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

Objective: To identify factors that can be targeted to promote the standardized management of proper limb positioning and improve the rehabilitation outcomes of patient.

Method: A qualitative descriptive study was conducted using semi-structured face-to-face in-depth interviews with 24 clinical nurses working in stroke-related departments between April and May 2024. Based on the COM-B model, the data were analyzed by employing the deductive content analysis method using the NVivo12 software and manual coding.

Results: Analysis revealed 11 themes and 22 sub-themes associated with the four domains of the COM-B model, including 15 barriers and 7 facilitators.

Conclusion: Clinical nurses' adherence to proper limb positioning is dynamic and positioning should address barriers related to capability, opportunity, and motivation, such as prioritize knowledge and skills training for clinical nurses, improved compliance among patients and caregivers, establish robust systems and supervisory mechanisms, and support scientific research and innovation to explore intelligent management solutions.

Objective: To compare the effects of up to three sessions of an early mobilization protocol combined with immersive virtual reality (VR) versus early mobilization alone in the experience of patients with acutely decompensated heart failure.

Methods: Complex mixed methods study with adult patients admitted to the intensive care unit. The Intervention Group (IG) underwent mobilization combined with immersive virtual reality and the Control Group (CG), isolated mobilization. The tool Net Promoter Score (NPS) and the Likert scale were used to assess patients' experience. In the qualitative approach, interviews were conducted with open questions.

Results: Sixty patients participated in the study, 44 (73.3%) men, mean age 59.7 ± 12.2. The procedure was recommended by 23 (76.7%) in the IG and by 24 (80%) in the CG. The mobilization experience was classified as good or excellent by 28 (93.3%) in the IG and 26 (83.7%) in the CG. Qualitative analyses revealed three categories: "Psychological Effects", "Physical Performance" and "Innovation".

Conclusion: Combining virtual reality with early mobilization provided a more positive experience for patients. ClinicalTrials.gov with number NCT05596292.

Objective: This systematic review and meta-analysis aimed to assess the effect of nursing interventions, considering their importance in the rehabilitation of patients undergoing knee and hip replacement.

Methods: Three databases were systematically searched. Two researchers carefully reviewed the full texts of the selected studies and extracted the required data. Further, a meta-analysis was conducted.

Results: Of the 19 studies reviewed, 17 revealed that nursing interventions can improve the rehabilitation of patients after knee and hip replacement operations. Among patients with hip replacements, the results indicated that nursing interventions can significantly increase the Harris hip score and activities of daily living compared with usual care. Among patients with knee replacements, the results revealed that nursing interventions can significantly improve range of motion and knee function and reduce knee pain compared with usual care.

Conclusions: Evidence reveals that individualized care and evidence-based strategies combined with various exercises and training provided by a multidisciplinary team significantly influence the physical rehabilitation among patients undergoing knee and hip replacement.

Objective: To analyze the social representations of nursing students regarding the sharing of information about latent tuberculosis infection in higher education.

Method: Descriptive, qualitative study, anchored in the procedural aspect of the Theory of Social Representations. It was carried out with 37 students who reacted to the tuberculin test, enrolled from the 1st to the 5th grade, in the Undergraduate Nursing Course at a public university in Belém, Pará, Brazil. Between March and July 2023, semi-structured individual interviews were conducted, the corpus of which was subjected to lexical analysis with the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (0.7, alpha 2), using descending hierarchical classification.

Results: A total of 1,939 text segments were identified, of which 1,686 (86.95%) were used, generating seven lexical classes. It was decided to detail class 7, which outlined two representational sets, addressing how information was shared and suggestions on the topic.

Conclusion: The limitations that weakened the timely sharing and quality of information motivated students to make suggestions to solve the challenges inherent to this context or mitigate its harmful effects.

Objective: This study aimed to determine the factors relating to climate change anxiety in women at reproductive age.

Method: This study is descriptive and cross-sectional. This study included 351 women aged 18-45 years. Data were collected via face to face interviews using the 'Women's Descriptive Characteristics and Climate Change Perception Assessment Form' and 'Climate Change Anxiety Scale for Women's Health' between June and October 2024 at a family health center in Mersin province of Türkiye. Data analysis included descriptive statistical methods and chi-squared automatic ınteraction detector analysis.

Results: The average age of the women was 27.91 ± 8.30 years (n = 351). The Climate Change Anxiety Scale for Women's Health mean score was 52.46 ± 17.19. Women's experience of anxiety regarding the negative consequences of climate change affected the scale and all sub-dimensions (physiological health, behavior, and gender) (p < 0.05).

Conclusion: Health professionals should provide information and assessments including the effects of climate change on health in care services. They should plan interventions to reduce women's anxiety levels towards climate change.

Objective: To evaluate the impact of an educational intervention on nursing care for women with signs of postpartum depression for primary health care nurses.

Method: Quasi-experimental, before-and-after study carried out with 14 primary health care nurses from a municipality, who participated in an educational intervention on nursing care for women with signs of postpartum depression. Qualitative data analysis was carried out before and after the intervention, using Bardin's thematic content analysis.

Results: From the comparison of the content responses before and after the intervention, the nurses presented more knowledge about postpartum depression, especially in specific signs and symptoms, and improvement in the recognition and management of baby blues; they began using scales for screening and better monitoring of emotional symptoms; they began adopting more humanized practices, in addition to reporting greater safety in care and multidisciplinary integration.

Conclusion: The intervention had a positive impact and expanded nurses' knowledge, skills, and attitudes regarding postpartum depression, which contributed to more empathetic and comprehensive care. ReBEC: RBR-3hv3hhs.

Objective: This article aims to analyze the performance of professors and preceptors of the Education Program for Health Work in the development of interprofessional collaboration in Primary Health Care.

Method: Descriptive study, with a qualitative approach, in which professors and preceptors from the Education Program for Health Work of five federal universities in the Brazilian Northeast participated. Between September and October 2020, 44 workers responded to the online questionnaire. Data were processed according to analytical procedures described by Bardin and interpreted in light of the four-dimensional Model of Interprofessional Collaboration with the aid of webQDA® software.

Results: Three categories were identified: 1) Provision for sharing common goals; 2) Mobilization for internalization of interdependence between professionals, and 3) Monitoring and adjustment for the development of interprofessional collaboration.

Conclusion: The study revealed that the role of professors and preceptors in developing interprofessional collaboration is significantly focused on the interactive conduct between health professionals and students, as well as on the development of actions and adjustments for collaborative work.

Objective: To identify pregnant women with urinary tract infections who are being monitored at a primary health care unit and their knowledge about antibiotics, as well as facilitating and challenging factors perceived by nurses that influence care, with a focus on antimicrobial resistance.

Method: Exploratory, descriptive study with a quantitative approach, involving pregnant women with urinary tract infections undergoing antibiotic treatment at a municipal health unit in São Paulo and nurses working at the same location. Data were obtained from computerized systems, medical records, and interviews, and were synthesized and analyzed using Microsoft Excel and Stata software.

Results: Of the 21 pregnant women included, 85.7% had knowledge about antibiotics. Of the 11 participating nurses, 36.4% did not identify the presence of facilitators, but 45.5% believed there were barriers to their care.

Final considerations: Most pregnant women had basic knowledge about antibiotics and recognized the importance of guidance from nurses. Nurses identified barriers that point to the need for technical support. Developing a care booklet for nurses who care for pregnant women with urinary tract infections may be a promising strategy to optimize treatment and prevent antimicrobial resistance.

Objective: To evaluate the effectiveness of intravenous laser irradiation of blood in reducing viral load and increasing LT-CD4+ and LT-CD8+ in people living with HIV/AIDS.

Method: Randomized, controlled, parallel, single-blind clinical trial. Twenty-eight participants were allocated to the intervention (ILIB n = 15) and control (CTRL n = 13) groups. The ILIB group received irradiation with red laser (660 nm), applied to the radial artery (30 minutes/day for 20 days), with a total energy of 180 J. The CTRL group received a sham intervention (without light emission). Viral load and LT-CD4+ and LT-CD8+ counts were assessed at the end.

Results: Both groups showed a reduction in viral load (ILIB: -1.7 log; CTRL: -2.3 log). In the ILIB group, 61.5% of participants achieved an undetectable viral load (p = 0.449). There was no increase in CD4+ LT count (p = 0.287), but a non-significant reduction in CD8+ LT count was observed in the ILIB group (p = 0.173). There were no statistically significant differences between groups for any outcome (p > 0.17). The study was stopped prematurely during the interim analysis.

Conclusion: ILIB, as an adjuvant therapy to ART, did not show clinical or statistical superiority in the immunological and virological parameters evaluated.

Brazilian registry of clinical trials (rebec): RBR-7j9rv5d (https://ensaiosclinicos.gov.br/trial/10848).

Objective: To compare the performance of trauma severity indices (ISS, NISS, REMS, mREMS) in predicting hospital and Intensive Care Unit (ICU) admission outcomes.

Method: Retrospective cohort study carried out with patients treated at the Emergency Room of a private hospital from January 2020 to January 2022. Medical records of adults with blunt, penetrating, or mixed trauma admitted up to 24 hours after the trauma were analyzed. Severity indices were used to predict hospital and ICU admission.

Results: The sample consisted of 151 patients. The ISS and NISS showed good discrimination capacity for hospital and ICU admission (AUC/ROC from 0.84 to 0.85). The REMS and mREMS indices showed insufficient performance (AUC/ROC from 0.62 to 0.67).

Conclusion: The ISS and NISS indices were effective in predicting hospital and ICU admission and can be used in clinical practice; however, the use of REMS and mREMS cannot be recommended due to insufficient performance for these outcomes.