Barriers to research utilization influencing patient safety climate: A cross-sectional study.

AIMS: This study aimed to investigate the influence of barriers to the use of research results in the practice of nurses on patient safety perception. BACKGROUND: The use of research results in clinical practice promotes safe care, increases quality and reduces the possibility of adverse events. DESIGN: This is a cross-sectional study. METHODS: The sample consisted of 207 nurses from three public university hospitals in the state of Minas Gerais, Brazil from March 2017 to November 2018. They answered a questionnaire with professional characteristics, The Barriers Scale and Safety Attitudes Questionnaire. Descriptive analysis, Student's t test, Pearson correlation and multiple linear regression were used for data analysis. RESULTS: The findings showed most nurses had unfavourable competencies for implementing research results in practice. As barrier scores for the use of research results in practice increase, safety climate scores decrease. Taking a training course on the use of research results in clinical practice and organization characteristics, limitations of the setting were statistically significant, constituting factors that influence the perception of the safety climate. CONCLUSION: Investments in education are needed for health professionals to be aware of evidence-based practice and how to use evidence to impact decision-making outcomes, strengthening safety outcomes in health services.

Factors associated with the social, individual and programmatic vulnerability of older adults living at home.

OBJECTIVE: To verify the occurrence and factors associated to social, individual and programmatic vulnerability among older adults. METHOD: A household and cross-sectional survey conducted with 701 community-dwelling older adults. For evaluation of the individual component, we used the frailty phenotype; for the social component, the social vulnerability index was implemented; and for the programmatic component, the Index of access and use of health services. Descriptive and bivariate statistical analyzes and multinomial logistic regression were also carried out (p≤ 0.05). RESULTS: It was verified that 15.7% of the older adults lived in areas of high social vulnerability, 31.8% were physically frail and had a moderate programmatic vulnerability score. Older people of a lower age, having lower education and income levels were more likely to live in areas of high or very high social vulnerability. The female gender and the high age groups increased the chances of the frailty condition. It was also observed that the older adults in the 70├ 80-year age group and having lower education were more likely to have medium programmatic vulnerability. CONCLUSION: The importance of primary care professionals to consider the multidimensional aspect of vulnerability in identifying older adults who need to be prioritized in health care is evidenced.

Common mental disorders and associated factors: a study of women from a rural area.

OBJECTIVE: Identifying the prevalence of Common Mental Disorders and analyzing the influence of sociodemographic, economic, behavioral and reproductive health variables on Common Mental Disorders in women of childbearing age living in the rural area of Uberaba-MG, Brazil. METHOD: An observational and cross-sectional study. Socio-demographic, economic, behavioral and reproductive health instruments were used, along with the Self-Reporting Questionnaire (SRQ-20) to identify common mental disorders. Multiple logistic regression was used for multivariate data analysis. RESULTS: 280 women participated in the study. The prevalence of Common Mental Disorders was 35.7%. In the logistic regression analysis, the variables of living with a partner and education level were associated with Common Mental Disorders, even after adjusting for the other variables. CONCLUSION: Our findings evidenced an association of social and behavioral factors with Common Mental Disorders among rural women. Identification and individualized care in primary health care are essential for the quality of life of these women. OBJETIVO: Identificar a prevalência do transtorno mental comum e analisar a influência de variáveis sociodemográficas, econômicas, comportamentais e de saúde reprodutiva sobre o transtorno mental comum em mulheres em idade fértil, residentes na zona rural do município de Uberaba-MG, Brasil. MÉTODO: Estudo observacional e transversal. Foram utilizados instrumentos de caracterização sociodemográfica, econômica, comportamental e de saúde reprodutiva, e o Self-Reporting Questionnaire (SRQ-20) para identificar os transtornos mentais comuns. Na análise multivariada dos dados, foi utilizada a regressão logística múltipla. RESULTADOS: Participaram do estudo 280 mulheres. A prevalência do transtorno mental comum foi de 35,7%. Na análise de regressão logística, as variáveis convivência com o companheiro e escolaridade, associaram-se ao transtorno mental comum, mesmo após o ajuste para as demais variáveis. CONCLUSÃO: Os achados evidenciaram a associação de fatores sociais e comportamentais com o transtorno mental comum, entre mulheres rurais. A identificação e a assistência individualizada na atenção primária de saúde são essenciais para a qualidade de vida destas mulheres. OBJETIVO: Identificar la prevalencia de trastornos mentales comunes y analizar la influencia de las variables socio-demográficas, económicas, de comportamiento y de salud reproductiva en el trastorno mental común en las mujeres en edad fértil, que viven en el municipio rural de Uberaba, Minas Gerais, Brasil. MÉTODO: Estudio observacional y transversal. Se usaron instrumentos sociodemográficos, económicos, de comportamiento y salud reproductiva, y el Self-Reporting Questionnaire (SRQ-20) para identificar los trastornos mentales comunes. En el análisis multifactorial de los datos, se utilizó la regresión logística múltiple. RESULTADOS: El estudio incluyó a 280 mujeres. La prevalencia de los trastornos mentales comunes fue de 35,7%. En el análisis de regresión logística, las variables convivencia con su pareja y la escolarización se asociaron con trastorno mental común, incluso después de ajustar por otras variables. CONCLUSIÓN: Los resultados muestran la relación entre los factores sociales y de comportamiento con el trastorno mental común entre las mujeres rurales. La identificación y la atención individual en la atención primaria de salud son esenciales para la calidad de vida de las mujeres.

[Under the shadow of maternity: pregnancy, suicidal ideation, and intimate partner violence]. / Sob a sombra da maternidade: gravidez, ideação suicida e violência por parceiro íntimo.

OBJECTIVE: To investigate the association between intimate partner violence and indicators of suicidal ideation during the current pregnancy. METHODS: This is a cross-sectional observational study developed with 358 pregnant women selected by systematic random sampling in Ribeirão Preto, southeastern Brazil. The Back Suicidal Ideation Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to identify indicators of suicidal ideation and psychological, physical, and sexual acts of intimate partner violence during the current pregnancy. Multiple logistic regression was used to obtain adjusted prevalence odds ratios with a 95% confidence interval. RESULTS: The prevalence of indicators of suicidal ideation was 7.8%. Of the participants, 17.6% reported some type of intimate partner violence during the current pregnancy. Among these, 95.2% reported having suffered psychological violence, 36.5% physical violence, and 1.6% sexual violence. Multiple logistic regression analysis showed that women exposed to violence were 6.29 times more likely to have indicators of suicidal ideation. CONCLUSIONS: Policy makers and health care providers must be made aware of the impact of intimate partner violence, including in terms of suicidal ideation, especially during pregnancy. The adoption of simple measures, such as the scales used in the present study, may provide information regarding the extent of intimate partner violence and suicidal ideation in health care services.

Depressive disorder in pregnant Latin women: does intimate partner violence matter?

AIMS AND OBJECTIVES: To identify the association of antenatal depressive symptoms with intimate partner violence during the current pregnancy in Brazilian women. BACKGROUND: Intimate partner violence is an important risk factor for antenatal depression. To the authors' knowledge, there has been no study to date that assessed the association between intimate partner violence during pregnancy and antenatal depressive symptoms among Brazilian women. DESIGN: Cross-sectional study. METHODS: Three hundred and fifty-eight pregnant women were enrolled in the study. The Edinburgh Postnatal Depression Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to measure antenatal depressive symptoms and psychological, physical and sexual acts of intimate partner violence during the current pregnancy respectively. Multiple logistic regression and multiple linear regression were used for data analysis. RESULTS: The prevalence of antenatal depressive symptoms, as determined by the cut-off score of 12 in the Edinburgh Postnatal Depression Scale, was 28·2% (101). Of the participants, 63 (17·6%) reported some type of intimate partner violence during pregnancy. Among them, 60 (95·2%) reported suffering psychological violence, 23 (36·5%) physical violence and one (1·6%) sexual violence. Multiple logistic regression and multiple linear regression indicated that antenatal depressive symptoms are extremely associated with intimate partner violence during pregnancy. CONCLUSION: Among Brazilian women, exposure to intimate partner violence during pregnancy increases the chances of experiencing antenatal depressive symptoms. RELEVANCE TO CLINICAL PRACTICE: Clinical nurses and nurses midwifes should pay attention to the particularities of Brazilian women, especially with regard to the occurrence of intimate partner violence, whose impacts on the mental health of this population are extremely significant, both during the gestational period and postpartum.

Exploring the effect of the structural model of active aging on the self-assessment of quality of life among older people: A cross-sectional and analytical study.

BACKGROUND: Although studies have examined the relationship between variables associated with active aging and quality of life (QoL), no studies have been identified to have investigated the effect of a structural model of active aging on QoL in a representative sample of older people in the community. OBJECTIVE: To measure the domains and facets of QoL in older people and identify the effect of the structural model of active aging on the self-assessment of QoL. DESIGN AND SETTING: This cross-sectional analytical study included 957 older people living in urban areas. Data were collected from households using validated instruments between March and June 2018. Descriptive, confirmatory factor, and structural equation modeling analyses were performed. RESULTS: Most older people self-rated their QoL as good (58.7%), and the highest mean scores were for the social relationships domain (70.12 ± 15.4) and the death and dying facet (75.43 ± 26.7). In contrast, the lowest mean scores were for the physical domains (64.41 ± 17.1) and social participation (67.20 ± 16.2) facets. It was found that active aging explained 50% of the variation in self-assessed QoL and directly and positively affected this outcome (λ = 0.70; P < 0.001). CONCLUSION: Active aging had a direct and positive effect on the self-assessment of QoL, indicating that the more individuals actively aged, the better the self-assessment of QoL.

Efficacy of a program in increasing coping strategies in firefighters: randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of a program in increasing coping strategies focused on military firefighters' problems and emotions. METHOD: randomized, parallel, single-masked clinical trial. The sample consisted of 51 participants in the intervention group and 49 in the control group. The intervention group received the intervention program including coping strategies based on the Nursing Interventions Classification, lasting six consecutive weeks, one day a week. The control group followed the Service Unit routine. Descriptive statistics, Student's T test with Welch's correction and the Mann-Whitney test were used for the analyses. The magnitude of the intervention effect was calculated using Cohen's d index. A p-value of ≤0.05% was considered. RESULTS: in the analysis of the mean difference between the scores in the groups, the means of the intervention group increased significantly for the coping strategies: social support (p = 0.009), acceptance of responsibility (p = 0.03), problem solving (p = 0.05) and positive reappraisal (p = 0.05). The impact of the intervention was moderate in magnitude for social support (d = 0.54). CONCLUSION: the intervention program enabled the increase of coping strategies focused on military firefighters' problems and emotions. ReBEC: RBR-8dmbzc. (1) The intervention program increases coping strategies. (2) The study included military firefighters. (3) Social support was the main strategy of the study. (4) Intervention group presented better results than the control group. (5) The use of the Nursing Intervention Classification was effective.

[Caregivers of individuals with spinal cord injury: caregiver burden]. / Cuidadores de indivíduos com lesão medular: sobrecarga do cuidado.

A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.

[Factors associated with the quality of life of elderly men]. / Fatores associados com a qualidade de vida de homens idosos.

This was an analytical, cross-sectional household survey study aimed at describing the sociodemographic characteristics, health and quality of life of elderly men, and to verify the socioeconomic and health factors related to quality of life. Participants in this study included 804 elderly men. Data were collected using the following instruments: Older Americans Resources and Services scale (OARS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive analysis, student's t-test, Pearson correlation and multiple linear regression (p<0.05) were used. The prevalent characteristics were: individuals 60-70 years old, married, 4-8 years of education, and a minimum wage income. The lowest quality of life scores were in the physical domain and autonomy facet, and were associated with: the absence of a companion, education, low income, higher number of comorbidities, and functional disability. Functional disability had the strongest influence on the quality of life, except for the physical domain and intimacy facet.

Factors associated with surgical site infection in myocardial revascularization: a retrospective longitudinal study.

OBJECTIVES: to analyze the influence of sociodemographic and clinical variables, as well as the surgical checklist adherence score, on the occurrence of surgical site infection among patients undergoing myocardial revascularization. METHODS: an observational, longitudinal, retrospective study was conducted at a university hospital, involving 266 medical records of patients who underwent myocardial revascularization surgery. Instruments containing sociodemographic, clinical, and infection-related variables were used, along with the Perioperative Surgical Safety Checklist. Descriptive, bivariate, and logistic regression analyses were employed. RESULTS: surgical site infection occurred in 89 (33.5%) patients. There was a statistically significant association between body temperature outside the range of 36 degrees Celsius to 36.5 degrees Celsius (p=0.01), the presence of invasive devices (p=0.05), surgical procedures with the anticipation of critical events (p<0.001), and the occurrence of infection. CONCLUSIONS: body temperature, the presence of invasive devices, and surgical procedures with the anticipation of critical events were significant factors contributing to an increased risk of infection.

[Breastfeeding: knowledge and practice]. / Aleitamento materno: conhecimento e prática.

The objective of this study was to characterize the practices of breastfeeding promotion developed by nursing professionals of the Family Health Strategy and analyze the correlation between their knowledge of breastfeeding and how often they provided teaching regarding this topic. This cross-sectional, descriptive study was performed at the Family Health Strategy units of Uberaba, Minas Gerais with 85 nursing professionals, using two questionnaires. Data analysis was performed using frequency distribution and Spearman's correlation analysis. Most professionals said that they often addressed breastfeeding in the investigated practices. However, a poor correlation was observed between the frequency of this approach and the mean score on knowledge test. The nursing professionals' statements indicate that breastfeeding recommendations were provided regardless of their knowledge on the topic.

Effect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial.

BACKGROUND: Preoperative anxiety and postoperative pain are frequent in cardiac surgeries and constitute important stressors for patients, which can cause several complications. One strategy that aims to alleviate these phenomena is listening to music as a non-pharmacological intervention. The aim of this study is to evaluate the effect of listening to music on preoperative state-anxiety, postoperative pain, at rest and when instructed to cough, and cardiorespiratory parameters in patients undergoing cardiac surgery. METHODS: A randomized, parallel, simple masking clinical trial will be conducted with patients 18 years of age or older who have undergone elective cardiac surgery by sternotomy, who agree to participate in the research and sign a free and informed consent form. Study participants will be randomly divided, in a 1:1 ratio, to one of the two groups: experimental (subjected to listening to music for 20 min in the pre- and postoperative period) or control (standard care in the pre- and postoperative period), using a randomization scheme generated by the Randomization.com website. The sample size calculation was obtained after conducting a pilot study. DISCUSSION: The results of the study may contribute to the implementation of non-pharmacological interventions in health services, highlighting the protocols for listening to music, to minimize anxiety and pain in cardiac surgery. TRIAL REGISTRATION: ReBEC RBR-8mdyhd . Posted on December 10, 2019.

Microbial contamination of procedure gloves after opening the container and during exposure in the environment.

The objective of this study was to quantify the colony forming units (cfu) on latex procedure gloves in the beginning, middle, and end of the containers in real (professional) and controlled (researcher) gloving situations; evaluate the microbial load of the gloves, considering the time of exposure in the environment. This comparative prospective study was conducted at an intensive care unit of a teaching hospital. The microbiological data was collected from the gloves using digital-pressure. Microbiological evaluations were performed on 186 pairs of gloves: 93 in the control group and 93 in real gloving situations. In the control group, the average cfu was 4.7 against 6.2 in the real gloving situation. Hence, no statistically significant difference was found (p=.601). In addition, the cfu values of gloves in the beginning, middle and end of the containers also did not show any significant differences (p>.05). The most common strain was Staphylococcus spp. The time of exposure in the environment did not increase the cfu value of the latex gloves.

[An association between forms of coping and the socio-demographic variables of people on chronic hemodialysis]. / Associação entre os modos de enfrentamento e as variáveis sociodemográficas de pessoas em hemodiálise crônica.

This sectional study was performed with the objective to verify the association between the forms of coping used by people on chronic hemodialysis and their socio-demographic variables. A semi-structured instrument and the Folkman and Lazarus' Coping Strategies Inventory were used. The sample consisted of 107 adults, mostly male (62.4%), on ambulatory hemodialysis for over six months. The most commonly referred forms of coping were related to the positive reevaluation factor (coping centered on emotions); with the highest mean scores among women for all factors and for people who reported having a partner, living with their families and receiving support in their treatment, and the highest scores were common for the factors control, self-control, and social support. Knowing the forms of coping prepares nurses to reinforce or seek, with patients on hemodialysis, choosing positive forms of coping and propose actions that permit patients to develop adaptive mechanisms.

Association between living arrangement and quality of life for older adults in the community.

OBJECTIVE: to compare the sociodemographic and economic characteristics of the older adults in the community according to the living arrangement and to verify the association between the type of living arrangement and the quality of life scores. METHOD: a cross-sectional epidemiological study conducted with 796 older adults in the community. To assess quality of life (dependent variable), network and social support (adjustment variable), validated and applied chi-square tests, descriptive statistical analysis, multiple comparison analysis (ANOVA) and multiple linear regression model (p<0.05) were used. RESULTS: the older adults who lived only with their spouses had better quality of life scores in all domains and facets, except in the death and dying domain, which did not show any significant difference. The lowest scores for quality of life were identified in the groups with the presence of children and, exceptionally, in the domain of social relationships and, in the facets death and dying and intimacy, those who lived alone had worse assessments. In the adjusted model, there was an association between the type of living arrangement and the different domains and facets of quality of life. CONCLUSION: living arrangement was associated with quality of life scores for older adults in the community, even after adjusting for the gender, age, number of morbidities, and social support variables.

The demands of family caregivers of elderly individuals with dementia.

The purpose of this cross-sectional observational study was to identify characteristics of caregivers of elderly people with dementia, types of care demands and to relate demands to the stage of dementia. The study was carried out in 2004 with 104 older adults and 90 caregivers in Ribeirão Preto, state of São Paulo. The OARS instrument was utilized and a questionnaire answered by caregivers. Among older adults, 66.3% were female, aged 75.5 years in average and 86.5% had caregivers. Eighty percent of the caregivers were women family members, aged 52.3 years in average. They spent 15.10 hours/day with care, without help. An important relationship was observed between caregiver's burden, physical and emotional effort and stage of dementia. Emotional overburden was higher at dementia early and late stages, this difference was statistically non-significant. Results reveal the urgent need to plan formal and informal support strategies to caregivers of Brazilian elderly people with dementia.

Temporal evolution and characterization of congenital syphilis cases in Minas Gerais, Brazil, 2007-2015. / Evolução temporal e caracterização dos casos de sífilis congênita em Minas Gerais, Brasil, 2007-2015.

The objective was to analyze the temporal trend of the incidence of congenital syphilis (CS) and to characterize the disease in the state of Minas Gerais (MG) between 2007 and 2015. Quantitative study, of a time series analysis, with the database from the Information System of Diseases Notification, referring to cases of CS reported in MG between 2007 and 2015. It was used descriptive statistics, calculation of the incidence rate of CS and polynomial regression model for temporal trend analysis. The results showed that in the period 4,381 cases were registered. The incidence rate ranged from 0.61 to 5.08 per 1,000 live births (LB),with an increase in the temporal trend of the CS incidence coefficient in the period from 2007 to 2015, with an annual rate variation of 30.6% (95% CI: 21.0 - 41.0). There was a predominance of brown-skinned newborns (38.7%), up to 6 days old (94.7%) and the majority (63.6%) did not present any suggestive manifestations of CS, but definitive diagnosis for recent CS (95.2%). The number of reported cases is increasing, suggesting that it is necessary, for improvement in the prenatal care, diagnosis, appropriate treatment, health care and notification.

Objetivou-se analisar a tendência temporal da incidência de sífilis congênita (SC) e caracterizar a doença no estado de Minas Gerais (MG) entre 2007 e 2015. Estudo quantitativo, de análise de série temporal, com banco de dados do Sistema de Informação de Agravos de Notificação, referentes aos casos de SC notificados em MG entre 2007 e 2015. Utilizou-se estatística descritiva, cálculo da taxa de incidência de SC e modelo de regressão polinomial para análise de tendência temporal. Os resultados mostraram que no período registraram-se 4.381 casos. A taxa de incidência variou entre 0,61 e 5,08/1.000 nascidos vivos (NV), com incremento na tendência temporal do coeficiente de incidência da SC no período de 2007 a 2015, com variação anual da taxa de 30,6% (IC95%: 21,0 ­ 41,0). Houve predomínio de recém-nascidos de cor de pele parda (38,7%), faixa etária de até 6 dias de vida (94,7%) e a maioria (63,6%) não apresentou, em relação ao exame físico, qualquer manifestação sugestiva de SC, porém teve diagnóstico definitivo para SC recente (95,2%). O número de casos notificados é crescente, sugerindo que há uma necessidade de melhoria na assistência ao pré-natal, diagnóstico, tratamento adequado, ações de saúde e notificação.

Factors related to patient adherence to antidiabetic drug therapy.

The objective of the present study was to assess patient adherence to antidiabetic drug therapy and its association with factors related to the patient, patient-provider relationship, therapeutic regimen and the disease itself. The study comprised 46 diabetic patients enrolled in a research and extension education center in the State of Sao Paulo, southeastern Brazil, in 2007. Data was collected through interviews using a questionnaire and the Treatment Adherence Measure (TAM). The patient adherence level to antidiabetic drug therapy was 78.3%. In conclusion, since prevalence of adherence is below that recommended in the literature, and in the light of poor blood glucose control and alleged failure of therapeutic regimen, health providers are urged to measure diabetic patient treatment adherence, because it is key to adequate diabetes management with drugs.

Insulin self-administration technique with disposable syringe among patients with diabetes mellitus followed by the family health strategy.

This cross-sectional study aimed to describe the most common correct and incorrect self-administration techniques for insulin using disposable syringes by patients cared for by the Family Health Strategy (FHS), relate the findings to sociodemographic variables and also identify the professional responsible for teaching this technique. A total of 169 patients were selected by simple random sampling in 37 FHS units in a city in the state of Minas Gerais, Brazil from August to October 2006. The results identified errors in all the steps recommended by the American Diabetes Association and Brazilian Diabetes Association for the safe administration of insulin, from hand washing to compression on the injection site. The FHS favors the development of interventions focused on the needs of the clientele registered at the unit, stimulating self-care. Results from this study can contribute to the planning of these interventions.

Cross-cultural adaptation and validity of the 'Edmonton Frail Scale - EFS' in a Brazilian elderly sample.

This study aimed to assess the cross-cultural adaptation of the Edmonton Frail Scale (EFS) and its validity in a Brazilian elderly sample. Translation and back-translation were performed, as well as discussion with professionals and elderly for conceptual equivalence, semantic validation and pre-test of the scale. The scale was applied to 137 elderly aged 65 years or older who lived in the community. In the know-groups validation of the frailty diagnosis between gender, age and cognitive deficit, elder elderly, female and with a cognitive deficit scored higher on the frailty diagnosis. A negative convergent correlation was found between the EFS and the Functional Independence Measure (FIM) (-0.53, p< 0.01) and the total score of the Mini-Mental State Examination (MMSE) (-0.60, p< 0.01). The watch test presented high sensitivity and low specificity levels. The Portuguese version of the EFS was considered valid in the study sample.