they received. Routine nursing was conducted for the control group, whereas risk management plus predictive nursing was performed for the observation group.

Results: No intergroup difference was detected in self-injury behavior from the aspect of incidence rate before intervention (P > 0.05), while in contrast to that in the control group after intervention for 3, 6 and 12 months, it declined in the observation group (P < 0.05). Prior to intervention, no intergroup difference existed in the Social Dysfunction Screening Scale (P > 0.05), while the observation group presented a decrease in the score compared with the control group (P < 0.05). Significantly increased nursing satisfaction was obtained after intervention from the observation group (93.44%) in comparison to that from the control group (77.05%) (P < 0.05).

Conclusion: Risk management plus predictive nursing can alleviate the NSSI behavior of adolescents.

This essay aims to reflect on the complexity of neonatal pain in light of Fritjof Capra's systemic thinking. It analyzes the phenomenon of pain in newborns admitted to neonatal intensive care, highlighting its complex and multidimensional nature. It observes the main characteristics of the neonatal system that guide and support multidisciplinary care from a systemic perspective. A parallel is drawn between the reductionist view, characterized by punctual and isolated interventions, and the view of pain from the perspective of complexity, which leads to integrality, multidisciplinarity, and interconnectivity. Systemic-complex thinking is established as a relevant framework for understanding the multidimensionality of pain perception by newborns admitted to neonatal intensive care units and by care teams, aiming at integrated, multidisciplinary, humanized care sensitive to the particularities of the newborn and their environment. The implications for neonatal nursing include the need for continuous and contextualized pain assessment, the development of competencies for integrated management, and leadership in coordinating multidisciplinary strategies.

Objective: To map existing knowledge on palliative extubation in adult patients admitted to intensive care units.

Method: Scoping review conducted according to JBI guidelines. Searches were conducted between October and December 2024 in seven databases and four repositories, in addition to a reverse search. The selection was independent, the extraction followed a structured protocol, and the report used PRISMA-ScR. The analysis of the results was based on the PAGER framework (Patterns, Advances, Gaps, Evidence for practice and Research recommendations).

Results: The search identified 1,463 materials and included 44 studies. Publications in 2023 predominated. The findings addressed recommendations for practice, time to death, comparison between terminal extubation and terminal weaning, symptom management, experiences and challenges of professionals, as well as aspects related to decision-making and the use of protocols in palliative extubation.

Conclusion: Palliative extubation remains marked by heterogeneous practices and limited production of high-level evidence. There is a need for evidence-based protocols and multidisciplinary training to ensure quality care, dignity, and relief from suffering at the end of life.

Objective: To analyze the effectiveness of the oral administration of rosemary dry extract capsules (Rosmarinus officinalis L.) (1g/day) on the estimated cardiovascular risk, over ten years, in nursing professionals working in emergency and urgent care services.

Method: Quasiexperimental study conducted in Southern Brazil. Participants completed a sociodemographic and clinical questionnaire, had blood collected for glycemic and lipid profile analysis, and took oral capsules containing 500 mg of dry rosemary extract twice a day for 8 weeks; subsequently, a new blood sample was taken. The Framingham Global Risk Score was used to estimate cardiovascular risk. Data analysis used descriptive and inferential statistics; significance level of 5%.

Results: The study included 36 professionals, predominantly obese and those with elevated total cholesterol. When comparing the variables before and after the intervention, differences were found in blood pressure (p = 0.048), in total cholesterol (p < 0.001), and in the Framingham Global Risk Score (p = 0.047).

Conclusion: Dry rosemary extract was effective in reducing the estimated cardiovascular risk of nursing professionals. Brazilian Registry of Clinical Trials No. RBR 88hrnnw.

Objectives: To assess the health literacy (HL) of patients in the pre- or postoperative period of digestive surgeries and to verify associations with sociodemographic and clinical variables.

Method: A cross-sectional study was carried out at a public hospital. Data were collected from October 2023 to July 2024, through the application of a form with sociodemographic and clinical data and the Health Literacy Questionnaire (HLQ). Descriptive analyses, inferential statistical tests, and multiple linear regression were performed.

Results: Of the 319 participants, 78.4% were in the postoperative period at the time of data collection. Among HLQ scales, "Ability to actively engage with healthcare providers" received the best score (3.70 ± 0.69), while "Having sufficient information to manage my health" (2.73 ± 0.29) had the worst score. Education level, race, age, having children, living with other people, and having a caregiver were associated with HL (p < 0.05). In adjusted analysis, the variables remained associated, except for race, income, and operative period.

Conclusion: Interaction with professionals contributes to HL, while understanding and critically assessing health information weakens it. Lower education was the main factor associated with lower HL.

Objective: To measure the average direct cost of care provided by senior nurses to patients on day zero of autologous, cryopreserved hematopoietic stem cell transplantation in a public transplant hospital in the state of São Paulo.

Method: Quantitative, exploratory-descriptive, single-case study based on bottom-up micro-costing, conducted from February to April 2025.

Results: Twenty-eight procedures performed by senior nurses on 16 patients on day zero of the transplant were observed, covering the pre-infusion (n = 718), intra-infusion (n = 375), and post-infusion (n = 463) phases of hematopoietic stem cell transplantation. In the pre-infusion phase of hematopoietic stem cell transplantation, the total average direct cost was US$59.52; in the intra-infusion phase, US$663.45; and in the post-infusion phase, US$16.84. The average direct cost of nursing labor predominated in all three phases. However, in the intra-infusion phase, the cost of supplies was the largest contributor to the total average direct cost.

Conclusion: Considering the three phases (n = 1556 observations), the total average direct cost was US$739.81 (100.00%), with 8.04% related to the pre-infusion phase, 89.68% to the intra-infusion phase, and 2.28% to the post-infusion phase.

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Objective: To map the scientific evidence concerning the prevalence of hepatitis B virus (HBV) and immunization among Community Health Workers (CHWs) worldwide.

Method: A scoping review was conducted using the LILACS, Medline (via PubMed), Embase, and Scopus databases, as well as grey literature (Google Scholar, Pro-Quest), employing the recommendations of PRISMA-ScR (extension for scoping review) and the Joanna Briggs Institute Manual.

Results: Eleven studies were included, all conducted in Brazil and without parameterization of the outcome measure. The estimated prevalence of HBV infection ranged from 8.2% to 11.1%, while vaccination coverage varied between 41% and 88.8%. Only one study used the anti-HBs serological marker to assess immunization, estimating that 71.6% of community health workers were immunized. Two additional studies were based on self-reported anti-HBs, with prevalences of 30.0% and 30.2%.

Conclusion: The overall estimate of HBV infection prevalence and immunization among community health workers could not be determined due to the scarcity and geographical limitations of existing studies, as well as the measurements deparameterization.

Objective: To analyze the factors associated with long Covid in older people 18 months after the acute phase of the disease.

Method: This cross-sectional and analytical study was conducted with older individuals who had Covid-19 in 2020 and survived the disease in the state of Paraná, Brazil. Sociodemographic, lifestyle habits, health and treatment information, as well as information on signs, symptoms and sequelae of the disease were collected through telephone interviews conducted 18 months after notification or hospital discharge. For the analyses, descriptive measures, association tests, and Poisson regression models with robust variance were used.

Results: Of the 345 older people who participated in the study, 224 (65%) still had some symptom or sequelae of Covid-19 18 months after the illness. Being a smoker or former smoker (PR = 2.21; 95% CI = 1.06;3.36), self-reported sleep quality (PR = 0.32; 95% CI = 0.16-0.47), and the use of continuous medication (RP = 5.24; 95% CI = 2.64-7.85; p < 0.0001) were associated with long-term Covid.

Conclusion: Morbidity and polypharmacy rates are high in this population, contributing to the persistence of symptoms. In this context, it becomes essential to align health services, together with professionals, to meet the needs arising from the sequelae in older people.

Objective: To analyze the dimensions of the work environment of primary health care nurses (PHC) and its relationship with these professionals' sociodemographic characteristics.

Method: This was a cross-sectional, analytical study conducted between April and October 2024 with 243 PHC nurses in Manaus. A questionnaire and the Workplace Environment Assessment Scale were used. Descriptive and inferential analysis was performed.

Results: The overall assessment of the work environment was average, with a score of 98.1. The average score for the Motivation for Work dimension was 47.2. The Workplace Safety dimension had the lowest average (14.6), classified as "attention", and Strategic Management for Healthy Work, with an average of 36.3, was classified as having warning points. A negative correlation was found between income and motivation, length of time working in PHC and management, age/length of work and job security. Temporary nurses evaluated strategic management more positively.

Conclusion: Weaknesses were identified in security and strategic management, highlighting the need for improvements in infrastructure, participatory management, and protection of professionals' health to promote a safer and healthier work environment.