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

Objective: To map and analyze scientific evidence on care provided to women deprived of liberty during labor and childbirth.

Method: A scoping review, developed in accordance with JBI methodology, whose information sources were accessed in databases and gray literature. Selection was carried out between October and December 2023, based on reading titles, abstracts and descriptors, considering the following eligibility criteria: articles, dissertations and theses with different methodological designs available in full, without language and time limitations. Analysis was conducted by two independent reviewers, using inductive content analysis.

Results: Fifteen studies were included. From the synthesis of results, two categories emerged: From the cell to the delivery room: care for women deprived of liberty; Experiences of women deprived of liberty during labor and childbirth.

Conclusion: This study highlights the fragility of care practices during labor and childbirth, imposing significant challenges and resulting in adverse experiences that compromise the quality of motherhood and violate women's fundamental rights.

Objective: To understand how nursing care management occurred during the COVID-19 pandemic.

Method: A qualitative study conducted at a university hospital in São Paulo, Brazil. The sample consisted of eight nurses who worked caring for patients who tested positive for COVID-19. Data collection was carried out through semi structured interviews about experiences in managing care in coping with the pandemic. Thematic analysis and interpretation based on psychodynamics of work were used in data analysis.

Results: The results allowed constructing three thematic categories: The invisible that limits: biosafety, distress, uncertainty and fear of the pandemic, protecting oneself and ensuring the protection of others; Management work process instruments: team training, staff sizing, materials management, creative practice in the face of insufficiency; The competencies involved with the team, teamwork and leadership.

Conclusion: Care management in COVID-19 was permeated by objective and subjective conditions, with situations of distress, pleasure, fear, insecurity and creative adaptation. Teamwork and leadership competencies, when present, can alleviate the distress that occurs in nursing work.

Objective: To evaluate the impact of educational intervention on the occurrence of factors that interfere with the caloric-protein supply to critical and non-critical patients undergoing enteral nutritional therapy.

Method: This is an intervention, a field experiment without a control group, carried out in a teaching hospital in Juiz de Fora, Minas Gerais, Brazil. Three training cycles were carried out with nursing professionals over 57 weeks, covering the same content. The data collected were divided into pre-intervention and intervention periods. Interference in caloric-protein support was analyzed based on the evaluation of days with non-conforming nutritional supply and the occurrence of factors that led to non-conformities.

Results: Following interventions, there was a significant reduction (p < 0.05) in the number of non-conforming and inadequate days (nutritional supply < 80%), the frequency of occurrence of interfering factors and non-conformities caused by failure to follow the vomiting protocol.

Conclusion: The educational intervention was an effective strategy to increase the quality of the therapy evaluated, especially from the fifth day of enteral nutritional therapy onwards.

Objective: To analyze the effect of breastfeeding on reducing Pentavalent vaccination pain in infants and to identify the necessary breastfeeding interval for antinociceptive action.

Method: Open parallel randomized clinical trial. Ninety mother-infant dyads participated, distributed into intervention group 1 (n = 30), which breastfed five minutes before vaccination; intervention group 2 (n = 30), which breastfed five minutes before and during vaccination; and control group (n = 30), which did not breastfeed. The outcome variable was the pain level measured by the FLACC Scale. Data analysis was conducted using descriptive and inferential statistics, applying Fisher's Exact, Kolmogorov-Smirnov, Kruskal-Wallis and Dunn's multiple comparison tests, with 0.05 significance level.

Results: Pain induced by the Pentavalent vaccine was reduced in intervention groups 1 and 2 (mean pain of 6.06 versus 3.83, respectively) compared to the control group (mean of pain of 7.43), which was significant for intervention group 2 (p < 0.001), indicating that, to achieve lower levels of pain, breastfeeding should be carried out before and during vaccination.

Conclusion: Longer breastfeeding, conducted five minutes before and during vaccination, reduces the pain induced by the Pentavalent vaccine. No vaccination risks were identified to outweigh the benefits. These results endorse that health professionals should encourage breastfeeding at least five minutes before and during vaccine injection for an antinociception effect. Brazilian Clinical Trials Registry: RBR-9vh37wr.

Objective: To map evidence about care and gender stereotypes in nursing scientific research.

Method: A scoping review developed under the JBI framework with analysis of gender perspective in care approaches. The searches were carried out on January 31, 2023 in SciELO, Scopus, CINAHL, PubMed, BDENF.

Results: Of the 3,743 studies located, 25 were included. Evidence was grouped into categories: essentially female care (n = 9; 36%); calling and service of love (n = 3; 12%); erasure of gender inequalities (n = 2; 8%); "inadequate and harmful" care (n = 5; 20%); neutralization of gender and bodies (n = 3; 12%); and reporting oppression in care work (n = 3; 12%).

Conclusion: Most scientific research on care reproduces gender stereotypes that reinforce the oppression of women in nursing. In contrast, resistance denounces naturalization of care as "inadequate and harmful", for perpetuating gender oppression in care work.

Objective: To analyze the effect of Unna's Boot on the healing of venous ulcers compared to other therapies.

Methods: Systematic Review carried out in the databases Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and grey literature. Population - adult patients with venous ulcers; Intervention- Unna's Boot (UB); Control - other compression therapies (CT); Outcome- healing; Designs- randomized clinical trial, cohort study, and case control, published from 2001 to 2024. The effect of the intervention, risk of bias, and quality of evidence were evaluated. Registered with PROSPERO (CRD42021290077).

Results: A total of 39 studies were included, with 5.151 patients. The majority (71.8%) were randomized controlled trials (RCT). UB was used as intervention/control in eight studies. When comparing CTs, only 1 study with UB showed a superior effect (p < .001) in healing, compared with high compression elastic bandage. In the quality of evidence analysis, 27 studies were assessed as having a high risk of bias.

Conclusion: No superiority of UB was found in the healing of venous ulcers when compared to other CTs.

Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19.

Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed.

Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death.

Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care.

Objective: To analyze public management actions regarding organ, cell, and tissue transplant procedures and their financial investments in Brazil.

Method: Mixed (time and place) ecological study, carried out based on data from the Hospital Information System of the Brazilian Public Health System (SUS) Information Technology Department and the National Transplant System, from 2001 to 2023. Temporal trend analyses, descriptive and inferential statistics were performed.

Results: Organ, cell, and tissue transplants are concentrated in the Southeast region of the country, with increased costs there. The Northeast and South regions of Brazil have the longest waiting list, with an increasing trend (R2 = 0.96), associated with a decreasing trend in the number of transplants (R2 = 0.97).

Conclusion: The difference in the total number of transplants and procedures performed among the Brazilian regions represents the need for organization and investments with strategies aimed at training professionals and raising awareness among the population.

Objective: To investigate the repercussions of COVID-19 on the length of breastfeeding and analyze the associated factors in Belo Horizonte, Minas Gerais, Brazil.

Method: This is an epidemiological, prospective cohort study. Data were collected from medical records and through telephone interviews. Women who weaned were estimated using Kaplan-Meier survival analysis. The log-rank test was used to verify differences between groups, analyzing weaning time, according to sociodemographic and clinical characteristics. The values of hazard ratio and 95% confidence intervals were estimated using Cox regression analysis.

Results: A total of 1,729 women participated in the study. During the COVID-19 pandemic, brown women and women undergoing cesarean section were more likely to stop breastfeeding.

Conclusion: The birth route and mothers' ethnic characteristics were associated with early weaning during the COVID-19 pandemic. Such findings are important to guide the assistance of the multidisciplinary team, especially nursing, during the post-pandemic period and in future epidemiological scenarios.

Objective: To analyze nursing skills in military aeromedical transport of the Brazilian Air Force.

Method: Descriptive, qualitative research, carried out in three Brazilian Air Force hospitals in Rio de Janeiro, involving 64 military nurses. Discursive textual analysis identified competencies in healthcare, communication and decision-making.

Results: After characterizing participants, it was possible to understand the reality experienced by nursing professionals in air medical transport, highlighting the skills related to healthcare, communication and management, essential in all phases of air medical transport.

Conclusion: It was evident that nursing assumes unique skills in caring for airborne patients, using diverse knowledge and experiences in solving problems encountered in the aeromedical work process. The need to implement continuing education strategies was also highlighted. The findings serve as support for professionals and managers to identify gaps in knowledge, performance and management of professional schedules in aeromedical transport.