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

Objective: To analyze primiparas' perceived experiences and unmet nursing needs regarding discharge readiness, using the King's Theory of Goal Attainment, to optimize clinical discharge management.

Methods: Using the phenomenological method in qualitative research, through purposive sampling, 18 primiparas from a tertiary hospital in Sichuan Province were subjected to face-to-face semi-structured in-depth interviews. NVivo 15.0 software was used to manage the interview data, and the Colaizzi phenomenological 7-step analysis method was used to analyze the data.

Results: A total of 5 main themes and 12 sub-themes have been identified, including complex psychology at discharge (positive expectations, full of worries), promoting factors of discharge preparation (personal proactive coping, the degree of family support was high), hindering factors of discharge preparation (the self-care knowledge was weak, insufficient self-care skills, difficulties in parenting), nursing service needs (maternal and infant knowledge and nursing needs, continuing nursing knowledge needs), and interactive participation (the implementation of interactive assessments is inadequate, insufficient participation, expect to participate in decision-making).

Conclusion: Primiparas' discharge preparation needs remain unmet. Medical staff should address various factors affecting discharge readiness, enhance the interaction between nurses and patients, and increase the initiative of primiparas in self-management, to help them adapt to life after discharge and achieve maternal and infant health goals.

Objective: To analyze and compare the nursing care provided to users with Post-COVID Conditions (PCC) in Primary Health Care (PHC) and Specialized Care (SC).

Method: This is an analytical cross-sectional study carried out with 226 nursing professionals from PHC and SC in Brazil. Data were collected through a self-responding form published by the Nursing Councils and on social media and were analyzed using descriptive statistics, followed by the t-test to compare means and chi-square tests to study associations with categorical data. The study was approved by the UFSCar Research Ethics Committee.

Results: An association between PHC nursing professionals and the identification of persistent cough as the most common symptom of PCC (80.2% vs 50%; p< 0.01) and neurocognitive deficit as the most severe symptom (62% vs 42.1%; p = 0.04); and an association between SC professionals and the identification of loss of appetite as the least common symptom of PCC (43.7% vs 22%; p = 0.02).

Conclusion: The results highlight challenges such as the difficulty in identifying PCC, the absence of widely used protocols, and the limited training of PHC and SC nursing professionals, impacting the quality of care.

Objective: To detail the stages of the method for analyzing the clinical applicability of terminological subsets in the context of Primary Health Care.

Method: A theoretical- reflective study that presents three prerequisites and four stages of the method for analyzing the clinical applicability of terminological subsets, based on reflection on two operationalization experiences.

Results: The prerequisites are related to the choice of the research setting, the selection of participants-clients and nurses, with an emphasis on inclusion criteria-and prior knowledge of the terminology and theoretical model. The steps of the method are: development of the data collection instrument, according to the steps of the Nursing Process and the categories of the theoretical model; systematic and participatory observation of the nursing consultation; evaluation of the return consultation at the health unit or at home; organization and analysis of data, in a descriptive manner and according to the theoretical model. In addition, a case study example can be developed. Final considerations: The method presented can be replicated in Primary Health Care settings, so that it can be critiqued, adjusted, and reorganized. It is understood that the method is a tool for analyzing praxis.

Objective: To understand the meanings attributed by female nurses to work and politics in liquid modernity.

Method: This qualitative study involved 46 graduate faculty students of a public state university in the city of Rio de Janeiro. Data were collected from April to November 2021 through semi-structured individual interviews and submitted to IRaMuTeQ®.

Results: Similarity analysis was structured around two central axes ("work" and "politics"), surrounded by peripheral words. The first emerged as a means of subsistence. The second is seen as yet another duty amid the intensification of work, which distances female nurses from political activity, even though they recognize its importance in achieving collective benefits. Regarding professional associations, they view them as a financial investment with little or no concrete return.

Conclusion: Concerning liquid modernity, there is an emptying of meanings associated with work concomitant with the devaluation of class entities, culminating in the removal of female nurses from political action.

Objective: To investigate the current status of oral frailty in elderly stroke patients in East China and analyze its associated factors, in order to provide a reference for the implementation of targeted interventions.

Method: From June to September 2024, a convenience sample of 300 elderly stroke patients from two tertiary hospitals in Binzhou, Shandong underwent assessment with the General Information Questionnaire, Oral Frailty Index-8 (OFI-8), Oral Health Assessment Tool, Perceived Social Support Scale, and Geriatric Self-Efficacy in Oral Health Scale. Data were subjected to descriptive and inferential analysis.

Results: The prevalence of oral frailty in elderly stroke patients was 47.0%, and age, smoking history, past history of stroke, number of teeth, subjective masticatory difficulty, oral health score, and perceived social support scale were the factors influencing oral frailty in elderly stroke patients (P < 0.05).

Conclusion: In Eastern China, where nearly half of elderly stroke patients exhibit oral frailty, caregivers should prioritize routine OFI-8 screening and implement individualized interventions during stroke rehabilitation to break the oral frailty-stroke recurrence cycle.

Objective: To map disordered eating behaviors in people with Type 1 Diabetes Mellitus using the instrument Diabetes Eating Problem Survey-Revised (DEPS-R).

Method: This is a scoping review, guided by JBI and in accordance with the PRISMA ScR recommendation. Four sources of information and grey literature were consulted. The search took place in January 2024. For the analysis of Similarity and Word Cloud, the software IRaMuTeQ was used. The interpretation of lexical analysis was based on the Theory of Social Representations.

Results: The 21 articles selected describe the prevalence of disordered eating behaviors, with emphasis on insulin omission, binge eating, and dietary restriction. Body image, depressive symptoms, high HbA1c levels, and the presence of complications resulting from early high blood glucose levels are also related to disordered eating behaviors. The use of the DEPS-R instrument proved to be effective in detecting these behaviors.

Conclusion: The results support the hypothesis that disordered eating behaviors are not just eating disorders in the traditional sense, but reflect dysfunctional coping strategies for chronic illness, often as attempts to control body weight or for emotional relief. Analytical studies on interdisciplinary clinical approaches using the DEPS-R instrument are fundamental to understanding the complexity of disordered eating behaviors.

Objective: Examine the relationship between parenting stress and thriving at work among nurses. Examine whether organizational support mediates the association between parenting stress and thriving at work among nurses.

Methods: A questionnaire survey was conducted with 534 clinical nurses using the Parenting Stress Scale for Clinical Nurses, the Thriving at Work Scale, and the Perceived Organizational Support Questionnaire.

Results: The mean total scores for nursing parenting stress, perceived organizational support, and the Thriving at Work Scale were 2.72 ± 0.47, 3.63 ± 0.81, and 4.80 ± 0.74, respectively. A significant negative correlation was observed between nursing parenting stress and thriving at work (r1 = -0.233, p < 0.001) and between nursing parenting stress and perceived organizational support (r2 = -0.289, p < 0.001). A significant positive correlation was also observed between perceived organizational support and thriving at work (r3 = 0.469, p < 0.001). Perceived organizational support partially mediated the relationship between parenting stress and thriving at work, accounting for 52.72% of the total effect.

Conclusion: This study supports the mediating role of perceived organizational support in the relationship between parenting stress and thriving at work among nurses. Interventions to promote perceived organizational support among nurses with parenting stress should be studied to improve their well-being.

Objective: To interpret the lived experiences of women in situation of violence who request the revocation of emergency protective orders.

Method: Strauss and Corbin's Grounded Theory (GT) and Symbolic Interactionism were used at the Women's Police Station in a town in the State of São Paulo, through interviews with 28 participants from two sample groups: women experiencing violence and police station professionals.

Results: The results were organized into categories related to the components of the theoretical model, "Experiencing the Request to revoke an Emergency Protective Order," highlighting the emotional and contextual challenges faced by women seeking formal help. These challenges are permeated by ambivalent feelings, experiences of revictimization, and different coping strategies to reframe their life trajectories.

Final considerations: The revocation is related to family consequences - guilt, regret, and sadness -, despite acknowledging the violence. The lack of understanding of the judicial system and the emotional bond with the perpetrator demonstrate the need to consider the symbolic meanings of interactions in primary care nursing practice.

Objective: To identify risk factors for surgical site infection and to establish a prediction model.

Method: Retrospective cohort study with 20,778 surgeries performed between 2009 and 2019 at a university hospital in Rio de Janeiro. Clinical and operative variables were analyzed using multivariate logistic regression (p≤0.05).

Results: The overall surgical infection rate was 7.2%. Age ≥41 years presented an odds ratio between 1.52 and 3.77 (p < 0.0001). Contaminated and infected surgeries increased the risk threefold (95% CI: 2.48-3.63). Urgent procedures (OR = 2.04; 95% CI: 1.83-2.28) and ASA III (OR=3.77) were associated with a higher risk. Each additional hour of surgery increased the risk by 34% (OR = 1.34; 95% CI: 1.30-1.38). Conventional technique had a risk 2.7 times greater than videolaparoscopy (RC = 2.72; p < 0.0001).

Conclusion: The developed model allows for precise stratification of surgical site infection risk and supports preventive strategies, improving the surveillance and management of surgical risk in highly complex hospitals.

Objective: To list reflective elements on child care in the face of contemporary dilemmas involving parenting and social diversity to promote child development and its implications for nursing.

Method: Reflective study based on the theoretical perspective of practical wisdom, supported by the understanding of practical knowledge involving choices in the face of everyday contingencies.

Results: Reflective elements were listed on parental choices and possible contemporary dilemmas regarding social diversity related to care provided by someone of another skin color, another sexual orientation, another religion, and male figures. Practical knowledge related to parental choices and supposed resistance to other people's abilities to care for children suggests that reflections on the implications for parenting and the promotion of child development should be expanded.

Conclusion: Practical wisdom contributes to analyzing and considering aspects of care, bringing important elements for nursing to assist in parental choices that encompass social diversity in childhood, considering the avoidance of discrimination, prejudice, and hostility, to value opportunities to promote full child development.